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HomeMy WebLinkAbout12-30-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Doris C Dieter also known as COUNTY, PENNSYLVANIA File Number 21-10 ~- ~ ~ ~ (.,Q ,Deceased Social Security Number 202-20-2633 Patrick L Dieter 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 the named in the last Will of the Decedent, dated and codicil(s) dated State relevant arcumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: Ci. ~~ 1rvY+ 1 hl o"T' fl PA Rry +°"O A p~~~fN~- ~Irctic~ G'CZoCGEpIN~- ~~ ~t-Ht: ~-frh~ a~ Ur`,(~~T'N ~'~~t'~-iN ~vc/Wbs !~d~. ~1~ ~~.c~ t-tpD ''~~~N ~ scn~-9~ts+~tE~ ~S ~~FtMc-~ Qy '23 ~~ C.S.A~ ~ '323 g) ® B. Grant of Letters of Administration ap ica e, en r c..a.; .n.c..a.; n e; uran e a sen a; uran mind a 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: (If ~ Adminisl lion, c. t. a or d. b. n. c. t. a., enter date of ill in Section A above at~i complete list of eirs.) ~ ti`l ~,,, Nt;~r A p ~ , !~ ~~ ~ r ~S c~. ~ ~'d n` .~ Qc-vc ~ ~.1. r-~ ~, ~ ~. rQ., .~ ~ r' i ~.rst s d~v t' C' ~ v o A=~. ~j l~"~ '~'~~J I f ~ -e ~l f d `Q.S~S ~ ~t P ~`. U . r o. vJ _ Name ~ ~ Relationship Residence Max A Buford Stepchild 2861 N. Starlight Dr. Prescott Valle , AZ 86314 Patrick L Dieter Son 114 Yates Street (COMPLETE /N ALL CASES:) Attach additional sheets if necessary. ft~ ~ tin ~ ~ ` -=- Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal re ~ Z Forest Park Health Care Center Carlisle Cumberland PA 17013 .G,. ~ x C~ gw r-~ ~~~ ....A..~ g.. (List street address, town/city, township, county, state, zip code) ©{~ ~ t ~? i ~ ~' .. ~,., , "r"1 Decedent, then _$~ years of age, died on 10/01/2010 at Forest Park Health Care Center, Carlisle; Cu~erland ,~-T , 70T~~~ Decedent at death owned property with estimated values as follows: ~ (If domiciled in PA) All personal property $ - 5.800.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 0.00 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 Letters in the appropriate form to the undersigned: ~I nature Typed or printed name and residence Patrick L Dieter 114 Yates Street Mount Holly Springs, PA 17065-1018 Form RW-02 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } 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) wilt well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this day of _~ 1 ~ - ~` I /~ -~.'L_ Signature of Personal Representative patrick L Dieter ~,.,, Signature of Personal For the Register J~9na~u-C vi rciwr~a~ rcafneacrnauvc ~~~ ~ ~~ '~~ ~. File Number: 21-10 r ~'~}- ~ (..p Estate of Doris C Dieter Deceased Social Se.,curity Number: 202-20-2633 Date of Death: 10/01/2010 AND NOW, ~.~_LVI~ ~~~~~ ~ ~~ ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Patrick Dieter in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters .......................................... $ Short Certificate(s)...... ~.2: ~...... $ Renunciation(s) ............................ $ JCP $ Automation Fee TOTAL ................................... 45.00 8.00 5.00 23.50 5.00 86.50 - _ Register of Will;-~ ,~ ~ ~ - ~~) ~ ~i Attorney Signature: ~~ Attorney Name: George F Douglas, III Esq.. , Supreme Court I.D. No.: 61886 Salzmann Hughes, P.C. Address: 354 Alexander Spring Road, Suite 1 Carlisle, PA Telephone: 71 T-249-6333 Form RW-U2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 RENUNCIATION Estate of Doris C Dieter REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Deised ~ ~ ~ ~~ ~~~ , -~, son Max A Buford in my capacity/re' ~ ' hip as~ „~ w (Print Name) r+~~ ~- ' of the above Decedent, hereby renounce ffie right to administer the Estate of the Decedent and respectfully request that Letters be issued to Patrick L. Dieter ~e~ ~ ~o/~ (Date) (Signature) Ma ABuford 2861 N. Starlight Dr. (Street Address) Prescott Vallev, AZ 86314 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 Rey. ~o-~s-loos Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the ren n,~ciation for the purposes stated within on this ~ day of l~ ~.e~- 7~ 0 . Notary Public ' My Commission Expires: ~~/~-Zo! ~/ (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission. ) !lnda DAKnyb~r f '' ~y ~"YYII{i r ~ + , ~~ '' July 1 S~ Z014 Copyright (c) 2006 form software only ri~s.~o~ a;~v ro~«?~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ~ ~66~36~~ Certification Number ~~ . CJ ~,~ M,oa.ia~aEV it/l006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS vF `w~Nr" CERTIFICATE QF DEATH BLACK Mil( ESN IRl~i1C.~lOf1s ~~ f17Ii1777pIWi OA ftlt~f'N) tT~ta cu c w rrwcw l L s'*'t ~? W p ~ c;;'7 - _` Q ... _.... ~'~ t. Nana d Daoada. trial. nid~a. YaL ~) Y. 7iaa 3. Saalal 9auagi rAardr a. DaN d DaaN P~+n. ~. M~1 C ~1~+ Female 202 - 20 - 2633 October 1, 2010 i. Aqa yM Ord IMdiM t IMrir t t N L aai able r !a, r110a d QIMr YwM OWa 11nra laArw ~~ . 82 Mme. September 30, 192 Carlisle PA ~~ pEniairaliw Ooa+ [8w•+rw-+~» Oh:+^~. Oanar~so•aM re. c«..r a aah ~ ar, ~. r,.r. a oaaN K ~ Mrna pr rr1 wMAn-~+a aYaa1 awi naNaq ~. WYa oaeairi d ~~ oipw- Ma Mae lo. Raoa: Anwiean a+~an. B4dc, wnM, ac. ( Clmberlartd Carlisle fl~est Park Health Care Otter te ~•r.- • n. oaoadri'a uarl d wet i w aral d u. Oa ~ Mra t7: rllaoaaalri air k M t3.Onoioae's irsalon ~ , ~~. w'~iro~..d CMN~w ~ wr..a +s. sww~+a ~pa+. 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Ow 5gnad (~. aM. ~i - - - - - - - paaa, ani iua Y in..rwa{q.w nwrw w rrd~ - - - _ - - - - - - ro tra real d nw lwwya, iaaN aaarwi a the tint, iaM, ea c `J d ~ U ~ > ~ ~ v / 7 ~'~ / • lra~w E:awk»r l a.nar oa Na raala N aaanrnaian aM t ar rraalirwn. fA of aPrian, read ooarrai at rM tra.• ida, ani wca, ani ina M Ma awaats- d anrrnr r aoMOL ^ _ 7 T Y ~ - r - pOa n ia. fWr Aar a Vanoan Who ~ry~Md CMra a DaaN (Mtn T // ~ ~ j n.. r r+ 35. and ~~ ~ (C 1 ~ I 3. ow at rr- S r' ~ G ~ ~ S ( J This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be fi~rwarded to the State Vital Records Office for permanent filing. /2 ~ /d Local R gist Date Issued rya an.arri ~. 049 µo Z$