New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VII - Surrogate's Court Forms
Subchapter A - Forms Authorized By Section 207.52
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. ________
