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HomeMy WebLinkAbout02-11-08 o PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUtII\ e-et2.I..4N i) COUNTY, PENNSYLVANIA also known as Estateof ~N A..J(otl~~.\ File Number r2/ - or -- Qllj 7 .t' ,Deceased Social Security Number :1...0.3 - * - ~70~ PeTrr~ if ~4 ~~Nl 'l) ~ ~e.eS' (. ~- 4:;9 fWl ''l-:S-ir'''''-,I}.Jh:- VOw ('Ie )~l IE fiE. A · J"fc12. 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 (State relevant circumstances. e.g.. renunciation. death of executor, etc.) C) '-,;0 , :::0 ," -c, .' n j:....,;-~ .c:::., -r; ,--..> ~,.' ~amedjnJ ~ec! fR r";'j ( ) rr1 '", ;.c.2 e; '.".;. ~~) - 1"".1-" . C) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution oft~~~ offerelf ,. for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ' ~o E:.d ;~ --1 (./) ~. j ~ B. Grant of Letters of Administration o eJ: (If applicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) Petitioner{s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Ad tinistration. c.t.a. or d.b.n.c.t.a.. enter date of Will ~Section A above and com ete list of heirs.) /l /1 ':J. '7 0 . '. n.? (f4-.. Name Relationshi .. (J.. County, Pennsylv~nia with his / her last principal residence at !.E. . ~6 J /.@-i ~c ) r;,(? ~ ~ ~ Decedent, then '-t 1- years of age, died on f/lrr7Ib) ~<;. at Decedent at death owned property with estimated values as follows: (If domiciled in P A) 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 $ ~OO 1-/" $ ( $ $ \ -r;.cnl?:?1? . +/- . situated as follows: c.. v.u ,,~,.-t \..--l4.u0 r- <:::) v,c.rt- __I / 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: Si nature T ed or rinted name and residence ~~ vA~ i e:LL):: /j(l,tJ. aJ'?~ 7f5) ~ J.-.. Form RW.02 rev. 10./3.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PEN"NSYL VANIA SS COUNTY OF(A.l~~vt(Jy The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tme and con-ect 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. Sworn to or affirmed and subscribed before me the J (th day of \)!1YrJ j O/'v{f . )/)0 f fhiiJJlnJ, Q ~ or the Register "" ~0~K~ Signature of Personal Representative ,.... "-- ,.-~ :~;:o 7.-1'"') ;-'.......::1 r:=:-:o co .., rT1 m 'J \:J -,.. _.::.... W i l"::) C', Signature of Personal Representative -or'- ." , r"--" 1 ")'="-:";- -...... .... S(fJnature of Personal Representative --'- , ---I File Number: c:2{-D9- 0/'/7 Social Security Number: Date of Death: U<Ir( lk IdOOk:. AND NOW, <12Wg , in consideration of the foregoing Petition, satisfactory proof having been presented before e,. ~ .pECREED th. etters are hereby granted to --1X:L n I-e:..U c. Rr-,' () S-e r Estate of {\p , Deceased and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Dee ~ent. in the above estate FEES Letters............... $~~ Short Certificate(s) . . . . . . . . $~ Renunciation(s) .......... $ ;;;....~/OD 0f.P ~ '" $ 'Q:{)O BLtt5~ ... $ ,C),OO .. . $ .. . $ '" $ . .. $ .. . $ .. . $ '" $ TOTAL . .. .. . .. .. . .. . $ (m .(7) Attomey Signature: Attomey Name: M Supreme Court J.D. No.: J6 3/ J... Address: 6 J.-1i 8'Ce.f?-toJl/t c.t!..