HomeMy WebLinkAbout12-15-10PETITION FOR PROBATE AND GRANT OF LE~'~'ERS
REGISTER OF WILLS OF L'u~ ~r l4r~P COUNTY, PENNY),VANIA
Estate of PQT File Number ~
r 1 C l 0. D . /~ 1'Y1 ~ ! ~ Z
.
also known as Pa_ km e f ~
Deceased Social Security Number
8- boa
, i
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(vCIOMPLETE 'A' or 'B' BELOW:)
~p A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / aze the I G
last Will of the Decedent dated a 113 J q 1 and codicil(s) dated t
~ 11"011 named in the
(Blatt relevant circumstances, e.g., renunciation, death ojezecutort etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after executio
was not the victim of a killing and was never adjudicated an incapacitated person:
for
robate
of I)
he instntment(s) offered
p
,
^ B. Grant of Letters of Administration 0
o ~C1
~ ~
~~
(ljapplicable, enter: c.t.a.; d.b.n.c.t.a.: pendente lire; durance absentia; du
Petitioner(s) after a proper seazch has l ha•. •°rtained that Decedent left no Will and was survived by the following
Adntirtistration, c.t.a, or d.b.n.c.t.a., enter date ofrVill in Section A above and complete list ojheirs.) ~
~ _
ate) ~ C~f~x
f'1"f ('7"1
ny) ~i~heirs:~
Q ~ _f; ~
Tt ._ "'r1
Name Relafionshi R ' e -
%/
, ,..~
•
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at de th in C 1-16 n ~ County, Pennsylvania with his /her last principa
3 r~ rh S i
re~idence at y 1 ~ f 6r~,
(List street address, town/ciry, township, county, rate, zip code) 1
died on ~ 2 12 ?CIO at I OS T
Decedent
then ~
years of age
i
,
,
_
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) Alt personal property i
i
4tsr7, Odd
S I
(If not domiciled in PA) Personal property in Pennsylvania I
S
(If not domiciled in PA) Personal property in County S ~
Value of real estate in Pennsylvania $
--
situated as follows: .
WhercFore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant o
the undersigned: f ett~ rs in the appropriate form to
Si nature T d or rimed name and residence
~~~.~~', ~ M ~t:h . SI ~ c ~
I
'~~
Forst RW-0? rev. 10.13.06 ~ Page I of 2
I __
~~ St
u~
Oath of Personal Representative '~
'~
CO1vI~fONWEALTH OF PENNSYLVANIA
SS
COUNTY OF C Iy! ~ ~a. n .
The Petitioner(s) above-named swear(s) or affirm(s) that the statementsain the foregoing Petition are iv
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petition r(
administer the estate according to law.
Sworn to or affirmed and subscribed
bef me the ~ day of
~~ ~ln
For the Register
~.re,% Q
Signature ojPersona! Repres alive
and correct to the best of
~) will well and truly
~.
Signature of Persona! Representative ~ ` `~ • ~ ~'~j
~ _ ~ ~' ~
Signature ajPersona! Representative `~ ~ ~ t!! ~:. -~i t;y7
~ ,s. ~ ~
File Number:
Estate of r ~ ~ ~~
Social Security Number: J~~ 9 ' ~~ ~ ~ 7 D d Date of Death: r°2 /
AND NOW, ~`" Zo~v , in consideration of the foregoing
having been presented before me, I IS DECREED that Letters
are hereby granted to `"~~ ~l'v ~~~-~'~°~ ~ - -
and that the instrument(s) dated _T~.~%~
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of
FEES
__ Register ojWitls
Letters ............... $ ~~~.~
Short Certificate(s) ........ $ j2 ao Attorney Signature:
Renunciation(s) .......... $
wi (I $ ~~ ~ Attorney Name:
... $ ~3"5~ Supreme Court LD. No.:
.. $ inn
$ Address:.
... $
... $
.. $
• • $ Telephone:
.. $
TOTAL .............. $
3(~5,5~
Fa•rn RW-UZ rev. 1U.13.Ub
O ~.+~ ~.
satisfactory proof
in the above estate
i
ent.
I
.~
Page 2 of 2
~,fn~ 2°v ,~ ~ /~,,
,Ci ~ - ~ ~ ~ ~Z~.J~
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17029302
Certification Number
~irl/gEtr~iur~ COMMONWEALTH OF PENNBYLVANUI. DEPARTYEHT OF HEALTH . VRAL RECORDS ~
F~ cERnFlCnte of oenntH
(s« Na~uonr.ra .z.ea.. oe nK...y STiTE ~ li
I
i
N
...
