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HomeMy WebLinkAbout10-19-06 I- Register of Wills of Cumberland County PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of. ~~" tJelll/lSeV'/ 'c. No. ~, - Cto- Oq\~ also known as To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Deceased. Social Security No. /~~ -~O -/~~5" The petition of the undersigned respectfully represents that: Your petitioner( s), who is~18 years of age or older, appl ,'6.$ for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. ~ ~ IJ If II (.If"/V /) Decedent was domiciled,lt ~ath in County, Pennsylvania, w~ h~ last family or principal residenceat.~O .:l~ ~71fl.~e-7~ ~L,'J'~ tF~ P;II} ~OI..1 (list street, number and municipality) , Decedent, then C I years of age, diedS e:p T. 2 (; TII- , 20'!!p ' at 9: j ~ P'~. IP-F vv/~.so,v #~-o,e~'A1e. #OJ'P"17H-" !l!;!#rIVsoA/ (!.;?'" NY $ ~/~O- $ $ $ Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: rol.J 171-0 J.1 1~<)/.3 THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the appropriate form to the undersigned. Residence( s) of Petitioner{ s) .-~.~O .'" ~~!) J'71lC-<PT ~~~lS'~ p~ f?'(')/J va 'lJ'J Ui~-tma-l^JnO lCln08 S,Ni/HrlHO :10 >lCl310 90 :" WV 6' 1309DOZ' C'] P " II' y~ i 1"03' ,,; 4",'\ J I ',' 'J J v -'-'-vV :10 38/:1:10 03080838 . Register of Wills of Cumberland County COMMONWEALTH OF PENNSYLVANIA OATH OF PERSONAL REPRESENTATIVE The petitioner(s) above-named swear(s) or affinn(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or ~ffinned ubscribed {jf) ~;4c1.'n A Before me yof VtJ 7 ,20 ~4+~ COUNTY OF CUMBERLAND } SS: lZl l --- '" '-' No. a\ - c>\o-Oqt " Estate of .s.NA- g" R V j'S ev~ Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW 20_, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, ITIS DECREED that St:/t:uO""" Oe:A v/.sev/c is/~entitled to Letters of Adrvinistration, and in accord with such finding, Letters of Administration are hereby granted to S (f/p.c.,1J I.,.., .l>i?ev,;sf!'V~c. in the estate of S4,l1A /)l?12 V'S ~ V/~C FEES Probate, Letters, Etc. ............. Will........................... ...... $ ~S', 0' $ $ $ $ Automation Fee................... $ Bond............ ..................... $ Tofal $ II O. () 0 IOller 2~ f Vd "O~) ONV}cf::l8VVno ltlnOO SNvHdtlO :10 )ltl310 eo :11 WV 6' 130900l Renunciation.. . . . . . . . . . . . . . .. . . . . . . Short Certificates ( ).. .. . .. .. .. . JCP. . .. . . . . .. . . .. . . . .. . . . . . . . . . . . . . .. 10. () 0 ito . Of) to. or; s, ()() Filed S 11i//~ J'u'- ,W::! ': iC'J:J U , I W....Ll" ",.dV.Jl.I .:;0 38/::!::!0 03080838 ..7:2; 6 ~p 1';-. Addres~~~ /+ /,)'"'6"0 ~ /7/:;-/ cl9J --~7'OO [ , Phone / .:ooH.1961 (10f.!005). RECO~O~O~~T . DE~~~::"TH' .... ~ \" ~lc.,. Dq \ '1 1,....,...-: ~~::-; : ;~B11~:~:~:n; ::~~"l~~~~J!:l~>" 4A. PlACE OF DEATH: ~. _'!2P.!!!-_ HOSPl!~ N!I.,!,_NG PR~!EIj '. ' '.' .,.. : 48, IF fAClJ'IY;DAl! : __ ,,' .... (C/Ieck one) !lOA Ell ~ INl'AT!fllT.. HOME RESI FACIlITY (Spdy);. ',' I" ,,-y ,.' ODD .,: to' 0 0 '- 0., 0 I,' 1,.4 --~-. I : 4C NAME DFFACIllTY: !" ::', '. '.. . ,40. : I1IIf IIId JJIffIIYJ . .... . '" 1 4t COUNTY OF 0fA~ / . . . .. .' ; ~./ .' .. _4. I CITY YIUAilE T1lWN . ( ,. Wilson Metnoria~ Host i tal ! 0 ;XX 0 Johnson City ...! Broome :46 4F. IlEDICAl RECORD NO. j:4&.W.lIll Yes ow' EO .. ,.t,fMCII&instIIlIl*m,.,.litJrr_COI/III}'IIIId~'.' .... ... 