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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:
Janet Moyer
Decedent's Information
Name: Carl Edward Moyer File No: 21-14 '{
ciy
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 06/02/2006 Age at Death: 54
Decedent was domiciled at death in Cumberland County, PA (state)with his/her last
principal residence at 42 Mountain View Terrace,Newville 17241 Newville Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at Lehigh Valley Hospital Salisbury Township Lehigh 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 $ 15 000.00
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 $ 15,000.00
Real estate in Pennsylvania situated at
(Attach additional sheets,if necessary.)
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)that he/she/they is/are the Executor(s)named in the Last Will of the Decedent,dated G`- arCiMlicil(s)
thereto dated C3 t�7- trf
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-1 a C7
State refevant circumstances(e.g.,renunciation,death ofexecutor,etc.) X Cts r"I M
Except as follows:after the execution of the instrument(s)offered for probate,Decedent did not mar was not div„„or�ced Was nota part-Ao9a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§§3323(g),an lr dict not have a childc�.ortx),lr
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. t,� -0 `-r1 `n
NO EXCEPTIONS ❑ EXCEPTIONS ' r
® B. Petition for Grant of Letters of Administration (If applicable) r r—
ata.,d.b.n.,d.b.n.c.t.a.,pedente lite,durante abser tom' ;durant�e rW”itate
If Administration,c.t.a ord.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 pending divorce proceedingwherein 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 adudicated an incapacitated person.
®NO EXCEPTIONS [] 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
Janet Moyer Wife 42 Mountain View Terrace
Newviile PA 17241
Form RW-02 rev.10-11-2011 Copyright(c)2011 form software only The Lackner Group,Inc. Page 1 off22
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF Cumberland
Petitioner(s)Printed Name Petitioner(s)Printed Address
Janet Moyer 42 Mountain View Terrace
Newiville,PA 17241
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,,The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are true and correct to the best of tNd1nowIedg?1nd
belfef of Pefitioner(i),and that,as Personal Representative(s)of the Decedent,Petitioner(s)will well and truly administer the estate according to law.
Sworn to or ffirmed and subscribed before Date
me 'g day of Date'DT'U'y)b2
By, Date
fzp )6�prj-u Date
Date
BOND Required? � YES rX1 NO To the Register of Wills:
tA
FEES: Please enter my appearance by my signature below:
Letters....... ............. ....... $ 60.00 Attorney Signature:
I )Short Certificate(s)......... 5.00
)Renunciation(s).,............
)Codicil(s)........................
)Affidavit(s)........I.......... Printed Name: George F Douglas,III Esq.
Bond.... ........._..........._.............. Supreme Court
Commission.................................. ID Number: 61886
Other Inheritance Tax 16.00
JCP 35.50 Firm Name: Salzmann Hughes,P.C.
Automation Fee 6.00 Address: 364 Alexander Spring Road,Suite I
I S\ALL fu'A-f _t5,CSS
Carlisle,PA 17016
Phone: 717-249-6333
Automation Fee............................
JCS Fee...................................... Fax:
TOTAL......................... .............. $ 01Z0 5th E-mail: gdougias@salzmannhughes.com
DECREE OF THE REGISTER
Date of Death: 06/0212006
Social Security No: cr
Estate of Carl Edward Moyer File No: 21-14 —
a/k/a:
AND NOW, M.L-0-It' 19 ZO...f S.. in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to Janet Moyer
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 Decede6t.'
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