Letters of special administration may be in substantially the following form, after properly entitling the court: In the Matter of the Estate of ) ) Case No. ) deceased. ) Letters of Special Administration ...................................................... ) On (day) (month) . (year), the court entered an order appointing (name) as special administrator of the decedents estate. The order includes: [ ] a directive for the establishment of a blocked account for sums in excess of $.; [ ] a directive for the posting of a bond in the sum of $.; or [ ] a directive for both the establishment of a blocked account for sums in excess of $ . and the posting of a bond in the sum of $..... The special administrator, after being duly qualified, may act and has the authority and duties of special administrator. In testimony of which, I have this date signed these letters and affixed the seal of the court. CLERK OF THE COURT By . Deputy Clerk (date) OATH I, , whose mailing address is ., solemnly affirm that I will faithfully perform according to law the duties of special administrator, and that all matters stated in any petition or paper filed with the court by me are true of my own knowledge or, if any matters are stated on information and belief, I believe them to be true. Special Administrator SUBSCRIBED AND AFFIRMED before me this .. (day) of .. (month) of (year). CLERK OF COURT By ..................................................... Deputy Clerk (or) ................................................... NOTARY PUBLIC County of State of ...........
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