Petition For Probate And Grant Of Letters Form - Court Of Common Pleas - Lebanon County, Pennsylvania
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2IN THE COURT OF COMMON PLEAS OF LEBANON COUNTY, PENNSYLVANIA
Register of Wills
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of __________________________________________,
ESTATE NO: ____
___
Deceased
a/k/a:__________________________________________
FILE NO:_____________________
SS NO:_________________
who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION ‘A’ or ‘B’ AND “C” as applicable:
Petitioner(s)
A. Probate and Grant of Letters
Testamentary
Administration ________________(
)
complete Part C also
CTA, DBN, or DBN CTA
and aver that Petitioner(s) is/are entitled to the aforementioned Letters ________________________________ under
the last Will of the above-named Decedent, dated ____________________ and codicil(s) dated _________________
____________________________________________________________________________________________________________________
(State relevant circumstances, e.g. renunciation, death of executor, etc.)
Except as follows, Decedent did not marry or divorce, did not have a child born or adopted after execution of the
documents offered for probate; was not the victim of a killing, was never adjudicated incapacitated, and was not a party
to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as provided in 23
PA C.S. section 3323(g):
________________________________________________________________________________________________________________
B. Grant of Letters of Administration _____________________________________________________________
(If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived by the
(If Administration c.t.a. or d.b.n.c.t.a. enter date of Will in Section A and complete list of
heirs)
following spouse (if any) and heirs:
Name
Address
Relationship to Decedent
USE ADDITIONAL SHEETS IF NECESSARY
:
THIS SECTION MUST BE COMPLETED
Decedent was domiciled at death in Lebanon County, Pennsylvania, with his/her last family or principal residence
at ___________________________________________________________ ___________________________
S
Decedent, then ______ years of age, died ____________________________ at ________________________
Month, Day, Year of death
City and State where death occurred
Note: No “UNKNOWN” values will be accepted
Estimated value of decedent’s property at death:
_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
$ __________________
Total Estimated Value
$ __________________
Location of Real Estate in Pennsylvania: (Provide full address if possible.) ________________________________________________
TYPED
Complete
Mailing Address(es)
Name(s)
&
Signature(s)
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