HomeMy WebLinkAbout03-27-07
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Register of Wills 0 Cumberland County
PETITION FOR GRANT OF LETTfRS OF ADMINISTRATION
Estate of. Kathleen Ann Conn No. I J - 0
also known as 0:
, Deceased.
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
Social Security No, 187-64-1542
The petition of the undersigned respectfully represent that:
Your petitioner(s), who is/are 18 years of age or older appl ies
Decedent at death owned property with estimated values
(If domiciled in Pa.) All personal property
(Ifnot domiciled in Pa.) Personal property in Pennsy
(Ifnot domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minori te)
the above decedent.
Decedent was domiciled at death in Cumberland County, ennsylvania, with h~ last family or principal
residence at 4907 Delbrook Road, Mechanicsbur ,PA 17050
(list street, number and municipality)
Decedent, then 23 years of age, died Novem r 12, , 20 06 , at
Hershey Medical Center, Derry Township, Dauphin Count , Pennsylvania
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Petitioner_ after a proper search ha~ ascertai ed that decedent left no will and ~arvived b~e
following spouse (if any) and heirs:,;:::z
Name Relationshi Residence ~~~ CJ
Aidan Richard Self Minor Son 4907 Delbrook Road. Mechanicsbu
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THEREFORE, petitioner(s) respectfully request(s) the gr t ofletters of administration in the appropriate form
to the undersigned.
Residence s ofPetitioner(s)
4907 Delbroo Road, Mechanicsburg, PA 17050
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Register of Wills 0 Cumberland County
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OATH OF PERSONAt REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }
SS:
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that t e statements in the foregoing petition are true and
correct to the best of the knowledge and belief ofpetitioner(s) nd that as perso al r presentative(s) of the above
decedent petitioner(s) will well and truly administer the estate cco d" g ola
Sworn to or affirmed~d sl}bscribed
B~ this ~ tL. day of
l1Qh. L _,2007
;1 nda ,1(JAJ1~a ~'lU-~
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No.
Estate of Kathleen A n Conn
, Deceased
AND NOW 2007, in consideration of the petition on the reverse
side hereof, satisfactory proof having been presented before m ,
IT IS DECREED that Justin R. Self
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to Justin R. Self
in the estate of Kathleen Ann Conn
FEES
Probate, Letters, Etc. ............. $
Will ................................. $
Renunciation........ ........ ....... $
Short Certificates ( ).... ...... .. $
J CP . . . .. .. .. . . .. .. .. .. .. .. .. .. .. .. .. . $
Automation Fee................... $
Bond..."............................. $
Total $
Filed
20_
ire #19198
Ntomey (Sup. Ct. I.D. No.)
Schmidt Kramer PC
209 State Street, Harrisburg, PA 17101
Address
(717) 232-6300
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RENUNCIATION
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REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
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Estate of
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, Deceased
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(Print Name)
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, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
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(Signature)
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(Street Address)
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(City. State, Zip)
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this ~ ~ day
of ""Decem 'ber , 7 ~<o .
-='<~~b. ~\:ldkcr
Notary Public (
My Commission Expires:
Deputy for Register of Wills
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Kimberly S. DeFalco, Notary PublIc
City Of Harrisburg, Dauphin County
My Commission Expires Jan. 17,2009
Member, Pennsylvania Association of Notaries
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SCHMIDT KRAMER PC
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BY: CHARLES E. SCHMIDT, JR., ESQUIRE
J.D. #19198
209 State Street
Hanisburg,PA 17101
(717) 232-6300
cschmidtlalschmidtkramer. com
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Attomeys for Plaintiffs
ESTATE OF
KATHLEEN ANN CONN,
DECEASED
REGISTER OF WILLS FOR THE
COUNTY OF CUMBERLAND IN THE
COMMONWEALTH OF PENNSYLVANIA
SOCIAL SECURITY NUMBER
187-64-1542
PRAECIPE TO WITHDRAW
PETITION FOR GRANT OF
LETTERS OF ADMINISTRATION
PRAECIPE TO WITHDRAW
PETITION FOR GRANT OF
LETTERS OF ADMINISTRATION
AND NOW, comes Justin R. Self, by and through counsel, Charles E.
Schmidt, Jr. Esquire, of Schmidt Kramer PC, and who respectfully requests
that his Petition for Grant of Letters of Administration for the Estate of
Kathleen Ann Conn be WITHDRAWN.
