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Form 113 (version 1)
Supreme Court Rules Part 78 rule 8

RESEAL

COURT DETAILS
Court	Supreme Court of New South Wales
Division	Equity
List	Probate
Registry	Sydney
Case number
DECEASED'S DETAILS
Estate of:	[name of deceased]
Late of:	[address]
Occupation:	[occupation]
Date of death:	[date of death]
Jurisdiction of original grant:	[jurisdiction]
Date of original grant:	[date]

Sealed with the seal of the Supreme Court of New South Wales under the Probate and Administration Act 1898.

The 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