HomeMy WebLinkAbout05-30-13 __ _ _ _ n��►
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PETITION FOR GRANT OF LETTERS � � � �'°� ;�,;
REGISTER OF WILLS OF COUNTY,PENNSYL�.y�j � yY �"r
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Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as spe�f�i�low, and �� ,�„4
support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropr�e�drt� :�'? .
Decedent's Information _ ` f. � � �;�
��.�.�► al-i3-�11 �-: _� ,_�,
Name: �. .�..z U TS H Q L..L File No:' "� �' �'
�� �–f— "T"....' � ',
��a� (Assigned by Register) c:.a -�! '
a/k/a:
��a� Social Security No: � �(� -�'�
Date of Death: Age at deat6: 5'�
Decedent was domiciled a death in Cc,`MJg E2 L 1�� n County, ��'S�c.y��1�,¢ (Srure)with his/her last
principal residence at �"�y�c ,E �Q//c%pLt� 9Q7) �IG°CffilN[Cz',/�(1�2G � /�f(j�I��N 7'C.�'� Cc�
Street address,Post Office and Zip Code City,Townshi�ugh County
Decedent died at '�`��'�C� �t 1�7�CZ �� 1�Q#�t?nl���Udl� �71rV1�0�N T�u� QctirtgF�,� ',
Street address,Post Offlce and Zip Code City,Township ar Borough County State
Estimate of va(ue of decedent's property at death:�.. ,
Ijdomiciled in Pennsylvania............................ All personal property $
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. ....................... Personal property in County $
Va[ue of real estate in Pennsylvania......................................................... $
TOTAL ESTIMATED VALUE. ... $ � ���-�j_`°'�'
Real estate in Pennsylvania situated at:
(Artach additionnl sheeu,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County ',
❑ A. Petition for Probate and Grant of Letters Testamentarv •
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 execulor,etc.) '
Except as follows: after d�e 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 (If applicable)
c.t.u.,d.b.n.,d.b.n.c.t.a.,pendente lite,durunte abe•entia,durante minoritute '
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.
�NO EXCEPTIONS �EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no W ill and was survived by the following spouse(if any)and heirs(attuch
additionul sheets,if necessury): '
Name Relationshi Address
�.���c7� �I �uTS�R� �r��� ��� � � � � m����sr�� :,�tdsa
�-.F���s 1'� �UTSf'tA i-�- o �2 � ti r r
Form RW-02 ,���.Ini�vzn�� Page 1 of 2
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Oath of Personal Representative � Q OfficialdkcOnl� �
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COMMONWEALTH OF PENNSYLVANIA } � �= � � `f; '"�
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COUNTY OF � � '�' � ` "°�
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Petitioner(s)Printed Name Petitioner(s)Print� ess "`"
��c�ec=s M G�l,'K�,t_c_ h'�'��f E `]31i n,�T��t_. � �{�l�u�cs�c3�'c l�� i'�C�.�o
�E NA5 E`rhF � �u TSI�A+--� v � 4 � ���; : __� �
The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are true and correct 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 r affirmed a s bscribed b ore �f �v�rv�a.<,, J�'1 ��.� Date �`�'3d — / � '
me t ' � day of , �/�� i„5 � ..��a ,P__P Date �-3�s -��
By: Date
t Registe� Date '
BOND Required:�YES �NO To the Register of Wi!!s:
FEES: � Please enter my appearance by my signature below:
, 00
Lett�ef s . . . . .. . . ... .. .... .. ... $ v Attorney Signature:
( �/ )Short Certificate(s)..... . •Ob
( � )Renunciation(s).. . . .. .. .
( )Codicil(s). . . . . .. . .. ...
( )Affidavit(s)... .. ..... ..
Bond.. . . . . .. . .. . . . .. . . . .. .. . Printed Name:
Commission. . . .. . . . .. . . . .... . Supreme Court
Oth r � ... . ID Number:
►� /� I"��.. ... �`�(� Firm Name:
,/.. ..... Address:
. . ..... . Phone:
Automation Fee. . . .. .. . . ..... . . Od Fax:
JCS Fee. . .. . . .. . .. . . . ...... . EmaiL•
TOTAL. . ... . . . . . . . . . . . ..... $ �
DECREE OF THE REGISTER
Estate of I' C/� File No• /�.1 ^ �'� / l
a/Ic/a: "
AND NOW, �� , OL��J , in consider ion of the foregoing P titio , ,
satisfactory proof having bee •esented before me,IT IS DECREED at Let rs i ��',,�"2
ar hereby grante t
in t e above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of record a the last Will(a d Codicil(s))of cedent.
Register of Wills
Form RW-Od �•�v.roi�tnni i U /P,age 2 of 2
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CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
Name of Decedent:_ � (�11 C! 1(' G� '� . � 1�' �j h G, �, �
Date of Death: S I I � I I � File Number:
Date Letters Granted:
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C.Rule 5.6(a)of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
1'''�a�� �� , Z(�! :
Name: Address: r P� '.,���
l�e,-�n��Fh C-�ui-s(-,r�I � �17 2y �. �7-r,�d I� TZ� i'�'1 �,c2 n� cS�auP��
_ ��Df�.S i°� ��G��S�IA� � ���ZL/ � • 1 !'�� n� �� �, PCJ�aniGShGc` ,' �i9
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(If more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa.O.C.Rule 5.6(a)except:
yy� ��C.'
Date_ �/ � � l � � /�`"1. � l,
� Signnture of Per-on Filing this Form
"='" Capaciry: �Personal Representative ❑Counsel � ' '
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Form RW-08 rev. /0.I3.06 �j