HomeMy WebLinkAbout01-10-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WII,LS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of roctx s F. at:nmvw
a/k/a:
Deceased ESTATE NO: 21- ~ ~ ' ~~'
SS NO: ,na-eo-a„e
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION'A' or'B' AND ~'C" as
applicable:
^ A. Probate and Grant of Letters Testamentary or ^Administration c.t.a., or d.b.nc.t.a. (complete Part C also)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters under
the last Will of the above-named Decedent, dated and codicil(s) dated
(State relevant arcumstances, e.g. renunciation, death of executor, etc.)
Except as follows, Decedent did not m r-..>
arry, was not divorced, end did not have a child born or adopted after cution of tli
instruments offered for probate; was not the victim of a ]tilling, was never adjudicated an incapacitated perso~ ell was no a
party to a peeding divorce proceeding at the time of death wherein grounds for divorce had been establ as defit~ in
23 Pa. C.S.A. § 3323(g):~?et~dent was m ordered on De ~mhnr 8 X010 , r; -r n ~
~ B. Grant of Letters of Administration
cuter d.b.n., pendent lite, durantt
C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived by the ~~ ru
following spouse (if any) end heirs (If Administration c.t.a. or d.b.n.c.La., enter date of Will in Section A and coTtiplete list ofN
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pending divorce
proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(g), except as follows:-
H9m~
w°aress Relatioashi to Deced~
Mitchell Berman 30 Entrekin Rd., Purvis, MS 39475 Father
a h
USE ADDITIONAL SHEETS IF NECESSARv
:nt
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence
At 740 Colonial Court, Mechanicsburg, Silver Snr;no Tno.,,ch;n r.,...~,.._,__~ „
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(Street address with Post Office and Zip Code, Municipality: Township, Borough, C8y)
Decedent, then- z~ years of age, died 12/28l201o at Z[,p_ (:n1 nn; a l rn„rr M t,
Estimated value of decedent's ro (Month, Day, Year of death) (C~tY °~ State ~~ death oxurted) PA
P PertY at death:
_If domiciled ht PA All personal property g50, 000
If not domialed in PA Personal property in Pennsylvania S
If not domiciled in PA Personal property in County y
-Value of Real Estate in Pennsylvania S
Total Estimated Value 5~0, 000
Location of Real Estate in Pennsylvania: (Provide full eddtess if possible.)
Signature(s)
Name(s) a$ Mailing Address(es)
I Berman, 330 Entrekin Rd, Purvis, MS 39475
l o by
OATH OF PERSONAL REPRESENTATIVE
~~1 _=~~
RE','~~~~~'`' r:`'=DICE OF
rrz~(,-r'!II~C
~St~a,ci ~ ;,r.,.,.r
Commonwealth of Pennsylvania SS ?(~ ~ ,)~-~ 10 Ph112~ 2b
County of Cumberland
CLERK OF
The Petitioner(s) herein named swear or affirm that the statements in the foregoing Pe ' ' T
correct to the best of the knowledge and belief of Petitioner(s) and that, as personal re 'd'Cthp '
Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ,~~~ ~
1'1 (
bef re me this 5`~ day of
0
For the Register
DECREE OF PROBATE AND GRANT OF LETTERS
Estate of NICOLE F. BERMAN ,Deceased File Number: 21- a~I I _ Ob T
AND NOW, this J' ~ day of January , in consideration of the Petition on
the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters
Testamentary X of Administration are hereby granted to:
(I(npplfuDle, enter c.t.a„ d.b.n., d.b.n.c.t.n., etc.)
Mitchell Berman
the above estate and that instruments(s) dated
described in the petition be
in
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
lenda Farner Strasbaugh, ~ ~ t I~ ~~~~1 ~ - _~, ,.
Register of Wills Vll ~ gy" ~ `'
FEES:
Letters ....................$
Will ........................ ~'
Codicil(s) ...............
( )Short Certificates
( )Renunciations.......
Bond ........................... -~.
Other ...........................
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.50
TOTAL ................$ 3'
Signature of Counsel Required to Enter Appearance
Atty's Signa
PRINTED N LIZABETH P. MU UGH
Supreme Court ID No.: 7s3s7
Address: MCNEES WALLACE 8 NURICK LLC
PO BOX 1166, HARRISBURG, PA 17108
Phone: 717-237-5243
Fax: 717-26a1729
Interim Forth RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
3105.N05 RP,V rp)/p7,
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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 17027273
Certification Number
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I,II~EpITH OF "
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Thts 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 O~cj fo~ermanent filing.
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CORONER'S CERTIFICATE OF DEATN a`
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December 29 2010
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