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PETITION FOR GRANT OF LETTERS ~ ~° r~ ~; ~
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REGISTER OF WII,LS OF CUMBERLAND COUNTY, PE ~1~ANfAA ,-„~,~ ,~,
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Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters sp~ified Belo a~u ~~d in
support thereof aver(s) the following and respectfully request(s) the grant of Letters in the a rite f "~°~ "' °~
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Decedent's Information
Name: DOROTHY M. DURHAM
a/k/a:
a/k/a:
a/k/a:
Date of Death: February 28, 2011
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M, .._
File No: `"~
(Assigned by Regist~p ~
Social Security No:
0
Decedent was domiciled at death in Cumberland County, Pennsylvania (stare) with his/her last
principal residence at 9 Larken Lane, Mt. Holly Spriincs, PA 17065 Mt. Holly Springs Cumberland
Street address, Post Office and Zip Code Gt3y-~e~s~ip or Borough County
Decedent diled at Forest Park Nursing Home, Carlisle, PA 17013 Carlisle Cumberland PA
Street address, Post Office and Zip Code ~ewn~~p or Borough County State
Estimate of value of decedent's property at death:
Ijdomiciled in Pennsylvania ............................ All personal property $ 10,000.00
If not domiciled in Pennsylvania ........................Personal property in Pennsylvania $
If not domiciled in Pennsylvania ........................ Personal property in County $
Value of real estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VALUE.... $ 10,000.00
Real estate in Pennsylvania situated at: N/A
(Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough County
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
and Codicil(s)
State relevant circumstances (eg. renunciation, death of executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate 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(g), and did not have a child born or
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)
c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, durante minoritate
If Administration, c.t.a. or c~b.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(g) 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, if necessary):
Name Relationshi Address
Violet McCauslin Sister 12 Mountain Street, Mt. Holly Springs, PA 17065
Connie C. Balatri Niece Via Del Porcellana 51, Florence, Italy 50123
Arlene M. Koser Niece 12413, Rte. 235, Thompsontown, PA 17094
Violet McCauslin and Connie C . Balatri hay renounced their rights to administer th
Estate in favor of Arlene M. Koser.
Form RW-02 rev. 10/11/2011 Page 1 of 2 ,.;,
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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Petitioner(s) Printed Name Petitioner(s) Printed Adds ~-- w- ~ ~`~
Arlene M. Koser -i t"~'
12413 Rte. 235 Thom sontown PA 17094 ~ ~ ~
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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) of the Decedent, the Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed before ~h_.F'~~,ao ~ ~ ~~ ~C~ Date j ~ - SJ-- ~;L
me th' .day of Date
$y; Date
o the Register Date
BOND Required: ®YES ~ NO
FEES:
Letters ...................... $ 45.00
( $) Short Certificate(s)...... 20.00
( ~) Renunciation(s)......... /~.
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other .......
Automation Fee ............... 5.00
JCS Fee . .................... 23.50
TOTAL ..................... $ 93"'6'
To the Register of Wills:
Please enter my appearance by my signature below:
Attorney ignature:
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Printed Name: Marlin R. McCaleb, Esq.
Supreme Court
ID Number: 06353
Law Offices -Marlin R. McCaleb
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7.19 Fast Main Street
P C). Rox 2~0
Mechanicsburg, PA 17055-0230
717-691-7770
717-691-7772
marlinmrcalehnmcn_cnm
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DECREE OF THE REGISTER
Estate of DOROTHY M. DURHAM File No: ~` f~ / ~~
a/k/a:
AND NOW, ~ , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to ARLENE M. KOSER
in the above estate and (if applicable) that
the instrument(s) dated N/A
described in the Petition be admitted to probate and filed of record
Register of Wills
Form RW-02 rev. 10/11/2011
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~' '~ RENUNCIATION
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``~ cx W REGISTER OF WILLS
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Estate of DOROTHY M. DURHAM ,Deceased
I, CONNIE C. BALATRI , in my capacity/relationship as
(Print Name)
niece and next-of--kin
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
ARLENE M. KOSER
OCT ~ 2~~ , 2012
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
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(Signature)
Via Del Porcellana 51
(Street Address)
Florence, Italy 50123
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that= she executed the renunciation for the
purposes stated within on this 3'O day
of C~~-~c~ ~2 ~ c~ Z.
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Deputy for Register of Wills
1~1bt~~i.c-
My Commission Expir~tephen A..- arneby
(Signature and Seal of Notary or other offi~;i~~if~ SIC
administer oaths. Show date of ex~~}~~]o~y'~j~o~i~l
INDEFINII'EL~r'
Form RW-06 rev. 10.13.06
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RENUNCIATION
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t-..~ ~ ~ w REGISTER OF WILLS
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Estate of DOROTHY M. DURHAM ,Deceased
I, VIOLET McCAUSLIN
(Print Name)
sister and next-of--kin
in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
ARLENE M. KOSER
November 2 ,2012
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this ~ ~` i~c~ day
Deputy for Register of Wills
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(Signature)
12 Mountain Street
(Street Address)
Mt. Holly Spriings, PA 17065
(City, State, Zip)
Executed out of Register's O, ff ce
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this ~_c~ day
l
Notary Pub
My Commission Expires:
(Signature and Seal f Notary or other o~~
administer oaths. S ow date of expiratia~'~#ission.)
Il~t~ry'llrli~
MT. N~LLY SPDII~ NN, NM~EDLDIID CIITY
MD ~~~N1i~~ ExDint fiD 1t, 2D14
Form RW-06 rev. 10.13.06