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HomeMy WebLinkAbout02-15-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS -~ PETITION FOR PROBATE AND GRANT OF LETTERS .---- Estate of O~R ~ Q. ~ r~ S Deceased ESTATE NO: 21- (`~ ~'`~ Za ~ a/k/a: a/k/a: n ~. Z-~ b a/k/a: SS NO• cX ~O " ~ j~ Petitioner(s) who islare 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.n.c.t.a. (ebmpt~ete Part Ca[so) 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 ptndia~ divorce proceeding at the time of death wherein grouoda for divorce bad bab 23 Pa. C.S.A. ~ 3323(8): Grant of Letters of Administration enter d.b.n., pendent life, dannte absentia, C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived following spouse (if any) and heirs (If Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section ~ heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and waa not a pa proceeding wherein =rounds for divorce bad been established as providal in 23 Pa. C.S.A. §33231 USE ADDITIONAL THIS SECTION MUST BE COMPLETED: ',execution of the !ptt, and was not a ~jbhal as dual in as -"l7 c~~ r~i•~ ~'= :~ -~ ; -==Ca ~n Deced nt was d ~micile~ at death ~n Cumbgrland ty, Pennsylvania, with his/her last family, or principal residence 1~ ~ ~s~~( urc~ (Street address with Post Office and Z\ip~Code, Municipality: Township, Borough, City) ` / _ Decedent, then ~ years of age, died ~n . ~ ~ ~~ ~ ~ at `~rC# f ~ , ~ ~ Y111S~~ Y ~' n 1 ~'' (Month, Day, Year of death) (City and State where death o¢cutted) Estimated value of decedent's property at death: If domiciled in PA All personal property $ ~~ I O 0 6 If not domiciled in PA Personal property in Pennsylvania $ _If act domiciled in PA Personal property in County $ _Value of Real Estate in Pennsylvania $ T I~~~~m to .Value $ l'~ a`~etr Location of Real Estate in Pennsylvania: (Provide full address if possible.) ~ ~ Ldt" C )'1 O ~ Glr ~P IZ-S , G 2 Siaoatnre(s) Namefsl & Mailiea Address(esl ' ~ v °~ - .. -- -. ~• ; ~n ~ II ~ G-1 I Interim Form RW-02 revised 12.26.10 by Cumberland County ptnding action by the Court Page 1 of 2 T 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 repre~e>r~tative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed bef me this ~~ day of 2~ l~ ..(~. r°a -~ __ s~ For the Register ~n °D ~; J DECREE OF PROBATE AND GRANT OF LETTER~i°c~o = '.r ~; Estate of ,Deceased File Number: 21- o (( ~~L D 7 ~''3 ~ , AND NOW, this ~S~day of ~o d~ , in consideratioln of the Petition on the reverse side here n, satisfactory proof having en presented 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.) .~/,[All,~1_ VY,i,~,r/irr~l~vJ in e above estate and that instruments(s) dated T~, described ~n the petition be admitted to probate and filed of record as the last ill and Codicil(s) of Decedent. _., ~ ; ~fenda Farner Strasbaugh, Register of Wills ~~ _, ~! .~~~ FEES: Letters ....................$ ~°' Will ........................ _' Codicil(s) ................. ( lo) Short Certificates ~(~ (~) Renunciations....... ~~-m Bond ............................ - Other ............................. - ................................. Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ ~ ~'SV Signature of Counsel Required to l~ttt~r!Appearance Atty's Signature PRINTED Name: Supreme Court ID No.: Address: Phone: Fax: Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 oft _i__ ~ ; - r-~ ra ~ ~ ~' RENUNCIATION ~~ ~+ ~-'- 1"r1n ~ G? ~~~ REGISTER OF WILLS ' ~ n © -u c ~~'~ `~ f hn~Det'~AhC~,. COUNTY, PENNSYLVANIA p~T' w ~ rn t `~~ r------- Estate of <~ C'~'f l+Cl 'I \ ` ~ 1~ ~ ~ ~ O r 1^'e S ,Deceased I, . J~~'~ ~ ~ ~ ~G r t ~ m r C ~ in my capacity/relationship as not Ndme) ,~0'~~t? V' of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to, ~r~Y~ ~-.Du15e ~il~r~SGh ~~ cam, . ~~ . 2,0 -1 (Date) Executed in Register's Office Sworn to or affirmed and subscribed befo a me this (~ _ day of , ~D l I Deputy for Register of Wills r (Street Address) (City, State, ZipJ 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 thhis day of , Notary Public My Commission Expires: (Signature and Seal of Notary or other ot~icial qualiRed to administer oaths. Show date of expiration of;Notary's Commission.) Form RW-06 rev. 10.13.06 n C O ~ rva ...