HomeMy WebLinkAbout03-12-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of KARL M. HECKERT
also known as
File Number
~ ~ - Dl- DW
.
, Deceased
Social Security Number 171-28-1823
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the
last Will of the Decedent dated and codicil(s) dated
named in the
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
IZI 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 in Section A above and complete list of heirs.)
r Name Relationshin Residence I
L. Dennis Heckert brother 413 E. Market St., Gratz, PA 17030
Decedent's parents predeceased him, he was never
married, no children, no other siblings
Q
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.'"" 55
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Decedent was domiciled at death in Cumberland County, Pennsylvania with his / her last principal r~sM~e at
1 Richland Lane. Aoti 04. Camo Hill, P A 17011 East Pennsboro Townshio ' "C' iT]
(List street address. town/city, township, county. state, zip code) i'-} ~(
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Decedent, then 71
East Pennsboro Townshio
years of age, died on February 4,2007
at Golden Age Retirement Center~: ~-:.?
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Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
N
10,000.00
$
$
$
$
situated as follows: none
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:
T d or rinted name and residence
L. Dennis Heckert
413 E. Market Street, P.O. Box 205
Gratz, P A 17030
Form RW-02 rev. 10.13.06
Page 10f2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
SS
COUNTY OF
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 ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
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Sworn to or affirmed and subscribed
before me the !,.,.2..C:n day of
f1\ttMJ\ ,~
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For the RegIster
_~..;.J<.,
.
Signature of Personal Representative
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Signature of Personal Representative
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File Number:
~ \ D\ oa~
Estate of KARL M. HECKERT
, Deceased
Social Security Number:
\"\ \ ~ ct \~~) Date of Death:
AND Now,f'0oi' C/D "d--
having been presented before me, IT IS DECREED that Lett s
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
Letters ............... $
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
~cQ
... $
~\-o ... $
... $
... $
... $
... $
... $
... $
... $
TOTAL . . . . . . . . . . . . . . $l l . OD.....e:oo-
~s . (j)
\::l.6D
FEES
\l) 'ou
s- O()
Attorney Name:
?--Jh~ ~~&2:JL'
~errence J. Kerw , Esq.
Attorney Signature:
Supreme Court I.D. No.: 29922
Address:
Kerwin & Kerwin
4245 Route 209
Elizabethville, P A 17023
Telephone:
717-362-3215
Form RW-02 rev. 10. l3. 06
Page 2 of2
H105.805 REV 1/05
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
13106251
No.
~/7;r
Local Registr~
Fee for this certificate, $6.00
p
FEB 0 7 2007
Date
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REV 1112006
I PRINT IN
IlANENT
,CKINK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIRCATE OF DEATH
(See Instructions and examples on reverse)
uly 23,1935
emoyne,PIl.
~l-
STATE RLE NUMBER 0 I - D
N
VIS.
4. Date 01 Death (Month, day, year)
- 28-1823 Feb.4,2007
1.Nameo/_{A...._.Iasl,sufllxl
Karl M.
5.NJil{LasIBIrthday)
71
6. Date of Bir1h (Month. .
7.80111
and state or
Sb. Coonty of Death
Cumberland
6d. FacIIy Name (W noI_.1tR "reel and nuniler)
Golden Living Retirement
P.O. Box 205
'7b. County
ppnn~ylv;ln;;I
Cumberland
14. :"~~"f~MaIlled. 15. SUf'living Spoo.. (Wwife. giwmaiden name)
never married
D<d Oecedent
Uvolna
Townohip?
17C.lXlves._Uvocl" F.;I~t
17d. d No, Oecedenl Uved within
Aduallinlls of
PAnnqhnrn
Top.
11.lJecadenfsUSuol mos1of l118.lJonol_
Klndo/_ Klndof_llndustry
minister church
~ 16. ~s MaiingAdd.... (S1Jeat. otyl_. _, lipcodol
12. Was Decedent ever in ltle
U.S. Annad FoIte8?
