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HomeMy WebLinkAbout06-10-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Chad Michael Derr also known as James D. Derr Deceased COUNTY, PENNSYLVANIA File Number _ ~~ ~(1(D - ~~ 7 V Social Security Number 188-64-9320 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ~, ~? ° -= A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~ ~~_ na~i~l qtr-;lte last Will of the Decedent dated and codicil(s) dated '-`; ~ c7 ~ ~ ~-, ~; -- C"3 C~ 7cs (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ "i t rjC~ "_.. ,.r~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of tai instrume~n (s) of~eied-~> for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~" B. Grant of Letters of Administration (If applicable, enter: c. t. a.; d.b.n.c.t.a.; pendente life; 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 Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Relationshi Residence Sylvia B. Derr Mother 69 Caravan Court, Middletown, PA 17057 James D. Derr Father 2039 Eshelman Street, Middletown, PA 17057 (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 10 East Green Street. Shiremanstown, PA 17011 (List street address, town/city, township, county, state, zip code) Decedent, then 35 years of age, died on March 5, 2006 at Holy Spirit Hospital, Camp Hill, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 100,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania g situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the gant of Letters in the appropriate form to the undersigned: ~/a, _ I I I. O _ . _ ~ 2039 Eshelman Street, Middletown, PA 17057 Form RW-02 rev. 10.13.06 Page 1 of 2 r Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS 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 affirmiied and subscribed befo a me the I ~' day of '-B F r the Register ~~ of Personal Representative Signature of Personal Representative Signature of Personal Representative F -fir i© ',_~~ ~.J C Cs /n~ /~ FileNumber:__ v'•~~,-.b~Q oj~~V ~ Estate of Chad Michael Den ,Deceased r:._"; :. Ca` C''~ '- -i "=7 ,,_. .a C i ... _ _._t l Social Security Number: 188-64-9320 Date of Death: March 5, 2006 AND NOW, ~ ~ ~,Q _ . ~~, in consideration of the foregoing Petition, satisfactory proof having been presented before m , IT D CREED that Letters of Administration are hereby granted to James D. Derr 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)) o Decedent. FEES d $ ~ ~ Register of Wills Letters ........ ~• Short Certificate(s) ........ $ ~ Attorney Signature: 1/lN~~ Renunciation(s) .......... $ Attorney Name: Victor A. Neubaum ... $ • • • $ Supreme Court I.D. No.: 29159 ... $ Address: 42 South Duke Street ... $ • • • $ York, PA 17401 ... $ ... $ " ' $ Telephone: (717) 843-8001 ... $ TOTAL .............. $ ~ y 9~9A ~-~?~ i C~ Ca~~ Form RW-02 rev. 10.13.06 Page 2 of 2