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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 �
Name: DAVID A. SYBERT File No: (— I —M5 I
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: OCTOBER 25,2013 Age at death: 42
Decedent was domiciled at death in CUMBERLAND County,PA (State)with his/her last
principal residence at 65 W.BIG SPRING AVE.,APT.#4,NEWVILLE,PA 17241 NEWVILLE CUMBERLAND
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at HERSHEY MEDICAL CENTER,500 UNIVERSITY DRIVE,HERSHEY PA 17033 DAUPHIN PA
Street 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 $ 5n.000,nn
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......................................................... $
TOTAL ESTIMATED VALUE. ... $ 0.%
Real estate in Pennsylvania situated at:
(Attach additional sheets,if necessary) Street address,Post Office and Zip Code City,Township ear B7ugh C_. G`a G�ounty
W 'L1 � P C7
A. Petition for Probate and Grant of Letters Testamentary rn C> rtt m
-;0 , r— H
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated nn CT) aaa aicil(s)
thereto dated + C I
State relevant circumstances(e.g.renunciation,death of executor,etc.)
C: i" ' r.,. rT1
Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not diivvoi ,was no�iparty ppading
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §3323( an did note a c old TiBm or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. "
0 NO EXCEPTIONS 0 EXCEPTIONS
M 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,durante minoritate
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.
0 NO EXCEPTIONS 0 EXCEPTIONS see Renunciations attached hereto
Petitioner(s),after a proper search bas/have ascertained that Decedent left no Will and was survived by the following spouse(if any)and heirs(attach
additional sheets,if necessary):
Name Relationship Address
DAVID F. SYBERT FATHER 46 QUARRY HILL ROAD
NEWVILLE PA 17241
THERESA L.SYBERT MOTHER 46 QUARRY HILL ROAD
�NEWVILLE.PA 17241
COREY A. SYBERT SON 517 BROADWAY AVE.,NORTH# 10
SAINT HILAIRE MN 56754
CHRISTINE M. SHEETS SISTER 44 QUARRY HILL ROAD
NEWVILLE PA 17241
Form RW-02 rev.10/11/2011 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
DAVID F.SYBERT 46 QUARRY HILL ROAD NEWVILLE PA 17241
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 th edent,the Petitioner(s)VAll 7 ell and truly administer the estate according to law.
Sworn to or_gffirmed and subscribed b�e^f'o'r'e /�-1 Date_/ I& /
me this k(o day of ,61U� Date
By:_ Date
For the Register Date
BOND Required: 0 YES (:) NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters. . . . . . . . . . . . . . . . . .. . . . $ 00 Attorney Signature:
( 6 )Short Certificate(s).. . . . . 41l W
( 3 )Renunciation(s).. . . . . . . . O�
( )Codicil(s). . . . . . . . . . . . .
� � A d4'
CJ
( )Affidavit(s).. . . . . . . . . . . CO � '-
Bond.. . .. . .. . . . . . . . . . . . . . . . . Printed Name: WILLIAM A.DUNI-OkM n -(
Commission. . . . .. . . . . . . . . . . . . Supreme Court
OtherW k, . . . . . . . . 5-°o ID Number: 22080 " (!� �, p
—rr
IV)VP rTroy
n�T XX1'1 \6 C Firm Name: DUNCAN&HARTr}�?dxl,
. . . . . . . . Address: 1 IRVINE ROW �" rF 8 F m
• • • • • • • • CARLISLE,pA J-AW 3-i <D
[-s] -rt
. . . . . Phone: 717-249-7780
Automation Fee. . . .. . . . . . . . . . . 5.CC Fax: 717-249-7800
JCS Fee. .. . . . ... . . . . . . . . . . . . 23• Email: bill oduncanhartmanlaw_com
TOTAL. . . . . . . . . .. . . . . . . . . . . $ 7.03 G
DECREE OF THE REGISTER
Estate of DAVID A. SYBERT File No:
a/k/a:
AND NOW, —fa� ,in consideration of the foregoing Petition,
satisfactory proof ha dg g been preser(tjd before me,IT IS DECREED that Letters ADMINISTRATION
are hereby granted to DAVID F.SYBERT
in the above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of re'; rd as the last Will(and Codicil(s)) of Decedent.
nIx a
' ter of W' s
Form RW-02 rev.1011112011 Page 2 of 2
11105,
,,,
RECORDED OFFICE OF
REGISTER OF WILLS
f61114 AN 16 AM 10 97 RENUNCIATION
CLERK OF REGISTER OF WILLS
O R P H A N SCQWRLAND COUNTY, PENNSYLVANIA
CUMBERLAND CO., PA
Estate of DAVID A. SYBERT , Deceased
1, COREY A. SYBERT , in my capacity/relationship as
(Print Name)
SON of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
DAVID F. SYBERT
-7
(Date) (Signatu )
517 Broadway Ave.,North# 10
(Street Address)
Saint Hilaire,MN 56754
(City,State,Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed an*ubscribed Before the undersigned personally appeared the
befor, me this --7 da party executing this renunciation and certified
of v Lt that he or she executed the renunciatiWor the
purposes tated within on this "7 day
of
Deputy for Register of Wills Notary Public
My Commission Expires: OV3141-7
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration�ofNotary's Commission.)
ROb@1t(30"vu"
Form RW-06 rev. 10.13.06
11D &I-0
J
RECORDED OFFICE OF
REGISTER OF WILLS
4,14 JAN 16 AM 10 47 RENUNCIATION
CLERIC OF
ORPHANS' COURT REGISTER OF WILLS
CUM$E R LA N D(Ci > IIRLAND COUNTY,PENNSYLVANIA
Estate of DAVID A. SYBERT ,Deceased
1, THERESA L. SYBERT , in my capacity/relationship as
(Print Name)
MOTHER of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
DAVID F. SYBERT
(Date) (Signature)
46 'Quarry Hill Road
(Street Address)
Newville, PA 17241
(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
purposes stated within on this day
of
Deputy for Register of Wills 14tary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COM 7. OVOENNSYLV NI
NOTARIAL SEAL
JOAN D.ADAMS,Notary Public
Form RW-06 rev.10.13.06 ty
Carlisle Boro.,Cumberland Coun
My Commission Expires March 15,2015
RECORDED OFFICE OF'
REGISTER OF WILLS
t18N 16 AM 10 46 RENUNCIATION
CLERK OF
ORPHANS' C REGISTER OF WILLS
C U:M 6 E R L A�� . .�,I I�ND COUNTY,PENNSYLVANIA
Estate of DAVID A. SYBERT ,Deceased
I, CHRISTINE M. SHEETS , 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
DAVID F. SYBERT
(Date) (Signature)
44 Quarry Hill Road
(Street Address)
Newville,PA 17241
(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
purposes stated within on this day
of - I
Deputy for Register of Wills Public
Y C mmissio Expires:
(Signature and Seal of Notary or other official qualified to
adminis aMEMM�kMIEN �e@F±W%�'�ommission.)
Notarial Seal
Kabroth,Notary iOFWrM]M
Twp.,Cumberland
-on bcpin s Dec
LVMRA ASSOMTION
Forn:RW-06 rev.10.13.06