HomeMy WebLinkAbout01-20-09PETITION FOR PR//OBATE AND GRA.IVT OF LETTERS
REGISTER OF bVILLS OF (,(,LM.p ~'J~~P
COLwTY, PEV:VS~"LVAVL~1
Estate of ~~ ~Q~~~ ~
also known as
Deceased
Pe~i[ioner(s), who is/are 13 years of age or alder, apply(ies) for:
(COhIPLETE 'A' or 'B' BELOW:)
^ A. Probate and Grant oC Letters Testamentary and aver that Pe5[iocer(s) is /are
last Will oF(he Decedent dated
and codicil(s) da[ad
File Numbe; l~~'L~~VI~-~~~/
Social Security Number~~~~ ~~
(State relevmrt circumstances, e.g., remumintion, death of eeecutor, etc.J
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
Petitioner(s) after a proper search has/ have ascertained that Decedent left no Will and was survived by [he following spouse (if any) and heirs: (ff
Adrnuustratio'r,c.t.u. ordb.n.c.r.a., enter d¢te of Will irc SectionA¢bove and complete list ofheirs.)
in the
3Ft41PinStrvment s) offefed
.t/
~fs. Grant of Letters of Administration ~~ O ~ ~
((f applicable, enter' c.t. n.; d. b. n.at. n.; penden(e lire; durnn[e nbserztia; durance mirtori(a(eJ "" I
77
was domiciled at
is with his /her lass principal residence at
address, town/city. townshrp, rounty, smte, v'p code)
Decedent, [hen ~ years of age, died on / ~ ~ ~ at ~~7 ~u~ ~.~- ~L1~ ~~ ~/,~.,
~l ~i/
/ 7'~To
Decedent at death owned property with estimated values as follows: ./
(If domiciled in PA) All personal property $1 C/ 5~., `~ ,1'
(lf not domiciled in PA) Personal property in Pennsylvania $
Qf no[ domiciled in PA) Personal property in County g
Value of real estate in Pennsylvania
$-l~~ S.- ~-~-z~-
sihia[ed as follows:
Wherefore, PeG~ioner(s) respecthdly request(s) the probate of the lust Will and Codicil(s) presented wieh this Petition and the giant of Letters In the appropriate form to
the undersigned:
• 7c 7
Form HFV-02 rw !0_!3.06
Page 1 of 2
(COtYIPLETE WALL CASPSQ At1ac6 ¢dditianal sheets if necessary. V ~d~ ~ // ~-' "-" "`~
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Oath of Personal Representative 2~~g JAPd 20 AP1 ID~ 27
CO<vIMONWEALTH OF PENNSYLVANIA
SS l.~ F ~
COUNTY OF ~~l h~~`GrIA~~"~ ('1RF'I'w',~ ` ~ l `~)~ ~,gT
C~'
'ihe Petitimter(s) above-named swear(s) or afnrm(s) that the statements in the foregoing Petitton are true and correct [o he 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 a£fi rmed and subscribed
U
~,. ore me the _~~~ day of '/'
~ o
~ ~ ~ he Register
Signature of Personal Represenmtive
Signnture ofPzrsmml Represenmtive
File Number ~~~~~ ~~~~~
Estate of
Social SeevrSty Number: ~~1 ~ ~~7
AND NOW, ~ .~,~'J/~~1i (l/~~ ,~-C/~
having been presence of e me 1"P~~DE REED tlrat Letters _~
are hereby granted [ ___~. ~ ~
and That the instrument(s) dated __
described in the Petition be admitted Co probate and filed of record as [
FEES ~ GU
Letters ......... .... $ ' _~_
Short Certificate(s) ........ $~
Renunciations . ~ $ L,~'
O , lj
$
_ .. $
$
$
TOTAL .............. $
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
Address:
Telephone:
of Death: ~ °7~"
~erati of t re foregoiuo Petitimt, saps Cory proof
;~~~~,
in the above estate
Wilt (apd Codicy~(s)) of
Regis(er of
r-n~~n~ Rov.o: rn~ to-~3 or Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH ~~ ~)~ ~
WARNING: It is illegal to duplicate this copy by photostat or photograph..
lee for this cenificae, $b.00 -- "Phis is to celTil'y thal the inftmnation here given is
~~~p~1N~OF pENyf~ rurrcUly copied lium un ori~mal Certillcate of Death
poi ~ ~~A dul~~ Idcd with Inc a Local Rc.ti xlrar The oligmal
f ,r, ~z,~ cerlihc,ac will he IiTrwmdcd ro the State Vial
~~~~+ Inc Rccouh Office to Tennanent filing.
