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HomeMy WebLinkAbout08-31-14 \ . PETITION FOR/ GRANT OF LETTERS REGISTER OF WILLS OF GI.�- 6Q'ria.,h 4 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: B 0.4- ,,,..4.--&iF-(Q 4 I e...1-- File No: a/k/a: (Assigned by Register) a/k/a: Social Security No: Date of Death: /61, 12 ) b r /f Age at death: ( l Decedent was domiciled/at death in # ., : i 0 County, (State)with his/her last principal residence at 7 G 6 hilt t►i rnP, AY-e-,) Apt, 1 - . lite,. it _7• —, ,* [avid Street address,Post Office and Zip Code J City,Tow f' ip or I orough County Decedent died at . e- 6 _ Med10.4 Cert-{pf- ?A 17630 (� Street address,Post Office andOp Code City,Townshi1 or Borough } County Stat LK PAEstimate of value of decedent's property at death: 15 If domiciled in Pennsylvania. All personal property Alf re.)$ .c.5--00-,---- If not domiciled in Pennsylvania. Personal property in Pennsylvani $ If not domiciled in Pennsylvania. Personal property'n County $ Value of real estate in Pennsylvania. CA-- $ 6 TOTAL ESTIMATED VALUE. ... $ �, 00 -- Real estate in Pennsylvania situated at: No 11,e. (Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County V[ A. Petition for Probate and Grant of Letters Testamentary d 1 Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated 'e 1 i and Codicil(s) thereto dated �.1 State relevant circumstances(e.g.renunciation,death of executor,etc.) C s "4:3 fT1 G;1 Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorce, s�t a pagto a d g divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §3323(g),MI npt-have child ben adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. t rn m 'O EXCEPTIONS 0 EXCEPTIONS `.—. Cn o c) 0 B. Petition for Grant of Letters of Administration (If applicable) C.) C--. * c e.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,duraTtte d entia,dufMe nuMriftt*e If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above and complete list of he -11 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. 12k10 EXCEPTIONS El 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,if necessary): /Vert Name Relationship Address Form RW-02 rev.10/11/2011 • Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF • Petitioner(s)Printed Name Petitioner(s)Printed Address Zv4(.v\ , AR:v>ita-e r- Sr; /6-5 t r Td,, Zl`lLr4 7 jTA- 17©/ 7 The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are t e and correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the De edet the Petitio ier(s)will w Il and truly administer the estate according to law Sworn to o affirmed a I subscribed before Date 0 V me / day of ail At , Mt/ Date e=i, By:W ` /LQ_f MT/ rn ` Date C7 For the Register =I Date '� ro � cr)rot � �,. r— N m rn BOND Required: I S ❑NO To the Register of Wills: a c' FEES: Please enter my appearance by my situ`re'below-to - •"r1 om" q Letters $ Attorney Signature: C7 ( )Short Certificate(s) - rn Imo- -+ ( )Renunciation(s). "*1 ( )Codicil(s). ( )Affidavit(s) • Bond. Printed Name: Commission Supreme Court Other ID Number: • Firm Name: Address: Phone: Automation Fee. Fax: JCS Fee. Email: TOTAL $ DECREE OF THE REGISTER Estate of File No: a/k/a: AND NOW, , , in consideration of the foregoing Petition, satisfactory proof having been presented before me,IT IS DECREED that Letters are hereby granted to 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 the last Will(and Codicil(s)) of Decedent. Register of Wills Form RW-02 rev. 10/11/2011 Page 2 of 2 n Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF } Petitioner(s)Printed Name Petitioner(s)Printed Address The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are t e and correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the De�edei the Petitio ter(s)will w Il and truly administer the estate according to laZzca/V Sworn too affirmed a subscribed before Date met day of �/� Date :10 By qA e" Date For the Reggister *;U Date C a `d G7 Cn i N P'E'I BOND Required:&YIrs-10 NO To the Register of Wills: FEES: Please enter my appearance by my siii tune f;"ew�- lop —n —n Letters . . . . . . . . . . . . . . . . . . . . . . $ iw Attorney Signature: ( 1 )Short Certificate(s). . . . . . r10 r --1 ( )Renunciation(s).. . . . . . . . CD .� ( )Codicil(s). . . . . . . . . . . . . ( )Affidavit(s).. . . . . . . . . . . Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Commission. . . . . . . . . . Supreme Court Other ) . . . . . . . . C ID Number: Firm Name: . . . . .. . . Address: . . . . . . . . Phone: Automation Fee. . . . . . . . . . . . . . . U Fax: JCS Fee. . . . . . . . . . . . . . . . . . . . . Email: TOTAL. . . . . . . . . . . . . . . .. . . . . $ DECREE OF THE REGISTER Estate of �ka� File No: a/k/a: AND NOW } 4 _ O ,—��� in consideration of the foregoing P/etition, satisfactory proof havin been presented before me,IT DECREED that eters A"1'x) are hereby granted to fl_ Gl_t'Yl( l in the above estate and(if applicable) that the instrument(s) dated described in the Petition be admitted to probate and filed of ecord as the last Wil nd Codicil(s))of Decedent. JR gister of Wills, Forni RW-02 rev. 10/1112011 Page 2 of 2 Unlimited Power of Attorney Notice:This is an important document.Before signing this document,you should know these important facts.By signing this document, you are not giving up any powers or rights to control your finances and property your- self.In addition to your own powers and rights,you may be giving another person,your attorney-in-fact,broad powers to handle your finances and property. This unlimited power of attorney may give the person whom you designate (your"attorney-in-fact") broad powers to handle your finances and property,which includes powers to encumber,sell or otherwise dispose of any real or personal property without advance notice to you or approval by you.THE POWERS WILL NOT EXIST AFTER YOU BECOME DISABLED,OR INCAPACITATED.This document does not authorize anyone to make medical or other health care decisions for you. If you own com- plex or special assets such as a business, or if there is anything about this form that you do not understand,you should ask a lawyer to explain this form to you before you sign it.If you wish to change your unlimited power of attorney,you must complete a new document and revoke this one.You may revoke this document at any time by destroying it,by directing another person to destroy it in your presence or by signing a written and dated state- ment expressing your intent to revoke this document.If you revoke this document,you should notify your attor- ney-in-fact and any other person to whom you have given a copy of the form.You also should notify all parties having custody of your assets.These parties have no responsibility to you unless you actually notify them of the revocation.If your attorney-in-fact is your spouse and your marriage is annulled,or you are divorced after sign- ing this document,this document is invalid. Since some 3rd parties or some transactions may not permit use of this document,it is advisable to check in advance,if possible,for any special requirements that may be imposed. You should sign this form only if the attorney-in-fact that you appoint is reliable, trustworthy and competent to manage your affairs.This form must be signed by the Principal(the person appointing the attorney-in-fact), witnessed by two persons other than the notary public, and acknowledged by a notary public. I, 361440(-6-c, , of be,fektpitei "6 4Lei AV -- A c 1) City of Pp State of ,as Principal, ^�- do appoint ..l P� YL �1✓I,ra62.-P" ,of I cs I 3 ai.t City of Fra i<t Ian , State of S j` -bai- ) ?,4 / 7D/`�' , as my attorney-in-fact to act in my name,place and stead in any way which I myself could do,if I were personally present, with respect to,all the following matters to the extent that I am permitted by law to act through an agent: I grant my attorney-in-fact the maximum power under law to perform any act on my behalf that I could do personally, including but not limited to,all acts relating to any and all of my financial transactions and/or business affairs includ- ing all banking and financial institution transactions,all real estate or personal property transactions, all insurance or annuity transactions, all claims and litigation, and any and all business transactions. a..l If the attorney-in-fact named above is unable or unwilling to serve,then I appoint $n' . f ,of I 4-5 Br-00 'c (De)bra ok /1414--,), City of M.e,dti,gyt4 e 5 11) �— , State of -PA 6 7DST ,to be my attorney-in-fact for all purposes hereundYr. • My attorney-in-fact is granted full and unlimited power to act on my behalf in the same manner as if I were person- ally present. My attorney-in-fact accepts this appointment and agrees to act in my best interest as he or she considers advisable.To induce any third party to rely upon this power of attorney,I agree that any third party receiving a signed copy or facsimile of this power of attorney may rely upon such copy, and that revocation or termination of this power ALFP126 Unlimited POA Pg.1 (03-13) of attorney shall be ineffective as torsuch third party until actual notice or knowledge of such revocation or termina- tion shall have been received by such third party. I, for myself and for my heirs,executors, legal representatives and assigns, agree to indemnify and hold harmless any such third party from any and all claims that may arise against such third party by reason of such third party having relied on the provisions of this power of attorney.This power of attor- ney shall not be effective in the event of my future disability or incapacity. This power of attorney may be revoked by me at any time and is automatically revoked upon my death. My attorney-in-fact shall not be compensated for his or her services nor shall my attorney-in-fact be liable to me,my estate,heirs, successors,or assigns for acting or refrain- ing from acting under this document,except for willful misconduct or gross negligence. Signature and Declaration of Principal I,V 3 et+19 cura, F ( ,the principal, sign my name to this power of attorney this______ day of A-141/4..al and,being first duly sworn, do declare to the undersigned authority that I sign and exf'cute this instrument as my power of attorney and that I sign it willingly,or willingly direct another to sign for me,that I execute it as my free and voluntary act for the purposes expressed in the power of attor- ney and that I am eighteen years of age or older,of sound mind and under no constraint or undue influence. If I ,b e_o v p v e, ckceazezi) x Signatureci r4ri. Goa'Alt) Toil et Mcoihaker- I ,. •6-. . ) --470_,Iroct le., 6)-tt)h Witness Attestation diS,b 6-4 4: I Alt, le,s- f'TL- 5JO_)- ,the first witness, and I, Aki1 T© `fie , the second itness, sign my name to the regoing power of attorney being first duly sworn and do declare to the undersigned authority that the principal signs and executes this instrument as his/her power of attorney and that he/she signs it willingly, or willingly directs another to sign for him/her, and that I,in the presence and hearing of the princi- pal, sign this power of attorney as witness to the principal's signing and that to the best of my knowledge the principal is eighteen years of age or older,of sound mind and under no constraint or undue influence. 4,11.11 , t Aie-- .. -__ (7,j 9"1/45.:‘r, 74 oS Signatu of First Witness S gnature of Sec. d mess 'X` 'o 14e7 ) 3 —1 et- ii-14 Notary Acknowledgmentoo 'u State of -er e\b- 0,-e; Q,,. County of---N�-�+ ;/1 ' © o C' 3 ni Subscribed,sworn to and acknowledged before me by _ __l.�' .�, ,�e. ,,th 0 cipal, ( , and subscribed and sworn to before me by Irr� I--\-40 9.0 ,-i rf i ss,thi day of ) ----)C���� yl-- P� f–A U - Notary Signature J COMMONWEALTH OF PENNSYLVANIA Notary Public, Notarial Seal ! Dorothy Miller,Notary Public In and for the County of�(). ...,p1-"N ,-----) Derry Twp.,Dauphin County - My Commission Expires April 25,2016 State of?-�✓N.e 5-..\\V pw1F MEMBER.PENNSYLVANIA ASSOCIATION OF NOTARIES ../ My commission expires: Seal -N