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HomeMy WebLinkAbout04-22-13 PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF 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: k File No: 4 QVIC a/k/a: (Assigned by Register) a/k/a: aJkJa: Social Security No: 17f-2! 001—r-7 Zl:: Date ofDeath: 0v1-1-k1-,26213 Age at death: Decedent was domiciled at death in Count A his/her as zy7,;L114!1711-, (state)with h /h I t CVLO�f2&,Z principal residence at J��V � 4��� -Z-I,,2 �J /;ZV/ 0, Street address,Post Office and Zip Code City,ToWE!�ipaorougk' / County AX 7 m6r.41all/ Decedent died at A&-Ael-,�h' to 4Z 4&1Z&1-2A1&e / 716a� / C-420 Street address,Post Office and Zip Code City,Township o'r Borough 'County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania............................ All personal property $ 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 VALUig.. $ rn Real estate in Pennsylvania situated at: (Attach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Town;4�P,".gh -;0 U' i 'y County r%) ryl 1-J ❑ r- Q-1 A. Petition for Probate and Grant of Letters Testamentary )> 7-1 Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated anACodicil(s) thereto dated State relevant circumstances(e.g.renunciation,death of executor,ek.) C73 Except as follows:after the execution of the instrument(s)offered for probate Decedent did not marry,wa;�Tot divorced,wALhot a partyM 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.,db.n.,db.n.c.t.a.,pendente lite,durante absentia,durante minoritate If Administration,c.t.a.or d.h.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. P4 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 Relationship Address IM?0 Form RW-02 rev.1011112011 Page I of 2 ^— Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF } Petitioner(s)Printed Name Petitioner(s)Printed Address The Petitioner(s)above-named swear(s)or affirm(s)th statement oin Petitio e and correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)0�th e h ecedent etiti s wit ell and truly administer the estate according to taw. Sworn to or aff,�ed a d subsc ibed before Date me 4Say of , of Date By Dal@; For the Register C�o t►1 BOND Required: Q YES QKNO To the Register of Wi11s: c7 rv °; " FEES' Please enter my appearance by _,,,v 5ftnrifurelbdow: Letters . .. . . . . . .. . . . . . . . . . . . . $ 09-0-00� Attor t nature: ( }Short Certificates}. . . . . . _f 5-©(} `r`'• c� ( )Renunciation(s).. . . . . . . . rrt ( )Codicil(s). . . . . . . . . . 4C)l ( )Affidavit(s)... . . .. . . . . . — _n Bond.. . .. . .. . . . . . . . . . . Name: Commission. . . . .. . . . . . . . . . . . . Supreme Court Other ID Number: :UufMIX t . Firm Name: . . . . . . . . Address: -2110 . . . . . Phone: —,tom Automation Fee. . . . . . . . . . . .. . . Fax: 212-23V— JCS Fee. . . . .. . .. . . . . . .. . . . . . Email: TOTAL. . . .. . . . . . . . . . . . . .. . . DECREE OF THE REGISTER Estate of Kcaocffi . i �CV File No: n�Q'O--L a/k/a: AND NOW, in consideration of the f re oing Petition, satisfactory proof having been e ente before me,IT IS DECREED that Leate s ndefl _ are hereby granted to bin AU 1.. in the above estate and(if applicable)that the instrument(s)dated described in the Petition be admitted to probate and filed of record as the last Will(and Co icil(s)) of Decedent Register of Wil 1 orm RW-02 rev. 1011112011 a 2 of 2