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Home My WebLink About03-23-10PETITION FOR PROBATE AND GRANT OF LETTERS REG[STER OF WILLS OF ~` LII-1~L"~LA~~ COUNTY, PENNSYLVANIA Estate of + - - ~ ~C C~- ~ ~~ /-1 ~e ~~ ~~ ~~ File Number t~~ ~~(,' ~ l.~' ,~~~~~~~.~% also known as -7 ,Deceased Social Security Number ~ ~ ~ ~~ ~ 7 / 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 Testamentary and aver that Petitioner(s) is /are the last Will of the Decedent dated and codicil(s) dated rv :7 ° "named in tNe ;_ ~ ~ Tyr tU (State relevant circumstances, e.g., renunciation, death of executor, etc.) - '~.._ C:~ -p ~' ' Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution o~j 1~ iristrumer~s) ot~ered - for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ..~ =~i ~~ ~ -'"~ ~ , B. Grant of Letters of Administration ~ (If applicable, enter: e.t.a.; d. b. n. c.t.a.; pendente lire; durance 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.) 3 ~, /~~~~. was domiciled at death in ,1 NC' County, C tiLL! ttln ~i= S ; ' ~~ Lt S L L- (List street address, town/city, township,, county, state, zip code) with his her ast principal residence at JG' ~~ Decedent, then ~~ years of age, died on lCl Ly1~lAI~'~ i't o7 C/C at Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ Qt ~~ ~ , (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: or printed name and residence Form RW-02 rev. 10./3.06 SIAV~Et.~E Srn ~T~ ssg s. ~4I~~OV~ ~,sT. Cl~2l.lsl.~, P ~ t1o l 3 Page l of 2 'v ~~ (COMPLETE /NALL CASES:) Attach additional sheets if necessary. Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CU Y-'- IMP ~t ~R N C~ SS 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 a~ subscribed before me theme ~ ~ day of i s ~~ For e Register i File Number: C7 r.a ~ `'- 0 0 -i '7") ~ ~ .~ _ ` -~ W j i ~ ~ -Cl ~ _~ ~ -_~.~ .Y _~,~ ~. c Estate of ~ /~ ~ ~ ~'t`~' '~ ~ U ~ l C~L~( -- ,Deceased Social Security Number:T / ~~ ~ g ~'i ~ ~ Date of Death:,% C~ ~JL~~.t A~ ~( ~ 7 ~ o~G~ ~D AND NOW, ~ ~~~~ ~f~~r ~ i~ ~%` , in consideration of the foregoing Petition, satisfactory proof { - ,- , .' having been presented before me, I IS DE REED that Letters ~#'r}"L~'-~ d~'t~~~1 t`.1.~{~~~'`~._~ are hereby granted to -~ ~~-+~1-E ~ ~ ~ ~LtiL'~. ~~}°`~. ~~ in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of FEES t~ ~ ~Li Letters ............... ifi . , $ $ / ~%~ cate(s) ...... Short Cert .. Renunciation(s) ........ .. $ f- ~' ~ . ~~ .. $ ~ '~ . l..~L ..~y, 1 ,~ . ~ L`~ . $ -~~ . .. $ . .. $ . ..$ . ..$ . ..$ . .. $ . .. $ TOTAL ............ .. $ L, of Personal Representative Signature of Personal Representative Signature of Personal Representative as the last Will (and Codicil(s)) of Decedent. Attorney Signature: Register of Wills ~,1 / `~_.lr x,1.11/ ~. Attorney Name: ~IAGLC''- u\ ~~m ~ ili Supreme Court I.D. No.: / ~ y Address: ((~ << ~ • ~v(.~~ ~~~~ Telephone: ~ ~ ~ ~ `~' ~ ~ ~ ~ l Form RW-02 rev. 10.13.06 Page 2 Of 2 ~ ~ __~~-U~La ,. F~~GISTRAR'S ~~RTI~ICATlON OF' ~~A°~H V+/ABC=1~IG; It is illegal to tit!plicate this copy by photostat or photograph. P ~16320~7~+~ . °~ ~'~ ~ ~~ '. ~ , °~ 43 A j \ ~ ~fl. 9~~f =fit ~; 4 `~`~' ~~, lhls l~ti E„ C(°~"lfl Ih~i; ~~1~ 1;1fGP?t1~lllt7l! Ill~'~' ~'i~e1~I t 311 C.1_I i+.'j~.t. E 1f,7t11 tSl OI I~~t13 1~ ~~C" I~ l~i~~" ,)f L~~:1 d?sl~ t~ilctl ~ti~r<< ;re ..1 Ll cal kc ~i,tt~at. Tl~e ,r~gin '~tiFil i ~,~. 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Notary Public My Commission Expires: ".Ttt n..~ ~ ~~%~ (Signature and Seal of Notary or other ofticial qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PENNSYLVANIA Notarla15es1 Dawn L. Russell, Notary Public Middle Smithfteld Twp., Monroe County My Commission Expires June 4, 2013 Member, Pennsylvania stssociation of Notaries c7 ~~, ~ -~. RENUNCIATION ~ ~-' _ , ~,,_ ~~ ~ ( REGISTER OF WILLS ;~ _; ~ , ~il M YJ~k ~fl-~J~ COUNTY, PENNSYLVANIA _ ; ~ ~`~ ~ > .:u n ~ , ri ~~~ ~~ _~> .__ Estate of ~ ~~ ~ ~ ~ ~ ~~~~ ~ ,Deceased V I, ~~ ~, ~-' IU ~ ~C'--C'.1- , in my capacity/relationship as (rint Name) €:~ N of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~~.1 I ~ ~ ~`t~-f~ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills ,.~~ ~~~~ (Signature) '~ (Street Address) ~~rST~~., U ~~ c~ ~ yy3 (City, State, Zip) 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 /s' day Notary Public My Commission Expires: :~ i,c,~;~ (Signature and Seal of Notary or other official qualitied to administer oaths. Show date of expiration of Notary's Commission. ) Form RW-06 rev. 10.13.06