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HomeMy WebLinkAbout01-17-13PETITION FOR GRANT OIF LETTERS REGISTER OF WILLS OF _ ~ U w3 h.e r l c,.x rA COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/arc IS years of age or older, apply(ies) for Letters as specitied below. and in support thereof aver(s) the following and respecthdly requests} the grant of Letters in the appropriate form: Decedent's Information Name: ti4 ~: ~: c. _5 ~~~ c~C a/k/a: Date of Death: / 7_ - / 7' / Z Decedent was domiciled at death in Cu.v~l'j"¢r1c,.-t~ County, principal residence at 3 Z l-1~.ze 1 C: rclJL. ~e ~~ Street address, Post Otfiee and Zip Code Decedent died at 1~`'"z~e-- File No: ~ / Assigned by Register) Social Security No: 20 ~/- 3G' FS ~l ~~ Age at death: l z City, Township or Borough Street address, Pas[ Office and Zip Code City, Township or Borough (Smte) with his/her las ~~.-../w(cvd County County State Estimate of value of decedent's property a[ death: ~ ~, ljdonsiciled in Pennsy!vania ............................ All personal property $ ~ U ~U' /foot domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $ !f not Aomiciled in Pennsy!vania ........................ Personal property in County $ Vatue ojreal estate in Pennsylvania .................................... ..... ... ...... ....... $ TOTAL ESTIMATED VALUE.... $ CP (J UG~- Real estate in Pennsylvania situated at N G n Q (Attnch ndditionnl sheets, i(necessary.) Street address, Past Otfice and Zip Code City, Township ar Borough County ~A. Petitio for Probate and Grant of Letters Testamentar Petitioner( aver(s) he/she/[hey is/are the Executor(s) named in the last W ill of the Decedent, dated ~" Z. Z ~ ~ Z and Codicil(s) thereto dated Slate relevant circmnstances (ug. renuncintion, death of aecutvr, etc.J Except as follows: akerthe execution of the instrument(s)offered for probate Decedent did notmarry, was not divorced, was notapany to spending 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 ([f applicable) e.t.a., d.6.n., d.b.n. c. t.a., pendente life, durmste absentia durante minoritute 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 ~ e_Y Petitioner(s), after a proper search hasPoave ascertained that Decedent left no W ill and was survived by th~111gying spouse(A'anyl'311d~rs (attach ~7 c ~ ~? n additional sheets. i(necessury): Ci) t71 ~ '-may ~.." Q Name Relationshi r r f•--s -"! t~ rT7 ?. -~ "a N o ~. trr S+ Ul 's~ Fo.,n nw-nz ,~,.. fnitlrzan Page 1 of 2 Oath of Personal Representative COLI~IpY~,VE:gLTFi Of Pc`+YSYLV,~VL~ t 1 SS: Or7cial Usc Only , . , ' I' -~ Vl a I ~ ~ (s ~l Q l ~ (~~ ~uW ~' e c ~ t /7 ~~IG 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 Dcced t, the Petitioner s) ~ i w/ell and truly administer the estate according ro law. Sworn to or affirmed a d subscribed before / ,/ ~ Dated / ?- l.~ m 's ay o J Dace y' Date o the Register Date BONDRequired:QYES ~NO FEES: Letters ...................... 5~ (~ )Short Certificate(s)..... . ( )Renunciation(s)....... , . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission .................. otner ~jt,c~ Ih.~ Automation Fee . ....:::......: ~-r~ ~• JCS Fee... rL.L_s~! TOTAL ..................... S~o~, To the Register ojWii(s: Please enter my appearance by my signature below: Attorney Signature: Printed Name• Supreme Court ~ w ~ m [D Number: ~ ~ C ~ ~ ~ ' Firm Name: ~ '~ ~ ~ CJ Address: ~ p ~ Z .Ty -rt Phone: C t--' Fax: Email: ?~ ~` ~ llECREE OF THE REGISTER ~ r + (, _ r/ Estate of ~j Cif ~ 1,~Q7~~CX~~- File No: _!