Loading...
HomeMy WebLinkAbout96-00895 II 1'1\ Thi, I' 10 ullIly Ih,ll du- 1l1Iullll.II,.11l lult ~:I\t'U.'" llllHll1\ tElI'It,III"lll .11I.llll~1I11lIC'11I11(.III' 1I11k.llh dlll~' hll..1 with IIll'.l' I.llt..1 HC'gl'"'.lr Tin' '1I1~1I1,t1.(,lllllt..It. "III bl- hll" 11,1, dIll ,bt ~I.Ht Vu.t! 1{",'lIh<< HIltl' Jill 1'1'111\.1111'111 ldlllg WARNING: 111111I000110 dupllcoto this copy by pholostot or photograph. ,<<,,,,',,'"'<<,,,'','~''' ;J1k. fl(/L -1/V~~it",~;"" ~ 3814395 NI). /, - "~/?'P~' rF'.~, . ---- D.lle ~.. 1111 (,nl.llA('NWI'"AIUffU' r'Nt.'YlVANlA. Df.PAllItM'NT 0' Hf!ALTfl. vitAl n[CO~ CERTIfiCATE OF DEATH ".I'H"__ ~~~';;'~~'"I'';-_'t~.:.''' -- ~~"-l-'-"'~~' ~,R. - '~:. Mttl~--~~~~~':~.- ~.n~;4;-~.~~~i.~~'-'i ..' j' ....~..-- .~f..f.u.-1-;....~;'..-1-'-;;."IN...... I tK~-';;.1 ~~.;'-~~~-=7;;';'" - -~.-::::---:- '. _......~. --1 ,.., "-1- .....- ....'.. ,~. .::;rr.. }I'"'' _.~ - -- . . !' I) --r1 .- ~s...! i, " :.1 \.' rh.ll!ll..':~/t'l'l!J'P^ -, ..............l ~'" ,- ~ -~_~.n :;~.':;f:" -- ~-(;:;::~;:,:~;'- [':;;:~,~:~:::,~:~;~::--_. , .7~,:~~:;--;,:-'~"- l..lIl.!t'\U..."'.........,~'" r ......~~..;.";".;:. :;;;;:~. -l~...~,li;;rh;;r,;;l .... lI.... '''''''~'lGvt 11I..- ...... ..... ...... "." . ....... 'r,.'" 4".~1:-" J~f~'''1'OW.. . ... .~_.... J'l:.7f;:............".......... ___I..~ ','1, l'.~i.,:,...,'J,~J,. ..1., .....~__~~~___ .:.'_;~~.,:~-~~~-1. ~~:;7i .'-----..., 'U'['o(i'o.717.':;;-l~;';('-"'''' .~'':';~'..r'" /',\ --.-~ .,.lj___"_u,~,~uthll"p("'_ .---.,.- - Slt'pr,'I\t.IUI'll.r., ".,4 "-"'" W:l"HI\t1Ul:'::'" ,.......-- !,.t__________. ..~_...!!_._:!.~-_"!~_;=7::c;~.-__=:...;;::..=_.;: .- .11.....'...... ~.. ......,... ....l"."''''''...~.. - -.......-. !, ~l(t":.~ C. l.l'tt.ft.l1":!<.______.___.__ ,. G1!llCI' A. ffMduw ...,_..., "'.......'.......... . ...~I'~'~._.....__l",..... ~!'.!'~_ __ ___ _ ~ '" 40 C'dbtn l.1l'li'. Sh(t'''rn~,..l!1a.. PA I n"7 ..fii.li.-j~_.... I..;.-'.r."l~....~ - .~- ..."''''CIIW'<'''...__.I'~r.-. ".A;.l'I-.:;;.-c::;;;;T."j';;;,------ I r.:-O ::.-..~~~::-lJ =-I..:......:.~__ .~...:~~N './C':}.?t :r;,7n.c1t~ Mtm.J.'fltl Ga,'tdrt1~ r~'1"{~tH' Tlt'r.. r~.ld'((ll Ct..r,;': ....-....~~"'ijd"-"4\l~r.~.') ...........,...... r:77,;,,;-.....;;- ........,.,"'.......u,.. . 'I Ift--L{[;{"I'- _!t_ I ~~ V(r-,' , .., I,. ,~" ~ .:. IJ~~':'l.!.U~l;'~~~'t(l~JM'I1.ff.ltr'~rtl ~'!...3~lb ~.!~1lY'~.fl..!':!1'..\J.:~'~~ ........