~~~ ;(12 C#c4<lVr 'c( i1 cviI~ r:lJ...) /OsD Telephone: 7r7 - 9'79~ Crylfo Form RW.02 rev. 10.13.06 Page 20f2 filn< "" ~cV III" ....., '.C;; 'ii' 7 , Th~s to certify that the information here given is correctly copied from an original certificate ci' ~leat~ duf; ~ed 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 photogra~~. No. r Fee for this certificate, $6.00 p 12496178 ~- -;)~-c::>~ Date C::? ..., fAt~~ G:J v H1CIl144AEV._ ~IPIWlTN ~ #30-247 t._,,_lfiol,_....-*l John 5..,........ 42 ~ ~ COIUIONWEALTHOf PENNSYLYANIA . DEPARTMENT OF HEALTH .YITALRECORDS CERTIFICATE OF DEATH (CORONER) (,.) A Koveleski YII. I 0. ... March 2,1964 ... ~".... .' Cumberland T... C1f1- \ fl'lL 230ccnr_ ....... _.noI_...."_" ..wy-,,- _~lI_bo_"'_ ....-- :II _~~ 25.o._000dI_dor.,.., May 23, 2006 CAuse 01' DUTIl'" _..... ........, "'11. PARTt -.._._........--....-._.._.OOHOT____.__ ""*'""'-..----...oIoDiw.UoI...__GII_... ===-...;. a Asnhvxia 0.. II tot.......... all: . Suffocation by Plastic Bag 0.10 tar........... oft: " :II w.c.._,,__,Caaow""._OIw"'~.._ .Y. ~ ~__ ,...:Erwalw........UI'IItiIfIrw..................IIII..... .. DidTobc:oU.~>>O"1 CQot"OoIII ...noI.-.g"..~_giIon"....,. -0 Y. 0........, 0- 0- lI.!fr* 0...._-.,.. .1 0 PIogon. ...,,- .0...._..._-0..... ,,- 0:-.=-..._03....."1,.. '-'--".'" 32< _",..,,_ __F-,. bag over head ca.=e"'~ _ l.GI:IIGII""(Soool.",,__, Neponsit Lane, Camp Hill, PA e;:&"-...r. .CIIM......... _ _YIlI~ =-..:.=.':...~ o...lOf..~af): .....,( t. _"000Il 0- 0- 0- 0,...,.......... 1Il- 0 Couil....bo__ 33a ~(dloclcnr"" . . CIllIWIaI"'-~COIIIIlOlI-"--__"~_"'_""23).. .., T. ....-"............--......_,..._.IlIlIjI.. __ _ __ _.. _.. _ _ _ _ -.;oIit:' _ _ _ _ _ _ _ _ _ _ _ _..0 =:=."::"..:=::..::::..-::=::-...:..-:...;........ _________________..0 33c~_ - ,e.- 011...._" o Y. III- .. 300.w...~ - D. _~I'lnqa --,,~ "c-"..... o Y. 0 No Coroner I ~ J 35. ~ RENUNCIATION REGISTER OF WILLS Lv,l,( r1>~ Li4lJ/) COUNTY, PENNSYLVANIA J 1- Og - 0/ t/7 8 -0 :i;~ 1--- - r-...:> ,= C::l 0::> .., rrJ c::o i 1_,1 :.,r) , : , v :31: -,-I :::.j W Estate of -reo H N It ~ J~ VeL e ~ t<r " a u , beceased I, JI\ L C {-\. e L<( S' (S ~ e rf:int Name) k () M ~ R. * , in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to M.y 5' i $.-re.o 11 1! N 1 ~ LL e> I . t:>~lf\J,S~ ~ ~c"'.Y/&C>08 (Date) m/I!~t#l '!/(thrJlAC (Signature) ~\ W~5:rt Mo (be~~'-J St-. Ae~~s). '3 D , .Ll / ~~ 'rt-M~ 1<- ft0 . f~ ~- \ (8"1 J (City. State, Zip) J ' 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 purpo es stated within on this I -f day of 7 ('?)o ~ l{~- Notary Public My Commission Expires: 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 Betsy M. Holdren, Notary Public Coal TWp., Northumber1and County My Conmission Expires Aug. 20, 2009 Member, Pennsylvania A.soclatlon of Notaries RENUNCIATION REGISTER OF WILLS Cll,lt\~~ COUNTY, PENNSYL VANIA J / - ()9 -- (JIll 7 ~~~ c.:.;:l c:J ." ", co 'J) v w Estate of Jot\tJ U<o\l<2.l~\'t I'~I.