HomeMy WebLinkAbout09-07-12PETITION FOR GRANT OF LETTERS
12EGISTER OF WILLS OF _ C V M ('~ ~ (Z-LA till COUNTY', PENNSYLVANIA
Petitioner(s) named below, who is/are lg years of age or older, apply(ies) for Letters as specified below, and in
support thereof aver(s) the following and respectfitlly request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name:._QC~p H - kosAlznwtcH
a/k/a:
a/k/a:
a/k/a:
Date of Death: -~ +
Decedent was domiciled at death in C ~ M 3 ~ ~ LA ~~
principal residence at OD lrL.i: IJ F
Street address, Past Omce and Zip Code
Decedent died at___IOO MT - A(rC,~N D1Z
Street address, Post Omce and Zim Code
Estimate of value of decedents property at death
Street address, Post Otnce and Zip Cade
fjdamiciled in Pennsylvania ............................ All personal property
/jnot domiciled in Pennsylvania ........................ Personal property in Pennsylvania
IJnot domiciled in Pennsy[vania ........................ Personal property in County
Value ojreaf estate in Pennsyfvania .........................................................
r/ TOTAL ESTIMATED VALUE....
Real estate in Pennsylvania situated at: _J b 6 /~ t-L ~ IV V I ~ W AR I"~ E~ e, h! /~ ~
(Aflor/h additional sheen, if neceuary.)
p' A. Petition for Probate at
Petitioner(s) aver(s) hdshe/th~~ ~ryy is
thereto dated N a n.7 ~
the Executor(s) named in
File Not. I - ' 41 ~ 1 ~~
(Assigned by Register)
Social Security No: I~ Z - z O ' `j (~~
Agc at deaths I o p
City, 7owmhip or Borough ' C U
1CS(~iJ
Township or Borough
with his/her last
TW
tC~oyu-n~ty Shte ~ 70rJ5
$ Z Ivy Q~~. ~C7
iC
Ciry, Townhip or Borough
ua~~~A,~
County
Will of the Decedent, dated ~~C.T I t I 1 ! /and Codicil(s)
State relevant circumstances (eg. renunclarion, death ofacecuror, etc.)
Except as follows: after me execution ofthe instmment(s)oReredforprobate Decedentdid notrnatry, was not divomed, was notaparty to upending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8), anr~d'd not have a'e](>j' d bom or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ~~ rv
'D .
~NO EXCEPTIONS ^ EXCEPTIONS W z c: ~ m
^ B. Petition for Grant of Letters of Administration (If applicable) ~ c~ , _ t~ r-
_x> C 7
c.t.a., d.b. n., d.b.n.c.t.a., pendente lite, durant ti /ia, durante mino2urte,....
If Administration, c.t.a. or db.n.c.Ga., enter date of Will in Section A above and comolet~]tst of heirs _' _i
---T-t~y :._
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds &n divorce h~been establisiml es deGt~d-'-'
iit 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 hasPoave ascertained that Decedent left no W ill and was survived by tlu: following spouse (if any) and heirs (attach
additional sheets, if necessary):
Name Relationshi Address
p. er_~gNc~lz~ MA2c}{i ou~ ~qt)~I TFR -0 - @o I I
D~usl3c~2rJ PA (~~I
G AFL A~ oS~~ ic(-1 Sow (4ca C,Z~1~i~t'_T LAND,
GOi P ~u_ P,t 17o I 1
Form RW-n1 rrr. uuui~nlt Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
~,r } SS:
COUNTY OF C~ M LSE K LA N~ }
,_
_r. - '
. ~.~'J Official Usc Only
2t1~2 ScP -7 F 12~ 48
naoi;`.r. ~:,
Petitioner(s) Printed Name .,. ~~ ~ ~niu J ..
P~~ d Address
o . ~~~Fl NoCzl~ A Izcl~, ~~ P• ~~. ~d~' 119 ~ILt,13t,26 ~~ 1
lC~ ~~ _ c~SARo ,e,~ i~ CIS lck~T L~N~
N ~ ~,t., PA i'7o 1 I
The Petitioner(s) above-named swear(s) or affirm(s) the stater
of Petitioner(s) and that, as Personal Representative(s) of the
Sworn to or affirmed a subscribed before
me is day of~e J~, ~v
(\..-1 _
Fod Jk Register yy~,,~~~~""
BOND Required:QYES (1gN0
FEES: 7~
i~
the foregoing Petition are we and correct to the best of the knowledge and belief
i~e Petitioner(s) 'll well and tnly administer the estate agcc~ording to law.
F17.1c' ~__ Date l ~ CI Z.
Date `j , L
Date
Letters ................... ... S ~ i ~ ._.
( ~ C~) Short Certificate(s)... ... ~-
( )Renunciation(s)...... .. .
( )Codicil(s) .......... .. .
( )Affidavit(s)......... ...
Bond ..................... ...
Commission ............... .. .
Other
......
..
.....
Automation Fee .............
1CS Fee ................... ..
.. -
.