_,......._.__ '._,_..-,..".......,..... ..~.....- -. ....u ....~.- t'f"'~ (>&" .......0 I ......._._.........._.......... """. ...,..,:.to::'{)"T ..........-. '....._~_ ... '" :~'\.. 'L... '-'~I.I"I ".."l.~:f'lf..'.I!.,.,l..1 _ ',__W_" -..,,';;'" ... T,;...;:~r'!..'" ,~.'..;' --- _"....,_""~'~,..,;;;m~......---_.j __....-........ II ,. ~.' ..I, ' '1'1, ,,__ j' ":._ _._If. _1.1 ...tot ..- .._.. ,_..-..;.;".;;-~;;,::.,;;;:..:.:...... _...~..._ "..,..................................- ,..1'. ._~...___.._w ....-....,--....... :---..- ...._.<'\I.....---,-~.....,.,. ,_.__ I I /'\ ~ I ,.. j _"".e.....'.... .-,.......... -..,.,..-,."-. \.i C' , \; ............,... - ,\ \'. .1 " llr', ) '\i"..k~/,_ ('. ' . !. f 1". (..,....' t"'r.... .........___. .1 " /! <-4 :"':_,i_'.'f\ _ " /' --- .....-.-. '_'___.'110 C.UIf._...... ...----- _....._.1". \: ,- --- -.---.-.'-- -.......,"'..... ...'...."...."..... ......,-,.. _...I......'~. ............. ...., ...,...... ,). ,,- :_" ..\ '"-' \ .....d. ..'.... .. I.. \ \ ,', !...' I. ,.1. ...."...........,. . , , . 'I" ) .. I ~ ( : _ . .t_..~~_ J,,"f. ::......(... 1,.LJd.~h " .. ). , " j # '- '. 1 j',' \~'I\~' \ . I.' -,' .":I"'O...~._C'['........,;-~..";-;-....; ,- - '. ..1' 17 ',:"':', .._;...!':.__._.~.... - -t;.......'...=-- ..-.;..-:....---- ..............T~.j,:r..;t".-...ii._.-_- -. -.. LJlt..._/~_/\r.'<..V~.,~ji.~. U"IL.~_~~ -:--....-. .........._" ,......,........,..,... I' }-~ (' -:.'1.... ..\. . :' '. ,~. : ' . "....'...,W;,,,J",,~.'..;,;r...',:,,'".,..or, .'... -. ,~'''t"!'..... ... .... ......... _.._...".........,_ ,"fit_;" l.J"f-t ;, ,';-, ),t,... " " l:J:I"- l.... ->/'. -', 'it:'" i-. . __,...__ _~__..L'-.:)_ ._,__.__' ,.,.."';?P:,.,.. ' . '/.' .-f ~".. I \' ! ,', ,.,~.. // .-1.~-:- /r....;~ . .....; >" .;.cru..._...._.L._. 1...'_ ____. ," . U ..,'I .11 - ..,......"..~.~.- ... - u~.i"";.=;;:. ...;---- 'C1.'.IO'I'In""'.I"'''~'''''''' .......,........-..... ...~ . " ,...-......-.0 ...........--......-..-..-.......... .. .\IOfIC'IIOI............ull,.,......................... _. ".. R _. ,.. .....-....,.-..........................-.- ....-.... _.............~. .~.. .-.."..., .",Do(lL..,,,,,,,Il'f"""""'" 011............__............."....._ ....,.......... ft...................." _M"_ . to. " ~..,....,.."..,.......,.....-. ~'/'/' ' t 1,/ " d It /, I.' 1 l --'1/" clUj. /.