HomeMy WebLinkAbout08-24-12
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: FREA D. JOHNSON File No: ~ l ~ I a ' ~~
a/k/a. (Assigned by Register)
a/k/a:
a/k/a:
Date of Death: JUNE 15.2012
Social Security No:
Age at death: 75
Decedent was domiciled at death in CUMBERLAND County, pP.NNaYi VANIA (Sean) with his/her last
principal residence at 87 B STREET CARLISLE 17013 CARLISLE CUMBERLAND
Street address, Pos[ Omce and Zip Cade City, Township or Borough Count
Y
Decedent died at 87 B STREET CARLISLE 17013 CARLISLE CUMBERLAND
Street address, Pos[ Office and Zip Code City, Township ar Borough Count PA
Y State
Estimate of value of decedent's property at death:
If domiciled in Pennsy/vania ............................ All personal property $_ 1 16,600 00
ljnot domiciled in Pennsy(vania ........................ Personal property in Pennsylvania $
/f nor domiciled in Pennsylvania ........................ Personal property in County $
Value ojreal estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VALUE.... $ 116 600 00
Real estate in Pennsylvania situated at: 87 B STREET CARLISLE 17013 CARLISLE CUMBERLAND
(Attach addlrional sheers, ijnecessary.) Street address, Post Office eod Zip Code City, Township or Borough Coun
ty
^ A. Petition for Probate and Grant of Letters Testaments
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated
thereto dated and Codicil(s)
--
State relevant circumstances (eg. renunciation, death of ececulog etc) S
~ a T
Except as follows: afterthe execution ofthe instrument(s)offered for probate Decedent did not ma C ~`
rry, was not divorc rf't notap oap~n~j
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), an ice, b[ havetild b
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
Q NO EXCEPTIONS 0 EXCEPTIONS n O - A ` . ~~
m B. Petition for Grant of Letters of Administration (If applicable)
~~
a[.a., d. b.n., d. b.n.c. t.a., pendente lice, durance absentia, duray~ minoritat
If Administration, c.ta or d.b.n.c.t.a, enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedent was no[ 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.
Q NO EXCEPTIONS ~ EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent left no W ill and was survived by the following spouse (if any) and heirs (attach
additional sheets, ifnecessaryJ:
Name
RUTH M. JOHNSON
FRED D. JOHNSON, JR. Relationshi
SPOUSE
SON Address
87 B STREET, CARLISLE, PENNSYLVANIA 17013
16642 CAXTON PLACE, DUMFRIES, VA 22025
Form Rw-oz reg. )oinnon Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} ss:
COUNTY OF CUMBERLAND
of5cial use omly
~ECORG~ ~ ~:?rFrCE Of
REf. ~,-r, ,, ,; ttNl c
1~:.;, ,e,_w
Petitioner(s) Printed Name Petitioner(s) Printed Address
RUTH M. JOHNSON 87 B STREET CARLISLE PENNSYLVANIA 1701 ~ ~ ~' j
CUMBERLAND CO.. PA
The Petitioner(s) above-named swear(s) or affirm(s) the statements ' t the foregoing Petiti n are true and correct to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the D het a titioner( ill well and truly administer the estate according to law.
Sworn to or affirmed and ubscribed before Date ~
me this ay o , v~ / z
Dale
By' `~~ - Date
Forte gister Dale
BOND Required: Q YES Q NO To the Register of Wi[!s:
FEES: Please enter my appearance by my signature below:
Letters ...................... $ 260.00
( )Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ........
RENUNCIATION ........ 5.00
Automation Fee ............... 5.00
JCS Fee ..................... 23.50
TOTAL ..................... $ 79 050
Attorney Signature:
JC
Printed Name: MARC IGHT, III
Supreme Court
ID Number: 25476
Firm Name:
Address:
Phone:
Fax:
Email:
IRWIN & McKNIGHT, P.C.
