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PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland COUNTY.. PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in
support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: Christopher Adam Selewach
a/k/a:
a/Wa:
a/k/a:
Date of Death: Julv 26, 2009
File No: ~I I " I c~( -Q7~
(Assigned by Register)
Social Security No: 306-52-3506
Age at death: 52
Decedent was domiciled at death in Cumberland Colrnty, penngylvania (Srare) with his/her last
principal residence at 220 Market Street. Aot A. New Cumber]and Pennsvlvania 17070
Street address, Post Omce and Zip Code City, Township or Borough County
Decedent died at Pinnacle Health Svstem Harrisbur Hospital Harrisbur Dauphin Countv PA 17101
Street address, Post Office end Zip Code City, Township or Borough Caunty State
Estimate of value of decedent's property at death:
/jdomiciled in Percnsylvarcia ............................ All personal property $ 26,000.00
/jnol domiciled in Penosy[vania ........................ Personal property in Pennsylvania $
/jnot domiciled in Pennsylvania ........................ Personal property in County $
Value of real estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VALUE.... $ 26.000 00
Real estate in Pennsylvania situated ak
(A(tach gddirianal sheets, ifnecessary.) Street addresa, Post Oface and Zip Code City, Township or Borough County
r~~
o
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 Will of the Decedent, dated
thereto dated
State relevant circumstances (eg, renunciation, depth oj¢xecutor, elc.) ts'> ~ IV
pt..~. C..;~;._~,
Except as follows: after the execution ofthe instrument(s)ofiered for probate Decedent did not marry, was notdivor~l~ty~es notapar~to apeiadie~j
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8), ~ not have a child ~~
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ~-~ .. r- {{--~~
® NO EXCEPTIONS ®EXCEPTIONS ~ fV ~n '6r
B. Petition for Grant of Letters of Administration (Ifappticabte)
c. t.a., d.b.n., d. b.n.c.t.a., pendente Lite, durance absentia, durande minoriaate
If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and comalete list of heirs.
Except as follows: Decedent 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 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 survivedby the fbllowing spouse (if any) and heirs (attach
additional sheets, if necessary):
Name Relationshi Address
Frances A. Shine sister 3416 Canyon Creek, Mechanicsburg, PA 17055
Form RW-01 rev. 70/7//20/1
Page 1 0
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Official Use Oaly
The Petitioner(s) above-named swear(s) or affirm(s) the statements in t e 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 Decede ,the Petitioner(s) lil el and tmly administer the estate according to law.
Sworn to or armed and~sub~cribed before ~ Date
met ' '~` ay of
By:
For the Register
BOND Required: ®YES Q NO
FEES:
Letters ...................... $ 90.00
( 2) Short Certificate(s)...... 8.00
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other
Automation Fee ............... 5.00
JCS Fee ..................... 23.50
TOTAL ..................... $ 126.50
Date
Date
Date
Ta the Register of Wi[[s:
Please enter my appearance by my signature below:
Attorney Signature: ,~f
S -~-
Printed Name: Robert C. Saidis
Supreme Court ..a,
ID Number: 21458 r.a
~ C r•n
Firm Name: Saidis, Sullivan & Roge ~~: t- G-'., -_`_, .
Address: ~` 1 r=•- r ' i
Carlisle„ PA 17
'V .:.i ~.~ =i
C. _ T,
Phone: (717) 243-6222. ~ :xy - ~_
Fax: (717)243-6486 tV
Email: rcaidic csr_attnmevc rnm
DECREE OF THE REGISTER
Estate of Christopher Adam Selewach File No: _ ~ I - 't~ (~ ~p'2~
a/k/a: (~ Q
AND NOW, ,~u4~ .1 J (~, in consideration of the foregoing Petition,
satisfactory proof having ee presented before me, IT IS DECREED that Letters ~~~~tt\'t`~~4 , o ~
are hereby granted to Frances A. Shine
in the above estate and (if applicable) that
the instrtunent(sl dated Y~ fig
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil } of Pe edo t.
~ ~
Register of Wil ~ ~ ~
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