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Home My WebLink About11-03-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA 02 / 'O~(() ?__ u3~ Estate of JUANITA NOLL also known as JUANITA CAROL NOLL, JUANITA MARGARET NOLL, JUANITA M. NOLL . Deceased File Number Social Security Number 149-24-7091 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE ~' 0' 'B' BELOW:) o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is 1 are the last Will ofthe Decedent dated and codicil(s) dated n :'narned in the C-. (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 ofthemstrument(s):otfered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ('1 ....- '--' III B. Grant of Letters of Administration (Ifapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minori/ate) Petitioner(s) after a proper search has 1 have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. or db.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) I Name Relationshio Residence I RENATHA HAMILTON DAUGHTER 915 Indiana Ave., Lemyne, Pa. 17043 JAMIE NOLL SON 2124 S. Benton Cir., Masa AZ. 85209 ERIC BOZIAN GRANDSON 542 B Criswell Dr., Boiling Springs, Pa. 17007 (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in CUMBERLAND 1942 CHATHAM DR. CAMP HILL. PA. 17011' (List street address, town/city, township, county, state, zip code) County, Pennsylvania with his 1 her last principal residence at Decedent, then 73 years of age, died on 02/14/07 at 7;15 am Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (lfnot domiciled in PA) Personal property in Pennsylvania (lfnot domiciled in PA) Personal property in County Value of real estate in Pennsylvania 5,645.00 $ $ $ $ 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: T or rinted name and residence Renatha Hamilton 915 Indiana Ave., Lemoyne, Pa 17043 FormRW-02 rev. 10.13.06 Page 1 of2 Of1- (03d Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS " -) '.-'.--J COUNTY OF Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct ~<?the best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) wilfwell abcl truly administer the estate according to law. Sworn to or affirmed and subscribed )3</1. ~ ~~~~ Signature of Personal Representative en C Signature of Personal Representative Signature of Personal Representative File Number: ::2/~~0'7~ I03d Estate of JUANITA NOLL , Deceased Social Security Number: 149-24-7091 Date of Death: 02114/07 AND NOW, ;7 Lr Iv Lt~-L-.. 13, c:xJ (/7 , in considerayon 9-f the foregoing Petition, satisfactory proof having been presented befor~e, IT IJJtEC~hat Le1:J:ers (ia/J0/~ CY1- are hereby granted to t; (p Lif L rr ~ f1fVI in the above estate and that the instrument(s) dated -- described in the Petition be admitted to probate and filed of recor ti1--- '/SW Letters ............... $. 'w Short Certificate(s) . .. ., . . . ~.JO . R .. (). $ /0 UP> enunCiatIon s .Cf.....' J ... $ If), ei) fI,.elf) .. . $ ~JjO I .. . $ ... $ .. . $ .. . $ .. . $ .. . $ . .. $ TOTAL . . . . .. . . . .. . . . $ FEES Attorney Signature: Attorney Name: Supreme Court LD. No.: Address: Telephone: qd.(f~ Form RW-02 rev. /0.13.06 Page 2 of2 llOS.80S REV 1/05 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. 0'7 -( () 3:)- WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~I?~ Local Registrar Fee for this certificate. $6.00 p 13106696 FEB 1 6 2007 Date ,.' " ..........,.j (~1) ~'7 . ( o :ev 1112006 )~INTIN INENT KINK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See InstructIons and examples on reverse) STATE FILE NUMBER _'s AcIuaJResldence 17a.SCate OOthe'.Spec;~: 10. Race: American Indian, 8lack. White, ele. (Specifyj hite 1. Name of Decedent (First, middle, last, suffiX) G. Ooto of Bilth (Month, do , yest) 73 YIS. Feb. 1 8, 1 933 Camden,NJ Sb. County of Death Cumberland ed. Fadfi~ Name (II nollnstilutlon, giv<"eel and number) 1942 Chatham Dr. 11. Oecedent's Usual Kind ol woOl: done du most 01 life. 00 not state reti KindofWor1t Kind af Business I ll'ldtmry home maker 16._'sMallingAddrass(SlraeI,cllyJlown,SIaIe,zillcoda) Dr. 12. Was Decedent ever in the U.S. Armed Forces? o Vas fX/Io 13. _'s Education (~on~ h;ghasl groda compIelad) Elementary I Secondary (0-12) Coll&ge (1-4 or 5+) 9 14. Marital Status: M&rried, Never Married, W_,OivorCad(Specifyj idowed Did Decedent Live ina Township? 17c.1RJ Yas,o-datllL1v<<lin 1.0\'/'01:1:" AIIQtl 17d.O No,OacadanlUvadoilhln ActuII Limits 01 Twp. 17b. Cou~ PA Cumberland City 1 Bolo 208. lnlolTTlSnt's Name (Type I Print) Ms. Renatha 21a. Method of DIsposition o BUfi81 0 Removal/rom State o Olhar' Spedfy: 22o~~~elor ~ ~. CornpIete "ems 23a-c only when cerUfying physician is not available at time 01 death 10 certify cause 01 death. 118ms24-26_ba complatad by parson wOO prooootIC8S daath. 19. Mother's Name (First, middle, maiden surname) Renatha Clay 2Ob. Informanl's MaMing Ac:khss (Streel, ctty I town, slate, zip code) 915 Indiana Ave.Lema ne 2tc. Pfscaof Dioposifion (Na~oI_, CI9/1lIl!ory orother~""') Evans Cremation Service 17043 21d.,l.ocation (CiIY.L-, sfal...ri, codal cnaerrersLown,PA 22c. Name and Address 01 Facility usselman FH&CS Inc.324Hummel Ave.Lemoyne,PA 23b. License Number 23c. Date Signed (Month, day, year) 24. Time ol Death . _ '7 ',/5 -I(-M. 26. Was Case Refel19d to Medical Examiner f Coroner for a Reason Other lhen Cremation or Oooam? ~Yas ONo CAUSE OF DEATH (See Instructions and examples) I Approximate IntElf\l'al: Part \I: Enter other !liQnilicant condtions r::ontributiTlQ to cklRth, Item 27. Part I: Enterthe~-dtseases, injuries, or compIIcetions-that directly caused lhedea.th. 00 NOT enter lerminal events such as cardacarrest, f OnseltoDeaIh bot not resulting in lhe underIyiIlg cause &Wen in Part!. respiratory arrest, or ventricular IbriIIation without showing the etiology. list only one cause on each line. I ='~~us:;~)~~. k 'Ald'T; /)/\/\..I~;f~ wC-o/'4/ DuetO(Orasa~~ b" d. o Homicida o - 0 Panolng Invas'gation o Suicida 0 Cou~ Not ba Oat_ 28. DId Tobacco Use ContTibtM 10 Death? DYe< DProbabfy o No 0 Unknown 29. If Female: o Not pregnant within past year o Pregnant altirne 01 dealh o Not pregnant, but pregnant within 42 days oldeath I o Not pregnant, buI pregnanl 43 days 10 1 year beloredeath o Unknown if pregnant Within the past year 32c. Place 01 Injury: Home, Farm, Street, FactorY, 0IIice ElIJi1ding, ~c. (Spec;~) =:t~=='~i:;a. en.., ihe UNDERLYING CAUSE ~~~":.grtrJ." b. Due to (or as a coosequence on: c. Due 10 (or as a consequence on: o Vas JOb. Were Autopsy Findings Available Prior to CornpIetlon of Cause of Death? OVes ONo 32d. Tnne of Jnjury 3019. Was an Autopsy Perlomled? M. 321. II Transportation Injury (Specify) o Driver 1 Oparalo, 0 Passenga' OPadeslran Olha, ' Speci~: 33b. ~ture and Trtle of Certifier 330. Ce<lfier (chad< ~ on.) Certttjing physician (Physician C8I1ifying causa of daalh.... snolhar phyaiQan has pI1lI\OIJl1Cad daath snd corn~~ad Item 231 To the be8tof my knowtedge, deeth occurred due to the cause(l) and nnnlfasstatecL. _ _... _..... __ _...... _ _... - _ _ -...... - -...... -........... _ -... :~ou:::.-= ::::.:: o:=~~ :thti~:~~~~=~oto::~':: mlnner 81.mted........... _............ _.... _... _... _ 0 MecBcal Eumlnlf I Coroner On the ~I of examlnstion lnet I or in~tlgstion, In my opinion, duth occurred at the Ume, dete, Ind place, and due to the cauae(a) and manner IS stated_ 0 35. Registrar's Signa~ Districl Nu ~ ~ IJ.I/I~I/II 0'1 ~ IO~ , r, ". ! f:: 5U RENUNCIATION REGISTER OF WILLS ",. ,. CUMBERLAND COUNTY, PENNSYL VANIA 0(1- \O~ Juanita Noll, also known as Juanita Carol Noll, also known as Juanita Margaret Noll, also known as Juanita M. Noll Estate of , Deceased I, Jamie Noll (Print Name) , in my capacity/relationship as of the above Decedent, hereby renounce the right to son administer the Estate of the Decedent and respectfully request that Letters be issued to my sister, Renatha Hamilton (Date) 6/:50 / I I 2007 / /~lItu tJt/P (Signature)' / Jam1.e Noll (/ r.:"- 2124 South Benton Circle (Street Address) Mesa, AZ 85209 (City, State, Zip) 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 30 ""'- day of ~"'I. ~ 2007 6~~-- Notary Public 8. /5' 0& 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.) (i'-> BFF~{K~NNEER ~'. NOTARY PUBLIC-ARIZONA '." PINAL CC!UNIY . 'eO" Vy Cc"'~ ~X:::5 ';Jg. 13.2008 ~...~ Form RW-06 rev. 10.13.06 0'1- f03d RENUNCIATION ;: S [J REGISTER OF WILLS ,n CUMBERLAND COUNTY, PENNSYL VANIA ()(-\ ". I b3d Estate of Juanita Noll, also known as Juanita Carol Noll, Juanita Margaret Noll, Juanita M. Noll, Deceased I Eric Bozian , (Print Name) , in my capacity/relationship as of the above Decedent, hereby renounce the right to grandson administer the Estate of the Decedent and respectfully request that Letters be issued to my aunt Renatha Hamilton //-07- (Date) 2007 C?T@. ...-.c--- Q JiA-- .~~ignature) G 54~-B Criswell Drive (Stre(!t Address) l!9iHqg Springs, Pa 17007 (City, State, lip) 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 c; -:tC. day ~8d17 . 'NO~ PublIc COMMONW~ALTH OF PENNSYLVANIA M C .. E . r NOTARiAL SEAL Y ommlSSlon xPl~~icHAEL R. CARANC!, Notary P\Jb!ic i LelT!vn' 80 0 Cumberland County (Signature and Seal of Notary or ~r. . , fie ires June 1:), 2010 administer oaths. Show date of e ' --' Deputy for Register of Wills Form RW-06 rev. 10.13.06