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HomeMy WebLinkAbout07-08-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS ,- Estate of ,Deceased ESTATE NO: 21- ~~ - ~~(..~a- a/k/a: 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 (St to relevant circumstances, e.. renunciation death of executor etc. ~~ ~ ` g ~ ) 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): ~. Grant of Letters of Administration (If 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: 1.Mi~~C l~ ~ ~e mn Address ~sJ Relatlonshi to Deced~ I iCC A ATiTilIIU A i cilccTa rr. AiT /~T C.f. ~ T., ~o __ _ THIS SECTION MUST BE COMPLETED: Decedent was domicile at death in C erland At l Z Pennsylvania, with hi (Street address wi st Office and Zip Code, Municipality: Township, Borough, y) Decedent, then ~ years of age, died 6 / ~ O at /~'! Pte. ,,,,,`~ s,~, ( onth, ay, Yeaz of death) (City and State where Estimated value of deceden*.'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 Personal property in Pennsylvania Personal property in County Total Estimated Value . ~... _...,~ ~.~'1 r_- nt ~. -~-~ ~~ r-r-~ C ~;7 ~_~ f"`" 'I:1 - ---~ I r- y ~=--r 'c re°s°dence"' ``~ ` .-~, '~~ ~.~~~~ _r ~~ de'~h occurred) ...__ --r~ $ ~~~ Location of Real Estate in Pennsylvania: (Provide full address if possible.) ~ .2.~ ~r~~_ ~r /Yf ~c~.~.~ ~s f~~ / 7p~'v Signature(s) Name(sl & Mailing Addrecc(ecl t t ~7~a z sl-Z _..__ ............._.. .,~ .,..........~..~..,..., .,y ............~~o~~u .,vuu~y Ncuw~~g a~uuii uy u~c ~.oun Page l Ot Z 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 tc, the bst of the knowledge and belief of Petitioner(s) and that, as personal rep>~~tative( of the ~~- ; T, Decedent, Petitioner(s) will well and truly administer the estate according to law. ~.~o ~ ;~ ~~ ::I7 ~ rte-- i'"` ' r Sworn to or affirn~ed and subscribed =~~,~~ ~ ~_~ -~`-; - ~~:~ befo me this ~~ f ~ day of ~ ~ = ~__-_~- ~' . • - ~.. J For the Re DECREE OF PROBATE AND GRANT OF LETTERS Estate of I~GZ u ~ ~dl~~ a'~OI~ ~/U~~~~eased File Number: 21- 1 - a AND NOW, this ~~ day of ~ ~ ~ ~ ~ ~ , in consideration of the Petition on the reverse side hereon, 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., b.n.c.t.a., etc.) ~. ~1 ~ ~,SO /"1 ~~"I ~ l ~ f i S~~ C~ ~1 /%~1 (~~1 C ~~- - -- - in the above estate and that instruments(s) dated _ described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner trasbaugh, `~'~ ~~ ~ c a Register of Wills ,' ~~~~-= FEES: Will ....................... Co icil(s) ............... (~ ~ Short Certificates ( )Renunciations....... Bond ............................ Other ............................. ................................. Automation FEE......... 5.00 JCS FEE .................. 23.50 TOTAL ................$ I5 b •$V 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