N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. VII, subch. A, Surrogate's Forms, form A-3 - Notice of application for letters of administration

SURROGATE'S COURT OF THE STATE OF NEW YORK

COUNTY OF ________

________X

ADMINISTRATION PROCEEDING

Estate of ________ NOTICE OF APPLICATION FOR

LETTERS OF ADMINISTRATION

a/k/a (SCPA 1005)

________ Deceased. File No. ________

________X

Notice is Hereby Given That:

(1) an application for Letters of Administration upon the estate of the above-named decedent, has been made by ________, petitioner, whose post office address is: ________

(2) each and every name of the intestate decedent known to the undersigned is as indicated in the above caption.

(3) petitioner prays that a decree be made directing the issuance of Letters of Administration to ________

(4) the name and post office address of each and every distributee of the above-named decedent, as set forth in the petition and known to the undersigned, are as follows:

(a) Distributees who have been duly cited, have waived citation or have appeared in this proceeding:

Name of Distributee Domicile and Post Office Address

________ ________

________ ________

________ ________

(b) Other Distributees:

Name of Distributee Domicile and Post Office Address

________ ________

________ ________

________ ________

[CONTINUE ON REVERSE SIDE IF MORE SPACE NEEDED]

(5) That the undersigned does not know of any other distributees of the said decedent.

(6) That Letters of Administration will issue on or after ________, 19________.

Dated: ____________, 19________

______________

Signature of Petitioner or Attorney

______________

Attorney for Petitioner

______________

Print Name

______________

Address (Office)

______________

Address

Tel. No. ________

Notes

N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. VII, subch. A, Surrogate's Forms, form A-3