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 AA-3 - Notice of application for ancillary letters of administration
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF
________X
ANCILLARY ADMINISTRATION PROCEEDING, WILL OF NOTICE OF APPLICATION FOR
ESTATE OF ANCILLARY LETTERS OF ADMINISTRATION
a/k/a
a domiciliary of the State of File No. ________
Deceased.
________X
Notice is hereby given that:
1. An application for ancillary letters of administration upon the estate of ____________, deceased,
domiciled at ____________
State of ________ has been offered for ancillary administration in the Surrogate's Court for the County of ________.
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 [ ] Ancillary Letters of Administration [ ] Ancillary Letters of Administration d.b.n. to:
____________
4. The name and post office address of each and every distributee of the above-named decedent, as set forth in Paragraph 6 of the petition and known to the undersigned, is/are as follows:
NAME OF DISTRIBUTEE DOMICILE AND POST OFFICE ADDRESS
(USE ADDITIONAL SHEETS IF NECESSARY)
Date ________
[Note: Complete Affidavit of Mailing. If serving infant 14 years of age or older, list and mail to infant as well as parent or guardian.]
Name of New York Attorney: ____________ Tel. No.:________
Address of New York Attorney: ____________
AA-3 (12/97)
NAME OF DISTRIBUTEE DOMICILE AND POST OFFICE ADDRESS
AFFIDAVIT OF MAILING NOTICE OF ANCILLARY ADMINISTRATION
STATE OF NEW YORK)
) ss.:
COUNTY OF)
________, residing at ____________
being duly sworn, says that he/she is over the age of 18 years, that on the ________ day of ________, he/she deposited in the post office or in a post office box regularly maintained by the government of the United States in the ________ of ________, State of New York, a copy of the foregoing Notice of Application for Ancillary Letters of Administration contained in a securely closed postpaid wrapper directed to each of the persons named in said notice at the places set opposite their respective names.
________
Sworn to before me this ________ Signature day of ________, ________
________
Print Name
________
Notary Public
Commission Expires:
(Affix Notary Stamp or Seal)
Name of New York Attorney: ____________ Tel. No.: ________
Address of New York Attorney: ____________
AA-3 (12/97)
