HomeMy WebLinkAbout10-10-08 (2)PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Fctate of CHAD MICHAEL DERR
also known as
LATE OF SHIRESMANTOWN BOROUGH
Petitioner(s), who is/are l8 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW )
Deceased
File Number 21- ~ 6- 0 2 4 0
Social Security Number 188-64-9320
^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of tju+ Tlr:vrlert( rlatr_rl anrj rnrliril(gl rjatPti
(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 bom 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:
^ B. Grant of Letters of Administration d.b.n. (Current administrator, James D. Den, died September 8, 2008)
(1f appiicavie, enter.• c.t.a.; d.n.n.c.t.a.; penaenre iite; dumnte aosentia; durarae 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 fist ofheirs.J
- Name ReIationshi Residence
Sylvia B. Derr Mother 69 Caravan Court, Middletown, PA 17057
(COMPLETE INALL CASES:) Attach additional sheets ijnecessary.
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, tawn/ciry, 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 $
situated as follows: NONE
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 lure T or ~ led name and residence
2252 PINETOWN ROAD, LEWISBERRY, PA 17339
~ 2252 PINETOWN ROAD, LEWISBERRY, PA 17339 ~? •^'~
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Form RW-02 rev. 10.13.06 _~~e I (~.~. 2
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named in the
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
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
1 ~-{i y
before me the , ~ da of
j~~~
(~ the Regrster
Signature of Personal Representative
File Number: 21- 0 6 - 0 24 0
Estate of CHAD MICHAEL DERR _, Deceased
Social Security Number: 188-64-9320 Date of Death: MARCH 5, 2006
AND NOW, . in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters OF ADMINISTRATION, D.B.N.
are hereby granted to LAURA D. RICHARDS and PHILIP C. RICHARDS
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)) ~f Decedent.
FEES
Letters ............. .. $
Short Certificate(s) .... .... $
Renunciation(s) ...... .... $
... $
... $
... $
... $
... $
... $
... $
... $
... $
TOTAL .......... .... $ 0.00
Re r o Wrll's/f ~ l
Attorney Signature: 1 ~ • / v
Attorney Name: VICTOR A. NEUBAUM, ESQ.
Supreme Court I.D. No.: 29159
Address:
Telephone:
42 SOUTH DI1KE STREET
YORK, PA 17401
717-843-8001
Form RW-02 rev. 10.13.06 Page 2 of 2