HomeMy WebLinkAbout10-16-08 (2)PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
Estate of ~ ~ (~[i'tn rl ~ `~~~
also known as
~1 [_.l/'ll~ D ~ l i ~~ I)eceacPA
COUNTY, PENNSYLVANIA
File Number ~~ ' QO ~ 033
Social Security Number
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 named in the
last Will of the Decedent dated and codicil(s) dated
(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 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:
~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.)
xeiauonsm Residence
i_
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(COMPLETE INALL CASES:) Attach additional sheets if necessary. - ~_ --
Decedent was domicile death in C V''M ~A-u Cou t Pe s lvania wit his /her last rmcipaliegid~atic5e at .~
(List street address, town city, township, county, state, zip code) !~
Decedent, then ~~ yews of age, died on ~/tom G,
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) 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
situated as
J -~-i Q
~~ Ct]
$~ ~; ~/~ ~
Gso~
'~ Y
Form RW-02 rev. 10.13.06 Page 1 of 2
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
SS
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed ~~~~-~~/f/l. ~~~i ~~' ' ~ h..
~~ Signature of Personal Representative ~-~
before me the ~
day of C ~;
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S~ Signature of Personal Re
resentative ~ -~
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ror the Register Signature of Personal Representative =-~~_-;~ ~ -
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File Number: 2 ~ - (~~ - ~Q
Estate of ~~i i ~,~tln . A a ~&, „Q ~ -R,tln ,Deceased
Social Security Number: 215 - 3$- (pQ59 Date of Death: q - „~Q - Q~
AND NOW, (~oa ~(D _, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters I~m- n i sT2A-~ ~ one
are hereby granted to'i~ob~r~ 3 ~1- ~~,~ a -- c-}rnr, ,r~
and that the instrument(s) dated
described in the Petition. be admitted to probate and filed of recopll_as the last
FEES
Letters ............... $ ~ o~ , (~
Short Certificate(s) ........ $ 1 . C~
Renunciation(s) ....... ... $ 5 , [~~~
lam MCP ... $ - o ~ cX~
... $
... $
... $
... $
... $
... $
TOTAL ........... ... $ IZ3-tR~ ~e
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
Address:
Telephone:
Codicil(s) of Decedent.
in the above estate
Form RW-02 rev. 10.13.06 Page 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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This is to certify that the information here given is
correctly copied from an original Certificate of Death
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RENUNCIATION
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~1 REGISTER OF WILLS ~~
6~1---~ ~j-C r ~ ~ r1. ~ COUNTY, PENNSYLVANIA ~,-r-, _,_, '
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Estate of _ ~ -~r -Q ~~~ ; -~ `a w ,Deceased
I, K e ~ ~ ~ ~~+~ ' ~, a w , in my capacity/relationship as
(Print Name)
~U -''' of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
~ ~ ~(~, D ~
(Date)
Executed in Register's Office
(Signatur
(Street Address)
F~recl ~ rr clc /yj c1. .Z t ?~ 1
(City, State, Zip)
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 day
of
Notary Public
My Commission Expires:
(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
Sworn to or affirmed ~r1d subscribed
be~re1me this ~ l~ ~, day
of 1~~+.~ , ao~~ ,
_~
BOND OF PROBATE
Bond #104931296
IN THE Cumberland ounf,~ COURT OF THE STATE OF Pennsylvania
IN AND FOR Cumberland COUNTY No.
IN THE MATTER OF THE ^x Estate
^ Guardianship
OF June Ritlaw ^ Conservatorship
Q Deceased ^ Minor
^ Incompetent
KNOW All MEN BY THESE PRESENTS: That we, Robin Ritlaw-Hartman
as principal, and Travelers Casualty an_ d~n~p+y Com~~y of America , a CT corporation, as
Surety, are held and firmly bound unto the State of PA , in the full and just sum of Fifty Thousand --------__- oo/loo
( 50,000.00 )Dollars for the payment of which, well and truly to be made, we bind ourselves, our and each of our heirs,
executors, administrators, successors and assigns, jointly and severally, by these presents.
Sealed with our seals, and dated this 16th day of ~ nb r 2nnR
THE CONDITION OF THIS OBLIGATION SUCH, That, WHEREAS Principal was by an order of said Court made on
^ Guardian
the 16th day of netnher 2nns ,appointed ^ Administrator of the above named Estate.
^X Executor
^ Conservator
^ Personal Representative
NOW, THEREFORE, if the said principal shall faithfully execute the duties of the trust according to law then this obligation to
be void; otherwise, to remain in full force and effect.