-- -~ ~ rr'~ ~ ~ t~? RENUNCIATION ~~ ~ v; try ~x ~:~; REG STER OF WILLS ~~ ~,, ~~~ Q ~ COUNTY, PENNSYLVANIA ' ~~ .^._ `" Z 1-I [-o zo-~ ~O ~.1~ V ~ ~ /V ~ `~- ~orr~. ~ Estate of ,Deceased ~u I, ~(' ~- ~ ~~ ~ ~Y'r'e in my capacity/relationship as ~ ~ ri Name) ~O ~ of the above Decedent, hereby irenounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~cty~A ~ ~ k i 5~ ~ ~ ~ l-~ t r-~So I~ ~ , (Date) (Signature) Ig i 3 e~ao ~w~~ {~ due (Street Address) ~ t •e ~ ~-~1' `-1 SSa ~o (City fate Zip ' , , , l~~g--1J Executed in Register's Office Executed out of Register's) Office Sworn to or affirmed and subscribed Before the undersigned per sonally appeared the before me this day party executing this renunc ~atian and certified of that he u d the a nciaticn for the pulp i ~ daY Of ___ DENIZAK_ cHlrw '^L-r"r"seio^ Expi-es~ 2013 I Deputy for Register of Wills Notary Public j My Commission Expires: (Signature eal of Notary or other o I ~ci~I qualified to admini r oaths. date of expiration of Notary's Commission. ., Form RW-06 rev. 10.13.06 ___ R ~, ~ p T, ~ r*~ RENUNCIATION ~ ~` r,~ ~' tT- ~ vcs ~:- ,~~ ~, ~ x ~ _,..a ~:_~ REGISTER OF WILLS c-~ p ..o ~-~~~ '== ~r.,,~nor~ n COUNTY, PENNSYLVANIA Q ~ ~ w .- rn ~ ~' -- `'" Zf~ll-b2p7 _ ~(~ Estate of Q ` a ~ r'e ,Deceased x I, 1g~1f "t'6 G % oo r~ rrP S' , in my capacity/relationship as {Print Name) '~ /Q,r• 07~, r~ of the above Decedent, hereby renounce the right to administer the Estate of the Decede~n"t~and respectfully request that Letters be issued to', ~ra~ ~ou,i se yy i l~.~nS~ t'~ ?( 7 Fe b old ~/ ~C `'~.~ /~ (per) (Signature) (Street Address) ~c ~6;1~~.~ -~ -~- ~ 9G'o~ (City, State, ZtpJ Executed in Register's Office Sworn to or affirmed and subscribed before me this day of - Deputy for Register of Wills Form RW-06 rev. 10.13.06 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 t~is ~7t'r'' day ~RACED.KEEYS,~L _~ ~. ~~t~Q~ era eoe{,10U.S.C.10~4s~1b Notary Public ~OAAf~S~ My Commission Expires:~,t7'pCf ~,Al~.;•_,,,,,._ (Signature and Seal of Notary or other o ~ciW t{ ~ • '"""•~ ~ w use •. administer oaths. Show date of expiratign o~'No~u~As,~ommissionJ ' ~= S~AI, Aad~ori~eiNogryA~oah ~ •• . ., Unda'13de 1bU. 5. C.10~14a "•",.,,",.~~.,,~~'~ c; __ _ __ f r~.a c~ ~ RENUNCIATION ~ ~ ~,'~; vo c:-~ ~:?n . . .} REGISTER OF WILLS _cnx ~ ~' ~::~ ~_~ Curer lar~ d COUNTY, PENNSYLVANIA b° -a '-~ 4~ ~~ w n~_ ~~(I-~ZO"] ~ --- ` O Estate of ~O 1'~ e. Or r~ ,Deceased I, Q.~T~ F-~ 1'~IR le n ~Ur h in my Gapa~city/relationship as rint Ndme) J P,~ of the above Decedent, heret~y renounce the right to e-- administer the Estate of the Decedent and respectfully request that Letters be issued to `X~r0.~ ~-oui5e ~i ~K.i nsa ~ mob. ~r , ao~ 1 (Date) (Signature) ~a ~~~ 5. ~~ ~- (StreletAddress) -~'i r i~c5 l'~ ~ d (City, State, Zip) Executed in Register's Office Executed out of Register's, Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunc~at~on and certified of that he or she executed the renunciation for the purposes stated within on t~4is' day o , Deputy for Register of Wills Notary Public ~ .- 1 1 My Commission Expires: 1 (Signature and Seal of Notary or other o ~ci}l qualified to piratio~n oENotary's Commission.) NOTARIAL SEAL ~I pENIZ AK, Notary Public StseNon Bono, Dauphin CDUnty My Conrnf~ion Expires .Ianueiy 04.2019 Form RW-06 rev. 10.13.06 - ~rtlt(.QnS Rc~. /Ilt~n^1 LOCAL REGISTRAR'S CERTIFICATION OF DE/I1TH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P x.7114483 Certification Number This is to certif' that the information here given is correctly copied~rojm an original Certificate of Death duly filed with ~ne'', as Local Registrar. The original certificate will ~, be', forwarded to the State Vital Records Office for permanent filing. ~x Local Registrar !~ Date Issued rU ~' 7p ;n n ~~ C7 ~ ~~ ~;J ~ ~i+J ~~ ~~ t~•t~ W - r~ ~~ ~-- ~ ~ ~ tn9u« iev,7r9999 cw~-L7H of PENMBYLVANU- - oEPAR't#IEIfr of HEALTH • YRAL RECORDS ', CORON~R'8 CERTtFlC/kTL~ oR DEATH. 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