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Home My WebLink About04-15-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ~• ~ ~ ~~ ~ c;~.l'`-I ,Deceased ESTATE NO: 21- ' ~~ d ~~ a/k/a: r a/k/a: 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 (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 after execution of the instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person, and was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in 23 Pa. C.S.A. § 3323(g): B. Grant of Letters of Administration (lf applicable, enter d.b.n., pendent lite, 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:- l ~. T . ~-•- _ `.... 5...~ i TCTi A ililiTilllU A i QLIL~L"ro trr. t~Tr. ~ncc. • r.c, ,~' `~ `~\ THIS SECTION MUST BE COMPLETED: Decedent as do~r~iciled at de th i Cumberland County, Penns lvania, wi is/her (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then ~ years of age, died ~~~-r~ q - ~® at (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: _If domiciled in PA All personal property $ ~ ~1 _If not domiciled in PA Personal property in Pennsylvania $ _If not domiciled in PA Personal property in County $ -Value of Real Estate in Pennsylvania $ ~~~~ Total Estimated Value $ o.oo ~(~,-~ Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature(s) NAmPlcl .{~ Mflilino Ar~/l.~oealo•.l J inter: w. C.,.... Dill !1^f ~.,.,...,.,i t^f ~c to t_. n__~t___t---~ ~._ t 4~ ~~~ ~ 1/ ~~ v~ ~VL f rage t of 1 ~A Vame Address Relationshi to Decedent ~~ -r. ~ +`n r ..., .- "t t anvil or nci al residen '~r~ ~f y ~' p ce J w ~,. f`°• OATH OF PERSONAL REPRESENTATIVE ~ _~ ~~-~ r~ -~~ ~, , r~.J .~ Commonwealth of Pennsylvania r'T r j~ ~ _._ ` S S r~ -' ins , , -''. County of Cumberland ~r '"~ ~ ~'~` -, _. ~~ ~ `; } --r~ ~ _--, -n ,d The Petitioner(s) herein named swear or affirm that the statements in the foregoing Petit oori~re true~nd ~ f~ ~ correct to the best of the knowledge and belief of Petitioner(s) and that, as personal repre~ntative(s~f the --~, Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and ~~abscribed bef re me this ~' _ _ Say of _~ -o ~- ~u2 ~~~ / ~-, For the Register DECREE OF PROBATE AND GRANT OF LETTERS ~~/ / Deceased File Number: 21-_ /~ - Estate of /' ~ ~ - AND NOW, this ~hday of r~~ ~ ~~/ , in consideration of the Petition on the reverse side here ,satisfactory proof h wing been presented before me, IT IS DECREED that Letters Testa entary of Ad inistration are hereby granted to: ~/'^~ // ' ~ a/ / icable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) ~lP~ n I in the above estate and that instruments(s) dated admitted to probate and filed of record as the last Will lcll(S) described in the petition be Decedent. n ,rl G enda F'arner Strasbaugh, ~`' J~~~ Register of Wills FEES: d0 Letters .................... $ Will ...................... . C icil(s) ............... ( Short Certificates ~ Q ( 1) Renunciations.... ... ~ Bond ........................... . Other ............................ Automation FEE......... 5.00 JCS FEE .................. 23.50 TOTAL ................$ Signature of Counsel Required to Enter 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 of 2 RENUNCIATION ~- - ~,., REGISTER OF WILLS A7 ~ ~ Boa ; u ~ ~ X1.1. t ~ COUNTY, PENNSYLVANIA ` _ ~ _` -~ , - -z-, ~-, _ ___ t~ -.~-- ~~_ ~.,~ --~., ' I ~- Estate of f~ ~ ~~IU ~ - ~ ~~~`~~ - , Dcccascd I~ ~ ~ ~ ~ ~ ~~~Q ~ _, in my capacity/relationship as (Print Name) ~ `~~~/~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to -ii - ~~ (Date) J ,\ttti1111141f11/1///, li~ to ~ • N~ f? ~ ' ptlBLIG :Q .~~ -- ~F~'•.OF~itas~ .. ~ ~~ ~.,~f!/r / /L,K 1 ~ to \ , ``t\\\~ ~`l` ~ 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 ~~`~~ ~N ~ ~kt ~>>~i ~• . F ~~ P;.~GomMis••.~ ~i 1 ~ ~ NOTAI?r~i~7 : i y ~- "• "" PUBLIC T '• _. ~" `~. ~~ ~~~ (Street Address) CJ ~ ~ (Ci , Sta ip) Executed out of R'egister'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 >~;xpires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.)