By:
Charles E. Schmidt, Jr., Esquire
Attorney J.D. #19198
209 State Street
Harrisburg, PA 17101
(717) 232-6300
Attorneys for Plaintiff
Date: ft/((r.Q7, /).00:;"
.
Register of Wills of Cumberland County
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Kathleen Ann Conn
Estate of
also known as
No. ;). \ () l D\08
To:
, Deceased,
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
Social Security No, 187-64-1542
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl ies
for letters of administration
on the estate of (.,~
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Decedent was domiciled at death in Cumberland County, Pennsylvania, with h~ last family~~cipaN
residence at 4907 Delbrook Road, Mechanicsburg, PA 17050 " uj 5~ -.J
(list street, number and municipality) d ~ "
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
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Decedent, then 23 years of age, died November 12, , 20 06
Hershey Medical Center, Derry Township, Dauphin County, Pennsylvania
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Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$
$
$
$
o
o
o
o
Petitioner_ after a proper search ha~ ascertained that decedent left no will and was survived by the
following spouse (if any) and heirs:
N R I' h' R 'd
ame e anons lP eSl ence
Aidan Richard Self Minor Son 4907 Delbrook Road, Mechanicsburg, PA 17050
THEREFORE, petitioner(s) respectfully request( s) the grant of letters of administration in the appropriate form
to the undersigned.
Residence(s) ofPetitioner(s)
425 South Main St, Telford, PA 18969
.
Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TO OF PENNSYLVANIA
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SS:
COUNTY OF CUMBERLAND
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 above
decedent petitioner(s) will well and truly administer the estate ac~g to l~w. ,
Sworn to or affirmed ~d subscribed { ~fA~ (] ~LH
Before me this ;;;), "I day of
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No.
Estate of Kathleen Ann Conn
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
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AND NOW X'<\,<. r Ch d.l 20~, in consideration of the petition on the reverse
side hereof, satisfactory proof having been presented before me,
IT IS DECREED that Kathleen A. Smith
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to Kathleen A. Smith
in the estate of Kathleen Ann Conn
FEES
Probate, Letters, Etc. ............. $
Will ................................. $
Renunciation... ...... .............. $
Short Certificates ( )............ $
JCP............... ........... ..... ... $
Automation Fee................... $
Bond................................. $
Total $
Filed ~\d\- 20bl.
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Attorney (Sup. Ct. LD. No.)
Schmidt Kramer PC
209 State Street, Harrisburg, PA 17101
Address
(717) 232-6300
"d.Cl ,00
Phone
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WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
. DEPARtMENT OF HEALTH VITALRI!:CORQS
a \ (Yl D \08
L.OCALREGISTRAR'S CERTIFICATION OF DEATH
November 1 7,lQOS
Date of Issue of This Ceritlk;ation
Social SecurityNd.
Birthplace
Place of Death Hershey Medical Center
Facility Name
Occupation ~t!Jdent ArmedF()rc~;?(Yes or No) No
Married Deced~t)rs .4907 Delbrook Road, Mechanicsburg,> PA 17050
Marital Status Mailing Address
. ',- Number - - - -, - Stree;t . " City. Qr Town State
Informant Funeral Director Jeffrey A. Naugle
Name and Address of .. >. ........ ..
Funeral Establishment Jeffrey A., Naugl~.Funeral Home,.lO N. Ambler St., Quakertoyvn, PA 18951
Mar 29; 1983
City '. S;Of9l..!gh or Township
. Natural 0
Accident %1-..
o
: Interval Between
: Onset and Death
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Describe hQw jnjulY occurr.ed:
Pedestrran V$. sUV
(a)
(b)
(c)
(d)
OtherSigrlificantGonditions
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Homicide
Pending Investigation
Could not be Determined
Name and Title of Certifier
1271 South 28thSt"Harris~l.Irg, PA 17111
This is to certify that the information here 'givenis'COTrectlycopiedfrotri an originalcerHficate
of death duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vital Records Office for permanent filing. Ii IJ
k VUd&( Ad. k~ 09-106
'f98ClKa~a~rr;;;~~rRoad '-1 OuakertC:~ No
November 1 7. 2006
Street Address
City, Borough, Township
Date 'fi'eceived by Local Registrar