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Appo+ntme~t of person~l representat~ve ' (2) Appo~ntment of adm~nistrator
(i) Appointment of executor, or administrator with Q Petit~oner ~s a nom~nee (See attachment 3e(2?)
will a~nexed Petit~oner is ~elated to the decedent as:
f. Pet~l~oner ~s named as executor m tne wiu.
ii. ~ No exetutor is named m ths wdL
iii. ~ ~etiiiiuiiei is a i~i~ni~t?et~a ~Sera aiiaGiui~~t+~i ' l3j ~ hN~uit~i:nai~i ui sN~ciai ~om~nisi~aiui rr~iur~i-
3e) ed (See ettaChment 3e(3) fo~ grounds and re-
iv. Q Ot~er named ezeculors w~ll not act be• quested powers).
• Cause of Q death ~ dechnahon f. Pet~tione~ ~s a~$~~es~dent ol Cal~tom~a.
C] other reasona as set fohh in attach- Q nonresfdent of Cal~forn~a.
,
msnt 3s(iv).
FACTS CONCERNING HEIRS ~
t
• (Comp/eb ?n ell cases.) ~ (Compfete onfy ?I no spouse or ~ssue surv,ved the dece-
t a. The decedent is survived by_ . dent.) (P?ob C 228, 229) ~
(1) C spouse. ~ no spouse. c. The decedent
(2X$~h~ld. Q no ch~ld. • (1) Q had no predeceased spouse.
(3) G issue of pre- no ~ssue of pre- - (2) C had a predecease0 spouse whose Ae~rs are
dec fased child. deceased ch~ld. named m the I~st of heirs_
(I) C parent. ~ no parent. (Compfete only il no pa~ent or ~ssue su~v~ved the dece-
b. No surriving child o~ issue of a predeceased ch~td dent.)
has besn omitted irom Ihe I~st of heirs. d. The decedent is survived by
(1) Q a brothet or siste~ or issue of a predeceased
brother or s~ster and none has been om~tted
hom the I~st of heirs.
(2) ~ no brother or sj~ter or issue ot a predeceased
brother or sister.
S. The names, addresse~, relat~onships and ages of he~rs, devisees and legatees so far as knoNn to petitioner are:
(lfst a~dit~onal names, addresses, relat~o~ship's. and ages of he~rs, dev~sees, and le9atees m attachment 5.)
, Name and Address Relatwnsh_ip Ags '
Barbara Jean Coberly i
2144 Cotner, L.A. , CA 90025 Former 1Vife Over 18 :
Jack Neal Coberly, II '
3233 Q St., Eureka, CA 95501 Son Over 18
Scott Neal Coberly, Deceased
~
Linda C.~Coberly, 2140 Cotner
~ 2140 Cotner, L.A., CA 90025 Daughter Over 18 ;
R
i Marsha ~egum (formerly Brown) • -
~ 335 Reims Lane, Costa Aiesa, Ca ~25~i ~vu~in C~?er 18
~ -
~
3
~ ADDiT10NAL FACTS CONCERNING THE INDEPEN~ENT ADMINISTRATION OF ESTATE .
~ 6. a. Q DeCedenYs +ivill does not preclude independent administration of this estate under Prob C 591 et seq.
b. Q Decedent die0 iniestate.
~ ps1sd: August 30 , 19 7 7
~ . .BARBARA JEAN COBERLY. . . . . . l ~ «r'
(Typ~ a vwN n+nN) (S~p~f~tw~ ot Mutarnr)
~ certity (o~ declare) under penaity of pery'ury that the foregoing is true and conect and that this declaratian is ex uted
on (Date): Aug. _30 _ 1977 _ . at (Placa):. Lns .Ange 5 . . _ . . . _ ~itor a.
BARBARA JEAN COBERLY
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