~ t - ~~ - Qd ~p a/lJa: l~n art!' n '~C / /] /~ n Y TYV7^:r^ t2 ~. i n AND NOW, ~~u1.U.D-I(~,~ CSI ~1 , o~J3 , in consideration f the for going Petition, satisfactory proof having been pr nted before me, IT IS DECRE D th t hers P are hereby granted to I D C in the above estate and (if applicable) that the instrument(s) dated described ui the Pettiton be admitted probate and filed of record as the last Wi11 and Codicil(s)) D cedent. Re tster of Wills Fw..... -JtLnf.._. _...n.....u_ LOCAL REGISTRAR'S ~ERTl~lCA,TlOlV ~° C2~.A~R WARNING: It is illegal?1~ duplicate ti~ii:> c©g~~, by nh~tnst;zt or r.r~;te>~i~as~:~ Ia=.: IIa 1h'n .c10ficdla. ±;(,J 11J P 19064835 -- _ _. -_. -C'~Itl iialion 'YU~tnrr /~ YP /..Int In 3-404 ~/ RECORCEf3 C~~ fCE CF I r ri~Jir REGIS ~xc 0 _~ , , ~ /,y. >•ay+` / J• I t x:013 'Gti ' ~ ~ i ~~, ' ' a SCR CLERK t ~_°b ~,,~~ - ORPHANS' C J ~'9ry y, era` CUMBERLAND u--•. ~' l - ~ PII ~Itl ltnlll i1t 11' .,I ~il ..'.1 <tl, t~Ul"U~!U_.u 1 Uc dlh . ' _.~i ha•° a~;lr. lh: rrrigclai a. ~. I ~ , Ibl Sl.uu e'rur~ ~ rl. ~, t..,,l j~~ '~ p~C 1 ~' 1U12 aal I ~ ~ U h.lr !~ u..i ~ #3 Cttc 11r1a..+1cv t<Pfw nlmn/navn.l lsP<rr me, e n° t ~~y i.<I . =I «am r... < moral.. 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PA t]O60 De `ember t6. 20t2 P e63]6aBrnahorc Roatl l ` . Coranar Hal CM1erlan E . r<eer+e re ~ / l +[.rx[ N,.mn<. o ~ _ ~ // b 6 wmenam= nlxPnxmnn f•e.mn Ne. U'7`7 `P~7'-~ n[vP+/zn.. Last Will and Testament of ~~,~ r 5 ~~~:~k I ~ ti~ r~ c ~ J_ S~ o}. c ~~ ,whose address is 3 2 H~ Z P( l.- r c ~e ~ ~ W ~ fl I ~ 0 Q ,declare that this is my Last Will and Testament and I revoke all previous Is. My marital status is that ~ i ~ O~ I have -3 child(ren) living. My child(ren)'s names, addresses, and birth dates are as follows: (9-Z2~S~j P2nn~l ~~Sh2T ~,~1`'l-(o~l ~es1.9 v ~5~-.~_~lA II 1 l d W I~', . ~ ~ (~ c~ S'F'. lc~ t UI~ W 3yll Morn Bch ~ (~ 110SU Qor+ "~'~eUor}on Q~ II~S~y ~~„~ ~s1~`er lL ,.. c:_ `? fl I ~ z s ~ W~ _x> <.~ r- ~ rn -.~ :rr .y -. _ y~ ~ T' `dE ' _, ~` s ~~.. I have _ J grandchild(ren) living. My grandchild(ren)'s names, addresses, an~ ti~i?th dates~ere a~-fdl~9ows: i3~ ~ e~..,wber~c~o~ s+- CIS Ste,-~.~~~~ S+~ [~.~~~~ Q~' S1~`Qpe~S~' CJ PA l~ZS7 ~~~, alp E S~~a~ -~-,-~g l~o`l d~~ ~i<<~ ~.,tt ~~ MFr~ Q~ l~uSO C. S~U~~ ~-a~"OG ~.,~~~ti ;law ~,. ~t Rd p(j I~USU r~~~ -Z~~~~~ F~s1~ Page ~ of ~ pages Testator's initials NOVA K307 Will w/Childrens Trust Pg.l (02-09) L make the following specific gifts: N/~ I give all the rest of my property, whether real or personal, wherever located, to L.2 S~ 2 ~~~R-- , my r•~ 1 uc,~~~ or if not surviving, to ,my All beneficiaries named in this will must survive me by thirty (30) days to receive any gift under this Will. If any beneficiary and I should die simultaneously, Ishall be conclusively presumed to have survived that beneficiary for purposes of this Will. m ~ u u. ~-~ lappoint LaS~j' `~' S~c`~ ~ ~ Y of as Executor, to serve without bond. If not surviving or otherwise unable to serve, I appoint my of _ as Alternate Executor, also to serve without bond. In addition to any powers, authority, and discretion granted by law, I grant such Executor or Alternate Executor any and all powers to perform any acts, in his/her sole discretion and Page ~ of ~ pages Testator's initials NOVA K307 Will w/Childrens Trust Pg (02-09) without court approval, for the management and distribution of my estate, including independent administration of my estate. If a Guardian is needed for my/any of my minor child(ren), 1 appoint N ,my of _ as Guardian of the person(s) and property of my/any of my minor child(ren), to serve without bond. If not surviving, or unable to serve, I appoint. my of as Alternate Guardian, also to serve without bond. In addition to any powers, authority, and discretion granted by law, I grant such Guardian