HomeMy WebLinkAbout08-10-07
PETITION FOR PROBATE AND GRANT OF LETTERS
Register of Wills of Cumberland County, Pennsylvania
Estate of
EARNEST WAYNE SMITHERMAN
Deceased
File No.
Social Security No.
~\ - 01 - o~~51
425-90-1924
MARGARET E. SMITHERMAN
Petitioner, who is 18 years of age or older, applies for:
(COMPLETE "An OR "B" BELOW:)
D A. Probate and Grant of Letters Testamentary and aver that Petitioner is the
named in the Last Will of the Decedent, dated and codicils(s) dated
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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 adopteQ~fter execution of
the instrument(s) offered for probate; was not the victim of a killing and was never adjudicated an inSaPacitateogerson:
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Grant of Letters of Administration
(if applicable. enter: c.I.a.; d.b.n.c.l.a.; pendent elite; durante absentia; durante minoritate
Petitioner. after a proper search has ascertained that Decedent left no Will and was survived by the Petitioner and heirs
listed below. Petitioner requests that Letters of Administration be granted to the Petitioner. MARGARET E,
SMITHERMAN. who is the survivinq spouse of the Decedent.
Name Relationship Residence
Colleen Watkins Daughter 581 Majestic Park Lane
Cedar Hill, Texas 75104
Ronald Smitherman Son Unknown
(COMPLETE IN ALL CASES): Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County. Pennsylvania, with his last family or principal residence at
9 West Highland Avenue. Enola. East Pennsboro Township. Cumberland County. Pennsylvania
(List street, address, town/city, county, state, zip code)
Decedent, then 61
years of age, died on
January 17. 2007 at
Select Specialty Hospital. Camp Hill. PA
(Location)
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 ......................................................................................................................$
T otal......................................................................................................... $
22.000.00
22.000.00
Real Estate situated as follows:
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:
Si nature
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MARGARET E. SMITHERMAN
9 West Highland Avenue
Enola, PA 17025
Oath of Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
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COUNTY OF CUMBERLAND
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The Petitioner above-named swears or affirms that the statements in the foregoing Petition ~e true and
correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the estate according to law.
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MA GA T E SMITHEIjM1AN
Before me this
Sworn to and affirmed and subscribed
day of
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,2007.
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File No. ,Q\ - OJ ~ 761
Estate of
EARNEST WAYNE SMITHERMAN
, Deceased.
Social Security No: 425-90-1924
Date of Death:
January 17. 2007
AND NOW, -At ~() (")-\- I() ,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 MARGARET E. SMITHERMAN in the above estate.
FEES
Letters.................. .........
-3 Short Certificate(s)
Renunciation............. .
Affidavit ( )..................
Extra Pages ( ).......
Codicil........................... .
JCP Fee.......................
Inventory......................
Other..&J:ill.mQ,\J.QYI
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TOT AL.........
Oafh ~ e P~lcL
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$ VO. 00
$IJ.OO
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$
$ f) .00
$ 13/ . 00
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Register of Wills pi? r Ct mO.t) cJi
Attorney: EDMUND G. MYERS
I.D. No: 20558
Address: Johnson. Duffie. Stewart & Weidner.
301 Market Street. P.O. Box 109. Lemovne. PA 17043-
Telephone: 717-761-4540
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11'0<;~~F\~ :'n;. e tify th~t the information here given is conectl)' copied from an original certificate of death du~r filed with me
Lo~:tR:g~<;t~ar. 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.
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Registr~r
Fee for this certificate. $6.00
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hl05.143 REI! 11/2Q06
TYPE I PRINT IN
PERMANENT
BLACK INK
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH: VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
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Other:
I (j 4-5 ?c n t C LC +oc. N\5 IEJ 'o",".n' 0 ER' O",p,"'" 0 DOA 0 N",,'og Horn. 0 R."""" 00lh0,. 50"''''
8d. Facility Name (If nO! inslituUon. give streelllnd numbel) I 9. (~~~~~~;;l ~~:~nic Origin? 10 No 0 Yes 10 ~~Iican tndian, Black, While, etc.