TOTAL ................... .. S
Date
To the Register ojWi/!s:
Please enter my appearance by my ai¢nature below:
Attorney Signature:
Printed Name: ~~ ~~ ~ W (N`T'~
Supreme Court p
ID Number: Z Zs (7~j
Firm Narne:
Address:
Phone: Z~'~ `{-'U (7 CJ
Fax: 3 3 L ~ ~L~-
Email:
DECREE OF THE REGISTER
Estateot dl(Rr, 1't,°Ilr-S~o.,r rMj~c~~ File No:Q~~ "_' ~ f~` ~ -s
a/k/a: -~"
AND NOW, ~/'' ~ ~ I ~-- , in cansiderat'on of the fore oing Petition,
satisfactory proof having b en presented before tne, IT IS DECREED that Letters
are hereby granted to ~"'`'
in the above estate and (if applicable) that
the instrument(s) dated _
described in the Petition be
to probate and filed
the Iast,pVill (and.
forniRW-02 rev. l0/!l/20// s II ~ _
- -- 1 Page 2 of 2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee fur this certificate, 56.00 This is to certily that the information here given is
correctly copied from an original Certificate of Death
duly tiled with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office (nr permanent filing.
P 18 5 9 7 7 5 9_ ;~t..~,,,,a~ ~~,,~,>.,~~,~, gl to l ~~
Certification Number Local Fegistra ~ Date Issued
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i
LAST WILL AND TESTAMENT '~~
}^. _>
OF ~-TC~ m i?O
z~r. __~,
OLGA H. KOSAROWICH ~U _ ' -~.r =i7 n
I, OLGA H. KOSAROWICH, of Mechanicsburg, C'umberl', Cou~y,`~~
Pennsylvania, being of sound and disposing mind, memory nand
understanding, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking and making void any and
all prior wills, codicils, or writings thereto, made by me at any
time prior to the making of this Will.
ITEM I: I direct that the payment of my debts and the
expenses of my last illness and funeral shall be paid from my
estate as an administrative expense as soon after my death as
conveniently may be done.
I direct that my personal representative be responsible for
making all necessary arrangements for my burial.
ITEM II: I give, devise and bequeath may entire estate,
consisting of all realty, personalty and mixed, wheresoever
situate, to my son, MICHAEL A. KOSAROWICH, of Camp Hill,
Pennsylvania, and my daughter, 0. ELEANORE MARCHIONE, of Dillsburg,
Pennsylvania, IN EQUAL SHARES, PER STIRPES.
ITEM IV: No interest of any beneficiary under this will or
any codicil shall be subject to anticipation or voluntary or
1r : ~ ~ -'
' ,,(SEAL)
GA H. KO:>AROWICH
~ r
involuntary alienation.
ITEM V: All taxes, interest and penalties thereon payable by
reason of my death with respect to property comprising my gross
taxable estate, whether or not passing under this Will, shall be
paid from the principal of my residuary estate.
ITEM VIs In addition to powers given to tYiem by law, my Co-
Executors and their successors shall have the following powers,
applicable to all property held by them, effective without Court
Order and until actual distribution:
a) To retain any property received by therm, in the form in
which it is received, until actual distribution;
b) To sell real estate for any purpose, publicly or
privately, for such prices and on such terms as they deem
proper, without liability on the purchaisers to see to
application or the purchase monies;
c) To compromise controversies;
d) To distribute in cash or kind or both at such valuations
as they may fix.
ITEM VI: I nominate, constitute and appoin{t my son, MICHAEL
A. KOSAROWICH, of Camp Hill, Pennsylvania, and my daughter, O.
ELEANORE MARCHIONE, of Dillsburg, Pennsylvania, Co-Executors of
this my Last Will and Testament. No fiduciary acting hereunder
shall be required to post bond or enter :>ecurity in any
jurisdiction.
"~'~/'~W'w`+ (SEAL)
GA H. KOSAROWICH
s
IN WITNESS WHEREOF, I have set my hand and seal to this my
Last Will and Testament, consisting of this and two (2) other pages
at the end of which I have also set my hand and affixed my seal for
(greater security and better identification, this~n~ day of
`~ C~~~t-:~.` A.D., 1997.
~~~ ~~ ~~~~Vl%"1 (SEAL)
OLGA H. KOSAR.OWICH
WITNESS: 1~
,~~~~ residing at P,4 („~.(,y(Z,4 p~
2
PCB.; residing at y~rti~/, ~`/
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
I, OLGA H. KOSAROWICH, 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 and Testament; and that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Sworn or affirmed to and acknowledged bs~fore me, by the
Testator, this ~ ~ day of (~ ~~;~,~~ 1997 .
~ \ ~ `~" " ~~ ~~ ~~ 1~GrYf./'L ( SEAL )
I ~, "` OLGA H. KOSAROWICH ~I
Notary Public
M Commission ex fires:
NOTARIAL SEAL
DIANE D. FRITZ, Notary Public
Hershey, PA Dauphin County
Nty Commission Expires Nov. 8,1999
--- AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
We, A. Mark Winter and Marilyn J. Cichelli, the witnesses
whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do deposes and say that we
were present and saw Testator sign and execute t;he instrument as
her Last Will; that she signed willingly and that she executed it
as her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testator signed the
Will as witnesses; and that to the best of oiar knowledge the
Testator was at that time eighteen (18) or more years of age, of
sound mind and under no constraint or undue influence.
1 ~/- // `-'(SEAL)
Witness '
Sworn to and su`scpibed
before me t isn 1..YY
day of ~ c~:'~e~ 1997.
YL.~ ( ~- ( SEAL )
Witness
f ,_
N. i . ,~ i\ iVi
Notary Public
My Commission expires:
NOTARIAL SEAL
DIANE D. FRIR, Notary Public
Hershey, PA Dauphin Coumy
My Commission Expires Nov. 8,1999