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HomeMy WebLinkAbout08-26-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS p~ Estate Of Anna Mae Shuey ,Deceased ESTATE NO: 21- ~ ~' Oq~0 a/k/a: a/k/a: SS N O ~_ J03-t D_4488 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 G rant 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 executia~of the instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person, and was rldt 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(8):. ~ B. G rant of Letters of Administration (If applicable, enter d.b.n., pendent life, durante absentia, durante minoritate) C. Petitioner(s), after a proper seazch, 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(8), except as follows: isa M. Smith 222 East Maln Street, Mechanicsburg, PA 17055 randdaughter USE ADnt~InltlAL._ N FTCI [JCf`cCCeov THISSfCT10iU Ml7ST BE COMPLETED: C7 '~ r r-'~ y i ,.._.. ter' _.GJ .? n~ ~ ~ ,..:i .. -~ _ r:r ~'_~ Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family o€~~a~ipal tv~denc~ ' At 940 Walnut Bottom Road, Carlisle, South Middleton Township, PA 17015 ~o ~ ~= (Street address with Post Otlice and Zip Code, Municipality: Township, Borough, City) D --! ~ r-' :'rt Decedent, then ~Q_ years of age, died July 22, 2011 at Carlisle, PA ~ ~~ (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 $ _If not domiciled in PA Personal property in Pennsylvania $ _If not domiciled in PA Personal property in County $ _Value of Real Estate in Pennsylvania $ r , ~ Total Estimated Value $ oa Location of Real Estate in Pennsylvania: (Provide full address if possible.) . Signature(s) ~ Name(s1 R Mailinn Cddroeero~i isa M. Smith, 222 East Main Street, Mechanicsburg, PA 17055 Interim Form RW02 reviseA I2 ~F m h., ~•.,...~.i~.,a r.....,«, _e_,,:__ __.:_ o ...........~ .....,...... Name Address Relationshi to Decedent Page 1 of 2 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ,~ l~, ~ ~ ~ Q~ before me this d ly of iJ ~ ,,. r, n-. 0 ~:n ~~ ~,-, - r r.~ ~~.--o-~ ~.., cn x For the Register ~ . 7C~~ :~ DECREE OF PROBATE AND GRANT OF LETTERS~'~ r".~ _ ~, -z ; ;-~, r-~ r~ -; =`'- ~_, , ;_., ;_, ~_ _~ -'- ~= -n ;._ ~( ,:.~~ ~ ~y} t o U C" Estate of Anna Mae Sht~ y ,Deceased File Number: 21- ~l~ ~ 1 - -`~ AND NOW, this ~ day of 1"~ `~'"~r~c5+ '~~ ~ 1 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been 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.) Lisa M. Smith 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. aJ ~ OQ.Q Glenda Farner Strasbaugh, ~p r ~~ Register of Wills T" FEES: Letters ....................$ ~w Will ........................ Codicil(s) ................. (/~) Short Certificates (-~~ ( )Renunciations....... Bond ............................. Other ............................. ................................. Automation FEE......... 5.00 JCS FEE ................... 23.50 c~~ TOTAL ................$ --~8-5" Signature of Counsel Required to Enter Appearance Atty's Signature v~ PRINTED Name: Andrew C Sheely Esquire Supreme Court ID No.:62469 Address: 127 South Market Street, P.O. Box 95 Mechanicsburg PA 17055 Phone: 717-697-7050 Fax: 717-697-7065 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 ; OS399 HF.V (91/07) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $6.00 P 17697550 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 f ce permanent filing. Local Registrar to Issaed CoMA10NWEALTH Of PENI~yLVA111A •<OEPARTYEHT OF HEALTH . 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