HUNTERDON COUNTY SURROGATE'S COURT

In the Matter of the estate of RENUNCIATION FOR ADMINISTRATION

AD PROSEQUENDUM

NAME OF DECEDENT a/k/a

A/K/A OF DECEDENT (if any)

Deceased

To the Surrogate of the County of Hunterdon, State of New Jersey:

Be it Known, that I [NAME OF PERSON RENOUNCING], [RELATION TO DECEDENT] of [NAME OF DECEDENT] late of the [TOWNSHIP/CITY/or/BOROUGH] of [NAME OF MUNICIPALITY] in the County of Hunterdon and State of New Jersey, who died on the ______day of ______, 20____, intestate, do hereby renounce my right of administration ad prosequendum of the said [NAME OF DECEDENT], and request that letters of administration ad prosequendum upon said estate be granted to [NAME OF APPLICANT].

Dated: ______

Witness:

______

(print & signature of witness)

___

(print & signature of person renouncing)

STATE OF ______

SS

COUNTY OF ______

On this _____ day of ____, 20____, before me a Notary personally appeared [Name of person renouncing] who I am satisfied is the person in the within Renunciation named, and I having first made known to him/her the contents thereof he/she did thereupon acknowledge that he/she signed, sealed and delivered the same as his/her voluntary act and deed.

______

(Notary sign & seal)