}~Se ko~,~ (Print Name) 9-i S'~ o u, , Deceased , in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~ 5'Cf~L, 1:UrN €- \ te (j'ltl:"-S ell. ~~~ '.1lirJUA-rYL /4 ,J~()? (Date) T ' (Signature) i2;~is) tJYR s tQl) A V 8<.1 M AA.eJs~ w 1.) &~.J 70 ;3 b (City, State, Zip) I 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 purposes stated within on this / Aj '11J day of JJ:trJ U If I<- Y , ~"():{ ~~~ 4,f5~ Notary Public ' . f My Commission Expires: 0 l/ 0 7/ ~()CJ / (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission) Deputy for Register of Wills Form RW-06 rev. 10.13.06 COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL PATRICIA A. BOYER, Notary Public Oerry Township, DBuphin County My Commission Expires July 7 2009 ..........-...-...--"'--, RENUNCIATION REGISTER OF WILLS (2;1-1 M~0l?1.~D COUNTY, PENNSYLVANIA 01/~Df -- oltj7 o -r: 1 ~~ r"l -i" C") . ; 1-'- r r_~ r'..... c::-o ':-:..::; 0:::0 -T1 ri."l OJ 'J , c/) /.:::: -0 Estate of :.-J ,- ---i w -TeD}\t0 4.> 1<0\1<2 \<2,~ k.1 I, Cu<; f/O\JQ. fe., kl. l..1.~ .~ ----kJ ~~ c:; <{Deceased , in my capacity/relationship as of the above Decedent, hereby renounce the right to 2JcRfllk- c2Y f~tl7 (. ate) 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 pu ses sta d within on this Q4~ day of ~O~ Deputy for Register of Wills (Signature and Seal 'lfNotary 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 JennIf8r L Harper, Notary PublIc LOwer Palcm 1\t4:).,1Jeuphh CcuIty My Comnllseb, ~ Feb. 3, 2008 Member, Pennsylvania AlIIOCIatlon Of Notaries RENUNCIATION REGISTER OF WILLS CV to{ ~Q)..LfJ. f'J ]) COUNTY, PENNSYL VANIA 21-0~ -DIY7 o c;o <,,~~ r--::> C~ ::;:; ......., '"'"I Co (. . " ....;.. Estate of ~~ A -- ~v~l~s \~t ::'~{h;e:),~:tr- ~^JloUu. > ,;:? of the above Decedent, hereby renounce the right to , _.nl ....-=1 c..) o ,qJ)ieceased , in my capacity/relationship as administer the Estate of the Decedent and respectfully request that Letters be issued to d"'- / <;.(>-~~ VtJ-v~} Ie f/J rQJ (V SU . Q\ -3l-~ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Executed out of Register's Office Deputy for Register of Wills 0; Form RW-06 rev. 10.13.06 (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COM EAL H OF PENNSYLVAN A Notarial Seal Patricia A. Gordon, NoIaIy Public FaiIviaW Twp., York County My Commission Expires July 31, 2009 Member, Pennsylvania A&8ocIation of Notaries ~ h I tA.. P (" - REGISTER OF WILLS <; U ~I!(.!~. COUNTY, PENNSYLVANIA c.u/'l'\. eY' QhS' D/</7 r{) I -0 - . RENUNCIATION f'--,) '=:;:;:'I (:-"~~ i,:::':-::l -" Pi CO '-..,-) C'l (.-.) Estate of ~ot\-J0 '(\. ~O~e Ie.:>> Ki 'J a (.i; , Deceased I, S- ff(t(l) JJ ItIrJ fl- , (Print Name) <;; l S~JL 51tlflO~ , in my capacity/relationship as of the above Decedent, hereby renounce the right to ~/ , Jr1n [,((l ~ (Date) 4/ 2008 E:c:ecuted iii. Register's Office Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciatij>I] for the purpdses stated wi hin on this TIJ y n of JQ f' , {) , ~cc.- 0 .5 ~ o~ ~ ~ 0,<- 0 ~ ~~ i No Publ, , .1. / IJ/) /t1 :: ~ ~~ ~M omm' sion Expires: jIJ/b/C/) /j ,g ~Z;;! Ci ",,-6" ~ ~ ::X:(S~at~e~ 'il~WiII1~ty~WIwtWfil~( ~.- ~~ ~~ltl'~t!'6f~M~1>rmrarYr'c .on,) _ c_ . ,_ tD OJ V'J... ,..._...~...~: ':',....''r',;.:.~ . ." C %1""1 ..;; I'I\lDJl'1'V 012 ftAUPHIK .~~.7.1{{'i;:. ," o'g.s.> Z \AlU1l1J. F 11ft ~_'~'_'>"'::~'" (') -' I>> r- :z ~:2_ (J) ~O'< -< - 0"1:1 !C ~S g. ~ 0':< ~ S Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06