HomeMy WebLinkAbout10-17-07
PETITION FOR PROBATE AND GRANT OF LETTERS
~'aL('o..rd COUNTY, PENNSYLVANIA
REGISTER OF WILLS OF
Estate of L () U l 5'"E E. S P (j R l-
also known as tv d J\J e
File Number
d\ (:)'1
b9'3 "-\
, Deceased
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
o 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
r"-'t
named in the
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(State relevant circumstances, e,g.. renunciation. death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of thy jnslroment4J offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
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1t' B. Grant of Letters of Administration
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(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absemia; dural/te mil/oritate) 0')
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 of heirs.)
s
2.13 8 ~l"1
Name
Decedent, then
'6 (J years of age, died on 3 ())l: 1'>1 VAt Q A ~ J... I ~L E
lREtn(!jNI'fL. Wl2Dlc.~'-
~- €f\9 TE((.
3 :2, tJ <0 0 ~o
$
$
$
$
Decedent at death owned property with estimated values as foliows:
(If domiciled in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(I f not domiciled in P A) Personal property in County
Value ofreal estate in Pennsylvania
situated as follows: S\t'C X L 2R-r( F l to'v\l'E-e
Wheretol'e, 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:
Ty ed or rinted name and residence
t:.. Sf><o
FOrJIIRW-02 rev 10./3.06 Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF e. U M E ~ t-JA IV t::>
The Petitioner(s) above-named swear(s) or affiml(s) that the statements in the foregoing Petition are hue and correct to the best of
the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
before me the , I day of
Oc40b, aCt:> 1
C.'
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c.....
Signature of Personal Representative
c. C')
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Signature of Personal Representative
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File Number:
c':J.\
\) '1 0 '13.L1
~"j PtJ l? L
co
L f) '1.{ t SE
Social SecurityNumber:~ 6 ~- ~ 2 -""3 2.6{ Date of Death: ?:i ~ SEPT 0,
AND NOW, 0 c.-tu~ y\. , d\:::b\ , in conside~ation oft~e foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters ~\'\) \~ ~\6Y\
are hereby granted to \=i \~eA ~. S~"C)'\ \
Estate of
€::::
, Deceased
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
~~
FEES
Letters ... .2A..~. $
Short Certificate(s) . . ~ . . . $
Renunciation(s) .......... $
~, ... $
~C? . .. $
~\-o ... $
.. . $
... $
... $
... $
. .. $
... $
TOTAL .... . .. . . . . . . . $
9\)
'5
Attomey Name:
_\-te ~91~y f:'"..
Supreme Court I.D. No.: O~ z.. G GO
3 q to 1 1M It J€. L--<.c::.J S 7"",
~1AtA P H- r t- L, jJ,4
l'70il-~
"t' "2.. 2..'
-, (7- 73 )- 0'-l-'4
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Attomey Signature:
\,t)
S-
Address:
Telephone:
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For/ll RW-IJ2 rev. /0./3.06
Page 20f2
II JO),HO:' RFV {OJ/ll!l
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate. $6.00
p
13823155
Certification Number
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.
Local Registrar
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Hl05.t-l3 REV 11,2006
TYPE, PAINT IN
PERMANENT
BlACK INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
~ \ (j'l 09
1 Name 01 Oece(Xinl (First, middle, last sullixl
Louise E.
Sporl
5 Age (la~16Inhday)
6. Date of Sinh iMonth, day, year)
80 y"
8b CQunly01 OeOilh
Sept. 20, 1927
8d, Facility Namt (II not mstibJIlon, give stfe&t and number)
most 01 work hfe. Du 001 slate retire
Kind 01 BuSiness! Industry
Education
12. Was Decedent eller in the
U.S. Armed Forces?
Dyes K]No
Decedent's
Aclual Residence 17 a Stale
13. Decedent'io Education (Specify onlV highest grade completed)
Elementary I Secondary (0-12) College (1.4 or 5+)
4
. 16 Dec&dlW'1l MaiIflg Address IStreet, ...., ~ slaw, zip code)
213 Berkeley Drive
Mechanics PA 17050
Pennsylvania
cumber land
17bCoUflly
19. Mothet's Name (First. middle, maiden surname)
Edna Ma uson
PA 17050
18 Father's Name (Firsl, mK:idfe,Ia;.t sultix)
Samuel Ellis
468 - 32 - 3251
4 Date 01 Death (Month, day. year)
September 30, 2007
14. Marilal Status: Married. Neller Mamed,
Widowed, Oillorced (~eclly)
Married
Alfred E. Sporl
Hampden
Top
Did Decedent
live in a
Township?
