HomeMy WebLinkAbout01-05-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGIISTER OF WILLS OF (JMIf~Cs.~~ COUNTY, PENNSYLVANIA
Estate of~ '1'~ A.~ lL~ ~MMA/' I ~L _ rJ/ /J~ 1~~ ~(~() j
also known as File Number CY ~J~^l/` C
Deceased Social Security Number ^~`''~ - 3~ -` / 9~
Petitioner(s), who is/are Ig years of age or older, apply(ies) for:
(COr4fPLETE 'A' or 'B' BELOW:)
^ A. Probate and Crant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of the Decedent dated named in the
--~_ and codicil(s) dated
(Store relevmn circumsrnnces, e.g, renuacintiort, lenrh ojexecuror 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:
CCU
^ B. Grant of Letters of Administration ~~ o
r~t~ "'ttt555 ~- '~'
fl/nPPlicab(e, ertrer: cr.n.; d.b.n.ar.a.; pendenre lire; rlurnrtte nbsenrin; rlurgr~ _ n[eJ ~.°' [~r
Petitioner(s) after a proper search has /have ascertained that Decedent left no Wil] and was survived by the following ,} ~ man t ~ ~~ r
AAministratiort, c.r.a, or d.b.n.ct.a., enter dale ajWil[ in Section A above and complete list ojheirs.) ~ 4 Q r
.'t
(COMPLETE /NALL CASES:) Artacl: additiona[sheets if necessary.
De a ent was dggticiled at death in ~ ~younty Pennsylvania with his /her last principal residence at /y y
YC~ L.In' `d~.1f~$ I7 '~~ J
(L r [ er nQA~i . s t /c ty r / P ty sr re
p cod
Decedent, then ~_ years of age, died on //
at
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) $- ~5 , ~~
Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania
situated as follows:
Wherefore, Petilion<r(s) respectPolly request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant ofLetters in the aeornndarr r ~~m ,,,
the undersigned:
`i
Farm R4V-0? rev. /0.(3.06
Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF ~~2 (' ~
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition aze hve and correct to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
before me the ~_ day of
~~~,
For the Register
N
b
Signnlure ofPersonnf
Signnlure ofPersannf Representative
AND NOW,
having been presented before me, IT IS DECREED [hat
are hereby granted to
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in consideration of the foregoing Petition, satisfactory proof
and that the instrument(s) dated in the above estate
described in the Petition be admitted to probate and filed of record as [he last Will (and Codicil(s)) of Decedent.
FEES
Letters ...... ...... ... $
Short Certificate(s) ... ..... $
Renunciation(s) ......
.... $ Attomey Signature:
. $ Attomey Name:
' ' $ Supreme Court I.D. No.:
-~_ ... $ Address:
-_ $ Telephone:
TOTAL .......... .... $
Farm RW-!1_' rev. lU.l3.OG
File Number: „~ I - ~GIQ- ~~ j ~ W
JJ~~ O
Estate of____~~, -x-1(1 n~ ~M-e~ ~'G ,Deceased
Social Security Number: ~~~~~ - ~„Cf SG Date of Death: (~ _ ~~ - ~cf
Wills
Page 2 of 2
C~ -C~C~
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
I Fee for this certificate, $6.00
P 16086342
Certification Number
This is [o certify that 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 forwarded to the State Vital
Records Office for permanent filing.
Ldfal Registrar Date Issued
N
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