Blank New York Wd 3 PDF Form

Blank New York Wd 3 PDF Form

The New York WD-3 form is a legal document used in Surrogate’s Court to request permission to compromise a wrongful death claim and to account for the administration of the deceased's estate. This form outlines the details of the claim, the administration process, and the distribution of funds among the beneficiaries. For those navigating the complexities of estate administration, completing this form accurately is crucial; click the button below to get started.

The New York WD-3 form is a crucial document used in Surrogate's Court proceedings, particularly in matters related to the administration of estates following a wrongful death. This form allows the administrator of the estate to seek court approval for settling claims related to the decedent's wrongful death, while also providing a detailed account of the estate's financial activities. The form requires the administrator to disclose various aspects, including the amount of the settlement being sought, the parties involved, and any funeral expenses that have been paid. It also outlines the distribution of proceeds among the decedent's surviving relatives and addresses any claims from creditors. Essential documents, such as the petition for administration and affidavits from legal counsel, must accompany the WD-3 form to support the application. By presenting a comprehensive account of receipts and disbursements, the form ensures transparency and compliance with legal requirements, facilitating a smoother judicial settlement process.

Document Sample

Form WD-3 (4/98)

SURROGATE’S COURT OF THE STATE OF NEW YORK

COUNTY OF

In the Matter of the Application of

 

 

 

 

 

 

 

 

 

as Administrat

 

 

of the Goods, Chattels and

 

 

 

 

 

 

 

 

 

Credits which were of

 

 

 

 

 

 

ACCOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deceased.

 

File #

 

 

 

For leave to compromise a certain cause of action for

 

 

 

 

 

 

 

 

 

wrongful death of the decedent and to render and have

 

 

 

 

 

 

 

 

 

judicially settled an account of the proceedings as such

 

 

 

 

 

 

 

 

 

Administrat

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TO THE SURROGATE’S COURT:

 

 

 

 

 

 

 

 

 

1. I

 

 

 

 

 

 

 

 

 

do render the following account of my

 

 

 

proceedings as administrat

 

 

of the goods, chattels and credits which were of

 

 

,

 

deceased, consisting of a claim against

 

 

 

 

 

, who is insured by

 

 

 

 

 

 

 

 

 

 

Insurance Company, for wrongful death arising on or about

 

 

,

as the result of an automobile accident involving the decedent and

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.Letters of Administration of the goods, chattels and credits of the decedent were issued to me on

_______________________, said letters being limited to the prosecution only, and not for the collection of any proceeds of, any action or claim for wrongful death. Simultaneously herewith, leave is being asked to

compromise the claim for wrongful death of the decedent for the sum of $

 

.

3.There is submitted with this account my petition as administrat________; and affidavit by

,Esq., attorney for the petitioner herein; a copy of the paid funeral bill; and waivers of the necessary parties.

4.In view of the facts and circumstances, it is my opinion that a satisfactory result has been achieved through the efforts of my attorneys, and they are requesting disbursements in the sum of

$

 

 

and that they receive thereafter a fee of

 

% of the net proceeds.

5.

The funeral bill in the sum of $

 

has been paid through no-fault insurance.

6.There are no outstanding hospital bills or doctors’ bills.

7.The only property coming into my hands is by reason of the compromise of the claim against the

Insurance Company in the sum of $

 

.

 

 

8. The decedent left surviving no other next of kin except

 

,

his/her widow/widower, and

,

his/her children. All of the above persons are entitled to share in the proceeds of the compromise.

(NOTE: WHERE THERE ARE NO DISTRIBUTEES UNDER A DISABILITY, THE RENDERING OF AN ACCOUNT IS USUALLY NOT REQUIRED.)

(NOTE: REIMBURSEMENT OF FUNDS PAID FOR FUNERAL AND OTHER ADMINISTRATIVE EXPENSES, UNDER MOST CIRCUMSTANCES, ARE ALLOWABLE, AS ARE STATUTORY COMMISSIONS TO THE ADMINISTRAT(OR)(RIX). IF REIMBURSEMENT OR COMMISSIONS ARE NOT SOUGHT, THE PETITION SHOULD CONTAIN A WAIVER THEREOF).

