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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: Margaret H. Fick File No: C~J
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 182-12-5375
Date of Death: June 2, 2012 Age at death: 90
Decedent was domiciled at death in Cumberland County, Pennsylvania (State) with his/her last
principal residence at 210 Big Spring Road Newville PA 17241 West Pennsboro Township Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 210 Big Spring Road Newville PA 17241 West Pennsboro Township Cumberland PA
Street address, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania All personal property $ 33,000.00
If not domiciled in Pennsylvania Personal property in Pennsylvania $ 0 00
If not domiciled in Pennsylvania Personal property in County $ 0.00
Value of real estate in Pennsylvania $ 0.00
TOTAL ESTIMATED VALUE.... $ 33,000.00
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 and Codicil(s)
thereto dated
State relevant circumstances (e.g. 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 (Ifapplicable) Cl) 1
c.t.a., d.b.n., d. b. n. c. t. a., pendente 14dante absentia, dcnninoritate
If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and wo-4 lisf4f helm.
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for dlvofoe had beqk$stabhshecJ as defined
in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated perg, C!,
C
NO EXCEPTIONS ® EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (i€any)Atid he5rs (attach
additional sheets, if necessary):
Name Relationship Address
Margaret Bratek Daughter 7807 Alberta Drive
Ra id Ci SD 57702
Form RW-02 rev. 10111/2011 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s) Printed Name
Good News Consul[ine. Inc. 140 Roosevelt ,
Othcial Use Only
The Petitioner(s) above-named swear(s) or affiDn(s) the statements in the foregoing Petition aze true and oorrect 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 nd subscribed before ~ Qom .t.~/y~ [BSI ~' n'1C IJC~ Date ' !f5' 13
met is ~ day o ,~ -.J~r ~:Dil nlCnnlS l~ ry.SU u~'1 t16 (nr . Date
Date
~, <+r the Register Date
BOND Required: Q YES Q NO
FEES:
Letters ...................... $
( 4) Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ........
To the Register of Wills:
l ICNSC CpLCL LpJ
Attorney SJgnature: i
/,.
.'
Printed Name: Andrew H.
Supreme Court
ID Number: 87371
my 61g D8In re DeIOW:
Firm Name: Law Office of Andrew H. Shaw, P.C.
Address: 200 S. ~ ring Garcien Street
_ ~
Suite 11 n °J
Cazlisle, PA 170f3 n a n
~~ c_.. ~
Phone: 717-243-7135 ~ :~-~ cry ~'~
:V ~-Tr N ....a rrt
Fax: 717-243-7872
Email: andrew~aehawl ~ Luml%~ ~~ '~~~
-F r
y ~,. ~ s 1
Y~ M
DECREE OF THE REGISTER -
„~ .,.t
Estate of Marearet H. Fick File No: ~ ~ - j ~' = 11 5[r
a/k/a:
Automation Fee .............. .
JCS Fee ........ ...........
TOTAL ........ ..... ...... $ 0
~/U~
AND NOW, , Gtt/~, in con ideration of
satisfactory proof having been r ented before me, ITJJ$$ DEC E~ that Letters
a e hereby granted to ~,~~ IPSAJ C ,~~ ' rv
in the above estate I
the instrument(s) dated _ }~ !ti_
described in the Petition be admitted to probate and filed of~r~ as ~ last (Wjfl (and Codicil(s~~
Form RW-O2 rev. 10/IU20J/
r.
e foregoing Petition,
C
3 (if applicable) that
f De dent.
;~x~~
~ ~ Lt~
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