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Home My WebLink About01-29-07r IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA n ~ -,-~ IN RE: CHARLES N. STRAWSER, DECEASED C p _,_, c._. ~ ~ ~-~~-, ~ - N ~ .' ' --, ORPHANS' COUR~'1`i~VI9FON , ~ .~, ~_ -, PETITION FOR CITATION ~-" TO GRANT LETTERS OF ADMINISTRATION PURSUANT TO 20 Pa. C. S. ~ 3155 TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY: The Petitioner, Beverly Enterprises Pennsylvania, Inc. d/b/a Beverly Health Care -Camp Hill ("Petitioner°), a principal creditor of Charles N. Strawser, respectfully represents that: 1. Charles N. Strawser ("Decedent") died intestate on September 28, 2006. An original Death Certificate is attached hereto as Exhibit "A." 2. Upon information and belief, Decedent has two surviving heirs. Their names and addresses are: Name Relationship Jean Strawser Wife Robert Strawser Son Address Avila Road Apt. 937 Harrisburg, PA 17109 314 Mainsail Rd. Oceanside, CA 92054 1 ORIGINAL 3. At the time of his death, Decedent was a resident of Petitioner's nursing facility located at 46 Erford Road, Camp Hill, Pennsylvania 17011, and Petitioner was a principal creditor of Decedent. 4. Petitioner desires to have Shaun E. O'Toole, Esq. appointed by the Court to administer the Estate of Charles N. Strawser for the purpose of paying all debts owed by Decedent, qualifying the Decedent for Medicaid benefits, and distributing the balance of the estate pursuant to the intestate laws of the Commonwealth of Pennsylvania. WHEREFORE, Petitioner, Beverly Enterprises Pennsylvania, Inc. d/b/a Beverly Health Care - Camp Hill, respectfully requests that a Citation be issued pursuant to 20 Pa. C.S. 93155 to Jean Strawser and Robert Strawser to show cause why Letters of Administration for the Estate of Charles N. Strawser should not be issued to Shaun E. O'Toole, Esq. Respectfully submitted, SCHUTJER BOGAR LLC Date: \ 1. :1 0 1- By Misty D. Bar el Attorney J.D. No. 204190 Kirk S. Sohonage Attorney J.D. No. 77851 305 N. Front Street, Suite 401 Harrisburg, P A 171 01 (717) 909-8160 Counsel for Petitioner 2 , , EXHIBIT II A" HI05.905 REV.(6/06) Thi~ is, to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. /7 J -4 l-(5 ~ Cf~~ lf~ol No. Frank Yeropoli State Registrar Calvin B. Johnson, M.D., M.P.H. Secretary of Health 3944365 JAN 16 2007 Date H105:1<3 ~EV. 02I2l06 TVP6./':'RtNT IN PERMANENT BlACK INK 1. Harle of Decedent fFifsl:. middle, last. suffix) CHARLES N. STRAWSER CQHRECTED ITEMS / PER: jC j). DATE /~.:3/a6HfCOMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS '- CERTIFICATE OF DEATH STATE FILE NUMBER , 105062 11. Decedenrs USlJaI Kind of wen done d mosl of WCJl'1(i life. Do not !late retired . lOnjotw"",,-_ K(kIoI_,'......, Equlpnem: vperator Local Government . 16~'M"'N..Add""'5ml.",,_,_,Z)l.~1 'J3/ Avila Rd., Apt. 'jj1 Harrisburg, PA 17109 5 Age '''''' lli1hday1 90 Decodeor, AclualResidenc:e 17a. Stale lib Cooo~ PA Dauphin Did Oealdenl Li\teina Township? DRe....,ce DOne,. Spod~ 10 Ror:e:American Indian. Black, White,etc rSpoc'M Whi te .9-l v~ Sa. Plac:eofDeath Check Hospital ""'''' DER'_ DDOA DNU<SInil Home 9 Was Dececlent of Hispanic Origin? [iNo DYes lijl'8',,,,,,",C'-, Mexican,PuertoRican,etc.) 1.. Marital Slatw: Married, Never Married, W_,_rSpecify) Married 18 Flther's Name (Firs!. middle. last, sUffix) Sherman C. Strawser ~=rrsrt'r'~ser 17c. 0 Yes, Decedent Uwed in 17d,D~~~jWldwilhin Jean.AlexanderRichwine Lower Paxton Twp 21a.lIelhodollliopoOtioo DBul1,. D_fromSIaIe 19 Mo\tler's Nmne(Fil1t, middle, maiden surname) Elizabeth Turns 2Qb. lnformanl's M~ Adcnss jSIrMI, city 11OM1, sate, zip code) 314 Mainsail Rd., Oceanside, City/Boro CA 92054 Iil "l ~ " 21c. Plac:eafDisposilion(Nameofcemeklry,aematoryorotherplac:e) East Harrisburg Crematory 22c.N....lIld_oI''''''' FACKLER-WIEDEMAN FUNERAL HOME, 23rd & Derry 210 LocmoICIty'_,_.""