P 14955601 *~ *',
CclTificalion Number
Local Registrar U Date Issued
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,''00p COMMONWEALTH OF PENNSYLVANIA • DEPARTME
In ~~_'
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NT OF HEALTN • VITAL RECORDS 3, __
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CERTIFICATE OF DEATH ~ • =AJ '-'
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~~ ~ ~ STA1E FILE NUM6FR ~ ~ ( ~
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GI -S'/
RENUNCIATION
REGISTER OF WILLS ~' ~~ - ~ ~~ ~~ ~~
6s:~ ~ u COUNTY, PENNSYLVANIA
Estate of
~-~;
administer the Estate of the
Lam,,,
i("04 JAS! 20 ~h9 l~J: 28
~, r•r,r~ ~„-
/~ ,
1i Rri ~ ~ ~ r~~~~'~T
C ~,.,
Deceased
in my capacity/relationship as
of the above Decedent, hereby renounce the right to
and respectfully request that Letters be issued to
~/ i
it~ ~ Iti it
(~are~
~~%
[Sheer Address)
~~/~~
(City, Sraee, Zip)
Executed in Register's Offce
Sworn to or affirmed and subscribed
before me this _~_ day
of
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
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
purpo~ s stated within on this t ~ `.+ ~' day
Notary Public `~, \I
My Commission- xpires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANW
Notary[ Seel
Dorotlty M. Scott Notary Public
Cty d Harristwrp, Dauphin County
~' Commietlon E~irec Sept 11, ypip
Member. P neylvany Aasociatbn a Notaries
~~-5'l
RENUNCIATION
-~ ~ - ~,~
Z~C4 JAN 20 AFl 10~ c^8
C~ ~~~ (,:
OR?NAPd;; i'.7URT
REGISTER OF WILLS Cl, " ,l„ PA
-Limb~~~+k~P COUNTY, PENNSYLVANIA
Estate of
Deceased
I' ' \'~ t \ l• 'r ~' ~u'r ~ ~ V' , in my capacity/relationship as
eY (Pnnt Name)
--~ O ~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
L-/n-/r ~ Ls~.~:t i
f4 ~ ~~
-. ~ ~. ~.-r/.~~ Z~-1,t'
(Date)
(S~gnatureJ
(.Tneet/`AAdressJ
/I~A~a~k.~~ ~7 ~ F9! 7~
(Crry, State. ZipJ
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
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
--~--r-
Notary Public `\
~ \)
My Commission Lxpires:
($ignaNre and Seal of Notary or other ofricial qualified to
administer oaths. Show date of expirn[ion of Notary's Commission)
COMMONyyI:ALTrt OF PENNSYLVM/lq
Nofarlai SatN
Doromy M. Sport, Nt~ry PuDlk
Ciry M Harriaburp, DaupNn CWMy
My Commission Expires Sept 17, pDty
Member. Pennsylvania Aaapciatton d NtNarles
oq -51
2009 Ji°~ 20 Aft 10~ 28
RENUNCIATION ~~ ~=~~~ r
REGISTER OF WILLS ~~' ~ ~~~ PA
~~~~°'~ COUNTY, PENNSYLVANIA
Estate of
'7
I,
G
Deceased
m my capacity/relationship as
c- of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfu]1y request that Letters be issued to
I tir~s ~ L~~s
l~ 1 ~i i ,~
(Date "~ 1
atureJ (T--~
Sn ee(i{dd~,-,rsf
~.~~--pig ~~~~ c~
(Crry, State Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wil]s
Form RW-O6 rev. 10.13.06
Executed out of Register's Office
Before the undersib ed personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purpo es stated within on this ~ c('--~' day
Notary Public
My Commission
(Signature and Seal of Notary or other official qualified to
administer oaths Show date ofexpira[ion of Notary's Commission.)
COMMpNyyEALTN OF PENNSYLV,gN~q
Dorofh ~rlsl Seal
City d Hamsbu~~ ~~ Pub11c
My Commisebn ErG, DsupMn County
Member, P th, '~~ Sept 77, 2012
na ania Asaooiatbn rN NWar~s
U~-~7
- - , ~, -
'~R9 Jl, ~ 20 lib !tip 28
RENUNCIATION ~~~~~~,~ ~ `; ~ ; p
J .T
REGISTER OF WILLS
~ ~ COUNTY, PENNSYLVANIA
Estate of
I, ~, i i~
Deceased
r (PrirsrN e) ~,~in my capacity/relationship as
~ ~ ~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
(Date) T
V
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-O6 rev. 10./3.06
~l <-~
~~
(S~gnrs[uref
~/ ~~ Gl~i~~~' J-~ ~~r
(Sb'eer Andress) ~ /
r~~
r (cnt~pSmte. 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
purpose stated within on this - ~ l r`~- day
of t ern ~~tn ~ t,(_ _ ~.~ ~r,
C~
Notary Public
My Commission Exnires•
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
Doroth No~rk~ Seal
Cf of Y M. Scots, Notary Publb
A' Hamaburg, DaupMn Cou
MY C(xnmiaaion F_xpirea Sept 77, X12
Member, PennsyNanla AseoUation of Notarlea
O r - S'7
RENUNCIATION
2r~29 J?a"d 20 ~Pi IQ~ 28
C~fri't ;,--
ORF ~t ~ r;l;~T
Cl~i "'' _,, °A
REGISTER OF WILLS
~Ctmb~rlR~~-Q COUNTY, PENNSYLVANIA
Estate of
I,
Deceased
/~l ~ -5
(Print Name) > ttt 1ny capacity/relationship as
~~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
~ (c ~ ~^~LC.l.I~`i.a, ~
(~ateJ
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-O6 rev. 10./3.06
ii
-~
(StgnatureJ
(.CrreetAddressJ
p Lr '7
(Qry, State. Zrp)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunc ti n for the
pureg~gs stated within on this I ~~ day
~ ~ ~ ~~
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other ofr;cial qualified to
administer oaths. Show date otexpiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
Nofatial Seal
DoroMy M. Scott, Notary Public
CiyW Heniabury, Dauphin County
My Commiaahn Expires Sept 11, 2012
Member, Pennsylvania Association of Notaries
~~ ~ S !/
RENUNCIATION
;I_.
