HomeMy WebLinkAbout04-05-07
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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
COUNTY, PENNSYL VANIA
FileNwnber 62/-01- 331
:,"'::'~lr~~J.i~ i ~ ~lt~N
. Deceased
Social Security Nwnber
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE ~' 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
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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 olilie instrum~ offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
..4 B. Grant of Letters of Administration
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(State relevant circumstances, e.g., renunciation, death of executor, etc.)
_ r-i:
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
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 db.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
atJ;~ tt;1J Rti(.~ flJ) Grlts/GJf"
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
situated as follows: P5 ('} (n M.JI {(q to{ RJ) (Ct.\" h's lot J ~ J 7()/3
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s
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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:
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Form RW-02 rev. 10.13.06
Page 1 of2
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
: SS
COUNTY OF
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
,...4-. V
before me the D-day of
Q~ .~OCI
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\ . FO'theReg_~
Signature 0/ Personal Representative
Signature o/Personal Representative
File Number: CJ I-Ot - 33\
Estaleof VI~~"-- 'K u..)Q.'\::~ ,Deceased
Social Security Number: C\ - '?::,b- l..{ 4 ~ Date of Death: \ - ~q - 0 '1
AND NOW, (\. ~ L 5 AOO f . in ~o~ideration of the foregoing Petition, satisfactory proof
having been pres~fore m~, IT IS DECREED ~ Ll:.tters ~~, 'l'\A::)~~ II:N'"-
areherebygrantedto~ L ~~~...^k
in the above estate
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.
FEES
Letters ............... ~ /0. 0.::>
Short Certificate(s) . . . . . . .. s \( Q ~ 6U
Renunciation(s) .......... s~S-- l~
~CP ... siC> (~
~\~..s S-~60
... s
... s
... s
... s
... s
... s
... $
TOTAL .............. s~
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
Address:
Telephone:
Form RW-02 rev. 10.13.06
Page 2 of2
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~(.kl A/JN C. L.Lp_ 1 1\(51.\<<,t SI- g,ddw'lJ~vlllt IN r \30,1.1
Gt-kile-\le -f1wJ~'(~ 1\~~D~bl;", fL-H--dO/V I VA ),,0170
H10).80) REV 110)
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.
~t\.~~~..
Local Registrar ~
Fee for this certificate, $6.00
p
13310383
FEB 1 2007
Date
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VII.
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS )
CERTIFICATE OF DEATH r)/__nt)1
(See IMtrucllone end Bump'" on reve-l STATE RLE NUMBER ex u r:x.J
.. _ aI DoIlh (Monh. diy, jIII)
January 29, 2007
H1(J5..~43 REV ttl2OO8
TYPE I PRtIT ..
PEIlIWleNT
BlACK N<
Aug 15, 1938
Baton Rouge, LA
Olhor.
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68
7. "'''or
8b. CounIy aI Deolh
Cumberland
11.-'UouoI el _01 kOonol_
IClIldol_ IClIldol_/1ncUOy
Registered Nurse Nursing Home
. 1I.-.-.g_~IlIIy/-'_.zlp_'
506 Mill Race Road
Carlisle, Pa 17013
lid. FacIly_(IInol_gIvI_ondlUllborl
506 Millrace Road
OOlhor. Sl>IIlIIy:
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Pennsylvania
Cumberland
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South Middleton
Twp.
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Lee Walton
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Mary Ruth Stenken
2Ob._-.g_~IlIIy/-'_zlp_)
15 Countr Club Place East Carn Hill PA 17011
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lbUi.nger Funeral lbIe & CreoBtory Inc
Mt. IbUy Springs, Pa 17065
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Ronan Funerallble 255 York Road, Carlisle, Pa 17013
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RENUNCIATION
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REGI~TER OF WILLS
G lrl \ce n an. CkOUNTY, PENNSYLVANIA
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Estate of \j\''('0i'(\ ~ \{lA~
I, '/furhe,LAn., L7J?_
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, 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
~;e \ M. 0P'~K-
~/ III 2-007
(Date) I
~oO Q80--
i lUre)
?2a1d {)JlnsVI de. IV Y /30 Z 7
(Cily, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
-S:'fo,Ncb rN IH-G; Sr7.-::rE. 0/ N~-wy~t<.t
Executed out of Register's Office en..I ";"-f e fJl A
(J"-'CHJ ()~ "..-
Before the undersigned personally appeared the -
party executing this renunciation and certified
that he or lJfie)executed the renunciation for the
purposes s~d within on this / / TU day
of ~EK3~U A I<y . ZOO 7 .
[;{~~/(~
Deputy for Register of Wills
Notary Public
My Commission Expires:
/~/oY/C) y
(Signature and Seal of Notary or other official qualified to
administer oaths, Show date of expiration of Notary's Commission.)
