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FORMS FOR OBTAINING A DECLARATION OF DEATH AND TO PROBATE AN ESTATE FOR A PERSON MISSING IN CONNECTION WITH THE TERRORIST ATTACKS ON SEPTEMBER 11, 2001. (SUPERIOR COURT OF NEW JERSEY, CHANCERY DIVISION, PROBATE PART) Full Set of Forms for Use by Surrogates, Attorneys, and others Providing Assistance to Litigants FORM A -- VERIFIED COMPLAINT To be completed by litigant in all cases to initiate the following actions: 1.Obtain a Declaration of Death for an individual presumed dead because of the events of September 11, 2001, where a death certificate has not been issued; 2.Have the individual’s Last Will and Testament probated and an executor or executrix appointed, or, if the individual did not have a Last Will and Testament, have a general administrator appointed; 3.Have the Court appoint a trustee for a missing person’s estate to permit immediate access to certain of the decedent’s assets needed for the care and maintenance of his/her dependents while the court considers the case. FORM B - ORDER TO SHOW CAUSE Applicable to all cases; to be filed with the Verified Complaint. Blanks on first page should be completed. For cases related to the September 11, 2001 attacks, no newspaper publication of the Order to Show Cause is required. FORM C - TRUSTEE FOR MISSING PERSON’S PROPERTY To be completed and filed with the Verified Complaint only if the Plaintiff is seeking to have a Trustee named to obtain immediate access to Decedent’s estate. Blanks on the first page should be completed. FORM D - GUARDIAN AD LITEM To be completed and filed with the Verified Complaint only if there are minor children whose interests may be affected by the legal action. FORM E - PROOF OF SERVICE To be completed and filed after the court has issued an Order to Show Cause. Applicable to all cases, to prove that the Plaintiff has served the Order to Show Cause on all interested parties. All blanks should be completed and copies of return receipts should be attached. FORM F - JUDGMENT To be submitted to the court with the Verified Complaint in all cases; this is the document that the judge will sign to enter the court’s determination. All blanks on the first two pages should be completed, if the information is known. In paragraph #5 insert the name of the proposed executor or executrix. Delete paragraphs #4 and 5 if the decedent did not have a Last Will and Testament. In Alternate paragraph #4, insert the decedent’s name and the name of the proposed General Administrator. The court will insert the amount of the bond if necessary. FORM A -- VERIFIED COMPLAINT FOR A DECLARATION OF DEATH, ESTATE ADMINISTRATION, AND TRUSTEE APPOINTMENT __________________________________________ Plaintiff (Person filing the Complaint) Address: ___________________________________________ ___________________________________________ Telephone Number: ___________________________________ SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION ______________ COUNTY PROBATE PART IN THE MATTER OF ___________________________________________ , Print or type name of Decedent (the person who died) DECEASEDDocket No. (To be filled in by the court) CIVIL ACTION VERIFIED COMPLAINT FOR A DECLARATION OF DEATH, ESTATE ADMINISTRATION AND TRUSTEE APPOINTMENT Plaintiff, __________________ residing at _______________________________________, City/Township/ Borough of _______________________, __________ County, New Jersey, by way of verified complaint says: COUNT I (Declaration of Death) 1.On September 11, 2001, ____________________ (decedent) departed this life in the New York City World Trade Center [Pentagon][Airplane] terrorist attack. 2.The plaintiff is related to the decedent and is the decedent’s ________________. 3. The decedent was born on ___________________ in ___________________. 4. The decedent’s heirs-at-law are: (spouse, children, and -- possibly – grandchildren, parents, grandparents, brothers, sisters, aunts, uncles, nieces, nephews or first cousins. The Surrogate may be able to provide information as to whom to list.) NameRelationship Age (Adult/Minor) These are the decedent’s only heirs-at-law. 5. On September 11, 2001, the decedent resided at ________________________, _______________ County, New Jersey. 6.On September 11, 2001, the decedent was employed by __________________________________________, whose offices were located at _____________________________ (specify address). His/her occupation was that of ______________________. Attached is documentation of the decedent’s employment (paycheck, etc.). 7.Describe whatever you know about the decedent’s activities on September 11, 2001, including facts showing that he or she was at or near the World Trade Center [on an affected airplane] [at or near the Pentagon]: 8.Recount the effort to locate the decedent after the decedent failed to communicate or return home after the September 11, 2001 events: 9.[Cross out one] So far as the plaintiff has been able to ascertain, the decedent left no Last Will and Testament. OR The decedent left a Last Will and Testament dated ________. The names and address of the devisees (beneficiaries) named therein, in addition to any heirs-at-law listed in paragraph 4, are: NameAddressBeneficiary Interest (What is left to him/her.) 10. [If applicable] The decedent is record owner of real property commonly known as _________________________________, New Jersey. No person other than the heirs-at-law identified in paragraph 4 has, or would have, any interest in any real or personal estate by reason of the death of the decedent, and no other person is entitled to any interest which expires or is contingent upon the decedent’s death. 