Petition for Ancillary Probate - Free Download
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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 PROBATE PROCEEDING, WILL OF PETITION FOR ANCILLARY PROBATE
SCPA ARTICLE 16
[ ] Ancillary Letters Testamentary
a/k/a [ ] Ancillary Letters of Administration c. t. a.
[ ] Without Ancillary Letters
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 principle 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]
[ ] Executor(s) named in decedent’s will [ ] Creditor
[ ] Other (Specify)_____________________________________________________________________
2. The name, domicile, date and place of death, and national citizenship of the above-named decedent are as follows:
(a) Name:______________________________________________________________________
(b) Date of Death:________________________________________________________________
(c) Place of Death:_______________________________________________________________
(d) Domicile: Street_______________________________________________________________
City, Town, Village_____________________________________________________________
County__________________________ State _______________________________________
(e) Citizen of:____________________________________________________________________
AP-1 (4/99) -1-
