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PETITION FOR GRANT OF LETTERS
REGISTER OF WII.LS OF Cumberland 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: Omer J.McFalls File No: L� '�;�2'�„�'
a1k/a: (Assigned by Register)
a/k/a: ,/
� ��/ �
Date of Death: December 17,2012 Age at death: 81
Decedent was domiciled at death in Cumberland County, PennSylvania (srare)with his/her last
principal residence at 477 Wolf BridQe Road,Carlisle,PA 17013
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at y 7� G�v���1,�GQ(�r_ , U..frcl� ��_ �,�i '�� ��(� �
Street address,Post Office and Zip Code City, ownship or Borough /�� J� County�� St�
Estimate of value of decedent's property at death: �L'��UG[!e�e�C ���h�
If domiciled in Pennsylvania............................ All personal property $ 500.00
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsy[vania. ....................... Personal property in County $
Value of real estate in Pennsy[vania......................................................... $
TOTAL ESTIMATED VALUE. ... $ 500.00
Real estate in Pennsylvania situated at: None
(Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough Couoty
� 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
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r-,T .*�—yr
State relevant circumstances(e.g.renunciation,death of executor,etc.) � � `s't �-�,
i � �[7 _-.- ..9 C:.7
Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not�v�e�was rrofa party i�o�;pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§332 ),�,ndc�iid no�ve a child bom or
adopted;and Decedent was neither the vicrim of a killing nor ever adjudicated an incapacitated person. � :�� ° '' C� ,�... .-..
, �' CI) f�:� �_:.
Q NO EXCEPTIONS Q EXCEPTIONS
�, -
� ;
E7 � ., ...
� B. Petition for Grant of Letters of Administration (If applicable) 4:� ��= _,. - °>
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,�dur �e absenttu;durante rht�loritate
--t� �;,; �s
If Administration,c.�a. or d.b.n.c.�a.,enter date of Will in Section A above and co�tplete list o�eirs. �1
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined
m 23 a.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person.
��10 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 Relationshi Address
Mitzi M.Price Daughter 521 S.Pitt Street,C arlisle,PA 17013
��
��
� �
Form RW-02 .�.�oii�izoit Page 1 of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Mitzi M.Price 521 S.Pitt Street Carlisle PA 17103
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 Peritio er(s)will w and txuly administer the estate accordin to law.
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Sworn to or affirmed and subscribed before ;�. ^ • ���/ Date '� � ��
me t 's I � day of , 20 I 3 D�e �--J -��
By: � `-'' �"'� �c�
For the Register D� : ---- `'� �'
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BOND Required: Q YES (�O To the Register of Wills: � �_,7 � �! ,
FEES: Please enter my appearance by my signature��glot�:` � •_� ''i
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a"� �..+ � _.
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Letters . . . .. . . . . . . . . . .. . . . . . . $ �ov Attorney Signatur • .,� <=�; s---�
i`o
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( f )Short Certificate(s)... . . . 5 -D� ' .:�� � ` ,,.�
( )Renunciation(s).. . .. .. . . ' � ''' `�J
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( )Codicil(s). . . .. . . . . .. . . � �
( )Affidavit(s).. . . . . . . . . . . �
Bond.. . . . . . . .. . . . . . . . . . . . . . . Printed Name: � �
Commission. . .. . . .. . . . . . . . . . . Supreme Court �
Ot��� : : : : : : : ID Number:
"^ • • • • • • • l�j� � Firm Name: �IUS L[�
��'1(� . . . . . . . � Address:
.
. . . . . . . / /
. . . . . . . Phone: � —' 02��
Automation Fee. . . . . . . . . . . . . .. �,�_ Fax: ^ -- Ga-
JCS Fee. . . . . . . . . . . . . . . . . .. . . (� Email: �
TOTAL. . . . . .. . . . . . . . . . . . . . . $ ' : -'�6� _
DECREE OF THE REGISTER
Estate of Omer J.McFalls File No: o��' ��" I�;J/
a/k/a:
AND NOW, � , ��� ,in cons'de•ation of the fo agoing Petition,
satisfactory proof having been presente b fore me,IT I DECREE+AD th�t Letters j�( (iyl,
are her y granted to �j�'�I N�_ t't�L
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.
