HomeMy WebLinkAbout01-27-05
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of hl~ ~uck&/~
also known as
Not1/-05- ~
To:
Deceased.
Register of Wills for the
County of in the
Commonwealth of Pennsylvania
Social Security No. x
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl "I/1C::,
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
for letters of administration
on the estate of
~
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Wit~u~ r::.
{ 7DI::.
Decendent was domiciled at death in
~ h ,c., last family or principal residence at
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
/ {)DO oy La- ~/3
$
$
$
$
Petitioner_ after a proper search h,,- ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name
I
Cur A.5b
{
v
~fs~
6,07 S )12)5
{'11,211~
(?Di3
~~fm--,
ftcl07~
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned. 1_.'
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF 0lUYlh. In nA
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The petitioner(s) above-named swear(s) or affirm(s) that 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 above decedent petitioner(s) will well and
truly administer the estate according to law. Ov. a VI f\!\ .
Sworn to or affiW\e~d subscribed JX~ _ ~~~
~r: me this OJ 0 day of
~:;'d;~l~~~"W-"~~~ I
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Estate Ofh\\\\t) .:)nr.1< G/nV'!Y , Deceased
GRANT OF LETTERS OF ADMINISTRATION
1l9~ in consideration of the petition on
been I;resented before me,
are hereby granted to O-.-n n.{ An. c/. Ihavu. ~ .....
o
in the estate of '.~...' ~ \. ~ ~ r 1~ ....J:1..f rtV-ll r
~FEES 5.01:)
Letters of Administration b}() .no
Short Certificates( ).......... $ e.{-,D
~a8Q..~'.l--~$ c;.OO
..)~ $ 10.00
TOTAL _ $ 4'1!;.oo
Filed..\ :-.~~ .-:-.9.~.... A.D. ~_
d;Ufnth ~ l!~h" .,~
Register of Wills fU^- ~~
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
01/14/05 FRI 12:14 FAX 92552749
REGISTER OF WILLS
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Register of Wills of Dauphin County, PennsylvanJ~
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Estate of
RENUNCIA TION
6\1 (\/ ~ VLLl Gr lev/Cie
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No.
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also known as
, Deceased
C> II' /) y'Y) /Y7. r 11 _I r 1",'114{I05j r7:>'ff<&r5')
The undersigned, J lW V 14.//,00 II /ti/C- / I liIlY/~GUOC1rlu) urlft,_
(Relationship) IC.p.city)
Witness
hand this
j (,;; day of ~..ul (~~, .o?--'-{ . 20 () S-
Il~~
I ISignature)
/3/-S-__ $. Dulu{-tA. 5,'()VK._6/1~ 50.'5:7Lo5-
(Address)
VIM tJA-< .~~
(Sign ure)
70'6 tlAv _~DrD1 CieL.~/rn. {f(,ot}
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Ih u...T~rJ";_...?1~
(Address)
L.'JJ~ l.E~INC1TD~
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1'1'r
18Q32..
Sworn to or affirmed and subscribed
before me this _~.,.j (p dav.--51
~~""'IAt'''~)I~ ' 20 0'5 .
rb.J{<1? (/77 /;;fo }1)d2
Notary PUblic
My Commission Expires:Q-t I-t) 7
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Oen;se M.lengei, NotaIy Public
My~" Dauphin County
Expires Sept. 11. 2007
Member. PennlylvanlEl Association Of Notaries
~~un....JJft ""~ ""al 0' Notur,,;., <xl..., ..1!,~j~1
NOTE: Re.nunciwcions eJulcuted outside the Office of Rsgistsr of
Wills <lro required in 5':omf.l cOl..ltltie, to be notari:zed.
qv~llno:'lt,;.I>6f\'..li.l~,....L1I.. ~.....d.to...1
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Thi, i, 10 certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Loctl Registrar. The original eertihcate will be forwarded to the State Vital Records Office li)r permanent filing.
No.
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11105033
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECOROS-J
CERTIFICATE OF DEATH
(Coroner)
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Michael J. Shalol1is Funeral Home 206 Maple Avenue Marysville, PA 17053
LlCE.tl.SeNUMQER D"'ll;SIGNED
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Harrisburg, PA 17110
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8:27 AM . Janllary 6, 2005
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, Chief Deputy
OR1:.IIlGNED(M<nl.o.y......,
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I'WoIEAHDADORESS OF Pbl80H wHO~CAU8EOFOE.ollH
(Ilotn21)Typeor Prlnl PattyJ. Garber
~ 1271 South 28th Street
SlI. Harrisbu PA 17111
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