D Yes No
~s
ActuaJ ReskI8nce 17a. Slate
Cltyl8olO
Samuel G. Heckert
19. _'s Name (FnI, _. maiden surname)
Irene W. Lohr
2Ob. I_s Maiing_(S1Jeat,OtyI_. state. zipcodol
PO Box 205, Gratz,PA 17030-0205
21c.Placeof~(~0/,*"",ely._or_ofacel
amp Hill Cemetery
21d. Location (Cltyl_, _, zip codal
Camp Hill,PA17011
Hummel
23a-<1rit-COItif!O!9
pIly9Iclanlsnol_allImoof_1o
cat1IIy_ofdeslll.
Items 24-26 must bll c:ompIalod by person
~ "'" pronour<as_.
24. TIme of Daalll
C .'() M.
CAUSE OF DEATH <Seoln_a and eaamplea)
Item 21. PaI1 k E1ller1llo~--.injurie6. orc:ompllcalloM-lIIaIlIradtycausodlllo_. DO NOT ente<_ events such as ca_ arrest.
mplralory anasI. or _ _lion wIlhout shc>wing lhe lllioIogy, U911rit one causa on each ine.
~=~=)d~ /I1t"77'!-sffl-onc.- ~,,~A..l
Due to (or as aCCll'lSeqJ8nC8 of):
ApproxImate ntervaI:
0ns0I1o Daelh
Part II: Enter oIher Rimilil:MI c:onctIkm contrtIuti'la to dMIh,
butnollOsUting "lhe l.I1de1Iying-1tRn "Palf I.
28. Did Tobeoco Use ContrI:lute 10 Death?
D Yes DProbably
D No [jJ.;tfiknown
29. II Female:
D Not pragnanl wiIlln pest yoar
D Pl8gllOIllsttimeofclealll
o Not pregnant, bullRiJlanl withill 42 days
o/deslh
D Not pregnan\ but pragnant 43 days 10 1 year
beIoreclealll
D _MpI8gfla11I_lhepestyeai
32<:. Place of II'jur( Home. Fa... Slrset, FadOlj,
0IIlca BuidInO. etc. (Specify)
c-~c:.. C'72-
_NsIc:ordtions.ilany.
IeailnatohC8UIIlstedonlinea.
EI1ter h UNIlERI.Y1NG CAUSE
=:-~~~r.e
b.
Due to (or as a con.sequence of):
Due to (or as a consequence 01):
:lOa. Was an AuIopoy
-
d.
311>. W... AuIopoy F.oogs
AvaiablePrlorIoCornplollon
01 Cause of Death?
Dves ~
31. MaMor of Daelll
[].MliiaI D -
D _t D PendIng Invostlgation
D SUclde D Could Not be Determined
32d. Tlma of Injuoy
M.
321. If Transportation Injuty (Specify)
DOrMlI/OpeIalor Dpassengei Dpodestrian
OIlIer. Specify;
33b. Signa'" and Tille 01 Ce1tiller
329. Location oIlnjul'/ (Slrset. o~ I town. state)
DVes [j}.l<<('
I ,;{I / I ?i / I / I 7 '0'0'17
~_,,~ D.~" Nn ("') Ill\" l.. l I
330. Ucen.. _ 33d. Date S<gned (Monlh. <ley, ye8I)
DSOof"l'1 t ---L 2 - ~ - C>..,
34. Name andAddreas 0/ P'~&'R cg;o/ DaeIII.J..Item.Pl~1 Print
,j aE C::AHTN ,D.n. N
8'7 ;;;> i dJI)?;:..... ;:;;c
.A.- K -+ I
f):b
330. CeIfifier 1_ only onel
. ~"':::==:"~IIIo"':.::.'i'::=~~_~-~~~~~~- _______um____ D ~
"""""""* and COI1IIyIng pIIyaicIan (~ both pronou1CIng clealll and ceIfIty;ng 10 _ 0/ deslh)
To till belt 01 my ~ """'" occunecl allIIo_. _ and~. and dllOlo Il1o cause(a) and manner es stated... - - - - - - - - - - - - - - - --
. Mtc:IcaIEPmirw/Coronlt'
On tht bells of eXlmlnltion.oo I Of I~ In my opinion. de8th occumtd It the time, date, and pI8ee, 8nd due to the cause(s) .nd manner IS stIlecL 0