Docket No.: _______________
State of New Jersey
Essex County Surrogate’s Court
Hall of Records, Room 206
ALTURRICK KENNEY
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:
_______________________________________________, Deceased
AKA: _________________________________________
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RENUNCIATION
OF ADMINISTRATOR
AD PROSEQUENDUM
To: ALTURRICK KENNEY, Surrogate of the County of Essex
I, _________________________, ____________________ of the above decedent, late of _________________
in the County of Essex do hereby renounce my right of Administration Ad Prosequendum, and request the
appointment of ___________________________________________.
Dated: ____/____/____ ___________
Signature
*Copy of government issued picture I.D. required*
STATE OF NEW JERSEY
COUNTY OF ESSEX
}SS.
Be it remembered, that on this, ____/____/20___, before me, undersigned authority, personally appeared
__________________________, who I am satisfied are the persons in the foregoing instrument, to whom I first
made known the contents thereof, and thereupon they acknowledged that they signed, sealed and delivered the
same as their voluntary act and deed, for the uses and purposes therein expressed.
__________________________________________________
Notary Public/Attorney at Law of New Jersey
My Commission Expires: ____________________
Affix Seal
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