& \..c( + ~)IJt' c, t, I i -I- ~ H0Jpi-lt, M"i"o,P~rtoRi"",'Ic.J lV~\; 1<:-
j 2. Was Decedent evar in Itle 13, Decedenl's Educalion (SpeCily only higheSI grade completoo) 14. Marilal Stalus:. Married, Never Married, 15. SlJrviving Spouse (If wile, give maiden name)
U.S. Armed Forces? Elemenlary / Secondaf)' (0-12) COilege (1.4 or 5+) Widowed, Di~orc&dJ (Specify)
lJy" ONo \2 ~~lc" ~,(a
~:,~::';:..oc. <7, &," 1'l'\ B~ ~~~'d.oI ", M v". Doc",,", u", '"
17b. County L'vll/1\.).xr b vd Township? 17d. 0 ~~u~~~~~~~iVedwilhin
-0-1-767
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8b, Counly01 Dealh
('.v, W\,b, ,-Ie, vd
18,FathefsName(Firsl.middle,lasl, sul/ix)
[;e'"V'S-I- S"""+~'--""'C< '"
20a.lnlormard'SName(TypefPrinlj
'1t~(., ,0 ,,,,-I-
Twp
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19. MoIher's Name (Filsl, middle, ~iden surname)
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2Ob. 'nf()(manl's Mailing Address (Streel, cily flown, slate, zip code)
c, VJ~ST . hl<<!') d Av".
21c. Place 01 DisPOSilion (Name 0 cemelery. crematory or olher place)
S\ 3,)Seph G..V'l.
/NC 720 c/-v"tyd,
City/BorO
/2)1. 0 I C, 'J (fJA
21dlocalion(Cily/lown,slale,zipCOde)
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(;'1. 4Yl Ii, Ik P4
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17'i2/
23b. license Number
~~;~~~~S~ J~~~l dise.:;
I-{ u'a.r
CAUSE OF DEATH (See Instructions and examples)
lIem 27. Part I: Enter the ~ - diseases, injuries, or complications - lhal dilectly caused Ihe dealh. DO NOT enter lerminal evet1ls such as c.lfdiac arrast,
respiraloryarresl,orvenlriCI.IlarflllrillatIOflwilhOU1SI\oWinglheelioJogY.lisI only one cause 011 each line,
24. TIme ot Dealh
10 :3 (0
Os OCXp 5"(;,
ZOo 1
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26, Was Case Referred 10 Medical Examiner I COI'oner lor a Reason Other lhan Cremation or Donation?
G1Yes DNa
Approximaleinterval Parlll: EnlerOlherSiQlWlicanlcoodilionsconlrihlJlinalOdP.alh,
O.lsetloDealh bulno1resullinginlllelUldMyingcausegiveninPartl
DYes ~No
DYes DNa
31. Manner of Dealh
o NaluraJ o Homicide
DAccidenl DPendinglnvesligalion
o Suicide 0 Couid Not be Determined
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(v O'I'~ /I-d /)<;.,
29 II Female:
o NOlpregnanlwilhin pasl year
IDPregoantallill1eofdealh
o NOlpregnanl.bulpregnanlwilhin42days
o!dealh
o Not pregnanl,bul pre!lf1anl 43 days 10 1 yeal
be/orodea'h
o Unknown if plegnanl wllhin lha pasl year
32c. Place of lr1ury: Home, Farm, Slreel, Factory,
OtficeBu~ding, elc. (Speciiy)
seq~l8ntial~liSI COOdi,lions,IIany.
~~1~~~~0 UNeOEiWtYI~~~~~~e a,
(disease or injury Ihal initialed the
evenlsroStJtltnglndealh) lAST.
Due 10 (Ql as a consequence 01)
Ouo 10 (or as a consequence of):
Due to (01 as a Coosequence 01)
JOa.WasanAulOpsy
Perlormed?
30b. Were Aulopsy Findings
Avaijable Prior 10 Completion
ot Cause or Death?
32d. T1me 01 Injury
DiSp'JsilionPermrl No
321. II TraMportalion InJusy (Spor;ily)
DOriver/Opcr1'IOr o Passenger DPedestrian
OOlher.Specily-
33b. Signalurc and TIlle of Ccrtilier
~ -?~alct/ Et.//hfS 00_
33c.lic€nse"lumber 330'. Dala Signed (M-:>nlh,day, I'ear)
'OS OO((J5&1- ? 1-:; I C.()O-:j
32g, localionoflnjury(Slreel,ciiyllown, Sidle)
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33a, Caflilier(checkonlyWl&)
CertJlylng physician (Physician certifying causa of dealh when anolher physician has pronounced dealh and compleled Item 23)
To the besl 01 my knowledge, death Occurred due to the cause(s) and manner as stated_ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
. Pronouncing and certilyillg physlciarJ (Physicran both pronourlcln 9dealhand cerlifying!ocause of dealhj
To lite besl 01 my knowledge,dealh Occurred 1I11h~ lime, dale, antJplace, and Que to the cause(s) and manner as slaled_ _ _ _ _ _ _ _ _ __ _ _ _ __ __p
. Medical Examiner f Coroner
On the basis 01 examinaUoll and I or Invesllgallon, in my opinion, dealh occurred allhe time, dale, and place, and due to the clIuse(s) and milliner as staled_ 0
M.
