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HomeMy WebLinkAbout07-15-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF m ~ Gr 1 cz. --~ o _ COUNTY, PENNSYLVANIA Estate of .,._~ f y t, 1 S !~ • ( _ ~' N 5T' also known as Deceased File Number 01 f ~ V I ~~ S~ Social Security Number ~ ~ p ""' [~o ~ ~ G D ~ ~o 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 last Will of the Decedent dated and codicil(s) dated rya c~ e~ {~ ..r~ --~ ; _ . ~ C... i~'r~~ t°~? .ftT~ined i;-~ --~ L :.~~ ~. r ., , .-.r ., ~-r't (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~...~' ~ ~ , ~` "~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of instrument(I'ere~ ~'" "` for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ... B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; durante minoritate) `~p /7J1o I`7 iv 9 (COMPLETE INALL CASES:) Attach additional sheets if necessary. ~.. ~ Ce os s ~~ U,q~ ~ .~ 9 S~ ecedent was domiciled at death in County, Pennsylvania 'th his / r last principal residence at Dc ~ e. J a. ,tJ (List street address, town/city, township, county, state, zip code) Decedent, th ~_ ears of ag died on _~GC. h L ~ ~ , oZ D D ~ at _1 D ~ ~ G TD 8 ~,~, ~, . Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ ~~ t ~e ~. (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ Q 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 of Letters in the appropriate form to the undersigned: Si afore T or Tinted name and residence ~ ~. Cd. rn r /`7 . ~V ~ T13 ~.. I 's ~ Form RW-02 rev. 10.13.06 Page 1 of 2 Ts, ~~ /71/~ 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: (If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF 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 the ~~~ day of a~g or the Register Signature Of Signature of Personal Representative Signature of Personal Representative .3~- iV i "`~::°r i Y~ ,- c:, :~ C`J _.,,.~ File Number: ~ ~ - V-l - ~~0~ `T Estate of 'J ~ x~ n.~ l 5 !~ • ~ ~... ~J ST ,Deceased Social Security Number: I p t -' ~ ~ ~- ~ d 8 ~v Date of Death: ~'l~,~J ~ oL oL , ~U ~ AND NOW, ~ in consideration of the foregoing Petition, satisfactory proof having been presented before e, IT IS DECREED that Letters ~ ~ 1 r~ t ft~-rc~~- c~tJ are hereby granted to -~~arr-~,r- 'M • f-resT in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of FEES Letters ............... $ ~ r~ . UCH ___ Short Certificate(s) ........ $ ~a `DC~ Renunciation(s) .......... $ ~ C7 • U~ Jc.~ ... $ l~.c~ f-~i~~ro r,~,.~ - dam, ... $ 5 z a`O ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~ ~ -"l , OU ~ the last Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Telephone: Codicil(s) Form RW-02 rev. 10.13.06 Page 2 of 2 ~•*.s RENUNCIATION ~~ -~- ~ ~ ~-- ~ ~%;i ~' ~ :, ~ ~ ~::~ r ~.._~ ,4 REGISTER OF WILLS ;~ cr> ~~ ~' ~ ~ _~~ PENNSYLVANIA ~ ~ ~'' I 4 ~/ ~ COUNTY ~ ~ ~ ~ ~ ~~~ , w ~ i : ~.::~ : ,x ~ ~ ~ tv ~ . ~ . ~ _" Estate of ~ ~ r S ~/ ~h D ~/ ~ Y` J7 S ,Deceased I, ls-- ~ ~^t7~- ~ S ~ Jai ~ ~ ~ fill/ , in my capacity/relationship as (Print Name) ~'~`,~~ e -~^~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to f ~u~ ~ ~' ~ a•-U (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this of , day Deputy for Register of Wills Form RW-06 rev. 10.13.06 (Signature) (Street Address) (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he sh executed the renunciation for the purposes stated within on this _ day of ~ v``~ c~~g Notary Public My~Commission `Expirest:, `"31 ~ ~~ (Signature an Seal of Notary or other o icial qualified t~o`` ~ , TQC~ ''~.,~~~ administer oaths. Show date of expiration of Notary s C~+ ion. j• • • • • • • • ~ ~.,~ .•• Q •••• •~ ,,,,,''~~~,,~'qRY Pv ```,.``'`,,,. C~ rv o RENUNCIATION C ~ ° ~° ~ ~~{ ~~~ ~ ~ ~~:-~ ~y REGISTER OF WILLS .:~ ~~ ;~; ~ = ~-- ~~ M S ,~ ~ 1~ L7 COUNTY PENNSYLVANIA ~ ~ ~ L ~ ~ ~ ~' ~: r~~~ ~-'` . (' ~ .... ,~ Estate of ~ L=- J~ IV j,~~ ~ ~ ~1`,N S~ ,Deceased I, L ~ ~ ~ ~ i ~ .~ c~~ in my capacity/relationship as ~~O ~~~Pri~N~e) of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~/i s/o~ Executed in Register's Office Sworn to or ai~irmed and subscribed before me this day of , Deputy for Register of Wills Form RW-06 rev. 10.13.06 ~~~ ~ (Signature) (Street Address) ~1~~~c~~l s~U~~ ~~ I ~ ~©9 (City, State, 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 purposes stated within on this day of ' tip ~ vv9 -• / "c L~h.~ Notary Public My Commission Expires: ~~~ ~~/~ (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL SUSAN C. CIRANNI, Notary Public Susquehanna Twp,, Dauphin Coun My Commie>llo~ Expir®~ Apr(I Og, ~0~~