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HomeMy WebLinkAbout05-11-10r PETITION FOR PROBATE AND/ GRANT OF LETTERS REGISTER OF WILLS OF aj~(~t1 ~GiICO[ COUNTY, PENNSYLVAMA Estate of _ C 11 ~ m . ~~ ~ Q a also known as Deceased Petitioner(s), who is/aze 18 yeazs of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) File Number /1 / / " ~V ~ D ` O / Social Security Number (T ~ - 3-z - ~ ~ 5~ 3 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the H C I R ^~ named in the last Will of the Decedent dated and codicil(s) dated (State relevant circumstances, e.g., renunciation, death ofezecutor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ^ B. Grant of Letters of Ad `.£~ -~- ~C --Z, ~ ~ '~~ dtttrment~offe rf~" r^ _7 _ n - rt.., ~7 C7 wC-,i~ (!!applicable, enter: c.t.a.; d.b.rt.c.t.a.: pertdentelite; durartteabsentia; dura~78~ritate) •• ' ~ F d:?~ i Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) att~'4~tirs: (!f Administration, c.t.a. or d.b.n.c.t.a., enter hate of Wi[[ in Section A above and complete list of heirs.) (COMPLETE INALL CASES:) Attach additiotral streets ifnecessaty. Decedent was domiciled at death in County, Pennsylvania with his /her last principal residence at (List street nddreas, towst/ciry, towns/tip, county, slate, zfp code) Decedent, then ~_ years of age, died on o ~ - o y - 7, of vat ~ "1 ~, d Decedent at death owned property with estimated values as follows: (Ifdomiciled in PA) All personal property $ 3000 (If not domiciled inpA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $_ f~ QO p situated as follows: ~~_~i.~~.TIMo.C 7= -P~1C t" Cet~Pa~tS~2.S ~~ 1'~ 3a~ Form RW-0? rrv. !0.13.06 PSgB I Of Z Wherefore, Petitioner(s) respectfully request(s) the probate of [he last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Oath o#' Personal Representative COMMONWEALTF~OF PENNSYLVANIA / ( ~~ SS COUNTY OF _1L1' Iti,- 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 and,subscribed before me the ~ day of o?Oi ~ ~. the Register Representative Signature ojPersannl Representative Signature ojPersonnlRepresentative v' ~A;:i = rr-,, ys C, ~ ~ r> ry;a , ~ _ ~ File Number: ~ ~~ ~ ~ (/ ~ 1~~i ro .,;- ~ t~ _ ~~, Estate of , Dece~e~i F ~~ L va ,~ .1 a~ ~ '~ - s Social Security Number: ~ ~ ~~ c~ ~ ~~ ate of Death: U ~ AND NOW ~ ~ f ~/ . in onsideration of the foregoing Petition, satisfactory proof having been presented before , IT I5 DECREED tJiat etters 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 a last Will (a Codicil(s)) o cedent. , FEES Registeroj ills 'lA/ Letters ............... $~~z ~X/` Short Certificate(s) ........ $~ Attorney Signature: Renunciation(s) $ .$ ' ,$ .. $ .. $ .. $ .. $ .. $ .. $ TOTAL .............. $ ' Attorney Name: Supreme Court I.D. No.: Address: Telephone: Fa'm RW-02 reg. lo.r3.oe Page 2 of 2 ~ y~ 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 16534244 Certification Number V Nidb/q REV 1121m rrPE/PRrrr ~ rcxc ,i b This. is to 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 Vit211 Records Office for permanent filing. c R~ ~~xz>~>r M~fY 7 / 2010 Local Registrar Date Issued n _ C o '^ _ ~~ ~~i rn "x7 ~" ~"~ ~,~ Cr ~ vi - 's ~ ., m ~ ~ ~:a 1; 7 ~ 1~ ~~ _ ~ ~~ =`- ~ ~ . ~i IV QOMMONWEALTH OF PENNBYLVMIIA • DEPARTMENT OF NEALTH • VRAL RECORDS CERTIFICATE S>R t)EATN (Sse Immuctlons ~retl ~xampNs on rddwrw) e,,,r ~. b „~ ~.~„ 1. YbraDlrOb111+r. nddaF. e.e Neu s. Sw addgY Brrdi Wnbr ADrrauFFdi ldbad. d•x mW 199 - 32 -- 2253 Ma 4 2010 5.?p Wr79rhy~ Ibdbl 1 e. o.raaMC - a. 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LAIR ~ I, EVA M. LAIRD, of South Middleton Township, Cum~rland w ~~ ~. ~-~ tT', ~.. G~ -.;•, County, Pennsylvania, do hereby make, publish and declare this.to be my Last Will and Testament, hereby revoking any and all former Wills by me at any time heretofore made. 1. I direct the payment of my just debts and funeral expenses as soon after my death as will be convenient to my Executor hereinafter named. 2. I direct my Executor hereinafter named to sell my prope real and personal, at public or private sale, and to divide the proceeds of sale equally among my children, GARY L. FICKEL, KAREN Y. SHERMAN, SHARON E. GROUP, and JAMES R. FICKEL. 3. I nominate, constitute and appoint my son, GARY L. FICKEL, Executor of this, my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 16th day of December 1982. l , (SEAL) a Laird Signed, sealed, published and declared by EVA M. LAIRD, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. - ~ - COMMONWEALTH OF PENNSYLVANIA ) SS.. COUNTY OF CUMBERLAND ) I, EVA M. LAIRD, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law., do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by EVA M. LAIRD, the Testatrix, this 16th day of December 1982. ., _ ~i . c Carlisle, Cumberland County COMMONWEALTH OF PENNSYLVANIA ) ~Y Comroiscion Exptrer March 26~ 1981 . SS.. COUNTY OF CUMBERLAND ) We, JAMES D. FLOWER and JAMES D. FLOWER, JR., the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that EVA Ai. LAIRD signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hewing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to .before me by JAMES D. FLOWER and JAMES D. FLOWER, JR. , witnesses, this 16th day of December 1982, tness ~~ ,.votary runlic NOTARY PUBLIC Carlisle, Cumberland County ~Y Cammiulon txpira March 26, 1985 - 2 -