( j. , '.0 , '. '.:- r J r \0 I :"":"0 ~-~ ::~ 1_: ~..; \ ,J '- ~ C;u ~6a - 96 - LZ \ i, .eono,...rt;"'" """..21.."""......-.., ! t lComPeI. It,me 3. 41. and 4b. : I .~":: l~ name Ind ,del'''' on ltMt fiver,. oliN. IOfm 10 lhal we can ,eturn Un . ..-..,tth thI,tonn 10 lhe 'fcQ ollhl fMIlpitC8. or on IhI back Illplte doe' not pol"", J I 'Wn'l 'nttunt R~pI RIQ~.rld. on tho madpece below the artICle nufTi)er, ,ti . The n..urn RlCetpt Willhow 10 whom thl .f1ide was d."vored and Ihe date is _Of'" \i 3;:~a;~t~IN~IE~Q : 701 1:., I<.JNC,.sT) l .5itlP PE:N~BuRC), PA : nZ51 I 5, Racalv~ By: (Prinl Naral J . I S{. U,- J. ,U,,~, .( : \I 6, Signa ,a: tOssae or II I i!. X '/I IJ! PS Fonn 3811, De I also wish to ,ecelve the lollowlng saMeas (10' an ell1ra lee): 1. 0 Add,essee's Add,ass 2, 0 Restricted oellve'Y Consult postmaster lor lee, 40/'1 Artiela Numbe, l'~ CJ1.- 3o~ - f] 2. 4b, SeMca Type o Regtstared ~ertllled o Exp,ess Mall 0 Insured o Return Rocoipt for Marchllndiso 0 COO 7, Date 01 oellv8':./ (f -. 6, Add,e.. e's Add,ess (Only il requesled and lee Is paldl Domestic Return Receipt . or p. 49? 3 5 8 ":,,2 US postal ServlCO Receipt for Certified Mail !Jo !n')wunco GOVNag~ Pro'_ided. Dc, n~)1 use lor lntellli.\lional M,lil St.1tJ tollerso Posta'jo CC11jf,fdFc'! SpP.O.l1 Oe1r,ery Fee Hesttlctf'o1 Oe~very Fee ., ~ Helum f"lCCClpt $hOMO\) to Vl'hom A. 0,118 Oe~~ercd a Po'tr.'lf<o:t(ll~n;IO,,^W.. c( D,t~~.&W~~'SWt"!tS g TOTALPosugeA.Fees. S co M PO!.II'TWIo. 01 Oalc E o u. U) n. l~ .1 1,. ,., . ,. "..' f i." --., r~ r-~._.--:-"'-;"'~ - ~~... .-,-:.. . STATUS REPORT UNDER RULE 6,12 Name of Decedent: (';':h/d,{ {\-. {U, 1IIIi I" <, 10 I ~L/ I () G I Date of Death: Will No, Admin, No. 'J1 -:u - (ik- - (1 ~'IS Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2, If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No, 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No ~ . b. The separate Orphans' Court No. (if any) for the personal representative's account is: c, Did the personal representative s)<~e an account informally to the parties in interest? Yes, No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: I I /"1 <:'<) I L' .., C~1i ndJ llj~.1c;_ e, -" I Signatu e S/J~~ ,J Gu, ;,-A-~/ Name ( ease type or print) '7l'l ~ {( t " J ~r- Ad~1:~i}U)('~ s. L,,1.' ~ P A- (1"1) <;03if- '1l( L Tel, No. Cl) Capacity: Personal Representative ^ Counsel for personal T-'--representative ~ " ~ -- , 'J .. ~~ ':-~ (HAH: rmf/ AM3)