HomeMy WebLinkAbout10-16-12 (3)~~Vy~l~ PETITION FOR GRANT OF LETTER5
a
REGISTER OF WILLS OF ~it~t,YUI~)/'~Gl.yt.Lk, COUNTY, PENNSYLVANIA
Petitiorer(~) namzd below. who isiare 14 ;rears of ase or older. appty(ies) fer i,etters as specified below, and in
support thereof aver{s) the follo••.vinQ and respectfully request(s) the Brant of Letters in the appropriate form:
Decedent's lnformation i ~ ' 16!
Name: f'~V'4~~ . SSne~1.c1 SVL. File No: `Z~ '"~~~
a1k,'a: (.Assigned by Register)
a/lc/a:
aIk)a:
Date of Death: ~g 7.oi'L
Decedent was domiciled at death in ~tAW1~GV'Z~VLC~
principal residence at ~60 ~'r C~'C.G~~t... 81V'
S[reet address, Pos[ Office and Zip Code
Decedent died at 5e-~'~~ S(?~~i`4-~-`t`"`(
Street address, Post Office and Zip Code
Estimate of value of decedent's property at death
ljdomieiled in Pennsylvania.......... .
if not domiciled in Pennsylvania...... .
If not domiciled in Pennsylvania...... .
Value ojnal estate in Pennsylvania.... .
Real estate in Pennsylvania situated at:
(Attach additions! sheets, :f necessary.) Street ad
Social Security No: ~~ "~ .. a
Age at death: 6
~" (State) with his/her last
City, Township or Borough" unt
c~wtlp {-~c l! CwN„~reuta~ ~f~'
City, Township or Boroagh County
................. All personal property S
.................Personal property in Pennsylvania S
................. Personal property in County S
.................................................... S
TOTAL ESTIMATED VALUE.... S~TI~~
drew, Post Oftke and Zlp Code City, Township or Borough County
A. Petition for Probate and Grant of Letters Testamentary
Petitioners} aver(s) he/she/~hey is/are the Executor(s) named in the last Will of the Decedent, dated 0 $ ~ 2~ ~~ t1 ~ and Codicil(s)
thereto dated 1 H I D 1 (`7.110 ~__ _ _ _ _ _ _ ~ _ _ _ t E
State relevant circumstances (eg. renunciation, death oJexecular, eta)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did notmarry, 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), end did not have a child born ar
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)
e.t.a., d.b.n., d.b.n.c.t.a., pendentelite, durante absentia, durante minoritate
If Administration, e.t.a. or d.6.n.c.t:a., enter date of Will in Section A above and complete 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 survived by the following spouse (if any) and heirs (attach
additional sheets, i/necessary):
Name Relationshi Address
Form RW-01 rw. tniunnn Page 1 of 2
Oath of Personal Representative
COV(4lOVW'E:~LTHOFPEN~SYLVAVi.~ }
(1K-WL~fCN NJI.~ ~ S5:
~'~~iC~TY" OF '.
Official Usc Only
I
YVta#kew ~t - Wk Gvc, +rt.., S2 C~e~e Ct.-iZtl• P>w Cep ~ [''t-31 b
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 knowledgeand belief
of Petitioner(s) and that, as Personal Representative(s) of the Decedent, the Petitioner(s) 'wi~ll~w~ell"and truly administer the estate according to law.
Sworn t or ffirmed a s b ribed before ~~~--~~9`~_ ~f Date ~-/6~/~,
me thi ay Date
B ~ Date
ar he e,¢~sta Date
Letters ...................... S
( )Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Botid ........................
Commission ................. .
Other. ,,,,,,..
Automation Fee .............. .
JCS Fee .....................
TOTAL ..................... S
A rney Signature:
Printed Name: (^'~-'~~•~G • y ~' Vyt~t ~t^-~
Supreme Court 26 s~ ~,~
[D Number. / /~ [~-L,,,, '"' {-~ ~f1 ,,fin
Firm Name: l.. lr~ LD~M1 t~ [Y ~'v l
Address:
T t~ t~ b 1
Phone: ~I~'-E~g`~~-1a~
Fax:
Email:
DECREE OF THE REGISTER
Estate of`~"C(`lY! 1 r ~-. ~Y ICN1~ .~.1 } File No: (~/ (~ (cl. ~ / l.Y (,i
a/k/a:
AND NOW, , "-rn~f 1lD ,o~U~ . in consi atioy~ of the f regoing Petition,
satisfactory proof having been presented before me, IT IS DEC~EDAthat J.~tters ~ d7,trn.L
are hereby granted to /'u.C'(` lJ0 L ~l~a~
the instrument(s) dated _~~~~
described in the Petition be a fitted to
Fornr tR02 rrv. In/ll/2nll
and filed of record as the las
egister of Wills
the above eslEtte and (if applicable) that
Page 2 of 2
BOND Required: Q YES ~NO To the Register of Wills:
FEES: Please enter my appearance by my signature below: