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HomeMy WebLinkAbout03-19-12r~•.s ~~ ~'~ PETITION FOR GRANT OF LETTERS ~ "' -~ ~..= REGISTER OF WILLS OF CtJ;,vt b ~ltL/'~~l/~ COUNTY, _ -- ?~ f Petitioner(s) .named below, who is; are 18 years of age or older, apply(ies) for Letters as~pecified be~aw, ai~~, support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form:'""t Decedent's Information Name: ~~NIE ~d D a/k/a: a/k/a: a/k/a: Date of Death: "'D 9 '-aDt / Decedent was domiciled at death in ,,,~tJ~, ~/ County,. principal residence at.~4~_Gl/FST T~/Ilrl~L 1~D. rl address, Post Office and Zip Code File No: ~ r I~ ._.. (Assigned by Register) ~- Social Security No: /~~P"' e~ T~ '~~ O~ ~~ Age at de the Q~~' _ ~ (Srarej~}vith his/her last City, Township or Borough Decedent died at ~f4G ~Sl' 77~/ ~2.lPRO /Il~~tfibl4SRt~ ~u,~B~Q,c~a~ rry Street address, Poat Onice and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: Ijdomicfled in Pennsylmnia ............................ All personal property S `"-v ' Ijnot domiciled in Pennsylvania ........................ Personal property in Pennsylvania S ~ ~++ If not domiciled in Pennsylmnia ...................... .Personal property in County S ~' Q " Value ojt~eal estate in Pennsylvania .............. ......................................... S ~~~ TOTAL ESTIMATED VALUE..... 5~~ Real estate in Pennsylvania situated at (Attach additional sheets, ijnecessary.) Street address, Post Office and Zip Code City, TowashIp or Borough County LS A.: Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Wilt of the Decedent, dated thereto dated and Codicil(s) State relevant circumstances (eg. renunciation, death ojexecutor, eM.) Except as follows: after the execution of the instrument(s) otI'ered 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 born 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.ta., pendentelite, duranteabsentia, duranteminoritate If Administration, c.t.a. or d.b.n.c.ba., 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 EXCEPTI011'S ~ EXCEPTIONS Petitioner(s), afters proper search has/ttave ascertained that Decedent left no Will and was survived by the following spouse (ifany) and heirs (attach additional sheets, iJ'neeessury): Name Relationshi Address ~ nc~ s~~ f~ a ~ ~ !s e 2S on ~ ~s~ '~o N _ air ~ ~ ~ -~ r ~ ~ d .~ ForntRW-~2 rev. iniiinnir Page 1 oft rJ r:a Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } COliNTY OF ~VA1a~ie~-j~/V ~ } vi nry -; 1 d~su~s~ ~ VJ ~~ '~/ r ~ ~ t ~ ~ ~ ~ ^ ~,~ ~~ ~ Petitioners} Printed Name Petitioner(sj Printed Address 1~ n~ L . ~/ L~ a s 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) ofthe Decedent, the Petitioner(s) i w 11 and truly ad mister the estate according to law. r Sworn to or ed and , bscri d b r Date ~~ ~/o~ me th' ~df Date By Date r t e Register Date BOND Required:~YES- ~]NO FEES: Letters ....... ............. S 3Q. O 0 ( ~) Short Certificate(s)..... . (~!r Renunciation(s)......... ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ...... Automation Fee ............... ' 7CS Fee . .................... TOTAL ..................... $ ~ To the Register of Wills: 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 ~ File No: ~/~ D~~~_ a/k/a: AND NOW, ~/"~~ l~ , z~ r ~. , in conside ation o t e foceg~ing Petitio satisfactory proof having been presented before me, IT IS D REED that Letters / are hereby granted to - ` .' s in the above estate and (if applicable) llkat the instrument(s)- dated _ , described in the Petition be admitted to probate and filed of recgrd~s the last Wjil (and Codicil(s)) q~Deced'ent, _ Form RFR02 rev. !0/11/201 / O/Z ~- ~-0327 ~~ :~ ~ ~ ~~. RE~iU~1CIATION ~~~' `~O ~'~' ~~~ REGIS ~ ~ ` ' ~, TER OF WILLS ~~ ~~>~G~N ~ COUNTY P . . . i•- ~ cn , , ENNSYLVANIA . .} Estate of ~tl_!~R ~/ ..~/e E /~/E_ t~p y ni ~..--- Deceased I, in my capacity/relationship as ~~ ~ (Print Name) - of the above Decedent, hereby renounce the right to administer the Estate ol"the Decedent and respectfully request that Letters be issued to rDate) , 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.!3.06 U grwtureJ .~~L~~ IR~t/~S' G~ ICD l~~ (Street AdaGessJ ~~~'~~ t'/ge /~e14 (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 renunci tion for the purposes stated within on this day of ~ ~ ~ , li Notary Publi h ~ My Commission Expires: ~ ~~ td`d (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notarde n~ NOTARIAL SEAL Camela J. Manges Boro of Carlisle, Cumberland County My Commission Expires June 21, 2014 ~~~~~~_03~.~ ~..~ ~, ~~~ REiV'U~tCIATION ~ ~ REGISTER OF WILLS ~ -- ,'- .~ C~rr~berL~~, COUNTY, PENNSYLVANIA ~~ ~- ~_,~. -. ~~,. Estate of ~1r'~i ~~o-~~~.~~rnti- F ,Deceased -'7 _ ~. I, ~A.~eS A,11~1'¢..~a.1SL , in my capacity/relationship as (PrUet Name) .~©t,~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to a3~, ~, ~ ao{~ (~) 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 (StB~~'e> ~ 1Jo"~T ~NA~~ ~e.~ (Street Address) C,,e ~,.o ~ r 11.T-~,~--I~o 11 fey, state, pJ Executed out of Register's Offce 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 ~i,l~-YLC~- , Notary Pub My Commission Expires:. l~t1U.~~ 1 t ~~~ (Signature and Seal of Rotary or other official qualified to administer oaths. Show date of exoiratio^ ~f "'-'_-~~ ~^- NOTARIAL SEAL Cameia 7. Man9es Boro of Carlisle, Cumberland County My Cornmissfon Expires Tune 21, 2014