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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF (I" \"\1\ .b ~ ... / a. ~ J COUNTY, PENNSYL V ANt-\
Estateof R ClSa.Z f../lo. #1. ,To-c...k.:sO"v\
also known as
File Number ~ /-()g-(J{JcQ 7
, Deceased
Social Security Number /..57- l. Y - Ps-9.s-
Petitioner(s), who is,'are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
rK1 A. Probate and Grant of Letters Testamenta? and aver that Petitioner(s) is I are the
last Will of the Decedent dated /-1'1 /9''1' 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 born or adopted after execution of~ instl1lment(~ffered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ n ~
o~~ :::0
": 1:)
';~p
'7rr.
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; duran,Ie.-ffi1lO"fki!e) 0)
Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following sP~Ii1i~y) a~eirs: ':(I/-~
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. (~__:
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Reside';ce
o B. Grant of Letters of Administration
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Name
Relationship
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
D cedent was domiciled at death in
W' E f" r( J. .' .
(List street address. townlcity. township, coullly. state, zip code)
.d
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Decedent, then 9S
years of age, died on I ~/ /R;/ 07
at
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
) 3 9 I } 2.. J ~ 2..4
$
$
$
$
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 Letters in the appropriate form to
the undersigned:
Fonn RW-O] rev 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALn! i)F !)ENNSYLVANIA
SS
COUNTY OF
The Petrti')I;<:r<:; 1:11:-.,,\ '>!Ui'ld ~'.'.<:~lI(S) llr ~l 'Till11(S) that the statements in the foregoing Petition are true and COlTect to the best of
lh,~ ki1()\;, !Geist: Jnd belief of Petitiol1l'li S) Jnd [h:lt, as personal representative(s) of the Decedent, Petitioner(s) will well anci truly
administer the estate according to law.
,g",,~ S'g''''''""[P",,,,,,1
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Sworn to or affirmed and subscribed
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,dore me the" ,0' . day of
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AND NOW,
having been pres
are hereby grante
File Number: (-1-1 -()e - {fl.Jdl
Estate of liZo~o.... 2.~\ \(A.....- (Y\ ,-\QC.k..s~
, S 9 - J. ~ '- ~sqs Date ofDeath / J. / 'f . D7
, ~OO t , in consideration of the foregoing Petition, satisfactory proof
before me, IT r. ECREED that Letters ~ -;;'T f\ ME: NTA IU.(
Th()~ 1.t...'J,:J\.Llc.SOY'\ Il:n",~ l Sc..J'~\(.t- SCv\(hc,-.j ~fUJ..A-'-
in the above estate
...; cr3 ;:.::
')00
'~)"'n
c:
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:o.-j
~_l>
0:>
\:J
....,.
-
I.. -,;
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CJ1
, Deceased
and that the instrument(s) dated \ - \ q -lq ~q
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) ofDeced nt.
Short Certificate(s) . . . . . . . . .$
Renunciation(s) .......... .$
~~ $ IS,au
dcp '" $;0 .cD
~~ *. \lr--.-. ..$ S. 0V
$
$
$
.$
.$
$
TOTAL.............. $ 'S3D. oD
FEES
Letters
$ ~O .l)O
'-to. o,;j
Attomey Signature:
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Attorney Name:
Supreme Court 1.D. No.:
,"
Address:
Telephone:
Form RW-O] rev 10.1300
Page 2 of2
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
c,'IJ..JrJ b,;) tJ.-(f COUNTY, PENNSYLVANIA
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Estate of
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JjCl-~'r V lAJ. ~c--;;<L.I/1A and Lf:otMlL~ UJ. LJ e.-JSt/!1
(each) bein{duly qualified according to \aw, depose(s) and say(s) that she / he / they was / were well-
acquainted with RI7~IL'1.p II (A yY,l. J CL-c..k~~t.'J and amlare familiar
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with the handwriting and signature of the decedent, and that the signature of RL1~a;ld-l, &.-
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of~.s tAl Xl. /1 tf-..... /Y),
J h~-h ?dV\ is in his/her own proper handwriting.
