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This is a New York form that can be used for Surrogates Court within Local County, Queens.
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SURROGATE'S COURT OF THE STATE OF NEW YORK COUNTY OF QUEENS -----------------------------------------------------------------------------X PROBATE PROCEEDING, W ill of APPLICATION FOR PRELIMINARY LETTERS TESTAMENTARY (See SCPA 1412) File #____________ a/k/a Deceased. -----------------------------------------------------------------------------X 1. The proposed preliminary executor(s) is/are _____________________________________________ _____________________________________________ and is/are designated as executor(s) in the Will of the above named decedent dated ____________________________________________________________ (together with Codicil(s) dated ________________________________________) and duly filed with the court. 2. The person(s) who would have a right to letters testamentary pursuant to Section 1412.1 is/are: [enter "NONE" or specify name and interest] ____________________________________________________________________________________ 3. Preliminary letters are requested for the following reasons: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 4. Probate is expected to be completed by: ______________________________________________________ 5. A contest [ ] is [ ] is not expected. 6. The testamentary assets of decedent's estate are estimated as follows: [describe and state value; annex schedule if space is insufficient] Personal Property: ________________________________________________________________________ ________________________________________________________________________________________ _______________________________________________________________________________________ Total Personal Property: $_____________________ Real Property: ___________________________________________________________________________ ________________________________________________________________________________________ _______________________________________________________________________________________ Total Real Property: $________________________ 18 months rent, if applicable: _______________________________________________________________ ___________________________________________________________________________________ ____________________________________________________________________________________ Total of 18 months rent: $_____________________ 7. The liabilities of this estate are:_____________________________________________________ ________________________________________________________________________________________ ______________________________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com 8. By provision in the propounded will, the applicant(s) [is/are] [are not] required to file a bond or other security for the performance of his/her/their duties. Your applicant(s) respectfully request the issuance to _______________________________________ ________________________________________________________________________________________ of preliminary letters testamentary upon qualifying. Dated: _______________________ _______________________________________ Applicant _______________________________________ Applicant OATH & DESIGNATION OF PRELIMINARY EXECUTOR STATE OF NEW YORK COUNTY OF ) ) ss.: I, the undersigned, _________________________________________________, being duly sworn, say: 1. OATH OF PRELIMINARY EXECUTOR: I am over eighteen (18) years of age and a citizen of the United States; I am an executor named in the W ill described in the foregoing petition and will well, faithfully and honestly discharge the duties of preliminary executor and duly account for all money or property which may come into my hands. I am not ineligible to receive letters. 2. DESIGNATION OF CLERK FOR SERVICE OF PROCESS: I hereby designate the Clerk of the Surrogate's Court of Queens County, and his/her successor in office, as a person on whom service of any process issuing from such Surrogate's Court may be made, in like manner and with like effect as if it were served personally upon me whenever I cannot be found and served within the State of New York after due diligence used. My domicile is: ___________________________________________________________________________ (Street Address) (City/Town/Village) (State) (Zip) _______________________________________________ (Signature of Petitioner) _______________________________________________ (Print Name) On _____________________________________________, 20_____, before me personally came ________________________________________________________________________________________ to me known to be the person described in and who executed the foregoing instrument. Such person duly swore to such instrument before me and duly acknowledged that he/she executed the same. ____________________________ Notary Public Commission Expires: (Affix Notary Stamp or Seal) Name of Attorney:_____________________________________________ Tel. No.:_____________________ Address of Attorney:_________________________________________________________________________ NOTE: Each Preliminary Executor must complete a combined Oath & Designation of Preliminary Executor. American LegalNet, Inc. www.FormsWorkflow.com CONSENT AND DESIGNATION OF CORPORATE PRELIMINARY EXECUTOR STATE OF NEW YORK COUNTY OF ) ) ss.: I, the undersigned, a ________________________________________________________________________ of (Title) __________________________________________________________________________________________ (Name of Bank or Trust Company) a corporation duly qualified to act in a fiduciary capacity without further security, being duly sworn, say: 1. CONSENT: I consent to accept the appointment as Preliminary Executor under the Last W ill and Testament of the decedent described in this application and consent to act as such fiduciary. 2. DESIGNATION OF CLERK FOR SERVICE OF PROCESS: I designate the Chief Clerk of the Surrogate's Court of Queens County, and his/her successor in office, as a person on whom service of any process issuing from such Surrogate's Court may be made, in like manner and whenever one of its proper officers cannot be found and served within the State of New York after due diligence used. ______________________________________________ (Name of Bank or Trust Company) BY___________________