PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF 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: File No:
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: Age at death:
Decedent was domiciled at death in County, (State) with his/her last
principal residence at
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at
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 $
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. . . . $
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.)
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
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) and heirs (attach
additional sheets, if necessary):
Name Relationship Address
Form RW-02 rev. 10/11/2011 Page 1 of 2
Oath of Personal Representative
COMM ONW EALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Official Use Only
Petitioner(s) Printed Name Petitioner(s) Printed Address
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 Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed before Date
me this day of , Date
By: Date
For the Register Date
BOND Required: YES NO
FEES:
To the Register of Wills:
Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $
( ) Short Certificate(s). . . . . .
( ) Renunciation(s).. . . . . . . .
( ) Codicil(s). . . . . . . . . . . . .
( ) Affidavit(s). . . . . . . . . . . .
Bond. . . . . . . . . . . . . . . . . . . . . . . .
Commission. . . . . . . . . . . . . . . . . .
Other . . . . . . . .
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. . . . . . . .
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. . . . . . . .
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. . . . . . . .
Automation Fee. . . . . . . . . . . . . . .
JCS Fee. . . . . . . . . . . . . . . . . . . . .
TO TAL. . . . . . . . . . . . . . . . . . . . . $
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate of File No:
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