_1 Harrisburg, PA 17109 . 1710iL Sts., Harnsburg. PA 23b. Ucen!18 Number 23<. Dale Signed IMoo~, day, "'" aoo(P 26. Wf.fS Cage Referred to Medical Exaniner I Coroner lor a Reason Other Ihill Cremation or Donation? D V" 0 No ~aRylistcondilicrlS,.ifany., leading to cause bted on line a Enler!he UMlERl. YIlG CAUSE (dileaseori~\t1aIlriliiiedthe evenls resulting ., deaf! ) lAST. +rz...;( ~r~ : Appmllimale interval Part II. EflterotlersianificallcondilWn;. cadrihulinn 10 dsaIh Did Tobacco Use ConIribuIe 10 Oealh? : OnsetloDealh but not resulting in lhe underlying causegiYen in Part I ~q';.yes DProbabIy , D No ",,",OW" 2.9. .FemaIe "':il,Not pregnant within pas! year o Pregnantatbmeofdeath D~ant,butpregnaotwilhin42daYS DNol"-',boI"-"3d",to',... ol_ D Unknown rf pt'8I7lanl within the past year 32c Plac:eallnJury: Home. Farm, SlnleI, Factory, 0l1i0e8uOdlng,a1c.(~1 L =~~=---.;. Due 10 (Dr.. e ODnsequenoe of) Dv" tJNo Dv" DNo 31. MMnerofOealh t:I N.... D - D- DPending~ 3M. Timeol"'" D- DCouIdNo'be~ 3Qa. WlISanAutopsy Pertomled' 301>. W..._yF~ A__~~ of Cause of Death? ~ ~ l!; I 330. ~Ichack"""""", . =~':::~":=:=:"~'::""~':::"':~~~~-':':.~I----- __ __ ____ - _ ___.E . ~=:'-==~c!::.:::~~=:::~~~""nner........________......_........_..D . __/CGnINr an..._ol_andr................."'Y 35. Regisnr's ~ 70(( .. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: CHARLES N. STRAWSER, DECEASED ORPHANS' COURT DIVISION NO. 89 of 2007 PETITION FOR CITATION TO GRANT LETTERS OF ADMINISTRATION PURSUANT TO 20 Pa. C. S. & 3155 TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY: The Petitioner, Beverly Enterprises Pennsylvania, Inc. d/b/a Beverly Health Care - Camp Hill ("Petitioner"), a principal creditor of Charles N. Strawser, respectfully represents that: 1. Charles N. Strawser ("Decedent") died intestate on September 28, 2006. An original Death Certificate is attached hereto as Exhibit" A." 2. Upon information and belief, Decedent has two surviving heirs. Their names and addresses are: Name Jean Strawser Relationship Wife Address Avila Road Apt. 937 Harrisburg, P A 17109 Robert Strawser Son 314 Mainsail Rd. Oceanside, CA 92054 1 ~(Q)~V 3. At the time of his death, Decedent was a resident of Petitioner's nursing facility located at 46 Erford Road, Camp Hill, Pennsylvania 17011, and Petitioner was a principal creditor of Decedent. 4. Petitioner desires to have Shaun E. O'Toole, Esq. appointed by the Court to administer the Estate of Charles N. Strawser for the purpose of paying all debts owed by Decedent, qualifying the Decedent for Medicaid benefits, and distributing the balance of the estate pursuant to the intestate laws of the Commonwealth of Pennsylvania. WHEREFORE, Petitioner, Beverly Enterprises Pennsylvania, Inc. d/b/a Beverly Health Care - Camp Hill, respectfully requests that a Citation be issued pursuant to 20 Pa. C.S. 93155 to Jean Strawser and Robert Strawser to show cause why Letters of Administration for the Estate of Charles N. Strawser should not be issued to Shaun E. O'Toole, Esq. Respectfully submitted, SCHUTJER BOGAR LLC Date: \ 't -:1 01- BY~llJt~>~~ Misty D. Bar el Attorney J.D. No. 204190 Kirk S. Sohonage Attorney J.D. No. 77851 305 N. Front Street, Suite 401 Harrisburg, P A 17101 (717) 909-8160 Counsel for Petitioner 2 EXHIBIT II