HomeMy WebLinkAbout02-15-05
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ;eFm) c
also known as
j)t:Ifl!161?-NO. ..,21-05- 0 Ill%'"
To:
Register of Wills for the
County of CD m b in the
Commonwealth of Pennsylvania
Deceased.
:2 'IS- 7
Social Security No. /" J 76
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl (t:)
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
DJ'cendent was domiciled at death in CU, m County, Pen syl ania, with
h 1-' r last family or principal residence at 6- . ~ f?c."
(list street, num er ~
Des:~ndent, then /1 year]s of age, ~i~~ '7 ~o~
at ,f/e-_.A4.cy m-€:e?- (e~.__.
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:
$ /7"000
$
$
$
Petitioner_ after a proper search h"---. ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
..b'a /'
C'/ ~ /7?O
/( r!
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administrat;;;n irHhe
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C0~~\~,\
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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.
~
Sworn to or affirmed and subscribed
before me this \ \ -\-\.... day of
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Estate Ofa..t.tJ . 1
GRANT OF LETTERS OF ADMINISTRATION
No. .:0.1-05 ~ I Lj'g'
c..kA k 0
JJ Ii . 4H'-Ja..v
, Deceased
~re hereby granted to ~ ~ ;J:JlO ~~.~
m the estate of Cu . ~ O.~
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~ ~~'::i&bhQ\.UQ'--
Register ofWills~ ~. ~ \
~
~.... . ..:li'. .,..gEES 5 . <K>
Letters of Administration $1 r/) .DO
Short Certificates( ).......... $ '<l' .ex:>
Renunciation ................ $ 5. (:j:)
.:::.~ $If) .cO
TOTAL _ $ ~ .cf0
Filed ..::;1.:.!!.'7.Cl~.... A.D. ~
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
H\\I~\\\\~ H.F\ Ii\)',
';1;S is to certify that the information here given is conectly copied from an original certificate of death duly filed with me as
Lpcal Registrar The original certificate will be forwarded to the State Vital Records Office j{,r permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph~;'
No.
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Fee for this certificate, $6.00
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P 11339705
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D';{- oS-
Date
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H10!1.14tfk<v.I"1
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECOROlt
CERTIFICATE OF DEATH
(Coroner)
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DREOf'I.lERlt~.o.y.~
4, February 4. 2005
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04/07/1985
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o February 10. 2005
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Register of Wills of Cumberland County
Estate of
RENUNCIATION
a!fuJ ~ 12~
No.
Also known as
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
41ithu
Affirmed and subscribed before me this
/1 dayof Foh
d.QQ.<;
rrla-.JJ tl n () J~-<-,
Notary Pub .
(;;1, (\In fJ
~Lt(f!C'~ k
(Signature)
)7 90 {len-of J/c.OP "lei. &014- m.
, (
(Mdress)
l'7or;;;.r
My Commission Expires:
-~ fl ~re) (W.I.<,.)
1'"<1, L. J:J ,XOO ("
Ell I
Or
j()jyP' Ofit',.be,..... 5(;'~(I/ R..rj l/P.Jbbj,f)fi l/dfltJ
(Address)
Affirmed and subscribed before me this
_ day of
(Signature)
Register of Wills
(Address)
Deputy
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission)
NOTARIAl SEAl.
MARK J. 08MtER, NolIiIIy NIle
MilltltTwp.,PIlllyCoul\tt ..-
My ('.rmmiszloo Er.p~ F~. f';_
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