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Form 111 (version 4)SCR Part 78 rule 8

SUMMONS FOR LETTERS OF ADMINISTRATIONCOURT DETAILS

Court Supreme Court of New South Wales

Division Equity

List Probate

Registry Sydney

Case number Write the case number assigned when notice of intention to apply was published

TITLE OF PROCEEDINGS

Plaintiff Write the name of the applicant(s)

The estate of Write the full name of the deceased

Late of: Write the suburb or city where the deceased lived

Write the occupation of the deceased deceased

Date of death: Write the deceased's date of death

Gross value: Write the gross value of the estate

Net value: Write the net value of the estate

FILING DETAILS

Filed for Write the name of the applicant(s). Insert a ";" between names if there are more than one applicants

Contact name and telephone Write the name of the contact applicant Write the contact telephone number

Contact email Write a contact email address if you have one

Facts sheet: application for a grant of administration.

HEARING DETAILS

The summons is to be dealt with in the absence of the parties.

RELIEF CLAIMED

Type of Grant being sought: Letters of AdministrationCapacity of Applicant(s) and relationship to the deceased: Insert "Spouse; defacto; son; daughter, father etc as appropriateQualifications or limitations: if appropriate specify any limitations on the grant or if the administration bond is to be dispensed with (otherwise delete this field)

SIGNATURE

Signature of or on behalf of party if not legally represented

Each applicant to Sign here

Capacity Plaintiff(s)

Date of signature Write the date(s) you signed the summons


FURTHER DETAILS ABOUT PLAINTIFF

[First] plaintiff

Name

Address[The filing party must give the party's address.]

#[unit/level number] #[building name]

[street number] [street name] [street type]

[suburb/city] [state/territory] [postcode]

#[country (if not Australia)]

[repeat the above information as required for the second and each additional plaintiff]

Contact details for plaintiff[s] acting in person

Address for service[The filing party must give an address for service This must be an address in NSW unless the exceptions listed in UCPR 4.5(3) apply. State “as above” if the filing party’s address for service is the same as the filing party’s address stated above.]

#as above (delete if not applicable and complete below)

#[unit/level number] #[building name]

[street number] [street name] [street type]

[suburb/city] [state/territory] [postcode]

Telephone

Email


Form 119 (version 2)SCR Part 78 rule 12(SCR Form 98)

AFFIDAVIT OF APPLICANT FOR ADMINISTRATION

COURT DETAILS


Division Equity

List Probate

Registry Sydney


TITLE OF PROCEEDINGSThe estate of Write the full name of the deceased


FILING DETAILSFiled for Write the name of the applicant(s). Insert a ";" between

names if there are more than one applicants




AFFIDAVIT

Name Write the name of the executor(s) making this affidavit.

Address Write the address(es) of the executor(s) making this affidavit.

Occupation Write the occupation(s) of the executor(s) making this affidavit.

Date Write the date the affidavit is sworn or affirmed (leave blank to be inserted after sworn)

I Write "say on oath" if you will be swearing the affidavit on a bible or other holy book or

otherwise write "affirm"

1. I am state relationship to the deceased of Write the full name of the deceased, Write

the occupation of the deceased late of Write the suburb or city where the deceased

lived who died on Write the deceased's date of death aged Write the deceased's age

as recorded on certificate of registration of death years and I believe that the deceased

is Write the full name of the deceased as described in the certificate of registration of

death referred to in the certificate of registration of death which is annexed and marked

``A''.

2. I believe that the deceased did not leave a will or document purporting to embody the

testamentary intentions of the deceased If there are any possible testamentary

documents which should be disclosed mention them here after the word "except". It

may be appropriate to seek legal advice if there are possible testamentary documents.

Otherwise delete this field.

3. List all the searches that have been made for a will.

4. The names, ages, relationship to the deceased and entitlements of the persons

entitled in distribution of the estate of the deceased are: (state these).

Name of beneficiary (insert a line for each

beneficiary)

Age of beneficiary

(if under 18)

Relationship to the

deceased

Entitlement

Eg. Joanna Citizen Mother 1/2 share of the

estate

Eg. John Citizen Father 1/2 share of the

estate

5. State the facts establishing the persons in para 4 are the persons entitled in

distribution of the estate. Annex appropriate certificate evidence as to their relationship


to the deceased

6. The deceased left assets within New South Wales.

7. I am not an undischarged bankrupt, I have not assigned or encumbered my interest in

the estate and I am over 18 years of age.

8. If I am granted administration of the estate of the deceased:

(a)I will administer the estate according to law; and

(b)I will:

(i) verify and file; or

(ii) verify, file and pass,

my accounts relating to the estate of the deceased within 12 months from the date of

grant if so required by the Court.

9. Notice of this application was published on the New South Wales On-line registry

website on.Write the date the notice of intention to apply was published

10. A statement of all assets of the deceased of which I am presently aware is annexed

and marked Write this is annexure "B" or as appropriate to the affidavit. I will disclose

to the Court any other asset which comes to my notice.

