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HomeMy WebLinkAbout04-02-07 '4 i PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA Estate of Thomas M. Zock also known as / I / File Number e:l1- () 7 -(J 3 I ~ , , Deceased Social Security Number 203-54-5883 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the last Will of the Decedent dated and codicil(s) dated named in the ~ u ~ (State relevant circumstances, e.g., renunciation, death of executor, etc.) C-., ~ C");g ! "j .co:;. ('-" I " Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution offIiQ mtrum~s) offered~~J " r) ",' .... for probate, was not the victim of a killing and was never adjudicated an incapacitated person: , :_, ;:..; ......, ><2'~-1 ~ III B. Grant of Letters of Administration Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) -=c ~ (If applicable, enter: c.t.a.; d.b.n.c,t.a.; pendente lite; durante absentia; durtifJ7e ~;noritate) W, - ) " ; I ", Michael John Zock Melissa Marie Zock Son Daughter 2222 Ri 2222 Ri Residence ighway, Shippensburg, P A 17257 way, Shippensburg, PA 17257 Name Relationshi (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. County, Pennsylvania with his / her last principal residence at Decedent, then 44 years of age, died on March 24, 2007 at Carlisle Regional Medical Center Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in P A) Personal property in County Value of real estate in Pennsylvania situated as follows: 2222 Ri~ghway, Shippensburg, PA 17257 $ $ $ $ 10.000.00 150,000.00 r SilZI1ature 7'~- Wherefore, Petitioner(s) respectfuIly request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Tvoed or orinted name and residence 1 --... Michael John Zock, 2222 Rittner Highway, Shippensburg, P A 17257 Form RW-02 rev. 10.13.06 Page 1 of2 . I Oath of Personal Representative COMMONWEALTH OF PENNSYL VANIA SS COUNTY OF Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed Cld subscribed before me the j) I\. day of ~ ---- Signature of Personal Representative Signature of Personal Representative Signature of Personal Representative File Number: ;21-01- 319 Estate of Thomas M. Zock , Deceased Social Security Number: 203-54-5883 Date of Death: March 24, 2007 AND NOW, ~.-A- .2 , c2<.:u" ,in oonsWenltion of the furegoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Michael John Zock and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. in the above estate FEES Letters ............... ~.VD Short Certificate(s) . . . . . . .. $ too .00 Renunciation(s) .......... $ 5.00 d ...$ \t::>.~ ~~ ...$ 5,6b ...$ ...$ ...$ ...$ ...$ ...$ ...$ TOTAL ..... . . . . . . . .. $ 'Ol-.(6.00 Attorney Signature: Attorney Name: Andrew W. Barbin, Esquie Supreme Court LD. No.: 43571 5020 Ri~ad, Suite 109 Address: Mechanicsburg, P A 17055 Telephone: 717-506-4670 Form RW-02 rev. 10.13.06 Page 2 of2 "' RENUNCIA TION Cumberland REGISTER OF WILLS COUNTY, PENNSYLVANIA () '=0 ~ ::0 j-o l::~ 1'-..) r::~ = --.. :0:.. -0 ::v I N ~ I-Ol-L~\9 -'"-" ,..-- ,,:'.~\_;~' -\;5 '--i -0 -.,.,... _":"".... Estate of Thomas M. Zock N W ........., , Deceased Daughter I, Melissa Marie Zock (Print Name) , in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Michael John Zock April 2, 2007 (Date) Y'-f<J 0 ~'p--- -(Y'Ilv-t... (Signature) , .... 2222 Riltner Highway (Street Address) Shippensburg, P A 17257 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the PutpOo/statc;d within on this ,;( .el day of ry I o1oo? , ~t !'..>4-~~ Notary Public My Commission Expires: Deputy for Register of Wills (Signature and Seal of Notary or other official qualiiied to administer oaths. Show date of expiration of Notary's COmmissivn..) Form R W-06 rev. /0.13. 06 :TH OF PENNSYLVANIA NOTARIAL SEAL IWCINE I. GOODMAN, ~ PublIc ~jIoto.. CumberIIrid County 27,20'0 ~:..:. ..//...../ U10~.r;::(I:" 1Z"'::V 1/0:" This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 No. r;:Z'-J~,}# ~J"-_.:.G " Local Registra,r P 13487387 MAR 2 B 200L, (:=:) C)Date = Co -' ~:!~ ~ c, '-' C) :::::0 .:Slt8 ~ Cf) .~.~ '-, -0 ~TH cw ,...VLVANlA. DEMRTMENT cw HEALTH. YrrAL MC0AD8 COllIONER'S ceRTIFICATE OF DEATH .... ...-u... AI.......... __) &.. Zoclt Kale .'~'~~ :-...::.i -,::..... ............ - "",_.. - CJUaIOl" 130-482 1._.._____ ThalIa. 'lit ....... .~ w 44 Ya Karcb 11. 1963 fa. o..r PA CuDberl.nd It.~____~ f1l.[!__UilIlI. South Newton fH.O-..._UilIlI_ -~. ". K , ao..r__ Cuaberland ft. ------... CIr ,... (})ester T. Zoc~ Faye (I<iel) Zod Q.1Hft CrH~. A'l (15242 "'--'---- Wi lCllOt'e. PA 15962 Portage. 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I . ..~-.........-..... 0 ...__ .............. ,...--..-..--.......--............-...--.-.................. u_ b 26 2007 . --,- ....rc . ....---..,.~....~-_......._.............-...--.-. )l:llllllli'ftll!..t':"'~ ."..,.... -- 1 / I / I' / I.-?I..si --7."" ~~~!i::t:~:. ~lA178!6te 11 ____..../1/7 .33.;l~. Coroner