HomeMy WebLinkAbout04-12-07
Estate of
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF {;umbeR-llrJJd
Src .
COUNTY, PENNSYL VANIA
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B. Fl ~ l d ~
File Number
. Deceased
81-07-03'57
Social Security Number . J g Ql - C},"!;/ - 'lID t/
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also known as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
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(State relevant circumstances, e.g., renunciation, death of executor, etc.) , () C) :;po
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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~ent~ffere~~:;
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: . () --I .. , ..' "
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o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I are the
last Will of the Decedent.dated and codicil(s) dated
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~ B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minor/tate)
Petitioner(s) after a proper search has I 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.)
;n.psylvania with his I her last principal residence at
Ft- ~ c)s;7
home
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) -All personal property S 100
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in P A) Personal property in County $
Value ofrcal estate in Pennsylvania $ 10 J 00 0
situated as follows: ~ 1ft. 4 ,cd 0 f.{ MeA #JS. fh> J/ 6 vJ RJ I s;. h , f f~ )J ~ b cJ ~ I fA I 7e) -s.-- 1
Wherefore, Petitioner(s) respectfully 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:
T ed or rinted name and residence
t1f'JrJ ,StONffl ~1qOGf<AfJJ ~,~1 (?of C~mbe~hUR-~ f;/7~'
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Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C U V'Il foet<-Ip, JJd
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 ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Signature of Personal Representative
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File Number: ;21 - 0 7. - D.,,3 S7
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Estate of 0 n . S, fL~r. '.=: e ~
S<>oiaI Sonutity Number. I - '2- -2-2- 0 . ' Date OfDeath'~ ;?lX)le>
AND NOW, ~(i \ \ '2.- . '2007 . in consid~rati~n of the fore~oing Petition, satisfactory proof
having hoen "",outed ~'Pcnme, y IS DECREED that L''';'~ ~I f) I.rz;c:; rr
are hereby granted to n IN. ~1nflf -r an flU C I
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in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed ofrecor as the last Will (and Codici1(s)) of Decedent.
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Letters ............... $ 1dJ.oO
Short Certificate(s) . . :h. . . $ g",
Renunciation(s) ....~.... $ IS,DD
1iTI:tt~ ... $_-tS.OD~
~ ... $_ID.oo
f\ti1TmOtiM ... $ ,'300
.. . $
.. . $
.. . $
... $
... $
...$ CD
TOTAL.............. $38.
FEES
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
, Address:
Telephone:
Form RW.f)2 rev. 10./3.06
Page 2 of2
HIOS.90SMS REV. 6/06
This is to cenify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It Is Illegal to duplicate this copy by photostat or photograph.
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Frank Yeropoli
State Registrar
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
09555~8
. No.
OCT 0 6 2006
Date
Hl05.1"REV._
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~ #30-329
l. _"_jRoII._.IooI.IlAO
John
I JJ~07-0~57
+LTH OF PENNSYLVANIA e DEJlARTIIlENTOFHEALTH eVITALRECORDS
CERTIFICATE OF DEATH (CORONER) STATE FILEIIlMIER
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Fields 182 _ ,22 _September S, 2006
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. 12, 1931
Middletown, PA
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140 Cottage Road
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RENUNCIATION
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REGISTER OF WILLS
~1JJf/~Ef(LAlf/./) COUNTY, PENNSYLVANIA
1)1 -07 - tJ357
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Estate of
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. Deceased
I,
ff'ChIftt4 L .
(Pri"t Name)
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h(:/Is
, 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
v: (JAY }1 ?;'WI:.v ~ ll#~y /1J SfllVt'/l'.
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(Signature)
(Date)
//I1.? AAJ'fhIJAJ Y /-I, fJh W~ Y
(Street Address)
C;'I/.{mbet-'{htJ~ ~A /'1,;;)0 I
(City, State, Zip) I
Exec"ted ill R~r's Office
Sworn to or affirmed and subscribed
before me this \ day
of
Exec"tal o"t of Register's OJJice
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunc!J)1<>n for the
p~ ted 'thin on this b' day
of ~,
Deputy for Register of Wills
No Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of NotIly's Commission.)
Notarial Seal
Jordan F. Comer, Notary Public
Chambel'8burg 80m, FIINdIn County,
My Commission ExpII1t Dee. 30, 2008
FormRW-06 rev.lO.13.06
Estate of
RENUNCIATION
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REGISTER OF WILLS
(!'/)/fI~E~L/IJ1J {j COUNTY, PENNSYLVANIA
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administer the Estate of the Decedent and respectfully request that Letters be issued to
j/, (JAY /l!cGtAJIAI ~ 'HAlAI'I W cStoh('L .
, ~!j.5U)-f{
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(Street Address)
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. Deceased
I, ~fJ/\J S. he/d.s) JIt. , in my capacity/relationship as
(Print Name)
...$'r.) Al of the above Decedent, hereby renounce the right to
D3/0&(0'
(Date) r
Execllted in Register's OjJice
Sworn to or affirmed ....II cnlbscribed
before me this day
of
w t..Je.o+
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, "/0101
ExeCllted Ollt of Register's OjJice
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunci~n for the
purpo.~~ within on this t' day
of 'lrIA , ~7 .
~7~
No Public .
My Commission Expires:
Deputy for Register of Wills
(Signature and Seal of Notary or other official qualified to
administer oatha. Show dati: of expiDtim ofNotary'a Commiaaion.)
Notarial Seal
Jordan F. Conner, Notary Public
Chambel8burg BolO, Franklin County,
My Comml88lon ExpIres Dec. 30, 2008
Form RW-06 rev. 10.13.06
RENUNCIATION
REGISTER OF WILLS
~ I7IllfP.I A pO COUNTY. PENNSYLVANIA
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Estate of
.J;htV 73. F;~ Ids
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. oet?eased
7rAe~ V
d (Print Naml)
-~{)1 It f t! It of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
y. ~y .jY/{G~liu ~ #/I'~y J.I S'f,NflC..
I,
L.
Sh/; fA
. in my capacity/relationship as
to "'A:~ rlf)O 1
~ cR,~
(Si~
(Date)
6+.5'5 -r~ekt~ \<oAJ
(Street Address)
[;"~ el::b e_iJ"dk~A (1 ~a
~e. ZIp)
Execlltell ill Rqister~s Office
Sworn to or affirmed and subscribed
before me this \ day
of
ExeClltell Ollt of Register~s OjJice
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renun~~n for the
p~ted within on this day
of t:/". , :2/)07 .
~Y'~
No Public
My Commission Expires:
Deputy for Register of Wills
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Notarial Seal
Jordan F. Conner, Notary Public
Chambersburg Bora, Franklin County,
My Commission Expires Dec. 30, 2008
FormRW-06 rev.10.H06