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HomeMy WebLinkAbout11-30-09 (2)PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF C~,''r ~ Q f' ~~ ~ ~ COUNTY, PENNSYLVANIA Estate of also known as Deceased ~ - Q ~- ~ File Number Social Security Number ~~ ~ _ ~~~ 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 Testamen r a d aver that Petitioner(s) is /are the ~~''~Qr " ` ~.~'t ~ U named in the last Will of the Decedent dated ~~ ~f ~~~~and codicil(s) dated (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ ,~, ~,,, ~ ~.ca ~ , Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution~t~ji~ns,)tiume>~) offer-ed .r.,t ~C y3 for probate, was not the victim of a killing and was never adjudicated an incapacitated person: -?? t-- - _ ~,c,~ .~ i~.. '~ ^ B. Grant of Letters of Administration - (Ifapplicable, enter: c.t.a.; d. b. n. c. t. a.; pendente liter durante absentia; dttrk~toritate) '. ~ ~ ~ :. Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following mouse (if any) ~ heirs:. (If ~; Adntirtr'stratioit, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ l Name Relationship Residence (COMPLETE IN ALL CASES:) AttacJt ad itio[sa [ slTeets i f necessary. Decedent w s dom'ci ~ t le at death m ~ / l ~~f''t ~° ~- ~" ( d n ~ Cqunty, ennsyly 'a ith ' ~ ~ his /her last rincipal residence at ~© /V cx~to ti/~ ~j•~_ cai ~- [t i~ S a ~ ? o C (List street address, tow~e/city, township, county, state, zip code) ¢~ j Decedent, then ~ ~ years of age, died on ~~ at ~~~ ~ '` ~ r ~ / ~ ~ ~, ~~ 1 Decedent at death owned property with estimated values as follows: ~~~ If domiciled in PA ~~ ~ ~ Q O ( ) 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 ~, ( $ ~ '7Q ,O~y© situated as follows: ~ C~ RG ~ ~ ~~"' s2,- ~6 ~~ Q ~~~c.fisz a . ~~~ C f2- /' ' t.u ct r Z %-~1 ~ Q ~0 5 S Q- SS ~` o'.? a xc1, 'wt`i ~ FQ ~ /y1 • /LP C ~',2.~1 /? c 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: l signature Typed or printed name and residence ~ 7~~5~ ~~~~~y Forni RW-02 rev. 10.13.06 Pabe 1 Of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF ~ ~ ~~ ~cs ~ ! Oi ~ 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 ~S } ~ Signature of Persona! Representative ~ c~ before me the (J' `' day of ~C, Q ~a n ]^ ~ ~ / ~~~ >~~ Signature of Personal Representative ~ ~~~ ~ C-7 t~ r"" - Q t~¢ ~ ~ ~ _.. 1 f ~......, ~i' ,~ ~.+.,. For the Register Signature of Personal Representative ~7 C~ -~ t- '' ' r'~;,~„ ' ` ~ ;; ~~ ~ ,._ i File Number: / C ` A ' Estate of l ~ C ~- ~~ V v ~ ~ 2 ,Deceased Social Se urity Number: ~ ~ f / ~ _ S <~ / Date of Death: ~ ~ ``~ AND NOW, ~~~~, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters ~~~-rYl~~ ~A,uy are hereby granted to and that the instrument(s) dated described in the Petition be admitted to probate and filed of record he last Wi FEES Letters ............... $ O • ®~ Short Certificate(s) ........ $ ~ • ~~ Attomey Signature: Renunciation(s) .......... $ ~, ` ~~ $ I ~, ~~ Attorney Name: ...$ ... $ ... $ ... $ ... $ ... $ ...$ ... $ TOTAL .............. $ Supreme Court I.D. No.: Address: Telephone: icil(s)) q~ Decedent. Wills ~- in the above estate ~ ~ ~- 1 7 Q Furnt RW-O? ,~ev. lv.l3.vr, Page 2 of 2