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Home My WebLink About06-02-14 _ PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF ��, :1A ha�l a n � 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 /�� I r' � O�� Name• �.C' " Q �� nf ��'S� FileNo• `� a/k/a: (Assigned by Register) a/k/a: a/k/a. Social Security No: /� Date of Death: � � '��-' Age at death: 93 Decedent was domiciled at death in C,� u�t County, C-s� s var+�rA (srure)with his/her last principal residence at ,�s �` 1.—,v t�e LE a � i- z L� � � �, n Street address,Post Office n Zip Code City,To�vnshi or Borough County � C�+r�t.{� l-�ti l 1 "N � Decedent died at �� i � � - �a � E'°1` n Street address,Post OfFce an ip Code ity,Townshi or Borough County State Estimate of value of decedenPs property at death: If daniici[ed in Pennsy[vania.......... ...... ............ All personal property $ � `i�� If not domiciled in Pennsylvania. ....................... Personal property in Pem�sylvania $ If not domiciled in Pennsy[vania. ....................... Personal property in County $ �-- l�alue of rea!estate in Pennsy[vania................. ........................... ............. $ ;�(J•_�"" TOTAL ESTIM TED V L�. ... $�� '" � / �/ �_/ � Real estate in Pevnsylvania situated at: ��5� �TIT�l�G-t7� "°1�i �✓'K�d'' h � �� S (Attnch ndditional sheets,i(necessary.) Street address,Post Offce and Zip Code J� City,Township or Borough � County � s � rn ❑ A. Petition for Probate and Grant of Letters Testamentary � c� � � c� Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated � C -'�a�id�dicil(s) thereto dated r'7 '"" n � '"' %� ly � r-r-; r�"1 State relevant circumstances(e.g.renunciation,death of exec�dor,etc.)�„ � , � -°a � -.. t"7 ;;�: c.;'� C� Except as follows: after tl�e execution of the instrument(s)offered for probate Decedent did i�ot marry,was nbt�divarc�,was,�a part�t ending divorce proceeding wherein the grounds for divorce i�ad been established as defined in 23 Pa.C.S. §33�g�n'�Hid ave�t�thi�born or adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. : � � �- � �NO EXCEPTIONS ❑EXCEPTIONS � � r n CA Q _ 17 "' �B. Petition for Grant of Letters of Administration (If applicable) c.t.u.,d.b.n., d.b.n.c.t.u.,pendente lite,durun[e 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 �EXCEPTIONS Petitioner(s),after a proper search has/have ascertained that Decedent left no Will aud was survived by tlie following spouse(if any)and heirs(attuch udditionul sheets,i�necessury): Name Relationshi Address �� (t�'Q��`S ,.S� �� k[��c:X.^c. � �..L�`M t3 `n E- U l �, . +�j ( � � � �pn. � S£7 � CJ �C W°�Il�V�'�- G,hn��x 4�'I _ � _.__..,____� �-- ��g76 C�.._�._.....,.._.... _ f Fo,�,��Rw na ��.inirtiZO�i �Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } COUNTY OF C.c��nn �C'f�'� U'✓1� } Petitioner(s)Printed Name Petitioner(s)Printed Address �� 1�--�� -c S �cr. L>��o- - t� �a . The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are true aud correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the De nt,the e' ioi er(s)will well and truly administer the estate according to►aw. Swo-i to or�firmed and subscribed before Date �% m thi day a`` � , �/�� Date h � �� Date Fo�•Ihe Rc-�ister Date BOND Require . Y O To t/ae Register of Wills: FEES• � Please enter my appearance by my signature below: Letters . . . . . . . . . . . . . . . . . . . . . . $ � Attorney Signature: ( � ) Short Certificate(s). . . . . . Q ( ) Renunciation(s).. . . . . . . . � � � � � � ( )Codicil(s). � � � � ( )Affidavit(s).. . . . . . . . . . . m -� � --_ � Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: � -'- �' �` w'� � Commission. . . . . . . . . . . . . . . . . . Supreme Court r" � T-r, ��'i �'�"i pther ID Number: � �"� �, � ��3 � ..�� r. '' _y . � � � � �� . . . . . . . . � Firm Name: <� c� -r � _ "�'1 . . . . . . Address: � --i . . . . . . . . � V1 � , , , , , , , Phone: Autotnation Fee. . . . . . . . . . . . . . . �� Fax: JCS Fee. . . . r Email: . . . . . . . . . . . . . . . TOTAL. . . . . . . . . . . . . . . . . . . . . $ ` DECREE OF THE REGISTER ^ E�tate of ��C` �1� S �___ FileNo: �� `�� " a/lc,�a: AND NOW, � Q- ,C-�7'�� in cons'de ation of th fore ing Petition, satisfactoiy proof having been sen d before me,IT I EC�E that Letters �Ct_ _ are ereby granted to 'I'1�- i_ e 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 j) c:Decedent. ( �� ll � - �� Register of Wills\�f�� ,�/',�/� � /r-�,� � �r�� 7' � G'/ L {�'� Form R6V-07 rev. 10/1//20!/ Page 2 of 2 �, .�.� ,�� -.> 0 c� � � �.�',.� � � C � � � � �..,� � <.'� � -^� 2a C�� 3-,j �� RENUI�CIATION �M �= '=�� N �� =� � `�� ..,.. < , , . �, `�� n .�-, "C7 `.'-3 "�'i � C7 _5� � . �'t GISTER OF WILLS � �= =�� : � rv r- rn u�> COUNTY, PENNSYLVANIA � --� � v c� -•1 Estate of �t�G� ��'" Y�'d-�`.� ,Deceased I, �(J �I��CE.�1, �' (��l`� , in my capacity/relationship as (Prrnt NameJ �� '�. of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to t�'S o� �t_ .Q �.� `�e.�`.� — . S �6��Y �` �. (Date) (Si ature) �,o d' /�a ��u1 �� 6G�r� (Slreet AddressJ c�l/I.�"L G�Y7 C<C�I �Q- `'�'' /et `Z �� (Ciry,Stare.Zip) Executed in Register's Office Executed out of Register's Offzce 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 �Yecuted the renunciation for the purposes stated within on this �16�,l+ day of� , Zat<< Deputy forRegister of Wills ublic My Commission Expires: Z�y�T (Signature and Seal of Notary or other official quali5ed to administer oaths. Show date of expiration of Notary's Commission.) �OINMONWEALTH OF PENNSYLVANIA �� Notarlal5eal Jas�n Marks,Notary Publ;c Cit��of Sunbury,Northumberland County Form RW-06 rev.10.13.06 My Commissfon Expires Feb.4,2017 �_��._