State of New Jersey
Docket No.:
Essex County Surrogate’s Court
ALTURRICK KENNEY
Hall of Records, Room 206 DEVERO D. MCDOUGAL
SURROGATE
Newark, New Jersey 07102
DEPUTY SURROGATE
Phone 973-621-4900
Fax 973-621-2647
, Deceased CONSENT TO NEXT-OF-KIN
In the matt
er of the Estate of:
____________________________
AKA: ______________________
To: ALTURRICK KENNEY, Surrogate of the County of Essex:
I, , residing at ,
in the city/town of and state of , am the
of the above decedent, who died intestate.
I do hereby consent to having , the
of said decedent execute the necessary Affidavit of Next of Kin in order to collect and receive the
decedent’s personal assets for the benefit of and distribution to all remaining heirs and creditors
according to the estate and probate laws of the State of New Jersey.
I understand that the next-of-kin to whom I am giving consent has sworn or affirmed that the
decedent leaves no surviving spouse or domestic partner and that the estate does not exceed
$20,000.00. Therefore, he/she will be permitted to collect and administer said estate without having
to post a bond.
Signature
*
Copy of government issued picture I.D.*
Subscribed and sworn to before me
this day of , 20 .
Notary Public or Attorney at Law of New Jersey
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PAAF.doc Page 1 of 1
Docket No.: ______________
State of New Jersey
Essex County Surrogate’s Court
ALTURRICK KENNEY
DEVERO D. MCDOUGAL
SURROGATE DEPUTY SURROGATE
Hall of Records, Room 2
06
Newark, New Jersey 07102
Phone:
973-6
21-4900
Fax: 973-621-264
7
In the matter of the Estate of:
__________________________________________________, Deceased
AKA: ____________________________________________
}
POWER OF ATTORNEY
AFFIANT
KNOW ALL MEN BY THESE PRESENTS, that I, _________________________ residing at _______________________________
____________________________________________________, pursuant to the provisions of Revised Statutes 3B:14 - 47 do hereby
make, constitute and appoint Alturrick Kenney, Surrogate of the County of Essex, in the State of New Jersey, and their successors in
office, my true and lawful attorney upon whom may be served any and all process affecting the aforesaid estate, or any interest therein,
whereof I am the Affiant.
And I do further agree that any process against the aforesaid estate, so served, shall be of the same force and effect as if duly served
upon me within this State.
__________________________________________
Signature
STATE OF NEW JERSEY
COUNTY OF ESSEX
}SS.
BE IT REMEMBERED, that on this, ____/____/____, before me, the subscriber, a Notary Public of New Jersey, personally appeared
_________________________________ who I am satisfied is the person named in they signed, sealed and delivered the said power
of attorney as their voluntary act and deed, for the uses and purposes therein expressed.
______________________________________________
Notary Public/Attorney at
Law of the State of New Jersey
My Commission Expirees________________
Affix Seal
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1
State of New Jersey
Docket No.:
Essex County Surrogate’s Court
ALTURRICK KENNEY
Hall of Records, Room 206
DEVERO D. MCDOUGAL
SURROGATE
DEPUTY SURROGATE
Phone 973-621-4900
Fax 973-621-2647
In the matter of the Estate of:
____________________________, Deceased NEXT OF KIN
AFFIDAVIT OF ASSETS
AKA: _______________ AND DECLARATION
In Lieu of Administration Where Real and Personal
Estate Does Not Exceed $20,000.00 (R.S. 3B:10-4)
I, , of full age, being duly sworn, depose(s)
and say(s):
1.
I reside at .
2.
I am related to who died on ,
with a residence of in the County of Essex and State of
New Jersey without leaving a Will.
3.
The decedent was my .
4.
All of the decedent's next of kin are as follows:
NAME
Relationship
(and age if a minor)
ADDRESS/RESIDENCE
2
5.
