HomeMy WebLinkAbout04-23-15 PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF U(ryl'Jejf JQ I _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: I(haFile No: CA
a/k/a: �1�J (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: OrA 0 CROI Age at death: 13
Decedent was domiciled at death i COM W�rA _Count A (State) ith his/her last
principal residence at iOO 17D-7()
Street address,Post Officeand Zip Code 1 City,Township or Borough County
Decedent died at rfI U I ► L i I f"' oh+S DO 00 I
Street address,Post Ofric and Zip ode 11 1 O City,Township or Borough V County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania............................ All personal property $
If not douticiled in Pennsylvania. .......... ............. Personal property in Pennsylvania $
If not domiciled in Pennsylvania. ....................... Personal property in County $
Value of real estate in Pennsylvania......... ................................................ S
TOTAL ESTIMATED VALUE. ... $ 4a ( 7„
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 c�
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated C= `"wand(�4iggs)
thereto dated ? --0 a..)
State relevant circmnstances(e.g.renunciation,death of executor,etc.)
t M W rri fri
Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorced�,wa not a party to�a�ering
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S.§3323(g),'anq-oi4�ot haTna chi:�bKq or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. 79
Q rI
NO EXCEPTIONS ❑EXCEPTIONS � � Iv C�
r-
_Q'B. Petition for Grant of Letters of Administration (If applicable) "' rn , �
c.t.a.,db.n., d.b.n.c.t.a.,pendente lite,durante absentia,durante ntinoritate
If Administration,c.t.a. or d.b.n.e.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.
[1G0 EXCEPTIONS ❑EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the foil(-ving spouse(if any)and heirs(attach
additional sheets, ifnecessary):
Name Relationship
Address
COA,l AL e e 01S-?o /b� a t)v
J re �7 �� ► 1 I 'S)- D" fi-C, PC4, 1-1076
Form l?w n2 rev.10111/2011 /"Page I of 2
Oath of Personal Representative Official Use only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s)Printed Name Petitioner(s)Printed Address
J I ) t.( Irl J
The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petit10'F 3LQ true and correct to the best of the knowledge and belief
of Petitioner(s)and lira[,as Personal Representative(s)of the Dece tt,the tit/ r(s) 'll 11 and truly administer the estate according to law.
Sworntt, irmed and subscribed before Date -
me thi 1ay''of Nor;'I ,aoIis Date
By: M Ct.k V rtY r Date
For the Register Date
BOND Required:❑YES )QNO To the Register of Wills:
FEES: Please enter my appearance by my signature bp!gw:
Letters. . .. . . . ... . .. . . . . . .. I SL16 Attorney Signature: n r' rq
{ L-,!Short Certificate(s). . . . . . 6-3 G7
( Renunciation(s)... . . . . . .
{ }Codicil(s). . ... .... .. .. . s r— rU rn rrt
r- t-rt W
( ) Affidavit(s)... . . . . . .. . . _
Bond.. . . . . . . . .. . . . . . .. , . ... . Printed Name: = Cry
kJ
Comm�is�sion/. . .�. .�.-.�. .. . . . . . .. . Supreme Court p
Other w nCa t•�.. . . .. . . �rj ID Number: G'-)
Lt'l�lX�a1!Y7. L'5 .
. . . . Firm Name: —r ,74
. . .. ... Address:
Phone:
Automation Fee. .. . . .. . . ... ... Fax:
JCS Fee. . .. . . .. . .. . . . . . .. . . . ' -S'Q: Email:
TOTAL. . . .. . . . . . . . . .. . . . . . . $ 1." 0
DECREE OF THE REGISTER
Estate of l IP &041 eu File No:
a/k/a: ,
AND NOW, l"^U � , ' in con 'der tion of the foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED that Lett"s
are hereby granted to
iti the abo estate and(if applicable) that
the instrument(s)dated nick
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent.
CAigister of hills `
Form Rlv-n? re%�. 10/1112011 age 2 of 2
-RE60RD'ED O'F:F'1C'E!dF-,'
REGISTER OF W11 LS--
?015 PH 23 PM 2 57
RENUNCIATION CLERK OF
ORPHANS' COqU--
REGI `'TER OF WILLS `CUMBERIL-ANM C2,,01,,,',, rtA,
jo,�fr lfil)d,COUNTY, PENNSYLVANIA
Estate of t C /VA a Zoij Deceased
U 0
O&AU in my capacity/relationship as
(Print___ Nome( tX of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
�' L1145
-rj
1) A
c2y
ate (Sign lure)
(Street Address)
J9 A�PVV17/1/
(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 �P()-t", day
of t-- ;Z2.01_
Deputy for Register of Wills Nota N Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMM
L-PENNSYLVANIA
NOTARIAL SEAL
JERROLD COHEN,Notary Public
Hampden Township,Cumberland County
For?nRW-06 rev, 10.13.06 my commission Expires June 9,2018
RECt3KID orrFICE' OF
REGISTER DF-WILLS,
RENUNCIATION nis Pin 23 Qln 57
CLERK OF
ORPHANS' COURT
REGISTER OF WILLS �A
CWBERLAtl�,)
CUUM&A- 4*10 COUNTY, PENNSYLVANIA
Estate of Deceased
in my capacity/relationship as
'Print Name)
of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
V-.20
(Date) (Signature)
Z�g6l?
(Street Address)
t4) 70
(City,Stale,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
purpses stated within on this day
of C-11
—I % Ok
Deputy for Register of Wills ANo Ita ryc I
p1to
My Commission Expires: � `6
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
1.0111114ONWEALTH OF PENNSYLVANI
WTARLAL SEAL
ASM"K.Wrl9K Notary Public
Form RW-06 rev, 10,13,06 UPW Allen Twp.,Cumberland County
MY C*Mffdss$m Expires Oct Z 2018
'IESSUL PENNSYLVANIA ASSOCIATION OF NO's An,t-3