11.The plaintiff believes and understands that there is life, credit life or other insurance policy upon the life of the decedent with the following insurance companies: Insurance CompanyAddressPolicy Number Face Amount Beneficiary12.The plaintiff has made a diligent inquiry with the decedent’s relatives about the decedent’s whereabouts. The decedent’s living siblings, parents and other relatives have not seen nor heard from the decedent since September 11, 2001. The effort to locate the decedent has been unsuccessful and no satisfactory explanation, except that the decedent died in the World Trade Center [Pentagon] conflagration and building collapse [or airplane crash] on September 11, 2001, is known to the plaintiff. WHEREFORE, the plaintiff demands judgment declaring that: a.The said _____________________ was exposed to the World Trade Center [Pentagon][Airplane] terrorist attack of September 11, 2001 that resulted in loss of life to many persons known and unknown and his/her absence following the catastrophic conflagration and collapse of the World Trade Center [Pentagon] [airplane crash] is unexplained after a diligent search and inquiry and therefore the said _______________________ be declared to be dead and that he/she died on September 11, 2001. b.for such other relief as the Court may deem just and equitable. COUNT II (Estate Administration) The plaintiff repeats paragraphs one through twelve of Count I as if set forth at length herein. 13.The decedent departed this life [check one] 9testate (with a will) 9intestate (without a will) IF TESTATE (that is, if decedent left a will): Alternate 14a:The decedent left a Last Will and Testament dated _____________ that is being submitted for probate with this Complaint. Attached and made a part hereof is the decedent's original Last Will and Testament. The decedent's Last Will and Testament is self proving and may be admitted to probate without further affidavit, deposition or witness proofs. Named as the executor or executrix in the decedent’s Last Will and Testament is ___________________________. OR IF INTESTATE (that is, if decedent left no will): Alternate 14b:The plaintiff is first entitled to Letters of Administration. OR Alternate 14c:All competent adult persons entitled to letters of administration for the estate of the decedent, whose rights are prior or equal to the plaintiff have renounced or will be given notice of this application. WHEREFORE, the plaintiff demands judgment that: a.the court admit the decedent’s last will and testament to probate; b.Letters Testamentary be issued to _________________________; c.such other relief as the court may deem just and equitable. OR a.the court grant Letters of Administration for the estate of the decedent to _____________________________; b.such other relief as the court may deem just and equitable. COUNT III The plaintiff repeats paragraphs one through twelve of Count I and paragraphs thirteen and fourteen of Count II as if set forth at length herein. 15.The property of the decedent is necessary for the care, shelter and support of the decedent’s family and dependents or is subject to waste or dissipation pending the declaration of death and appointment of a personal representative herein demanded. 16.The provisions of N.J.S.A. 3B:26-1 to -4 authorize the appointment of a trustee for an absent person’s estate. 17.It is requested that the trustee’s powers be limited to certain property and further that the use of the property be limited to providing for the support, shelter and care for the missing person's family and the protection of the missing person's real property pending the declaration of death and appointment of a personal representative action herein maintained and therefore bond be waived. 18.The plaintiff requests that the trustee be given authority over the following of the decedent’s property: Bank/InstitutionAccount No.Account Owner(s) WHEREFORE, the plaintiff demands judgment that: a.a trustee be appointed to manage the estate of the missing decedent pending an adjudication of death. b.for such other relief as the Court may deem just and equitable. Date:_____________________________________________________________ SIGNATURE OF PLAINTIFF __________________________________ TYPE OR PRINT NAME VERIFICATION I, _________________________, hereby certify and say: 1.I am the plaintiff in the within action. 2.I have read the complaint and its contents are true to my personal knowledge. 