9.There are no other claims or creditors of the estate that have been presented to or have come into my hands or knowledge except for the following:

a)The Commissioner of Social Services has submitted a claim of $

for public assistance rendered to decedent and his/her family for the years

. This claim was rejected.

b)

has submitted a claim for $

 

 

 

based on

 

 

 

 

This claim was rejected.

 

 

 

c) Decedent’s father/mother,

has sought a share of the recovery based on an alleged pecuniary loss. This claim was rejected.

10. The following are the only persons interested in this proceeding:

 

[L IST NAMES OF DISTRIBUTEES, ETC .]

 

NAME

RELATIONSHIP

DATE OF BIRTH

County Department

 

of Social Services

 

Possible Creditor

New York State Tax Commission

Possible Creditor

 

 

 

Attorneys

 

 

 

Defendant

Insurance Company

Defendant’s Insurance Company

11.I charge myself as follows with the amount to be received on compromise of the claim for wrongful death against

Insurance Company:

$

-2-

12. I credit myself as follows:

 

 

 

 

a) With the amount to be paid to

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

Esqs., attorneys, including disbursements:

 

$

b) With the amount to be paid to

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

widow/widower and distributee: (

%)

$

 

 

 

 

 

 

 

 

 

 

c) With the amount to be paid to the guardian of the person

and property of

 

 

 

 

 

 

 

,

 

 

infant, jointly with the Trust Officer of

 

 

 

 

 

Bank (

 

 

%):

 

 

 

 

 

$

d) with the amount to be paid to

 

 

,

 

 

 

 

 

 

 

 

 

 

son/daughter (

%):

 

 

 

 

$

 

 

 

 

Total:

 

 

$

Leaving no balance.

 

 

 

 

 

 

 

 

 

 

Dated:

STATE OF NEW YORK

 

COUNTY OF

SS.:

being duly sworn, deposes and says:

That I am the administrat_______ /accountant in the above estate, having been duly appointed by a

decree of this Court.

The foregoing account of proceedings contains to the best of my knowledge and belief a true and complete statement of my receipts and disbursements in the estate of

of all monies and other property belonging to the estate or fund which have come into my hands or which have been received by any person or persons by my order or authority for use since my appointment, and a full and true statement of account of the manner in which I have disposed of same and all property remaining in my hands at the present time, and a full and true account of the nature of each and every transaction may by me since my appointment.

 

I do not know of any error or omission in said account to the prejudice of any person interested in

said estate or fund.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

___________________________________

Sworn to before me this

 

 

 

 

 

day of

 

 

.

 

 

Notary Public

(Form WD-3)

-3-

File Specifics

Fact Name Description
Purpose The New York WD-3 form is used to request court approval to compromise a wrongful death claim and to settle an account of the administrator's proceedings.
Governing Law This form is governed by the Surrogate's Court Procedure Act of New York, specifically relating to the administration of estates.
Submission Requirements Along with the WD-3 form, the administrator must submit a petition, an affidavit from the attorney, a paid funeral bill, and waivers from necessary parties.
Accountability The administrator must provide a complete account of all receipts and disbursements, ensuring there are no outstanding claims against the estate.

How to Use New York Wd 3

Filling out the New York WD-3 form requires careful attention to detail. This form is essential for administrators seeking to settle an estate following a wrongful death claim. After completing the form, you will need to submit it to the Surrogate's Court for judicial approval.

  1. Begin by entering the name of the county where the application is being filed at the top of the form.
  2. Fill in the name of the deceased in the space provided.
  3. Indicate your name as the administrator of the estate.
  4. Provide the file number assigned to the case.
  5. State the amount being requested to compromise the wrongful death claim.
  6. Enter the date on which the Letters of Administration were issued to you.
  7. Detail the circumstances surrounding the wrongful death claim, including the date of the incident and the parties involved.
  8. Attach the necessary documents: your petition as administrator, an affidavit from your attorney, a copy of the paid funeral bill, and waivers from necessary parties.
  9. Document the amount requested for attorney disbursements and the percentage fee based on the net proceeds.
  10. Confirm that the funeral bill has been paid through no-fault insurance.
  11. Indicate that there are no outstanding medical bills related to the decedent.
  12. List the only property received from the compromise of the claim against the insurance company.
  13. Identify the surviving next of kin and their relationships to the decedent.
  14. Note any claims or creditors of the estate, providing details on each claim's status.
  15. List the names and relationships of all interested parties in the proceeding.
  16. Calculate and document the amounts you charge yourself with and the credits you will apply.
  17. Sign and date the form, affirming the accuracy of the information provided.
  18. Have the form notarized by a Notary Public.

