HomeMy WebLinkAbout03-25-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of THOMAS J. ROZMAN
also known as
COUNTY, PENNSYLVANIA
File Number 21--~ - oa8g
,Deceased Social Security Number 181-58-8220
KAREN L. ROZMAN
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 nod in the
last Will of the Decedent, dated and codicil(s) dated ~ ~+ ,., . _;_~:
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State relevant circumstances, e.g., mnunciation, death of executor, etc. -' .1.3 (t't _. ` ~_~_
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the'in~trlh]4nt(s) of(gred `' , _ ~'
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ``-~'~ -:-, -
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~X B. Grant of Letters of Administration
app Ica e, en er c..a.; ..n.c..a.; en a e; uran e a sen ra; uran a m~non a e
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.)
Suppress heirs for Section "B" (Grant)
Name Relationship Residence
HUBERT T. ROZMAN Father 19 Greenway Drive
Mechanicsburg, PA 17055
KAREN L. ROZMAN Mother 19 Greenway Drive
Mechanicsbur PA 17055
(COMPLETE 1N ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his !her last principal residence at
1424 TIMBER CHASE DRIVE, MECHANICSBURG, HAMPDEN Township, Cumberland, PA 17050
(List street address, town/city, township, county, state, zip code)
Decedent, then 4p years of age, died on 02/27/2009
at 1424 Timber Chase Drive, Mechanicsburg, PA 17050
Decedent at death owned property with estimated values as follows
(If domiciled in PA) All personal property $ 5,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 85,000.00
situated as follows: Condominium in Mountain View Village - No. 1424 Timber Chase Drive, Hampden Township, Cumberland County, PA
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:
Signature Typed or printed name and residence
,, ` KAREN L. ROZMAN 19 GREENWAY DRIVE
%~~~~ .~ ~`~~ MECHANICSBURG, PA 17055
Form R W-OZ Rev. 10.13-2006 Copyright (c) 2006 forth software only The Lackner Group, Inc. Page 1 of 2
~~
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
couNTY of Cumberland
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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
before me this ~ ~ ~ day of
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F the Register
L.ROZMAN
Signature of Personal Representative
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Signatun; of Personal Representative C O ..a --~
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File Number: 21--~~k
Estate of THOMAS J. ROZMAN
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,Decease
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Social Security Number: 181-58-8220 Date of Death: 02/27/2009
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AND NOW, ~,`5 D~ IUL~tit' l~ ~1t Y l9 , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to KAREN L. ROZMAN
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)) of Decedent.
FEES
Letters ............................................ $ ~~~~• /vim~
Short Certificate(s) ........................ $ ~D~ VV
Renunciation(s) ............................. $
$ I v' ~ V
$
$
$
$
$
$
TOTAL .................................... $
Attorney Name: EDMUND G. MYERS
Supreme Court I.D. No.: 20558
JOHNSON DUFFIE
Address: 301 MARKET STREET
PO BOX 109
LEMOYNE, PA 17043
Telephone: (717) 761-4540
Form RW-O2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF [~ EA"THI
WARNING: It is illegal to duplicate this copy by photostat or photoclraph.
Fee for this certificate, $6.00
P 15.216566
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will he forwarded to the State Vital
Records Office for permanent filing.
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Local Fegistrar Date Issued
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CORONER'S CERTIFICATE OF DEATH
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RENUNCIATION
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of THOMAS J. ROZMAN ~ , Decea~l
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~. HUBERT T. ROZMAN in my capacity/relation~t~t~+as rv - `
(Pont Name) -~ p
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Father of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
KAREN L. ROZMAN
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(gate)
19 Greenway Drive
(Sheet Address)
Mechanicsburg, PA 17055
(CHy, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
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 ~3'~day
oftt J /~2t~no
Notary P b is "
My Com ' sion Expires
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's commission.)
COMMONYVEALTN OF PENNSYLVANIA
NotBrlal Seel
Margaret E. Rolf, Notary Public
Lemoyne eoro, CumbslAerW County
My Commletlon Ekes Msy 30, 2011
Mefnber, PennsyhreMe Aesodetlon or Nobxiee
Form RW-OB Rev. f0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.