HomeMy WebLinkAbout11-29-11n~
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PETITION FOR GRANT OF LETTERS ~ -moo ~' '~' ( ~`
rn -L C7 E ~ ~ `~ ::.
REGISTER OF WILLS OF ~(1 M b ~~ COUNTY, PENNS,~~IA ~ `_-~ -- ~? ='"
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as ~~C~red be~v, am~~i~r-j
support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropr~ form: w ~n ~; `
Decedent's Information ~y~' ~,'~,'
Name: " e_. ~'" File No: f~,~~ 1
a/k/a: ~G~ U r. ,tut R.f~P_ At"' (Assigned by Register)
a/k/a:
a/k/a:
Date of Death: ~~ ne- 3.St a.ci it
Decedent was domiciled at death in
principal residence at I CGD C;~rti~
Decedent died at
ity No: r~0y d2~ 1 ~~
Age at death: _ ~~
~o l3 M ~~ d tic T~ ~Mc~ ('~
(State) with
City, Township or Borough
Street address, Post Office and Zip Code City, Township or Borough 'County State
Estimate of value of decedent's property at death: a
If domiciled in Pennsylvania ............................ All personal property $~ ~ t t?G e ~ "~
If no[ domiciled in Pennsylvania ........................Personal property in Pennsylvania $
If not donsiciled in Pennsylvania ........................Personal property in County $
Value of real estate in Pennsylvania ......................................................... $
/ TOTAL ESTIMATED VALUE.... $
Real estate in Pennsylvania situated at: /~[~
(AUa~Ch addiKonal sheen, ijnecessary.) Street address, Post Office sad Zip Code City, Township or Borough County
^ A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) he/sheJthey is/are the Executor(s) named in the last Will of the Decedent, dated
thereto dated
and Codicil(s)
State relevant drennntances (ag. renunciation, death of executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was not divorced, was not a party to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8), and did not have a child bum or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
^ NO EXCEPTIONS ^ EXCEPTIONS
® B. Petition for Grant of Letters of Administration (If applicable)
c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durante minoritate
If Administration, Gta or db.n.c.t:a., enter date of Will in Section A above and complete list of heirs.
.Except as follows: Decedent was not a parry to a pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa. C.S. § 3323(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
~NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the folly wing. spouse (if any) and heirs (attach
additional sheets, if necessary):
Name Relationshi Address
~. e s 11 0 ~ ~ mlt ~+~ w- ~ i h ~ `~Pr
Form Rw n2 rev. toituaoii Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Official Use Only
Petitioner(s) Printed Name Petitioner(s) Printed Address
A' I -~
L
~ O ~~
'°'i'i ~- ~ ~7 ~, % r
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The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petiti are true and correct to the ti~t~the~CnowI?ktge and 1~elie~
of Petitioner(s) and that, as Personal Representative(s) of the t, the Petitione will well and truly administer~e~tate acco~g to ~ rn
Swoon to~ ~o~f a~f~irmed and subscribed before ~ Date 3
one S~~Q ~ - day o ~ Date
Forlhe ltegistei
BOND Required: [~ YES ~ NO
FEES:
Letters ...................... $ • o~
( ~) Short Certificate(s)......
( t) Renunciation(s)......... _~r~Q~
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ......
Automation Fee ............... - ~
JCS Fee ..................... 1
TOTAL ..................... $ U
Date
Date
To the Register of Wills:
Pieaae enter my appearance by my signature below:
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate
a/k/a:
File No• ~~' ~ ~' ~ ~7~
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 (if applicable) that
the instrtunent(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
Register of Wills
Form RK'-01 rev. [0/l1/10/1 PagB 2 Of 2
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RENUNCIATION ~ ~
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REGISTER OF WILLS ?o
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C ~~ 6 pr~G nil COUNTY, PENNSYLVANIA ~ =° w _
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Estate of ~~~ r 1 c-t c~, ~ (\ (~ M ~ l1 e ~--
Deceased
I, ~ S ~ I~^~e S ~ ~ ~ ~ M ~ ~ `~ f `~ in my capacity/relationship as
(Print Name)
_ S'~uct? of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
)_Jc~,~'~c~,Pe~ ~ l1 ~ C~rs?,_~,P
~1e) <
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
~~~~/~
w
(Street Ada'reu) / g
~~ ~~~ L /
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purpose stated within on this _ Z~ day
of ~~bveM~ _ 2 .~ 11 _
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLWWIA
NotattN tisal
Gint E. tistan, Notary PutN~
Svratara Twp., DauphM County
My Cttrnndeelon t_xpirea May 18, 2012
MNnbar, Panntyhrania Association of Notaries
CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
REGISTER OF WILLS
Cv Nib er lam COUNTY, PENNSYLVANIA
Name of Decede/nt: C ~ ~ ~
Date of Death: 6 `o~S'1 ~ File Number: ~ -
Date Letters Granted:
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
Name: Address:
J 4-n~e~ (.,~.r~- M~~~P ~ ~ ~ (nt t f ll v
l~~l~n rc. ~~ F1Git~P G ~'/ O ~ S
(If more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except:
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Si lure er^nn Filing this m
Capacity: Personal Representative ^ Counsel
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Nnme o~erson Filing this Form
~~ C~v~en_7` ~ ,MVP
address ~y
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Telephone
Form RW-08 rev. /0.13.06