Your Questions, Answered

  1. What is the purpose of the New York WD 3 form?

    The New York WD 3 form is used in Surrogate’s Court to request permission to compromise a wrongful death claim on behalf of a deceased person’s estate. It allows the administrator to present an account of their actions and seek judicial approval for the settlement of the claim, ensuring that all interested parties are informed and that the process is transparent.

  2. Who needs to fill out the WD 3 form?

    The form must be completed by the administrator of the deceased's estate. This individual is typically appointed by the court and is responsible for managing the estate’s assets, including pursuing any claims for wrongful death that may arise from the circumstances surrounding the decedent’s passing.

  3. What information is required on the WD 3 form?

    The form requires several key pieces of information, including:

    • The name of the decedent and the administrator.
    • The details of the wrongful death claim, including the name of the insurance company involved.
    • A summary of the financial transactions related to the estate, including funeral expenses and any claims against the estate.
    • Information about surviving relatives and their relationship to the decedent.
  4. What supporting documents must accompany the WD 3 form?

    When submitting the WD 3 form, the administrator must include several supporting documents. These typically include:

    • A petition from the administrator.
    • An affidavit from the attorney representing the administrator.
    • A copy of the paid funeral bill.
    • Waivers from necessary parties, if applicable.
  5. How does the administrator determine the fee for their attorney?

    The administrator typically discusses and agrees upon the attorney’s fee as a percentage of the net proceeds from the wrongful death claim. This fee must be clearly stated in the WD 3 form, along with any disbursements incurred during the legal process.

  6. What happens if there are no surviving relatives?

    If there are no surviving relatives or distributees under a disability, the rendering of an account may not be required. However, the administrator must still comply with any relevant legal obligations regarding the estate and any claims against it.

  7. What should the administrator do if there are outstanding claims against the estate?

    The administrator must disclose any outstanding claims or creditors when filling out the WD 3 form. This includes providing details about any claims submitted by entities such as the Department of Social Services or other potential creditors. Transparency is crucial in these matters.

  8. How is the total amount distributed among the interested parties?

    The administrator must detail the distribution of the settlement amount among all interested parties, including surviving family members and any other claimants. Each party’s share should be calculated and clearly stated in the form to ensure proper distribution.

  9. What is the significance of the notary public signature on the WD 3 form?

    The signature of a notary public on the WD 3 form serves to authenticate the document. It verifies that the administrator has sworn to the accuracy of the information provided, ensuring that the account is a true and complete statement of the estate’s financial activities.

  10. Where should the completed WD 3 form be submitted?

    The completed WD 3 form, along with all required documents, should be submitted to the Surrogate’s Court in the county where the decedent resided at the time of death. This court will review the application and issue a decision regarding the proposed compromise of the wrongful death claim.

Common mistakes

  1. Incomplete Information: Many people forget to fill in all required fields, such as the decedent's name or the date of the accident. Leaving out crucial details can lead to delays in processing.

  2. Incorrect Titles: Using the wrong title for the administrator can create confusion. Ensure that "administrator" or "administratrix" is used correctly throughout the form.

  3. Missing Signatures: Failing to sign the form or have it notarized can result in the application being rejected. Always double-check for required signatures.

  4. Improper Documentation: Not including necessary documents, like the funeral bill or waivers from interested parties, can lead to complications. Ensure all required paperwork is attached.

  5. Inaccurate Financial Figures: Providing incorrect amounts for claims or expenses can mislead the court. Double-check all figures for accuracy before submission.

  6. Neglecting to List All Interested Parties: Omitting names of distributees or potential creditors can create legal issues later. Include everyone who has a claim or interest in the estate.

  7. Failing to Address Claims: Ignoring existing claims against the estate can complicate the process. Clearly state any claims and their statuses in the form.

  8. Not Seeking Reimbursement: Some individuals overlook their right to seek reimbursement for funeral and administrative expenses. Be sure to indicate if you are requesting these reimbursements.

  9. Ignoring Court Instructions: Each court may have specific requirements or instructions. Not adhering to these can result in delays or rejections. Always review the guidelines provided by the court.

