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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: Betty J.Adrian File No: p2 a 1,3
a/k/a: Betty Jane Adrian (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: December 3,2014 Age at death: 87
Decedent was domiciled at death in Cumberland County, Pennsylvania (State)with his/her last
principal residence at 100 Mount Allen Drive, 17055 Mechanicsburg,Upper Allen Township Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 100 Mount Allen Drive, 17055 Mechanicsburg,Upper Allen Township 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 $ 250,000.00
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. . . . $ 250 000.00
Real estate in Pennsylvania situated at:
(Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County
Q A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)averts)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated January 30,2012 and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciation,death gfexecutor,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 Q EXCEPTIONS
Q B. Petition for Grant of Letters of Administration (If applicable)
c.t.a.,d.b.n., d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate
If Administration,ca.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.
Q NO EXCEPTIONS Q 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 Addressn
G7 CJ
i7 C�
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to �.
a{ N rn
Form RW-02 rev. 10/1112011 Page I of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Barbara Adrian 26 E.Main Street P.O.Box 66 Richland PA 17087
Gail F.Lockhart 872 E. Simmons Road,Port Angels,WA 98362
The Petitioner(s)above-named swear(s)or affirm(s)the statements it the foregoing Petitio re true and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of theDeced t,th Petitioner(s) '1 ell and truly administer the estate accordi g to la
Sworn to o fied d subscribed before Date
me thi g f f ` Date
By: Date
F t e Register Date
BOND Required: ® YES (a NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . S 310.00 Attorney Signature:
( 4) Short Certificate(s). . . . . . 20.00
( ) Renunciation(s).. . . . . . . .
( ) Codicil(s). . . . . . . . . . . . .
( ) Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: James K.Noel,IV,Esquire
Commission. . . . . . . . . . . . . . . . . . Supreme Court v-i ;�u m
Other . . . . . . . . ID Number: 60332 rTt C7
Comm.to take oath . . . . . . . 20.00
File Inh Tax Return 15.00 Firm Name: McNees Wallace&Nurtek
File Inventory . . . . . . . . 15.00 Address: 570 L.ausch Lane,Suite 200 ' �' rn M t rr7
Will . . . . . . . 15.00 I.nncacter,PA 1�7601-3057
. . . . . . . .
717.581.3709
. . . . . . . . Phone: '_� �� rd f'—" M
Automation Fee. . . . . . . . . . . . . . . 5.00 Fax: 717.260.1767
JCS Fee. . . . . . . . . . . . . . . . . . . . . 35.50 Email: Tnnelnmwn com
TOTAL. . . . . . . . . . . . . . . . . . . . . S 435.50
DECREE OF THE REGISTER !! ff nnnn�
Estate of Betty J.Adrian File No: _�, - `l ' 1 a0�
a/k/a:
AND NOW, 19QMn ,in consideration of the foregoing Petition,
satisfactory proof having been presenbefore me,I IS DECREED that Letters Testamentary
are hereby granted to Barbara Adrian and Gail F. Lockhart
in the above estate and(if applicable)that
the instrument(s) dated January 30,2012
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))of Decedent.
Register o ills
Form RW-02 rev. 10//11201/ J dtl b) Page 2 of 2
Oath of Personal Representative Official Usc Only
COMi%40NWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OFCV N\Q AYr la f3d }
Petitioner(s)Printed Name QQ Petitioner(s)Printed Address
l L ,� X— 7,2J Odl
r >2 s W 9836
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 DecedentAthe Peetytitioner )will w II and truly administer the estate according to law.
Sworn to or affirmed and subscribed before Date
me this 13 a , •20�t'S Date
Date
F r eRe ter vPeitivd Zo' vii' Ti�d�e ate U
BOND Required: (D YES (E) NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ 310.00 Attorney Signature:
( 4)Short Certificate(s). . . . . . 20.00
( )Renunciation(s).. . . . . . . .
( ) Codicil(s). . . . . . . . . . . . .
( ) Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: James K.Noel,IV,Esquire
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other . . . . . . . . ID Number: 60332 ry
Comm.to take oath . . . . . . . . 20.00 rri
File Inh Tax Return . . . . . . . . 15.00 Firm Name: McNees Wallace&Nur�t PCS
File inventory . . . . . . . . 15.00 Address: 570 Lausch Lane Suit "t7
Will . . . . . . . . 15.00 Lancaster,PA 17601-30511 s
—;—�Tt
?.
. . . . . . . . Phone: 717.581.3709 n r, -70a Q
Automation Fee. . . . . . . . . . . . . . . 5.00 Fax: 717.260.1767 2E --
!~ r=
JCS Fee. 35.50 Email Tnnem�+m rnm Z fil
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 435.50 cf) p
t—s
DECREE OF THE REGISTER
Estate of Bettv J.Adria File No:
a/k/a:
AND NOW, , in consideration of the foregoing Petition,
satisfactory proof having been presented before ine,IT IS DELetters Testamentary
are hereby,granted to Barbar!Adrian�an .Lockhart
in ove estate and(if applicable) that
the instrurnent(s) dated January 30 2012
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))o ent.
Register of Wills
Form Rtd1-02 rev. 10/l1/2011 Page 2 of 2