HomeMy WebLinkAbout04-28-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C' y ~, b ~~- ~, c~N~ ~ COUNTY PENNSYLV
ANIA
Estate of J' ~Kt'fy ~~ `~-~.~.1 ~ S '.,.. ~O
File Number
also known as ~~,Q~-may ~ -~ D~~~ ~
Deceased Social Security Number L (3 ~ 3 O ' (p ~ l~
Petitioner(s), who is/are 13 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 __
named in the
~~.~~
(State relevant circumstances, e.g., renunciation, death of executor, etc.) ~,; -~, ~,
Except as follows, Decedent did not many, was not divorced, and did not have a child born or ado led after execution o•'fe~ ~. .~ ~ c
P trums) offered -i
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ ~~ nJ ~ - -3
_~ -
~ ,-•~
B. Grant of Letters of Administration i ~ ~ ~ ~'' zi" ~' ' .~
(lJapplicable, enter.• c. t.a.,• d.b.n.c.t.a.; pendente life; durance absentia; c~i aii~ minoritat2~lD , -__ "
... r~
Petitioner(s) aftet• a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if arand heirs
Administration, c.t.a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of hefts.) ~ t
`~S~~J
Pp- ~~oll
~~o~
Decedent, then -i~ Years of age, died on ~g r v at Z . •
Decedent at death owned property with estimated values as follows: ~ ~a ~
(If domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania $_
(If not domiciled in PA) Personal property in County g
Value of real estate in Pennsylvania $ ~~ -
situated as follows:
Whe~•efore, 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:
S• re T ed or tinted name and residence
~7dlt
Forst R 6Y-02 rcw. l 0.13, 06
Page 1 of 2 ~'
~~
,~ ..~,
(COMPLETE INALL CASES:) Attac/z additiot:al s/:eels if necessary.
ecedent was dgttliciled at death in [~~-~, ~j .r ~,~ County, Penns Ivania with his /her last principal residence at ~~ ~ s
(List street adds ess town/crty towns/up, county, state, up code
Oath of Personal Representative
COMiV10NWEALTH OF PENNSYLVANIA
SS
COUNTY OF
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true 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 af#irmed and subscribed
before me the ~~ day of
,arno
,~ .
f For the Register
Signature of Persona! Representative ~~~ d '~
~
1 -7~^^ ~^^~
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Signature orPersonal Representative '``~,• -~ 1'~,J ~_-
-i :-~~
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Signature of Persona! Representative _ ~ ~j - "r
~.,, .. _ ~
~ `' C.~s
•,_i
File Number: .~.~ -' ~ ~ -- ~~
Estate of '
p. t' ,Deceased
Social Security Number: 1~t3 - 3Fr ~ ~ Dy ~ i Date of Death: `t ` ~ ~'
AND NOW, ~~ , ,,20tC~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters _ 1~rc~~ln~~'r-o~ ~ptn
are hereby granted to Foct-eS~. ~ -~s
111 T}tP. A}1(1VP. P.CtAtP.
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Wil
FEES
Letters ............... $ 'Z Ct0 -~
Short Certificate(s) ........ $ ~D -oo
Renunciation(s) .......... $ 5 -~
~c..s ~3 -~
...
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $L, ~,1D
Codicil(s)) of Decedent.
Register ojWills
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
F~,~,,; Rcv U? rev. lU.13.U( Page 2 of 2
C=
RENUNCIATION ' ~' ~'
'~~
c7
~_~~
r-
~
_ REGI ER OF WILLS `-~~~~~~
~h COUNTY, PENNSYLVANIA ` -' ~ ~~
.~
T, ---~
~.
Estate of _ ~''~~
....
~;
'- . ~: N
~ f.~
_..,~~
w ~ - 'tea
r ~ - ~~~
.. _..
C~ .~,~
Deceased
I, ~~'~
GO
(Pr t Name)
~ , in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully re uest that Le
>, _ q tters be issued to
y/1~~I~~
(Date)
Executed in Register's Office
Sworn to or affirmed a`nd subscribed
before me this __ ~ ~ day
of ,ao IO
~•~.
uty or R ister of Wills
v~
(Signature)
(Street Address)
5 ~,~~~sr~~~ ~, ~~'.
(City, State, Zip)
Executed out of Rea ister'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 day
of
,_
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form R6Y-06 rev. 10.13.06