~~
N ~~
1V -
d `~~ ~:
~..~
,.tre.aoeeerrtaa.aeat,ree.~o a sr s sew sray raba . otr oe/~ Mdw dr. ~
Patricia D tz male 579 - ~ - 4700 12 2010
a ~ R+et eobiM 1 u~rr 1 L Der of BiIU 7. ar a hw d Deer
Mra. ~ hM erer
tbepibh
Olrr.
78 ra. September 15 1932 Baltimore FD ®rp,l,et D ~ / ~e ^ oa, ^ D sdrue ^ aba -
a ca.+r a oeeb R Cly. Baa tep a oettn bl Fr111Yr dnr rrrae M+r.a.rnreen a rrr ome a tltp.eo agbt r, Ye, la neoc Mrtrn wr, sea, taae, et
C~mberlacid Fast Peru~sbono Hol t ital ~'~ ~ ~~ I' White
tt.w.ade daatab rra a rre to bra Geoelae es r a la sbritn FAio/si tsprq d+rliMa wd aw/bteA x rw sree trera Nwr ts. swwiiq spear 9t ese~ ya .clan true)
loa aw.b aretwreenrrp us Mre Farm / s,,,,,y,v p~+sf colpe tti a sd rsara owsAe/ ~M
'1laller D rr L$te 12 WicIClwed
aorernr.~sr..praa-/rr.w...~prr- ++ lyania aaorda
Y
418 East C,i Street ~~~ ne. srr
lirb• ne ^rr, Dewa•e ure
TO1"'~~
t ~
S~~frem~st
CRir1
PA 17011 ~m®
tw.a
0
~
tm.oaeq ~-='1aAd 9{FlirHllail3tCMt[1
.
F ~
d (7111se•
1a RrM•NrrgKnWe,Yt e+d 1a 11rrM1 1MIFYet aMr. ebilte rreaq
Jotui P Dell Marie Lomenz
Ia biarere Ira. tape r nl» a1a tlan.r7 ptlinl Aas.r tN.t~ eq/ ba1, dae, av req
Mic3~ele A, Sinonen 300 Chatsworth. Street NC 7 1
tu-w~maalpeera~ ~ (~~rrr ^sarien raoraorrt+rP~.rr.w0 z+cFrrdaigoermMr.aaar.y.mr.rFaawpr.t sta ~/b.ndre.anrrl
^ sew ^ n.earuaesrr ~ w+weerrreroaw"Fr"""IL~rr^ DeOelllbeL' 16 2010 T~Dll Noll PA
a d p/wreaYgradd ms.uoar.s.ar tleaewAmredFedd 8 Market Plaza Wd
FD - 014889 1 zi Funeral Hone Mect~ani PA 1 0 5
eyr air
~e~~ rtiaartbr Zr. T•M Mbati rrrrprrrlra(8drnagM ,
~ ~ VtS 136 lirr s.ew/
~!
I tle\\ar elg~d~Pl~a+i. M.yea)
~~UmOt/ ~2 Z~/0
Ln oral ew0e eaiortei M Faer M rise d [lath A as.0ebnaweaeoeed,0/aat M. M >x N4e Car b Wart / b< a Rater OIr ben CnatYr a Deneltnt
al•pgraarr/t. ! ~ ~ M. ~ T !a ~t7/Q ^Yr No
CNIEOF GE117r lAairawYs•••M rewpe•) ~ kPa+rb ernac Pat drr ee,er. b
1••2/.MeFrrlr~~-atrr•rkar amepsebr•brarty rurdlr 6eN DO NOTenrrrerraareaireegreneet ~ QeMbDrb re na
railYgbbutl`gigaar
e
b
A
ma
ruy enrt«asbrarree.rreler•Yq b. elr~. lit eey a»rvrrrle• ~ ~ ptr ~uaaen
a 1 Farr:
^
qar ~ ~
~
~ NetpigreMrperla
^
_
L ~~
1~j b W ~ y~~; s
~
~.. Fworlrbraatrl
ar bra
elk ~
b
rl
Ofallr
'~ ~ ^Ma prOrt Oapgra Mlin ~t ye
1
~\~ r/
~ri~ye~1 ~
r~ieaiprarb~tAaT~ a ~` /~fe~abr~~l~d. ~; ~ I d6~b
^
Dr b pr r e ewgrir dk ~ Ila pgaef, W ppre tl a4• b 1 lea
a ~
V
~ j Etrw her
D lkleloen 1 pnyredbb h pea lea
~Parre~ ~AwYIe RYtbf~aeOYen al,rreataarll 9~Ortd MafPbw. `P•Mal sa. DeeahFlev gerbea•nr I,, I b-eF lbme,Nmbsra. Feebry,
~`
dfYwdarbt Nred ^Ilenlalt ~ asrsrbq, at.~rM
D rr ~
^ r. j~o ^ Aorllrt ^ Pad'V rrtlyelr ~ ire d bkq 12- Har r Wat7 atl.1 Trupairien rte/ A9rtq~
^ sta lorlre d W /ran ere)
^ s+dee ^ arlrrr Orrnbae ^ rr D ie ora/oprr ^ F..a, ^ Feeerrn I
r Ohr-$pry ~.
il• nrltir~rlratryoa~ J!. 111edCnrr ~.
