HomeMy WebLinkAbout03-02-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF G' U r11 /3E72L/1~iU0 COUNTY, PENNSYLVANIA
Estate of__/1')Qri Q11/12 l~r~ $ 'LOYI'1 File Number .Z~ -/ O ~ ~~-h_J
also Imown as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
Deceased Social Security Number
^ 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
(Store relevnnt circanutnnces, e.g., renanciatiwt,
exewtor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after
for probate, was not the victim of a killitig and was never adjudicated an incapacitated
ySl~ 7a- S'fG7S
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B. Grant of Letters of Administration
- ~ (IJnpplicable, enter: c.t.n.; d.b.n.at.a,; pendente lire; tfurnnte absentia; durnnte miuoritate)
Petitioner( after a proper search has ~hnve ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (!f
Adntinistraria:, c.t.a. or d.b.n.c.l.a., enter date of Will in Section A above and complete list of heirs.)
Decedent, then 4~° years of age, died on TGt.1'1. )Qt ZOrD at Sao Rauert ~' tart I'tC ~kax~jGShtt
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ S, DOD. °°
(lf not domiciled iu PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ AJ~~}
situated as follows:
Fa~m HNC-0? re~•. to.13.06 Page 1 of 2
(COMPLETEINALL CASES:) Attach addi8oxalsheets if necessary.
DecetJ ent was domiciled at death in C krn be.f'~~ County, Pennsylvania with ors! her last pripripal residence at 3 DO ~~+NP.A
Cour'C ` INltc.hax-icsbwr4 ~~~~olar~ T' ~o, C'~,,~,,,,,,doc,- .,,.,1 ° T~ ~ lawns
(List street address, town/city, townsktp, county, state, ztp code) r
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:
~~. ~r~a~~ ~FF~',E
~atl1 of Personal Representative ri~'ut~~~c-~'~ ~%' ~'s'~j ~"
COMMONWEALTH OF PENNSYLVANIA 2aIO MAR ,~•~ AM ~ ~'~
SS
COUNTY OF C kYYI (~F~/'1~A(D ~ c
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are t (e)and co v~4~• .,
the knowledge and belief of Petitioner(s) and that, as personal Fepresentative(s) of the Decedent, Petitioners will
administer the estate according to law.
Sworn to or affirmed and subscribed
before e the ~ day of
~~~~t2~~ ~~~
the Register
Signature ajPetsoual Representative
Signature ojPe~ sonal Representative
Signature ojPeisann! Represenmtive
File Number: °Z/ ~Q - ~~V 3
Estate of /YIA-te.i.¢NNE G~eisCo~iN ,Deceased
Social Security Number: /~~` ~Q ` S~G7s Date of Death: fa/J• / 1, oZG/D
AND NOW, ~~~ ~ ~~~
in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Qf ~dm~n%s~.fi d n
are hereby granted to Ce /lCU? /N • SPdGC
in the above estate
and that the instrument(s) dated N/ ~•
described in the Petition be admitted to probate and filed of
FEES ~ ~
Letters ............... $
Short Certificate(s) ........ $~
Renunciation(s) $
~ .. $ •S
.. $~Z?'
.. $
.. $
..$
..$
..$
.. $-- ~~
... $ ~~U
TOTAL .............. $~ .
the last Wil]
Attorney Signature: ~'//~~~~~~"" " G . f,'i~CC~G//4- _•` _ ~,~
Attorney Name: (../7~P'/~CS E" ~/-~C~C+~S la.
Supreme Court LD. No.: //r3~S~3
Address: tQ a/auser /,~i~
~leclian~cs 6urg, P~ / 7asS'
Telephone: ~]/ 7- 7lo(o-Q.zQ/
Forty RW-02 rev /0.!3.06 Page 2 of 2
o -~03
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 16193303
Certification Number
, COMMONWEALTH OF VENNSVLVAlNA • DEPARTMENT OF MEAITH • VITAL RECORDS C~
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~ Mechanicabur Pa. 17050
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v u,~arraw 0425789
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
~c~ertificate will be forwarded to the State Vital
~~~•~%~',Cords~Offce for anent filing.
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Local Registrar Date Issued
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RENUNCIATION ~
REGISTER OF WILLS ~ ~+•
C 4 Mt BKI ~ e.~n COUNTY, PENNSYLVANIA
Estate of
Deceased
I, Ro13~'12T ? ~21SCoM
(PrtntName) in my capacity/relationship as
Stile her a^ u,nd Sow
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Y~ ~l~[~1 i'~ CoL [. E'EN ~i ~y~C,~C
~-~5~/0
(Dare)
Executed in Register's Office
(Stgnalure) T20QERT J. G'~15~'Di11
(Street Addrtss)
G~2/GNT.STo~.I! NT o~,s'd~ z
(c+ty, score. zt~l
Executed out of 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
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciatio~or the
purposes stated within on this ,~_ day
of /~ ~~~~
~ ,~iOl~~~ ~ l _/
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration ofNotary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
Notadal Seal
Charles E. Shields III, Notary Pubiic
Monroe Twp., Cumberlantl County
My Commission Expires June 20, 2912
Member, Pennsylvania Association of Natariea
CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHAIVICSBURG, PA 17055
GEORGE M. HOUCK
(1912-1991)
February 25, 2010
Register of Wills
Attn: Wanda Zeigler
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Marianne Grissom
No. 21-10.
DOD: 1/19/2010
Dear Wanda:
As per our discussion, please find enclosed the following items:
1. Death Certificate for Marianne Grissom.
2. Original of completed ROW form.
3. Check No. 1531, in the amount of $83.50 for Probating Estate.
4. Original completed Estate Information Sheet.
5. Original Renunciation of Robert J. Grissom.
6. Original completed Petition for Probate and Grant of Letters.
7. Original completed Oath of Personal Representative.
TELEPHONE (717) 76b-0209
FAX (717) 795-7473
I would appreciate you mailing to my office the short certificates at your earliest
opportunity.
As always, thank you for your kind assistance.
Very truly yours,
~~~~~`~~~ ~~y~°~
Charles E. Shields, III
Attorney-At-Law
CES/mjj