HomeMy WebLinkAbout04-09-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cvh1 be, !ani
COUNTY, PENNSYLVANIA
Estate of ~/,u~ ::J;;Y) e_J
also known as -rltd""d. et~." :r;A~r p'- '711cJ,."., j;",1O~~<r
. Deceased
File Number
~/"'07-0333
Social Security Number I 'I 5 ~ C) 7 - tJ g r,c I
Petitioner(s), who islare 18 years ofage or older, apply(ies) for:
(COMPLETE ',4' or 'B' BELOW:)
o A. Probate aad Gnat of Letten TestDleatu'y and aver that Pelitioner(s) is I are the
last Will of the Decedent dated and codicil(s) dated
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(Stou relewmt circumattmces, e.g., rerlU1lCiatiort. detzth of eucutor, etc.) , ~ ca :';;;;:. \..0
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of~~t(s)_ered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - . j~ \..0
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iii B. Gnat of Letters of AdmbdstratlOD
(If applicable, e"ter: c.La.; tlb.".c.t.a.; pe1Ide1lte liU!; durQ1lU! almmliD; tlurtmU! millOritllU!)
Petitioner(s) after a proper sean:hhas I have ascertained that Decedent teftno Will and was survived by the foDowing spouse (uany) and heirs: (If
A.dministration, c.I.a. or d.b.".c.t.a., enter dtlre of Will in Sectio" A. above and complete list of heirs.)
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Relationship
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Residence I
1'10/ 1',';< <i:~ ~- "": f C.f.wfl ~ f 1380
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at a(;o1~ lnub'-1ff,. 'fB37 e; TrlfoJik
Decedent at death owned property with estimated values as foDows:
(If domiciled in PA) All personal property
(lfnot domiciled in PA) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value ofreal estate in Pennsylvania
situatedasfoDows: f2.~QOO B~",~"I Aw-.-cll Cer-MR~~.p m-t. 1/35;614 V~A
$ ,() J) () O.
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$
$
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Wherefore, 'Petitioner( s) respectfully requeat(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:
We,y t
FormRW-02 rev.lO.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
: SS
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 of Petitioner(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 and subscribed
before me the 4'H1 day of
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F e k.egister
~"..G::!1-a.
Signature of Pentmol /lepresenllllive
Signature ofPersOMl Represenllllive
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Estate of 7he h-t a. To IA c..r . ~ased
Social Secwity Number: /9 5 - () 7 - () 8 ff-! Date of Death: (2-/ t. 6/ P 6
AND NOW, .' cO{)()7 i\ 5CODS~d~tion of the f~going Petition, satisfactory proof
having been presented ~Ilj me, IT IS >>EC~ fhat Letters f-Vlm I f) I sf/fl -h rn. _ .
areherebygrantedto~ fj:. ~n
in the above estate
File Number:
8.1 ~07- D3?/?;
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and that the instrument(s) dated
~mdEPetiti::_ttedro~~fficdof~~W~~S~~~ ~
Letters ."........,..,' $ 1~ Pj ~ ,/legi8terOfW'llls?J ~ 7r
Short C~fica te(s)..,..,.. $~' Attorney Signature:
RenUl1Cllltion(s) .......... $ . I
~ Attorney Name:
.., $
CYh.. '" $ (5 Supreme Court I,D, No.:
'.. $
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TOTAL .........,.... S
Address:
Telephone:
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FonrtRW-Ol nv.10.13.06
Page 2 of2
HI~.8lY.l REV llOS
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.
No.
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Loc Registrar
Fee for this certificate, $6.00
p
13147852
8tJ-07-0333
~TH OF PEllilBYLVANIA . DEPAImIIENr OF HEALTH . YrrAl. REC0RD8
CER11FICATE OF DEATH
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RENUNCIATION
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REGISTER OF WILLS
C ~A1~~/' ~PI tI COUNTY, PENNSYLVANIA
~1-07- ()333
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77;e(/H,~
I, Ec:lrJct k'urfz-
/ (Pri"t Name) I
.50 (e. .....J vrl("( v,~ .f I '.r rt.,e..
Estate qf
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X"n e J
. Deceased
. 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
~()be.rt-. /! Rvb/YJ
.
(Date)
)C . (~_ .,E. i!~
(Signature)
153 E- AI/fA;. (fhe-t
(Street Address)
terl'V1lC TX 777'15
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Execllted Ollt of Register's 0jJice
Before the undersigned personally appeared the
party executing this renunciation and certified
thai he or she executed the ~ for the
P~ted within on this '1 ___I day
$::~.
oIafy Public --
My Commission Expires:
Deputy for Register of Wills
(Signature and Seal of Notary or otba- official qualified to
administer 0Iths. Show date of expiration of Notary's Commission.)
[;.:8:' SUSAN BIfADRlRo W1WAMs
~ : . MY COMMISSION EXPIRES
~" "if:' . .IaIwIIIy 21, 200e
Form RW-06 rev. 10.13.06