HomeMy WebLinkAbout05-12-15 REVISED
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: Lois A. Wagner File No:
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 04/27/2015 Age at death: 84
Decedent was domiciled at death in Cumberland County, Pennsylvania (State)with his/her last
principal residence at 981 Maple Mall Mechanicsburq 17055 Upper Allen Township Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 981 Maple Mall Mechanicsburg, 17055 Upper Allen Township 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 $ 800,000.00
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. :,,**...—...*''**''** Personal property in County $
Value of real estate in Pennsylvania................................................... ...... $
TOTAL ESTIMATED VALUE. ... $ 800.000.00
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
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated 02/02/2001 and Codicil(s)
thereto dated N/A
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 bom or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
❑✓ NO EXCEPTIONS ❑EXCEPTIONS
❑ 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.
❑NO EXCEPTIONS ❑EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse(if any rd heirs(attach
additional sheets,if necessary): n :0
C
Name Relationship Addreo's =M)
YL) ;>
-� C'n t!�
Form RW-02 rev.10/11/2011 Page 1 of 2
REVISED
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address C=
ryl
Don Richwine 21 Timber Road, Mechanicsburg, PA 17050 o rn
C)
.� M I 3 r� r rt
ry ZD
71
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 knowledRS3nd b t#e
of Petitioner(s)and that,as Personal Representative(s)of the Decedent,the Petitioner(s)will well and truly administer the estatelaccording to law.t -
tai CD
Sworn to or affirmed and subs ribed b fore � //!6t!✓�1:�:_..i date
me thi day of Date
By: Date
F r the Register Date
BOND Required:Q YES [Z]NO To the Register of Wills:
FEES' (� Please enter my appearance by my signature below:
Letters . . . t-} Q� }.d . . . . . $ Attorne Signature:
( ) Short Certificate(s). . . . . .
( )Renunciation(s).. . . . . . . .
( )Codicil(s). . . . . . . . . . . . .
( ) iaL
Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Anna BOrro Hays
Commission. . . . . . . . . . . . . . .. . . Supreme Court
Other . . . . . . . . ID Number: 70375
. . . . . . Firm Name: Saldls, Sullivan & Rogers
. . . . . . . . Address: 635 North 12th Street, Suite 400
. . . . . . . . Lemoyne, PA 17043
. . . . . . Phone: 717-612-5804
Automation Fee. Fax: 717-612-5805
JCS Fee. . . . . . . . . . . . . . . . . . . . . Email: aboorohays _ssr-attorneys.com
TOTAL. . . . . . . . . . . . . . . . . . . . . $
DECREE OF THE REGISTER
Estate of Lois A. Wagner File No:
a/k/a:
AND NOW, 2015 , in consideration of the foregoing Petition,
satisfactory proof having beensented before me,IT IS DECREED that Letters Testamentary
are hereby granted to Don Richwine
in the above estate and(if applicable)that
the instrument(s) dated 02/02/2001
described in the Petition be admitted to probate and filed of record as the last ill(and Codicil(s))of Decedent.
Register of Wills pia
Form RW-02 rev.10/11/2011 Page 2 of 2