HomeMy WebLinkAbout02-18-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF COUNTY, PENNSYLVANIA
Estate of ~ {~A-~~C /t-~ . /~~,~1 _Y File Number _ _. p2 ~ - ~U I O ' V I5I
also (mown as
Deceased Social Security Number ~ Sc ~o ~/ oZ - .~ l.,
Petitioner(s), who is/are IS years of age or oldey apply(ies) Ibr:
(COMPLETE'A' or'B'BELOW.)
A. Probate end Greet of Letters Testamentary and aver that Petitioner(s) is /are the
teemed in the
last Will ofthe Decedent dated and codicil(s) dated --- _ ~n o __ -`
(57wte relevmu ctrctarvlances, eg., remmciatton, death of erecuror em.) --;. ~ ~ ap C z-
E as follows, Deoedem did mt "`~ ~~_ ` ~ ~.
xcept marry, was not divorced, and did twt have a child tom or adopted after execution a fy~er~ offet+ed ~-ra
~~
,. C
for pro ,was not the victim of a ' ' and was never 'ttdiceted an ' ~ _ ;_.:;
Inlltng adJ tncapecttated pe<sort: = ~ '_~'^~'r
~,~ ~
B. Grant of Letters of Admieistrstioe Glr "w~
((/'apptreable, enter. c.Ra.; db.n.ata: pendenre Iite: daraste absentia: a6ra+~ mtnarttateJ
Petitioner(s) after a proper search has /have ascermined that Decedent left no Will end was survived by the following spouse (if any) and heirs: (If
Administration, c.t.a or db.n.c.t.a., enter date of will in Section A above and complete list ofhetrs.)
Decedent was domiciled at death in CUIN R ~ Coumy, Permsylvatn~ withhis / t~et~ast principal residence at
street addi^ess, town/crry,
then
at ~ ~ .tL LbH.tt [r / ~/~71 1 nt' ~
Decedem 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 Cwmty
Value of real estate in Pennsylvania
a d
a
S
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Aonn ew.o2 rev. 10.13.06 Page 1 of 2
cotoity, state, z!p code)
of age, died
(COMPLETE WALL CASES:) Attack addWotro-skats {J'tntccessnry.
atn~ea as follows:
Wherefore, Petttiorier(s) rospectfiilty request(s) the probate of the last Will and Codicil(s) presented vrith this Petition and the grant of Letters in the apptc~priate form to
the undersigraxl:
-~, ,.
_i~~y ~, . _ ;,fin; 1 t^
Oath of Personal Representative 201U FEB I $ AM 11 ~ 05
COMMONWEALTH OF PENNSYLVANIA
ss CLERK OF
COUNTY OF ~ c ln1 ~ (-t~ ~,4{.j ~ ~P~~~ C~UR~
CUMBE~L~l'~1D CC.. PA
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are ttve and con•ect 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
before the the .~ r~~ /~d~ay~of
6~c=~
For the Regist~
ajPersonnl
Signnture ojPersonnl Represenrnrive
Signnrw•e ojPzrsaml Representative
File Number: ~~" a2~~U' V~,J~
Estate of(~' 1~C1t M , «C;%(,~-~{ ,Deceased
Social Security Number:.3'`jb -/~ • ~~ ~(. Date of Death: t ;,~/O S
AND NOW, ,inconsideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters
are hereby granted to - _ _
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 ............... $
Short Certificate(s) ........ $~
Renunciations} .......... $
-~1 CS .. $ a3, pro
Att-~ .. $ 5. ao
.. $
.. $
.. $
.. $
.. $
.. $
... $
TOTAL .............. $_
in the above estate
Attotey Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Register ojWi!!s
Porm RW-!1; rev. !0.13.06 Page 2 of 2
OCAL 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 given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
P 15980967
Certification Number
// b~~0~
Local Registrar Date I
C'7 ~
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COMMONWEALTH OF PENNSYLVANU • DEPARTMENT Of HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(Saa 61sb11etlons and axelmplu on rawrwl
_ _ STATE FILE
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