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HomeMy WebLinkAbout04-15-13 PETITION FOR GRANT OF LETTERS REGISTER.OF WILLS OF ' l3 /2 I-X I/-ILN 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 j Name:-1!21,#/Z d 5/-4 4 - 7, r-le I E A-1-D5 File No: a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: Z 13-1',3 Age at death: Decedent was domiciled at death in e U I"6FR County, P14 _ _(state)with his/her last principal residence at_5265' -6 7 p 2 9 C U A7&e R LAA12> Street address,Post Office and Zip Code Tr City,Township or Borough County Decedent died at -45"Od u N 1 U FIZ s j7Y b 4l& f- '703S H F9 15Hr-)? 7)A u PI-Il Af YAJ 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 Pennsyl vania............................ All personal property $ r3/ 6 Z 3 If not domiciled in Pennsy lvania. ....................... Personal property in Pennsylvania $ If not domiciled in Pennsylvania. ....................... Personal property in County $ Value of real estate in Pennsylvania......................................................... $ TOTAL ESTIMATED VALUE. ... $� 7 3 7&Z"5 Real estate in Pennsylvania situated at: (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 killing nor ever adjudicated an incapacitated person. ❑NO EXCEPTIONS ❑EXCEPTIONS X 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 d.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. 1O 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 Relationshig Address . ., cat? C n c�n un w C Fo,1n R n2 rev.1011112011 ?age 1 of NNW RENUNCIATION M REGISTER OF WILLS C c� .,� COUNTY, PENNSYLVANIA W -j r c� C.> � CD a © � Uj Estate of M A e E �C �''" l= I ,t,t 5 ,Deceased 19 fn (Print Name) �, in my capacitylrelationshlp as G H T C-2 of the above Decedent,hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to (Date) (Signa re) SZ015 5n . hhn far (Street Address) 1--702.5 (City,State,Zip) .Executed in Register's Office ,Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunciation and certified of ,_ that he or she executed the renunciation for the purposes stated within on this I day of AP12 /4 3 Deputy for Register of Wills Notary Public My Commission Expires: '- 1- Zd t (Signature and Seal of Notary or other official galified to administer oat ion.) NOTARIAL BEAt, DIANE A.FRIEND&NoWy Ptdft Upper Amn Twp.,Cwv ftww cowdy MY Ca""ME0MMOY11,2014 Form RW-06 rev.10.13.06