HomeMy WebLinkAbout07-09-12PETITION FOR GRANTpOF LETTERS
REGISTER OF WILLS OF~ V.~Y\~1~ (`0-Ov9i 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 fallowing and respectfully request(s) the grant of Letters in t:he appropriate form:
Decedent's nformation
Name: y1 ~ ~p I (~
a/k/a:~~ ® v (
a/k/a:
a/k/a:
Date of Death: ~U r~D "a .~("1 I
Decedent was domiciled at death i I:IJ~V'll1)]-2 t^ ~t
principal residence at ~ C7 i
SOtre ddrey Post O ¢ and Zjp Cpfe i
Decedent died at1 ~ ~~Q `~~ u t~
File No: ~f ~ ~ ~~
(Assigned by Register)
Social Securit}r No: d ~ to - ~~ S
Age at death: -
(Beare) with his/per la t
rClfy, T ship or Borough Cot
ld,. , ~FE l~°(I Cc.tm~~latf~ r~A
Street address, Post Office and ZIp Code City, Townahlp or Borough County Slate
Estimate of value of decedent's property at death:
ljdomiciled in Pennsylvania ............................ All personal property $ ~t~Ur QQ
If not domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $
ljnor domiciled in Pennsylvania ........................ Personal property in County $
Value ojreal esrme in Pennsylvania ................................ , , , $
......... ..... ... .....
TOTAL ESTIMATED VALUE.... $ p
Real estate in Pennsylvania situated at:
(Arrnch addirional sheers, i(necenary.) Street address, Pwt Ornce snd Zip Code C(ty, Township or Borough County
[,i}~ 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 _ U ~ Ol!1 and Codicil(s)
thereto dated
state relevant dreumstances (eg. renunciation, death ofexecutoq etc!
Except as follows: after the execution of the instmment(s) offered forprobate Decedent did not marry, 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 Decedrnt was neither the victim of a killing nor ever adjudicated an incapacitated person. r.,,~
~NO EXCEPTIONS ^ EXCEPTIONS _ r ° „ z
^ B. Petition for Grant of Letters of Administration (If applicable) _ c n
ar.a., d.b.n., d. b.a.c.t.a., pendente l!e, durant ~i{, durant`lDminorfi
If Administration, c.t.a. or rGb.n.c.t.a., enter date of Will in Section A above and com lete 'theirs. ~~ ~f;
P
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce ha stablished~as defer
in 23 Pa. C.S. § 3323(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. t
:~•~ `~ ery
^NO EXCEPTIONS ^ EXCEPTIONS t7 °I't
tr1
Petitioner(s), after a proper search has/have ascertained that Decedent left no W it l and was survived by the following spouse (if any) and heirs (attach
additional sheeh•, iJnecessary);
Form RW-02 rev./0/Jl/20)) Page 1 oft
Oath of Personal Representative
COMbIONWEALTH OF PENNSYLVANIA
COUNTY OF
To the Register of Wi!!s:
Please enter my appearance by my signature below:
}
} SS:
}
Petitioner(s) Printed Naine Petitioner(s) Prin[ed Address
~~~-s~,:~ ~ ,~ ~~os3
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)~~.\'~r'~~t~t•~/',~,ell a1~n~d~~Jtly administer the estate accordlIing to law.
Sworn t firmed ub cribed b ore ~~~~`jt~ 0 y (_,PyV-- Dace l~ ~ a--
me ay of Date
B
Dale
for the Register
Date
BOND Required:QYES I~Itz'O
FEES: ~
Le ers ...................... $ ~~
(~ )Short Certificate(s)......
( )Renunciation(s)........ .
( ) CndlCll(a) ............ .
( )Affidavit(s)........... .
Bond ........................
Com missio}~ ................. .
Other //~ i (I ..... , .. ~~
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Official Use Only
c
N
:"a~
•~~~~~~• Phone:
Automation Fee ............... ~- Faz:
.................. .
