HomeMy WebLinkAbout07-18-11 (6)r ,
PETITION FOR PROBATE AND GRANT OF Lit E i~A$ fi~i IO' ~'`'
Register of Wills of Cumberland County, Pennsylvania
CLERK OF
Estate of SHIRLEY BENNETT LOTZ File No. 21-10-1196 , QRPFiAN~S C(}URT
alk/a SHIRLEY ANNE BENNETT LOTZ Deceased Social Security No. - - 1
DYANE V. SMIITH
Petitioner, who is 18 years of age or older, applies for:
(COMPLETE "A" OR "B" BELOW:)
^ A. Probate and Grant of Letters Testamentary and aver that Petitioner is the
named in the Last Wili of the Decedent, dated Mav 26. 2010 and codicils(s) dated N/A/
State relevant circumstances, e.g. renundation, death of 6tecutor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of
the instrument(s) offered for probate; was not the victim of a killing and was never adjudicated an incapacitated person:
Q B. Grant of Letters of AdminisVation d.b.n.c.t.a.
(if applicable, enter: c.t.a.; d.b.n.c.t.a.; pendent elite; durance absentia; durance minorttate
Name Relationshi Residence
DYANE V. SMITH Daughter 24 Ridgewood Drive,
Reddin ,Connecticut 06896
(COMPLETE IN ALL CASES): Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at
Messiah Village, 340 Messiah Circle. Mechanicsburg. Cumberland County. PA 17050
(List street, address, town/aty, county, state, zip code)
Decedent, then 83 years of age, died on November 21.2010 at Messiah Village. Mechanicsburg. PA
(Location)
Decedent at death owned property with estimated values as follows: 3.~ Z r 3$ -~
(If domiciled in PA) All personal property.,........_ ...................._.._...._...._....._...........$
(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........_ ..............................................._._........................................... $ 3 $ Z .
Real Estate situated as follows: l+i1dAl~
Wherefore, Petitioner respectfully requests the probate of the last Will presented with this Petition and the grant of Letters in the
appropriate form to the undersigned:
Si nature T ed or tinted name and residence
DYANE V. SMITH
24 Ridgewood Drive,
Reddin ,Connecticut 06896
..
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OATS OF PER40NAL REPAf~S>C1tiTATIVIL ''~` , - ;` ' :,..~-'~
RE~~,,
Cotnmonweslth of Pentasylvania SS ~ ~ ~ y ~~~ ~ $ Ali !C~ "~ `~
County of Cumberland
~s c°ouar
The Petitionor(a) herein named swear or sffirxn that the stater in tk fin6oina ! . M
coaect to the best of the lcuowledge and belief of Peti~pnex(s) and that, ea personal fire(s) of the
Decedent, Potitiomer(s) wiit well and duly administer tie estate aeco~g oo law.
Swonoi to qr affi~m//e~~d and subscribed
b the f5is Uf~~_day of
(~~~'1
Register
DTCREE OF PRO$ATE AND GRANT OF LETTERS
EstatC Of~ L f ~ ~~' lJiJl ~-. Deceased Pik Number: ~ ~-~-J Y.
AND NOW, this daY ~ , it- eonaidezation of the Petition on
the reverst aide hereon, satisfactory proof having b en presented before tne, IT TS DECREED drat I.eteeTs
,Testam~ary,,,,_ of Administration ~~ , are hereby tsramted to:
v
the above estate ~ that instruments(s) dated
admitted to probate and filed of record as the last Will and Codicil(s) of,Deee
1.etters ....................5
Will........ .........
Codicil(s).. ........ .
( )Short CextlRcates..
( ) Renunciations.......
Bold ...........................
Other ...........................
_.._
Automation FF,k......... .
JCS FEE ...................
FEES:
TOTAL ................ S
the petition be
Si=astrra of Ca~nwl Rsadrad to tt./er Appaanaee
Atty's Signature
PRINTED Name:
Supreme Court 1D No.:
Addctss:
Phone:
Fax:
Inreelm pp,~, RW-02 rtvi~0 ~3.36.IU try C:un+beelud Cnunry penUiog sntipn by die Caen
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