HomeMy WebLinkAbout06-04-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of SHARON A. KEEFE
also known as
File Number
1;2/- ()7 - ()5t.{:2J
, Deceased
.. 207-34-6322
Social Secunty Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE j4' or 'B' BELOW:)
D 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
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(State relevant circumstances, e.g., renunciation, death of executor, etc.)
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrume~t(s) offered
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for probate, was not the victim of a killing and was never adjudicated an incapacitated person: .
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ug B. Grant of Letters of Administration
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(If applicable, enter: c.t.a.; db.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 ofheirs.)
r Name Relationshio Residence I
.. ,C! w Milisavic Son 79 Center St., Plttston, .PA 18
640
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in Cumbe r 1 and County, Pennsylvania with his / her Illst Qrinciu.al r,es.id.enc\:. at
2q7 Old Stonehouse Road, Mechanicsburg (Monroe Townshlpr, yA ~7u~~
(List street address, town/city, township, county, state, zip code)
Decedent, then 6] yearsofage,diedon Maf; 17, 2007 at 800 Block Of West Lisburn Road,
South Middleton Township,. Cum erland county, .penn sylvan a.
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
$ It:i,OOO.OO
$
$
$ None
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and CodiciI(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
rinted name and residence
homas W. Milisavic,
79 Center Street, Pittston, PA
;1.8640
Form RW.02 rev. 10.13.06
Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
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 beliefofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
before me the
Sworn to or affirmed and subscribed
4---f.~ day of
June , 2007
ONtUJf/fli_~WMJ
Fo e Register
Signature of Personal Representative
Signature of Personal Representative
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File Number:
r;)/ - 07- Q0'-/+
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Estate of
SHARON A. KEEFE
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, Deceased
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Social Security Number: 207 - 3 4 - 6322
Date of Death: May 17, 2007
AND NOW, June 2007 , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to Thomas W. Mi1isavic
in the above estate
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(lalt t
Letters
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Attorney Signature:
FEES
Short Certificate(s) . . . . . . . . $
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!lYlR{~~l'-. . . $
.. . $
...$
.. . $
.. . $
. .. $
...$
...$
TOTAL ... . . . . . . . . . .. $
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Attorney Name:
C. Sne1baker
Supreme Court J.D. No.:
#06355
Address:
44 West Main Street
Mechanicsburg, PA 17055
Telephone:
(717) 697-8528
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Form RW-02 rev, 10. /3.06
Page 2 of2
-:1.. / - (7 ':::::;;', ~ 1./2./
HlO~.RO) REV 110:" ...; '-/ 1./ ~ I
This is to certify that the information here given is correctly copied fro~ an original certificate of de~th duly. filed with me as
Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent fihng.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Fee for this certificate, $6.00
Local Registrar
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13524402
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Date
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H10514<1 REV 11/2006
TYPE I PRINT IN
PERllANfNT
BlACKINK 031-015
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See Instructlons and axampf.s on reverse)
1.Namo~~(F""_'''''._1
Sharon
. Ago (WI_Vi
A
Keefe
8.0l0~__. .
7.
STATE FilE NUMBER
Yrs.
lOll_or
61
Sep. 6, 1945
81>. County ~ 000..
Cumberland
Bd FdIy Namo 1"""_, <j<o.....IOd"""""l
800 Block West L1sburn Road
White
1,. Dec.denra lIsuIlI
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We.Donat..., .
12.WlI0ecedenl:~fl'"
U.S. Armed FOII::ea?
oV.. i!I6Io
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ActuaIAtsidenca 17a.saatt
Fo~fttrbperator "'" oIwr~l1"O'Ose
- ". Decedenl's ~ Addresa 1S&teel. ~ flown, 1IItt, zip code)
297 Old Stone House Road South
Mechanlcsburg, PA 17055
17t>. County
PA
Cumberland
Did_
live in.
Township?
11C.~8S,Oecedentliwldin
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18. Falhlr's Name (FIriI, midlI8, Iast,~)
COy I Boo>
Steven Danko
Betty Ness
2llI_.Maiilg-"'(_.0Iy1_._.","""l
79 Center Street Pittston, PA 18640
'9..........Namo(F...._,_.........
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21c.P1aco~_(Namo~_,_.._pIaoe)
Conollte Crematory
21.. loca1lon (COy ,_._. "'_I
Schaefferetown,Pa.17088
2Oa. ln1ormanI's Name (Type I POnt)
22c Nan1I andAddr.. of FIdlity
Myers Funeral Home. Inc. 37 eut Main Street Mec:hanlcsburg. PA 17055
23b. license Number
230. Ilalo S9>e<l (....... doy, _
118m$ 24-2611lU8l be compIellJd by person 24.1Ime 01 Dealh prx. 25. Date Pronol6ad Dead (MooCtl, day, year)
""'pronouncotdllm ~ 11:30 P. lA May 18, 2007
CAUSE OF DEATH cs.. lnatructlofta lIncI _xampl..)
Item 21. Pari I: Enter Ihe ~ - clseaseS, irpies, or compicaIionf. -lhaI dIr8ctIy caused lINt d88Itl, DO NOT..... terminalevenll auctl ascaniac armI,
re&fllrato~ arre&l, or ~ Iitrilation wiIhoul: showll'lg the etiology. List ooIy one CIUA 00 each line
26. Was Cue Aeterred to MIdicaI E.uminet I eoron.r tor. ANson Ofltr IhIn CtemlliOfl or Oonaiion?
)l:1 Yes 0"
ApproxWAIIeinlerYlI: PartR: EnlercXtlersianilr.anlc:adtiDnr.anrlUinak)d&aIfI, 2I.DidTotlaocoUltConerilUaIo~?
0ns0l100eall buI""_....~cauoogiv1n.""'1. 0 v.. oP-
0" 0-
~-==....:;
~iot_,'any,
=~~c:l.=:a
='t.:.1:m":~r
Head Trauma
Doe to (or as a consequence 01):
Motor Vehicle Crash
Due 10 (Of as a conseqoence 01)'
d.
29. . F....:
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32c==::'i~_F-',
ejected Rural Road
320.""""""~friurY(""".cilyl__1
W.Lisburn Rd.,Mechanicsburg, PA
Due 10 (or as a consequence 01):
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","w.....-.- "",w..o.-.-F_ 31.......~"". 32aOa1o~I<>MY(_,doy,_ 32b.__....'Y"""""" n e te
- =~m~ 0- 0- May 17,2007 roadway, struck pole,
]il:I- oP""",&_ 32dT"').op1'X. 320'lU'Y"Worl(/ 321. n..-friurYr_J
o~ oCouldNol..-..... 11:30 P. M ov,,)!:(.. ~."=oP_
.... ~ (- only ono) 33b S9>aW lOll
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-..g..._pIl....Ion(PII_ -pronounci1g..... ...CO<1jyinglo.....~_) 33c 33d. ..-_1-,.... rear!
::.:..-:::=.-..................-....................._.1...-..........._________________ 0 May 21, 2007
O"...-.._.../or_....,_,__..lho....._..................lhocauoo(.I..._..__ J:lll. 34.IFAo"ll_~~Vh>""""""CauooGl."""(""27) T...IP...
M1cnael L. Norr1S, ~oroner
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D;,posilioo""""" o'J.3b~1
ov.. !llI'"
ov" 0'"
Coroner
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