HomeMy WebLinkAbout08-25-10PETITION FOR PR/O'~B~ATE AND GRANT OF LETTERS
REGISTER OF WILLS OF V"'''"' ~~r ~t:'~ COUNTY, PENNSYLVANIA
Estate of ,' I~IWI~ V1 ~ ~ ~rrldl i1 ~S~ ~
also known as
, Deceased
File Number ~! ~ /Q ~~„U `W
Social Security Number ~"~ (d' j ~ ~ - ~ ~Z G
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 [he named in the
last Will of the Decedent dated and codicil(s) dated e~
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(State relevant circumstances, e.g., renunciation, death of executor, etc.) ~
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Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution ia~thltii l
mettl~j offeiedi r~
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ ~ ~ c y=' > .
•
~, B. Grant of Letters of Administration
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(lfapplicable, enter: c.t.n.; d.b.n.c.t.a.; pendente lire; durante absentia; durant8 ~inorit tea ~~
Petitioner after a proper search has /~ ascertained that Decedent left no Will and was survived by the following spqu~e (if any) and heirs: (!f
s
at dceath in _ ~.~-'t'~'17QN~a'-t W County, Pennsylvania with,J~J her last principal rdsitience at ~/ 3~ S~'~
GR9 ~ dP.S ONt'1 ~ 17
t street6ddress, towrdcity, township, county, state, zip codeee) '
Decedent, then ~ ~ years of age, died on /T~1 Y3i~ 201 d at ~ ~ L/1~-~/yj C~~r G O~` ,jl'~~rnc~ ~ ~i~
Decedent at death owned property with estimated values as follows:
(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
Value of real estate in Pennsylvania
situated as
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant
the undersigned:
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in the appropriate form to
,~.~~_
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Form RW-02 rev. l0.l3.od Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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 af#irmed and subscribed
before the ___E/////////JJJJ day of
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c
For the Register
Signature
Signature ojPersonal Representative
Signature ojPersonal Representative
File Number: ~~' ~~ `a 0 7
Estate of
Social Security
AND NOW, ~ ,C~J ~,
having been presented before me,
are hereby granted to ~
" /`/ " G / L(r Date
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satisf~ory pi°
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 (and odicil(s)) of Dec ent
FEES
0 o Register ojWi !s i
Letters ...... $_ ~.
Short Certificate(s)~~ ... $ ~ ~ Attorney Signature:
R ~ciation(s) .......... $ ,e
$ S~ Attorney Name: ^^ ~ ~'
• • • $ S_ oa Supreme Court LD. No.: eC ~~f~ `l
$ Address:
... $
... $
• • • $ Telephone: ~ (~ ^ 2 3$ "' Q 'Y7~ 1~
... $
TOTAL .............. $ '?
Fa•ni RW-02 rev. 10.13.06 Page 2 of 2
SOS.ROS REV mipp~ _ __ - - _ _- ~/ I I D V a /(Y
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photogralph.
Fee for this certificate, $fi.00 t tus is to certify tnat the tnrormanon Here given is
correctly copied from an original Certificate of Death
duly filed with me ss Local Registrar. The original
certificate will b~ forwarded to .the State Vital
.Records Office for permanent filing.
P 16587975 LGrm.~~ AUG091 i0
Certification Number Local Registrar Date Issued
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