New York Codes, Rules and Regulations › Title 22 - JUDICIARY › Subtitle D - Forms › Chapter VII - Surrogate's Court Forms › Subchapter A - Forms Authorized By Section 207.52 › Surrogate's Forms › Form AA-1 - Petition for ancillary letters of administration

Current through Register Vol. 46, No. 28, July
					 10, 2024
For Office Use Only
Filing Fee Paid $ ____________
____________ Certs: $ ____________
$ ____________ Bond, Fee: $
						____________
Receipt No: ____________ No:
						____________
DO NOT LEAVE ANY ITEMS BLANK
SURROGATE'S COURT OF THE STATE OF NEW
						YORK
COUNTY OF
________X
ANCILLARY ADMINISTRATION PROCEEDING,
						PETITION FOR ANCILLARY
ESTATE OF LETTERS OF ADMINISTRATION
SCPA ARTICLE 16
a/k/a [ ] Ancillary Letters of
						Administration
[ ] Ancillary Letters of Administration
						d.b.n.
a domiciliary of the State of
Deceased. File No. ________
________X
TO THE SURROGATE'S COURT, COUNTY OF
						:
It is respectfully alleged:
1. The name, citizenship, domicile (or, in
						the case of a bank or trust company, its principal office) and interest in this
						proceeding of the petitioner(s), are as follows:
Name: ____________
Domicile or Principal Office:
						____________
(Street and Number)
____________
(City, Village or Town) (State) (Zip
						Code)
Mailing Address: ____________
(if different from domicile)
Citizen of: ________
Name: ____________
Domicile or Principal Office:
						____________
(Street and Number)
____________
(City, Village or Town) (State) (Zip
						Code)
Mailing Address: ____________
(if different from domicile)
Citizen of: ________
Interest(s) of Petitioner(s): [Check
						one]
[ ] Administrator [ ] Distributee of
						decedent [State relationship] ____________
[ ] Creditor
[ ] Other [Specify] ____________
2. The name, domicile, date and place of
						death, and national citizenship of the above-named decedent are as
						follow:
(a) Name: ____________
AA-1 (4/98)
(b) Date of Death: ____________
(c) Place of Death: ____________
(d) Domicile: Street ____________
City, Town, Village ____________
County ________ State ____________
(e) Citizen of: ____________
3. The decedent died INTESTATE, leaving no
						will.
On ____________, letters were issued to
						________
by ________ Court, State of ____________,
						being a competent court of the state of the domicile of decedent having
						jurisdiction thereof, and the amount of the security given on the original
						appointment was $________.
[If additional space is needed in
						Paragraphs 4, 5 and 6, attach addendum.]
4. (a) The estimated gross value of the
						decedent's property in the State of New York, consisting of real property and
						personal property, is described and valued as follows: [list items and describe
						briefly, giving location. If space is insufficient, attach addendum.]
Personal Property
$
Improved real property in New York
									 State
$
Unimproved real property in New York
									 State
$
Estimated gross rents for a period of 18
									 months
$
Total $
4. (b) No other assets exist in New York
						State, nor does any cause of action exist on behalf of the estate, except as
						follows: [Enter "NONE" or specify]
____________
____________
Exemplified copies of the decree and the
						letters issued, if any, are submitted as part of this petition.
5. The names, addresses and interests of
						all persons entitled to process [(a) New York State Department of Taxation and
						Finance, (b) all domiciliary creditors or domiciliaries claiming to be
						creditors, and (c) such other persons entitled to letters pursuant to SCPA
						§ 1607] are as follows:
Nature of Interest or
Name
Address
Amount of Claim
New York State Department of
Taxation and Finance
Albany, New York
6. The name and address of each
						domiciliary distributee having an interest in the property in this state is as
						follows:
(a) Each distributee who is of full age
						and sound mind or which is a corporation or association:
AA-1 (4/98)
Name
Address
Interest
(b) Each distributee who is an infant or otherwise under
						a disability: [State disability and see SCPA § 304(3)]
Name
Address
Interest
Disability: ____________
TABULAR OR GRAPHIC MATERIAL SET FORTH AT
						THIS POINT IS NOT DISPLAYABLE
Disability: ____________
7. There are no persons interested in this
						proceeding other than those hereinbefore mentioned. No previous application for
						ancillary administration with or without ancillary letters has been made,
						except
____________
____________
WHEREFORE, petitioner(s) pray(s) (a) that
						process issue to all necessary parties and (b) that ancillary letters issue
						thereon as follows:
[ ] Ancillary Letters of Administration
						to: ____________
____________
[ ] Ancillary Letters of Administration
						d.b.n. to: ____________
____________
(d) [State any other relief
						requested]
Dated: ________
1.
____________
(Signature of Petitioner) 2.
____________
(Signature of Petitioner)
____________
(Print Name)
____________
(Print Name)
3.
(Name of Corporate Petitioner)
(Signature of Officer)
(Print Name and Title of Officer)
AA-1 (12/97)
SURROGATE'S COURT OF THE STATE OF NEW
						YORK
COUNTY OF
________X
ANCILLARY ADMINISTRATION PROCEEDING
						COMBINED VERIFICATION,
ESTATE OF OATH AND DESIGNATION
a/k/a
a domiciliary of the State of File No.
						________
Deceased.
________X
STATE OF)
COUNTY OF) ss:
The undersigned, the petitioner named in
						the foregoing petition, being duly sworn, says:
1. VERIFICATION: I have read the foregoing
						petition subscribed by me and know the contents thereof, and the same is true
						of my own knowledge, except as to the matters therein stated to be alleged upon
						information and belief, and as to those matters I believe it to be true.