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LAST Ill.=:-. ~ f' M1, _.. .. LAST.' ..... .' - ....." BlIiiko '. BlltI.....lJo.@'.,. A, \. " Mile.." Kl5:rk;o~ode < \ i'. lWolEOF 1IlfOIlMMT:. " l111UMlUllUOOREllS: ..... .'. '.i ...... ". .' . / '. .. . 17055 .. ';,-;; ';,.-- 1I..avit Slid eI . u'\"O i..nke:r ;jft. ~.dff Bd~ .etiDlhblQ:"l 4>.. . .., .... .' ". " _1j{l1lllllW. 20QltM1lOllIC.~ .offi.... . 1111UI.ACEOf....ql9iM11Off;~llRontER . .;.2llC.1.Ol'$OIt......._J.. .... I ,,~ .~ .... ;;g I~~ Shell:sville Cid>tery'''''lGr....dU.. hf..0 ~: : l .. =::l;S.'ebOFF:r~;:...'ner 81 ~ ill~8'" nio~~"~c '.' 11 ':"..JY'~...: """":\ , '. ..' 2tA NAME OF RJNEIW.1ltREC1Oll: .' ..' . ":.. Gf~I~ _ ' .........,. ."~, 122C. '. . .... _NlIMllSl: / . II ""M~se,h ~ H\tb;.~;;,. ..:.~A.>.J.'" It \ '. .0 9 .} I _ \ II I, ~:~ 1'~:"JMi~~~_, ~"_ '.0J-a.~ ~ :~:-- ~~~~ Th"~~'~'"_ ~deItb-lT;;~',"':,~ 7 .' -,,~:~ ,;,(....: c....rullle: ~~~ oO~_onbel1alfOlAllendlngPlly8iClani\_ .... ~~ _. '. . .i '. 2 0 Md:a Examtnei f Ileputy MiIllbI e,.IIllnIr , .-.:J~ ~ "T "'L~ J ~ .. 258."coronerlSnat'~eallrCGlone(s~'SI1lllll..lilIt:., IL.l:oIliMNI/.:'" . .. n . , . "~ ..' .' .,.. .., · I '1 . . I :;;==~~~;,_" . I,~:i I iii!"~: "~; , lii 1li,'.;"':~"'If~ ~il"1E~~l ': i~~~ I~ I' '.~ ..~ ... .'. .... · ..... -~"'f'OIlc8Miic.EnlttMii...,". ..... ~j). . , -'~ ~~ l:..-:.~.... ~~.~Iv:~// ...... ../ /..... _.':..! "~~~~\W9IIIIJ>AllT'(AI: ..... VIS 2 . ,ilOUIl: '1,f' ~ .".: ~, ... tt~, y~l ~ '~~I'."'''iiii.iLl_ ftdiilli '.' .:~_ IIllRI ---Mr Y&M.) LASTZ ?""...:.:; , 101F~.. i .n .~., . Register of Wills of Cumberland County RENUNCIATION Estate of S,..,.~ P-G R.V /S'e J/ / c.. No. a, - 0\0 ~ c'\\ '\ Also known as , deceased To the Register of Wills of Cumberland County, Pennsylvania The undersigned L (.,( 17/(;) I)eet/ / s € y I Co Go ~ ) (Name) (Relationship) (Capacity) of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters ~,:. ",.." H iN /sTJeA-T'lt:Jw be issued to S e / ;.::c, J)"~ ~/2. fl'1 :s- G y I c. , Witness my/our hand(s) this day of ,20_. iI";' jled and subscribep Pefore me this day of O~r , k~~ S.2+ 3ro j~ A (Addre~ ,D. '/'.J CA1l..-? / S ? e / r7# /'/ V". . Notary Public My Commission Expires: (Signature) Or (Address) Affirmed and =qed before me this ;'30 day of ~ , ~ ~u - . (Signature) (Address) (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission) Vd "U) ONflCJ38V'1nO lClnOO S.NVHdClO jO )fCl310 60 : II WV 6 I 130 900l SllUV\ JO 83181830 jO 3J/j~O 03080038 . Re~srerof~illsofCumberlandCoun~ RENUNCIATION Estate of ~ ~~:r-er/c Also known as No. ~\ - O\g- ()~ \~ , deceased To the Register of Wills of Cumberland County, Pennsylvania Theunden;gned ~wrvM~ Ce#/J/7c (tMIu~""'rete) (Name)' (lelationship) (Capacity) of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters br ~N/~/"sne"r"'o,,v be issued to S~/ic<.I DiAl Z;e~ 1/ ~:s ~ It" /'C , Witness my/our hand(s) this day of Affirmed and subscribed before me this day of Notary Public My Commission Expires: Or AJlirmed and subs9i~d ~fore me this .l!L day of {)c'iO~ , ~ Deputy (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission) ,20_. 6) ~~'G- ~ h (Signature) I ~5- (1, S'~ CAtz?jJ'?C' / (A"*- /r 01-3 (Signature) (Address) (Signature) (Address) Vd ''0,., ~, J}jn&P~VV 1&::lfJIVnO ..10 o,NltHdCiO ;:], )f1::J370 60 : I/;j~ 61 1.:10900l .;Jjg;1 :10 &315193& - BiD 030&003&