HomeMy WebLinkAbout08-23-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS O~Uty) \yy \an('J
CaYb( L-\~Y\ Iu-v-nev
COUNTY, PENNSYL VANIA
Estate of
File Number
~\ 6"l D'lq~
also known as
, Deceased
Social Security Number I 8' ~ - 3 ~ - &- S'I ~
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
~. Probate and Grant of Letters Testamentary and aver that Petitioner~ are the ~ x: e ~ -t-o V"
last Will of the Decedent dated ~ 3 \ (:) '-' and codicil(s) dated ~ /A
named in the
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) r.'.J
(,2 5
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spo@ (if any) and heirs: (If
Administration, c.t.a. or d.b.n.c.t.a., enter date a/Will in Section A above and complete list a/heirs.) '.'::'8 E r
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Name
Relationship
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Decedent, then { f7 0
at MoyG. vi a..n
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(Ifnot 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:J9l S l\A Gel u y- cs Gap t2.J ~ II S l e. P A
$
$
$
$ ..'3 Y s;- ,Q::x::> ..we Ce~t)
,
t,()\~
(O~ ~9"-Cln Cc~J)
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
~
II S4a
hose Fbvr-es+
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cu..\'Y) bcr (O-h 0\
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.
~~:mi~
Sworn to or affirmed and subscribed
before me the
Signature of Personal Representative
Signature of Personal Representative
o
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Estate of
File Number: fA \ b'1 () rm
(' (1 Yb l1I' U r n cv--
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, Deceased
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SociaISecurityNumber:.\g~-3~- (P5"'l8' Date of Death: .;;l-11i..:> 1=,
AND NOW, ~ kv-,,-, I;). , .4fh 7 ~wmriderntion of the fo,egoing Petition, ,.Mactory proof
having been presented efore mlJIJJ.1 DE~:D thajLe(G J..e... J I!?r~~
are hereby granted to rp. \'. . / r
and that the instrument( s) dated IP j;lRjD l.f
described in the Petition be admitted to probate and filed of record as the last Will (an
in the above estate
FEES
Letters .. .3S5d~:/)... $
Short Certificate(s) . .( f:5.1. . $
Renunciation(s) .......... $
~ill ... $
..)tJ . . . $
A. rr() . . . $
... $
... $
... $
... $
... $
... $
TOTAL.............. $
qinQ 00
.;}O
Attorney Signature:
Attorney Name:
IS
10
S-
~
Supreme Court I.D. No.:
Address:
Telephone:
'"lID ~
FormRW-02 rev. 10.13.06
Page 2 of2
HJ05.805 REV 1105
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
Date
.\l)h~
Local Registrar
P 13151103
No.
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"\~I4J REV 1112006
rYPE I PRINT ..
PE~
IllACI<INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reve...)
1. .... 01 0eadInr fFnt. midlIt. l1li:, ....,
CAROL L. TURNER
..... (lMl_l
60
7. ..... and.... Of
LANCASTER, PA
6.OoIocl_(llonIII. . )
JAN. 5, 1947
Vos.
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LANCASTER
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BUSINESS OWNER VARIOUS RETAIL
16-'-.__cOyl__..._1
1925 McCLURES GN> ROAD
CARliSLE PA 17015
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WILLIAM LEROY FORREST
EDNA MAE JANSEN
2DLWclnrwlI'S......(TpfPrinl)
CHASE F. CARTER
2llb._'-.__cOyl__.._1
133 QUARRY ROAD LEOLA PA 17540
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COMMONWEALTH OF PENNSYLVANIA
NOTARIAl SEAL
GAYlE A. SPICER. Notary Public
City of lancaster. L.ancaster County
My Commission Expires Sept. 1, 2007