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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 request(s)the grant of Letters in the appropriate form:
Decedent's Information
Name: BABY GIRL DULAM-KASIREDDY File No: -7�- �` t Y-5
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: September 29,2013 Age at death:
Decedent was domiciled at death in Cumberland County,Pennsylvania (State) with his/her last
principal residence at 416 Meadow Drive,Camp Hill, PA 17011 Wotmlevsbura Borough Cumberland
Street address,Post Omce and Zip Code City,Township or Borough County
Decedent died at INOVA Fairfax Hospital,3300 Gallows Road Falls Church Fairfax VA
Street address,Post Office and Zip Code City,Township or Borough County State
Estimate of value of decedent's property at death:
if domiciled in Pennsyl vania.. .. ... . .................... All personal property $ 1,000.00
If not domiciled in Pe nnsy lvania. ... .................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. i...... .—*.......— Personal property in County $
Value of real estate in Pennsylvania... . . . ... . ............. .... ........ ......... ............. $
TOTAL ESTIMATED VALUE. ... $ 1.000.00
Real estate in Pennsylvania situated at: NONE
(Attach additional sheets,if necessary,) Street address,Post Office and Zip Code City,Township or Borough County
El A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)averts)he/she/they is/are the Exceutor(s)named in the last Will of the Decedent,dated and Codicil(s)
thereto dated
State relevant circumstances(as.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 bom or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
ONO EXCEPTIONS ()EXCEPTIONS
® B. Petition for Grant of Letters of Administration (if applicable)
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durance absentia,durance 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.
O NO EXCEPTIONS O 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
additional sheets, ifnecessary):
Name Relationship Address
Bharath Kasireddy Father 416 Meadow Drive
Camn Hill PA 17011 _-)
Mrudula Dulam Mother 416 Meadow Drive
C,
Camp Hill-PA 17011 -O ^-__ C CD
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_ o CD
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Form RW-02 rev. 10/l!/2011 Pad>I Of 2
Oath of Personal Representative official Use only
COMMONWEALTH OF PENNSYLVANIA )
} SS:
r-o
COUNTY OF CUMBERLAND ) n
Petitioner(s)Printed Name Petitioner(s)Printed Address 0j't,
Bharath Kasireddy 416 Meadow Drive Camp Hill PA 17011
CD
�— .O
CA
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 Decedent,the;-P7etitioner(s)Iwill well and truly administer the estate accord' g to law.
Sworn to or affirmed an subscribed before'L ^ '�`,C1hO T� Date 08 I Oc p 19
me this/ day'of -1, Z6� 1 Date
By: Date
For the Register Date
BOND Required: Q YES Q NO To the Register of Wiits:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ 20.00 Attorney ' nature:
( 2 ) Short Certificate(s). . . . . . 10.00
( I ) Renunciation(s).. . . . . . . . 5.00
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Thomas F. Smida, Esquire
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other Inventory . . . . . . . . 15.00 ID Number: 37027
Inheritance Tax Return . . . . . . . . 15.00
. . . . I . . . Firm Name: METTE, EVANS&WOODSIDE
. . . . . . . . Address: 3401 North Front Street
. I . I . . . . PO Rox 5950
. . . . . . . . Harrisburg,PA 17110-0950
. . . .. . Phone: (717)232-5000
Automation Fee. . . . . . . . . . . . . . . 5.00 Fax: (717)236-1816
JCS Fee. . . . . . . . . . . . . . . . . . . . . 35.50 Email: tArmcla(i4mette,com
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 105.50
DECREE OF THE REGISTER
Estate of BABY GIRL DULAM-KASIREDDY File No: I
a/k/a: o
AND NOW, 1 U� , O Q in consideration of the foregoing Petition,
satisfactory proof having 6ebri presented before me, IT IS DECREED that Letters of Administration
are hereby granted to Bharath Kasireddy
in the above estate and (if applicable)that
the instrument(s) dated ' 1
described in the Petition be admitted to probate and filed of record as the last Will(and Codici)(s)) of Decedent.',
Register of Wills nn
Form RW-02 rev. 101111201 - Page 2 of 2
7
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Co- i (7
Co L _ C G%r�
T[-' r-
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA '' — FT-1
y F- 6
Estate of BABY GIRL DULAM-KASIREDDY Deceased
1, Mrudula Dulam in my capacity/relationship as
(Print Name)
Mother of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Bharath Kasireddy
DS � 19 2014
(Dare) (Si8^a/ore)
416 Meadow Drive
(Street Addremm)
Camp Hill PA 17011
(city,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
purposes stated within on this day
of
Deputy for Register of Wills Notary Pu lic
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
DONALD TRAUBE
733169vt Notary Public
Form RW-06 rev. !013.06 LEMOYNE BOROUGH,CUMBERLAND COUNTY
My Commission Expires Jun 3,2017