FormRW-06 rev. 10.13.06
ROBIN e. tAMSON
Notary Public. State of New York
No. 01 LA5052839
Qualified in Onondaga County- 1.00'1
CommisSion Expires December 04._
RENUNCIATION
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
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Estate of '/1 ( (() n l CC WD- { n y)s' ~ti\ H;
I, bQJo G.e.ll Q... ~AQX ~ (~\ "<oJ ' in my capacitylrelaliooship as
~I'. ~\\ \ ~ I' (P~Name)
~~ "--'" of the above Decedent, hereby renOWlce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
,
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(Date)
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(StnJe~~$)
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(City, State, Zip)
Exeellted in Register's Offlce
Sworn to or affirmed and subscribed
before me this day
of
Executed out 01 Register's Office
Before the Wldersigned personally appeared the
party executing this renWlciation and certified
that he or she executed the renunciati~ for the
purposes stated within on this ~ day
of No...r~ , _ cR- .
t!eIL ffJv1rL:--
Notary Public
My Commission Expires: ~g{)i ~
(SiSJllllWC md Seal of Notary or other ofticiallp18lifiod to
lIdministor 0lIth1. Show d8tc of expiration ofNotary'l Canmialion.)
Deputy for Register of Wills
Fot'mRW-()(j rev. 10.13.06
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RENUNCIATION
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REGISTER OF WILLS
eu,^"" MrJahJ COUNTY, PENNSYLVANIA
021-oi-331
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Estate of
tJ/r 1/1'1 I~ 1< W0/-fO^"
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. ~eased
I,
jo not~Y\. ~r-b'n 5f/l'l
(Print Name)
5o~
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate ofthe Decedent and respectfully request that Letters be issued to
fA{\. Ie-I /""~r..j.-,n. Sf,'r f- ~-_
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(Signahne) ~.,. ~
\ ?>l ~ ~ d ;~1'\ DQ~ r A .
(Street .Address) -F---j
P/\ 17~Dl
3)-2/-,tJ7
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(Date)
~()\ \: V\~ c;rr'l~cy
(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 ren~tion for the
purpose stated within on this 0\ ~ day
of ~(1)'1-
Deputy for Register of Wills
N Public
My Commission Expires: II) I a 0 \ 'ao t ()
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
COMMONWEALTI1 Or ,JtNNSYLVANIA
NOTARIAL SEAL
KATHRYN E. BERILLA, Notary Public I
Boro of Carlisle, Cumberland County
My Commission Expires Oct. 20, 2010
.,_~______,__,__,,_.__,_,_"._n ___ ..~.,_,._
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RENUNCIATION
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REGISTER OF WILLS
(}um berland COUNTY, PENNSYLVANIA
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Estate of
I j, f
V Ir61(J(~
tvfh Wi IIoYt
, Deceased
I, -&nr;'(/tj P1I.(t~ 0t'rIC
(P t Name)
,~Yl
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
'~inister the Estate of the Decedent and respectfully request that Letters be issued to
.... IJdYu't I tJ1drfrft ,-frrl'- .
d~lJifl
/s thurrkf {!/Uh f/k.e 6d~f
(Streel Address)
(Ci~/:J;iP)4 1/(, /A- ( 7tJ//
).- )..to-07
(Date)
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
purposes stated within on this 2-trH day
of ft t!b.J A(tv 200-r
,
Deputy for Register of Wills
FormRW-06 rev. 10.13.06
(Signature and Seal of Notal)' or other official qualified to
administer oaths. Show date of expiration ofNotal)"s Commission. )
COMMONWEALTH OF PENNSYLVANIA
NotarIaJ Seal
PhlUIp D. ZimmeIman, NoIaIy PublIc.
Lower Paxton Twp.. DauphIn 0:lu1ty
My ConvnI8slon Elcplres Mar. 28, 2009
Member. Pennsylvania Alloclatlon of Notari..
.
RENUNCIATION
R OF WILLS
OUNTY, PENNSYLVANIA
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Estate of
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, Deceased
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
ecedent and respectfully request that Letters be issued to
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 renu~~~ the
purpo stated ithin on this day
of Qon .
Deputy for Register of Wills
Notal)j Public
My Commission Expires: l 0 I~ () \-ao lO
Form RW-06 rev. 10.13.06
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration ofNQWYi~Commission.)
COMMONWEALTH OF ;;'ENNSYLVAN
NOTARIAL SEAL .
KATHRYN E. BERILLA, Notary Pubile ,
Boro of Carlisle, C~mberland County
My Commission Expires Oct. 20, 2010_