2. OATH OF ANCILLARY [ ] Administrator [ ]
						Administrator d.b.n.: I am over eighteen (18) years of age and a citizen of the
						United States; I will well, faithfully and honestly discharge the duties of
						ancillary administrator/administrator d.b.n.. I am not ineligible to receive
						letters.
3. DESIGNATION OF CLERK FOR SERVICE OF
						PROCESS: I do hereby designate the Clerk of the Surrogate's Court of ________
						County, and his or her successor in office as a person on whom service of any
						process issuing from such Surrogate's Court may be made, in like manner and
						with like effect as if it were served personally upon me, whenever I cannot be
						found within the State of New York after due diligence used.
My domicile is ____________
(Street Address) (City/Town/Village)
						(State) (Zip Code)
________
(Signature of Petitioner)
________
(Print Name)
On ____________, before me personally
						came
____________
to me known to be the person described in
						and who executed the foregoing instrument. Such person duly swore to such
						instrument before me and duly acknowledged that he/she executed the
						same.
________
Notary Public
Commission Expires:
(Affix Notary Stamp or Seal)
Signature of New York Attorney:
						____________
Print Name of New York Attorney:
						____________
Firm Name: ____________ Tel. No.:
						________
Address of New York Attorney:
						____________
AA-1 (4/98)
SURROGATE'S COURT OF THE STATE OF NEW
						YORK
COUNTY OF
________X
ANCILLARY ADMINISTRATION PROCEEDING
						COMBINED CORPORATE
VERIFICATION,
ESTATE OF CONSENT AND DESIGNATION
a/k/a
a domiciliary of the State of File No.
						________
Deceased.
________X
STATE OF)
COUNTY OF) ss:
The undersigned, a ____________ of
(Title)
____________
(Name of Bank or Trust Company)
a corporation duly qualified to act in a
						fiduciary capacity without further security, being duly sworn, says:
1. VERIFICATION: I have read the foregoing
						petition subscribed by me and know the contents thereof, and the same is true
						of my own knowledge, except as to the matters therein stated to be alleged upon
						information and belief, and as to those matters I believe it to be true.
2. CONSENT: I consent to accept the
						appointment as [ ] Ancillary Administrator [ ] Ancillary Administrator d.b.n.
						of the decedent described in the foregoing petition and consent to act as such
						fiduciary.
3. DESIGNATION OF CLERK FOR SERVICE OF
						PROCESS: I do hereby designate the Clerk of the Surrogate's Court of ________
						County, and his or her successor in office as a person on whom service of any
						process issuing from such Surrogate's Court may be made, in like manner and
						with like effect as if it were served personally upon me, whenever I cannot be
						found within the State of New York after due diligence used.
_______________
(Name of Corporate Petitioner)
_______________
(Signature of Officer)
_______________
(Print Name and Title of Officer)
On ________, before me personally came
						________ to me known, who duly swore to the foregoing instrument and who did
						say that he/she resides at ________ and that he/she is a ________ of ________
						the corporation/national banking association described in and which executed
						such instrument, and that he/she signed his/her name thereto by order of the
						Board of Directors of the corporation.
________
Notary Public
Commission Expires:
(Affix Notary Stamp or Seal)
Signature of New York Attorney:
						____________
Print Name of New York Attorney:
						____________
Firm Name: ____________ Tel. No.:
						________
Address of New York Attorney:
						____________
AA-1 (4/98)
SURROGATE'S COURT OF THE STATE OF NEW
						YORK
COUNTY OF
________X
ANCILLARY ADMINISTRATION PROCEEDING, WILL
						OF COMBINED CORPORATE VERIFICATION,
ESTATE OF CONSENT AND DESIGNATION
a/k/a
a domiciliary of the State of File No.
						________
Deceased.
________X
STATE OF)
COUNTY OF) ss:
The undersigned, a ____________ of
(Title)
____________
(Name of Bank or Trust Company)
a corporation duly qualified to act in a
						fiduciary capacity without further security, being duly sworn, says:
1. VERIFICATION: I have read the foregoing
						petition subscribed by me and know the contents thereof, and the same is true
						of my own knowledge, except as to the matters therein stated to be alleged upon
						information and belief, and as to those matters I believe it to be true.
2. CONSENT: I consent to accept the
						appointment as [ ] Ancillary Administrator [ ] Ancillary Administrator d.b.n.
						of the decedent described in the foregoing petition and consent to act as such
						fiduciary.
3. DESIGNATION OF CLERK FOR SERVICE OF
						PROCESS: I do hereby designate the Clerk of the Surrogate's Court of ________
						County, and his or her successor in office as a person on whom service of any
						process issuing from such Surrogate's Court may be made, in like manner and
						with like effect as if it were served personally upon me, whenever I cannot be
						found within the State of New York after due diligence used.
________
(Name of Corporate Petitioner)
________
(Signature of Officer)
________
(Print Name and Title of Officer)
On ________, before me personally came
						________ to me known, who duly swore to the foregoing instrument and who did
						say that he/she resides at ________ and that he/she is a ________ of ________
						the corporation/national banking association described in and which executed
						such instrument, and that he/she signed his/her name thereto by order of the
						Board of Directors of the corporation.
________
Notary Public
Commission Expires:
(Affix Notary Stamp or Seal)
Name of New York Attorney: ____________
						Tel. No.:________
Address of New York Attorney:
						____________
AA-1 (12/97)