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HomeMy WebLinkAbout01-04-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Estate of Stacey Sue Smith also known as Deceased COUNTY, PENNSYLVANIA File Number C~` ~ '- 1 ~ - L ~ , `) Social Security Number 200-64-7439 r.~, Petitioner(s), who is/are 18 years of age or older, apply(ies) for: C- ~~ ~,,, ?~? (COMPLETE 'A' or 'B' BELOW.) rr~` ~7 ~~, ~ i~ n ,. ~_1 [ ; ~, _-- A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the '~ rn ,timed in~the __ .. v~ ~ .. last Will of the Decedent dated and codicil(s) dated (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ ~,~ C.:J Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument( offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ©/ B. Grant of Letters of Administration (If applicable, enter.• c. t. a.; d. b. n. c. t. a.; pendente liter durante absentia; durante minoritate) 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 Administration, c.t.a. or d.b.n.c/.t_a., enter date of Willl'in Section A a`b~ove and complete list/o f heirs.) u~/n/~l ~~ ~ta~ J~ la ®~d ~:.~ ~uvr`~ ~Lp'f/~rri~ trr ~/LC:1~-0~0 ~ ~ •/~?YC ~ ~4/( ~ fYJ~e~( `~5~ ~ Gh /7~d f//r/LC.( L'M Z3 / ~ C ~ ~ ~ Z ~'S~ / Nd r-~ Allen Buck Name Madison Lee Miller son daughter Xander Ray Miller son Sierra Marie Castaneira daughter (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Residence 6995 Bull Rd., Dover, PA 17034 7 Fargreen Rd., Apt B, Camp Hill, PA 17011 7 Fargreen Rd., Apt B, Camp Hill, PA 17011 320 Rosedale Ave., Highspire, PA"'17034 Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 523 Third Street, West Fairview, Cumberland County PA (Lcst street address, town/ccty, township, county, state, zip code) Decedent, then 40 years of age, died on September 5, 2009 at Harrisburg, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ R ~ d C~' ° ~ v (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: Form RW-02 rev. 10.13.06 Page 1 of 2 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 OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania ~ SS County of Cumberland The Petitioner(s) herein named swear or affirm 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. Sworn to or affirmed and subscribed efore me this _ - _ day of ,~~~ ~ ,_ n _., 4 ~~ ~ ®... ,:,r ._.~., -, ~ J-- ~-- .~' ",~ ~.ti. ~' -, ,,.-. For the Register { , ~-~ ~ --t ~~ , ... DECREE OF PROBATE AND GRANT OF LETTERS ~" f ~~.,. ~..A...~ y~~ £.- t .+ r _.. ' _' _~ . , j'i fT ~~ ~ Estate of ~ - ~ ~ [ ~t,l.~ > Chi -} Y-~ ,Deceased File Number: 21-_~ -~ AND NOW, this ~-__~__ day of ~ L 1 , in consideration of the Petition on the reverse side hereon, satisfactory proof having bee resented before me, IT IS DECREED that Letters ~~ 'Testamentary ,~ of Administration are hereby granted to: (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) ~ GC's-l. _ in the above es to and that instruments(s) dated described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. - Signature of Counsel Required to Enter Appearance FEES: Letters ....................$ _ Will ....................... Codicil(s) .............. . (b~) Short Certificates ~~~) (1) Renunciations..... C~ ~'! Bond ............................ Other ............................. Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ (QI a ~~ Glenda Farner Strasbaugh, °~~e r~ C -_~.~~'- - ~~ =~1 ~ - Register of Wills Atty's Signature . PRINTED Name: ~S cr ~ ~ .-n , ~F, ~t.~S Supreme Court ID No.: ~ ~' ~-{ Address: ~ ~ t ~~~-KE 7~ ST l-c ~v10 -~N ~ ~' ~ i ~7 0~( ~ Phone: C ? ~ 7 ~ I - Z- ~ ~- i Fax: ~r ~ ~ ~? ~ i - y o 3 t -T Interim Form RW-02 revised 12.2b.10 by Cumberland County pending action by the Court Page 2 of 2 Lt~nC qnG nr.'1• ~ni rn~~ 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 16133737 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 Offi~ for p imanent fil Local egistrar Date Issued .:~ C-y -:_~, Certification Number ~. _. _._ .. _ _, _ __ __ ~ .W.~ .~ m ~ ^ -._, N?Oti. t41 PEV 11!7006 rte ~ PRRYf a. t` ~~ PE~tAREk! IiA..K lt0( ~~ s ~F " C.l7 :~ `.:3 ,~ ~ C';? .J ~ 'T? I _ _ i COMIAONWEALTH OF PtcNNSYLYANIA • DtcpARTMtsN7 OF HEALTH • VITAL RECORQS i,,;) .'~_,_ "~° ~ C!fJ~ONER'S CERTlFlCATE o~ UEATH t„„ _. _._...__,. -,-. ~ ~'~_ ~ i i t. Ilrr~ie M ~tM. ea6616, iq~, ~ ~ 9~. ` '1. doleh? 14irEe•• ~. ~ t76 QN~S £~A~. dMf. lwf ~' ~ ~...~.fii f~ JX/1~L~. ~ - Set}tssnbor 5, 2009.~'~~ k ape gale aea,sal ~ l s;edr , s. oree :» ~ aw ~. s>s ,ne 6m1. « b6. Ptrp at Owe race anei atee w.. ,~.,~. -btgAtc OIw~ ,,,, ~ . ~. ~ [] rwr ~ ~ - a+lu6+eo1 ~ Dt3+- U l-+++~ ~. ?.~1. geeiAenn L • a~ M t:awxy 6t tleeu+ Ic Cxpc 9or6. Tw• d C>w6s # f6oMY p eoe n.auaon triret an6 nuira!} ~ twr writ at r6itpteeie Oriliq? w Yw !0. 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I 4 Hturi PA 171.11 !jl uecwson +yn+ae tw ~~ 7x/'CX l I RENUNCIATION ~ ~ ti ...ti ~? ~ ~.... ,~, ; REGISTER OF WILLS ~-~ ~ rn t _i ~', ~ Cumberland COUNTY PENNSYLVANIA , "~`_' ~ ~ ; - ~ } , ~..~ a ~=, _-~ ,~.. Estate of Stacey Sue Smith ,Deceased I, Jeanette Fitz , in my capacity/relationship as (Print Name) mother of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Kody Allen Buck (Date) Executed in Register's Office Sworn to or sffrmed and subscribed before me this _: da oft ~ C __.!; ~ ~~ Deputy for R~,gi~ster of ~r~'ills ~~~~ .y ~j (Street Address) State, Zip) r Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this day of , Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06