HomeMy WebLinkAbout02-19-14 �
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PETITION FOR GRAl�1T OF LETTERS �a-c� ...
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REGISTER OF WILLS OF COUNTY,PENNSYLi���+IA � � ,-�a
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Petitioner(s) named below who is/are 18 �
, years of age or older, apply(ies) for Letters as sp�c� belov�and i�,c:�
support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropri��irm: �,p �.�=' �"'�''
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Decedent's Information / � � '"'''
Name: L��, \�J��v L�G� File No: ��'/�"���
��a� (Assigned by Register)
a/k/a:
��a� Social Security No: ��,►—
Date of Death:?�� )�� Age at death: �
Decedent was domiciled at death in v � County, (Srare)with his/her la'st
principal residence at �, — G �'� q�„l>
Street address,Post Oftice and Zip Code City,Township or Borough County
� Decedent died at ��� ��v�. �i Ll,.r(� ��C1-�PwTGS �t, C�,ng�2c.py,� Q�
Street address,Post Oflice and Zip Code City,Township or Borough County State
Estimate of value of decedent's property at death: �
If do�niciled in Pennsylvania............................ All personal property $
If not domici[ed in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. ....................... Personal properiy in County $
[�alue of real estate in Pennsylvania......................................................... $
TOTAL ESTIMATED VALUE. ... $ _ OOU .n�)
Real estate in Pennsylvania situated at: O G` �t^ �� ��i1� 1 `�G lctkn7',4L5[� �(. �(�����M,Q
(Attach additional sheets,if necessary.) Street address,Post Oft3ce and Zip Code City,Township or Borough County
❑ A. Petition for Probate and Grant of Letters Testamentarv
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated and Codicil(s)
thereto dated .
State relevant circumstances(�g.renunciation,death of executor,etc.)
Except as follows:after the execution of the instrument(s)offered for probate 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.a.,pendente lite,durunte absentia,durante minoritute
If Administration,c.t.a.or d.b.n.c.�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
udditionul sheets,if necessary):
Name Retationshi Address
0 • W 3�Yvt� Q SO N ��v �G�iv�T�.S �� �p►�"►S£�( �1� 01��
So�v 1� �o�„��ttivc¢,� �O ��Pr�ra�r+��1� j�d5
Form RW-O2 rev.10/11/2011 1 PSgB 1 Of 2
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Oath of Personal Representative ���us�oniy�:_ - ;,�
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COMMONWEALTH OF PENNSYLVANIA } --`" `= — �'
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COliNTY OF } ``��` - '
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Petitioner(s)Printed Name Petitioner(s)Printed Address � ` " '
�e �, 1/(ll/l �?9�S �D�"rl�tl/t V l�l..( �� /`� l,.°'/C7Vil� /'/`�=�'7�,� r�
So _ �tvt, Q 3 o s C s��( w5 61`f`f�
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 Personzl Representative(s)of die Decedent,tlie Petitioner(s)will well and truly adrpinister the estate according to law.
Sworn to ar :f ined a s�bsc:ibed before . Date���l��
me th�s ��a of , ` Date
By: � Date
F theTegister - Date
BOND Required:Q YES ❑NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letter . . . . . . . . . . . . . . . . . . . . . . $ �O O� Attorney Signature:
( �yShort Certificate(s). . . . . . �'_L'0 fj
( )Renunciation(s).. . . . . . . . �J ,� �
( )Codicit(s). . . . . . . . . . . . . �i
( )Affidavit(s).. . . . . . . . . . . F,
Bond.. . . . . . . . . . . . . . . . . . . .. . . Printed Name: �
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Commission. . . . . . . . . . . . . . . . . . Supreme Court O e��--� �
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Other . . . . . . ID Number: U �p
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. . . . . . Firm Name: �� �
. . . . . . � Address: p� �
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Automation Fee. . . . . . . . . . . . . . . i� Fax:
JCS Fee. . . . . . . . . . . . . . . . . .. . . � Email•
TOTAL. . . . . . . . . . . . . . . . . . . . . $ '�I')D
DECREE OI' THE REGISTER
Estate of I �Q� �� File No: Z�' �J /��
_ �7"! T—
a/k/a:
AND NOW, �������''��(i�-� 1� , �v/� , in consideration f the foregoing Petition,
satisfactory proof having been presented before me,IT I�nF. ED t t et rs � � �
are hereby granted to �� � /—
� {�/� i e above estate and(if applicable)that
the instrument(s)dat
described in the Petition be admitted to probate and filed of rec d as the last Will (and o icil(s))of Decedent.
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Regi ter of Wills �
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