Documents used along the form

When dealing with the New York WD-3 form, several other documents may be required to ensure a smooth process. Each of these documents plays a vital role in the administration of an estate, especially in cases involving wrongful death claims. Below is a list of commonly used forms and documents that accompany the WD-3.

  • Letters of Administration: This document grants the administrator legal authority to manage the estate of the deceased. It is essential for initiating the probate process.
  • Petition for Compromise: This petition requests court approval to settle a wrongful death claim. It outlines the terms of the settlement and the reasons for the compromise.
  • Affidavit of Attorney: This affidavit, typically prepared by the attorney representing the administrator, confirms the attorney's involvement and provides details about the legal services rendered.
  • Funeral Bill: A copy of the paid funeral bill is necessary to demonstrate that funeral expenses have been settled, which may affect the distribution of estate funds.
  • Waivers of Notice: These documents are signed by interested parties, indicating that they waive their right to receive notice of certain proceedings related to the estate.
  • Claim Rejections: Documentation showing any claims against the estate that have been rejected is important for transparency and to prevent future disputes.
  • Accounting Report: This report details the financial activities of the estate, including income, expenses, and distributions, providing a clear picture of the estate's financial status.
  • Distribution Plan: A plan outlining how the estate's assets will be distributed among beneficiaries. This ensures everyone is aware of their entitlements.
  • Tax Clearance Certificate: This certificate confirms that all estate taxes have been paid, which is necessary before the final distribution of assets can occur.
  • Guardian's Consent: If there are minor children involved, consent from their legal guardian may be needed for any distributions made on their behalf.

Having these documents ready can significantly expedite the process of settling an estate. It is crucial to ensure that all forms are accurately completed and submitted to avoid delays or complications. Proper documentation supports a smoother resolution for all parties involved.

Similar forms

The New York Form WD-3 is similar to the Affidavit of Heirship, which is used to establish the heirs of a deceased person. This document outlines the relationships of the heirs to the decedent, providing a clear picture of who is entitled to inherit. Like the WD-3, the Affidavit of Heirship often requires signatures from witnesses and must be notarized. Both documents serve to clarify the distribution of an estate, ensuring that all interested parties are recognized and accounted for in the process.

Another document akin to the WD-3 is the Petition for Letters of Administration. This petition is filed when someone seeks the authority to manage a deceased person's estate when there is no will. Similar to the WD-3, this petition includes details about the decedent's assets and debts. Both documents require the administrator to provide information about the estate and its beneficiaries, aiming to facilitate a smooth probate process.

The Release of Estate Claim is also comparable to the WD-3. This document is often signed by heirs or beneficiaries, relinquishing their claims to the estate in favor of the administrator's proposed distribution. Just as the WD-3 outlines how funds will be allocated among beneficiaries, the Release of Estate Claim helps to confirm that all parties agree to the proposed settlement, minimizing disputes.

The Accounting for Estate Assets is another similar document. This accounting provides a detailed summary of all financial transactions related to the estate, including income, expenses, and distributions. Like the WD-3, it aims to ensure transparency and accountability in the management of the estate. Both documents are essential for gaining approval from the court and for keeping beneficiaries informed about the status of the estate.

Next, the Waiver of Process is akin to the WD-3 in that it can be used to expedite the administration process. This waiver allows beneficiaries to forgo formal notice and court appearances, streamlining the proceedings. Both documents serve to simplify the legal process, ensuring that all interested parties are on the same page and agree to the proposed actions without unnecessary delays.

The Consent to Settle is another document that shares similarities with the WD-3. This consent is often required when settling a claim against the estate, allowing the administrator to proceed with a settlement. Both documents emphasize the importance of obtaining agreement from interested parties before finalizing any decisions related to the estate, thereby preventing future disputes.

The Final Distribution Agreement is also comparable to the WD-3. This agreement outlines how the remaining assets of an estate will be distributed among beneficiaries after all debts and expenses have been settled. Like the WD-3, it requires the consent of all parties involved and aims to ensure that the distribution process is clear and agreed upon by everyone.

The Declaration of Trust is another document that can be likened to the WD-3. This declaration establishes a trust to manage the assets of the deceased for the benefit of the heirs. Similar to the WD-3, it requires detailed information about the assets and beneficiaries, ensuring that all parties understand how the assets will be managed and distributed over time.