1CS Fee... Email:
TOTAL ..................... $
DECREE OF THE REGISTER
Estate
a/k/a:
AND NOW, t
satisfactory proof
FileNoa/ ~ /~ - ~~
presented before me, IT IS
_ are hereby granted to~'j
the instrument(s) dated !D~ ro ,~ GO
described in the Petition be adtnitted to probate and filed of
ay~ a , in cons/ider ion of t ~e foreg9t' g Petition,
EED [hat Letters JF' ~~~..,-~/,...~
_ in the above estate and (if applica le) that
Will (and C ~ il(s') of D Gede>9t.
t'o~,~~2w-nz rev.ingvzni! `" / / ~ l - /
~/ 1. Page 2 of 2
__
.~e-, ,, .
LOCAL ~~ ~~~ CERTIFICATION +OF DEATH
WARNING. ~K"~ ~ ~ ate this copy by photostat or photograph.
~~ 1 .. '~~~ t~~~
Fee for this certificate. $6.OQ j1,„1,~~~1•f1~°~~--.._, This ie: to certify that the information here given in
ZOi2 JUL -9 PN 4~ 0 I,~a~Te oFPfy=°_ + ,~
P 1865u864
Certification Number
Tvp/Pnnt In
PBI•ck lnk
I, ~~-~ ,r, cone~~ y cnp)c from an o((gm d Certtfxate of Death
~o`g~ ~~ duly tiled with me 1~ Local Registrar. The original
~,Ly; j~ ~ og ~ z, certificate will bE torwardF,d to the Slate Vital
'S ~~j +~` ,* ~ Records OFf~ e Rn rmanent filing.
~.AI~ (X).f °f',` T E T oE,~~`P`~ C~~~ ~~ ~ l 3 ~l~
.,.,,,,,,,,,,,,, w~C ~
Local Re>(strar Date Issued
COMMONWEALTH OF PENNEVLVANIA. DEPARTMENT OF HEALTN ~ VITAL RECORDS
CERTIFICATE OF UEATN ____ ___ _. ..
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Dl.pwhlx w.mtt No. 0 7 4 9 34 6 RNlos-laa
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LAST WILL AND TESTAMENT ~ c
7~
HELEN M.SZOLLOSY
fJ
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I, HELEN M. SZOLLOSY, a widow, of 501 Highland Street, Enhaut-Steelton, Dauphin
County, Pennsylvania 17113, declare this to be my bast Will and revoke any Will previously made by
me.
TCFM T I direct that all mY just debts and funeral expenses, including the cost of a suitable
grave marker and perpetual care for my burial plot, shall be paid from the assets of my estate as soon as
practicable after my decease.
TTFM TT. I give, devise and bequeath all of my estate, real, personal and mixed wheresoever
situated to be divided equally among my seven children: DOLORES M. HING, LOUIS P.
SZOLLOSY, JR, LOUISE M. VARVAR, JOAN M, CHAK, DAVID P. SZOLLOSY, HELEN
M. SZOLLOSY, JR, and ANN MARIE ROTH, in equal shares, per capita.
i'i'RM TTi~ No interest in income or principal shall be assignable by or available to arryone
having a claim against a beneficiary before actual payment to the beneficiary.
iTR.M iy: All federal, state, and other death taxes payable on the property forming my gross
estate for tax purposes, whether or not it passed under this Will, shall be paid out of the principal of my
residuary estate just as if they were my debts, and none of those taxes shall be charged against any
beneficiary.
