HomeMy WebLinkAbout12-22-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Clunberland COUNTY, PENNSYLVANIA
Estate of Sharon S. Hillegas File Ntunber ~ ~ " ~ 7 " / / O
also known as
Deceased Social Security Number 1822-8746
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.) na
A. Probate and Gnat of Letters Testamentary and aver that Petitioner(s) is /are the
last Witl of the Decedent dated and codicil(s) dated
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(State relevant circumstances, e.g., remuxiation, death of executor, etc.) `` ~ ~ ~ "L7 "" ~'
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Except as follows, Decedent did not many, was not divorced, and did not have a child bom or adopted after execution of tG~strumentEs}offereld::~=
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ •n `'~~.--J
® B. Greet of Letters of Administration
(lfapplicable, enter c.t.a.; db.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: ([f
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name
Michael S. Hillegas, Sr. ~ Spouse ~ 540 Brentwater Rd., Camp HI11, PA 17011
Michael S. Hillegas, Jr. Son 540 Brentwater Rd, Camp Hill, PA 17011
(COMPLETE W ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumber land County, Pennsylvania with his /her last principal residence at
540 Brentwater Rd.. Came Hill. Came HIII Borou¢h. Cumberland Counri. PA 17011
(List street address, town/ciry, township, coumy, state, zip code)
Decedent, then 59 years of age, died on 11/23/09 ~ Harrisburg Hospital, Dauphin County, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property S 0.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County S
Vatue of real estate in Pennsylvania $ 0.00
situated as follows: n/a (residence address was a rental)
Form RW-02 rev. J0.l3.06 Page 1 of 2
Wherefore, Petitioner(s) respectfully request(s) the probate of the last WiII and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
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COUNTY OF ~,~'~I 1 L1 ~-~
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition aze 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.
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Sworn to or affirmed and subscribed ~ ~ C7 ~' ~'
Signature of Perso Repre e ' e <~ ~ ~ _ '
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before me the ~ day of ~ ~ ~~~, ;.' ~
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~ ~ Qi!'Y1~1. Signature of Personal Representative ~`~ C!~ ~ N ' r".'?
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For the Register Signature of Personal Representative S7 ~~~ n
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File Number: ~ I- U_ I r I
Estate of Sharon S. HilleRas ,Deceased
Social SnnecGurity Nu~;m/ber:~1p82-42-8746 ,,, ~~~ ~ y n ~ Date of Death: l 1/23/2009
AND NOW, aO ~ ~ u-U Uf" ~~!%IYI~fX.I, N~J~ , in consideration of foregoing Petition, satisfact~rl' Proof
having been presented be re , IT ~ DEC thatQtters V L
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 Decedent.
FEES
Regrst f wi ~(L
Letters ............... $
Short Certificate(s) ........ $ ~ o~, • ~V Attorney Signature:
Renunciation(s) .......... $
Attorney Name: W. Scott Staruch, Esq.
. $
... $ ~ Supreme Court I.D. No.: 23887
$ Address: Laws, Staruch & Pisarcik
... $
... $ 20 Erford Rd, Ste 305
... $
$ Lemoyne, PA 17043
• • • $ Telephone: (717) 975-0600
.. $
TOTAL .............. $
Form RW-O2 rev. 10.13.06 Page 2 of 2
105.805 REV (01/07) ~ -~ '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
P 15692477
Certification Number
This is to certify that the information here given i
correctly copied from an origina l Certificate of Dean
duly filed with me as Local Registrar. The origins
certificate will be forwarded to the State Vita
Records Office for permanent filing.
Local Registrar -_
Date Issued
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3 REV 7112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
/ PRINT IN
CERTIFICATE OF DEATH
(See inatructlons and examples on reverse) STATE FILE NUMBER
1. Name d Decoded (Fast nadtlb, bal, suNix) 2. Sea 3. Sadel Secudry Maher 4. D ,d" M (Akntlr, day, vqA. ~ n j A, ,.-
Sharon S. Hillegas Female 182 -42 - 8746 .~ ,~j %
5. Ape (feet BNtltday) lkider 1 r !hider 1 8. Deb d &M Monts 7. end state a 8a Pbce d DeaM Check one
Naraa DeYe hkias AtiaMe H
ospital: Other:
5 9 yam. August 2 2 , 1 9 5 Harrisburg , PA r~
1pI Inpeaent ^ ER l ou~eti•a ^ DOA ^ Nunnp Nome ^ Reeitlence ^ Du,a ~ svaanY:
SE. Canty d DeaM &. Cey, Bono, Twp. d Death Bd. FecMly Nara (K nd kMatutlon, 9N• etMd end number) 9. Wes Decadent d Flkadac OdgM? No ^ Yes 10. Race: Amedcen hrdbn, &ad, White, ek.
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Dauphin
Harrisburg
Harrisburg Hospital IM yea. ea•ah Cubri,
Maslen, lhMrb Riau, eb.) (Spedfy)
11. Decedents Ileum tlon KMd d wakd oa mat d Se. Do mt mb re' 12. was Dearbm ever in Me 13. Decedents EtluaBOn (Seedy say Nghest grade canpl d•dl tt. Medld SbWa: Meded, Never Maned, 15. Survivkg Spo use pl w9e. gNe maiden nemel
IOnd d W Kind d BudrMesl IndiMtry
Theatrica~.Produc ~T-I.p.G. U.S. Ambd Faces?
^Yea ®No Elemenbry / Semdary (0.12) College t d a Sv)
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Married
Michael S. Hillegas r
18.Oecedad's klegrp Addsee (street dY / bvm, mob, Np code)
540 Brentwater Road Deadenys pA Did oecedem
Aabra Residence t7a. sbb w „a.®Yae. Deaden! LWee In East Pennsboro Tvo.
W«+adm+n
Cumberland 1?d.^o
Cam Hill PA 17011 ~~
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16. FeNMya Name (Fast nidde, lest euNhr) 19. Mahefe Name (Fret midde, maiden sumeme)
John C. smith Betty Cassatt
2M. InbnrMnl'a Name (Type / Prkd) 20b. IntomMd'a MeiYng Address l6trem, dY /lows, ebb, zlp ~)
Michael S. Hillegas, Sr. 540 Brentwater Road, Camp Hill, PA 17011
21e. McBad d Obpoeitlm I ~ CrenMeon ^ OaMkon 21b. Date d Dlepoeitlan (Mats, hy, year) 21c. Plea d DbpaNa (Name d Y, aemdory a odMr plea) 21d. Lace6on (Ciy! faun, mob, zip cede)
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22a. d F a ardMp d such) 22b. Licerrea NumM 22c. Name and AddMas d FedMy
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RENUNCIATION
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REGISTER OF WILLS
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Cumberland COUNTY, PENNSYLVANIA :~c~-~-; ~. -±
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Estate of Sharon S. Hillegas ,Deceased
I, Michael S. Hillegas, Jr. , in my capacity/relationship as
(Print Name)
heir/son of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
m~ father, Michael S. Hillegas, Sr.
12/23/09
(Date)
(Street Address)
Camp Hill, PA~ 17011
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
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 a 3rd day
of `>>cr_r~T v
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~'~ ~ Notary Public
~' z° ~ -~ My Commission Expires:
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H •~ ~ (Signature and Seal of Notary or other official qualified to
o ~ ~ ~ administer oaths. Show date of expiration of Notary's Commission.)
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