Affidavit of applicant for administration119 http://www.ucprforms.lawlink.nsw.gov.au/ucprforms/index.html

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
TITLE OF PROCEEDINGS
	The estate of [name of deceased]
	Late of:
FILING DETAILS
Filed 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]

AFFIDAVIT
Name
Address
Occupation
Date

I [#say on oath #affirm]:

1. I am (state relationship to deceased) of (name, occupation) late of (place) who died on (date) aged (number) years and I believe that the deceased is (name in 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 [where applicable except for (specify document)].

3. (State what searches have been made for a will or document purporting to embody the testamentary intentions of the deceased.)

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).

5. (State the facts establishing that the persons named in paragraph 5 are the persons entitled in distribution of the estate. Annex appropriate certificate evidence).

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. #Where a notice of the application was published on the New South Wales On-line Registry website Notice of this application was published on the New South Wales On-line registry website on (date).

#Where the deceased resided at the date of his or her death in the State and the notice was published before 21 January 2013 Notice of this application was published on (date) in the (name), which is a newspaper circulating in the district where the deceased resided at the date of the deceased's death, evidenced by the tear sheet annexed and marked ``....''. or

#Where the deceased did not reside at the date of his or her death in the State and the notice was published before 21 January 2013 Notice of this application was published on (date) in the (name), which is a Sydney daily newspaper, as evidenced by the tear sheet annexed and marked ``....''.

10. A statement of all assets of the deceased of which I am presently aware is annexed and marked ``C''. 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:

LIABILITIES

Date	Name of creditor,etc.	Description of liability	Estimated or known amount
			Secured	Unsecured
(date liability incurred eg 3-8-93 (date)	(name)	(description)	$ (amount)	$(amount)
(add a row for each liability)

12. The estate has a gross value of $ (amount) and a net value of $ (amount).

#[Where Part 78 rule 25A applies

#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 (state these).

#14. (State the facts establishing that the persons named in paragraph 14 are the persons who would have been entitled in distribution of the estate. Annex appropriate certificate evidence.)]

15. I am not aware of any circumstances which raise doubt as to my entitlement to a grant of administration of the estate of the deceased [where applicable except for (specify matter)].

#SWORN #AFFIRMED at
Signature of deponent
Name of witness
Address of witness
Capacity of witness	[#Justice of the peace #Solicitor #Barrister #Commissioner for affidavits #Notary public]
And as a witness, I certify the following matters concerning the person who made this affidavit (the deponent): 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
Signature of witness

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.]