11. The liabilities of the deceased of which I am presently aware are as follows:

Date Name of creditor, etc.

Description of liability

Estimated or known amount

Secured UnsecuredWrite the date of the liability

Write the name of the creditor.

Write a brief description of the liability

$ (amount) $(amount)

Add a row for each liability

12. The estate has a gross value of $Write the gross value of the estate as shown on the

Inventory of Property and a net value of $Write the net value of the estate, which is the

gross value of the estate less any liabilities as shown in the preceding paragraph.( paragraphs 13 and 14 must be completed if the applicant is the defacto spouse, otherwise delete these paragraphs and renumber following

paragaphs)

13. The names, ages and relationship to the deceased of the persons who, if the

deceased had not left a de facto spouse, would have been entitled in distribution of the

estate are:

Name of person entitled under Age (if under Relationship to the deceased


intestacy if not a defacto

spouse. (insert a line for each

beneficiary)

18)

14. State the facts establishing the persons in para 13 are the persons who would be

entitled if there was no defacto. Annex appropriate certificate evidence as to their

relationship to the deceased

15. I am not aware of any circumstances which raise doubt as to my entitlement to a grant

of probate of the will of the deceased. If you are aware of any circumstances which

may raise a doubt as to your entitlement to a grant, eg. a later will, these must be

disclosed. Add these here after the word "except". You should consider obtaining legal

advice. Otherwise delete this field.


#SWORN #AFFIRMED atDelete the option that does not apply:

Write the name of the suburb the affidavit is sworn or affirmed at

Signature of deponent The person who made the affidavit must sign in front of the prescribed witness

Name of witness Write the full name of the prescribed witness

Address of witness Write the address of the prescribed witness

Capacity of witness [#Justice of the peace #Solicitor #Barrister #Commissioner

for affidavits #Notary public] Select one

And as a witness, I certify the following matters concerning the person who made this affidavit

(the deponent) The witness must select one from options 1 and 2 to verify the identity of the person making the affidavit:

1. #I saw the face of the deponent. [OR, delete whichever option is inapplicable]

#I did not see the face of the deponent because the deponent was wearing a face

covering, but I am satisfied that the deponent had a special justification for not removing

the covering.1

2. #I have known the deponent for at least 12 months. [OR, delete whichever option is

inapplicable]

#I have confirmed the deponent’s identity using the following identification document:

Identification document relied on (may be original or certified copy)2

Witness must specify what type of identification document they

sighted to confirm the identity of the person who made the affidavit

Signature of witness

The prescribed witness signs here

1 [The only "special justification" for not removing a face covering is a legitimate medical reason (at April 2012).]

2 ["Identification documents" include current driver licence, proof of age card, Medicare card, credit card, Centrelink

pension card, Veterans Affairs entitlement card, student identity card, citizenship certificate, birth certificate,

passport or see Oaths Regulation 2011 or JP Ruling 003 - Confirming identity for NSW statutory declarations and

affidavits, footnote 3.]


Form 117 (version 1)Part 78 rule 10 (1)(a)(iii)SCR Form 96

ANNEXURE ``....''

INVENTORY OF PROPERTYThe estate of [name of deceased]

Late of:

1.Property owned solely by deceased [ taken into account towards the gross value of the estate]

Description Estimated or known value(Describe each item sufficiently to identify it) $(Amount)(add a row for each item)

TOTAL:

2. Property owned Jointly by deceased as tenants in common in equal/unequal shares. [ taken into account towards the gross value of the estate]

Description Particulars of other joint owner

Estimated or known value. Deceased’s share only

(Describe each item sufficiently to identify it)

Name and address of other joint owner)

$(Amount)

(add a row for each item)

TOTAL:

3. Property owned Jointly by deceased as joint tenants with another or others. [This property devolves to the survivor and should not be included in the gross value of the estate]

Description Particulars of other joint owner

Estimated or known value

(Describe each item sufficiently to identify it)

Name and address of other joint owner)

$(Amount)

(add a row for each item)

TOTAL:

This is Annexure ``...'' to the affidavit of (name) sworn at (place) this (date) before me.

signature of the applicant:


signature of the person before whom the affidavit is sworn:

Form 125 (version 3)SCR Part 78 rules 19(1)(a) and 21(3)(SCR Form 101)

CONSENT TO ADMINISTRATION

COURT DETAILS


Division Equity

List Probate

Registry Sydney

Case number

TITLE OF PROCEEDINGSThe estate of [name of deceased]Late of:

FILING DETAILSFiled for [name/s] plaintiff[s]

#Legal representative [solicitor on record] [firm]

#Legal representative reference [reference number]

Contact name and telephone [name] [telephone]

Contact email [email address]


DECLARATION OF CONSENT BY AFFECTED PERSON

Name

Address

Occupation

DateI declare:

1. I am over 18 years of age. I am not an undischarged bankrupt and I have not assigned or

encumbered my interest in the estate of the deceased.

