HomeMy WebLinkAbout01-17-13PETIT '~ ca `~`' ~ s'~•~
N FOR GRANT OF LETTERS =~° ~~ ~=- ~7:.y
REGISTER OF WILLS OF J ~' ~~~ `W
/~ 6~~- ~/1~ COUNTY ~ ~ ~-.., ~ ~~ ~ ~:~~
Petitioner(s) named below, who isi. ~,A t~~
r :s
Ire 18 years of a e or o M~ ~~ -.~ ter. ~ ;~~
support thereof aver(s) the following and respectfully req tests j therura~Plof 1Letteos iLetterS ~.~ ~pecitie~ belay, and in
Decedent's Information ' the ~ppr~opr~ate ~n . , •
Name: ~0 6~ R i LrE FS ,-~'~ ~~ -I ~..~ ~ ; E_.A .: ~.
~ ~ .t k "
a/lc/a: File No: ~`~ ~ ~M -:,~
v~t ~-.
a/k/a: (Assigned by Register)
a/k/a:
Date of Death: ~ S ZC 1 Z Social Security No: ~`~ ~ - ~~•--~'~o
Age at death: v D
Decedent was domiciled at death in C~~ -~~ ES c+Z.~ ~ ti ~ Co ~ ~~'
principal residence at unty, _ -~~~~ ~~5~-! ~,~ L ~2 ! ~i (State) with his/her last
~ ~~ ~~~~~~ Gh~ ~ ~ ~ ~~~~
Street address, Post Office andCode ~ ~ rn C3 ~t?c~,V ~~
Decedent died at ~~~~d City, /Township or Borough
~ ~ ~-I /'~ ~ aC~o la.t ~~~rcl-~ ~,Q 1 I ~/ County
Street address, Post Office and Zip Code '1~/ l~ ~~ ~/! ~~liyt,~ ~~,
Estimate of value of decedent's roe City, Townshi or Borough
p p rty at death: Count • ~ State
If domiciled in Pennsylvania.... "
I trotdo ••••••"'•""•••••••••• Allpersonalproper l•,,.
ty
.f miciled to Pennsylvania.......... .
......
If trot domiciled in Pennsylvania.. • • • • • , • • • • • • ~ Personal property in Pennsylvania
... Personal property in County $
value of real estate in Pennsylvania.... • • • • • • • • • •
..... • TOTAL ......... $
Real estate in Pennsylvania situated at: ESTIMATED VALUE.... $
(Attach ndditionnl sheets, ijnecessary.) Street address, Post Office and Zip Code
City, Townshi or Borough •`
^ A. Petition for Probate and Grant of Letters Testamen ~ `~= / coancy
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will t ~ f~"1
thereto dated of the Decedent, dated ~ ~~ ~~• `'~ a ~
,~, ~:: -,x, ...
r
State relevant circumstances (e.g, renunciation, deaf!: ojexecutor etc) ~°~ - ~ ~- ~-
.~ ` ~, .;
Except as follows: after file execution of the instrument(s) offered for probate Decedent did n „
divorce proceeding wherein the grounds for divorce had been established as define otma •_ ~ r+
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an inca ~~ was no;d'ivofced, ~as:hot apartytq~ spending
d to 23 Pa. C S § 33~`3(g), and did~ot hav~:a ~131d born or
^ NO EXCEPTIONS ^ EXCEPTIONS pacitated person.. _ i. ~..t
,„
~] B. Petition for Grant of Letters of Admin"stration If a t-
( rp tcalJle)
c. t. u., d. b. n., d.b.n.c•.t.u., pendente life, clatrutTte abs•entiu, durante minoritute
If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and c
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for d m lete ltst of heirs.
in 23 Pa. C.S. § 3323(g) a~ld was neither the victim of a killing nor ever adjudicated an incapacitated ersonorce had been established as defined
NO EXCEPTIONS ^ EXCEPTIONS p
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by tl~e followin
additional sheets, i~•necess•ury): g spouse (ifany) and heirs /rtttn.•ti
Fat•m RW-OZ rev, 10/!!/1011
Page 1 of 2
Oath of Personal Representative
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t lle Petitioner(s) above-named swear(s) or affirm(s) the statements in th or etition are ' e and ect to the best of the luiowledge and belief
of Petitioner(s) and that, as Personal Representative(s) ofthe Decedei.t,
ti ner s) w- v 1 ail administer the estate acco ding to law.
Sworn to r affirmed and subscribed before
me t ~ today of~ ~ ;~jl~ Date l /( ,~O/~
$y; Date
Date
r he .2egister
Date
BOND Required: ~ YES Gl ti O To the Register ojWi!!s:
FEES: Please enter my appearance by my signature below:
Letters ... , , ,
( l) Short Certificate(s)..... .
( )Renunciation(s).........
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Boiid.... ................
Commission ................. .
O per
Q fG/.~ .......
TCi
Automation Fee .............. .
JCS Fee . ................... .
TOTAL .....................
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h r, ~~
Lit
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J: t,'~'
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Attorney Signature:
~
__
:~:.
Printed Name: -r, ~.:.~
Supreme Court :,~;.: C,~
~ _==- t,~;s
ID Number: t"
`- ~' ~ t- ` "`
.a- .~„
Firm Name: ~ y ~.,, ~ G'r ,~..w
Address: ~~ ~ , „`~'-
~-- ~ ',
,~~
;;a=~ C.I~ ~ d'? r
Phone:
`~"i
Fax:
Email:
DECREE OF' THE REGISTER
Estate of G) P ~ L~~ File '
a/k/a:
AND NO~V, ~ e ~ Z v ~~
in considerati~~n cif the foregoin Petition,
satisfactory proof having been present d before me, IT IS DECREED that Lett s c~ ~ -
l7i17 ~%7 i5 f~~ /I~
are hereby granted to ?~~'~ ~
in the above estate and (if applicable) that
the instrument(s) dated
described in the Petition be admitted to probate and ftled of rec r a .the last 1~Vil and Codicil s
( )) ~ Decedent.
~~~~ ,~~~
Register of Wills ~ /~ ~~ -
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