HomeMy WebLinkAbout12-14-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
Estate of Michael J. Grassmyer
also known as
CUMBERLAND
COUNTY, PENNSYLVANIA
File Number 21-07- /13}2-
, Deceased Social Security Number
198-56-2715
John I. Grassmyer
Petitioner(s), who is/are 1 B years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
o A. Probate and Grant of Letters Testamentaryand aver that Petitioner(s) is/are the
last Will of the Decedent, dated and codicil(s) dated
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 bom 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:
00 B. Grant of Letters of Administration
(It appllcaOle, enter: c.t.a.; d.O.n.c.t.a.; pedente IlIe; durante aosenba; durante mlnorllate)
Petitioner(s} after a proper search haslhave ascertained that Decedent left no Will and was survived by the following spouse (if any) a,.Qg heirs(I'
Administration, c. t.a. or d.b.n.c. t.a., enter date of Wilfin Section A above and complete list of heirs.) 0 c=
,'- =
',~ C) -.A
Name
Grassmyer, John I.
Relationship
Father
Residence
75 Pine Street
DiIIsburg, PA 17019
75 Pine Street
PA 17019
.s::-
Grassmyer, Judith A.
Mother
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his / her last principal residence at
9 Terri Drive, Carlisle, PA 17013 (South Middleton Township)
(List street address, town/city, township, county, state, zip code)
Decedent, then 47 years of age, died on 12/02/2007
at 9 Terri Drive, Carlisle, Pennsylvania 17013
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:
"7
4.5" Ov
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 fonn to
the undersigned:
Signature Typed or printed name and residence
John I. Grassmyer 75 Pine Street
Dlllsburg, PA 17019
717-432.3993
l,;
Form
Rev. 10-13-2006
Copyright (cl 2006 form software only The Lackner Group, Inc.
Page 1 of2
Oath of Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
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 this J '-! th day of
l::feun hr.! , )W 7
J'YlIlibtlVlP Q (t&_
F~e Register
/~~A_~-;<;"ssmY.'
~'
Signature of Personal Representative
Signature of Personal Representative
File Number:
21-07- J L~2.,
Estate of Michael J. Grassmyer
, Deceased
Social Security Number:
198-56-2715
Date of Death: 12/02/2007
AND NOW, I
, Q}')(y) 7
, in consideration of the foregoing Petition, satisfactory proof
are hereby granted to John I. Grassmyer
of Administration
and that the instrument(s) dated
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent.
in the above estate
FEES
Letters........ .................................. $
~ 'JjJ . or)
40.00
5.00
)D, DO
5. (X)
MJ7da (qOA~iPIJL6kxw~if/}er
-~ .p ~ ---'
AttomeySignature: ~ ~ _
Short Certificate(s)........................ $
Renunciation(s)...... ....................... $
~p $
~$
$
$
$
$
$
$
$
Attomey Name:
Brian C. Linsenbach Esq.
Supreme Court 1.0. No.: 87360
Address:
124 W. Harrisburg Street
P. O. Box 310
DiIIsburg, PA 17019-0310
Telephone:
717-432-9733
q() . DD
TOTAL.................................. $
Form RW-02 Rev. 10-13-2006
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 2 of 2
nJV.l.OU.J ~v (UJ/U7)
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 13960165
This is to certify that the Illfomlation here given is
correctly copied from an on ginal Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filin .
C 1 0 2 07
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Certification Number
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TYPE I PRINT IN
PERMANENT
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1131-153
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See In.tructlon. end example. on reyer.e)
1.~oI~(F"l.mGIe,laIl.tuIlb:l
Michael
S.~rLaSlBw1hda'f)
47
April 17, 1960
STATE FILE NUMBER
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December 2, 2007
J
Grassmyer
5. Date 01 8ir1h (Month. ,year)
8b.CounryolDNlh
Cumberland
9 Terri Drive
Oc""".Spoo;fy
10. "-: AINrIc::an lrdIn. ---. ~ lie..
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11.OIardenrsUsull mosIoI ..DDnalNtl
K"f'ldolWtlrlr Knfol~11nllIIlry
Supervisor Manufacturing
. 16 Dtc:edenrSMailingAdlhs&fSlreet.cily/loMl.IIa,-.zipcodel
9 Terri Dri ve
Carlisle, PA 17013
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Actual RMIdInce 171. Slate
Pennsylvania
Cumherland
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Judith A. Harbst
2(b. 1nfomwl('~AddmlI9net.dtJfblWl. .....,,.codtl
75 Pine Street, Dillsburg, PA
21(. Pleceol~ lNamtol~,crwneJoryorOlliJtplKll
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10 N. Chestnut Street, Dills~ur ,PA 17019
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December 6, 2007
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6375 Basehore Roadr Suite 111
Mechanicsbur PA 7050
J / ~ 07 -11.3:L-
RENUNCIATION
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of Michael J. Grassmyer
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I, Judith A. Grassmyer
(Print Name)
in my capacity/relationship as
Mother
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
John I. Grassmyer
IJ!..- 13-.z~(J7
(Date)
75 Pine Street
(Street Address)
DiIIsburg, PA 17019
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me thi~
of
day
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he she executed the renunciation for the
purpo s stated within on this / ?tJlday
of /)'YJh~ ;ZOO.
Deputy for Register of Wills
(Signature and seal of Notary or other official qualified to
TH PENNSYLVANIA administer oaths. Show date of expiration of Notary's commission.)
NclIIIlIIIeII
JlnIts. Oore, NoIIry NIle
DIIbuIg 8010, Yolk COWtlr
M,n........ E,.ne Oct. 25, 2010
MeMber, ~........ AnoclIIItIon of Not8rIM
Form RW-06 Rev. 10-13-2006
Copyright (c) 2006 form software only The Lackner Group, Inc.