HomeMy WebLinkAbout02-02-15 PETITI N FOR(;RA
NT OF LETTERS
REGISTER OF WILLS OF M,V zeC 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 File No: p
Name: r1)� _ 15-
1�
Uti��,�` � �`��
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: ?
Date of Death: I ljo Age at death: :
Decedent was domiciled at death in County, (state)with his/her last
principal residence at L �Q'�
Street address,Post Office and�Ziipp Code City,Tow ship r Borough ^ L �unty
Decedent died at 1 (� fj �' 1't mow �/i1M� S� ?� flt/•V
Street address, an-VZip Code City,Township or Borough County State
Estimate of value of decedent's property at death:
If domboo
in Pennsylvania............................ All personal property $ ` ! o O
If not domiciled in Pennsylvania. .............. ......... Personal property in Pennsylvania $
If riot domiciled in Pernnsylvania. ....................... Personal property in County $
Value of real estate in Pennsylvania......................................................... $
TOTAL ESTIMATED VALUE. ... $ C
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 and Codicil(s)
thereto dated
State relevant circumstances(e.g.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 born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
NO EXCEPTIONS ❑EXCEPTIONS
N<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,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.
>KO
EXCEPTIONS M EXCEPTIONS
Petitionerus),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse(ifany)and heirs(attach
additional sheets,if necessary):
Name Relationship Address
RECORDED OFFICE OF
REGISMROFWl1- S
2015 FEB 2
Form RW-02 rev.1011112011 CLERK OF ORPHANS'COURT~—.,
CUMBERLAND COpage 1 of 2
UNI Y(>
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s)Printed Name Petitioner(s)Printed Address
bS r
The Petitioner(s)above-named swear(s)or affirm(s)the statements in th for oirC Petition are true and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of the Deceden, he etif ne (s)will well and truly administer the estate accoling t law.
Sworn to or affirmed and subscribed before Date 21 21 s
me thisf day oLf ,� Date
By: Date
For the Register Date
BOND Required:Q YES ❑NO To the Register of Wills:
FEES: h Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . Attorney Signature:
( 1 )Short Certificate(s). . .. . . S
( )Renunciation(s).. . . . . . . .
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name:
Commission. . . . . . . . . . .. . . . . . . Supreme Court u, O
Other InV . . . . . . . ID Number: iLj O U
. . . . . . Firm Name: 08
. . . . . Address:
0UQO
Phone: U
U
Automation Fee. . . . . . . . . . . . . . . Fax:
JCS Fee. . . . . . . . . . . . . . . . . . . . . Email:
TOTAL. . . . . . . . . . . . . . . . . . . . . $ C'D:,C�
DECREE OF THE REGISTER
Estate of Danic) [�BJ Mcolr e, File No:
a/k/a: �—^ t�
AND NOW, 1 cIJ�(. " ��' , 205 inco ideration of the fo e.goit Petition,
satisfactory proof having been presented efore me,IT IS DECREED that Letters m(i1 '�
are hereby granted to m is ae ` jcC.
in the above estate and(if applicable)that
the instrument(s)dated n(CL,
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s)) of Decedent.
V'1_'0 CL kk mlau a(A)
e sten of W lis
Form RW-n2 rev. 10/1112011 a e 2 of 2
I
t
RENUNCIATION w
REGISTER OF WILLS o 4w, H
v vn b e l2�cr' COUNTY, PENNSYLVANIA � o
NOO
U
U
Estate of a'n 1 e n (n; �1 �U f�-- ,Deceased
Iy S a j" \ ' C r' , in my capacity/relationship as
���t Name)
O .
of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
k I (-k&e- 1 A , Rao Cc
1221 Sr OA,,,--* , dAl�'
(Date) /`
4 v 1 S^` I ` � S t-
(StrtteeAddress)
Ale,�J
(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 2— day
of Zb i
Deputy for Register of Wills Notary Public
My Commission Expires:3t � 2-01
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVA IA
NOTARIAL SEAL
Ashley Rhoads,Notary Public
Form RW-06 rev.10.13.06 Lower Allen Twp.,Cumberland County
My Commission Expires July 9,2018
MEMBER,PENNSYLVANIA ASSOCIATION OF NOTARIES'