State of New Jersey
Gloucester County Surrogate’s
In the Matter of the Estate of RENUNCIATION
, Deceased FOR ADMINISTRATION
To Helene M. Reed, Surrogate of the County of Gloucester:
I, of the above decedent, late of Gloucester County, do hereby renounce my right of administration, and
request the appointment of _____________________________.
STATE OF )
COUNTY OF )
Be it remembered on this date, _____________________, before me, the undersigned authority, personally
appeared, who I am satisfied is the person named in the foregoing instrument, to whom I first made known the
contents thereof, and thereupon he/she acknowledged that he/she signed, sealed and delivered the same as his/her
act and deed, for the uses and purposes therein expressed.
Renunciation For Administration