Page 1 of 6
C:\19dZpR\Wi114'11uW 6F1ah Plpm~g\9]AIHW 01-Smlbrylitlm.M4mlloyHtlm M-CppP18 ~ Wil1.6x
iTFM V: I authorize my Executor:
(a) to retain and to invest in all forms of real and personal property, regardless of (i)
any limitations imposed by law on investments by executors or trustees, (ii) any principle or law
concerning delegation of investmern responsibility by executors or trustees, or (iu) any principle of law
concerning investment diversification;
(b) to compromise claims and to abandon any property which, in my Executor's
opinion, is of little or no value; to borrow from, and to sell property to others, and to pledge property
as security for repaymern of any funds borrowed;
(c) to sell at public or private sale, to exchange or to lease for any period of time any
real or personal property, and to give options for sales or leases;
(d) to join in any merger, reorganization, voting-trust plan or other concerted action of
security holders, and to delegate discretionary duties with respect thereto;
(e) to use administrative or other expenses of my estate as inwme tax or estate tax
deductions and to value my estate for tax purposes by any optional method permitted by the law in
force when I die, without requiring adjustments between income and principal for any resuhing effect
on income or estate taxes; and
(~ to distribute in kind and to atlocate specific assets among the beneficiaries in such
proportions as my Executor may think best, so long as the total market value of any beneficiar}~s share
is not effected by such allocation.
Page 2 of 6
C:\t 382 DTL\WiW,Trv48FtltlePlvuy\.VgIHOp01 ~ 9m11wy Htlm M\9IDIIw9 Hdm M-OW918- W II.Erc
These authorities shall extend to all real and personal property at any time held by my
Executor and shall continue in full force until the actual distribution of all such property.
All powers, authorities, and discretion granted by this Will shall be in addition to those
granted by law and shall be exercisable without leave of court.
TTFM VT: I appoint my daughter, ANN MARIE ROTH, of 2138 Derry Street, Harrisburg,
Pennsylvania 17104 as Executrix under this Will. Should my daughter, Ann Marie, fail to qualify or
cease to ad as Executrix, I appoint my daughter, JOAN M. CHAK, of 74 Lakeview Drive, Holland,
Pennsylvania 18966 as Executrix under this Will. I direct that any fiduciary acting hereunder shall not
be required to enter bond or other security in any Court or jurisdiction in which said fiduciary maybe
called upon to act.
IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this my
Last Will and Testament, consisting of Five (5) typewritten pages, including 1 his attestation clause and
the followin Acknowledgment and Affidavit, to be executed, declared and published this
/Q ~ day of ~~' % t7Fj'~/Z , 2000, at ~T~~~7~ // ,Pennsylvania.
%u'c't-gJk%f-~-/' 4~~
HELEN M. SZOLLOSY~K ~'
Page 3 of 6
c u sezmz~wut>wu a ~ineri.ooruwlxao oi -ezoiwaxe~eraronrnxa.~x. ooov~e-wu.m~
COMMONWEALTH OF PENNSYLVANLA
COUNTY OF DAUPHIN
SS:
I, HELEN M. SZOLLOSY, the Testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it willingly and that I signed it as my free and
voluntary act for the purposes therein expressed.
HELEN M. SZOLLOSY c
Sworn or affin ed to and acknowledged before me by HELEN M. S7.OLLOSY, the Testatrix
this ~~ of ~.. 2ppp.
(SEAL)
My Commission Expires: ~ J~/d3
Page 4 of 6
-SmlloyHtlmAh4xo11ory Helm M-000916~Wi11.Jx r~~
~1 ll~Ym
AFFii)AViT
COMMONWEALTH OF PENNSYLVANIA )
COUNTY F D
the witnesses, whose names ~~e-signed to the attached
or for oing instrument, being duly qualified according to law, do depose and say that we were present
and sa HELEN M, SZOLLOSY, sign and execute the instnrment as her free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will
as witnesses; and that to the best of our Imowledge, the Testatrix was at the time twenty-one (21) or
mo s of e, of mind d under no constraint or undue influence..
" Residing at o~J ~^'`+~-~--~ d~1 S~ ,
eliding at
~~ Residing at
Sworn or
to and ~cknov~ged ~~gfo
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7~ ~ 6 7051
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by ~ - _
_ the witnesses, this ~y of
(SEAL)
My Commission Expres:l7 /~~~3
Page 5 of 6
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