HomeMy WebLinkAbout06-19-06
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
, deceased.
No. 21-06- 5'4tn
To: Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
Estate of ETHEL MARY LOSCHER
also known as
Social Security No.
177 -24-7055
The Petition of the undersigned respectfully represents that:
Your Petitioner, who is 18 years of age or older applies for letters of administration on the estate of the
above decedent.
Renunciations for Gary S. Loscher are attached hereto.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal
residence at 6608 Carlisle Pike. Mechaniscbura. Pennsvlvania
Decedent, then ...1L years of age, died
Center. Carlisle. Pennsvlvania .
Mav 18 , 2006, at
Carlisle Reaional Medical
Decedent at death owned property with estimated values as follows:
(If domiciled in PA)
All personal property
Value of real estate in Pennsylvania, situated as follows:
6608 Carlisle Pike. Mechanicsbura. Pennsvlvania
$ 2.000.00
$72.000.00
Petitioner, Michael R. Loscher, after a proper search, has ascertained that decedent left no will and was
survived by the following spouse (if any) and heirs:
Name:
Relationship:
Residence:
Gary S. Loscher
Michael R. Loscher
Son
Son
36039 N. Grand Oaks Ct., Apt. 102, Gurnee, IL 60031
13 W. Yellow Breeches Road, Carlisle, PA 17013
WHEREFORE, Petitioner respectfully requests the grant of letters of administration in the appropriate
/JlfJ:J unders~ ';
~~ -) ::;
Michael R. Loscher .
13 W. Yellow Breeches Road
Carlisle, PA 17013
OATH OF PERSONAL REPRESENT A TIVE'.j
C~)
c.,
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
The Petitioner above named swears or affirms that the statements in the foregoi petition are true and
correct to the best of the knowledge and belief of Petitioner and that as personal re sentative of the above
decedent, petitioner W...ill well and truly administer the estate a~!to law.
Sworn to or affirmed and subscribed ..IL..f/.L'Y ~
before me this ~ q-+t.-", day of ' Michael R. Loscher
June, 2006.
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No. 21-06- 5~ lJJ
Estate of
ETHEL MARY LOSCHER
, deceased.
DECREE OF GRANT OF LETTERS OF ADMINISTRATION
AND NOW, June 19. ' 2006, in consideration of the Petition on the
reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Letters of
Administration are hereby granted to Michael R. Loscher
FEES
Probate, Letters, Etc. . . . . . . . $135.00
Short Certificates(-2-) . . . . . . . $ 8.00
Renunciation(s) ........... $ 5.00
JCP .................... $ 10.00
Automation Fee........ ....$ 5.00
Other . . . . . .. .... $
fill TOTAL:. . . . $163.00
Filed . . ~:- . . to :- ~q.-: Q\.t. . . . . . . . . . .
60 West Pomfret St.. Carlisle. PA 17013
ADDRESS
717-249-2353
PHONE
1/1
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.
Fee for this certificate, $6.00
p
12338874
No.
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Local Registr .
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TYPfJPAINT IN
P€MtANf:HT
BLACK INK
1. Name 01 DKl!denl (Fast micldle. last)
Ethel
c2l - ffiD - 54-(P
COMMONWEALTH OF PENNSYL VANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FilE NUMBEA
o
0-"
M.
Loscher
:;. Age jlasl biithdiYJ
8. Birth ce C and slale 01 lor .
76
v"
]. OaleolBtr1h Mofllh,da
6.
-Sb, Coonty 01 O"ealh
Cumberland
Carlilse
12.
o Yes No
Oecedenrs
Aclual Residence 17a Slate
PA
17b. C,"n~__ ~l,IlIl~ ~. rl~l!<L
19. MoIher's Name (Firsl.lfiddle, maiden surname)
18. Falher's Name (First, middle, last)
Medi ca 1 Ce
0Ih0r,
lienl 0 DOA 0 NUIS Home 0 Residence 0 OIhe"
9. Was Decedenl of Htspani; Origin? 10 Race. American Indian, flack, Whil., *
Xl No 0 Ves.(lIyes,speciry,Cuban, (SpeciI)1
MexIC8ll. Pueno Rican, flic,)
o h' esl ade
ColI8ge (H Of 5...)
14 Marlal Slatus. Manied, Ne'W8I marriid,
W_"'.D_(~
17, II V...Dec.....liv"'n.u~ili~T_ .~pr.in!!.__ _ Top
l1d. 0 No. Decedent lived within
ActualLimilsol
cty,,'Bofo
20a Informant's kame (T ,petprint)
Genrge Wa{J..9-O.n
Esther Hosler
2Ob, Inlormanl's Uailino Address (Slreel, clyllown. slale. z~ code)
Mi chael R. Loscher
13 Yellowbreeches Road Carlisle PA 17013
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21e. Place of DispositIOn (Name 01 temelery, crematorr Of other place) 21d. locaIion (~l1own, slate, zip codel
FD-012662-L
St. Pauls Lutheran Cemeter Enola PA 17025
24 TimeotDealh
25. Dale Pronounced Dead (Monlh, dar. year)
~
l' t~' f.M
CAUSE OF DEA TM (See inatrudions and eumptn)
lltm2'1, p.n l. fnlellh.~ - disNses, inpJfil$, orcOftl)licaWlis ~ IhaldirlllClly C&~tcIlhed8ath, 00 NOT enIer terminal events such eSC8rdlac ants!,
respwalory an.sl. 01 t'enUiculaf ibrilalion wlthoul showing the .lioIogy. 00 NOT Ibbf8~iale, EIier ontv ooe cause on a IifIe
IMMEDIATE CAUSi: IFNI disease Of
concIlI>>n resuling in death) -? a
~- If'
'2 ..; ',j ...
