I don't know of a sample but the following from How to request access to a deceased family member's Apple account - Apple Support describes the information needed in the order. If that doesn't help, use the contact Apple Support at the end of the excerpt below.
Request access with a court order or other legal documentation
In the U.S. and other locales, you can request access to a deceased person’s Apple ID and data with a court order that names you as the rightful inheritor of your loved one’s personal information. In some jurisdictions, such as France, Germany, Japan, Australia, and New Zealand, alternative documentation and process instead of a court order are accepted.
Where applicable, the court order needs to specify:
- The name and Apple ID of the deceased person.
- The name of the next of kin who is requesting access to the decedent’s account.
- That the decedent was the user of all accounts associated with the Apple ID.
- That the requestor is the decedent’s legal personal representative, agent, or heir, whose authorization constitutes "lawful consent.”
- That Apple is ordered by the court to assist in the provision of access to the decedent’s information from the deceased person's accounts. The court order should be addressed to the relevant Apple entity.
If you have a court order with this information, or if you need additional help, please contact Apple Support.