HomeMy WebLinkAbout11-25-13 Reset
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS 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 G
Name: PATRICIA ANN GROHOL File No: �� — 3 5 y
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 09/092013 Age at death: 63
Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (State) with his/her last
principal residence at 4119 NANTUCKET DRIVE MECHANICSBURG CUMBERLAND
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at UPMC PRESBYTERIAN HOSPITAL PITTSBURGH ALLEGHENY PA
Street address,Post Office sac!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 $ 8,000.00
Ifnot domiciled in Pennsy lvania. ................. ...... Personal property in Pennsylvania $
Ifnot domiciled in Pennsylvania. . ............. ... ...... Personal property in County $
Value of real estate in Pennsyl vania... .. ... ...... .... ...... .................. ............... $
TOTAL ESTIMATED VALUE. ... $ 8.00.00
c
Real estate in Pennsylvania situated at: C7
(Attach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or Bo li g 10 �ue
G
tp -D - N
El A. Petition for Probate and Grant of Letters Testamentary M C-) ry m °
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated r— m r atld Co¢lcil(s)
thereto dated x' ut
State relevant circumstances(e.g.renunciation,death oferecutor,etc)
r
Except as follows: after the execution of the instmment(s)offeredfor probate Decedent did not marry,was not divorced,jas not a party v to a pen M.
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. § 3323(g),at tf didInot havdUhildWmAr
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. CD
®NO EXCEPTIONS Q 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,durance minoritate
If Administration,c,t.a. or db.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 Will and was survived by the following spouse(if any)and heirs(attach
additional sheets, ifnecessary):
Name Relationship Address
JACQUELINE J.AYERS SISTER 831 HILLCREST CIRCLE,WEXFORD,PA 15090
ARDEN SHROYER SISTER 1300 PARKHILLS AVENUE,STATE COLLEGE,PA 16803
JOHN J.GROHOL,III BROTHER 110 WORDSWORTH AVENUE,ALTOONA,PA 16602
Formgw-o2 rev. to/luzon Page 1 oft
_Q
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA } "
} SS: RE ORDER OFFICE OF
COUNTY OF AIl,eOhewi } R n P. Qrp ,r,
r• L
Petitioners)Printed Name Petiti
s.
CLERK OF
ORPHANTGOURT
ClIMBEREAtl4f) CO., VA
The Petitioner(s)above-named swear(s)or affirms)the statements in the foregoing Petition are t and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representatives)of the cedent,the P no s)will 11 d truly administer the estate according to law.
Sworn to or affirmed a subscribed before ,` _ Date HOW
me thris y of e 201 (/ Date
Byl* _ Date
R rg, Date
BOND Required: Q YES Q NO To the Register of Wilts.
FEES: Please enter my appearance by my signature below:
Letters. . . . . .. . ... . .. ... .. . . . $ 45.00 Attorney Signature:
( 3)Short Certificate(s).. . ....., 15.W
( 2)Renunciation(s)ils) . . . . . . . . . . . 10.00
( )Codicil(s). . . . . . . . . . . . . �k
( )Affidavit(s)... ... . ... . .
Bond.. . .. .. .. .. . . .. Printed Name: Charles L.Holsworth
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other ... . . . . . ID Number: 36787
Inheritance Tax Return .. . . .. . . 15.00
Inventory . .. . . . . . 15.00 Firm Name: Holsworth,Sander and Assoicates,P.C.
. . . . , . . . Address: 5801 Brownsville Road
.. .. .. . . Pittsburgh,PA 15236
Phone: 412-653-2556
Automation Fee. ... .. ... . 5.00 Fax: 412-653-2558
JCS Fee. . .. .. .. . ... . .. .. . . .. 23.50 Email: holsworrh law0ieba org,
TOTAL. . . . . . . . . . . . . . . . . . . . $ 128.50
DECREE OF THE REGISTER �J
Estate of PATRICIA ANN GROHOL File No:
atkla: } '
AND NOW, 'V O"M be r JU (. ,in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT I� } 1 S DECREED that Letters 1`y.d1 J�I'fY(�
j are hereby granted to+<1 C f/i P .l A D �_1,,I-se f S
in the abolve 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.
l
i na u C(1\S4 "1"C"A J
We aster of Wills
c4v�113
Form RW--02 rev.1011112017 t '�-Q-l. P age 2 of 2
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ) ORPHAN'S COURT DIVISION
)
PATRICIA ANN GROHOL ) NO.
DECEASED, )
RENUNCIATION OF ADMINISTRATOR
Filed on Behalf of:
JACQUELINE J. AYERS,
ADMINSTRATOR
Counsel of Record for
Party:
CHARLES L. HOLSWORTH, ESQ.
PA. I.D. #36787
HOLSWORTH, SANDER AND
ASSOCIATES, P.C.
5801 Brownsville Road
Pittsburgh, PA 15236
Firm #875
(412) 653-2556
email: holsworth.law @acba.org
RECORDED OFFICE OF
RENUNCIATION REGISTER OF IVILLS
1013 t;'OU 25 Pn 2 20
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANJA CLERK OF
ORPHANS' COURT
CUMBERLAND CO., PA
Estate of PATRICIA ANN GROHOL , Deceased
I, JOHN J. GROHOL, III in my capacity/relationship as
(Print Name)
BROTHER of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
JACQUELINE J. AYERS
(Date) at e)
110 WO SWORTH AVENUE
(StreetAddress)
ALTOONA, PA 16602
(City.State,zip)
Executed in Register's Office Executed out of Register's Office
Swom 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 g day
ofoctoble'r
Deputy for Register of Wills Notary Ablic O
My Commission Expires: 01 / OQ/ 1 5
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Georgia A.Butterbaugh,Notary Public
Form RW-06 rev. 10.13.06 City of Altoona,Blair County
Cattm55bn BOM]an.9,2015
MEMBER,P806MVARIA ASSOOATION OF NOTARIES
RECORDED OFFICE OF
REGISTER OF WILLS
RENUNCIATION 7Ci3 (d0U 25 Ffl 2 20
REGISTER OF WILLS CLERK OF
CUMBEMND COUNTY, PENNSYQR1&MJ'1S' COURT
CUMBERLAND CO., PA
Estate of PATRICIA ANN GROHOL Deceased
I, ARDEN SHROYER in my capacity/relationship as
(Print Name)
SISTER of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
JACQUELINE J. AYERS
(Dare)
(Signature)
1300 PARICHILLS AVENUE
(Street Address)
STATE COLLEGE,PA 16803
(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
pure es stated wit on this / � day
of zol S
Deputy for Register of Wills o ary Public
My Commission Expiresac, �1C0
(Signature and Seat of Notary or other official qualified to
administeroanvs. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
JESSICA M NEBEL
Farm Rw--116 rev. 10.13.06 Notary Ptibtio
FERGUSON TINP.,CENTRE COUNTY
My Commission Eitpires Dec S,2016