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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
File Number 21-- O~ - (()~
Estate of James J Anderson II
also known as James J. Anderson
, Deceased Social Security Number
135-50-3308
JoAnne L Anderson
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/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 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:
00 B. Grant of Letters of Administration
(If applicable. enter: c.t.a.; d.b.n.c.ta.; pedente lite; durante absentia; durante mmonlate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following sR6Yse (if any) al1C81eirs: (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.):; 0 S:i
. " ;~2 c.
Name
Relationship
Residence
See attached schedule
0',
(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
5169 E. Trindle Road, Lot #21, Mechanicsburg, Hampden, Cumberland, PA 17050
(List street address, town/city. township. county, state, zip code)
Decedent, then 38 years of age, died on 11/06/2007
5169 E. Trindle Road, Lot #21, Mechanicsburg, Hampden Township,
at Cumberland County, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$
$
$
$
4,000.00
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:
^
Signature
Typed or printed name and residence
JoAnne L Anderson 4908 Shasta Way
Mechanicsburg, PA 17050
,r
/
I.
V
Form
Rev. 10-13-2006
Copyright (c) 2006 form software only The Lackner Group. Inc.
Page 1 of 2
.. ..
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
Signature of Personal Representative
Signature of Personal Representative
File Number:
21-- O~ -OO~9
Estate of James J Anderson "
, Deceased
Social Security Number:
135-50-3308
Date of Death: 11/06/2007
AND NOW,
~
, in consideration of the foregoing Petition, satisfactory proof
of Administration
are hereby granted to JoAnne L Anderson
in the above estate
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.
.~CP $
C~-t0~+1 (.\-.J
$
$
$
$
$
$
$
3o..{)0
QO . <.:U
I S- - ()O
;0. QO
S. G"O
Attorney Signature:
FEES
Letters......... ........ ..... ...... ...... ... ....... $
Short Certificate(s)........................ $
Renunciation(s).. .................... ....... $
Attorney Name:
Supreme Court 1.0. No.: 19475
Bogar & Hipp Law Offices
Address: One West Main Street
Shiremanstown, PA 17011
Telephone:
717-737-8761
TOTAL.......... .......... ............ .... $
'fID.i)Q
Form RW-02 Rev. 10-13-2006
Copyright (c) 2006 form software only The Lackner Group. Inc.
Page 2 of 2
". ..
PETITION FOR PROBATE AND GRANT OF LETTERS
(Continued)
CUMBERLAND
REGISTER OF WILLS OF
COUNTY, PENNSYLVANIA
File Number 21--
Estate of James J Anderson II
also known as James J. Anderson
, Deceased
Social Security Number
135-50-3308
Name
James J Anderson III
NOTE:
Relationship
Son
Residence
RD 1, Box 1238
Hop Bottom, PA 18824
Decedent, James J. Anderson, II, a/k/a James J.
Anderson was a single, unmarried individual at the date
of his death. The Decedent is the father of a minor
child, James J. Anderson, III (date of birth July 19,
2006 - age 1% years). The mother of the minor child is
Roxanne L. Fuller, a/k/a Roxanne Fuller. By virtue of
the death of the Decedent, Roxanne L. Fuller, surviving
parent, has sole legal custody of the minor child,
James J. Anderson, III. Roxanne L. Fuller, mother and
sole legal guardian of James J. Anderson, III, a minor
child, has renounced her right to request Letters of
Administration, said Renunciation being in favor of
JoAnne L. Anderson. JoAnne L. Anderson is the mother
of the Decedent. Jeffrey J. Anderson and Kimberly J.
Anderson-Sipe are the sole brother and sister of the
Decedent. Jeffrey J. Anderson and Kimberly J.
Anderson-Sipe have renounced their right to request
Letters of Administration, said Renunciations being in
favor of JoAnne L. Anderson. James J. Anderson, the
husband of JoAnne L. Anderson and the father of the
Decedent, died September 2, 1996.
RENUNCIATION
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REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYL VANIA
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Estate of JAMES J. ANDERSON, II, also known as JAMES J. ANDERSON , Deceased
brother
I, JEFFRY J. ANDERSON , in my capacity/relationship as
(print Name)
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
JoANNE L. ANDERSON, mother of JAMES J. ANDERSON, II, a)k/a JAMES J. ANDERSON
(Date)
~ig:1if~> '1 ~
307 South Shaffer Drive
~treet Address)
New Freedom, P A 17349
(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 renunciatjQp for the
purpo~~s. ~tated within on this /.:;; day
of~CliVlL( , '1.c{(Jr .
Deputy for Register of Wills
13 2a:.8
(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
S6MMblNWi:Al:tH SF j:leNNe~l\IAN1A
NO'fAFiiAL SE!AL
CH'.....ON R. KING, Notery Publlo
Weat Manchester Twp" York County
My CommissIon ExpIres Dec. 13, 2008
RENUNCIATION
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REGISTER OF WILLS
CUMBERLAND COUNTY PENNSYLVANIA
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Estate of JAMES J. ANDERSON, II, also known as JAMES J. ANDERSON , Deceased
I, KIMBERLY J. ANDERSON-SIPE , in my capacity/relationship as
(print Name)
sister
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
JoANNE L. ANDERSON, mother of JAMES J. ANDERSON, II, a/k/a JAMES J. ANDERSON
! . II . 08
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(Signature) I I
(Date)
1216 Kings Circle
(Street Address)
Mechanicsburg, P A 17050
(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 r executed the renunci ion for the
pu se t ted within on this day
o
Deputy for Register of Wills
(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
COMMONWEAlTH OF PENNSYLVANIA
NOTARIAL SEAL
SUZANNE M. DEDERER, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires Aug. 20, 2009
RENUNCIATION
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REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
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;21- Og -000<1
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Estateof JAMES J. ANDERSON, II, also known as JAMES J. ANDERSON
, Deceased
I,
ROXANNE L. FULLER
, in my capacity/relationship as
(print Name)
fiance and mother of JAMES J. ANDERSON, III, of the above Decedent, hereby renounce the right to
a minor child, being the only child of JAMES J. ANDERSON, II, a/k/a JAMES J. ANDERSON
administer the Estate of the Decedent and respectfully request that Letters be issued to
JoANNE L. ANDERSON, mother of JAMES J. ANDERSON. II. a/k/ a JAMES J. ANDERSON
I d- - d. 4 - 0 \7
(Date)
~Yh.~':~
(Signature) ROXANNE L. FULLER
R.D. #1, Box 1238
(Street Address)
Hop Bottom, PA 18824
(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 renunciation for the
purPB~~ :~ l~n on this .Q4 ~ day
of I' QDO'7
&-nhu- ~
Notary Public
M C .. E . NotarlalSe I
Y omml SSlOn xplres: Bonnie Phelps, NO:ry Public
~~= Boro. Susquehanna County
(Signature and Seal of Notary or other 0 1 iiIIon e~lre. June 7,2009
administer oaths. Show date of expirati . .. ary's Commission.)___
Deputy for Register of Wills
Form RW-06 rev. 10.13.06