SUPREME COURT OF THE NORTHERN TERRITORY
	
Form

Application for an Exemplification of a Grant of Representation

General information
An Exemplification of a Grant of Representation is a Court certified and sealed copy of a grant of Probate, Letters of Administration with the Will Annexed, Letters of Administration or Reseal of a Grant of Representation. 
Given that an Exemplification has the same force, effect and operation as the original grant of representation, it is usually only available to the executor(s) or administrator(s) of an estate. Requests from others will be assessed by the Registrar of Probates on a case-by-case basis. 
Applying for an Exemplification
To apply for an Exemplification of a Grant of Representation:
1.	Complete this form;
2.	Draft the appropriate Exemplification using the templates on the Supreme Court website at: https://supremecourt.nt.gov.au/about/registry/wills-and-probate;
3.	File the completed form and draft Exemplification by email to ProbateOfficer.NT@nt.gov.au; and 
4.	Pay the applicable court fee for the Exemplification.	
PART A – FILE DETAILS
File Name: _______________________________________________________________________
File Number: _____________________________________________________________________
Name of deceased: _______________________________________________________________

PART B – APPLICANT’S DETAILS
Name of Applicant:  ______________________________________________________________
Relationship to the deceased: 
	☐   Executor / Administrator of the deceased’s estate
	☐   Legal practitioner acting on behalf of the Executor / Administrator
☐   Other – please provide particulars of relationship to the deceased: 
	      _______________________________________________________________
	      _______________________________________________________________
Applicant’s contact details: 
	Phone:  ____________________________
	Email:	  ____________________________
	Postal address: _____________________
			   _____________________	
PART C – REASON FOR APPLICATION FOR EXEMPLIFICATION
The Exemplification is sought for the following purpose(s): 
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PART D – SIGNATURE OF APPLICANT

____________________________				____________________________
Signature of Applicant					Date