The assets in the sole name of the decedent or held "as tenants in common" with decedent,
known to me at this time do not exceed the sum of $20,000.00, and are as follows (with
documentary proofs of each asset attached):
ITEMS TOTAL ESTIMATED AMOUNT/VALUE
Cash on hand: $
Balances in bank accounts of decedent (list accounts) $
Corporate Stocks, bonds and notes, etc: $
Life insurance taken out by decedent without $
A named beneficiary or payable to the Estate:
Automobiles (include year, made, model, and VIN #): $
Household effects, jewelry, other chattel, etc.: $
All other personal property belonging to the Estate: $
(Refund checks, security deposits, etc.)
Real Estate, located at (list separately by type and address): $
(If market value is unknown, may use tax assessed value)
REMARKS:
TOTAL VALUATION OFF ALL PROPERTY: $
6.
Therefore, I am entitled to take custody of and duly administer said assets without Letters of
Administration, in accordance with the Laws of New Jersey, N.J.S.A. 3B:10-4 and will report
the findings of any additional assets.
Signature
Subscribed and sworn to before me
on this day of , 20 .
Notary Public/Attorney at Law of New Jersey
Docket No.: ______________
State of New Jersey
Essex County Surrogate’s Court
ALTURRICK KENNEY Hall of Records, Room 206
SURROGATE Newark, New Jersey 07102
DEVERO D. MCDOUGAL
DEPUTY SURROGATE
Phone 973-621-4900
Fax 973-621-2647
_____________________________, Deceased VERIFICATIONS:
AKA: CHILD SUPPORT
NOTICE OF PROBATE
State of New Jersey
} ss
County of Essex
KNOW ALL MEN BY THESE PRESENTS, that I hereby certify that I have been given a
copy of:
_________ N.J.S.A. 2A:17-56.23b, Judgment for Child Support Lien Against Net Proceeds
of Settlement: Priority, advising me as to my obligation to determine if child support arrearages
exist against any beneficiary entitled to receive more than $2,000.00 and to satisfy same prior to
disbursement of funds payable to said beneficiary identified as owing said child support.
_________ New Jersey Court Rule 4:80-6, Notice of Probate of Will, advising me as to my
obligation to send notice of the probate of a Will to beneficiaries and all persons designated by Rule
4:80-1(a)(3), including the testator’s spouse, heirs, next of kin, and any other persons entitled to
letters.
___________________________
Signature
Print Name:
Subscribed and sworn to before me
this day of , 20 .
__________________________
Notary Public/Attorney at Law
New Jersey Permanent Statutes
Title 2A Administration of Civil and Criminal Justice
2A:17-56.23b JUDGMENT FOR CHILD SUPPORT LIEN AGAINST NET PROCEEDS OF SETTLEMENT: PRIORITY
1. a. A judgment for child support entered pursuant to P.L.1988, c.111 (C.2A:17-56.23a) and docketed with
the Clerk of the Superior Court shall be a lien against the net proceeds of any settlement negotiated prior or
subsequent to the filing of a lawsuit, civil judgment, civil arbitration award, inheritance or workers' compensation
award. The lien shall have priority over all other levies and garnishments against the net proceeds of any
settlement negotiated prior or subsequent to the filing of a lawsuit, civil judgment, civil arbitration award, inheritance
or workers' compensation award unless otherwise provided by the Superior Court, Chancery Division, Family Part.
The lien shall not have priority over levies to recover unpaid income taxes owed to the State. The lien shall stay
the distribution of the net proceeds to the prevailing party or beneficiary until the child support judgment is satisfied.
