HomeMy WebLinkAbout06-01-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~,~ n/1 ~ COUNTY, PENNSYLVANIA
Estate of ~ ~ File Number d ~ - ~ ~ -~ U 5~~~h ---
also known as ~ ~ ~g ~~ ~~
,Deceased Social Security Number ~_~
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
A. Probate and Grant of L ters Testame a nd aver that Petitioner(s) is /are the ~~ P.~,cc~r i ~. named in the
last Will of the Decedent dated "i / and codicil(s) dated
- _ _ . _`
(State relevant cir~umstan'ces, e.g., renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
^ B. Grant of Letters of Administratio
.~. -
(Ifapplicable, enter.• c. t. a.; d.b.n.c.t.a.; pendentelite; duranteabsentia; du`~
~~
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followingt~
Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above anti complete list of heirs.) ~ ° ~~~
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any) aftd heirs; (If`
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
e e ent wa domiciled at th in ou Pe nsyly with his /her st incipa sidence at
(List scree[ address, town/city t wnship, county, state, zip code) ~ .
Decedent, then }ears of age, died on~ at ~ ~I
~ ad { ~
Decedent at death owned property with estimated values as follows: r~~
(If domiciled in PA) All personal property $ ~~1 ~ . ~ ~~
(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 Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Signature ,,,n Ty ed or ~intwed~name and residence ~ d L ~
Form RW-0? re,~. lo.r3.o6 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tine 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 me the ' ~ day of
o~v
~. (~ .G. -'(~~
For the Register
Signat re f Personal epresentative
Signature ofPerso~:al Representative
~
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c. ~,
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Signature of Personal Representative r~ ~ ~ ~ . ,
f~ ~ ~~ ;i
W~.-y ~
,~
C~ Q -rt _ ry
File Number:_ a ~ - 1 C7 -- O ~Jr rJ .' ~"~ ~ _ -
. ~ ~ ""~ .. •~ ~l ;l
Estate of ~ ~~ ,Deceased ~ ;-.
Social Security Number:__~~ + ' 1 Fr- 5'h ~ Date of Death: ~ ` ~. ' ~-~ ~ ~
AND NOW, l)...c~ 1 0~0 tc~ , in consideration of the foregoing Petition, satisfactory proof
having been presen d before me, IT IS DECREED that Letters -T~es-~
are hereby granted to i-~~r(~~o... 'A m c C `n ~.~ .
_ in the above estate
and that the instrument(s) dated __ Jc- - Z(7-- q "ij
described in the Petition be admitted to probate and filed of record as the last Will (aiyd Codicil(s)) o,~ Decedent.
FEES
Letters ............... $~, (~
Short Certificate(s) ........ $ ~ . (~
Renunciation(s) .......... $
_~ j. ~ Ll. ... $ ~ ~~ , C~17
~ ... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ~z •SO
Furor R6V-U' rev. 1U.13.U( Page 2 of 2
Register ojWills
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
Address:
Telephone:
OCAL REGISTRAR'S CERTIFICATION OF DEA'~H
WARNING: It is illegal to duplicate this copy by photostat or photograph. , ,
~ Fee for this certificate, $6.00
P 16192C~~2
Certification Number
R105~ti3 REV IIQ008
TYPE ' PRWT W
PERMANENT
BIACK da(
i~
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 rmanent filing.
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Local Registra>~ Date_ Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTIAENT OF HEALTH .VITAL RECORDS '~ -'~ • • ~` ' ' `° : _
CERTIFICATE OF DEATH ~' ~ ~ '~`-~-~
(Sae Instructions and examples tN1 reverse) STATE FLLE NusaRFR ~~
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LAST WILL AND TESTAMENT ~C?c.~'~ ~'"
MARY JANE McCLAIN ~ ~ ~ ~:
~r
I, MARY JANE McCLAIN of Mechanicsburg, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament,
hereby revoking any will previously made by me.
I - I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II - I bequeath my furs and jewelry to my daughter,
Linda Donohue McClain.
III - I bequeath certain other items of my tangible
SAIDIS, GUIDO,
SHUFF &
MASLAND
2109 Market Street
Camp Hill, PA
personal property, not including cash and securities, in accor-
dance with a written list made by me during my lifetime. In the
absence of such a list or designation on said list, I direct that
my executor hereinafter named distribute shall either distribute
said items to my heirs or shall sell said items and add the
proceeds thereof to the residue of my estate, as my executors in
their sole discretion shall determine.
IV - I forgive any indebtedness owed to me by my son,
Robert E. Donohue.
_ ~ 1'ti'1
Page 1~
V - I direct that the balance of a $4,000 loan to my
son, John E. Donohue, made during my lifetime shall be treated as
an advancement of part of his share of the residue of my estate.
VI - I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate to
my children Robert E. Donohue, Linda Donohue McClain and John E.
Donohue, in equal shares, the share of a deceased child to be
paid to his or her issue, per stirpes.
VII - I appoint my daughter, Linda D. McClain, and my
SAIDIS, GUIDO,
SHUFF &
MASLAND
2109 Market Street
Camp Hill, PA
attorney, John E. Slike, Coexecutors of this, my Last Will and
Testament. Neither of my personal representatives shall be
required to post bond in this or any jurisdiction.
IN WITNESS HEREOF, I have hereunto set my hand and seal on
this, the ~
a day
of
, 1997.
r
M Jane McClain
Page 2
Signed, sealed, published and declared by MARY JANE McCLAIN,
Testatrix therein named, on this and two (2) other sheets of
paper as and for her Last Will and Testament, in our presence,
who, in her presence, at her request, and in the presence of each
other, have hereunto subscribed our names as attesting witnesses.
Q~ ~ .
Address
~~~~ ~ ~~
Address
SAIDIS, GUIDO,
SHUFF &
MASLAND
2109 Market Street
Camp Hill, PA
Page 3
Name
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND)
WE, the undersigned, the testatrix and the witnesses,
respectively, whose names are signed to the foregoing instru-
ment, being first duly sworn, do hereby declare to the under-
signed authority that the testatrix signed and executed the
instrument as her Last Will and Testament and that she signed
willingly (or willingly directed another to sign for her), and
that she executed it as her free will and voluntary act for the
purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the testatrix signed the will as
witnesses and that to the best of their knowledge the testatrix
was at that time eighteen years of age or older, of sound mind,
and under no constraint or undue influence.
1~ ~;
e~..,~.
estatrix
n
SAIDIS, GUIDO,
SHUFF &
MASLAND
2109 Market Street
Camp Hill, PA
Subscribed, sworn to and acknowledged before me by the
testatrix, and s~scribed and rn to before me by both wit-
nesses, this ~O day of , 1997.
' C~ f/ r
~ Z ~c~~~
otary Public
NOTARIAL SEAL
THELMA S. McCAUSLIN, Notary Public
Camp Hill, Cumberland County
My Commission Expires July 3, 20t?0
,_~u........ ~_.
RENUNCIATION
REGISTER OF WILLS OF
Estate of Mary Jane McClain
CUMBERLAND
COUNTY, PENNSYLVANIA
~eceased~-;
F~ c.> c a- ~~°
cis ~' -- ' ~~ ' ~~~~
;::~:~ : C ; .;, , ;i
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John E. Slike in my capac ~/relations as ' ~'
(Print Name)
co-executor
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Linda McClain
May 4, 2010
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of .
Deputy for Register of Wills
~'-
(Signa
2109 Market Street
(Street Address)
Camp Hill, PA 17011
(city, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he o~s#~e executed the renunciation for the
purposes stated within on this y~~ day
Ndt~~ry~Public
My C mission Expires: ~ ~ ~ ~ 2~~ t ~Z,.
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's commission.)
coi~on+w~.n~ of ~~sn~
Form /?UV-06 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.
rVotariM se.l
Yvonne ssrsc:h. Wofalry Pubec
camp Hltl Boro, Cwnbariard county
My Corrm>lisslon Explnes Fib. 1. Z01Z
Member, Pennsylvania Assodatloln