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HomeMy WebLinkAbout06-08-09FOR PROBATE AND G1~:ANT OF LETTERS PETITION ISTER OF WILLS OF ~t~rn B ~~ L ~ ~ COUNTY, PENNSYLVANIA REG J _~~-D ,~ File Number ~~ 1 Estate of ~j/~ also known as ,s'1ULt, ~ Deceased Social Security Number ~~ "2 °'~ ~ ~`` ©~, S ~ ~EMII Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) named in the A. Probate and Grant of Letters Testamentary ~ andecrodicil( )ttdaoted s) is /are the last Will of the Decedent dated (State relevant circumstances, e.g., renunciation, death of executor, etc.) - .Zr ent(sered ws Iecedent did not many, was not divorced, and did not have a child born or adopted after' execution of 4~~ Except as folio rson: for probate, was not the victim of a killing and was never adjudicated an incapacitated pe ~r./ B. Grant of Letters of Administration (Ifapplicable, enter: c.t.a.; db.n.c.t.a.; pendente life; durance absentia; durant + Late) has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and~rs: Petitioner(s) after a proper search Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above a»d complete list of heirs.) Name ~A <i-~1? ..~ z•~ ~ ""w' +C `~ ~~ :~ :~" ~~ ~.~ ~C":~ ~~~ -,, '_ r (I. f (COMPLETE INALL CASES:) Attach additional sheets if necessatp• ~ ~~ ~~~ ~ was domiciled at death in U~ Q ~~ Coun , Pent%~~ ~ ~ th his /~se ~ ~rthci~~ ~~ nce at ~~ a (List street address, town/city, township, county, state. zip code) ~'f v h~ Al E-~ S 1'a w ~ I ~~~~ Decedent, then __~, ~_._ yew of age, died on _.,. Decedent at death owned property with ~~~ values as follow (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania All personal Property Personal property in Pennsylvania Personal property in County s ~~'04~, act S S situated as follows: resented with this Petition and the grant of Letters in the appropriate form to Wherefore, Petitioner(s) respectfully requests} the probate of the last W ill and Codicil(s) p the undersigned: _-- _-~ _....:ae..,.a - `~ 7~ Page 1 of 2 PA Form RW-02 rev. 10.13.06 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS I ~ ~J~`Q~l (~ COUNTY OF „_ ~~J~ ' ` The Fetitioner(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 the ~ day of .~ .C- - I~ F e Register Signat~a'e of Personal Representative Signature of Personal Representative Signctture of Personal Representative ~~ ,'~l - Oq - b5 3a ~~ File Number: t i 5 Deceas Estate of ~~r O ~- '~.~ •~ .+.~ r..„~7 C ~; r~V 4'i ~1y7 ~ r~'~ ,-°r-~ ~~`r r.':. y r.. =r~ ;. .. _,~ ,~..f, Q k r.~ a Social S curity Number:. ~ ~ J~ " ~Z " y ~' ~ ~ Date of Death: ~ ~ d ~ ~ ~ - AND NOW, ~~-~ ~ in consideration of the foregoing Petition, satisfactory proof having been presented ore me, IT IS DECREED that Letters r'~r~n~ n ~ ~+~r°`}~ ~~ are hereby granted to Qv - ~ ~ in the above estate and that the instrument(s) dated _ _ -_--... ~ , „_ ~~ __,._., ~r r~o,.e.tv.,t described in the Petition be admitted to probate and filed of FEES Letters ............... $ Short Certificate(s) ........ $ ~ ~ Renunciation(s) ... • • • • • • - ~ ---- ... $ --• $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~ 35 ~ ~ Supreme Court I.D. No.: Address: Telephone: Page 2 of 2 Form RW-02 rev. 10.13.06 Attorney Name: POWER OF ATTORNEY I, Robert Snell, a resident of 116 Robin Road, Hummelstown, Pennsylvania, Dauphin County, Pennsylvania, designate David L. Delbaugh, presently residing at 34 Gale Road, Camp Hill, Pennsylvania, 17011, as my attorney in fact (referred to as "the Agent") on the following terms and conditions. 1. Authority to Act. The Agent is authorized to act for me under this Power of Attorney and shall exercise all powers in my best interests and for my welfare. This Power of Attorney shall become effective upon execution. 