HomeMy WebLinkAbout08-14-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
COUNTY, PENNSYLVANIA
Estate of
(Ld.&' T ~;:;u~
FileNumber~ I-01-tJ7 &'-"
also known as
, Deceased
Social Security Number v~ - Y6 -.$ ~ 0
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 lare the
last Will of the Decedent dated and codici1(s) dated
named in the
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Except as follows, Decedent did not matTY, was not divorced, and did not have a child born or adopted after executio~'~~tiYstru~(S) ot'fr[red , )
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:'!:1? ~ ,. ' ,
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c(Jf applicable. en/er: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; du'raM~inoritate) N
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Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the followingJSpouse (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.) O't
(State relevant circumstances, e.g,. renunciation, death oj executor, etc.)
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B. Grant of Letters of Administration
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Residence
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(COlvIPLETE IN ALL CASES:) Attach additional sheets ifllecessary.
Decedent was domiciled at death in LV ~ k(\.~ \) County, Pennsylv3E.ia with his / her last principal residence at
Ct-P\"'~~l<I\tJ\J(l.~(t-JCf f...4.v"",.t2: . (t.oo CL/n'l..6rY'.:orJ\" "-.0. cI1YtLI~LL fA l'1t\j
(List street address. IOwl/lcity. township. county, state, zip code)
Decedent, then ~ years of age, died on t - ?. - D '''\
at C. Llrl p:.(I.4...!)fV r U V (lS l "'1 l-fc 1L't {2:" .
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
$ '38'72 -
$
$
$
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Lellers in the appropriate form to
the undersigned:
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Forlll RW-02 rev. 10 1306
Page 1 of2
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 con-ect 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
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Signatufe of ersonal Representative
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Signature of Personal Representative
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Signature of Personal Representative
File Number: ~ - C51-()tlolp
Estateof~ (J QD' ~
, Deceased
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Social Security Number:~- Lll()-Sl.::lD Date of Death: \ - ;;;; - () I
AND NOW, Cl.u. otr' ~-\:- 14- , doot , in conside;-ation ~fth; foreg~lg Petition, satisfactory proof
having been presented b~re-~e, ,IT. IS DECREED thay;,etters ~ X"Y\ , J't--l f:) ~ +1 Ory......._
are hereby granted to ~ ~ C<-. ts::Jg r if. _ _ i .
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record
FEES
Letters ...............
Short Certificate(s) . . . . . . .. $
Attomey Signature;
Attomey Name;
Supreme Court I.D. No.:
Address:
Telephone:
rQrm lUV-(]] rev. iO.i3.06
Page 2 of2
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This is to certify that the information here given is correctly copied from an original certificate of death duly filed with
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 photograp~ .
Fee for this certificate, $6.00
No.
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~LTHOFPENNSYLVANIA. DEPARTMENT OF HEALTH .WALRECORDI
CERTIFICATE OF DEATH
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1000 Clarenalt Rd.
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