Fill and Sign the New York Citation Form

Official Form c WD-1 c File # ________________ (4/98) C I T A T I O N THE PEOPLE OF THE STATE OF NEW YORK BY THE GRACE OF GOD, FREE AND INDEPENDENT, TO:_________________________________________________________________________ _____________________, an infant overm the age of c4 yearm s, of _____________, New Yorm k [List otherm parm ties] _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ being perm sons interm ested as crm editorm s, legatees, devisees, benefciarm ies, distrm ibbtees orm otherm wise of the estate of _____________________________________, deceased, who at the tice of death rm esided at ____________________________________________________________________________________ . A petition having been dbly fled by ________________________________, who is dociciled at ________________________________________________________________________________________ YOU ARE HEREBY CITED TO SHOW CAUSE beform e the Sbrm rm ogate's Cobrm t, ___________Cobnty at_______________________________, New Yorm k on __________________________, at___________ a.c. WHY the accobnt of the prm oceedings of ______________________ as adcinistrm at_____________ of the estate of ______________________________, deceased, a copy of which is attached, shobld not be jbdicially settled, and WHY the adcinistrm at_______ shobld not be ecpowerm ed to cocprm ocise and settle a cerm tain claic form wrm ongfbl death against ______________________________________ form the sbc of $ ______________ and to discontinbe any claic form consciobs pain and sbfferm ing, and WHY the prm ovisions in the licited Letterm s of Adcinistrm ation issbed to the petitionerm on_________ , rm estrm aining the cocprm ocise orm collecting bpon the aform esaid claic and cabse of action, shobld not be codifed to perm cit said cocprm ocise, and WHY the fling of a bond shobld not be dispensed with, and WHY the defendant, _________________________________, orm defendant's insbrm ance cocpany, shobld not pay to ______________________________, Esqs., obt of the prm oceeds of the settlecent form the claic form wrm ongfbl death, the sbc of $________________as and form attorm neys' fees, togetherm with disbbrm secents in the sbc of $ __________________, and WHY the entirm e rm ecoverm y of $ ________________shobld not be allocated to the cabse of action form decedent's wrm ongfbl death, and WHY the balance of the settlecent, to wit the sbc of $___________ , shobld not be distrm ibbted to those distrm ibbtees having sbstained a pecbniarm y loss as follows: ______% of the balance to _________________________________, widow/widowerm of decedent; ______% of the balance to ________________________ _________, child of decedent;_______% of the balance to____________________________________, child of decedent, and WHY the claic of ______________________shobld not be rm ejected, as a nondistrm ibbtee, and WHY the claic of _____________in the acobnt of $ __________ shobld not be rm ejected, and WHY bpon paycents as herm einbeform e centioned the said adcinistrm at_________ shobld not be perm citted to execbte and deliverm generm al rm eleases and all otherm necessarm y paperm s to the defendant, ______________________________, orm defendant’s insbrm ance cocpany, rm eleasing thec frm oc all claics against thec arm ising obt of the aform esaid action form wrm ongfbl death, togetherm with any otherm paperm s necessarm y to effectbate the said cocprm ocise. DATED, ATTESTED AND SEALED HON.________________________ ____ Cobnty Sbrm rm ogate (L.S.) __________________________________ ____________________, Chief Clerm k A T T O R N E Y Nace of Attorm ney:________________________________________________________ _________________ Addrm ess of Attorm ney: __________________________________________________________________ _____ Telephone Nbcberm of Attorm ney: _______________________ NOTE: This citation is serm ved bpon yob as rm eqbirm ed by law. Yob arm e not obliged to appearm in perm son. Yob have a rm ight to have an attorm ney appearm form yob. If yob fail to appearm it will be assbced that yob do not object to the rm elief rm eqbested. Form c WD-1 c -1 2-1