2. I consent to letters of administration being granted to Write the name of the applicant(s). Insert

a ";" between names if there are more than one applicants who is Write the name of the applicant(s).

Insert a ";" between names if there are more than one applicantsstate their relationship to the

deceased eg. spouse of the deceased] Write "and to the administration bond being dispensed with (if applicable)

( paragraphs 3 must be completed if the applicant is the defacto spouse, otherwise delete)

3. I have read the Affidavit of the Applicant for Administration and understand how the

entitlement of the de facto spouse affects the distribution of the estate of the

deceased.

.

Signature of person giving

consent


AFFIDAVIT OF WITNESS TO AFFECTED PERSON’S CONSENT

Name

Address

Occupation

Date* [ to be made before someone other than the affected person ]

I [#say on oath #affirm]:


1. The above document was signed in my presence on (date) by (name of person

consenting).

2. The signatures are respectively that of (name of person consenting) and my signature.


Form 126 (version 3)Part 78 rule 20(2) and rule 22(2)SCR Form 98A/99

AFFIDAVIT THAT DECEASED WAS NOT IN A DEFACTO RELATIONSHIP

COURT DETAILS


Division Equity

List Probate

Registry Sydney


TITLE OF PROCEEDINGSThe estate of Write the full name of the deceased


FILING DETAILSFiled for Write the name of the applicant(s). Insert a ";" between

names if there are more than one applicants




AFFIDAVIT

Name Write the name of the executor(s) making this affidavit.

Address Write the address(es) of the executor(s) making this affidavit.

Occupation Write the occupation(s) of the executor(s) making this affidavit.

Date Write the date the affidavit is sworn or affirmed (leave blank to be inserted after sworn)

I Write "say on oath" if you will be swearing the affidavit on a bible or other holy book or

otherwise write "affirm"

1. I am the widow or widower; or other relationship to the deceased or friend of the deceased of the deceased.

2. I lived with the deceased up to the time of his or her death and for a continuous period of number of years years beforehand. If the previous sentence does not apply delete that sentence and write how you are qualified to swear this affidavit; in particular how often you visited or communicated with the deceased.

3.The deceased did not leave any person who at the time of his death was his (or her) de facto partner, for whom the estate or any part of it is required to be held under a statutory trust for the partner.

4.I am aware of the provisions of section 21C of the Interpretation Act 1987.


#SWORN #AFFIRMED atDelete the option that does not apply:

Write the name of the suburb the affidavit is sworn or affirmed at

Signature of deponent The person who made the affidavit must sign in front of the prescribed witness

Name of witness Write the full name of the prescribed witness

Address of witness Write the address of the prescribed witness

Capacity of witness [#Justice of the peace #Solicitor #Barrister #Commissioner

for affidavits #Notary public] Select one

And as a witness, I certify the following matters concerning the person who made this affidavit

(the deponent) The witness must select one from options 1 and 2 to verify the identity of the person making the affidavit:

1. #I saw the face of the deponent. [OR, delete whichever option is inapplicable]

#I did not see the face of the deponent because the deponent was wearing a face

covering, but I am satisfied that the deponent had a special justification for not removing

the covering.1

2. #I have known the deponent for at least 12 months. [OR, delete whichever option is

inapplicable]

#I have confirmed the deponent’s identity using the following identification document:

Identification document relied on (may be original or certified copy)2

Witness must specify what type of identification document they

sighted to confirm the identity of the person who made the affidavit


The prescribed witness signs here

1 [The only "special justification" for not removing a face covering is a legitimate medical reason (at April 2012).]

2 ["Identification documents" include current driver licence, proof of age card, Medicare card, credit card, Centrelink

pension card, Veterans Affairs entitlement card, student identity card, citizenship certificate, birth certificate,

passport or see Oaths Regulation 2011 or JP Ruling 003 - Confirming identity for NSW statutory declarations and

affidavits, footnote 3.]


Form 112 (version 2)Supreme Court Rules Part 78 rule 8

LETTERS OF ADMINISTRATION

COURT DETAILS


Division Equity

List Probate

Registry Sydney


DECEASED'S DETAILS

Estate of: Write the full name of the deceased


Occupation: Write the occupation of the deceased

Date of death: Write the deceased's date of death

Date of will: Write the date of the will

Number of Codicils: Write the number of codicils or write "0" if there are none

Date of codicils: Write the date(s) of the codicil(s) or delete this field if there are no codicils

LETTERS OF ADMINISTRATION DETAILS

Granted to: Write the full name and address of each of the applicant/executors

Basis of grant: AdministratorThe attached inventory lists property disclosed to the Court under s.81A of the Probate and Administration Act 1898. It is issued by the Court under s.91 (2) of that Act.

SEAL AND SIGNATURE

Court seal

Signature

Capacity

Date


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