717 249-2353
717 249-6354
DECREE OF THE REGISTER
Estate of FRED D. JOHNSON File No: ~5 ~ ' ~ pr
a/k/a:
AND NOW, ~~~~{ / l ~ , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters OF ADMINISTRATION
are hereby granted to RUTH M. JOHNSON
in 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)),pf Decedent. ,
Form RW-02 rev. ronu?nu ~ r - Page 2 of 2
~FC~?R~rli t'_Gi~E OF
RENUNCIATION
REGISTER OF WILLS
2(i 12 AUG 24 APi t I ~ 07
OFPI-i~U~'~~'~OURT
~UMBERIPND CO., PA
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of FRED D. JOHNSON, SR. .Deceased
1, FRED D. JOHNSON, JR. . in my capacity/relationship as
(Prlet Nmne)
HEIR of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
RUTH M. JOHNSON
~I
(vote)
Executed itt Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
Form RW-06 rev./0/3.06
/~~~a cam. o~ P 1 ~~.
re:tn~aes,)
(C7ty, Srate, ZipJ
Executed out ojRegister's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purpa~~ys stated }vithin on this /D~~" day
of HI/Q U57 n ~!~/~- ,
Not9ry Public '"
Ivly Commission Expires
(Signature and Sal of Notary m other official quelifaat m
administer oaths. Show date ofexpiretion ofNotary'a Commission.)
c~ntHtaawEUrti of rerr sr vuav-
Nohneismu
Karen 5. Nod, tbdty Ptl11k
CaMtda Soto, CutttDergttE County
My Odtetg4att 6~ttee Dec 8, 2015
MEMBER, OQn751tVAN1A r~60aA7! OF NInARIB
LOCAL REGISTRAR'S CERTIFICATION ~OF DEATH
WARNING(~1(~l:{~~ lt~ate this copy by photostat oir photograph.
~±~hIC'r r _ ~~1~~~~ Q
Fec (or this certificate, $6.00
P 1866336
,por This is to certify that the informulion here given is
2612 AUG 24 QM I l ~ „ '~,aL~N nErfNy=_ correcrtly copied from an original Certificate of Death
ae`pkZ _ Frl duly filed with me as Local Registrar. The original
3~ v certificate will be forwarded to the State Vital
'~'-'-~ I' ' ~ Vii' a Records Otflce fbr permanent filing.
OHPIIAN'~ ~UUR :. ..
CUMBERLAND CO., °~AqN -' ~~~'''~ ~.R~~Q~x- JU16 18/2012
-~ rMEN10E~ell"lrl
Local Registrar Date Lssued
COMMONWEALT ARTMENT OF HEMLTHVITAL RECORDS
LE RTI FIGATE AF )]PATH
Certification Number
s
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QUALIFIED DISCLAIMER
In accordance with Internal Revenue Code Section 2518 (b) and pursuant to Section 6201
of the Pennsylvania Probate Estate and Fiduciazies Code, (20 PA.C.S.A. Section 6201), this
Qualified Disclaimer is being executed by the undersigned heir, FRED D. JOHNSON, JR. in
order to disclaim and renounce his individual capacity as a residuary heir of the ESTATE OF
FRED D. JOHNSON, SR., and hereby transfers his interest to RUTH M. JOHNSON,
specifically the real estate located at 87 B Street, Carlisle, Pennsylvania.
Fti
This disclaimer is executed as of this ~ day of August, 2012, the same being
effective as of the date of death of the decedent, Fred D. Johnson, Sr. on June 15, 2012.
COUNTY OF
SS
On this, the ~~ A.- day of ~ 2012, before me, the undersigned officer, personally
appeared FRED D. JOHNSON, JR., kno to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that he executed the same for the
purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Qp-.tMONWEALTH OF plNN
NehlleF SeN
Karen 5. Noel. Natery Plblk
Nea e
MEMBER, pENNMVAN[A p55O(,TAT[ON OF NOTARIES
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Notary ubhc O rti z.~ ,~,
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