Form SE-2A "Affidavit in Relation to Settlement of Estate Under Article 13, Scpa" - New York

What Is Form SE-2A?

This is a legal form that was released by the Surrogate's Court of the State of New York - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 1996;
  • The latest edition provided by the Surrogate's Court of the State of New York;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SE-2A by clicking the link below or browse more documents and templates provided by the Surrogate's Court of the State of New York.

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Download Form SE-2A "Affidavit in Relation to Settlement of Estate Under Article 13, Scpa" - New York

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SURROGATE’S COURT OF THE STATE OF NEW YORK
COUNTY OF ___________________________________
----------------------------------------------------------------------------X
AFFIDAVIT IN RELATION TO
VOLUNTARY ADMINISTRATION, Estate of
SETTLEM ENT OF ESTATE UNDER
ARTICLE 13, SCPA
,
File No.
(as of 9/96)*
Deceased.
---------------------------------------------------------------------------X
(INSTRUCTIONS: In com pleting this form ,
STATE OF NEW YORK
)
answer each question. This m ay be done in som e
COUNTY OF____________________________) ss.:
instances by crossing out words in parenthesis
and in som e instances by inserting the required
inform ation.)
I,
,being duly sworn, depose and say
(1) My dom icile is
(Street Address)
(City/Town/Village)
(County
(State)
(Zip)
(Telephone Number)
My m ailing address is
(If different from domicile)
(2) My interest is:
Distributee of decedent
(Relationship)
Other (Specify)
(3) The nam e, dom icile, date, place of death, and citizenship of the decedent, to whose estate this proceeding relates, are as
follows:
Nam e of Decedent (a/k/a, if applicable):
Dom icile of Decedent:
(Street Address)
(City/Town/Village)
(County)
(State)
Date of Death:
Place of Death:
(City/Town/Village)
(State)
Citizenship:
(4) Decedent died:
Intestate (without a will)
Testate (the original will is attached)
(5) A search of the records of the Court shows that no application has been m ade in, the estate of the decedent for voluntary
adm inistration, letters of adm inistration or for probate of a will, and your affiant is inform ed and verily believes that no such
application ever has been m ade to any other Surrogate’s Court in this state.
SE-2A *For use only where decedent died on or after August 29, 1996
SE-2A
-1-
SURROGATE’S COURT OF THE STATE OF NEW YORK
COUNTY OF ___________________________________
----------------------------------------------------------------------------X
AFFIDAVIT IN RELATION TO
VOLUNTARY ADMINISTRATION, Estate of
SETTLEM ENT OF ESTATE UNDER
ARTICLE 13, SCPA
,
File No.
(as of 9/96)*
Deceased.
---------------------------------------------------------------------------X
(INSTRUCTIONS: In com pleting this form ,
STATE OF NEW YORK
)
answer each question. This m ay be done in som e
COUNTY OF____________________________) ss.:
instances by crossing out words in parenthesis
and in som e instances by inserting the required
inform ation.)
I,
,being duly sworn, depose and say
(1) My dom icile is
(Street Address)
(City/Town/Village)
(County
(State)
(Zip)
(Telephone Number)
My m ailing address is
(If different from domicile)
(2) My interest is:
Distributee of decedent
(Relationship)
Other (Specify)
(3) The nam e, dom icile, date, place of death, and citizenship of the decedent, to whose estate this proceeding relates, are as
follows:
Nam e of Decedent (a/k/a, if applicable):
Dom icile of Decedent:
(Street Address)
(City/Town/Village)
(County)
(State)
Date of Death:
Place of Death:
(City/Town/Village)
(State)
Citizenship:
(4) Decedent died:
Intestate (without a will)
Testate (the original will is attached)
(5) A search of the records of the Court shows that no application has been m ade in, the estate of the decedent for voluntary
adm inistration, letters of adm inistration or for probate of a will, and your affiant is inform ed and verily believes that no such
application ever has been m ade to any other Surrogate’s Court in this state.
SE-2A *For use only where decedent died on or after August 29, 1996
SE-2A
-1-
(6) The nam es and addresses of the decedent’s distributees under New York law, including non-m arital children and
descendants of predeceased non-m artial children, and their relationship to the decedent, are as follows: (If m ore space is
needed, add a sheet of paper)
Post Office
Relationship
Nam e
Address, (Including Zip)
Indicate if non-m arital)
____________________
______________________
________________________________
____________________
______________________
________________________________
____________________
______________________
________________________________
____________________
______________________
________________________________
(7) (If decedent had a will) The nam e and address of all beneficiaries in the will of the decedent filed herewith are as follows:
(If m ore space is needed, add a sheet of paper)
Post Office
Nam e
Address, (Including Zip)
Bequest
_____________________
________________________
_________________________________
_____________________
________________________
_________________________________
_____________________
________________________
_________________________________
_____________________
________________________
_________________________________
8) The value of the entire personal property, wherever located, of the decedent, exclusive of joint bank accounts, trust accounts,
EPTL §5-3.1
U.S. savings bonds POD (payable on death), and jointly owned personal property, or property exem pt under the
,
does not exceed $20,000.00.
9) The following, exclusive of joint bank accounts, trust accounts, U.S. savings bonds POD (payable on death), and jointly
owned personal property, or property exem pt under EPTL §5-3.1, is a com plete list of all personal property owned by the
decedent, either standing in his/her own nam e or owned by him /her beneficially and including item s of value in any safe deposit
box. (If m ore space is needed, add a sheet of paper)
Item s of Personal Property
Separately Listed
Value of Each Item
_________________________________________
_______________________________________
_________________________________________
_______________________________________
_________________________________________
_______________________________________
_________________________________________
_______________________________________
TOTAL $
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(10) All the liabilities of the decedent known to m e are as follows: (If m ore space is needed, add a sheet of paper)
Nam e of Creditor
Am ount Owed
____________________________________
_________________________________
____________________________________
_________________________________
____________________________________
_________________________________
____________________________________
_________________________________
(11) I undertake to act as voluntary adm inistrator/trix of the decedent’s estate, and to adm inister it pursuant to Article 13 of the
Surrogate’s Court Procedure Act. I agree to reduce all of the decedent’s assets to possession; to liquidate such assets to the
extent necessary; to open an estate bank account in a bank of deposit or savings bank in this state, in which I shall deposit all
m oney received; to sign all checks drawn on or withdrawals from such account in the nam e of the estate by m yself, as voluntary
adm inistrator/trix; to pay the expenses of adm inistration, the decedent’s reasonable funeral expenses and his/her debts in the
order provided by law; and to distribute the balance to the person or persons and in the am ount or am ounts provided by law.
As voluntary adm inistrator/trix, I shall file in this court an account of all receipts and of disbursem ents m ade.
(12) I understand that this proceeding will not determ ine the estate tax liability, if any, in the event that the decedent had any
interest in real property or any joint bank accounts, trust accounts, U.S. savings bonds POD (payable on death), or jointly owned
or trust property.
(13) If letters testam entary or of adm inistration are later granted, I acknowledge that m y powers as voluntary adm inistrator/trix
shall cease, and I shall deliver to the court appointed fiduciary a com plete statem ent of m y account and all assets and funds
of the estate in m y possession.
Signature of Affiant
Print Nam e
Sworn to before m e on
, 20
Notary Public
My Com m ission Expires:
(Affix Notary Stam p or Seal)
Signature of Attorney:
Print Nam e:
Firm Nam e:
Tel. No.:
Address of Attorney:
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