HomeMy WebLinkAbout12-02-11nO ~~ -r~
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PF~~~ VAINIA l~
REGISTER OF WILLS ~ ~ ~ r`' -
PETITION FOR PROBATE AND GRANT OF LETTERS ~ `~' ~-~
Estate of _~~ ~-~ ~'E'a~ti ~A ~ a r1~' ,Deceased ESTATE NO: 21- ~~ 1 ~,;,~
a/k/a: ~~
a/k/a: ~
a/k/a:
SS NO: ~ 8 `~ - 4Z - 1 15 ~
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(8):
B. Grant of Letters of Administration _
(If applicable, enlcr 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
roceeding wherein grounds for divorce had been established as~provided in 23 Pa. C.S.A^§ 3323(8), except as follows:rl6
R...._ . - - - ~ - -
Name
Address
Bober--E- v~leh~-( 47 t, ,r ~..~~- PC~N PAtSzzt hu~.~~e~.-~
~.t-Y LUt~ strn ore. ~ VII. , stAf' ~ ~ '~ Yl
Rbt a t I vllen-i~l a3J Car-wa. ~-rep„-l- ~u,r-~ ~s( ~q I7o cla 1~~1-~.-
Igle~a+~d e r W ~ n z..el (oa ~,I u 5 R~ I ~s' ~t Il q ~b 1 sdv~
uJn AUUl l IVrvAL Jt1Y:C; IJ lr 1Vt.(.!!.SSSAKY
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence
At 33 I Laht,ua.~.., SFre.~- _ Cotx-l I s l e i~a_ 170 ( 3
(Street
with Post Office and Zip Code, Municipality: Tovmship, Borough, City)
Decedent, then 5~7 years of age, died 1l) ~ obi ~ ao l i at _ f{~i''~Lr1Gl/ P-/~,
(Month, Day, Year of death) (City and State here death occurred)
Estimated value of deceder.;'c 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 $
Total Estimated VatueG.,_~$~-}~~p r pOO , Od
Location of Real Estate in Pennsylvania: (Provide full address if possible.) ~"3 ~ ~'~ ula..1 ~r~? C~~ S ~ e ~~ (70 ( 3
Signature(s)
Name(s) & Mailing Address(es)
Relationshi to Decedent
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Offi~ Use Only ~-
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Petitioner(s) Printed Name Petitioner(s) Printed Address '~-. r- "'
Cfl R-UL ~ C Rtzy (-7~ Chan ~tn e. ~.~ ~ t_Q,,~' p v ~t~ (o`~ _.. ~.
~.
The Petitioner(s) above-named swear(s) or affirm(s) 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, the Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed ands ribed beft~,Fe l:.(11~~:.-(~ ~, Date l'L~ ~•~ ~ l /
me ~ r _ day of ~~o~l Date
g ~ - -f _ ,l ~/f__.-.~' Date
o, the Register Date
BOND Reduired: YES ~NO
FEES:
Letters ...............:...... $
( lU )Short Certificate(s)...... ~-j L3
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ........
Automation Fee ........ .......
JCS Fee .............. .......
TOTAL .............. ....... $ ~
To the Register ojWil[s:
Please 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 of ~ ~• ~C "'l ~1 ~" File No: ~ ~" f ' _ f ~~~
a/k/a:
AND NOW, I~~~~ t; -~y~ ~ ~ (; t , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters ~~,~1 Y 11.~-f`([^,f 'h C11D
are hereby granted to C'Clro ` (~ C (~,f
the above estate and (if applicable) that
the instrument(s) dated _
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
Ttegtster of Wills
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Fo,~,» ~w-nz ,-w. mirrizn~r Page 2 of 2
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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 17978376
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 Office for permanent filing.