Robin Ritlsw-Hartman Travelers Casualty and Surety Company of America
By
Mary nn rennan
Principal Attorney-in-Fact
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S-2131 E (7/84)
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
r
~ ~A- POWER OF ATTORNEY
TRAVELERS .1 Farmington Casualty Company St. Paul Guardian Insurance Company
Fidelity and Guaranty Insurance Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company
Seaboard Surety Company Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
Attorney-In Fact No. 220507 Certificate No. O 'j.J ~ l7 J O O O 1
KNOW ALL MEN BY THESE PRESENTS: That Seaboazd Surety Company is a corporation duly organized under the laws of the State of New York, that St. Paul
Fire and Marine Insurance Company, St. Paul Guazdian Insurance Company and St. Pau] Mercury Insurance Company aze corporations duly organized under the laws
of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America aze
corporations duly organized under the laws of the State of Connecticut, [hat United Stales Fidelity and Guazanty Company is a corporation duly organized under the
laws of the State of Maryland, that Fidelity and Guazanty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and
Guazanty Insurance Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that
the Companies do hereby make, constitute and appoint
James C. Byerly, Mary Anne Brennan, Richard C. Atkinson, James F. Cuff Jr, and Allen T. Miller Jr.
of the City of j,e.mnvTn_P ,State of pe^115~'~V2t13S ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their bus~ttess of guazanteeing the fidelity of persons, guazanteeing the performance of
contracts and executing or guazanteeing bonds and undertakings required or penuktin any'ai~tons or pY°Bceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this in~inun~~nt i~~ he ,i ~nad anal tf~rir <<~~T~ gate seals to be hereto affixed, this
day of October 2008
Farmington Casualty Co any
Fidelity and Guarantyranc~e Gpmpany
Fidelity and Guaranty Insur~lµtce Underwr#ters, Inc.
Seaboard Surety Company
St. Paul Fire and Marine Insurance Company
6th
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
r GI,BU.R~• s~>lafry Jy P0.Ea4 ~TN..~;~SG P~1NSU,P '~tY'~RO Y
O ,~y~,/~pR~~• ~ * aP ~. ~P e0! 9! 4J: ........, ;9.y aJ JG e"16~'e~
~- S ~ l1 ~ , fE011PWRRPk'~ R.~ POR '. P y
1982 o z ~l $ ai: tAa Rrf r• u s~ J$ `W
4~~ a 7977 g ~D 7927 ~ ~ ^ ~` :: ~ W Nnmrono, eum~aana ~ < "
bF 1957 m ~`•. S E A L 'o"l ' ` ~ ° W CONN. o" t~ '~/ ~e N lass
OFNtW R~NC 1S ~ t,N~ ,fg........ 'a~ b1 . ~~+s 1 A~
State of Connecticut
City of Hartford ss.
By:
Georg Thompson, enior ice President
On this the 6th day of October 2008, before me personally appeazed George W. Thompson, who acknowledged himself
to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guazanty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc.,
Seaboazd Surety Company, St. Paul Fire and Marine Insurance Company, St. Paul Guazdian Insurance Company, St. Paul Mercury Insurance Company, Travelers
Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guazanty Company, and that he, as such, being
authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
~p,TlT
In Witness Whereof, I hereunto set my hand and official seal. ~
My Commission expires the 30th day of June, 2011. ~ per`
`('(~ c~n~- C .
Marie C. Tetreault, Notazy Public
58440-5-07 Printed in U.S.A.
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
This Power of Attomey is granted under and by the authority of the following resolutions adopted by the Boazds of Directors of Farmington Casualty Company, Fidt~ti~ty
and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., Seaboazd Surety Company, St. Paul Fire and Marine Insurance Company,
St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of
America, and United States Fidelity and Guaranty Company, which resolutions aze now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice
President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking
shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretazy or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,
any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate
relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and
undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be
valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the
Company in the future with respect to any bond or understanding to which it is attached.
I, Kori M. Johanson, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guazanty Insurance
Underwriters, Inc., Seaboazd Surety Company, St. Paul Fire and Marine Insurance Company. St. Paul Guazdian Insurance Company, St. Paul Mercury Insurance
Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guazanty Company do hereby
certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is in full force and effect and has not been
revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the. seals of said Companies this 16tY1 day of ~CtOb2r , 2~8
Kori M. Johans Assistant Secretary
neU <f SIIPFTy ..fae6y D~~M..!NSb9 Jp1.1N$Vq''L SJPlfV 4hp ~` ~pyl~ yS~Y,t1~.
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To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.travelersbond.com. Please refer to the Attorney-In-Fact number, the
above-named individuals and the details of the bond to which the power is attached.
THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED