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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: JEAN M.POET File No: 0� a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: 10/11/2014 Age at death: 92 Decedent was domiciled at death in Cumberland County, Pennsylvania (state)with his/her last principal residence at 10 House Avenue,Camp Hill, 17011 East Pennsboro Cumberland Street address,Post Office and Zip Code City,Township or Borough County Decedent died at Holy Spirit Hospital Camp Hill 17011 East Pennsboro Cumberland PA 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 Pennsylvania............ .. .............. All personal property $ 5,000.00 If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $ If not domiciled in Pennsylvania. ......... .......... .... Personal property in County $ Value of real estate in Pennsylvania.. ....................................................... $ TOTAL ESTIMATED VALUE. ... $ 5.000.00 Real estate in Pennsylvania situated at: (Attach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or Borough County A. Petition for Probate and Grant of Letters Testamentary Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated N/A r., an"bt'Codicil(s) thereto dated Decedent's mother,Helen Todd,died on 10/8/66. Her father,William E.Todd,died on 2/3V50 Her brut r, r„ William F Todd,111,died Her husband,Richard Poet died on 4/l/90 Karen Hollenbush and William'- tdd havexenrnmc�dC� State relevant circumstances(e.g.renunciation,death of executor,etc.) F'1f—T _T7 z � C7 �' Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorced;was nota party o a peni1iiig divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. § 3323(g),and,did hot Have a child boinb�'i adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ...0 , <::") 0 NO EXCEPTIONS 0 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,durable absentia,du; e minoriteW 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 0 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): Name Relationship Address Karen Ann Hollenbush Niece 314 E.Derry Road Hershey,PA 17033 William E.Todd Nephew 3910 Walnut Street Harrisbum.PA 17109 �uh ltl �� Al's-c�. cY97 Form RW-02 rev.10/11/2011 Page 1 of 2 Oath of Personal Representative Official Usc Only COMMONWEALTH OF PENNSYLVANIA I SS: COUNTY OF Aft COA,13&146�&) ) I Petitioner(s)Printed Name Petitioner(s)Printed Address r rz arr 71t J The Petitioner(s)-above-named swear(s)or affirm(s)the statements in the foregoing Petition are true and correct to i�best of the k@61edge and?elief of Petitioner(s)and that,as PersonaMepressentative(s)of thethe Peti 0 )IM 11�anly admintswr thC�e estate ar in W 9ellns n'. " I Sworn t6oraaffirmed subscribed befor co Date Uhte me y of tris By; Mate rri 1`71 or the register :Date BOND Required-.Q YES Q NO To the Register of Wills: rr, FEES: Please enter my appearance by my,signature bele r Letters . . . . . . . . . . . . . . . . . . . . . . $-10)0 Attorney Signature: 5�)Short Certificate(s).... . . 495 Renunciation(s).. . . . . . . . C) Codicil(s). .. . . .. . . . . . . Affidavit(s)... .. .. . . . . . Bond.. . . . .. . . . . . . . . . . . . . .. . . Printed Name: Commission. ... . . Supreme Court -Otber . . . . . . . . ID Number: .2�a2 I Jjy-0 OJEL�\j . .. . ):5 Firm Name: C lex A, 4,e� -- - Address: 76/c— d"t . . . . Phone: 1"7"-12 lfdl Automation Fee. . . . . . . . . . . . . . . Fax: 4(7/7J IV/J-/ 41' ,e JCS Fee. . .. . . .. . .. . .. .. ... . . Email: co 1. TOTAL. . . . . . . . . . . . . . . . . .. . . $ I DECREE OF THE REGISTER Estate of File No: I OU H a/k/a: AND NOW, �JM in consideration of the foregoing Petition, satisfactory proof having been presented before me,IT IS DECREED that Letters ilia,Q are hereby granted tojjan— .. M 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 pp f T Form RW-02 rev. 10/1112011 . UPPage 2 of 2 RECORDEPi OFFICE OF RENUNCIATION REGIS"FF�-� OF VVIUS 2014 NjPU 7 nn I c9 REGISTER OF WILLS C L E i,;; t1;- CUMBERLAND r- CUMBERLAND - COUNTY, PENNSYLVMR,ANS` CCU'01,-J CUMBERL4,:D V Estate of JEAN M. POET Deceased 1, KAREN AIN HOLLENBUSH in my capacity/relationship as (Print Name) NIECE of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to JEAN M. BARRETT 10/21/2014 (Date) (Signal e) 314 E. DERRY ROAD (Street Address) HERSHEY PA 17033 (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 purpose Stated within on this 21st day purpose S" Of Oct er /12014 t Puo Deputy for Register of Wills N Pu y y Commission Commi ssion Expires: 1/27/2017 (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 Kelly P. Roberts, Notary Public Form RW-06 rev. 10.13.06 paxtang Borough, Dauphin County My Commission Expires jonuory 27,2017 'I RECORDED OFFICE OF RENUNCIATION REGIS."TI -DR 0F `11ILLS ?019 NOU 7 Pn .1 59 REGISTER OF WILLS CLEM, OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHtNS' COUIT CUMBERI-Ati-i- CO., !-tt Estate of JEAN M. POET , Deceased 1, WILLIAM E. TODD in my capacity/relationship as (Print Name) NEPHEW of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to JEAN M. BARRETT 10/21/2014 (Date) (Signature) 3910 WALNUT STREET (Street Address) HARRISBURG PA 17109 (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 21 st day of Oct6ber — , 14 j A Deputy for Register of Wills Aaotary Pu�Ohc MyCom My Commi ssion Expires: 1/27/2017 (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 Form RW-06 rev. 10.13.06 Kelly P. Roberts, Notary Public Paxtang Borough, Dauphin County My Commission ExpIres January 27,2017