or Alternate Guardian any and all powers to perform any acts, in his/her sole discretion and without court approval, for the management and distribution of the property of my/any of my minor child(ren). If my/any of my child(ren) is/are under years of age, upon my death, I direct that any property that I give him/ her/them under this Will be held in an individual trust for my/each child(ren), under the following terms, until he/she/ each shall reach years of age. In addition, I appoint my of _ as Trustee of any and all required trusts, to serve without bond. If not surviving, or otherwise unable to serve, then I appou7t ,my of _ as Alternate Trustee, also to serve without bond. In addition to all powers, authority, and discretion granted by law, I grant such Trustee or Alternate Trustee full power to perform any act, in his/her sole discretion and without court approval, to distribute and manage the assets of any such trust. [n the Trustee's sole discretion, the Trustee may dis- tribute any or all of the principal, income, or both, of any such trust as deemed necessary for the beneficiary's health, support, welfare, and education. Any income not distributed shall be added to the trust principal. Any such trust shall terminate when the beneficiary reaches the required age, when the beneficiary dies prior to reach- ing the required age, or when all trust funds have been distributed. Upon termination, any remaining undistributed principal and income shall pass to the beneficiary; or if not surviving, to the beneficiary's heirs; or if none, to the residue of my estate. 1 publish and sign this Last Will and Testament, consisting of ~]7~gfewritten pages, on ~~ 'L2 , 20 (Z ,and declare that I do so freely, for the purposes expressed, under constraint or undue influence, and that I am of sound mind and of legal age. ~~ r Signature of Testator Printed Name of Testator We, the undersigned, being first sworn on oath and under penalty of perjury, state that: Page ~ of ~ pages Testator's initials NOVA K307 Will w/Childrens 7rustP (02-09) On I~I c.. cn ZZ , 20 ~ Z , in the presence of all of us, the above-named Testator pub- lished and si ned this Last Will and Testament, and then at Testator's request, and in Testator's presence, and in each other's presence, we all signed below as witnesses, and we declare, under penalty of perjury, that, to the best of our knowledge, the Testator signed this instrument freely, under no constraint or undue influence, and is of sound mind and legal age. Signat e of Witness #1 v Signature Af Witness~2 ~mhe r l a ~ ~ h Printed Name of Witness # E l~u r~, ~1- Merh . ~ Address of Witness #1 ~1~ S ature of Wi ness /1~ Printed Name of Witness #3 ' 1~ ~~~ ~ oaf-oaf Printed Name of Witness #2 9 v l ~Py~p~~ ~C~ 1-e 1 ~~~ ~ ~i9 m~f Address of Witness #2 5~, `~ur~,~.r ~c t~L, M_~~iQa Moss Address of Witness #3 ~ Notary Ack(n~owledgment r State of 1 < ~~ Yl ST~ t/C~ r1.1 CL County of ~b wv he ~ ~ C~.I'1 C~ , On ~ i JU S't' a a , ZO~a ,the Testator,\~ C ~.t-'1 G t C~ ,,,o~ ~ ~ a-+ 1 C-~ and ~.,.... ono r T~ ~ ~ rv h I.~~ b Y' `,Y' ~\ ii~~~ ~ ~•_-t ~r-(~Q ~ ,the witnesses, personally came before me and, being duly sworn, did state that they are the persons described in the above document and that they signed the above document in my presence as a fnree andLv~oluntary act for the pu'rpMOSes stated. gna re of Notary Public ~yly~, ~ Nontrlebon, Nobly PubNe ~R YoekCaoMY Coannlpton ~0, t014 Notary Public, In ('~ ' and fcrr the County of Mate of PD Pl Yl~l...l 1~1(i h ~ My commission expires: _s~__~_ 3~t~ ~ Notary Seal L Testator's initials ~ ~~ Page ~ of~ pages NOVA K307 Will w/Chiltlrens Trust Pg.4 (02-09)