• ~1MM!yplpaarOMrlra~YMaawdOrbrr~aMia
ar~rr~sbrrsaal
~.
~
-----------------D
wra.~«rrtwwMrwwerrra.rr..ryy.r
~ t
•
~ hrrrwrM~rtrMSM7~r11wnrsprrasNr/~areMyYbbaredtltr~ If[llrr MaBr pay y~
T•selerdrFbrMe}~aaseaarerrYSr,Yra/pW,MYbllreerypnrearwratrl__________________^ ~~~:
• 1ltrer ~leal0aeea ,,, Z+~/•
tInMWYaaaalrMeeMlerbweyrlArapaprletiYSrrw~rMSr~atb.Nprrlar/rYMrryyar wrnlrrebbL ^ a1.IMY WAYrtdFaeen lNbCrprMtYaed Mr
9a 8raen ad Olteil 76. Deb Frelraat rY,Yen) ~/^~''~"~l~~T Cr
~ IvZ.I ~ lob I I Io7 I ~ O e ~~ s ~. {
V fe ~~n~~~ VY7/77~k
This is to certif tat the information here given is
correctly copied~frt~n an original Certificate of Death
duly filed with $ne', as Local Registrar. The original
certificate will III be' forwarded to the State Vital
Records Office ~or (permanent filing.
~ /' is
Local Registr ! Date Issued
V
I
J
FAST IiiILL AIiD TESTAMBdiT
OF
PATRICIA D. IQI$TZ
I, PATRICIA D. Rl~TZ of the Borough of Shiremanstow
County, Pennsylvania, declare this to be my Last Will
hereby revoking any will previously .made by me.
I - I direct the payment of all my just debts
expenses out of my estate as soon as may be practical
II - I devise and bequeath all of my estate of
and wherever situate unto my husband, Michael J. Kmetz
survives me by sixty (60) days.
III - Should my said husband fail to be liv
first (61st) day following my death, then I devise and
my estate of whatever nature and wherever situate unto
Michele A. Sironen, or her issue per stirpes.
IV - I appoint my husband, Michael J. Kmetz, E
my Last Will and Testament. Should my said husband fa
:-
v
~`
~`
~ ~~~ _ ~
:~
tv
..
~a.
I -~-~ a` ~_ *~.~`
,~I Cumberland ~
Testament,
funeral
my death.
~!
whatever nature
(providing he
the sixty-
ueath all of
daughter,
of this,
to qualify or
II cease to act as such, then I appoint my daughter, Mich l~e
act in this capacity. Neither of my personal represen aft
i '~
required to post bond in this or any jurisdiction.
III
A NOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 1 Ollll
_. ___.. __.__ -._.... ___.... _ ~ _.I
A. Sironen, to
ves shall be
Page 1
. ~ .~
IN wlTIiBSS i~IHffitSOF, I have hereunto set my hand
the day of 1991.
I
~eal on this
(SEAL)
Z
Signed, sealed, published and declared by PI~iTRICIPi D. R'Z, Testatrix
therein named, on this and one (1) other sheet of pa ryyas and for her
Last Will and Testament, in our presence, who, in her p ~senee, at her
request, and in the presence of each other, have here n~o subscribed our
names as attesting witnesses.
Name
Name
/~
Page 2
ARNOLD & SLIKE, ATTORNEYS-AT•LAW, 2109 MARKET STREET, CAMP HILL, PA 17011
~ i
i
COMMONWEALTH OF PENNSYLVANIA) 'I
SS. '
COUNTY OF CUMBERLAND)
WE, the undersigned, the testatrix and the witness s
whose names are signed to the foregoing .instrument, i
sworn, do hereby declare to the undersigned authority t.
signed and executed the instrument as her Last Will a d
that she signed willingly (or willingly directed anot e
her), and that she executed it as her free will and v 1
the purposes therein expressed, and that each of the i
presence and hearing of the testatrix signed the will a
that to the best of their knowledge the testatrix was a
eighteen years of age or older, of sound mind, and un e
or undue influence.
respectively,
q first duly
at the testatrix
testament and
'to ,sign for
~ttary act for
nesses, in the
witnesses and
.that time
no constraint
Testa
Witne s
Vic.
Witness
Subscribed, sworn to and acknowledged before me by
subsc 'bed and sworn to before me by both witnesses,
1991.
otary
THELMA S. Mc(
Camp Hiil, PA
MY Commission
~ to a#~rix, and
s ~~ day of
c
ry PubNc
County
3. 1 fl92
ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL. PA IyOt I