7/<.Ei/o \..E / ?&. /9'C{S- ~
(Ci(r, Slate, Zip)
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~J 0 !IJ I jJ /~ c; Dt-I tt~ 1< oJ
(Street Address) , I
~~ 1f7/)8-.tn5 b~J PI) /7),57
(' ity, Statf. 7pp) .
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1ti~ t{), y,~
3~o4i CJ/E5/;VVT )'I've,
(Street Addres~)
Executed ill Register's Office
Sworn to or affirmed and subscribed
beFfle, me this ~ day
f , f"lOO'R .
0' Ale; ex!-
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Form RW-04 rev, 10.13,06
LAST WILL AND TESTAMENT
I, ROSAZELLA M. JACKSON, of 84 West King Street, Shippensburg,
Cumberland County, Pennsylvania, do make, publish and declare this as and for
my Last Will and Testament, hereby revoking and making void any Wills by me
at any time heretofore made.
FIRST:
I direct the payment from my estate of all
my just debts and expenses of last illness and funeral, as soon as this con-
veniently may be done.
SECOND: I givE> aRQ e8EJ.1:leath tIlt:: sum ot. P.i~nd
DQ].lars.-~,OGO.gg) tg CUMBERL.\NI> V..^..U.EY LOBBE F &: A 11 NO. )15. Elf SI.lppenslilltg
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P~Uilyl".-a~._.lY 111-" -J
Efi1Iu...__aH.t -;::d.
T~Oft88N. L~ '8 a~4e4 bu Lheir
of uOJ
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~ ~gjl~...~ ~*l~-;OO7--to-"elfM'IHi'R"'fAlnrTT^TTRYn()Rr... 69S1H?kNJ.\ vi 5h1pPt::us~,~,
~a. in ;~d~:l~) ~,;~ Jl~Kj?~~~~~, .
FOURTH: I give and bequeath the sum of One T ousan
TlHR.D.;
~.=l. Q:ivE> ",~..1 bt::l.l.uei:1~ .1,... "'"m {"If' linE> 'L:J>/mt<'aftd
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Dollars ($1,000.00) to each of my grandchildren living at the time of my de-
y
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mise.
FIFTH:
I give and bequeath the sum of One Thousand
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Dollars ($1,000.00) to my two sons-in-law and to my one daughter-in-law.
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SIXTH:
I give, devise and bequeath the rest, resi-
due and remainder of my estate, whether real, personal or mixed, of whatsoever
nature and kind and wheresoever situate, in equal shares among my three
children, DONNA LEE SCHENK, SANDRA JANE WEAVER and THOMAS W. JACKSON, or unto
the survivors or survivor of them.
SEVENTH:
The interests of the beneficiaries hereunder
shall not be subject to anticipation or to voluntary or
until distribution is actually made.
involunt~y alie~ion
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EIGHTH:
I direct the payment by my Executors out
of the principal of my residuary estate of all inheritance, estate, transfer,
succession and death taxes, Federal and State, and any interest or penalties
thereon, payable by reason of my death.
NINTH:
In addition to the authority conferred upon
fiduciaries by law, I authorize my Executors to retain any real or personal
property pending distribution hereunder, to invest in or purchase any property,
real or personal, without restriction to legal investments for fiduciaries,
to distribute property in kind, to compromise claims without Court approval
and to sell any real or personal property at public or private sale.
TENTH:
I nominate, constitute and appoint my
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children, DONNA LEE SCHENK, SANDRA JANE WEAVER and THOMAS W. JACKSON, or the
survivors or survivor of them, to be the Executors of this my Last Will and
Testament, to serve without bond.
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IN WITNESS WHEREOF. I have hereunto
set my hand and
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seal to
this my Last Will and Testament this /7
198 q .
day of
A. D.
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(SEAL)
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Signed, Sealed, Published and Declared by the above-named Tes-
tatrix, ROSAZELLA M. JACKSON. as and for her Last Will and Testament, in our
presence, who, in her presence, at her request, and in the presence of each
other, have hereunto subscribed our names as witnesses.
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Address
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