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HomeMy WebLinkAbout05-27-09PETITION FOR P OBATE AND GRANT OF LETTERS REGISTER OF WILLS OF i',fr COINTY, PEN:VSYL~'ANIA Estate oC vl EyVta h t~ p / r IZ File Number QG/' O~ " O ~~/ also known as~7~ Deceased Social Security Number_ _ ~9y -~~a - ~~ 7 rcuuonerts), wno is/are l3 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOiV:) ^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are last Will of the Decedent dated and codicil(s) dated e.g., renunciation, death afexecutor, etc.) Except as Follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution for probate, was not the victim of a killing and was never adjudicated an incapacitated person: B. Grant o[ Letters o[ V 2we (lfnpp(icab[e, enter et. n.; d. b.n.cr.a.; pendente life; durance nbsen/ia; durmne minoritnre) ~ _ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) amend heirs: (If ~` Administration, c.t.a, ord. b.n.c.t. a., enter dare of Will in Section A above and complete list ofheirs.J Decedent was omiciled a[ deaf in~~ Cou /1 y ~Jttsylvania with his /her last principal residence at god t r er dd s t y j ~~-Y ~~ 9 J t ro sl p, county, store, zrp ode~)q p Decedent, then ~~ years of age, died on,~r lQU ~~~ 1 Decedent at death owned property with estimated valueslues as follofollows: (If domiciled in PA) All personal property $ b_ (If not domiciled in PA) Personal property in Pennsylvania $ (If no[ domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania c situated as fol 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: ch~s~ph~- Dv~;lre 1t/~ew Form RYKOZ rev, /0./J.06 IAn~ }~f'~ 17U71J Page 1 of 2 ~ X3' named in the w ('' t--J (COrLlPLETE fNALl CASES:) Attach additional sheets if necessary. o~ - ~/~ Oath of Personal Representative COivIMONWEALTH OF PENNSYLVANL4 SS COUNTY OF The Petitioner(s) above-named swear(s) or affirm(s) that the statements iu the foregoing Petition are bve 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 Vuly adn»nister the estate according to law. Sworn to or affirme~d, a'`nd subscribed before me the ~ day of Estate of Signnmre of Persona! Representative File Number: Social Security Number: f- AND NOW, having been presented be or me, IT IS D~F`~R~TFD that are hereby granted to OQt;! ~, Kpp{ Q,(~ '~~V / '~VYAO~y wUJ Date of Deatl aG~ , in consideration and that the instrument(s) dated described in the Petition be admitted to probate and filed of record FEES L tt r ~~ ~ e ers ............... $ Short Certificate(s) ....... - ~ - . $ o • ~''~ Renunciation(s) ......... . $ _ . $ ~ .. - ~~ . $ / c4~ C!~ .$ . . $ .$ .$ . . TOTAL .............. $ last W'll (and dicil(s)) of Regisler of W' Attorney Signature: Attorney Name: Supreme Court LD. No Address: Telephone: in the above estate N -Q ==t "? n _ Deceased ~ '; T,^ rJ ij -s, ~:7 :..' C' Petition, satisfactory proof rw,n Rw-n: reg. ro.ls.or, Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH VGARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 This is to certify that the information here given is correctly copied from an original Certificate of Death du]y filed with me as Local Registraz. The original certificate will be forwarded [o the Slate Vital Records Office for permanent filing. P 15189568 Certification Number c~+~s+~.-~-~~aa.~AY/1 9 1p09 Loca] Reg~straz Date Issued _ _____..__--_._- _...___ __-.___-____- n IV O __ 4 =~~ ]Y Cpl ~ A ~ ~ -+C c~ r'~ ~ ..._,~_C J t r _ _. ..'i ~~C~ ~ ~ ~InmHHS COMMONWEALTNOF.PENNSVLVANUI•DEPARTMENT OF NEALTH•VITAL RECORDS ~~1'1 ~ - '~l E"` CORONER'S CERTIFICATE OF DEATH ~ Iwr< 11 ~ sD 32-022 (sa In~tyuctbm antl axemplN on rwana) STATE FILE NUMBEF ~ - f. Nnroa 0.rYHfnr. mbs, WL nAfq x. Ea, 3. E"eYl&nFl%NaM•r lD"bMMMH Ib"nl", Hfy re.p~p Joseph E Mart z Male 194 - 26 - 6303 May 11, 20©9 S. kFIW SnIbY 1.1bx1 LVIMfN 0.0MaSYT boM. t. WFb« YPbra Mrt Cbf «n ' 72 ",.. °•" "°" ..,.. Nov. 16, 1936 Nw{NHI: °"'"' ya. 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