HomeMy WebLinkAbout11-21-13 PETITION FOR GRANT OOF/LETTERS
REGISTER OF WILLS OF COUNTY,PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ics) for Letters as specified below, and in
support thereof aver(s)the following and respectfully request(s) the grant of Letters in the appropriate to
Decedent's I t'o �j� .�/. g I – I —I UU (
Name: /� ��� �r !� File No: 2_f— l 5–
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: Age at death: 7�
Decedent was domiciled at death in C / County, t/ / State)with his/her last
principal residence at /�Cn' G W 1 % � �j 50 / f/.f'l � i2ROW
Street'address,Post Office and Zip Code I City,Township or Borough County
Decedent died at f'O ��P� 6mmz G� 'C��GS ( /� ��
Sheet 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 $ op
If not domiciled in Pennsylvania. .......... . ............ Personal property in Pennsylvania $
If not domiciled in Pennsy lvania. ......... . ....... ...... Personal property in County $
Value of real estate in Pennsyl vania................ .................. ..... .................. $ 1 Ic
TOTAL ESTIMATED VALUE. ... $
Real estate in Pennsylvania situated at: GAP /�Q/ � �(.(J' �Q 27k�e4 _t )fit) ���IV
(Attach additional sheets,ffnecessary.) Street address,Post Office and Zip Code City,T wnship or Borough County
A. Petition for Probate and Grant of Letters Testamentary J ��p
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated /) (lyand Codicils)
thereto dated t -
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 a killing nor ever adjudicated an incapacitated person.
WO EXCEPTIONS ❑EXCEPTIONS
❑ 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,duraite minoritate
If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above angluilDlete liwof eaawo
M GD Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds ftir di ce had b�estavi shy�as defined
in 23 Pa.C.S. §3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated cm- C? --A t7
❑NO EXCEPTIONS ❑EXCEPTIONS r— Z M
Petitioner($),after a proper search has/have ascertained that Decedent left no Will and was survived by thffP1F0vii(gsspous4fanJ$n eirs(attach
additional sheets,if necessary):
C7 O
�
Name Relationship • Al ji... v r— rn
Fomr 2w-oz rcv.1011112011 Page I of 2
Oath of Personal Representative Official Usc Only
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF � +
Petitioner(s)Printed Name Petitioners)Printed Address
6 Tit ,1n FP A) 6_ &dk 'LL 6
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 Pet` ne (t we y administer the estate accordi g to w.
Sworn to or affirmed and subscribed before � Date
me d �^yr���,
\ ,SlG1iJ Date ( ! !
$y: Date
For the Re' s r 1 Date
BOND Required:AYES NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters.. . . .. . .. .. . . ... . . . . . . $ Attorney Signature:
( )Short Certificate(s). ..
( )Renunciation(s).. . . . . . . .
( ) Codicil(s). . .,.. . . . . .. .
( )Affidavit(s)............
Bond., . . . . . . . . . . . . . . . . . . . . Printed Name:
Commission. . . . . . . . . . . . . . . .. . Supreme Court
Other . . . .. . .. ID Number:
. . . . . . Firm Name:
. . . . . . . . Address: c
Go °c cn
ro
. . . . . . . . Phone: 2 "{
Automation Fee, Fax:
JCS Fee. . . .. . . . . ...... .. .. . . �._ Email: 7e O
TOTALL. . . . . . . . . . . . . . . . . . . . .
DECREE OF THE REGISTER -�i
c�
Estate of tj} 1QQ t�. 1 Fite No: cl I - '5 - 100 9
alkla:
AND NOW, Np\I M bP y' c�5 (} I in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED that Letters-T �4 4 a U
are hereby granted to 10be(h 1 fYS fY G' h
C1Cl_I A-v)11 f'7 1 ; in the above estate and(if applicable) that
the instrument(s)dated Z- Z L! - i 9-7V
described in the Petition be admitted to probate and filed of record as the last Will (and Cor i(s})of Decedent.
egister of Wills
¢V 65 e.� ^u,t, ,�
For„ Rry-nz 1011112011 , �' Page 2 of 2