HomeMy WebLinkAbout01-27-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of Drew a. sors~k
a/kla:
a1k/a:
aik/a:
Deceased ESTATE NO: 21- / ~" ~JS
SS NO• saz~x~ 8-aa22
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `)~' AND "C" as
applicable:
^ A. Probate and Grant of Letters Testamentary or p Administration c.t.a., or d.b.n.c.t.a. (coniJplete 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 circumstances, 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
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated
party to a pending divorce proceeding at the time of death wherein grounds for divorce had been
23 Pa. C.S.A. § 3323(g):
D B. Grant of Letters of Administration
r.~ ~ t ;,
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~~tion~the `-,,
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~ ~ d wi~not ar ~ :~
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~hed as d8t'ine~~
(If applicable, enter d.b.n., pendent life, durante absentia, dunnte mi(roritate)
C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived bye t~e
following spouse (if any) and heirs (If Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section A ah complete list of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party tb a pending divorce
proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(g)~ except as follows:`
tv..~. Address Re aiionshiu to Decedent
Denise B. BOrSUk 80 Echo Rd. , Carlisle, PA 17015 S USe
USE ADDITIONAL SHEE"1'S !k' N1:CP:SJA1tY
THIS SECTION MU5T BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or ~Irincipal residence
At 280 Echo Road, Carlisle, North Middleton Township, Pennsylvania 17015
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then as years of age, died 11/2/2010 at riersney, Harry Townsnipwnnsylvania
(Month, Day, Year of death) (City and. State whore death occutr d)
Estimated value of decedent's property at death:
_If domiciled in PA
If not domiciled in PA
If not domiciled in PA
Value of Real Estate in Pennsylvania
All personal property $ /T ~ _ ~"'~
Personal properly in Pennsylvania $
Personal property in County $
$
Total Estimated Vatue $ o•~
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s)
Name(s) & Mailing Address(es)
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 Petitioners} and that, as personal represjentative(s) of the
Decedent, Petitioner(s) will well and truly administer the estate according to law. ~,
Sworn to or affirmed and subscribed
befo a me this ~ 7 ~ day of
Zit/
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For the Register ~
SIC-? ~,,, - = ?
DECREE OF PROBATE AND GRANT OF LETTE~'T' ~ `='
~~ ~ ~~
Estate of Drew A. Borsuk ,Deceased File Number: 21- Zo t Q ~- _
AND NOW, this Z? day of a 1 L_._, in consideration 'pf the Petition on
the reverse side hereon, satisfactory proo having bee presented before me, IT IS DECR)~ED that Letters
Testamentary X of Administration are hereby gran~ed to:
(If appGuble, enter c.t.a., d.b.n., d.b.n.at.a., etc.)
Denise B. Borsuk lri
the above estate and that instruments(s) dated described iil !tile petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
lenda Fanner trasbaugh, `~''~
Register of Wills - -
FEES:
Letters ....................$ ~D, o~
Will ........................ '~''
Codicil(s) ............... -'`
(~) Short Certificates ~ ~~
( )Renunciations....... '-
Bond ............................
Other ............................. -
Automation FEE......... 5.00
JCS FEE ................... 23.50
~ .~
TOTAL ................$ -
Signature of Counsel Required to E~Itl~r Appearance
Atty's Signature
PRINTED Name: Michael A. Scherer
Supreme Court ID No.: s~s7a
Address: 19 West Sopt~h Street
Carlisle, PA 17013
Phone: (717) gas-sa73
Fes{; (717) 249-5755
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
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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 This is to certify that the information here given is
correctly copied frpm an original Certificate of Death
duly filed with m~ ~s Local Registrar. The original
certificate will b~ 'forwarded to the State Vital
Records Office fob permanent filing.
P 16855238 .~~~~ Nt~N 3 /2Q1p
Certification Number Local Registrar ' ' Date Issued
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