As used in this act "net proceeds" means any amount of money, in excess of $2,000, payable to the prevailing
party or beneficiary after attorney fees, witness fees, court costs, fees for health care providers, payments to the
Medicaid program under section 6 of P.L.1979, c.365 (C.30:4D-7.1), reimbursement to the Division of Employment
Security in the Department of Labor, the employer or employer's insurance carrier for temporary disability benefits
that may have been paid pending the outcome of a workers' compensation claim as provided by section 1 of
P.L.1950, c.174 (C.34:15-57.1), reimbursement to an employer or the employer's workers' compensation insuranc
e
carrier as provided in R.S.34:15-40, and other costs related to the lawsuit, inheritance or settlement are deducted
from the award, proceeds or estate; "prevailing party" or "beneficiary" shall not include a partnership, corporation,
limited liability partnership, financial institution, government entity or minor child; and "agent" means an authorized
representative of the prevailing party or beneficiary, a union representative, an executor or administrator of a
decedent's estate, an arbitrator or any other person or entity if such person or entity is responsible for t
he
distribution of net proceeds to a prevailing party or beneficiary.
b. Before distributing any net proceeds of a settlement, judgment, inheritance or award to the prevailing
party or beneficiary:
(1
) the prevailing party or beneficiary shall provide the attorney, insurance company or agent responsible
for the final distribution of such funds with a certification that includes the prevailing party's or beneficiary's full
name, mailing address, date of birth and Social Security number; and
(2) the attorney representing the prevailing party or beneficiary shall initiate a search of child suppor
t
judgments, through a private judgment search company that maintains information on child support judgments, to
determine if the prevailing party or beneficiary is a child support judgment debtor.
If the prevailing party or beneficiary is not represented by an attorney, the judgment search shall be initiated by the
opposing attorney, insurance company or agent before the proceeds are distributed to the prevailing party or
beneficiary. In the case of a workers' compensation action, the Administrative Office of the Courts shall, at least
once every 60 days, transmit information on child support judgment debtors to the Division of Workers'
Compensation in the Department of Labor. The information shall include the debtor's name, Social Security
number, the amount of the child support judgment, the Probation Division case number and the Probation Division
office to which the judgment is payable. The Division of Workers' Compensation shall match the data received on
child support judgment debtors against the information it maintains for individuals who have filed workers'
compensation claims with the division. When a match is identified, the Division of Workers' Compensation shall
notify the appropriate judge of compensation of the child support judgment before the decision, award,
determination, judgment or order approving the settlement is rendered. The judge of compensation shall
incorporate in the decision, award, determination, judgment or order approving the settlement, an order requiring
the employer or the employer's insurance carrier to contact the Probation Division to satisfy the child support
judgment out of the net proceeds of the workers' compensation award, order or settlement before any such monies
are paid to the employee. The Division of Workers' Compensation shall be immune from any civil liability that may
arise from any information provided by the division or any order issued by a judge of compensation relating to a
child support judgment, in accordance with this section. In the case of judgments or settlements resulting from a
labor arbitration involving employees of a school board or school district, a judgment search shall be initiated by the
school board or district prior to the release of any net proceeds to the employees and only if there is an income
withholding for child support active against the employee in the records of the school board or district. In the case
of an inheritance, the executor or administrator of the decedent's estate shall initiate the judgment search. The
judgment search company shall provide a certification to the attorney, insurance company, agent or party initiating
the lawsuit identifying whether or not the prevailing party or beneficiary is a child support judgment debtor.
In the case of net proceeds that are to be paid through a structured settlement or other payment plan, the attorney,
insurance company or agent shall be required to conduct the child support judgment search only at the time of
settlement or prior to the distribution of the first payment under the plan. If a child support judgment is identified,
the attorney, insurance company or agent shall provide the Probation Division with a copy of the structured
settlement or payment plan within 30 days of identifying the child support judgment.
If there are no attorneys representing either party in a civil lawsuit, the party bringing the lawsuit shall initiate the
judgment search and shall be required to file the certification with the court at least 10 working days prior to the trial
or with the stipulation that the certification shall be filed at the time of the settlement or dismissal of the lawsuit.
For monies deposited with the court, no distribution of funds shall be made until the attorney, prevailing party or
beneficiary provides the Clerk of the Superior Court with a copy of the certification showing that the prevailing party
or beneficiary is not a child support judgment debtor.
