Post on 14-Dec-2020
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. Page 1
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
Facts sheet: application for a grant of administration. Page 2
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
Facts sheet: application for a grant of administration. Page 3
Form 119 (version 2)SCR Part 78 rule 12(SCR Form 98)
AFFIDAVIT OF APPLICANT FOR ADMINISTRATION
COURT 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 PROCEEDINGSThe estate of Write the full name of the deceased
Late of: Write the suburb or city where the deceased lived
FILING DETAILSFiled 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. Page 4
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
Facts sheet: application for a grant of administration. Page 5
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
Facts sheet: application for a grant of administration. Page 6
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.
Facts sheet: application for a grant of administration. Page 7
#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.]
Facts sheet: application for a grant of administration. Page 8
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:
Facts sheet: application for a grant of administration. Page 9
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
Court Supreme Court of New South Wales
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]
Facts sheet: application for a grant of administration. Page 10
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
Signature of witness
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]:
Facts sheet: application for a grant of administration. Page 11
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.
Facts sheet: application for a grant of administration. Page 12
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
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 PROCEEDINGSThe estate of Write the full name of the deceased
Late of: Write the suburb or city where the deceased lived
FILING DETAILSFiled 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. Page 13
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.
Facts sheet: application for a grant of administration. Page 14
#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.]
Facts sheet: application for a grant of administration. Page 15
Form 112 (version 2)Supreme Court Rules Part 78 rule 8
LETTERS OF ADMINISTRATION
COURT 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
DECEASED'S DETAILS
Estate of: Write the full name of the deceased
Late of: Write the suburb or city where the deceased lived
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
Facts sheet: application for a grant of administration. Page 16