SURROGATE'S COURT OF THE STATE OF NEW YORK

COUNTY OF [________________________________]

IN THE MATTER OF THE APPLICATION FOR
LETTERS OF ADMINISTRATION IN THE ESTATE OF

[________________________________], Deceased.

File No.: [________________________________]

PETITION FOR LETTERS OF ADMINISTRATION

(SCPA §§ 1001–1005; EPTL § 4-1.1)

TABLE OF CONTENTS

1. Jurisdictional Statement
2. Decedent Information
3. Petitioner Information and Priority
4. Distributees and Interested Persons
5. Estate Assets
6. Request for Appointment
7. Bond
8. Prayer for Relief
9. Verification
10. Execution

1. JURISDICTIONAL STATEMENT

Your Petitioner respectfully shows to this Court that jurisdiction is proper in [________________________________] County, New York, because the decedent was domiciled in this county at the time of death. This Court has subject matter jurisdiction pursuant to SCPA § 201.

2. DECEDENT INFORMATION

The decedent died intestate, leaving no valid Last Will and Testament. After diligent search and inquiry, Petitioner has been unable to locate any will of the decedent.

☐ The decedent was a resident of New York State at death.
☐ The decedent was a non-domiciliary who owned property in New York.

3. PETITIONER INFORMATION AND PRIORITY

Petitioner has priority for appointment pursuant to SCPA § 1001:

☐ Surviving spouse of the decedent
☐ Child or children of the decedent
☐ Grandchild or grandchildren of the decedent
☐ Parent of the decedent
☐ Sibling of the decedent
☐ Other distributee of the decedent
☐ Nominee of a person entitled to letters

4. DISTRIBUTEES AND INTERESTED PERSONS

The following are ALL distributees of the decedent as determined under EPTL § 4-1.1:

Renunciations and Consents:

☐ Renunciation(s) and/or consent(s) of persons with equal or higher priority are attached.
☐ No renunciations required (Petitioner has highest priority).

5. ESTATE ASSETS

6. REQUEST FOR APPOINTMENT

Petitioner requests that this Court issue Letters of Administration appointing Petitioner as Administrator of the estate with full authority to collect assets, pay debts, and distribute the estate pursuant to EPTL § 4-1.1.

Petitioner further represents:

☐ Petitioner is at least eighteen (18) years of age.
☐ Petitioner is a citizen or lawful resident of the United States.
☐ Petitioner has not been convicted of a felony.
☐ Petitioner is not otherwise disqualified under SCPA § 707.

7. BOND

Pursuant to SCPA § 801:

☐ Petitioner requests bond be fixed by the Court.
☐ Petitioner requests bond be waived upon consent of all distributees.
☐ Petitioner is willing to furnish bond in the amount of $ [________________________________].

8. PRAYER FOR RELIEF

WHEREFORE, your Petitioner respectfully prays:

(a) That this Court issue a decree granting Letters of Administration to the Petitioner;

(b) That citation issue to all necessary parties as required by SCPA § 1005;

(c) That bond be fixed or waived as requested;

(d) That Petitioner be authorized to administer the estate in accordance with New York law; and

(e) For such other and further relief as the Court deems just and proper.

9. VERIFICATION

STATE OF NEW YORK
COUNTY OF [________________________________]

I, [________________________________], being duly sworn, depose and say that I am the Petitioner in this proceeding; that I have read the foregoing petition and know the contents thereof; and the same is true to my own knowledge except as to those matters therein stated to be alleged on information and belief, and as to those matters I believe them to be true.

Petitioner Signature: _______________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

Sworn to before me this [____] day of [________________], [________].

Notary Public: _______________________________________________

My Commission Expires: [__/__/____]

[SEAL]

10. EXECUTION

Attorney for Petitioner (if applicable):

Signature: _______________________________________________

Date: [__/__/____]

DESIGNATION OF CLERK FOR SERVICE OF PROCESS

Pursuant to SCPA § 307, Petitioner designates the Clerk of the Surrogate's Court of [________________________________] County to receive service of process on behalf of Petitioner in the event Petitioner cannot be served within the State of New York.

Petitioner Signature: _______________________________________________

Date: [__/__/____]

This template is provided for informational purposes only. Consult a New York-licensed attorney before filing.