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HomeMy WebLinkAbout11-15-10PETITION FOR PROBATE ANA GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY,~PENNSYLVANIA File Number v I ~' O ~-11-=-= Estate of Pearl J. Clouser, also known as ,Deceased Social Security Number 210-18-9591 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) named in the rv ca A. Probate and Grant of Letters Testamentary an and c dicil(s) d teas) Is are t e C ea _~ last Will of the Decedent dated ~}-; ._,-J {_~ c ~ ~ i ', (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~~ - ~ ~ ~ : •,~ tfZih'rtent s offere __; Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of t s ~ (~ ~ i- , ~' for probate, was not the victim of a killing and was never adjudicated an incapacitated person: M1 ~ .>- _-T r .Q .. ~. ~ ® B. Grant of Letters of Administration (If applicable, enter: c.t.a.: d.b.n.c.t.a.; pendente lire; durance absentia; durance minoritate) W Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (/f Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ---'--°~ iCCJlucuw Kelanonsm u PAP 284 Countryside Circle New Hope, PA 18938 A. (COMPLETE W ALL CASES:) Attach additional sheets if necessary. Penns ivania with his /her last principal residence at ~.- Decedent was domiciled at death in Cumberland County, Y 1000 Claremont Road Carlisle PA 17013 (List street address, town/city, township, county, stare, zip code) Claremont Nursing & Rehabilitation Center Decedent, then 89 -years of age, died on March 19, 2010 at ert with estimated values as follows: $ -~ _ Iecedent at death owned prop Y All personal property _ C~ (If domiciled in PA) $ (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: decedent's asset is limited to life insurance policy 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: ~.._sa ,.~ ..~;nrrrl name and residence Judy A. Murphy, 284 Countryside Circle, New Hope, PA 18938 Form RW-02 rev. 10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF P/ /ENNNYLVANIA SS COUNTY OF ~V ~ I C~ The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tru s wdll well and tru vest of the knowledge and belief of Petitioner(s) and that, as personal-rr presentative(s) of the Decedent, Petrttoner( ) administer the estate according to law. Sworn to or affirmed and subscribed ~1 ~_ before me the __1____-- day of ~6~ ~' ~ For the Reg' er Representative ;~~~„ ~t' (, ~ X P Signature of Personal Representative Signature of Personal Representative T3 1D i _ ; n /i? ~ File Number: Estate of Pearl~J, Clouser Deceased f - I `~ r~l rv +~ .- o , .~. , : a r~.} r~ +G .O ~ CJl -r .-j O -~ ^"t ~ <"-' ; ,. -~• ~ _ ~°~~: `,~ ~~ Date of Death: March 19 2010 Social Security Number: 210-18-9591 f~ ~~ ~ ~~u r~ ~_, in consideration of the foregoing Petition, satisfactory proof AND NOW, ~~ having been presented before me, IT IS DECREED that Letters of Administation are hereby granted to Judy A. Murph in the above estate and that the instrument(s) dated n/a described in the Petition be admitted to probate and filed of r~c~'d as th last Will (~^ od1icA(~)) of FEES $ 20.00 Letters .......... ..... 00 8 Short Certificate(s) . $ ...... . . Renunciation(s) • • • • • • • • • ' $ Automation Fee ... $ 5.00 $ 23.50 JCS Fee • • ... $ ... $ ... $ ... $ ... $ ... $ ... $ $ 56.50 TOTAL ..... ......... C'~ w1,,~~ssiaiu ~ 5G, ao Attorney Signature: David L. Styer Attorney Name: Supreme Court I.D. No.: 23356 Address: 10 Pepperell Drive Langhorne, PA 19053 215-757-8345 Telephone: Page 2 of 2 Form RW-02 rev. 10.13.06 US.A05 RED' fOl/071 ~ ~ a. ~ ~ ~ ~ ~ ~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ee for this certificate, $6.00 P 16355166 Certification Number 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 permanent filing. l`~-~ ~~~K~~~Mad 2 3_~Q~4_. Local Registrar Date Issued N __ ~ Q ~., r_ _ ~_ _.. °- -..~.___° t"~ .~ ~ ,~ ,_~ - ._ _ __ _. ._ _-_--~ ..__c~~._ ~~~ (j~ ~ ____ ._ ___. C..~ C ~~ ~~~ ~ ~ ~° W COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS nas-IU REV n/moq TYVE~ w CERTIFICATE OF DEATFF ease nrK (SBe Instructions end examPlas ~ ravers) STATE FILE !!UMBER 2 9a 3. Sodr 9raNy RunEe !. Dob d DMn l~M, aY. Yw) I +-w^+dD'°d""~"i0°'~r'"'s'1 PEARL JANE CLOUSER Female 210 _18 _ 9591 March 19, 2010 r'~ ~" ,.•. ~ 1920 Lewistown PA ^gor.a ^ER/rnnprwn LJt~ LTRraw~ ~"°° '-"'°"-"""" 89 Tn. June 13 , Ro ~,. w. Ror: N,rrken uer. erck w+rb, rc q1 FrlY NAnr lq nqt Yr/bgan, qfw tort rr nundM 0. Ytr DoaMr d fgeprAO OnynT ® ^ IaFArM1 qb. Coury d DoAi Be. DN'/• Bao, 1w0. d Dash (K Yp• ~P•AY ~^~ CLsrmnnt Pk1ralTlp, 6 Reheb111tatwn Centxr ~, HrM Rfan, AIC.) 1~'llte Cumberland Middlesex Twp. d ar Aor net d Ab. Do na rrc 12 rYr D.aaa «« n tlr +8. 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Please enter my appearance on behalf of Petitioner, Judy A. Murphy, as Admi 'stratrix of the Estate of Pearl J. Clouser, Deceased. ~,~~ ~~ David L. S e , E Attorney ID # 23356 10 Pepperell Drive Langhorne, PA 19053 215-757-8345 dlstyesa verizon.net n ° c~ ~?~.~ Z r~-; ;~~? ~ -+o `•-~'E~n p ''C ' _ ~' t_ ~ vi t1t ~z~ -a _ ~ ~ - c_.' c~~ c~~ ~-T, ~C =- .: =~ - ~i w ~:*~ y w