HomeMy WebLinkAbout07-07-14 PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND 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 requests the grant of Letters in the appropriate form:
Anita D.Thompson
Decedent's Information
Name: Ralph R.Domene III File No: 21-14 �-- �° 7
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 05/26/2014 Age at Death: 47
Decedent was domiciled at death in Cumberland County, pA (State)with his/her last
principal residence at 506 Lamp Post Lane,Camp Hill 17011 Hampden Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 506 Lamp Post Lane,Camp Hill 17011 Hampden Cumberland PA
Street address,Post Office and Zip Code Ciry,Township or Borough Counry State
Estimate of value of decedenYs property at death:
If domiciled in Pennsylvania...................... All personal property $ 20 000.00
Ifnotdomiciled in Pennsylvania................ Personal property in Pennsylvania $
If not domiciled in Pennsylvania................ Personal property in County $
Va/ue of rea/estate in Pennsylvania................................................................... $ 50,000.00
TOTAL ESTIMATED VALUE $ 70,000.00
Real estate in Pennsylvania situated al 506 Lamp Post Lane,Camp Hill 17011 Hampden Cumberland
(AKach additional sheets,if necessary.)
Street address,Post Office and Zip Code Cily,Township or Borough County
❑ A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)aver(s)that 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(e.g.,renunciation,deafh 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.a.,d.b.n..d.b.n.c.t.a.,pedentelite,dur sentia.du min . jt��
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If Administration,c.t.a or d.b.n,c.t.a.,enter date of Will in Section A above and omol t list of h irs. .x'�J���_ _ � ,
Except as follows:Decedent was not a party to.pending divorce proceeding wherein the grounds for divorce had bee [i�Med as,�fined�- ; r--'-;.
in 23 Pa.C.S. §3323(g)and was neither the wctim uf a killing nor ever adjudicated an incapacitated person. �� - � -
�NO EXCEPTIONS � EXCEPTIONS nrY) �.
A •;. ;
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Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spo��(if any)g�heirs fat�h
additiona/sheets,if necessary): -p ..
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Name Relationship Address
Anita D. Thompson Mother 412 North 21st Street
Cam Hili PA 17011
Form RW-02 rev.10.11-2011 Copyright(c)2011 form software only The Lackner Group,Inc. Page 1 of 2
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Official Use Only
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Anita D.Thompson 412 North 21st Street
Camp Hill,PA 17011
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The Petitioner(s)above-named svrear(s)or affirm(s)the statements in the foregoing Petition are true and corre to the best of the knowledge and
belief of Petitioner(s)and that,as Personal Representative(s)of the Decedent,Petitioner(s)will well and tr l dminister the estate according o la .
Date G � �
Sworn to o �i�r;ed subscr' fore Date
me th� dfi �.�� Date
By: Date
th Register
To the Register of Wills:
BOND Required? ❑ YES �ND please enter my appearance by my signature below:
FEES: —� ,A'i
Letters................ . $ (��- Attorney Signature:
( � )Short Certificate(s)......... � �� �tL �,.c/" - ' � �
� )Renunciation(s)..............
( )Codicil(s)........................ • Michael L.Ban
( )Affidavit(s)......................
Printed Name: 9
Bond............................................. Supreme Court 41263
Commission.................................. ID Number:
Other
y� �l � -e� Firm Name: Ban4s Law Office LLC
1�`"�.� Address: 429 South 18th Street
Camp Hiil,PA 17011
Phone: 717/730-7310
Automation Fee............................ C' • ' 717/730-7374
Fax:
JCS Fee....................................... " -^�� E-mail: mikebangs@verizon.net
TOTAL......................................... $ ��X.�
DECREE OF THE REGISTER Date of Death: 05/26I2014
Sociat Security No: 180-54-4382
Estate of Ral h R.Domene ill File No: 21- �7 _
a/k/a:
,�}� �- � ,in consideration of the foregoing Petition,
AND NOW, � '
satisfactory proof having been presented bef re me, IT IS DECREED that Letters of Administration
are hereby granted to Anita D.Thompson
in the above estate and(if applicable)that the instrument(s)dated
described in the Petition be admitted to probate and filed of record as he t tNill(and o icil(s)) f ec�,nt. .
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egister of Wills � �/(J����.,r' �����,����-� � � �
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