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HomeMy WebLinkAbout08-10-10PETITION FOR PR BATE AND GRANT OF LETTERS ~A f REGISTER OF WILLS OF , ~a ~ ~ V 5 COUNTY, PENNSYLVANIA t~l Estate of l ~ ~Apg also known as ~ t Deceased Petitioner(s), who is/are 18 yeazs of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) File Number ~ Social Security Number ^ 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 s` a ~ '. tale relevant circumstances, e.g., renunciatiors, death ojexecutoa etc.J T "' . Except as follows, Decedent did not ma ?3 ~ _~ <=~> :~~ for probate, was not the victim of a killing and was neverrad udicated an incapac to ed personr adopted after execution 3j ~ ~ l ~ntme@(s) offeYtd ~:i u B. Grant of Letters of Administration C~_-~p ~ - ~+t ~~ ~ ~"' (ljapplicable, enter: e.t.a.; d. b. n.c.t.a.; pendentelite; duranreabsentia; duranteminoritate) ~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and Ireirs~ /i! Administration, e.t.a, ord.b.n.c.t.a., enter date of Will in~e~tionAabovea„d~.,,.,..t,,,,. r: _. _~, . m scree[ nddress, town/ciry, township, county, ,state zip Decedent, then ~ years of age, died on r ~,.~ Decedent at death owned property with estimated values as follows: (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania situated as Form RW-02 rev. 10.13.06 with his / het last All personal property Personal property in Pennsylvania Persona] property in County at $--~_~f L7r~ P Page 1 of 2 --'- -" ~~~ ~~~c~:~ Attach additional streets ifnecessaty. Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented w~tti ~i,,.. o_.:.:__ _ the undersigned: , ., Oath of Personal Representative COMMONWEALT OF PENNSYL/~VA,N~IA~ COUNTY OF te~'t/~U 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. /1 ~~ /~ Sworn to or affirmed and ~ me the day of Signature ojPersona! Representative () / " i ., Signature aJPersam! Representative Signature ojPersona! Representative File Number: r~' ~ 1 V - C~~ Estate of ~ ~.Q-/l ~. and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will r Social S urity Number I l.(/ I ~ ~ - ate of AND NOW, O having been presented for me, IT IS C > in consider D t Letters are hereby granted to FEES /~ Letters .......... $ C-L} Short Certificate(s) ....... $ Renunciation(s) .. , , , , , , .. $ ---•-- .. $ ... $ ... $ L .. $ .. $_ .. $ .. $ .. $ .. $ TOTAL . , ' Fa'ua RW-UZ rev /U.13.U6 Attorney Signature: Attorney Name: Supreme Court LD. No.: Address: Telephone: c~ v -. II~ceased N 0 n :.E c tr;.-, ~ c. ~ :~ _"<'J ~-7 S* ?'~'? ~ '' c`y _~] .. . ~~i Cn ~ ~ `~-> foregoing Petition, satisfactory proof n in the above estate Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH Lb~~ WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.OD P X5_935 66 Certification Number This is to certify that the information here given correctly copied from an original Certificate of Deat duly filed with me as Local Registrar. The origin. certificate will be forwarded to the State Vita Records Office for permanent filing. ~~ ~ ~ FEB~2 4 ~ 10 Local Registrar Date Issued -____.__~__ o a ~p rri ; -, ~ ~3 T ~_`~ ~~ ~- ~ ~OWR x COMMONWEALTH OF PENNSYLVANIA .DEPARTME _ NT OF HEALTH . Y1TAL RECORDS CERTIFICATE OF DEATH ~` ~ ''J ~) - r (see Nutruayona ens exemplar on ravens) ,.r~.ao.o,aiAtmna..wtaaop nn CC) , / ~G~„~~S 284 alooW ~MNrEa BTAn: FaF MMIBER a'~ed`r Female _ °i~", a oar a sn """' ~- 553 rsrr Dee. rbu, Bear r' .rrra `ors ~,, ,~ 2 a., r p 40br rDaY1 49va September 28, 1960 Harrisbur pA s. asp r oar, B, sear ec~,eaa*ra.roer~ saAee eb ~ ^a„ae r O a.mnr br r D ow ^ Dau hin e`rr'' dwrrrranb,~ D, car oe,eerv a aeD.,b apq P Lower Paxton Twrp. Community General O t Q°'^ '~° " ^ Rerrb, ^ py,. ~ v. "`r""""""t°"' A1 d s ° eaa eopathic Hospit i~n.bw r a1,ab ,a a tln rl tsb.OM `"^~« ' 1 , r 4rdr rrr b h ,a ~eeeemh Feiartl grrxr, - -. iaeeaerrtl, laorh r+r hpar arrr etlprq is xrr aer lark blry u a Amae Rwr a,,,,,,r,,, i eaadq. Ia,A Mree4 Rwr State Government ^ v a. a s.t ~tla nestle npy~ p ~a ° white r.eee ,e. &,W.er N,r, p wM dr aeb,n tlae~ . Re ~ `i0it„~o"mwrerw, cb~b.n, rrxom,r( Married 807 Second Street Atial~Reryp rnrre Peanavlvaaia Richard P. Sellars New C erlan PA 17070 r::~iDV 1O ^r^,oetlerrureb ,a r+aAerrtl(nx n+ar., w,,.,s,1 ,m.d,uW G,+,aherland nn ®r+ptler+uaerw, T"D~ Harr Carroll ,armr.rar Aarumbr IRnt MdY.n.e,n.n.e.( New Cumberland gy,Ran ~0RN1dn"'~eNY"'m0'~PiYel Roberta Flemia Richard P. Sellers °m "°"'~r+~oAe`a.(s~nrib.,,,r.,,,ae,rq a`"tliv0g0~°a'" CAc~rn,a, ^aartl x,aoera 807 Second Street, New Cumberland, PA 17070 ^ err ^ RarMbAnbab iry, Otlax,Itl Drr~n AD~Pr+R M.Yeeel r,eRgrGlQey,n Mrtlr A,r ~ "`~ ~brrreerti.,oaaan wree®rr^rr February 23, 2010 Evans Crema~tr~a~~( aom.. s`D"'tl"r"r'rr,l r`(°~^foa~banrr~mtlr( ~ l~lbaaeRlrrr ~,,,,,a~a~ FS Schaefferatown, PA 17088 ~!~ ,.~.,~ n.raeawrmrb,owr,a~.r,~..... ~t L Parthemore FH tr Cs. T„n o r, a--- ,... -- irrae,,anarrmipr,eeyDeaon x.llraloeeR ,Mahaaabee eeeh 823 P we oar NR,ekdr.rw ra n. Or,u ¢aa e, cAwe oFUUm P~raua,tln.,e ~u +-1 2pj~ ^epYre7 Ir~Im~MweaaMe~~~/dtreMOieIA DD~~anmel carne emhrttirec ~ -'~„__6'~rMeeea ~q~ ~y.~~~OY.WmN as tlremreh ir. ~ ~ Q~eMbDra ir~wnl -i .. y~N~U ~J / /76.C" (~ .,rr, F/4/LU,Q,(,,1 i ~~iI1Yp~be~x~~eM1tlYI~Mena l~iR'a a 11` UG ~/yii ~l ytl~ae Yl0a11~1Y1Y 0i(~ Qabferr....r. ~M,. y~ ~ ~ e1Fnl ~r1YT ~(WT. ~~ i (6 nab (a tl e mnwpiap, yq_ ~ e ~ ~. 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