HomeMy WebLinkAbout07-01-08PETITION FOR PR~OBAT/ E jAND GRANT OF LETTERS
REGISTER OF WILLS OF [ [tM~Cr nano! _ CC)UNTY, PENNSYLVANIA
Estate of O t Y I~ File Number ~ I "o V
also known as O t G t t ov/
.Deceased Social Security Number ~~.7 ~Jr'o`I "~L `T ~n
Petitioner(s), who islare 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 = t Ct-~¢ r' named in the
last Will of the Decedent dated Fib.:!0 t ,SOD ~ and codicil(s) dated f b ,70 t o?001
(State retevm~t circumstances, e.g., renunciation, death of executor, etc.J
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution oflthe instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: WQS dIVOYC~ 7~'~ 1a?00]
^ B. Grant of Letters of Administration
(!f applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente tire; durante absentin; durm~te n:iaoritate)
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t ' „(G"QtKPLL~ IN
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Decedet~was
(List street
town/city, townsdip, county, state, ztp code)
,Pennsylvania with his /her last principal residence at
Decedent, then ~ years of age, died on 1 l O$ at Leaano n VA tt6S~J tit
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ ~FpOb • O ~
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania /~ $
situated as follows:J~~r r1PCY ]ru dC, ~ersonal CheckirlQ AeC~
Wheretbre, 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 T-y7 ed or rioted name and residence,
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Forst RW-01 reg. to. t3.o6 Page 1 of 2
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: (lf
Adntir:istrat~n, c. t. a. or d. b. n. e. t. a., enter date of Will in Section A above and complete list of heirs.)
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Oath of Personal Representative ~~ ~ ~ `' ~ "~` ~`~' ' ~~~'~
COMMONWEALTH OF PENNSYLVANIA Z~~~ JUL " ~ PM I~~ d6
SS
COUNTY OF C~,lmk~rl~r~ P ~~Rli Or
The Petitioner(s) above-named swears} or affirm(s) that the statements in the foregoing Pe,Ei ~ct~to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s)iwil~ wel~and truly
administer the estate according to law.
SWJCI7 ±o or• aff rmed and subscribed
before"~me t1he ' S~ day of
c A rll~.1 Z~Y
For the Register
-~
Signature
Representative
Signature ofPersorral Representative
Signatzu-e of Persona! Representative
File Number: Z ~ ' ~ ~' / Q
Estate of Ro~P / `. ~ 1 ~ ~o,tn// ,Deceased
Social Security Number: „~ I3 ~~~ ~ ' ~~ 7 ~ Date of Death: ~r ~ ~ t ~~
AND NOW, J u ~ ~/ ~ d QS , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters B-F ~ e S~4 rr~ P n-~ r
are hereby granted to l i ~aT BU r k~`
in the above estate
and that the instrument(s) dated /z6~ „7d, b2dO I
described in the Petition be admitted to probate and filed of record as the last Will (and C:odici'.(s)) of Decedent.
FEES
Letters .. Z ,d0~~: CK? $ ~~ ~ 0~
Short Certificate(s) ..J...... $ ~2..d0
Renunciation(s) .......... $
1 \ ... $ ~S~~O
~- ... $
~.~ ... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ l~ Z l7~
Attorney Signature:
Attoney Name:
Supreme Court T.D. No.:
Address:
Telephone;
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Pornt Rwtlz rev_ lo.l3.oh Page 2 of 2
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Regisrer of 4f'i!!s
LUCAL REGISTRAR'S CERTIFICATION ®F DEATH
WARNING: It is illegal to duplicate this espy by photos~at or photograph.
Fee for this certificate. $E~.(l0
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Thiw is to cel~iiy° that the information here gi~~en is
correctly copied from an original Certificate of Death
duly tiled with me a., Loral F:egistrar. The original
certificate wit? 4~e lorwarded to the State Vital
R Ards nff~ ~~ ~I_)r rma gent filing.
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_ ul Rc~i h~ai Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTh1 • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) __.__ _ _ _ _ __ '~ 1 ^G ~Y1 f
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~~ EVAN J FREEDMAN D.O.
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L BANON VA. MEDICAL CENTER, LEBANON, PA. 17042
/ PsposngnPerm9NOr J(~l/~7( ~,J
_ ~ ~Q LAST SILL AND TESTAMENT
0. ~o~ OF
- ~ ~- ROGER L. DILLOW
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I, GER L. DILLOW, of Stewartstown, York County, Pennsylvania, being of
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sound mind, memory and understanding, do make, publish and declare this as and for my
Last Will and Testament, hereby revoking and making null and void any and all Wills
and Testaments and writings in the nature thereof by me at any time heretofore made.
ITEM 1: 1 direct that all my just debts and funeral expenses be paid as soon after my
demise as may be convenient.
ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situated, whether it be real, personal or mixed, including property over
which I have a power of appointment, I give, devise and bequeath unto Suann F. Dillow,
absolutely, provided she survives me for a period of thirty (30) days.
ITEM 3: Should Suann F. Dillow predecease me or fail to survive me for a period of
thirty (30) days, or should we die simultaneously, Ithen give, devise and bequeath my
entire residuary estate unto Tiffany B. Dillow, absolutely.
ITEM 4: I direct my Executor to pay all inheritance, estate, succession and legacy taxes
of whatsoever nature and kind, to which my Estate or the transfer of any property passing
WITNE
T ~ r ROGER L. DILLOW
~. ~
hereunder or otherwise passing by reason of my demise, maybe subject and to charge
such taxes against my residuary estate, it being my intention that none of the aforesaid
taxes, either federal or state, on any property required to be included in my gross estate,
under the provisions of any state or federal law now in force or hereafter enacted, shall be
prorated among the persons interested in my Estate to whom such property is or may be
transferred or to whom any benefit accrues.
ITEM 5: I appoint Tiffany B. Dillow as Executor of this my bast Will and Testament.
ITEM 6: I direct that my Executor or her successor shall not be required to give bond for
the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ ~°
day of ~~~~~~ ~''-} , 2001. ,_
GER L. DILLOW
The preceding instrument, consisting of this and one other typewritten page was on
the day and date thereof signed, sealed, published and declared by ROGER L. DILLOW
the Testator herein named as and for his Last Will and Testament, in the presence of us,
who at his request, in his presence and in the presence of each other, have subscribed our
names as witnesses hereto.
%~1~d9
~~.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF YORK
We, ROGER L. DILLOW, - ~ ~ ~ K. ~ ~ ,and
>~, C - ~-, bbl ~. ,the Testator and the witnesses respectively,
whose names are signed to the foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testator signed and executed the instrument
as his Last Will and Testament, and that he signed willingly, and that he executed as his
free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testator signed the Will as witnesses, and that to the
best of their knowledge, the Testator was at the time eighteen years of age or older, of
sound mind, and under no constraint or undue influence.
~;
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t~C~GFR 1L,. DILLO~~"
SWORN TO AND SUBSCRIBED
BEFORE ME THIS ~~ DAY
OF / ~t?r'V'4t l , 2001.
' ~ ,,~~. (SEAL)
NO'CARY PUBLIC
~....~..,~_v___.....__~....._....._ . _ .
Notarial Seai
~ricki L. Boca, Noiary F'u'o;::.
Dover Boro, York Ccuni~r
My Commission Expires Gci. ?3; ;_ ;
Member. Pennst~l~,r~nia~"ss~~~,: