HomeMy WebLinkAbout04-23-15 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: Harry W. Burkepile File No: 15-&L 6'-E)
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 04/07/215 Age at death: 88
Decedent was domiciled at death in Cumberland County, Pennsylvania (state)with his/her last
principal residence at 134 Mountain Road Shermansdale. Middlesex Twp Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 801 North Hanover Street Carlisle 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 $ 20000.00
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. .... ........... ...... Personal property in County $
Value of real estate in Pennsylvania......................................................... $ 130900.00
TOTAL ESTIMATED VALUE. ... $ 150900.00
Real estate in Pennsylvania situated at: 134 Mountain Road Shermansdale. Middlesex Tim Cumberland
(Attach additional sheets,if necessary) Street address,Post Office and Zip Code City,Township or Borough County
F1 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 �"'g and Codicil(s)
thereto dated
5 rT1 C->,
State relevant circumstances(e.g.renunciation,death of executor,eta) <D
—0
IF771 17-1
Except as follows:after the execution of the instrument(s)offered for probate Decedent did not marry,was not diyerc _F;nottompffffing
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. § 3323(g),-p ',�id...not haWa child bRn or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. C�l C')
M -rt -1
F]NO EXCEPTIONS FIEXCEPTIONS
C=) r— rn
B. Petition for Grant of Letters of Administration (If applicable) r- ED
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,d0ante absentia,dante minorjtate
If Administration,c.t.a or db.n.c.ta.,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.
ONO EXCEPTIONS MEXCEPTIONS
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
Thomas Burkepile Child 295 Sled Dr.,#7, Shermansdale, PA 17090
Wanda K. Culley Child 132 Mountain Rd., Shermansdale, PA 17090
Form RW-02 rev.1 011 112 0.11 Page 1 of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Thomas Burkepile 295 Sled Drive#7, Shermansdale, PA 17090
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 Decedent tPetitioner(s)will well and truly administer the estate according to law.
Sworn t or affirmed and subscribed before Date 4-
n thi day of Date
By: Date
For the Register z Date
BOND Required:[—]YES E]NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ 2-(DQ Attorney Signature:
( )Short Certificate(s).. . . . .
( )Renunciation(s).. . . . . . . .
( )Codicil(s). . . . . . . . . . . . . { '
( )Afftdavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Mark A. Mateya
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other . . . . . . . . ID Number: 78931
. . . . . . . 15
r�lY T_VY?. . . . . 15 Firm Name: Mateya Law Firm
. . . . . . . . Address: 55 W. Church Avenue
Carlisle PA 17013
. . . . . . . Phone: (717)241-6500
Automation Fee. . . . . . . . . . . . . . . 5 Fax: (717)241-3099
JCS Fee. . .. . . . . . . . . . . . . . . . . . 35.5D Email: mam@mateyalaw.com
TOTAL. . . . . . . . . . . . . . . . . . . . . $
DECREE OF THE REGISTER
Estate of �+ . Burke l File No:
a/k/a:
AND NOW, PnO rI I Q3 ,�« ,in consideration of the foregoing Petition,
satisfactory proof having een presented before me,IT IS DECREED that—Letters
are hereby granted to T1-nr )QS '�.e—yelgLL 6
in the above estate and(if applicable)that
the instrument(s)dated Y) I OL
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent.
%C06L MYM@T
R g' ter of Wills Pgr
Form RW-02 rev.10/11/2011 U Page 2 of 2
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RENUNCIATION
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
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Estate of Harry W Burkepile c-, , Dei-t ceasedi .
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c' � cn �,
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Wanda K Culley in my capacity/relationship asp
(Print Name) `ri
Child of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Thomas Burkepile
(Date) (signature) Wanda K Culley
132 Mountain Road
(Street Address)
Shermans Dale, PA 17090
(City,State,Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and pubscribed Before the undersigned personally appeared the
before me this �3 day party executing this renunciation and certified
that he or she executed the renunciation for the
of , I . purposes stated within on this day
of
(��
J ,
L aml
Deputy for Regi ter of Wills Notary Public
My Commission Expires:
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's commission.)
Form RW-06 Rev.10-13-2006 Copyright(c)2006 farm software only The Lackner Group,Inc.