Approrimale inte(val
onsel10 dealh
_.BET ,j"1bQtc' c... E IJC- C /-1#,-f- L a/' ff T tf ~_.._
DU8Io(Qfasae~eol): . r:-
s_"." '0"""", ''"v. .... _ .___/1.1:.. AL.Lt...b__~~R.e........
- =~~~~=~a ~:~.,_as-''Z''it?clL__fl~lLJ{o5LS_..__________..n_
QvenI$ resuling in death) LAST Due 10 (or as a COflS8QUeIlCe 01):
, ". _ .",..f"k..A,c.ZILEd: TiLl ~
JOa. W&sanAllopsy 30b Wer.AutopsyFlldings 31 Man.!"ofDealh
Performed? A-wailiible Prior 10 Corrlllelion 6 Nalufal 0 Horricide
01 Cause 01 Dealh?
o '1'8$ 0 No 0 Accidenl 0 Pending Invesligalion
o SUICide 0 Could Nol8e Det.rmined
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32a, Oile at Injurr (Month, day, yeat)
o Vas--",No
Pafl f1: EllIer oIheI siani6canl conditions conlribulina 10 death,
bUlnotlllultinGinlht~CMIM~inPartI.
28 Did Tobacto UM ContrIluIa 10 Dull?
CV..CProbatllr
srNo 0 """-
2i. . Female'
........-... pragnao. ..... pa. 'fOIl
'0 PregnanlatlimlotdeaCh
o Not pregnant buI plegnanI wU1i'I 42 days
0'.....
D Notpr~.Wpr&Qf'llnl43d1yslolYNl
_......
o Unknown if pl'~ wIhin Iht PHI yeal
32e. PI&c.oI~: Home, farm. S1rteC, FICIofy, Ofk,
~.alc{_
32b Describe how Injury Occuned:
o Yes ~No
32d. TIfOO of Injury
32.. Injury al Worll?
o Yes 0 No
M
J3a. Cenlfiel (chec& only on.,
Cerlitylng ph,.s.Ic~n (Ph~SlCiarI cenily-iog taU$& 01 (le.ln when anolhlilr phYSICian has pronounced dealh and cofl1llaloo Item 23)
To &hebesl of my knowkldge, deoillhoccurred due 10 lhe caUH(s.) .md manf1llf as SU1Id... .. ............................................. ...................0
Pronoundng and Clrtifylnj ptlysltiul tph~sician buill plOflOUOCing dtIalh and cel1ityll"lg 10 cause oj death)
To !hi best Of my knowtedtt, dulh OCCUlted at lhe lime, dati, and pa.ce, oiInd due to lhe c:ause(.) Ind INInner as staled.. .. ......... ..... ........................ ......... ....... ....rJ
lladk;al examine,Jc:o,onet'
On the b.asi$ of exarnin.aUon and/or Inve$ti~llon, In my opinion, dulh occurred .Illhe lime, dale. and place, and due to the Ciluse(sland manne, as stated. ..... 0
Dale Flied (Month, day. yeal)
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321 II Tlanspor1alion Injury (Sped/)')
o OriverfOpelalof D Passenger
o Pedestrian 0 Oher - $peary:
33b. SignaWreand UIe01 Cerliief./7 '
/ ~G->L--
llCefl$&Nuntlef
HP
32g. Localion (Slreec. cityAown, SSlS8)
~.- Jl'tZ IA/ T D~ IVF-
c~/lL/) Le, I'A- 17013
33d, Oat. Stgned (Month, day, year)
s-, /8 l':;' C'.b
I1/)07'r321-L
34 Name and Address 01 Pllfson Who Conllleted Cause 01 Oaa\J\ (Il&m 27) Type/Print
J"VLI1/52-- Vlrt?:"C-<-<--1 I ND
, I/5sPfllA/r PILIVfi:"
Lll L~~ '0 O() _~U5t..J<" P.4- 170'3
(See instructions and e amples on reverse)
RENUNCIATION
In regard to the Estate of Ethel Mary Loscher
To the Register of Wills of Cumberland
, deceased.
County, Pennsylvania.
The undersigned
Gary S. Loscher
of the above decedent hereby renounce(s)
the right to administer the estate and respectfully ask(s) that Letters
of Administration
be issued to Michael R. Loscher
WITNESS our hands this !J / (.1, day of
SWORN AND SUBSCRffiED BEFORE ME
THIS~~AYOFMAY, 2006.
/'
May , 2006.
/~lstd-
36039 N. Grand Oaks Court. Apt 102
ADDRESS
Gurnee. IL 60031
'C~
COMMONWEALTH OF PENNSVT :VANIA
No:C\riai Se~J
Kalen S Noel, ]"J;"ary Public
Carlisle Buw, Cumberland County
My Commission Expires Dec. 8, 2007
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