The fee for a judgment search which is required by this section shall not exceed $10 for each name of a child
support judgment debtor that is searched. The fee for a judgment search is chargeable against the net proceeds as
a cost of the settlement, judgment, inheritance or award.
c. If the certification shows that the prevailing party or beneficiary is not a child support judgment debtor,
the net proceeds may be paid to the prevailing party or beneficiary immediately. If the certification shows that the
prevailing party or beneficiary is a child support judgment debtor, the attorney, insurance company or agent that
initiated the search shall contact the Probation Division of the Superior Court to arrange for the satisfaction of the
child support judgment. The attorney, insurance company or agent shall notify the prevailing party or beneficiary of
the intent to satisfy the child support judgment prior to the disbursement of any funds to the prevailing party or
beneficiary. Upon receipt of a warrant of satisfaction for the child support judgment, the attorney, insurance
company or agent shall pay the balance of the settlement, judgment, award or inheritance to the prevailing party or
beneficiary. If the net proceeds are less than the amount of the child support judgment, the entire amount of the
net proceeds shall be paid to the Probation Division as partial satisfaction of the judgment.
If there are no attorneys representing either party in a civil lawsuit and the certification filed with the court shows
that the prevailing party or beneficiary is a child support judgment debtor, the court shall order that the opposing
party pay the amount of the child support judgment to the Probation Division before any funds are paid to the
prevailing party or beneficiary. The court shall also insure that any judgment related to the lawsuit docketed with
the Clerk of the Superior Court reflect the Probation Division's superior claim to such funds.
d. An attorney, insurance company or agent shall not be liable for distributing net proceeds to the
prevailing party or beneficiary based on the results of a judgment certification showing the prevailing party or
beneficiary is not the debtor of a child support judgment, if it is later shown that the prevailing party or beneficiary
provided inaccurate personal information on the initial certification to the attorney, the insurer or agent.
e. An attorney, insurance company or agent who, in accordance with this act, satisfies a child support
judgment from the net proceeds of a settlement, judgment, inheritance or award, shall not be liable for payments
which otherwise would have been made pursuant to subsection a. of this section which were not so identified to the
attorney, insurance company or agent at the time of satisfaction.
f. An attorney, insurance company or agent who, in accordance with this act, satisfies a child support
judgment from the net proceeds of a settlement, judgment, inheritance or award, shall not be liable to the prevailing
party or beneficiary or to that party's creditors.
g. An attorney shall not be required to challenge a child support judgment unless retained by the prevailing
party or beneficiary to do so.
h. A private judgment search company is prohibited from using any information provided by an attorney,
insurance company or agent in accordance with this act for any purpose other than: (1) determining if the prevailing
party or beneficiary is the debtor of a child support judgment; and (2) preparing a certification as required pursuant
to subsection b. of this section.
i. To the extent feasible and permitted by the Rules of Court, the Administrative Office of the Courts may
share information on a child support judgment debtor with an insurance carrier for the sole purpose of complying
with the provisions of P.L.2000, c.81 (C.2A:17-56.23b et al.).
CHARLES JONES, A LexisNexis Company = P.O. Box 8488, Trenton, NJ 08650-0488
(609 538-1000 or (800) 792-8888 - Fax (609) 882-4371 - www.charlesjones.com
* INFORMATION NEEDED FOR SEARCH *
Full Name/Also Known As * Mailing Address * Date of Birth * Social Security
THIS NOTICE IS PROVIDED TO INTERESTED PARTIES AS A CONVENIENCE
AND IN NO WAY IMPLIES ENDORSEMENT OF THIS PROVIDER OR ITS SERVICES.
Notice of Probate & Proof of Mailing - REQUIREMENTS
Rule 4:80-6, N.J. Court Rules, 1969, effective September 4, 1990, requires personal
representatives to send notice of the probate of a Will to beneficiaries and all persons
designated by Rule 4:801(a)(3), including the testator’s spouse, heirs, next of kin,
and any other persons entitled to letters.
