HomeMy WebLinkAbout05-04-15 PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COIJNTY, PENNSYLVANIA
Petitioner(s) nained below, wbo is/are 18 years of age or older, apply(ics) for Letters as specified below, and in
support thereof aver(s)the following and respectfully request(s)the grant of Lcttcrs in t�appropriate forin: ,�
�
Decedent's In ormation . � �. ��'��� ���� "�' rn r�i�
Name• Ds D .��� �l�ul Filc No �� � ,:����
a/k/a: (Assigned by��e�sEeT) --c ,-,� .�a
r. .._
.. ..... I .,.4. r,....�
a/k/a: -, .,� ,. �
a/k/a: Social Sccurity No: .5(ox ����?'��3� '�..�
Date of Death• r� ��� �al� Agc at death: 8 "L '-n ` '��
.._ � ,
Decedent was domiciled at death in C1,rn�berla�►� County,��),_�'f�+'t�'��(�tare)with hisf�r��st
principal residence at l�3�o Nvriu�cl� ��-���-, ���/��. � �� ��'°�� ,� "� �"'��'Q����`� ~ .
Street address,Pust Office and Zip ude Crty,'I o��nship nr Boruugh � G'���Y
� r �
Decedent died at p�S �.�5'� S�a�e- �� �'�G��iC ���"% �"`�,���>"l�
� C�ty,,'lownsh� o Qo ough County State
Street address,Post Office and Zip Code P
Estimate of value of decedent's property at death: ,- �'
If doroiciled rn Pennsy(vania.......... .. ... ....... ... ... All personal property $ /d%
If not domiciled in Pennsy/vania. . .... .... ....... . ... ... Personal prorerty in Pennsylvania $
If not doniiciled in Pennsylvania. . .... .... ....... . ...... Personal property in Counly. .. . ...... . $ ��O�-
Value of rea/estate in Pennsy[vania...... .. ....... ..... .. � �
TOTALESTIMATLD VALUE. ... $ -�?/ � /
0('kJ( � f1U-�., G��J�G.. 6�,� �,,���� �u �� �-�J,
/ � � r� . �t
Real estate in Pennsylvania situated at �� � Count
(Attach additional sheets,if neceseary.) Street address,Post Office and Zip Co��� City,Township or Boroug Y
� A. Petition for Probate and Grant of Letters Testamentarv
Petitioner(s)aver(s)he/sheJihey is/are the Executor(s)named�n the last Will of the Decedent,dated
and Codicil(s)
thereto dated
State relevant eircumstances(e.g.renunciation,death of c�recutor,ete.)
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 killin or evde,r�ad'udicated an incapacitat� pexson. �
l�^��' 'fG�t`�`G.� `�i," ��>,x/� `ir.�,,p.,. "'S/l 2 C^D
w�" 9
�NO EXCEPTIONS ❑EXCEPTIONS � �� �
� B. Petition for Grant of Letters of Administration (lfappticable) __
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante ahsentia,durante n�inoritate
If Administration,c.t.a. or d.b.n.e.t.a.,enter date of Will in Section A abovc and complete list of heirs.
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the erounds 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 ine�apacitate;d person.
�NO EXCEPTIONS �EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was s�uvived by the following spouse(if any)and heirs(attach
additional sheets,if necessaryJ:
Name Relationshi Address
� ` " _
u �v� ��l�z I/`�✓� 4� �'i'w�r.�- riU2.-
1�rnd� �'J�'� �, 2 c/'
Page 1 of 2
Form RW-02 rev. l0/ll/2011
,e�1111fP1r..��1 ��..,�_. e
Oath of Personal Representative orr;��a�use o„�y
COMMONW�ALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland } � �
cr—i � �
Petitioner(s)Printcd Name Petitioner(s)Yrinted Address �� � � r1� �
�/ F J 4�- � `� ' J ;T7
u f L �0 3�� /vd P4l��c /`r d� (���, :� �_
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7 �.:7
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The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoin�Petition are true and correct to the best of the kn�edge�li d�lief
of Petitioner(s)and that,as Personal Representative(s)of the Decedent,the Petitioner(s)will well rand U•uly administer the estate accor�lin to law.
Sworn to or f irmed a �b ribed b ore ����n-'� ----- �ate� /�
me t �s ay_of ,�� ____. Date
By: ___ Date
or te Re�stei� _____ Date
BOND Required:Q YES �NO To tlie Register of Wills:
FEES' Please enter my appearance by my signature below:
Letters.. . . . . . . . . . . .: . . . . . . . . . $ ���'CC Attorney Signature� .%"�
( � ) Short Certificate(s). . . . . . •�1� " '
( )Ren�inciation(s).. . . . . . . . ��',i����
, ,
( )Codicil(s). . . . . . . . . . . . . ti '�"�
� rc�
( )Affidavit(s).. . . . . . . . . . . t� /�
Bond.. . . . . . . . . . . . . . . . . . . . . . . Pr�nted Name: G-re�ae...c� /C i /C2e�
Commission. . . . . . . . . . . . . . . . . . Supreme Court
�
Other . . . . . . . ID Number: .:� �i ��'�5
, j� � ,�� �/�
. . . . . . , � Firm Name: (,-f�.,��'cc�,_�f IZ ��-'�-Y'
, , . . . , , Address: 312i�('�°=���L'�/I�.✓ �ah-�---__
. . . . . . . ���,��!'��- .^�; r�� 1 Z�! /
. . . . . . . Phone: ��_'=:a;,3 8 -C?�(3y
Automation Fee. . . . . . . . . . . . . . . � �' Fax: Z["iP -.::!.3 - g
JCS Fee. . . . . . . . . . . . . . . . . . . . . . Email: Q�:;a n�"�_�.c� �,� /`_2�_�,0� Q,�.�I��(Ji'�'►
TOTAL. . . . . . . . . . . . . . . . . . . . . $ t.
DECREE OF THE REGISTER
Estate of ' U / ° P�'► .� File No: _ �/ � � ���
a/k/a:
AND NOW, / , (�/ �, in consideration of the foregoing Petition,
satisfactory proof having been r ented befor�me, 1T I ECREED tha ters C.� � � h">>rl�3/-r��i��
are hereby granted to�uS a r� r' � 1�,�'
in the above estate and(if applicable)that
thE instrument(s) dated
described in the Petition be admitted to probate and filed of rec r�..�s the last �1lill (and o cil(s))of Decedent.
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gis o Wills ���
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Forn�RW-02 rev. 10/1//20]l � � O
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