HomeMy WebLinkAbout11-30-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~~ ~F1~l.~I~II.D COUNTY, PENNSYLVANIA
Estate of ~~
also known as
Petitioner(s), who is/are i8 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
Deceased
File Number t-~ 1-- vg - t ~a~
Social Security Number ~D~ ~~~ ' ~ ~ t/V
^ 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
G'a ~ Q --;- ~ .--
State relevant circumstances, e. ~ - ' ''" ~
( g., renunciation, death of executor, etc.) ;~ Q .+a
4 J _r•t
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after executio o e instturt~ir (s) of~exed,;;
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ ~ ~^.-a ~--
r
~B. Grant of Letters of Administration
- (!f applicable, enter.' c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia; durante ntinoritate)
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: (!f
Administration, c.t.a. or d.b.n.e.t.a., enter date of Will in Section A above and complete list of heirs.)
at
his /
N
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at
rt street address, towrfz/-city, towns/rip, count), state, zip code)' / ~ ~ /J j~ /~g~- ~ ~ /~
Decedent, then (~ ~ years of age, died on dV . ~ t /V[tT~~~ (DTI IL_~ ~~~,~.~ ~~ V ~ }
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 $
situated as fo
..
676.E
Forur RVV-0? rev. 10.13.06
Page 1 ofd
W~
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(COMPLETE INALL CASES:) Attach additional sheets if necessary.
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:
rT
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
., f ,,} SS
COUNTY OF ~ Ul1~l ~e ~` Cl V"t V
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 acid subscribed
before. me'the' _ day of
~~ ~~
~~
For the R i er
Signature ojPersonal Representative
N
c~s
A ~
a~O ,,...
File Number: :z7~ 'e <
W ~ ,=,
Estate of~~I'I \~~ CAA Tl ~~iYVI~_C ~ -d ~ ~.;~
• ~ -p a
Social Security Number: _ c3U1 ` ~~G Date of Death: - - ~
~ _..t -~- _ T,
AND NOW, ~~ ~)1t~.Q ~~1h ~. ~ e~U ~~ . ' '~ t.,~, ,. _.,
m consideration of the foregoing etition, satictory pi`obf
having been presented before me, IT IS DECREED that Letters rid yn l~ r S +-~~ ~ U~`~_
are hereby granted to
~ ,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 DAced~nt. -
FEES ~_ /~ ~ "'~~ ~~~
Register oJWills P C ~ 11 ~i(1 p
Letters ............... $ ~ " v,"`
Short Certificate(s) ........ $ ~ (D ~ (~O r1
Renunciation(s) .......... $
~~Cp ... $
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Fo+•,u RW-0' rev. lU.13.06 Page 2 of 2
___ _
i. n-. ROB ~~~~r01 /0";~ ~ ~ ~,~
G
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.:
Fee for this certificate, $6.00
P 16021718
Certification Number
This is to certify that the inform~~tion here given is
correct y copied ftaln an original (:ertificate of Death.
duly filed with me as Ioca1 Registrar. ]fie :original
certificate will be focivarded ao the State Vital
Records Office for permanent filing..
,~ NOV 1 9 ~ 09
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Local Kegi ~ Date Issued
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