HomeMy WebLinkAbout11-17-10r
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~ ~~ ~np~., ~ _~~ non a COUNTY, PENNSYLVANIA
Estate of ~ ~ ~ i ~ ~ S ~ R [''~_ File Number ~~ ~ ~ ~!
also known as ~'
,Deceased Social Security Number, ~ ~ ~ ~ i l~
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOl3!)
~. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of the Decedent dated and codicil(s) dated
(Stare relevant circumstances, e.g., renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after executio of tl
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
t73
rn
B. Grant of Letters of Administration
(If applicable, enter: e.t.a.; d.b.n.c.t.a.; pendente lire; durante absentin; du tEd
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followings
Administration, e.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~
Name Relationshi Resrden~
named in the
instrutr~(s) offered
o -~~~
_....t._~.}
any)~d heirs~c~;(IJC`Y '!
N ' ~=
r~
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. '
Decedent was domiciled at death in ounty, Pennsylvani with his /her last principal resi ~
-C
ence at
V
(List street ad r , town/c , township, county, stale, zip code)
Decedent, then ~~ years of age, died on ~ C1 at
~ ` ~ 5 ~', m i
'~
„
Decedent at death owned property with estimated values as follows:
.
(If domiciled in PA) All personal property $
I .~
3
(lf 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 Lette
the undersigned: r in the appropriate form to
'
Si nature T ed or tinted name and residence
1 '
C~~
~~
Forrn RW-01 rev. 10.13.06 Page 1 of 2
Oath of Personal Representative
COIVI~IONWEALTH OF PENNSYLVANIA ,~
SS
COUNTY OF IC V~_ Q ~ ~ ~~_ i
The Petitioner(s) above-named swear(s) or affirm(s) that the statements+in the foregoing Petition are hve ~nd 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
2dl D
J
For the Register
Signature ojPersona! Representative
Signature ojPersonn! Representative
0
~ r-- _
"V `;
File Number: ~~~ ~-~I '7'y' 4 3 ~ ,~,`~n
C N r..a_
Estate of L-- t3 \ L \ S ~ S ~ ~ n C"~' . Derma ed ~ `•~
Social Security Number: ~ ~( ~T~j_ j;L,,l,~' Q Date of Death:_~~ ~_
AND NOW, ~ 17~~,~~ ~~~Lk%1yLGt=f.~ /D . in consideration of the foregoing Petiti n, satisfactory proof
having been presented bef re me, S DECREED that Letters
arc hereby granted to .a i~~~ ~
i in the above estate
and that the instrument(s) dated ~ 2/ 9
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Deceden .
FEES
Letters ............... $ /~ °
Short Certificate(s) ........ $ g• e °
Renunciation(s) .......... $
LU;~~ ... $ /spa
CS .. $ ZS..Sa
$ .J.-.oa
... $
.. $
... $
... $
.. $
... $
TOTAL .............. $ 9/° . Sa
ojWiits
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone: 1
.~~,
i ..
Funn RW-U1 rev. lOJ3.Ob ~ Page 2 of 2
105.R05 REV r01/0T - ~ 4 / / U / I ~ / _.
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 16809730
Certification Number
This is to certify chat 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 permanent filing.
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Local Registrar Date Issued
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LAST WILL AND TESTAMENT OF LOUISE S. HART
I, LOUISE S. HART, of the Township of Upper Al~.en,
County of Cumberland and State of Pennsylvania, bei#~g of
sound and disposing mind, memory and understanding,~do make,
publish and dealers this my Last Will and Testament hereby
revoking and making void any and all prior Wills by'~me at
t,_ a~ any time heretofore made. ~,
G~. N
~: G
1.
~~..,, a ~
rya ~:. ..~+
+~., '~ ~ direct the payment of all my 3ust debts and funeral
.~, ~, ..
+~ e~ac ~s as soon after my decease as the same can bey conveniently
done.
2.
I give and bequeath all the rest, residue and remainder
of my estate, real, personal and mined, whatsoever a#~d wheresoever
the same may be situate, to my three (3) daughters, to wit,
PATRICIA HART BLOSSER, PEGGY HART STONER and JANA Hll1~T MacGINNIS,
share and share alike, per stirpea.
LASTLY, I nominate, constitute and appoint my d~.ughter,
PATRICIA HART BLOSSER, Executrix of this my Last Will and
Testament, and in the event that my said daughter should predecease
me, or should she be unable or unwilling to serve in such capacity
for any reason, then in such event, I nominate, const'dtute and
appoint J. ROBERT STAUFFER, Esq., Executor of this my Last Will
and Testament, in her place and stead. II
,~,..
_. _ ~-. _
IN WITNESS WHEREOF, I have hereunto set my han~ and
Beal this ~,~~ day of May, A. D., 1991.
-;--~-~~-. `~~~s~- I~ ( SEAL)
Louiee 3. Hart
Signed, sealed, published and declared by the move
named, LOUISE S. HART, as and for her Last Will and ~estament,
in the presence of us, who have subscribed our names~~hereto as
witnesses, at the request of said testatrix, in her ~resence and
in the presence of each other.
. 2 w
COl4tONW8ALTH OP BENNSYLVANLA )
t SS.
.COUNTY OP ,CUMBERLAND )
I, LOUISE S. HART , the testat rix
whose Hams is signed co the attached or foregoing inatrumsnt, ha~,ing
bean duly qualillsd according to law, do hereby acknowladgs that II
signed and executed the instrument as my Last W111 and Teatament;~~
that I aignsd it willingly; and that I signed it as my frss and volun-
tary act and dead, for the purposes therein contained.
Sworn and affirmed to and acknowlsdgsd bsfors me by 5~..
LOUTSE S. HART the teeitat~_, .this ~ / ",,,~
day of ^~~~, ,~,, A. D. 1991.
i~~~~'E7q~Yes Pbw6,199;3
Aseoolalbw d Ncamtes
,
COMMONWF~ALTK OF PRNNSYLVANIA )
s SS .
COUNTY OP CUM$ERLAND
Ws, the undaraignsd, J. ROBERT STAUF
and GLADES P. DEAN ,the witnesses whoas namsa a e
signed to the attached or loregoing instrument, being duly qualified
according to law, depose and say that we ware present and saw the
testatrix , LOUTSE ,sign and ex~-
cute ebi instrument as er Last W1 an aetamant{ that the
acid tsstat r___i~,_, LOUIS , exscuted it as '
~/her fres and voluntary act or she purpoeas therein exprasaed;~
that each of ue, in the hearing and eight of the teatatrj,a_, •ign~d
the Will as witnesses; and that to the beat of our knowledge, the
tsstat rix wa:, at the rims, eighteen (18) or more years of age,'
of sound mind, and under no constraint, duress or undue influence.,
»~
Sworn and subscribed to before
aye t is ! $~ day of
r__..__~
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