HomeMy WebLinkAbout05-01-15 PETITION FOR GR-kNT OF LETTERS
REGISTER OF WILLS OF _ b m�erhnd 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 f / 2
File No: (�' — � iC) -�9J
12/1 a: (Assigned by Register)
a/k/a:
a/k/a: ZSocial Security No: /
Date of Death: Age at death: / 02.
Decedent was domiciled at death in �_County, (state)with his/her las
principal residence at
Street address,Post Office and Zip ode City,Tolffnship or Borough County
Decedent died ateu Vt� �
Street address,Post O fico and ilp Code City,Towns ip or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania.......... ................ .. All personal property $
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
Ifnotdomiciled in Pennsylvania. ..................... .. Personal property in County $
Valite of real estate in Pennsylvania.................... ..... .. .............................. S
TOTAL ESTIMATED VALUE. ... $ 672 /jt b
Real estate in Pennsylvania situated at:
(Attach additional sheets,.,/necessary) 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 ,g j 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
ad pted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
O EXCEPTIONS F-1EXCEPTIONS
B. Petition for Grant of Letters of Administration (If applicable)
c•.t.a.,d.b.n.,d.b.n.c•.ta.,pendente lite,tlurante absentia,durante niinoritate
If Administration,c.t.a. or db.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 2 a.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person.
NO EXCEPTIONS F�EXCEPTIONS
c.rt
Petition.,. (s),after a proper search has/have ascertained that Decedent left no Will and wa. wavived by the followim seise(if any4ld heif3l W!(,h
additional sheets,ifnecessary): pG? Q
T"1 � �
Name Relationship Addrds-S � r�rl tfi] (TI
C?
'h•„ r_fJ (f) Q
Fara,RW-02 rein.1011112011 Page I of 2
Oath of Personal Representative Official Usc Only
COMMONWEALTH OF PENNSYLVANIA }
��oabnd } ss:
COUNTY OF b� � }
Petitioner(s)Printed Name Petitioncr(s)Printed Address
jV--'e4p
The Petitioners)above-narrtcd swear(s)or affirm(s)the statements in the foregoing Petition are true and correct to the best of the knowledge and belief
of Petitioners)and that,as Pdrsonal Representative(s)of the Decedent,the Petitioner s)will well ano truly administer the estate accordin to 1
Sworr'to o`'affirined an`d subscribed before Date •S
me this- �i--da f` a Date
By: 1 YOU Date
For the Register Date
BOND Required:❑YES 21 O To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . S POO Attorney Signature:
O a ) Short Certificate(s). . .. . .
( ) Renunciation(s).. . . . .. . . C'C> r*I n
( )Codicil(s). . . . . . . . . . . . . K :10 n o
Affidavits --C Cn
( ) O.. . . . . . . . . . . � n
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: y r—
Commission. . . . . . . . . . . . . . . . . . Supreme Court k+ T d
Other . . . . . . . . ID Number: = C�
0 i
O ::3
. . . . .. . . Firm Name: . ,
i
� . . . . . . . . J'S Address: L O � M
. . . . . . . . Phone:
Automation Fee. . . . . . . . . . . . . . . Fax:
!CS Fee. . . . . . . . . . . . . . . . . . . . . 60 Email:
TOTAL. . . . . . . . . . . . . . . . . .. . . $
DECREE OF THE REGISTER
Estate of 1 File No:
a/k/a:
AND NOW, ( , in consideration of the foregoing Petition,
satisfactory proof having be presenticd beforc me,IT IS DECREED that LettersTa n'
are hereby granted to { g C� C ) _ Q S r-
in the abov tate and(if applicable) that
the instrument(s) dated — �j - lG 4� . ' '
described in the Petition be admitted to probate and filed of record as the last Will and Codicil(s))of Decedent.
q1ACA Kn1
Register of Wills
i
Form RIY-02 rev.101112011 'wPage 2 of 2
LAST WILL AND TESTAMENT
OF
ELEANOR WITHERIDGE
I, ELEANOR WITHERIDGE, of the Borough of Wyoming, County
of Luzerne and State of Pennsylvania, do hereby make , publish
and declare this to be my Last Will and Testament , hereby
revoking all former wills and codicils heretofore made by me .
ITEM 1: I direct that all my just debts and funeral
expenses be paid as soon as convenient after my death.
ITEM 2: I give and bequeath to my grandchildren,
WILLIAM PAUL BERGSTRASSER, VALERIE BERGSTRASSER, and ELLY JANE
BERGSTRASSER, the sum of Five Thousand ( $5 , 000. 00 ) Dollars
apiece.
ITEM 3: All the rest and residue of my estate , real and
personal, I give , devise and bequeath to my daughter, ELEANOR
PAULA BERGSTRASSER.
ITEM 4 : I hereby nominate , constitute and appoint my
daughter, ELEANOR PAULA BERGSTRASSER, Executrix of this my Last
Will and Testament . No bond shall be required of my Executrix
in this or any other. jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
L- thi& day of — 1991 .
U-) r
( SEAL)
ELEANOR WITHE DGE
!4,j Uj `'� LQ
�
rr>3 -�
P
Signed, sealed , published and declared by the Testatrix
above named, as and for her Last Will and Testament , in the
presence of us , who have hereunto, at her request , subscribed
our names in her presence , and in the presence of each other,
as witnesses hereto.
residing at� \'JN\W� c�
residing at
-2-
AFFIDAVIT
WE, ELEANOR WITHERIDGE, the Testatrix and the witnesses ,
respectively, whose names are signed to the attached or foregoing
instrument , being first duly sworn , do hereby declare to the
undersigned authority that the Testatrix signed and executed the
instrument as her Will, and that she had signed willingly and
that she executed it as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses , in the
presence and hearing of the Testatrix, signed the Will as
witnesses and that to the best of their knowledge , the Testatrix
was at that time eighteen ( 18 ) years of age or older, of sound
mind, and under no constraint or undue influence .
ELEANOR WITHERIDG W S
WITNESS
Subscribed, sworn to, and acknowledged before me by ELEANOR
WITHE/R�IDGE, the Testatrix, and subscribed and sworn to before me
byY- -. ��. .�,h andLC
witnesses ,
1991 .
NLID
PUBLIC t
U AM HOUSEWICK,�OTA,RY PUBLIC
KE8 RE,LUZER%E CO