HomeMy WebLinkAbout03-13-12PEThT^I~O"N FOR GRANT\OF LETTERS
REGISTER OF WILLS OF ~,1M~~Z, JAS 4 COUNTY,
Petitioner(s) named below, who is; are 18 years of age or older, apply(ies) for Letters
support thereof aver(s) the following and respectfully request(s) the grant of Letters in -the a
Decedent's nfor am tion
Name: ~N~ ti ~. ~ l..'~T~~4R-•
a/k/a:
a/k/a:
a/k/a:
Date of Death: ~. - l a-'~aI ~
Decedent was domicile at death in ~.
principal residence at ~~ W a~~o
Decedent died at
Street address, Post Oftict and Zip Code
Street sddrea, Poat Office and Zip Code City,
N
~
t•V
3^
r,~
.~
w (-"7 .
y~
NIA-p
3 ~f
led low, l
forrt~
File No• ~~" I ~ - n 3(,~,i
(Assigned by Register)
Social Security No:
Age_at death•
with his/her last
or Borough - ~" ~ ~opgty 1 ~a
Y4f`OA 1~
__ u~-_ NCoanty State
Estimate of value of decedent's property at death:
Ijdoneielkd in Psnasylvanla ............................ All personal property S ~ _ Sal
Ijaat daasiclled bt Pennsylvania ........................ Personal property in Pennsylvania S-~~
Ijttot deaeklled in Penasylwattfa ........................ Personal property in County S
Yatue ojreal estate in Pennsylvanla ....................................... :.............. S
TOTAL ESTIMATED VALUE.... S
Real estate in Pennsylvania situated at: ~ D ^--
(dnach pddttional sheets, ijnecessary.) Street address, Poat Office and Zip Code City, Township or Boroogh Connry
^ A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s), aver(s) hdshdthey is/are the Executor(s) named in the last Will of the Decedent, dated and Codicil(s)
thereto dated
State relevant dreamstances (eg. renunciation, death ojexecuto~ ere)
Except as follows: after the exxution of the instrument(s) offered for probate Decedent did cwt marry, was not divorced, was not a party to t pending
.divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), and did not have a child. born or
adopted; and Decalentwas neither the victim of a killing nor ever adjudicated an incapacitated person.
^ N'O EXCEPTIONS ^ EXCEPTIONS
' B. Petition for-Grant of Letters of Administration (if appticable)
e.t.u., d.b.n., d.b.n.c.t.a., pendente lit[, durance absentia, dttranta minoritute
If Administration, Gba. or d b.n.c.~a., enter date of Will .in Section A above and cornulete 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
PetitioneKs), after a proper search has/have ascertained that Decedent left no W ill and was survived by the following spouse (if any) and heirs (uttuch
additionu?sheets, ijnecessary):
Name Relationshi Ad ress
~~~
1' i3 t t ~.
. :.
.~~
Form ttw.Al rev. lrululnli Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
r..Y
'al Use Ong
sy
~ ~ ~n
~tiJ Si C7
c.:,' ~ r
-Q r-: '~ y
~,:
~
,
Petitioner(s) Printed Name Petitioner(s) Printed Address
6 as ~ ~ ~
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 snd belief
of Petitioner(s) and that, as Personal Representative(s) ofthe nt, the titioner( will w an truly administer the estate according to law.
Sworn to ed bscri ore Date ,~ ~3 `Ic~-
me Date
By' Date
Register - v Date
BOND Required:[;~~IT,S [~NO
FEESs -
Lett .............. ~ , 6 6
(~) Short Certificate(s)...... d
( "~ Renunciation(s)......... • ~~
( )Codicil(s).... ..... .
( )Affidavit(s)........... .
Bond .. ....................
Commission ................. .
Other .,,,.,
Automation Fee....... ... .
JCS Fet ............... ... .
TOTAL ..................... S
To the Register ojWA[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 - s/ ~ Q /~ /gyp V ~e r(~ P~ File No• ~~' ~ 2 ' ~_
a/k/a:
AND NOW, ~ Q.~oZ. in consid ation of the foregoin Petition,
satisfactory proof having been presented fore me, IT I ECREED that to ~dlJ
are hereby granted to ~p t lil~7dn
- in the above estate and (if applicable) that
the insttwnenf(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (prtd Codicil(s)) of Iaacedent
Form RW-02 rev, I0/1!/201/
RENUNCIATION `
~`" ~:
~;, ~~, ~;
_:r ~ ~
REGISTER OF WILLS 7~ -b ~~:~,-~
~ ,~
COUNTY, PENNSYLVANIA ~,..,~ , ,~, t
Estate oft Le~~r.,r p~ ~d ~~p~~ 9 ,,~ ,Deceased
I, __ IVII¢K ~ L yn! N ~} - ~~ F -C ~' in my capacitylrelationship as
(Prtnt Name)
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
(Dare)
-~'~`>
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
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
pu oses stated within on this ~ day
of r afl~~
~~ ~2.e~n ( ~ ~~~ ~
Notary Public ~
lviy Commission Expiresa -~-/7-a Oi S . _...
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
". ,,,,~'TH,~PBN~LVAN
NOTARIAL,
IIOR~EN C. P'OPLQSKL, P~'c
Bethel Vark 8oro., AMs~her~-
~ 1T. 'I~`
r..~
`~
~ ~~
REGISTER OF WILLS a~~ c i ~'
COUNTY, PENNSYLVANIA ~q •v ~=:_~ c~
~~~ ~ ~ ~ 0~~~ ~~ r
• N era
.~
Estate of v.~~~~~J.(~ Deceased
I, ~~-~-V ~ L ~ !I-t 4~ . in my capacity/relationship as
(Print Name)
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
(Dare)
Executed in Register's Office
Sworn to or affirme d subscribed
before ~ 's ~ ~~ day
of
uty for Register Wills
!h~-~/
(Signature)
~~4 ~OI~CCI~S~yi~~~G'~-
(street Address)
-~ ~o5v
(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 renunciation for the
purposes stated within on this day
of ,
Notary Public
My Commission Expires:
(Signature and Seat of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06