~~ei~.~~es~~-~b~x' oo~r ~ ~ 2Q11
Local Registrar Date Issued
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H10S1q REV 112003
TYPE/PRWrIN
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See Instruetlons end examples on rolrenel
,. Ndre d Demdnn IF+n middle, Md, ed3x) Nancy Jean LaMOnt Female 3. soar seadry Numbm _... _ ..-...-_. 1. t>r a orln iMOnm, mr. ,~,
189 - 42 - 1154 October 29, 2011
s. Ap IVd ewmmyl lAtar 1 lbM 1 e. Der a aro~ T. erd ater a ea Plere a Dsoa Grm ae
Llonde °"" "°~' l`""a° Dec. 27, 1953 Ames, IA "°°~'°'~ om°°
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Administrative Law School ^vr ®No Married Robert Earl Wenzel
• 18. DeadeM's (Slreel,dry/bwn, arr, zip Dade)
231 Conway Street DeceOenre
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Bernard LaMOnt Helen Davis
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RENUNCIATION
REGISTER OF WILLS
C~la~/1' COUNTY, PENNSYLVANIA
Estate of /~/Q~1
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Deceased
I, -~4~'t ~ ~~~'( in my capacity/relationship as
(Print Name)
(,JY of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
~ ~- ~ Z ( Ze, i 1
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
(Signattre)
4-72q ~~~ ~, l~r~--~'
(Street Address)
~~bu~~ , ~.~ ~~szzg
(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
purposes stated within on this -~ ~ day
o~f'~/l) 011 P m ~e ~ (`) ~ ~
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.)
t~01MMONWEA PHWVSYLVAN
NO~IN SCI
~Y
. i, Z01~
~ .,. _ hlgr ~lQg1 d ~~
RENUNCIATION
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
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Estate of ~ N c ,Deceased
I, AQ~TF1'U e TA laF S UICSrI~y{t.E . E'S61. ~ , in my capacity/relationship as
(Pri t Name)
S O ~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
oZ`~ NCu~ MgE"~ .101 I
(Date)
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
(Signature)
-r - g a u~. IuH 1TE1-}A1.tr eA .
(Street Address)
srA-rE ~ cn.LEGt~ PA 16 go 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 renunciationfor the
purposes stated within on this ~~ day
of ~~~e.~~,j..rz. ~.o,'i
Notary Public
My Commission Expires: L.~c a 7j ,Z,o /
(Signature and Seai of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYIYANIA
Notarial Seal
Shari ~. Wekh, Notary Publk
Stabs t7dieye Born, Centre County
~Cp~rrISSIOn By11re5 April 27, 2014
Member, pennyyNanla AssodartMn of Notaries
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RENUNCIATION ~~" `z =~ -
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REGISTER OF WILLS -~ ~ ~~~
(,a~M.c3~~21~4~` ~ COUNTY, PENNSYLVANIA c
2.1- I--1z-9~..
Estate of iy ~ ~~ ~1~~; /~ ~~, ~~ l ,Deceased
I, ~`~~ ~~ (L j~~~ ~-t-- , in my capacity/relationship as
(Print Name)
~~l~~ri-E-TE~ti. of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
AiC Vr; )~;~ 23 2D l l _
(Date) (Signature)
Z 3 I C~,~~~4Y ~z~~
(Street Address)
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
(City, State, ZipJ
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciationfor the
purposes stated within on this ~~ T~ day
of l~t`~VEJIJI~~. 7.~ 1 r
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.)
COMMONVVEAL"Tli OF P~-VANIA
Notarial Seal
Pamela R. I~rrowlCon, Notary ~
Qrn+berlat-d CourttY
COfrMn~ DtW~ ~. 9, 2014
Member. Penrtsyivanla pssodadon at Notaries
RENUNCIATION
REGISTER OF WILLS
~~~ Lf~/~ D COUNTY, PENNSYLVANIA
2 i-11- I ~,g~..
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Estate of ~~[/y~~ ~Jl~:~~ ~-"~¢~~ 1 ,Deceased
I, ~(.~~C 1~N ~E~.. ~U~f'l~ ~L ~ L-- , in my capacity/relationship as
(Print Name)
,:5~/'lJ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
~ ~ ~~~~
N'~v~~C 2~ 2 ~o-G c
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of ,
Deputy for Register of Wills
n~~~v
(Signature)
~QD z /l~ ~S ~a~~`P _I ~
trees Address)
~~ ~~S~U~U ~~ ~ ~~~~
(City, state. Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and~,~cJe~rtPified
that he or she executed the renuni~~r' "" r the
purposes stated ithi on this day
,~~~r~-~1~~
Notary Public
My Commission Expires:
day
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
cor~n+oNw~Trl of P~s~vfwv-
Form RW-06 rev. 10.13.06
howl seal
Pamela R. KswrYlbort, Notary PubNc
Cerllsle Boro, Cumberland County
My Commisslort F~Ires Nov. 9, 2014
Member. Pennsvlvanla Ossodatlan of Notaries