HomeMy WebLinkAbout05-29-15 PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF 66/ 96PlCOUNTY,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: File No:. . o/(- �c�' c�a 0
a/k/a: • (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: A1e j p/ W IAJ Agee at death: '73
Decedent was domiciled at death in (vm&1-,1z2/1�_County, )1*% (state)with his/her last
principal residence-at
Street addrefs,Post Offee and Zi Code City,Township dr Borough County
Decedent died at.
Street addr s,Post Office and Zip Code City,Township or Boro gh 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 $ Q
If not domiciled in Pennsylvania. ..........:.. .......... Personal property in County $ 0
Value of real estate in Pennsylvania............................................ ......... ..... $ 10
TOTAL ESTIMATED VALUE. ... $ /i$
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 and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciation,death of executor,etc) n o
c_rl f rl
Except as follows:after the execution of the instrument(s)offered for probate Decedent did not marry,was not'&—W pw,was n�art}j_�,2 nding
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §3323(p),and did not h&e a dh'll prn or
adopted;and Decedent was-neither the victim of a killing nor ever adjudicated an incapacitated person. M M
fr rn CAO Q:)
❑ 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,duranteabsentiarante tn: ritafe
If Administration,c.t~a. or db.n.cata.,enter date of Will in Section A above and complete list ofheirs.c?
Y' cca
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:
T` NO EXCEPTIONS ❑ EXCEPTIONS
Petitioner(s),after.a proper search bas/have ascertained that Decedent left no Will and was survived by the following spouse(ifany)and heirs(attach
additional sheets,if necessary):
Name Relationship Address
kellil %Ml e //
/
Form RW-02 rev.10/11/2011 Page 1 of 2
fv
Oath of Personal Representative (r{"'al U$�- y rT. c'
70 v; ;:0•
COMMONWEALTH OF PENNSYLVANIA } 11 "4" 71
N Cn
SS: rrt Cid xt
COUNTY OF { utl`/t� } 7 r,� ` • c ' ,t
Petitioner(s)Printed Name Petitioner(s)Printed Address J ��
r
Ct)
C.0
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, lie Petitioner(s)will well and truly administer the estate according to w.
Sworn to or affirmed and subscribed before Date
me this Iq day of Date
By: _ Date
For the Register Date
BOND Required:AYES IEIVO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters. . .. .. . . .. . .. .. . . . .. . . $S__ Attorney ig�ature:
{ L(1 }Short Certificates}. . .. . .
Renunciation(s).. . . . . . . .
{ )Codicil(s). ... . . . . .. .. .
( ) Affidavit(s).. . . . . . . . . . .
Bond.. . . . .. . . . . ... . .. Printed Name: y$SI C� I3fa�11 ��6 _
Commission. . . . . . . . . . . . .. . . . . Supreme Court 3 y S,,.
Other . . . . . . . . ID Number: �y "�
_ Firm Name: L, 1 �C I t G¢ c�i 9—ery.4
Address: 15s, ;x;'
Phone: tr)�7> S °eZ3�.
Automation Fee. .. . .. . . .. . ... . Fax:
JCS Fee. . . . . . .. . . . . . . .. . .. . . Email:
TOTAL. . .. . . . . . . .. . . . . . .. . . $
DECREE OF THE REGISTER p�
Estate of 0 Id 144N Ono File No: cz!K 5R 4
a/k/a: U M�tt�
AND NOW,� �_ ,�', in consideration of the foregoing Petition,
1A I
satisfactory proof having been presented before me,IT IS DECREED that Letters
are hereby granted to AdLIL JA
in the ab6vd estate and(if applicable)that
the instruments)dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s-))of Decedent.
egister of Wills
ronin RW-02 rer, 10/1112011 ge 2 of 2
ry
n c�i"1 %O frt;
RENUNCIATION =- � -_3 C> a
rSJ U —G CO
REGISTER OF WILLS 7 r~1 �' =� '
y - ,
LjMh-6-1,9Z2W COUNTY,PENNSYLVANIA
co
Estate of _ /��i7 ��� , 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
(Date) (Signature) / ` ,o
3 v �-c-A Jz.-t� oc.r /6
(Street Address)
(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 .-e-7 day
of /2M�
Deputy for Register 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.)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
Form RW-06 rev.10.13.06 ROLAND L.DOYLE,JR.,Notary Public
Mechanicsburg Boro.,Cumberland County
My Commission Expires December 31,2016
r
�v
RENUNCIATION
orn
70
REGISTER OF WILLStD
j%fYl h(r'1 nw COUNTY,PENNSYLVANIA , '�` Co '`'
b r-�
r 'L7 rl
e F t. Z3 —n
--s
Estate of ,E11 fit? Tmd11`I7 �� ; Deceased
6L in my capacity/relationship as
-(Print Name)
0 f) of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
1� lrl f. Adlen
i a�
(Date) V (Signature) f
(Street Address)
s
d rr fS yr W /710-3
(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 l q' day
o April
Deputy for Register of Wills 4�&u lic
My Commission Expires: �y vrAr� 9.8,ao 14,
(Signature and Seal of Notary or other official qualified to
'administer oaths. Show date of expiration of Notary's Commission.)
commoNwr ALTWOF•PENNSYLVAN A
NOTARIAL SEAL}.
Johnny L.Teaht Jr:,.Notnry.:P,Pblia
Form RW-06 rev. 10.13.06 North Londondeny Twp:;t bbanon County
My Commission EXPltes;fan.2812018
MEMBER.PENNSYLVANIA ASS CI TION OF NOTARI S