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34, Name and Address of PlIrsOfl Who CompIele<J Cause of DeaU, (Item 27) Type' Plint
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/ERRY R. DUFFIE
RICHARD W. STEWART
C. ROY WEIDI\;FR. JR
EDMUND G. MYERS
DAVID W. DELuCE
/0111\ A. STATLER
/EFFERS01\ /. SHIPMAN
/EFFREY B. RETTIG
KEVIN E. OSBORNE
RALPH H. WRIGHT. JR.
MARK C. DUFFIE
/OH1\ R. NINOSKY
MICHAEL /. CASSIDY
LAW OFFICES
JOHNSON
DUFFIE
MELISSA PEEL GREEVY
ROBERT M. WALKER
WADE D. MANLEY
ELIZABETH D. SNOVER
KELLY L. BONANNO
OF COUNSEL
HORACE A. JOHNSO:-.J
F. LEE SHIPMAN
( 1965-2006)
August 8, 2007
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Via Express Delivery
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
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RE: Petition for Probate and Grant of Letters
Estate of Earnest Wayne Smitherman
Our File No. 15063-1
Dear Register:
Enclosed please find all of the required documents for filing for Letters of Administration along with the
Petition for Probate in the above referenced Estate. Mrs. Margaret E, Smitherman is the surviving spouse of the
decedent, who left no Will. Mrs. Smitherman was given the Oath at the Dauphin County Register of Wills
Office. We enclose for filing the following:
1. Petition for Probate - Oath of Administratrix taken at Dauphin County Register of Wills Office.
2. Copy of the Receipt from Dauphin County verifying Oath.
3. Estate Information Sheet
4. Original Death Certificate
5. Copies marked "File Copy" to be time-stamped and returned to us after filing is complete in the
enclosed self addressed stamped envelope
6. Copies marked "Copy" to be time-stamped and returned to us after filing is complete in the
enclosed self addressed stamped envelope
7. A check made payable to you for probate costs of $87.00 as follows:
a. Letters of Administration for $22,000 Estate 60.00
b. 3 Short Certificates 12.00
c. Auto/JCP Fee 15.00
301 MARKET STREET po. BOx 109 LEMOYNE, PENNSYLVANIA 17043-0109
WW\V.JDS\V.COM 717.761.4540 FAX: 717.761.3015 MAIL@JDS\V.COM
JOHNSON, DUFFIE, STEWART & WEIDNER, P.C.
8. Self addressed stamped envelope for the mailing of the Original Letters and Short Certificates
to us.
Should you have any questions, or require any additional information, please feel free to contact the
undersigned.
Very truly yours,
JOHNSON, DUFFIE, STEWART & WEIDNER
{~~W~
Dana L. ~eman
Estate Administration Paralegal
c: Margaret E. Smitherman, Administratrix
:306657
DAUPHIN COUNTY REGISTER OF WillS/CLERK OF ORPHANS' COURT, DAUPHIN COUNTY, PA
RECEIPT
Inv Number: 11838 Invoice Date: 08/08/2007 10:01 :58 AM
Customer: Last Change:
EARNEST WAYNE SMITHERMAN
RECEIPT
Reg/Drw 10: 0101
By: PP
Chg # Charge 1 Payment 1 Fee Description
1 OATH - RW
Fee Detail:
NO FEE
OATH FEE
Amount Inst # Ilnst Date
$20.00
Municipality
$0.00
$20.00
TOTAL CHARGES
$20.00
PAYMENTS
CASH
TOTAL PAYMENTS
$20.00
$20.00
AMOUNT DUE
PAYMENT ON INVOICE
BALANCE DUE
$20.00
($20.00)
$0.00
Date: Aug 8, 2007 10:02:43 AM
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