HomeMy WebLinkAbout12-03-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~' a ~++ /S r r L ,4 h a COUiVTTY, PEN~SYLVA.NIA
Estate of _ L r e iQ ~ h 5 //G ~•~( /fir r
also known as
Deceased
FileNumber~~'lJ~~ 1~9~
Social Security Number ~
Petitioner(s), wl~o is/are 13 years of age or older, apply(ies) for:
(COtY1PLETE A' or 'B' BEL06Y:)
^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of the Decedent dated and codicil(s) dated
(State relevant circumstances, e.g., renunciation, death of executor, elc.)
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:
L7 B. Grant of Letters of Administration
(lfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durante absen[ia; durmite niinoritate}
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: (!f
Administration, c. t. a, ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name Relationshi Residence
/,n i~c N ,$aG/''~ /'~~'nr[Vs6 ~.d 2!~ 7tii ~ 57 q/'7`/ Cti~/~~.-l.~~d
named in the
(COMPLETE IN ALL CASES:) Attach additional streets if necessary.
Decedent was domiciled at death in County, Pennsylvania with his /her last principal residence at
(List street nddress, town/city, township, county, state, zip code)
Decedent, then ~~ years of age, died on G~J 19y 2oJy at ~IA/p,C • S jj,.i5 %/a y ~ / ~ 4 C
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 follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant o ppropriate form to
the undersigned:
i ~ignanire Typed or printed name and residence
~~~~ ~ ~~
Form RbV-0? re.-. ~o.r3.o6 Page 1 of
Oath of Personal Representative
COMMON`NEALTH OF PENNSYLVANIA
COUNTY OF
SS
'The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are Uve and con•ect 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
t-C~
before me the ~ day of
For the Register
Signnture ojPersont:l Representative
Signature of Personal Representative
Signature ojPersonnl Representative
File Number:_ o[ ~ -- O~- (~ q'}
Estate of ~~ (~rr~ S~`~tv~.,,~-Pr ,Deceased
Social Se\curity Number: ~ ~~ _ "~o~- -OS ~~ Date of Death: I U Idq ~Ok
AND NOW, 1~~~~ 1tioA 3 CX~B , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters ~~ rn r n . 5-~ra~'r rlr
are hereby granted to ~hr~~e N S~nvmp~r
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of
FEES
Letters ............... $ ZO .oc7
Short Certificate(s) ........ $ 12
Renunciation(s) .......... $
_I~ JCP ... $_l0 - oy
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ~-l`t . c~1~
as the last Wi}1 (and Codicil(s)) of Decedent.
Register oJWills
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
For,n R6V-(J? rev. 10.13.0( Page 2 of 2