HomeMy WebLinkAbout11-23-09Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF Cumberland
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 affirm~ed~an~-~d subscribed
before me the ~, t~ day of
For a egister
U ~~~~ ~
Signature of Personal Representative
Stgnature of Personal Representative
Signature of Personal Representative ~ Q _;}
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File Number: a ~ ` ~~ ` ~~~{-P ~ ~-~ ~ ~ ,~ C~
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Estate of Betty F • Peters Dece~sa~ ~ ~ ``~'
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Social Security Number: 2 0 0- 2 2- 7 4 2 6 Date of Death: 8/ 2 6/ 2 0 0 9
AND NOW, ~~~~.1~ r ~U ~ , in consideration of the foregoing Petition, satisfactory' proof
having been presented before me, IT IS DECREED that Letters o f A d m i n i s t r a t i o n
are hereby granted to Kenneth A• S h o 11 e y
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 ............................. $ ~ ~ v~1-
Short Certificate(s) •...•.•....• $ • C~~
Renunciation(s) •••••••.•.•...•. $
„ ~S P .... $ ~-
f~s ~ 1n-,ni;~nn .... $l~ coo
.... $
.... S
.... $
.... $
.... $
.... $
.... $
TOTAL ............................. $ C ~~Q
Attorney Signature:
Supreme Court I.D. No.: 4 0 4 8 6
Address: 414 Bridge Street
New Cumberland
PA 17070
Telephone: 717-774-7435
Form RW-02 rev. 10.13.06 Page 2 of 2
Attorney Name: Gerald J• Shekletski, Esq•
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumber 1 a n d COUNTY, PENNSYLVANIA
Estate of Betty F • Peters
also known as
Deceased
File Number ~~ - 6~- ~ ~ ~~
N
Social Security Number 2 OBI?- 2,',~ 4
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
(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 bom or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
^X B. Grant of Letters of Administration
(Ifapplicable, enter: c.t.a.; d. b. n. c. t. a.; pendente life; durante absentia; durante minoritate)
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.)
Decedent was domiciled at death in Cumber 1 a n d County, Pennsylvania, with his /her last principal residence at 6 3 9
Gettvsburca Pike Mechanicsburg PA 17055 U{~per Allen Township
(Lrst street address, town city, township, county, state, zip code)
Decedent, then 82 years of age, died on8/26/2009 at Golden Living of West Shore
770 Poplar Church Road Camp Hill PA 17011
Decedent at death owned property with estimated values as follows
(If domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 15 0 , 0 0 0 • 0 0
639 Gettysburg Pike, Mechanicsburg, PA 17055
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:
Signature Typed or printed name and residence
~~'~~ Kenneth A• Sholle son-in-law of decedant
~, \1h9j1~~1 L.~9 (:ctt~i~h~ir~n DiLo_ M.,~I..~.,.~..b.,...... ,-~nrr
Form RW-02 rev. 10.13.06
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
'; OS.SOS RFV 19'./07)
•LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: 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 giv<;n is
correctly copied from an original Certificate of I:eath
duly filed with me as Local Registrar. The: original
certificate will be forwarded to the State 'Vital
Records Office for permanent filing.
P 15478017
Certification Number
AUK 0 oe
o istrar Date Issued
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~ REV ttrzoo3 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
/PRINT IN
,„K CERTIFICATE OF DEATH
(See intstructlons and examples on reverse) STATE FILE NueeRFR
1. Name d OecedNa (Firet mkldle, rel. wdfix)
Betty F. Peters 2. Sex 3. SadN Sewgy Nanba d. Dope d'~ Deem IMOrdh, day, Year)
female 200 -22 ,-7426 8/26/2009
8. Ap (teal BkBldey) Under 1 ar Under 1 ds 8. Der d BHh MtrdA r J. and etW a Be. Prce d Dam Check err
82 M~,aw ~" ~e amaa 7/22/1927 Dauphin, PA HOepNel °Xr`
YB. ^ kp,d,d ^ ER I t'Ai~atlant ^ DDA Nr„kg Ibnr ^ Rakrrrs ^ Odwr ~ Spedy:
rt. Caa,y d Dam Bc. Cdy, Bao, Tap. d Dam &!. Fadey Name (M not ItrBhNon, giw,heel end Harter) 9. Wa Decederd d tMepenk Odgr? Pr ye8 18. Race: Anrdcan Inden, Brdr, While, er.
Cumberland EastPennsboro'Itap. Golden Living of West Shore (M,~ °i'b~„n',,,~,1 (white
11. Dsaderds l1aW NYd d warkdar meet d Yr. Do nd elate retl 12 Wee D,cadem war r the 13. Deadenfe Edwetlcn (Seedy any hiplwt gr,d, carg l,Eedp td. Medal Srsa: Msmed, Never Merrrd, 15. SurvYdng Spo use pe Bile, gHe maiden name)
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tm AcIwl Lirtsrd ciylilao
18. Fetlrrs Nare (F1rsL nedde, Int srdfix)
(first name unknown) Heinbaugh 19. Mamere Name IFk,t mkkM, nWden wmenr)
(unknown)
20e. Inkamem'e Name (Type I Pdm) 20h. InMrronYa Mewing Adbep (StrsM, dry /tam, err, sip coast
Kenneth A. Sholley 639 Gettysburg Pike Mechanicsburg, PA 17055
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