3.The value of the decedent's personal estate will not exceed $______________ and the real estate value will not exceed $_____________. I hereby certify that the statements made by me are true. I am aware that if any are wilfully false I am subject to punishment. Date:______________________________ SIGNATURE OF PLAINTIFF ______________________________ TYPE OR PRINT NAME FORM B --ORDER TO SHOW CAUSE FOR DECLARATION OF DEATH, WILL PROBATE AND APPOINTMENT OF ESTATE PERSONAL REPRESENTATIVE (EXECUTOR OR GENERAL ADMINISTRATOR) __________________________________________ Plaintiff (Person filing the Complaint) Address: ___________________________________________ ___________________________________________ Telephone Number: ___________________________________ SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION ______________ COUNTY PROBATE PART IN THE MATTER OF ___________________________________________ , Print or type name of Decedent (the person who died) DECEASEDDocket No. (To be filled in by the court) CIVIL ACTION ORDER TO SHOW CAUSE This matter having been presented to the Court for an adjudication that _________________ died on September 11, 2001, [for probate of his/her last will and testament] and for granting (Letters Testamentary) (Letters of General Administration)] and for such other relief as the Court may deem just, and the Court having read and considered the verified complaint, supporting affidavits, and other papers and pleadings for this application, and for good cause shown: (Do not write below this line- for court use only.) IT IS on this day of , 2001 , ORDERED that: 1.The parties-in-interest show cause before this court at the ____________________ County Court House, ______________________________, New Jersey on the day of , 2001 , at o’clock in the noon, or as soon thereafter as plaintiff may be heard, why a judgment should not be rendered declaring that the above decedent died on September 11, 2001 and [his/her last will and testament be admitted to probate] and a personal representative appointed for his/her estate. 2.A copy of the verified complaint, supporting affidavits and this order to show cause shall be served on the heirs-at- law, insurance companies and the other interested parties set out in the complaint by certified mail, return receipt requested within ___ days of the date of this order. 3.That any person wishing to contest this application may file not later than four days before the return date any interested party shall file and serve the court and the plaintiff, either an answer, or answering affidavit, or a motion returnable on the return date and in default thereof the action may proceed ex-parte and the entry of a judgment granting the relief requested. In the event you are unable to obtain an attorney, you may communicate with the legal services office or lawyer referral service in your county. J. S .C. FORM C -- ORDER APPOINTING TRUSTEE WITH LIMITED AUTHORITY FOR MISSING PERSON __________________________________________ Plaintiff (Person filing the Complaint) Address: ___________________________________________ ___________________________________________ Telephone Number: ___________________________________ SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION ______________ COUNTY PROBATE PART IN THE MATTER OF ___________________________________________ , Print or type name of Decedent (the person who died) DECEASEDDocket No. (To be filled in by the court) CIVIL ACTION ORDER APPOINTING TRUSTEE WITH LIMITED AUTHORITY FOR MISSING PERSON’S ESTATE This matter being presented to the Court by ________________ seeking the appointment of a Trustee with the limited authority to protect and preserve the estate of a missing person; and it appearing that __________________ is missing and has not been seen or heard from since September 11, 2001; and the appointment of a Trustee to marshal and conserve the missing person’s estate is necessary while an application for a declaration of death is pending; and it appearing that good and sufficient cause exists for the relief requested. It is on this _____ day of _______________________, 2001 ORDERED and ADJUDGED that pursuant to N.J.S.A. 3B:26-2 ________________________ whose address is __________________________________ be and hereby is appointed the Trustee of the Estate of ____________________, a missing person, without bond upon otherwise qualifying according to law. It is further ORDERED that pending the outcome of the declaration of death litigation and subject to right of the Trustee to apply for additional powers deemed necessary to protect and preserve the missing person’s estate or support the missing person’s dependents the authority of the Trustee be and hereby is limited to: A.Securing the missing person's residence at ___________________________ ___________________________, __________________ County, New Jersey, B.the procurement, if necessary, of fire and liability insurance to protect the missing person's real and personal property including any motor vehicles; C.the authority to make withdrawal of funds from account #___________________ ____________________ in the name of the missing person at ___________________________ Bank for the payment of any real property taxes, mortgage installments, insurance and utility charges, accrued or accruing, connected with the missing person's residence and any funds necessary for the support, care, welfare and maintenance of the missing person’s dependents. And, it is further Ordered that after the Trustee qualifies as herein set out, the Surrogate of ___________ County shall issue Letters of Trusteeship as herein provided. __________________________________________ J.S.C. FORM D -- ORDER APPOINTING GUARDIAN AD LITEM __________________________________________ Plaintiff (Person filing the Complaint) Address: ___________________________________________ ___________________________________________ Telephone Number: ___________________________________ SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION ______________ COUNTY PROBATE PART IN THE MATTER OF ___________________________________________ , Print or type name of Decedent (the person who died) DECEASEDDocket No. (To be filled in by the court) CIVIL ACTION ORDER APPOINTING GUARDIAN AD LITEM It appearing from the plaintiff's verified complaint in the above-entitled action that the interest of a minor(s) without a general or testamentary guardian(s) is (are) involved; and good cause appearing. It is on this ___ day of _______________________ 2001, ORDERED that _____________________________________ be, and hereby is, appointed the guardian ad litem for ______________________________________________ for the purpose of representing the interests of said minor(s) in the above-entitled action. _________________________________ J.S.C. FORM E -- PROOF OF SERVICE __________________________________________ Plaintiff (Person filing the Complaint) Address: ___________________________________________ ___________________________________________ Telephone Number: ___________________________________ SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION ______________ COUNTY PROBATE PART IN THE MATTER OF ___________________________________________ , Print or type name of Decedent (the person who died) DECEASEDDocket No. (To be filled in by the court) CIVIL ACTION PROOF OF SERVICE __________________________________, of full age, hereby certifies and says: 1.I am the plaintiff in the within matter. 2.On ______________________, 2001, I mailed by certified mail, return receipt requested, a true copy of the verified complaint for a declaration of death, [will probate] appointment of [an execut(or)(rix)] [a general administrator] , supporting affidavits and documents and the order to show cause returnable on _______________ to the following parties- in-interest: 2.(continued) NameAddress3.Attached are photocopies of the certified mail return receipt cards signed for by the aforesaid parties in interest except: _________________________________. I certify that the foregoing statement made by me is true. I am aware if the foregoing statement made by me is willfully false, I am subject to punishment. Dated:_____________________________________________________________ Plaintiff FORM F--JUDGMENT DECLARATION OF DEATH [AND ADMITTING THE DECEDENT’S LAST WILL AND TESTAMENT TO PROBATE AND GRANTING LETTERS TESTAMENTARY ][AND APPOINTING A GENERAL ADMINISTRATOR/ADMINISTRATRIX] __________________________________________ Plaintiff (Person filing the Complaint) Address: ___________________________________________ ___________________________________________ Telephone Number: ___________________________________ SUPERIOR COURT OF NEW JERSEY CHANCERY DIVISION ______________ COUNTY PROBATE PART IN THE MATTER OF ___________________________________________ , Print or type name of Decedent (the person who died) DECEASEDDocket No. (To be filled in by the court) CIVIL ACTION JUDGMENT OF DECLARATION OF DEATH [AND ADMITTING DECEDENT’S LAST WILL AND TESTAMENT TO PROBATE AND GRANTING LETTERS TESTAMENTARY] [AND APPOINTING A GENERAL ADMINISTRATOR/ADMINISTRATRIX] This matter being presented to the Court by ____________________ seeking a declaration of death for _________________________, last a resident of the _______________ County, New Jersey; [and for the probate of the Last Will and Testament and the appointment of an Execut(or)(rix)]; and it appearing that all matters required by law for the probate of the decedent's last will and testament have been submitted] OR [ it appearing that ____________________ died intestate and all matters required by law for the appointment of a general administrator has been submitted]; and proof of publication and proof of service on the parties-in-interest having been filed with the court and the court being satisfied from the proofs submitted that oral testimony is not required; that a diligent and satisfactory inquiry has been conducted; that ___________________________was exposed to the World Trade Center [Pentagon][Airplane] terrorist attack on September 11, 2001,and it appearing that and good and sufficient cause exists for the relief requested. It is on this _____ day of __________________, 2001, ORDERED and ADJUDGED that: 1.The said _____________________, a resident of New Jersey, was exposed to the World Trade Center [Pentagon][Airplane] terrorist attack on September 11, 2001 that resulted in loss of life to many persons known and unknown. 2.The said _____________________’s absence following the catastrophic conflagration and collapse of the World Trade Center [Pentagon][airplane crash] is unexplained after a diligent search and inquiry. 3.The said _____________________ be and hereby is declared to be dead and that he/she died on September 11, 2001. 4.The Last Will and Testament of _______________________, deceased, dated _____________________ be and hereby is admitted to probate. 5. ___________________________ be and hereby is appointed Execut(or)(rix) of the Estate of __________________ upon qualifying according to law. OR 4.Letters of General Administration for the Estate of the said __________________________, deceased, be granted to ______________________________ without bond [with bond in the amount of $________________ ] and upon qualifying according to law. ______________________________________J.S.C.