A" This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance -:.vith Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Ct-~ <<~,l No. Frank Yeropoli State Registrar Calvin B. Johnson, M.D., M.P.H. Secretary of Health 'I ~ 'j 1\ ''I ("' ..:; ::J L~~ Lf- j b ~j -JAN 1 6 2007 Date HI05H3 "EV o21!.J6 TYPE 1.2RINT IN PERMANENT BLACK INK , Na'I1e of Decedent fFIrs\. middle. lasl. suffix) CHARLES N. STRAWSER Co\{RECf ED ITEMS / PEl(: ;:1])' Ol\1E /Oj3/v6MCOMMONWEALTH OF PENNSYLVANIA 0 DEPARTMENT OF HEALTH o VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER 105062 Yo 8600 Bb County or Dell\tl Cumberland Olh.. Inp<*enl DERJOutpatienI DooA o Nursing Home 9 Was~loIH'spantCOrigin? [iNo DYes (1Iyes.spec:il'jCuba'l t.4ellC<ln.PuertoRic:an.elc) 14 Marital $latus: Manied. Never Mamed WIdowed, 0iY0rced (Specify) Married o Residence 0 Other. Specify 10 Race Amencao lrdiWl, Black. While. etc (SpeCIfy) Whi te .9-1. 5 Aqe (Lasl Bir1hday\ 90 17b.Cot.nly PA Dauphin DId Decedent li...elllll Township' 17e 0 Yes. Oecedenl Lived In 17d 0 ~=~~Wedwilhll1 Jean AlexanderRichwine Lower Paxton Tw~ 11 Decedent's Usual ation KInd d wen done dt.rin most 01 wor1Ii Iile Do no! SIale relired . KindOIW~ KK1do!8usInes!-llnduslfy Equ1"pnent v[Jerator Local Government . 16 Decedent's Mailir)g Address ISlreel. city 110Wfl. s1ate. 1I'p" code) 937 Avila Rd., Apt. ~31 Harrisburg, PA 17109 -" Actual Residence 1701. SIale Cily/Boro 18 Father's Name (First. middle lasl. sufIU:) Sherman C. Strawser '"Y~~rSTtr'~lser 19 Mothe(s Namt'(First. middle, m8ldefi surname) Elizabeth Turns 20b In/omlanrs Maiting Address jSIreeI. city flOWn. stale, Zip codel 314 Mainsail Rd., Oceanside, CA 92054 L ~ ~.~ ",. 21c Place 01 Disposition (Name 01 cemelery, cremill()('f Of oIher place) 21d L0c.3lJl)n {Crly I ta.wl. slate. lIpc.OOe) 2101 MeltIodol Disposi1ion o Bun. 0 """"'. ,.." Sial< East Harrisburg Crematory Harrisburg, PA 17109 . 1710<' Sts., Harrlsburg. PA 22t Name and AddJess 01 Facility FACKLER-WIEDEMAN FUNERAL HOME, 23rd & Derry t'3tllir.enseNumber 231;. Dale$ignedlMonthday.year) ~~ d.t>Otp 26 Was Case Referred to Medical bcmner I Coronef lor a Reason Other th.... Cremation Of Oonabon') DYes ~No =~~~:::J:~l<R~ -lw,.;( ~ r~ : ApproximatE interval p~ II Enlerolher Sl9"ificantmndibonsmnlnbulinc ID deat!. 28__.Dtd Tobacco Use Contribute III Deatl" : QnselICDeath butootresullioginltleuoderIyifrijcausegiveoinParlI D.Ves OProbably . b No KI Uo'_ fj IIFemale ..~.~ =::i:;:::~ o NoIpragnanl.bulpregnan1witntn42days oIdealh o Nolpregnant.bulprelJnant43dayslo1yeiY 01 death o UnkrlOWO If pregnanl wilhtn \tie past year J2c Place 01 Injury Home. Farm. Street FactOfY OfflceBuiId1ng.elc (SpeciIy) Sequenhat1y lost condibons. If any \eadng Ie cause ~sted 011 hoe a Enler!he UNDERlYING CAUSE (dlSe3S( C,' 'nlUry\tlallniliatedthe . events rBu1ting 10 dealh I LAST Due 10 (DI' as a con~enc:e of) o Yes Kl No 3()) WereAutopsyFlfldIngs Available Prior k:l CompIebOn 01 Cause of Oeath? DYes ON' 31 MM!lerofDeath tJ N~~. 0 """",,,,, 0""''''''' Op""",-- 320 T"",d",,"~ o Soicicle 0 Could Nol be Delennined JOa WasaroAulopsy PerlormerP ~ o o i 3Ja Ceftifiel'lcheckonlyonel ~:=-~~=r~~::::t~Ih~:n<<~~~~:~~I:"_2~)________________ __-E PronouItCIng and ~lJ physician {PnysiciiWl bolh ~ death and cerbtying kl tause of dealh} To the bHt 01 my kn~, death oc;curr-' at me time, dele. and pia<<, and due to the ClU"(S) and msnner n stllttd_ _ _ _ _ _ _ _ - - - - - - - - - _...D ~:: =:mc::r~= Ind I or Invntigltion, In my opinion, dHtt1 (ICCttITMt at the time. dn. and pa.ce, and due to the Cluse(S) and menn... as atettd_ _ ...D J5 Regislrar's 70(( c:. ~