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 WD-1 - Wrongful death citation

Current through Register Vol. 46, No. 28, July
					 10, 2024
Form WD-1
(Wrongful Death Citation)
CITATION
THE PEOPLE OF THE STATE OF NEW YORK
BY THE GRACE OF GOD, FREE AND
						INDEPENDENT,
TO: ____________
____________, an infant over the age of 14
						years
of ____________, New York
[list other parties]
____________ being persons interested as
						creditors, legatees, devisees, beneficiaries,
distributees or otherwise of the estate of
						____________, deceased, who at the time of death resided____________
at ____________,
(Street/Number) (City, Village/Town)
						(State) (Zip Code)
A petition having been duly filed by
						____________,
who is domiciled at ____________,
(Street/Number) (City, Village/Town)
						(State) (Zip Code)
YOU ARE HEREBY CITED TO SHOW CAUSE before
						the Surrogate's Court, ____________
County, at ________, New York on ________,
						19________, at 9:30 a.m.,
WHY the account of the proceedings of
						________ as administrat ________ of the estate of ________, deceased, a copy of
						which is attached, should not be judicially settled, and
WHY the administrat________ should not be
						empowered to compromise and settle a certain claim for wrongful death against
						________ for the sum of $________ and to discontinue any claim for conscious
						pain and suffering, and
WHY the provisions in the limited Letters
						of Administration issued to the petitioner on ________ 19________, restraining
						the compromise or collecting upon the aforesaid claim and cause of action,
						should not be modified to permit said compromise, and
WHY the filing of a bond should not be
						dispensed with, and
WHY the defendant, ____________, or
						defendant's insurance company, should not pay
to ________, Esqs., out of the proceeds
						of the settlement for the claim for wrongful death, the sum of $________ as and
						for attorneys' fees, together with disbursements in the sum of $________,
						and
WHY the entire recovery of $________
						should not be allocated to the cause of action for decedent's wrongful death,
						and
WHY, the balance of the settlement, to wit
						the sum of $ ________, should not be distributed to those distributees having
						sustained a pecuniary loss as follows: ____________% of the balance to
____________, widow/widower of decedent;
						________% of the balance to
________, child of decedent; ________% of
						the balance to ________, child of decedent, and
WHY the claim of ________ should not be
						rejected, as a nondistributee, and
WHY the claim of ________ in the amount of
						$ ________ should not be rejected, and
WHY upon payments as hereinbefore
						mentioned the said ________ should not be permitted to execute and deliver
						general releases and all other necessary papers to the defendant, ________, or
						defendant's insurance company, releasing them from all claims against them
						arising out of the aforesaid action for wrongful death, together with any other
						papers necessary to effectuate the said compromise.
Dated, Attested and Sealed, ________,
						19________.
HON. ____________
Surrogate, County of
(L.S.)
______________
Clerk of the Surrogate's Court
WD-2 (4/98)
ATTORNEY
Name of Attorney:____________ Tel. No.:
						________
Address of Attorney: ____________
(Street/Number) (City, Village/Town)
						(State) (Zip Code)
This citation is served upon you as
						required by law. You are not obliged to appear in person. You have a right to
						have an attorney appear for you. If you fail to appear it will be assumed that
						you do not object to the relief requested.
WD-2 (4/98)