'i~Q9 J~,~ 20 f~P9 (t~~ 28
,i ~~
~.~ .,_1f~ (~li~
nnl p` ^y'II L-T
~~ . ,'?4
REGISTER OF WILLS
r~'--^'~~~ ~~~ COUNTY, PENNSYLVANIA
Estate of
,Deceased
,~~
I ~' j ~~ ~~' t ~ ~ ~ ~O ~ fi , in my capacity/relationship as
(Prm! Name
h 4u c'1' ,7 p '' of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
t
ll;; ~. c.
~•,
(Date)
Executed in Register's Offce
Swom to or affirmed and subscribed
before me this ~_ day
of
Deputy for Register of Wills
Form RW-O6 rev. !0.17.06
~ a ~ -,
/' ~~ cam? ~";/t-ri tt //'
(SignolureJ ~1'
V'
13 a ~~ ~~~ Cj` l~Li ~~ ~S
(Street ~fddressJ
/~~~a~rwLy ~e / 7/d 3
rc~ry. ta,e. zp~
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
purposgs stated within on this cc`s--- day
of ~ fin,.,, r.. 4,a. n.-„r,
Notary Public !
My Commission
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Doromy M. Scott, Notary public
City of Harnaburp, Dauphin County
MY Commlaabn Expires Sept 11, 2072
Member, Pe nsylvania Association of Notaths
C)~' ~ r~
C;,'-~,
~.
2~'~9 Jr"~r~ 20 Ar`910~ 28
RENUNCIATION
~L~^< n,:
ORr= t, ,~ , r'~>URT
r REGISTER OF WILLS
~ ~ COUNTY, PENNSYLVANIA
Estate of
I,
Deceased
in my capacity/relationship as
(Print Name)
~~ `` t" °' ~l'` ~' ~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
(Da(eJ ~ ` o
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-O6 rev. 10.13.06
1
Y -~/In
(Signature)-1' -~
1~(](] ~ v F~ VI~ l
(.Sneer AAdressJ
IaLQ~~~ ~b ~~ ~r l ~ ~I
(Crry, Srare, 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
purpo§§es stated within on this ~ ~ `~ti`-' day
Notary Pubtic
My Commission
(Signature and Seal of Notary or other otTcial qualified to
administer oaths. Show date ofezpira[ion of Notary's Commission)
COMMONWEALTH OF PENNSYLVANIA
NoNrW Seel
Dorothy M. Scott, Notary Public
city of Namalwrp, Dauphin county
My Commiaebn Ertplrea Sept 1 t, 2012
Member, PednayNania Association of Notades
>~_r ~7
RENUNCIATION
REGISTER OF WILLS
£'~ ~ COUNTY, PENNSYLVANIA
Estate of ~ Y ~ Ct(` I ~,t„t (~~~ b
Deceased
h~Jr/i9 ~ P ~erl n
7 a„ntNameJ , in my capacity/relationship as
t ~o }4 ~ ! ~~,°
`, of the above Decedent, hereby renounce the right to
administer the Estate ]of the Decedent and respectfully request that Letters be issued to
(~ ate) ~~~ I~
Executed in Register's Office
Swom to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Farm RW-O6 rev. 10.13.06
o~ ~~~ Y~',~~~~~-v~/f
(,Sa eat AddiessJ
(Gty, Seare. rp) ~
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
purpo es stated within on this ~ ~-~_ day
of ~ ~ A>~; ~~~L~1
Notary Public
My Commission Expires: l
(Signature and Seal ofNOtary or otheyr ~opffincQial quaarliyfied to
administer o~~f~rat~nQNN$1'LVANIA~ssion.)
Notetial Seal
Dorothy M. Scott, Notary public
City of Harrisburg, Dauphin County
MY Commission Expires Sept 11, 2012
Member Pennsylvania AssoClaOon o! Notaries
1 _r., v.
1~..
~p~g ~H~ 20 khi ID: 28
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