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PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland COUNTY,PENNSYLVANIr'�' ;z�
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Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters a�a�s�a:�cified�low;..'.a� in
support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appr.�pr�'ate,.forr� ��
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Decedent's Information : � � 4�}
Name: David Rav Wilson File No:��'���2�1 ' ` � � "�
a/k/a: David Wilson (Assigned by,l�i�er)� =-�
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a/k/a: l�avid R Wilson ' � �"' �� ��
��a: Social Security No: �?0=(sb-2433 �� r�� o
Date of Death: 03/20/2014 Age at death: 41 �' -�
Decedent was domiciled at death in Cumberland County, PA (State)with his/her last
principal residence at 69 W.Main Street A t.#6 Mechanicsbur Cumberland Coun PA 17055 coun
Street address,Post Oftice and Zip Code City,Township or Borough �'
Decedent died at Intersection of York Road and Old Stone House Road Moneroe Townshin Cumberland Countv PA
Street address,Post Office and Zip Code C�ty,Townsh�p or Borough County State
Estimate of value of decedent's property at death: $ 500.00
If domiciled in Pennsylvania............................ All personal property
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. ....................... Personai property in County $ ���
Value of real estate in Pennsylvania.............................................
TOTAL ESTIMATED VALUE. ... $ 500.00
Real estate in Pennsylvania situated at: NONE Coun
Street address,Post Office and Zi Code City,Township or Borough tY
(Attach additional sheets,ifnecessary.) p
❑ A. Petition for Probate and Grant of Letters TestamentarV and Codicil(s)
Petirioner(s)aver(s)he/she/they is/are the Executor(s)named in the last W�II of the Decedent,dated
thereto dated
State relevant circumstances(e.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 divoand did not ha ea a child boml og
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323(g),
adopted;and Decedent was neither the victim of a kiliing nor ever adjudicated an incapacitated person.
�NO EXCEPTIONS o EXCEPTIONS
� B. Petition for Grant of Letters of Administration (Ifapplicable)
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.
�NO EXCEPTIONS o EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the foliowing spouse(if any)and heirs(attach
additional sheets,if necessary):
Name Relationshi Address
Karen R Wilson Mother 4115 Rosemont Avenue
Cam Hill PA 17011
Kerry L Wilson Father 12 Hartzdale Drive
Page 1 of
Form RW-02 rev.l0/II/2011
1
v� � Official Use Only
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cambria }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Karen R.Wilson 4115 Rosemont Avenue Cam Hill PA 17011
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 Dec dent,the Petitioner(s)will well and truly administer the estate�or�g���•
1
Date
Sworn to r firmed sub ' ed b ore Date
me th' �d Y Q � f� Date
By: Date
F t Register
BOND Required: Q YES � NO
To the Register of Wills:
Please enter my appearance by my signature below:
FEES:
�DD Attorney Signature: ,
Lett�s. . . . . . . . . . . . . . . . . . . . . . $ .0 6 =.'�
( � )Short Certificate(s).. . . . . ��
,p� • �
,._ -
( �)Renunciation(s).. . . . . . . . ; _ `�t "�''
e �-- f •, ..
� �COC11C11�S�. . . . . . . . . . . . . �� —!_3 �,�� C '_
( )Affidavit(s).. . . . . . . . . . . �_ --
Printed Name: _ � �'�
Bond.. . . . . . . . . . . . . . . . . . . . . . . gupreme Court �
Commission. . . . .. . . . . . . . . . . . . ID Number: �Z� � � ^ , ��
Other . . . . . . . �.a c�� -
. . . . . . . � �� �
� . D Firm Name: `~' `'"" �„~ �
�. . . . . . . . �
. . . . . . . . Address: �.T � � •
. . . . . . � �- � — ��
Phone:
Fax:
Automation Fee. . . . . . . . . . . . . . . C6D Email: ` r��
JCS Fee. . . . . . . . . . . . . . . . . . . . . �'�•-6'�
TOTAL. . . . . . . . . . . . . . . . . . . . . $ , • _
/Dy�6
DECREE OF THE REGISTER
File No• ��-�'T+��� —
Estate of David Ra Wilson
aJk/a:
� 2l��_, in consideratio of he foregoing Petit.ipn,0�
AND NOW, n fn "tl
satisfactory proof ha ng been presented befo�anted to IS ECREED t t L tt rs.
are hereby g
in the above estate and(if appl;cable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of re d as the 1 st Will(and C i il(s))of Dece ent.
�.���
eg er of Wills ��
a o�
FormlZW-01 rev.!0/1l/2011
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RENUNCIATION t--- ; `.f,
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REGISTER OF WILLS `�' '=� � '� !'�'
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Cumberland COLJNTY,PENNSYLVANIA ; �� � �� ��
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a� o c�� d
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,Deceased
Estate of David R Wilson
I, Ke L Wilson , in my capacity/relationship as
(Print Name)
Father of the above Decedent,hereby renounce the rig t to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Karen R Wilson
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(Signature)
(Date)
12 Hartzdale Drive
(Street Address)
Camp Hill,PA 17011
(Ciry,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
'-- purpo stated within�n this �0�� day
of ��— �
�
ta Public
Deputy for Register of Wills Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. l0.13.06
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CERTIFICATE OF
REGISTER OF WILLS GRANT OF LETTERS
CUMBERLAND COUNTY ADMINISTRATION
PENNSYLVANIA
, �,
� PA No. 21- 14- 0551
No. 2014- 0055 9
Estate Of: DAVID RAY WILSON
(Fiist,Middle,Lastl
a/k/a: DAVID WILSON DAVID R WILSON
Late Of: CUMBERLAND COUNT OUGH
Deceased
Social Security No: �70-60-2433
WHEREAS, DAVID RAY WILSON
lFirst,Middle,Last1
a/k/a DAVID WILSON DAVID R WILSON
late of MECHANICSBURG BOROUGH CUMBERLAND COUNTY
died on the 20th day of March 2014 and,
WHEREAS, the grant of Letters of Administration
is required for the administration of the estate.
, Re ister of Wills in and
THEREFORE, I, LISA M. GRAYSON, ESQ. g
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day- granted Letters of Administration to:
KAREN R WILSON
who has duly qualified as ADMINISTRATOR (RIX) of the estate
of the above named decedent and has agreed to adrninister the estate
according to law, all of which fully appears of record in my office at
CUMBERLAND COUNTY COURT HOUSE, CARL/SLE, PENNSYLVAN/hand and affixed the seal
IN TESTIMONY WHEREOF, I have hereunto set my
of my office on the 6th day of June 2094.
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST