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HomeMy WebLinkAbout01-17-14 PETITION FOR GRANT OF LETTERS � REGISTER OF WILLS OF ��,C/I�I!g`e/eC,�/� 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: V/I��,��A� ��N�� ST�I°f!')�Yl�P�v File No: `7� a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: � Date of Death: -/�'� —020/ Age at death: �9 Decedent was domiciled at death in�(,����?�GAN� County, ��}. (Srare)with his/her last principal residence at 1� .al O,�� e P.fcL-!�/�-[� Street address,Po t Otfice and Zip Code City,Townshlp or Borough County Decedent died at �� �D i �I � /Y�t,�1 y. � �'C ���� '���� �����/✓� Street address, ost Office and Zip Code ity,Township or Burough County S ate Estimate of value of decedent's property at death: ,�. If domiciled in Pennsylvania............................ All personai property $_�� c3. � If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $ If not dvt►riciled in Pennsylrania. ....................... Personal properry in County $ Value of real estate in Pennsylvania.... . ............................................... $ TOTAL ESTIMATED VALUE.... S � Real estate in Pennsylvania situated at: /��f} (Attacl�additional sheets,ijnecessary.) Street address,Post Office and Zip Code City,Township or Borough County � A. Petition for Pro6ate and Grant of Letters Testamentarv � Petitioner(s)aver(s)heJshe/they is/aze the Executor(s)named in the last Wili of the Decedent,dated '7— 5-1 y� and Codicil(s) thereto dated State relevant circumstances(�g.r¢nunciation,death oJexecutor,eta) � Except as follows:after the execution of the instrument(s)offered for pcobate 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. �NO EXCEPTIONS ❑EXCEPTIONS ❑ B. Petition for Grant of Letters of Administration (If applicable) c.t.u.,d.b.n.,d.b.n.c.t.u.,pendente lite,durunle ubsentiu,durante minoritute 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 parry 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 []EXCEPT[ONS =`�.s Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by tli��"bllowing spou�if an}r�n�irs(a{tuch udcfitionul sheets,if necessury): � '�" p i"'�1 � �� � C_ � Name Relationshi e�'!�" � "� � F..'' �`1 � �* � � ``� � � , . � . � � � � � � � � � �D N C"" 1 f M � � � � , For•m RW-02 i•�v.tnit�izn�� Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF } Petitioner(s)Printed Name Petitioner(s)Printed Address !� � � o t � l3 � ��� v v �/ov7s '`'� z� d�� F �s/ 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 cedent,the Petitioner(s) ill well and truly administer the estate according to law. Sworn to or ��ed subscribed before - Date �"��`7"' me th' day o ,�� � Date /�r/'I -/�/ By: � Date r e Register Date BOND Required:�YES �N� To the Register of Wills: FEES: Please enter my appearance by my signature below: Le rs.. ... . . .... .... .. ... . . $ �`�v Attorney Signature: ( � )Short Certificate(s).... .. �O .�•,s ( )Renunciation(s)... .. ... . � � �' � ( )Codicil(s). . ... . . . ... . . '�► � ".� t�l r�j, � )Affidavit(s).. . . . . .... . . '„"` � �, .... � Bond.. .. ... . . . . . . . . . .. .. ... . Printed Name: � � C'? � � � Commission. . .. . . . . .... .. ... . Supreme Court �'" �'""" t'�'1 � . iC7 Oth r� .. ..... . ID Number: � "� ;�[? � Q ..... .. � . , � � � 't� "� '"`�'1 . ... . . Firm Name: �., � .,,,, � ,� '"'� ' . . ... .. Address: � � --�- � . . . .. .. " �:.- .. ... .. - 't�„ �""� »,� .. ... .. Phone: Automation Fee. .. . . .. . . . ... . . Fax: JCS Fee. . . . . . .. . .. . .. .. ... . . Email: TOTAL. . . . . . . . . . . .. .. .. ... . $ DECREE OF THE REGISTER . Estate of � � /I crnm File No:_ ��'���lQQ alk/a: � AND NOW, �� , ,in co ' eration of the fore oing Petition, satisfactor roof havin been sented before me,IT IS DECRE D that Letters ���/7�t/�7Fa�' YP g P � are h reby gran�ed to /� /Q CL I'l � . ' ���l(J in the above estate and(if applicable)that the instrument(s)dated described in the Petition be admitt to probate and filed of rec as the last Will(and Codicil(s))of Decedent. � - �-,�,. Register of Wills Form RW-02 r�.ro�riizol� Page 2 of 2 H105. __ _ _____ ____ _ _ � � • OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS �l,C�� —� COUNTY,PENNSYLVANIA Estate of l f/�f/f��1¢ �� .5��141?e�,, ,Deceased /I�ir/�� �i� /1Ji� � �� . and , (each)being duly qualified according to law depose(s)and say(s)that she/he/ hey was/ ere well- ,/► acquainted with v/r /�iQ E� ��'rn�-� and am/are familiar with the handwriting and signature of the decedent, and that the signature of �f i�i' �'e� G l to the foregoing instrument purporting to be the Last Will and Testament/Codicil of is in his e n proper handwriting. � . tgn tu e) (Signatur //�' �J �Y���� __�;� � (Street ddress) t ee ddr ss � � � , ta e,Zi Ci ,Stat, tp � Executed in Register's Office #� � c'�"'� Sv�orn to or affirmed and subscribed `� ,� � � � befor�me this � day �.' ,c,� -,,�a � � "� �° '�"' '"''� � of Q r ,`� �° / �'' �� � �` � � � �" —v � � � - � �� -•- �� L,�• � ..cy �;►. .t"�'� e ty for Register of�Vills ��. � N � ,� � � � � ,� Form RW-04 rev.lOJ3.06 �..a �, . ,� � _ r . r r���' � r ; , . 1� � : t� �ii �;�� ;.��s������ �• +�"►����r� 0� �"��`�` �9►��`'� ���'��F�kJ�� .�;�� �� �� �: � . ., �� �� 1"�!'#1'��C� -�� �T�:���.l�` �!�"' .� '��3 '�@ :�,���i �, ._ , * ,: . . .. � � �'�.�.�»!� �f. �: .�.• � �' '�`' � . _ � T� ;�t�b�:� �� �'i� S, .� �t �� � � � -��� ., � �� • . 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