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PETITION FOR PROBATE AND GRANT OF LETTERS

Kenneth J. Gamble, Clerk of Records

)

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 requests the grant of Letters in the appropriate form:

Decedent’s Information

File No:________________________

Name: _______________________________________________

A/K/A: _______________________________________________

Social Security # ________________

A/K/A: _______________________________________________

Age at Death: ___________________

Date of Death: ________________________________________

Decedent was domiciled at death in ______________County, Pennsylvania, with his/her last family or principal residence

at_____________________________________________________________________ ________________________

Street address, Post Office and Zip Code

Municipality: Twp, Borough, City

Decedent died at___________________________________________________________________________________

Street address, Post Office and Zip Code

City, Township or Borough

State

Estimated value of decedent’s property at death:

►If domiciled in PA

All personal property

$ _______________________

►If not domiciled in PA

Personal Property in PA

$ _______________________

►If not domiciled in PA

Personal Property in county

$ _______________________

Value of Real Estate in Pennsylvania

$ _______________________

Total Estimated Value $ _______________________

Real Estate in Pennsylvania Situated as follows: (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) that 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 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 to Decedent

Address

NOTE: This form must be printed double-sided.

Form RW-02 Rev. 10-11-2011

Form Rw-02 - Petition For Probate And Grant Of Letters - Register Of Wills Of Erie County, Pennsylvania

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