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2. If you've scheduled an appointment, please note the date/time:
   If you've scheduled an appointment, please note the date/time:

   If you've scheduled an appointment, please note the date/time:

   You can make an appointment by calling us at 908-788-1156.

4. Name of Decedent:*

   As stated in death certificate. 

5. Alternate Name(s) of Decedent:*

   Name as listed on driver's license, accounts, etc.  

6. Age of Decedent:*
8. FULL Address of Decedent:*

   Where the decedent physically resided at time of death. Include zip code. 

9. Township/Borough:*

   Where were taxes paid to?

11. Has an attorney been retained to assist with the estate?*

    1. Yes
    2. No
13. Attorney Name:*
14. Attorney Phone:*
16. Attorney Mailing Address:*
17. Attorney Email:*
19. Affiant Name:*

    As stated on ID.

20. Relation to Decedent:*
22. Affiant Address:*

    Include zip code; NO PO Box

23. Affiant SSN:*
24. Affiant Phone:*
25. Affiant Email:*
27. NEXT OF KIN NAME / RELATION / ADDRESS / AGE (if minor):

    Include name, relation to decedent, and FULL address. Include age only if under 18.

    Decedent's closest next of kin (starting with spouse and children) must be listed here, regardless of whether they are beneficiaries or not, estranged, etc. You MUST provide their addresses.

    Start with spouse and children.  If there are no spouse or children, list grandchildren.  If there are only parents living, list parents.  If there are only siblings living, list siblings.  ETC. 

29. DOUBLE-CHECK: Did you put the relation AND address for each next of kin listed above and notate age of minors?*

    1. Yes
31. Did the decedent have any children who died?

    1. Yes
    2. No
33. Deceased Child Information:

    List the deceased child's name and year of death. 
    If the deceased child had children, you must list those children's name(s) and full addresses here. List ages only if under 18.  
    Please be as clear as possible. 

35. ASSET INFORMATION

    To apply for an Affidavit, the assets must be less than $50,000 and you must have account or VIN numbers and values.  
    Use Kelly Blue Book for current vehicle values.

37. Bank / Company and Type of Account:
38. Account #:
39. Current Value:
41. Bank / Company and Type of Account:
42. Account #:
43. Current Value:
45. Bank / Company and Type of Account:
46. Account #:
47. Current Value:
49. Bank / Company and Type of Account:
50. Account #:
51. Current Value:
53. Titled Vehicle Make/Model/Year:
54. VIN:
55. Current KBB Value:
57. Titled Vehicle Make/Model/Year:
58. VIN:
59. Current KBB Value:
61. More Assets? List them here:

    Be sure to include type of asset, account or VIN number, and its current value.

63. UPLOAD DEATH CERTIFICATE:

    Upload a copy of the death certificate here.  You must present the ORIGINAL death certificate to the Court.

65. NOTE ABOUT FEES:

    The cost for an Affidavit is $5 in fees per $100 of assets.  Consents are $5 each.  Maximum fee is $50. Fees are payable via cash, check, Visa, Mastercard, or Discover card.  We cannot accept a check with the decedent's name on it unless it is from a joint spousal account.    

67. Do you have any questions for us or is there anything else you'd like us to know?
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69. 1. Receive an email copy of this form.
70. Email address

    This field is not part of the form submission.

71. Submit

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