HomeMy WebLinkAbout10-13-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~~m -(tg~ ~ COUNTY, PENNSYLVANIA
Estate of_ l (71f/~//'e ~~ ~"'Il~e~d ~l~
also known as
Petitioaer(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A'or'B'BELOW:)
Deceased
File Number Q(I - (/"/ --y^(-J"/~Ofx,~ {',~/ /
Social Security Number / pJ ~V ~~~ I /
^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are
last Will of the Decedent dated and codicil(s) dated
named in the
(Stare
e.g., renuncintiort, death ofesecuroq __.' ~t~}
Ezccpt as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution o~#h~l comet {~ offe,.~~ `~ }
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~-- ~ ~ ~ <;' }
~'tr r- -{ r_s`7 ..r7
UQI B. Grant of Letters of Administration ~[7 ~"['~
~.J i-7 'S7 ~: . 'il
(lfappficabfe, enrec cr.n.; d.b.n.ar.a.; pendenre life; duranre nbsenrin; durah(e~'-iyraritare) :; - >-t'
-'I r;?
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived b the followin ouse if an ~~ ~- '~'n
Administration, c.[.a. or d.b.n.c. [.a., enter dare ajWifl in Section q above and complete list ojheirs.) y ~ g~ ( y) W heirs!-~~fc'~)
(COMPLETE INALG CASES:) At7acG addilionals ers ijnecessary.
Decedent w domici a at ~y i ~ ~
~ d3 )r ~ ~ // ~ Co P ns Iv~ania ' h hi_s / flet ast principal residence at
(List sn'eet addrers. fawn/cily. township, county, mare, zip code) lV -~
Decedent, then (7 L years of age, died on /~ / '' ` ~~~
Decedent at death owned property with estimated values as follows: ,t
(If domiciled in PA) All personal property g~UDd
(If not domiciled in PA) Personal property in Pennsylvania g
(If not domiciled in PA) Personal property in County g
Value of real estate in Pennsylvania $ %l)
situated as Follows:
303 lf/e 1y ~All~ ~'~ ~~gJ~~~ ~ t7o/~ ~
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of betters in the appropriate form to
the undersigned:
Oath of Personal Representative
COMbfONWEALTH OF PENNSYLVANIA
SS
COUNTY OF
The Petitioner(s) above-named swear(s) or af£rm(s) that the statements in the foregoing Peti tion are hve and coaect 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.
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Sworn to or affirmed and subscribed X ~ ,g
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t rj-~-l Signature o r~ntnti ve
before me [he ~~~
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Signature afPersonaf Representative T-• r- C'7
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For the Re ister
g Signature ofPersonnl Represenmtive ~ j ~
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File Number: ~ ~ ' 0 ~ ~ ~9 ~ r.Z.
Estate of ~K/N(`C 4e,e. 'uleJ ~~ ,Deceased
Social Security Number: Date of Death: C _~/ ~ /
AND NOW, ~,p9~ t ~ , -ZU-O- 9-~.inf~~stderatio of`~e_f°~Tegoing Petition, satisfactory proof
having been presented befor--_! fJt, te, IT IS D>~RF that Lg)terg V1- (,~LJ/~~l"C~
are hereby granted to ''pp~dTy~1}Q=/ 7 FoCj
and that the instrument(s) dated
described in the Petition be admitted to probate attd filed of record as the last
FEES
Letters ............... $2(QQ ,~
Short Certificate(s) ........ $ .OO
Renunciation(s) .......... $ 5 -op
P $ O~W
.. $
..$
.$
$
.. $
.. $
TOTAL .............. $ C'1 - UD
Form RW-!1: rev. lp.(3A(
Attorney Signature:
Atiomey Name:
in the above estate
~(a~nd~Co~di~ci~l(s)~) oaf Decedent.
_.-~-~111~ }
Regis r of Wi!
~l~Rsc~£ ~. LbC
Supreme Court LD. No.: ~~ `/
Address: 3~D 7 N' ~N
ARRtD ~ 17/,~
Telephone: \?~/~~+V'b b i5 /
Page 2 of 2
n C
RENUNCIATION ~ 0
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~~GISTER OF WILLS ~ '~ ~ r`' `
COUNTY, PENNSYLVANIA ~ 1, ~ - '~?
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Estate of__
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Deceased
~" ~oeR~~
,~ ~( /D (Print Name) - , in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Dec dent and rest ectfully request that Letters be issued to
oI ~3,~
(Date) ~
Executed in Register's Office
Swom to or affirmed and subscribed
befor~m_ a+this ~ d'~ day
Of IJC.~p aw , ~nUq
.Q•
put for R gister of Wills
~ ~ ~ ~1 ~-~
(SignalureJ
'~3 U)-~l l~lw~ ~w.1
(StreeUdrh essJ
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~PP/I/IQ/wj Iv"'r 1 kr ~ 7ajJJ
(City, Smte. ZipJ
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
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration oCNotary's Commission.)
Form RW-06 rev. !0.13.06
ev wrro~r
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
I P 15838728
Certifca[ion Number
Y~asnuorv llrzx°
nvr. rgat w
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This is to certify [hat the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registraz. The original
certificate will be forwazded to the Stale Vital
Records Office for permanenpt filing.
- ~ R~2~a~~„a.~1a /1~ /a 9
Local Reglstraz Date Issued
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COMMONWEALTH OF PENN6VLVAfM • DEPAgTt#ENT OF HEALTH • VITAL pECOpD4
CERTIFICATE OF DEATH
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