HomeMy WebLinkAbout10-01-07
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PETITION FOR PROBATE and LETTERS OF ADMINISTRATION
No: ;) I' (1) - (JOe:; d-
To: Register of Wills for the County of
Cumberland County in the
Commonwealth of Pennsylvania
Estate of Benjamin L. Freet
Also known as
, deceased
Social Security No. 181-38-7941
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is 18 years of age or older, applies for letters of administration on the estate of
the above decedent.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or
principal residence at 214 School Avenue, Carlisle, PA 17013.
Decedent, then 54 years of age, died July 14,2007, at his residence.
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
Situate as follows:
$2,500.00
$
$
$
, ,-',
"'-')
Petitioner after a proper search has ascertained that decedent left no will and was survived by the follo\Ying
spouse (if any) and heirs:
Name Relationship Residence
Frances E. Freet Mother 15 Appalachian Dr, Carlisle, P A
17013
THEREFORE, petitioner(s) respectfully request(s) the grant ofIetters of administration in the appropriate form
to the undersigned.
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Frances E. Freet"
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYLVANIA
SS
Sworn to or affirmed and subscribed
Before me this is\ day ofO::Jz~r
2097- 'l: 1w '
.j~c~;c ..c~o..A_ 1\2", 1r:vbo ~'-
? r 0r\. (j-~A ~ Register '
'-' Uf''-' \"'G
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 according to law.
~ ' 6!." VI , -
c::--.../&A. {1',' --1 ,\:=- h.(7, /~
Frances E. Freet
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No. ----CiJ - dc:; - ()O~-:;- c).
Estate of Benjamin L. Freet, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW, CCt:--6A \ ,2007, in consideration of the petition on the reverse side
hereof, satisfactory proof having been presented before me,
IT IS DECREED that Frances E. Freet is entitled to Letters of Administration, and in accord with such finding,
Letters of Administration are hereby granted to Frances E. Freet in the estate of Benjamin L. Freet.
FEES
Probate, Letters, Etc.............$ 30.Lx::;,
Short Certificates ( )............$ \ ;)00
Renunciation... ..................$
.......:,c'P. . $il.:.) 00
GA.2-;-F-"~f'o..:\-1 (~~ -=-, . c..."'-o
TOTAL $ '51 CO
Filed.. [q.l. .1.9.1......... =................
Andrews, Esquire
78 We Pomfret Street
Carlisle, PA 17013
717-243-0123
r
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UP<'~
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
\NARNING I! is illegal to duplicate this GOIJV by photostat or photograph.
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1105144 REV l1/2-C \ N AL
TYPE I PAINT IN~
PERMANENT
BLACK INK
1/31-056
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
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Nay 24, 1953
Chambersburg PA
STATE FILE NUMBER
1. Name 01 Decedent (First, middle, last, suffix)
Benjamin
5. Age (Last Birthday)
L
Freet
6. Dale of Birth (Month, day, year)
8b. County of Death
'\. Cumberland
ad. Facility Name (II not insmulion, give street and number)
214 School Avenue
Residence DOther-Specify"
10. Race: American Imn, Black, VVhite, ate
(S".dry, Whi te
54
most of wofkin life. Do not state retired
Kind 01 Busil1essl Induslry
Telephone
12, Was Decedenl ever in tf1e
U.s. Armed Forces?
Dv" [>>N,
13. Deeedenfs Education (Specify only highest grade completed)
Elementary I Secondary (0-12) COlle2, (1-4 or 5+)
14, Marital Status: Married, Never Married,
Widowe<:l, Divorced (Specio/J
Never Married
. 16. Decedent's Mailing Address (Street, city! lown, state, zip code)
214 School Ave.
Carlisle PA 17013
Decadent's
Actual Residence 17a. Slate
17b. County
PA
r.llmhPrland
Did Decedenf
Liveina
Township?