The notice is required to state the name and address of the personal representative*
and that a copy of the Will may be requested from the personal representative. In the
case of a charitable bequest, however, the Attorney General of the State of New Jersey
is entitled to a copy of the Will with the notice. If the names and addresses of all
personal entitled to notice are unknown and cannot be ascertained upon reasonable
inquiry, a notice of probate must be published.
Proof of Mailing of the notice must be filed with the Surrogate within 10 days thereof.
The filing fee, payable to “Essex County Surrogate,” is $5.00 per page.
* The term “personal representative” is used in lieu of executor/trix
and administrator with the Will annexed.
=======================================
For your information, the full text of Rule 4:80-6, from the Current New Jersey Court
Rules, follows:
4:80-6. Notice of Probate of Will
Within 60 days after the date of the probate of a will, the personal
representative shall cause to be mailed to all beneficiaries under the
will and to all persons designated by R. 4:80-1(a)(3), at their last
known addresses, a notice in writing that the will has been probated,
the place and date of probate, the name and address of the personal
representative and a statement that a copy of the will shall be
furnished upon request. Proof of mailing shall be filed with the
Surrogate within 10 days thereof. If the names or addresses of any of
those persons are not known, or cannot by reasonable inquiry be
determined, then a notice of probate of the will shall be published in a
newspaper of general circulation in the county naming or identifying
those persons as having a possible interest in the probate estate. If by
the terms of the will property is devoted to a present or future
charitable use or purpose, like notice and a copy of the will shall be
mailed to the Attorney General.
Note: Source-R.R. 4:99-7; former R. 4:80-8 amended and rule redesignated June 29, 1990 to be
effective September 4, 1990.
Docket No.: ______________
State of New Jersey
Essex County Surrogate’s Court
ALTURRICK KENNEY Hall of Records, Room 206
SURROGATE Newark, New Jersey 07102
DEVERO D. MCDOUGAL
DEPUTY SURROGATE
Phone 973-621-4900
Fax 973-621-2647
In the Matter of the Estate of
NOTICE OF PROBATE OF WILL
_____________________________, Deceased PURSUANT TO RULE 4:80-6
AKA:
TO:
PLEASE TAKE NOTICE that the Will of _______________________________ ,
who died on ____________________, 20____, was admitted to probate by the
Surrogate of Essex County, New Jersey, on _____________________, 20 ____.
You are entitled to have a copy of the Will upon request to the personal representative
(Executor/Executrix), ____________________________________, at the address
provided below.
Dated:
______________________ _________________________________
Signature
Address of
Personal Representative:
_________________________________
_________________________________
____________________________________
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Docket No.: ______________
State of New Jersey
Essex County Surrogate’s Court
ALTURRICK KENNEY Hall of Records, Room 206
SURROGATE Newark, New Jersey 07102
DEVERO D MCDOUGAL
DEPUTY SURROGATE
Phone 973-621-4900
Fax 973-621-2647
In the Matter of the Estate of
PROOF OF MAILING OF
_____________________________, Deceased NOTICE OF PROBATE OF WILL
AKA: PURSUANT TO RULE 4:80-6
I, ____________________________, residing at ________________________________________,
certify as follows:
1. I am the Executor/Executrix of the above estate.
2. On_________________________, 20 ______, I forwarded Notice(s) of Probate of Will to all
next of kin and to all beneficiaries named in the Will of _________________________________.
3. I forwarded copies of the attached notice(s) by (Select the method you used):
__________ Regular Mail __________ Express Mail
__________ Certified Mail __________ Hand Delivery
To the following:
Name(s)_______________________ Address(es)___________________________________
I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing
statements made by me are willfully false, I am subject to punishment.
Dated:________________________ ___________________________
Signature
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