Register of Wills of Bucks County, Pennsylvania Petition for Probate and Grant of Letters Estate of No. 09- also known as , deceased Social Security No. Petitioner(s) who is/are 18 years or older, apply(ies) for: (complete “A” or “B” below) A. Probate and Grant of Letters Testamentary and aver that the Petitioner(s) is/are the execut named in the attached last original Will (□ Self-proven) of the decedent, dated dated and codicil(s) (State relevant circumstances, e.g., renunciation, death of executor, etc.) After the execution of the documents offered for probate: decedent did not marry; had not been divorced and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S. § 3323(g); did not have a child born or adopted; was not the victim of a killing; and was never adjudicated an incapacitated person, except as follows: B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) 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 (if Administration, c.t.a. or d.b.n.c.t.a., enter date of Will on Section A above and complete list of heirs), was not the victim of a killing, was never adjudicated an incapacitated person and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S. § 3323(g), except as follows: Name Relationship Decedent was domiciled at death in last principal residence at Decedent, then years of age, died on Residence (Attach additional sheets, if necessary) (twp/boro) Bucks County, Pennsylvania, with (his/her) at Bond required: □ yes □ no $__________________________ 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 of Bucks Value of real estate in Pennsylvania situated as follows: $ $ $ $ Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned. Signature Typed or Printed Name, Residence and Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com Oath of Personal Representative(s) Commonwealth of Pennsylvania County of Bucks The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of the Petitioner(s) and that, as personal representative(s) of the decedent, Petitioner(s) has/have provided proper identification and will well and truly administer the estate according to the laws of the Commonwealth of Pennsylvania. __________________________ for the Register of Wills  Identification:  Identification:  Identification: File No. 9- Estate of: Sworn to or affirmed and subscribed before me this day of , , Deceased Decree and Grant of Letters , AND NOW in consideration of the foregoing Petition on the reverse side hereof, satisfactory proof having been presented herewith, IT IS DECREED that Letters are hereby granted to in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the Last Will [and/or Codicil(s)] of decedent. FEES Letters Pages in Will ( ) Codicils ( ) Pages in Codicil ( )…………….…………… Short Certificates ( ) Renunciations ( ) Witness Affidavits ( ) Bond Filing ……………….……………….…… Filing Inventory Filing Inheritance Tax Returns Processing Fee Pleadings & Papers State Surcharge Bucks County ACP Traveling Registrar Mileage Other TOTAL Register of Wills $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Attorney of Record (Supreme Ct. I.D. No.) Address Telephone American LegalNet, Inc. www.FormsWorkFlow.com