Lastly, the Estate Inventory is similar to the WD-3 as it provides a comprehensive list of all assets owned by the deceased at the time of death. This inventory is crucial for both the administrator and the court to understand the total value of the estate. Both documents aim to provide a clear and accurate representation of the estate's assets, which is essential for proper administration and distribution.

Dos and Don'ts

When filling out the New York WD-3 form, it is essential to follow specific guidelines to ensure accuracy and compliance. Here are six things to consider:

  • Do: Provide complete and accurate information about the decedent, including their full name and date of death.
  • Do: Attach all necessary documents, such as the paid funeral bill and waivers from interested parties.
  • Do: Clearly state the amount of compensation you are seeking for the wrongful death claim.
  • Do: Ensure that all parties entitled to share in the proceeds are listed, including their relationships to the decedent.
  • Don't: Leave any sections blank; every part of the form should be filled out to avoid delays.
  • Don't: Forget to sign and date the form before submitting it to the Surrogate’s Court.

Following these guidelines can help streamline the process and ensure that the form is processed efficiently.

Misconceptions

Here are ten common misconceptions about the New York WD-3 form, along with explanations to clarify these misunderstandings:

  • The WD-3 form is only for wrongful death claims. While the WD-3 form is often associated with wrongful death claims, it can also be used in other contexts where an administrator needs to account for the estate's assets and liabilities.
  • Only lawyers can fill out the WD-3 form. Although it is advisable to have legal assistance, anyone appointed as an administrator can complete the form. However, understanding the details is crucial to ensure accuracy.
  • Filing the WD-3 form is optional. In many cases, filing the WD-3 form is required to provide a clear account of the estate's financial activities. This helps protect the interests of all parties involved.
  • All debts must be paid before filing the WD-3 form. While it is important to address outstanding debts, the WD-3 form can be filed even if some claims have been rejected or are still in dispute.
  • The WD-3 form guarantees approval of claims. Submitting the WD-3 form does not guarantee that all claims will be approved. The Surrogate's Court will review the form and make decisions based on the information provided.
  • Once filed, the WD-3 form cannot be amended. If errors or omissions are discovered after filing, it is possible to amend the form. It is important to notify the court of any changes as soon as possible.
  • Only the administrator can receive funds from the estate. The WD-3 form allows for distributions to be made to various parties, including heirs and creditors, not just the administrator.
  • All claims against the estate must be included in the WD-3 form. The form should list known claims, but it is not necessary to include every potential claim, especially if they have been formally rejected.
  • The WD-3 form is a one-time submission. The form may need to be filed multiple times throughout the administration of the estate, especially if there are ongoing transactions or changes in circumstances.
  • Filing the WD-3 form is the final step in estate administration. The WD-3 form is an important step, but additional actions may be required to fully settle the estate, including final distributions and tax filings.

Key takeaways

Filling out and using the New York WD-3 form is an important process for administrators managing the estate of a deceased person. Here are some key takeaways to keep in mind:

  • Purpose of the Form: The WD-3 form is used to seek approval for compromising a wrongful death claim and to settle the account of the administrator's proceedings.
  • Gather Required Documents: Before filling out the form, collect all necessary documents, including the funeral bill, waivers from interested parties, and any relevant claims against the estate.
  • Letters of Administration: Ensure that you have the Letters of Administration, which grant you the authority to act on behalf of the estate. These should be limited to prosecuting the wrongful death claim.
  • Claim Details: Clearly state the details of the wrongful death claim, including the parties involved and the insurance company responsible.
  • Account of Proceedings: Provide a thorough account of all receipts and disbursements related to the estate, ensuring accuracy and completeness.
  • Disbursements and Fees: Include any attorney fees and disbursements you are requesting, specifying the percentage of the net proceeds that will be paid to the attorneys.
  • Distribution of Proceeds: List all distributees entitled to share in the proceeds of the compromise, including their relationships to the decedent.
  • Sworn Statement: The form requires a sworn statement confirming the accuracy of the information provided. This must be done in front of a notary public.

Completing the WD-3 form accurately is crucial for ensuring that the estate is settled properly and that all parties receive their rightful shares. Take your time and double-check all entries before submission.