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HomeMy WebLinkAbout06-22-15 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 �y Name: E Lillian Pastula File No: it -15 a/k/a: Lillian E Pastula (Assigned by Register) a/k/a: Emma Lillian Derry a/k/a: Lillian Derry Pastula Social Security No: Date of Death: 12/03/2010 Age at death: 88 Decedent was domiciled at death in Cumberland County, Pennsvlvania (state)with his/her last principal residence at 210 Senate Ave..Apt 118, Camp Hill. PA 17011 Street address,Post Office and Zip Code City,Township or Borough County Decedent died at 503 N 21st Street, Camp Hill Pa 17011 Street address,Post Office and Zip Code City,Township or Borough County State Estimate of value of decedent's property at death: 06 If domiciled in Pennsylvania............................ All personal property $ 14�t Ifnot 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. ... $ `` io Real estate in Pennsylvania situated at: (Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County r^V ❑ 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 C t, 'and CAciO) thereto dated —; State relevant circumstances(e.g.renunciation,death of executor,etc.) i~ fir, rV rr] t'r1 Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorced�t3ag of a party to a pen g divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §3323(g),Arid did iL°>havermchild:Aorn-pr adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. (7) CD ::3 :2 ❑NO EXCEPTIONS ❑EXCEPTIONS %� ►—� t— m O 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. ONO 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)and heirs(attach additional sheets,if necessary): Name Relationship Address CCA wad�n 'nQ_2"A Gfe eA c�VA Form RW-02 rev.1011112011 Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Petitioner(s)Printed Name Petitioner(s)Printed Address s * �L P VA aaal 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,the Petiti ner Uwa truly administer the estate according t lawSwom to or affirmed'and subscribed before (�i1� Date me ,day of Com�•.. Date By �� p �LdXLQ Date For)he Reiner ` Date BOND Required: YES NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters. . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature: Short Certificate(s). . . . . . ( a )Renunciation(s).. . . . . . . . ( )Codicil(s). . . . . . . . . . . . . ( )Affidavit(s).. . . . . . . . . . . Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Commission. . . . . . . . . . . . . . . . . . Supreme Court Other . . . . . . . . ID Number: c_ r� . . . . . . . . Firm Name: P u-) . . . . . . . . Address: 7 -,,,CD 7-1 rT1 CD __4rt 'rl . . . . . Phone: c— - Automation Fee. Fax: 1- JCS Fee. . . .. . . . . . . . . . . . . . . . . Email: J CJ TOTAL. . . . . . . . . . . . . . . . . . . . . $ -T1 DECREE OF THE REGISTER Estate of File No: J a/k/a: AND NOW, ,in consideration of the foregoing Petition, satisfactory proof having been presented before me,IT IS DECREED that Letters are hereby granted to in the above estate and(if applicable)that the instrument(s)dated described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent. Register of Wills Form RW-02 rev.10/11/2011 Page 2 of 2 RENUNCIATION REGISTER OF WILLS © c, CUMBERLAND COUNTY,PENNSYLVANIAANv r- -- C-) J r— 1-0 j 1`x•1 Y-p Cr C"'•' C3 ri wy B -n :3 r _ rTl Estate of E. Lillian Pastula _I r—Deu� d r� I, Richard J. Pastula , in my capacity/relationship as (Print Name) Son of the above Decedent,hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sandra A. Pastula (Date) (Si ature) a57L (StreetAddress) bZ6�� ( ity,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 be re me this. w day parry executing this renunciation and certified of T that he or she executed the renunciation for the purposes stated within on this day of Deputy fir 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.) Form RW-06 rev.10.13.06 RENUNCIATION a M. C> � � . REGISTER OF WILLS c a CUMBERLANDCOUNTY,PENNSYLVANIA r— r--73 l Nrn `� —rr > —tj Ta Fr r 1't.l Estate of E Lillian Pastula , Deceased I, Janie E Coleman , in my capacity/relationship as (Print Name) Daughter of the above Decedent,hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sandra A. Pastula (Date) (Signa ) (Str ddre,$) ( te,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 mjthin on this g day of M"Z'111 2 . 1 Deputy for Register of Wills Notary Public _ My Commission Expires: " ""1_3 j_ 2 O 1�7 (Signature and Seal of Notary or other official qualified to administer oaths. S�GfVI1CIYr/1o��ltY{GU Commission.) NOTARY PUBLIC 357232 Form RW-06 rev.10.13.06 COMMONWEALTH OF VIRGINIA MY COMMISSION EXPIRES MAY 31, 2017 H105.905 MV.(06/14) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WAff ilvegal Ctc c�licate this copy by photostat or photograph. REGISTER OF WILLS din OF 01 ?OSS JUNJUN22n 1 `i5 `�""'a ._- Eyy-- 'o� Lana R. Adams CLERK OF `cm i s State Registrar ORPHANS' COURT rJ D C '° Y'* 8 5 4 5�}'�®R L 1, ;,0., P P� �`�9TMENT•DF„Z�`P°? April 17, 2015 No. ”"" Date 11106.143 REV 10M COMMONWEALTH OF PENNSYLVANIA•DEPARTMENT OF HEALTH a VITAL RECORDS 119510 TYPE I PHM W CERTIFICATE OF DEATH (See Instructlons and examples on reverse) STATE FAE NUMBER 1.Nenaa Deadadp3oLmafde,tm,oux�p 2 Sm, a SWsemey Mmba 4.oft d old(Nadi,day,TO 5.Ape A>W awl I UM*IM 1 Md 1 Q Dae at BM Ik Piece of OnA Peek afly one S�( Madn Cep Hme a -}' •!'NHV*t Odm: v Y. l� � f- 7-2- New i-1 / . 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