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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~ ~......~ ~ et--~~UNTY, PENNSYLVAKIA
EstatelJ~a.'(.; \ ~- cy C. 'D "" lA "r-
also known J'
File Number
'1. \ 0 9;
boL\S"'
, Deceased
Social Security Number
Petitioner(s\ \\ ho is/are 1 S years of age or older, apply(ies) for:
(COMPLETE ',.(' or '8' BELOW:)
o .'~. Probate :llld (;rallt of Letters Testamentary and aver that Petitioner(s) is / ,\re theC-t.> .p ""J-'C: ,. - ~ "' ..." <::' ~ named in the
last \\ ill or'the Lkc;:(knt dated IS CL. {q (" 1 and codicil(s) dated ~ t:> "'\. ~
(State relevant circumstances, e.g., renunciation, death of executor, etc)
Except as follows, Decedent did not marry, was not divorced, and did not ha,;e 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.; db.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)r;iad heirs: (If
Administration, c.t.a. or db.Il.c.t.a., enter dale of Will ill Section A above alld complete list of heirs.) (; @
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Name
Relationshi
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(COi"IPLETE IN ALL CASES:) Attach additiollal sheets if lIecessary. ~ ~
Deceden~ was domiQkllat death in Gc........... ~.... '7~"t ~..lntv Pennsylvania with his I h.er last principai:;esidence at ~~ 00\.
.-:( .:J <--t. \.C),- ~..... \(L.c..c::- ~ ~-\: ~I... ~ '\ c:> \ \.....\ct ., "\. """T ~ '-1.
(List street address, townleity, township, county, state, zip code)
Decedent, then
-to
years of age, died on \" ~ L 4- "D c,.. at
\-\... \. 'L -S \,-..~.,,\- '\.....\",0"5 ~ ~ '"'\: ~\,
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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 P A) Personal property in County
Value of real estate in Pennsylvania
situated as follows: ~cA-~~""l",~<l. ~ Q --
$?<p DOe)
$
$
$
Wherefore, Petilioner(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:
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Fonll RW02 rev 10. /3.06
Page I of2
Oath of Personal Representatjve
COMMONWEALH! (iF PENNSYLVANIA
COU>HYOr
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ss
The Peri li<JI<:n; I ar.t;" ,,'-!i.tilled ;;'." c':li(S) Oi' /1:(I11(s) that the statements in the foregoing Petition are tme and correct to the best ot'
Lb<: ~d,)I), kd;!.e JI!J helid of Petitional 51 anJ thaI, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
~. (jJ~
ature of Persolla! Repres~ .
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Signature vI Persol/a! Representative
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File Number:
Estate Of~
;2.,1 0 ~ t13'fS-
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109 /'-1 qS~;(
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, Deceased
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Social Security Number:
Date of Death:
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AND NOW,
having been presented before me, I
are hereby granted to
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in the above estate
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 Decedent.
FEES
Letters ...... ..30,(j.j). .
Short Certificate(s) . . . . ~. .
Renunciation(s) ..........
-~
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$ tic
$ 2.Y
$
$
$
$
$
$
$
$
$
$
$
Attomey Signature:
Register of Wills
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Attomey Name:
Supreme Court LD. No.:
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Address:
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Telephone:
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Form RW.!!2 rev /0,13.06
Page 20[2
H!05.805 REV l!O5
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~~ .
No.
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Fee for this certificate, $6.00
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
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LAST WILL AND TESTAMENT
I, PAUL J. O'CONNOR, of 4639 Fritchey Street, Harrisburg,
Pennsylvania, do hereby make my Last. Will and Testament and revoke all
Wills by me at any time heretofore made.
FIRST: .I direct the payment out.of my estate of the expenses of
my last illness arid funeral.
SECOND: I give, devise and bequeath all of my estate, real and
personal, to my wife, Ann O'Connor, her heirs and assigns forever.
THIRD: In the event my said wife. Ann O'Connor, does not
survive me, then r give, devise and bequeath all of my estate, real and
personal, to my daughters, Sondra Petrasic am Janice Garrison, share
and share alike, their heirs and assigns forever.
FOURTH: I nominate. constitute and appoint my said wife, Ann
O'Connor, Executrix of this my Will. and I direct that she shall not be
required to enter security in any jurisdiction in which she may act. In the
event my said wife, Ann O'Connor. does not survive me, then I nominate,
constitute and appoint my daughters, Sondr-a Petra sic and Janice Garrison,
Executrices of this my Will, and I direct that they shall not be required to
enter security in any jurisdiction in which they may act.
IN WITNESS WHEREOF, I have set my hand and seal to this my
Last Will and Testament this day of October, 1967.
v~ hJ () I al-.-..----.--.t~RAL)
pa~. O'Connor
We, the undersigned witnesses, in the presence of the above-nam d
Testator and in the presence of each other. did hear Paul J. O'Connor decl e
the foregoing to be his Last Will and Testament and did witness the signing
of the same by him.
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OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
c::.. "'--. "" ~ <=- <t ~-z. L COUNTY PENNSYLVANIA
,
Estate of V......_ '--
o ' ~ D ...... -. c.:r---
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and
, Deceased
(each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well-
acquainted w~""" --<-'-. ~. b~ C- ~ ~ <L S-- and am/are familiar
with the handwriting and signature of the decedent, and that the signature oR -............ <-~
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
i~~-vL~ .-S- is in his/her own proper handwriting.
(t:.~ ~~
{325' A LTAV(S~ Av~ ,
(Street Addres!.j , .
M~.~;)? 50 tQ{, I P~t. L 7 Ll {
(Signature)
(Street Address)
(City. State. Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this _~ "-1 _ ~y
Of_~\ , llt'6 .
Form RW-04 rev. 10.13.06
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