� �
� egister of Wil �� �
Form RW-02 rev.10/ll/20/1 ge 2 Of 2
t1�f`�!"� C. ��°� ;>r
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RENUNCIATION ' ' �'.�� �� `:; ' _y ���
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REGISTER OF WILLS ac��'�{�s°�� �:'.�;.� ' 4�
���'�I�in� COUNTY,PENNSYLVANI���BEr�L�iY�' �'� , '��
� L F'' � �� �
Estate of t"�'� �, C � 1��' ,Deceased
I, ���-'�-���.Ja�'{J���'C�.�"�C`� , in my capacity/relatianship as
� jPrint N e
L�- of the abave Decedent, hereby renounce the right ta
administer the Estate o the Decedent and respectfully request that Letters be issued to
f '� '� r��
� �' _ /��"�-�..Cgl�
(Date) (Signature)
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i
(StreetAddress) /(/`�y n��y�T� - w 1+��cC ..-��,�
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(Ct .SLaLe,Zip} �
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Executed in.Register's Office Executed out of Reg�ster's Offi�e
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
before me this day party executing this renunciatian and certified
of , that he or she executed the renunciatz�n fcrr the
purposes stated within on this _ 1��day
�f—����.��� ,_ �t�1 �
Deputy for Register of Wills Nota ublic
My Commissian Expires: ��-I1�/
(Signature snd Seai of NoYary or other official qualified ta
adminis�c���how date of expiration af Notary's Cammission.}
'"�""�._.'��'LNN�Yl1fANIA
T�Y 6. �a!Sea-.._.�'"'_""'.�'~
�uehann�a�yp,D�u rY�'ublic
�0"�+�s qPhln County
Form ItW-06 rev.10.13.06 ���'•PenttsVhtani8,4,ssac(a�qp�f�02�d
otaries
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RENUNCIATION '����3 � �� ''� ._� -_ '`.�
�4. f A�a.. . .
GTSTER OF WILLS Q�,�=};;�;�;' � , ;; ;;
�.�a����COUNTY, PENNSY�����L�,A�� ''C , ��-'�
,------� '}.� /
Estate of , !"}'1°�.-�'`---� , � " `�� �l-� ,Deceased
...---�
I, I�f?.r `� r ��c ���..:�' , in my capacity/relationship as
��Print Nume} ��
��,_ of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
�5 -� 1� � r.�
(L7ate} (Signature)
�,�o�"1�1.�-� f ��t�
(Street Address)
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� tc��;stAt�.z��
Executed in Register's Office Executed out ofRegister's Of�ce
Sworn to or affirmed and subscribed Before the undersigned persanally appeared the
before me this day party executing this renunciation and certified
of that he or she executed the renunciatio for the
� purposes stated within on this 1�r� day
of ��,{��c.s� , �t7I.3
.-�
Deputy for Register of Wi11s Notai 'u lic
My Commission Expires: ��i3�f�tfit y
(Signature and Seal of Natary or other afficia!qualified to
admini,�t��a hs. Show da#a of expiration of Notary`s Commission.)
��E�1�
��+Y G. ��sea�NSYEY,qNy�
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Forrn RW-06 rev.I0.13.tt6 �e��r�+-'�►+tsvlva�la�a�'�•�2�014
on op IVo�n�
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H105905 REV.(8/11) ��
This is co certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with
the Vital Statistics Law of 1953, as amended.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
n�'C u�iE u' ��,����,�iN� pEN �an�.r.`` 0 I'��`'�c,�.t�Jk°�,'
�`"��� ° '-•`` � � _ � ,yJ'r-, Marina O'Reilly Matthew
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