17c. 0 Yes, Decedenl Lived in
17d.~Nc,DecedenILivedwithin
ActualUmitsol
Twp
18. Father's Name (Firsl, middle, last, sulfix)
Carlisle
City/Born
John F. Freet
20a. InfOfmant's Name (Type! Print)
19. Mother's Name (First, middle. maiden surname)
Frances E. Lon
o
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2Ob. Intonnant's Mailing Address (Streel, city /town, stale, zip code)
15 Applachian Dr., Carlisle PA 17015
21c. Place 01 Disposition (Name 01 cemetery, crematory or other place)
21d, Location (City/lown, stafe, zip code)
Norland Cemetery
22c. Name and Address of Facility Hoffman-Roth Funeral Home
219 N. Hanover ST, Carlisle PA 17013
23b, License Number
Chambersburg PA
& Crematory
2&. Date Signed (Month,day, year)
Items 24-26 musl be compleled by person
who pronounces dealh
24, Timeaf Death
25. Date Pronounced Dead (Month, day, year)
July 15, 2007
26, Was Case Relerre<:lto Medical ExamiMr I Coroner for a Reason Other than Cremation or Donation?
~Yes ONo
CAUSE OF DEATH (See instructions and examples)
Item 27. Part I: Enter the ~ diseases, injuries, Of compiications- that dirllCtly caused the death. DO NOT enter termiMI evenlssuch as cardiac arrest,
resprraloryarrest, or ventricular fibritlation wilhout showing tI1e etiology Ust onlyooe cause on each line
z
o
u
o
o
~
321. If Transportation Injury (Specify)
o Driver {Operator 0 Passenger DPedeslriafl
Other-Specify.
33a. Certifier (check only orre) 33b, SignatUfll
~,z~r:r~~;~~=".:."~~::: ;;~~,;:"~~:~:.:,:,h: ~="'."_ ~~h:~d_~~~ ~"~ ~~ _ _ _ _ _. _ _ _ _. _ _ _ _ _. 0 ~ Co rone r
Pronounclng and cmlfylng physician (PhySician both pronOUncing death and certllying to cause of death) 33c. License Number 33d. Data S;gned (Mooth, day, year)
To the best of my knowledge, death occurred at the lime, date, and place, and due to the cause(s) and manner a9 stated_ - - - - - - - - - - - - - - - - - 0 A 6 , 200 7
Medical Eumlner/Coroner ugus t
On the basis of examInation and I Ot Invesllgation, In my opinion, death occurred at the lime, dale, and place, and due to the cause(sl and manner as stated_}:it 34. Name and Address 01 Person Who Completed Cause 01 Deatf1 (Item 27) Type I Print
Michael L. Norris, Coroner
35R.gj" ',g""",""dl/il<"ctr~" tI..l I ,'I II I a I I I [) I D".F"'" eo_,,,,",,,,,, 6375 Basehore Roadi Suite III
~ H. ~~c::!t\: ,c;lI " '-' , '-, Mechanicsbur PA 7050
DYes ONo
o Natural 0 HomiCide
gAccident OPendinglnvestigalion
o Suicide 0 Could Not be Determined
Approximate interval: Part II: Enter other sianifrcant conditinn.~ contributino 10 death, 28. Did Tobacco Use Contribute to Death?
On58lto Death but not resulting in the underlying cause given in Part I 0 Yas 0 Probably
o No 0 Unknown
29. II Female'
o Not pregnant within past year
o PregnanlallimeoldeaUl
o Not pregnant, bul pregnant within 42 days
ofdaath
o Notpregoant,butpregnan!43daystolvear
beloredeath
o Unknown II pregnant within the past year
32c, Place 01 Injury: Home, Farm, Street, Factory,
Office Building, etc. (Specify)
:~~~;:suCRt~1; ~~~~tl dise~
Mixed Drug Toxicity
Dueto(orasa oonsequenceof}
SeQuential~ Iisl conditions, if any,
~~t~l~o U~~~YII~b~.w;~e a.
(disease or injury that inRiated the
events resulting in death) LAST.
Due to (or as a coosequence 01):
Due 10 (or as a consequ6nce of)'
JOa Was an Autopsy
Penormed?
30b. Were Autopsy Finclings
Available Prior to Completion
of Cause of Dealh?
31. Manner 01 Death
DYes t&I No
32d,Timeof In/ury
32g. Location of Injury (Streef,city/town, state)
Disposition Permit No