2. Powers of Agent. The Agent shall have the full power and authority to manage and conduct all of my affairs, and to exercise my legal rights and powers, including those rights and powers that I may acquire in the future, including the following: a. Collect and Manage. To collect, hold, maintain, improve, invest, lease, or otherwise manage any or all of my real property, my personal property, my motor vehicles, or any interest therein. b. Buy and Sell. To purchase, sell, mortgage, grant options, or otherwise deal in any way in any real property or personal property, or motor vehicles, tangible or intangible, or any interest therein, upon such terms as the Agent considers proper. c. Borrow. To borrow money, to execute promissory notes therefore, and to secure any obligation by mortgage or pledge. d. Business and Banking. To conduct and participate in any kind of lawful business of any nature or kind, including the right to sign partnership agreements, continue, reorganize, merge, consolidate, recapitalize, close, liquidate, sell, or dissolve any business and to vote stock, including the exercise of any stock options and the carrying out of any buy sell agreement; to receive and endorse checks and other negotiable paper, deposit and withdraw funds (by check or withdrawal slips) that I now have on deposit or to which I may be entitled in the future in or from any bank, savings and loan or other institution. e. Taz Returns and Reports. To prepare, sign, and file separate or joint income, and other tax returns and other governmental reports and documents; to file any claim for tax refund; and to represent me in all matters before the Internal Revenue Service. f. Safe Deposit Boxes. To have access to any safety deposit box registered in my name alone or j ointly with others, and to remove any property or papers located therein. g. Proxy Rights. To act as my agent or proxy for any stocks, bonds, shares, or other investments, rights, or interests I may now or forever hold. h. Legal and Administrative Proceedings. To engage in any administrative or legal proceedings or lawsuits in connection with any matter herein. i. Transfers in Trust. To transfer any interest I may have in property, whether real or personal, tangible, or intangible, to the trustee of any trust that I have created for my benefit. j. Delegation of Authority. To engage and dismiss agents, counsel, and employees, in connection with any matter, upon such terms as my agent determines. k. Restrictions on Agent's Powers. Regardless of the above statements, my agent (1) cannot execute a will, a codicil, or any will substitute on my behalf; (2) cannot change the beneficiary on any life insurance policy that I own; (3)may not exercise any powers that would cause assets of mine to be considered taxable to my agent or to my agent's estate for purposes of any income, estate, or inheritance tax, and (4) cannot contravene any medical power of attorney I have executed whether prior or subsequent to the execution of this Power of Attorney. 3. Durability. This durable Power of Attorney shall continue in effect until my death, or until revoked by me in writing. 4. Reliance by Third Parties. Third parties may rely upon the representations of the Agent as to all matters regarding powers granted to the Agent. No person who acts in reliance on the representations of the Agent or the authority granted under this Power of Attorney shall incur any liability to me or to my estate for permitting the Agent to exercise any power prior to actual knowledge that the Power of Attorney has been revoked or terminated by operation of law or otherwise. 5. Indemnification of Agent. No agent named or substituted in this power shall incur any liability to me for acting or refraining from acting under this power, except for such agent's own misconduct or negligence. 6. Original Counterparts. Photocopies of this signed Power of Attorney shall be treated as original counterparts. 7. Revocation. I here revoke any previous Power of Attorney that I may have given to deal with my property and affairs as set forth. 8. Compensation. The Agent shall be reimbursed for reasonable expenses incurred while acting as Agent and may receive reasonable compensation for acting as Agent. 9. Placement in Facility. My agent shall take charge of my person in case of illness or disability of any kind, to authorize my admission to a medical, nursing, residential or similar facility, and to enter into agreements for my care; and to remove and place me in such institution or places as my Agent may deem best for my personal care, comfort, benefit and safety after giving consideration to any wishes I have previously expressed on this subject. c j ~~~ Date Executed: Signature: Robert Snell Signed in the Presence of: a~ ~~ Witness: COMMONWEAL T1~I OF PENNSYL VANIA COUNTY OF DAUPHIN Witness my hand and official seal on this !/ } day of 2009. Nota Public ,,/~~ ~ • /.,~ce/~../~~ rY r~otatwL sEAL wwcir a ~aNOCic LOWER PAXfON ?WP O~AUPFIIN COUMY My Camrnbsion Expires Ocf 26.2009