He, KJ Ves. DecedenlullOO in
17d. 0 No, Oecedenllived wilhlt'l
Aclual limits 01
CIly/Boro
2Ob. Informant's Mailing Address (Slreet, city I town, stale, Zip code)
20a, Informants Name (lype I Ponl)
Alfred E. S rl
213 Berkele Drive
21c. Place 01 DispositlOfl (Name ol cemet8f'y, crematory or OCher place)
21a Method of DISposllion
"
W
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25. Date PIOOOunCed Dead (Monttl. day, year)
I'M S-4.*,.,.,a1'Jt, ~"":A()I.
CAUSE OF DEATH (See tn.true'lon. and examples)
Item 27. Part I: Enl8f lhe tlliul~ - diseases. injuries. or complicatlOos -thai direcuy cauwd:!he death. 00 NOT enter lemlinaJ events such as cardiac anes!,
respjralofy arrest, Of llsolricular fibriIIalion wiUJOU1 showing lhe etiology list only one cause on each line
i..buP:=; ~,QS'S - G..h\ "'~~;;t"I!I4.CF.>
Due to (or f ,consequence 01):
b. H-~I".....J.A~,e S;J.ae/tC..- '"D..rc_.
Due to (or as a consequence of)
I Appro)l.imaleinl8fllal
: Onselto Dealh
,
,
.
.
,
,
,
,
,
I
.
I
,
,
,
240""''14 4 ~~
~~~~~~)di6e~
Sequentially bstcondlhOf:s. dailY,
~~:1:~~~AU~ a
(osease or injury thai lOitialed Ihe
evenl& rwsulMg Ul dedlh)LAST.
Duu 10 (or Q il COOMIql.HtIK:8 01)
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32a, Date ollojury (Month. day, year)
PA
Hane
8 Mark~t
Mechanics
23b, licel'l$e Number
23c, Cal8 Signed (Month. day, year)
26. Was Case Relerred 10 ~ E)l.amioer I CorOli&f for a Reason Other Ihan Ctemabon or 00naIi0n?
DYes ~
Part d: Enter Olher sianificant cooditions contribulino to death,
but noIlesulting in the underlying cause gillen in Part J
28. Did Tobacco Use Contribute 10 Death?
Dyes ~
~ Unknown
29. n FemaIe-",""",
~pregoanIlVltI'IInpaslyear
o Pregnant allime of dealh
o Noc pregnanl, bul pregnant wlliun 42 days
01 death
o Nul JlI"9'lilll. but p1~lanl"3 wys to 1 ytloll
......-
o ...".,."."egnanlwflllonfl1epas'YW
32c. Place 01 Injury: Home, Farm. Sreel, FilClOry,
0lIic0 Bu'""'ll. .~ (SpooIy)
DYes
DAccidenl DPendioglnvesligalion
o Suicide 0 Could Not be Detennined
M
321, II Transportaliorlll'lfUry (Specify)
o Driv8f I Operator 0 Passenger OPedes n
OIhe'. Spedly,
330. Signature and Tille 01 Certi
32d, TllTIeoflnlury
33a Cert~ (chad. only one)
~::~,~~~~=n~~~~:~= ;::e~~~::e~=:r ~ :=~_ ~a~ _a:d _,:,~~e~ ~~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
Pronouncing and certifying physician Whysiclan both pronouncmg dedlh and certllyiog 10 cause of dealh)
To the best 01 my knowledill, death occurred III the time, Gate, and place, and due 10 the cause(ll) and manner as stated- _ _ _ _ _ _ _ _ _ _ - - - - - --
::at ~~":'::~~:::: and / or lnvelillgatlon, in my opinion, dealh occurred al the time, date, and place, and due lo the cause(s) and manner as stated- 0
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1c11 I I,,;{ 1 I 10::< 1
36, Dale Filed (Month. day, year)
CT"b(! ie./ ::l ~'c;l
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Disposition Permil No ()6/c z.. Cj I 2-