HomeMy WebLinkAbout05-20-13 __ F 11 7_
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF �.U�1�O�'�IC,�I,�' 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: ,�f� /.��T-� ,�,��(',l� File No: 6�.� � -,���
a/k/a: (Assigned by Register)
a/k/a: �/
a/k/a: Social Security No:
Date of Death: ,�`,�,1�� lc� Zl"� Age at death:_�'�
�
Decedent was domiciled at death in['�/,�yJ��,�(.j� County, }� (Srare)with his/her last
principal residence at�/�,y T� A/(Q�jSI.UI� f�M� C'.�4/QL� st.f'_ C��/h���L+`�''��
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at �rQ,4ff 7Ll.�/1�/!/PS_/N�' /Sl�'�/�fj f?��QL/5�t �(/�f��' .4 D �rhi
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 $ ��.�'+L'Yn. c�[>
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $ -'-
If not domiciled in Pennsylvania. ....................... Personal property in County $
Vnlue of rea!estate in Pennsylvania......................................................... $
TOTAL ESTIMATED VALUE.... $ /� C"C'�C�. Cn
Real estate in Pennsylvania situated at: ���[
(Attnch additianal sheets,i/'necessary.) Streel address,Post Office and Zip Code City,Township or Borough County
❑ A. Petition for Probate and Grant of Letters Testamentarv !�O ��' < <� .
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of tlie Decedent,dated and Codicil(s)
tl�ereto dated
State relevant circumstances(e.g.renu�tciation,death ojexeudar,etc.)
� _,r
Except as follows:after the execution of the instrument(s)offered for probate Decedent did not marry,was not d v4""er was not 8-party to- �' ing
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323(�a�did not haaq a c1�b6'�h or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. � � --- �
t'R -;- Cf -c ��y :+:Y
❑NO EXCEPTIONS ❑EXCEPTIONS _ _ � ?� t'- �j "`° '^�
�,,,�, .oi f'i�—�7.i "'�_
-,a f!> �:', "_� .;.3
(�' B. Petition for Grant of Letters of Administration (tfapp►icable) _ ,°"R, ` %`� _ � �;,
c.t.u.,d.b.n.,d.b.n.c.t.u., endentelite, � � � '�
p tlry-�t��entiar"durante rhtnb�itute
If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above and cotnpbebe list ofc�4irs.:�..= '`>
,, r ry
Except as follows: Decedent was not a party to a pending divorce proceeding wherein tl�e grounds for diyc�rce had been�ta�blish¢yi�ass8afined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person. ^'� T�
[ra'NO EXCEPTIONS �EXCEPTIONS
Petitioner(s),after a proper search has/have asceRained that Decedent lefr no Will and was survived by the following spouse(if any}and heirs(attach
actditionu[sheets,iJ necee•sury):
Name Relationshi Address
�? L
���t��.�, .� fsr T , �l�a ! :_ PA
�;���
.
Fornt RW-01 rev.10/l1/101/ PagO 1 Of 2 1 ��
�ii �
Oath of Personal Representative �`t''` �'' `°t,"'��s`��� ��
„
;t...�y ' i :. � i�i� .._'�
COMMONWEALTH OF PENNSYLVANIA }
} ss: ':.�� (`i'��' �0 ';:�I � '
COUNTY OF �l;`Y�lYVI�1����-�C1� } ��
r�i -
Petitioner(s)Printed Name Petitioner(s)Printe tr� ;„, � ,
� ';'� 1
�j
� � r . . �
The?'etitioner(s)above-named swear(s)or afftrm(s)the statements in the foregoing Petition are true and correct to the best of the knowledge and belief
of Petiti�nens)and that,as Persona]Representative(s)of the Decedent,the Petitioner(s)will well and truly administer the estate according to law.
Swori:to or affirmeci ar.d subscribed before � s/ �"//ft����"�' Date S-,j�—��
m�e t ' day of ,�� Date
By<< 1�.Q ��f ;�5(�. ��'1 -
Date
i�orthe Re�ister Date
BOND Requ3red:QYES r' NO To the Register of Wil[s:
FEES' Please enter my appearance by my signature below:
Letters . . . . .. . . . .. . . . . . .. . . . . $ '�I� Attorney Signature:
( 2 )Sliort Certificate(s).. .. . . _( �
( ) Renunciation(s).. . ... .. .
( )Codicil(s). . .. . . . .. . .. .
( )Affidavit(s)... .. . ... .. .
Bond.. . . . . .. . . . . .. . . . . . .. .. . Printed Name:
Commission. . . . . . . . .. . . . . . .. . Supreme Court
Other .. .. . .. . ID Number:
��� {��!��_ .... ... ��_
�_
� -�-(�Y � . ,. .. , , , )�_ FirmName:
Address:
...... r
Phone:
Automation Fee. . . . . . . . . . . . .. . � Fax:
JCS Fee. . . . . . . . . . . . . . .... .. . Etnail:
TOTAL. . . . . . . . . . . . . . . . . . .. . $II����
DECREE OF THE REGISTER
Estate of �1 . k-P�Ct `I Q Yl� r `� File No: G �� �,� � ���7 �
a/k/a:
AND NOW - � , ZL , in consideration of the foregoing Petition,
satisfactory proof having en presented before me,IT IS DECREED that Letters , i'Y1,i f l I�t7C�fl 5c71
are hereby granted to i`(�i 1�P 1"l � �_�'� L� .�-I-(':lrl
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 Codicil(s))of Decedent.
�
C� �t�' � � ',(� _.
RegisterofWills lif��'�.�,�^�;; IC �us� �
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Fo,�,,,nw-n? ,•�v. inii�iznt� Page 2�;�
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