HomeMy WebLinkAbout03-25-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of T ~ N w~ F E R M • Z -~ ~ ~ ~ ~ ,Deceased ESTATE NO: 21- 1' ` -" 1~
a/k/a:
a/k/a:
tea; SS NO:
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.n.c.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~Q `"' ~~
~i a+~
-'"i -~ ~ ~ f, a ~
i3
~~~ N - -
(State relevant circumstances, e.g. renunciation, death of executor, etc J ~-J. ~o ~, fy ,. ,
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted ~x~tution of the • -
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated ~c~•nd vr~i not s -r
party to a pending divorce proceeding at the time of death wherein grounds for divorce had been Es~ished as ~efined~'
r _ ;-+-r
23 Pa. C.S.A. § 3323(g): - ~„ ~ ,~,~ - '~ GQ
~.B. Grant of Letters of Administration
(If applicable, enter d.b.n., pendent life, durante absentia, durante minoritate)
C. 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 Will in Section A and complete list of
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:-
Name
~.AvtRtN ~~au~>=N c~Er~ • ~-•- -
a1~4 goEHm~ -~ Ra. SP~IeRO~~I~S+~ I~l~ Ia~Ba
i~lo~~
USE ADDITIONAL SHEETS IF Nt:(:N:SJAt(t
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland Count, Pennsylvania, with his/her last family or principal residence
At 7~a i-Ir~~ovE~(Z Mr~NOR C~+c~lisle, ~ ~P~ •
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City) ,~1
Decedent, then ~_ years of age, died O .a O (o o1V I ~ at ~ ~ ~ I i S ~ 2 ~ ~" ~ ~~ H ~ V A N i ~
(Month, Day, ear of death) (City and State where death occurred)
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
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
C •...... ~....e/cl
Total Estimated Value
$ ao, ooo. coo
S
S
Name(s) & Mailing Address(es)
~s..a.....~,,
~
`p
t.awi'en ~..o.k ~en ~gi~ W 1'l 6a~NM~~R R.c aD
q
,
c-., QI .
- - - ... ,• --- ~- -ti_.._..~ Pa¢e l oft
All personal property
Personal property in Pennsylvania
Personal property in County
Interim Form RW-02 revised 12.26.IU by Cumbenana ~oumy penamg acuun uy u~c wu~~
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF C1rtm ~ ~C~n d
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are hue 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
before me the ~`~~ day of
~~ ~
For the Register
Signature of Personal Representative tc"a'`
`~ _~
Signature of Personal Representative S ~ ~ ~ }
~ t %,
~.~ z ~ ~
d1-i1-0389 °~' ~ ~_~y
File Number: ~~ t;? ~~'~j
~ t R t- !Z , Dec~sed ~''~ '~
Estate of ~ ~N -y ~- F t i2 'N1 ~ "-'
Sociai Security Number: ~ $ ~ - ~ ~ ~ a °~ ~ ~ Date of Death: O a~ O (~' ~ a 01
AND NOW, , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters
are hereby granted to
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) .~ ..... $
Renunciation(s) .......... $
C~' ... $
.. $
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $~r~ • aSC1
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Register of Wills
Page 2 of 2
Form R6V-0? rev. /0.!3.06
-! -11- 03`3`
Hl(IS.ROS R8V (01107)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Eee for this certificate, $6.00
P 17115166
Certification Number
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 Office for permanent filing.
L~i~y~~~t'a~a~c~~~Y' FED 102411
Local Registrar Date Issued
~7
C!] ~
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H105.te4 NEV 112008
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