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Home My WebLink About12-12-07 Estate of it? I !. 0 I<. E" D PETITIOX FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF ,CL '/11 bE~LIf/LJ DCOUNTY, PENNSYLVANIA File Number:2I-(J7 -I/:J V Social Security Number J ~ C, - / L/ - / /) 3 / L" 811tf. NtER- also known as , Deceased Petitiom:r(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) '" C') <= r-=: 0 ~ed irLthe,: ", :n C::.J i -',' "') .' " r F'l '=~(} r-l \.") ,) , ;_~~.:: fin.'" ) . ,;, (Slale relevant circumstances, e,g., renunciation, death of executor, etc.) , (/) ,c:i N ~ .,.) '-.':) ~,~, ~ ~::--;? C") Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution oft~..@stniment~ffere(i.:' ., ,', ) '"- :.. for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ,-' :TJ r=;' , :-D ~ .. :Ie> .::- f.': ,\ -.J 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 ~ B. Grant of Letters of Administration (If applicable. enter: c.I.a.; d.b,n.c.l.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, e.t,a. or d.b,n.e,t,a., enter date of Will in Section A above and complete list of heirs.) i ,1~" (CO'Ji/PLETE IN ALL CASES:) Attach additional sheets ifnecessary. (List street address, towl/lcity, townsilip, cot/nty, state, zip code) :3/0 Decedent, then Cb tf years of age, died on OcT IS) ;?oo7at -3 It!) /J,f IO&E ~T N~w c~W\Jer-01k / 7~ '?f) Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in P A) Personal property in County Value of real estate in Pennsylvania $ SOO.fO $ $ $ situated as follows: J/c 8/C I/J<$-E s7ReC1 "x)Ek> C-te/VI i1c(Llfrlp /4 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: jJ ;f /70 {P:::<"" c. FOr/II RW.OJ rev. 10,13.06 Page 1 of2 Oath of Personal Representative COMMONWEAL TH OF PENNSYLVANIA ss COUNTY OF It:. v.. nl ~!? JZ 1./9 /Y 1/ The Petitioner(s) above-named swear(s) or affim1(s) that the statements in the foregoing Petition are hue and correct to the best of the knowledge and belief of Petitioner(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 30 tfl "" = = -..l -'i , .1 ".~} PI () Signature of Personal Representative f"-:l Signature of Personal Representative . ~2 (=--L l.......J --rl . ; c . 'CIl ::'=i ~ ~- ~.'T-~ '2 .J:"" -..J :=2 r"J": File Number: r:J/- ()1-11r1~ Estate of 117 /Lf) /( Ep L, t8/fJ/2 AfE.-<2.. , Deceased Social Security Number: I y ~- / '1- / c 3 / ANDNO~. Ie)... ,CJeDI having been presented before me, IT IS DECREED that Letters are hereby granted to r- Date of Death: (!)c.. T )/i ,:2 C07 , 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. ) f l FEES C A Letters ............... $ [).O . Q~ Short Certificate(s) . . . . . . . . $ I ~ . cD Renunciation(s) .......... $c!)O. DO '-.J~p ... $/0.00 O~ .k.~+<Jh1.a.J-J 6Y\... $ S. l1D $ $ $ $ $ $ $ TOTAL .............. $ '7 j 00 Attomey Signature: ~~,' \. J,.t., ~--c-J Attomey Name: Supreme Court LD. No.: Address: Telephone: Form RW-O] rev. 10.13.06 Page 2 0[2 H105.112 REV. 1/05 (FEE FOR THIS CERllFICA TE $6.00) WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITALRECORDS lOCAL REGISTRAR'S CERTIFICATION OF DEATH GERT. NO. T 6163906 October 20,2007 Date of Issue of This Certlficatron Name of Decedent Female Mildred L. Barner Rrst Middle Last Sex Social Security No. Jan. 31, 1923 Birthplace 196 - 14 - 1031 Date of Death Oct. 15,.,2007 Date of Birth Mi11erstown, PA Place of Death White Residence Cumberland New Cumberland Pennsylvania Facility Name County City, Borough or Township Race Seamstress No Occupation ArmedForces? (Yes or No) . " Divorced ~~~~n~e~~sdress 310 Bridge Street New Cumberland Number Streel City::or- ToWn PA 17070 Marital Status State If t KarlaLevy n orman Name and Address of Funeral Establishment Funeral Director Sally A. Myers David Myers Funeral Home, Newport, PA 17074 (a) (b) (c) (d) Other Significant Conditions Hypertensive Cardiovascular Disease I I I I o ,..-..,. )'""lCJ . . J.::n ;'-. J:,j! (?J (~~f fJ (T)~, -~; ~ ',-{ . -\-' ~P-,-j .:.~ I ntervaJ Between Onset q.nd Death ,...~, = = -.... c, t-\l <;"'") '-:'~1 <i,,; :..~)l ;.1) "' Part I: Immediate Cause C -, -', , f\,) '- ~ (~-:) :"_'! (-'-I ;) ~."'7J ,: i-.-~; ,"""" :,;Z '2 1-....., Part II: ,-?-/ ..z=- '",'''' . ~ j"t Manner of Death Natural []{X Accident 0 Suicide 0 Describe how injury occurred: Homicide Pending Investigation Could not be Determined o o o Address Michael" L . Norris Coroner (M.D., D.O., Coroner, ME) 6375 Basehore Road, Suite #1, Mechanicsburg, PA 17050 Name and Title of Certifier This is to certify that the information here givenis 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. Date R'eceived by Local Registrar 50-455 DistricfNo. October 19, 2007 St., New PA17068 StreetAddress City, Borough, Township RENUNCIATION o ,- -cc::O - ::0 :\10 ):~ F7~, -.~~ ,....." c::> = -..J o rq n REGISTER OF WILLS W MAe:,e L"# L.XOUNTY, PENNSYL VANIA N -,:;3 ~ ~"_.j,,-~~ -.:~ }i2 ):;>.'0 :J1: <:;> .$:"" -.J Estate of 1YJ ) Lj} I( E .t? L, lJJ1~///'ER- , Deceased I, /r/1/? L# (Print Name) D/1/A G//Tcf2 LEvY , in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to C~/ltt IE..> /11 tffitf.If!Ee ~,e. ~f~~ (SIgnature) ~ ////8/0 7 (Date) (Street Address) v/ / tfo /5" I!i ~ ? t./ Ifi. 9-: I :tf;Zd.2.~ , /S(U;#Sd~/e, 172 ?S.:266 (City, State, Zip) &t^~e / A"','COYlti) CO"'->>!y ~ /J1J.JI'r~;oi!-) Execuledout of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciatis.n for the purposes stated within on this /3-e day o~v , .9a>~ ~~~ Notary Public My Commission Expires: ~i/If2A-lQj, I J -~~~ Executed in Register's Office Sworn to or affirmed and subscribed before me this day of 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_) Form RW-06 rev. 10.13.06 CHRISTOPHER N MARRS Notary Public - Arizona Maricopa County My Commission Expires November 3. 2009 RENUNCIATION ("") c: 1'--) c.:,::) C~ -.J REGISTER OF WILLS ~b€r\O\---{_ COUNTY, PENNSYLVANIA C) r- I"Tl -:0 - ~), :S~~ )C:: .~?l ~ CJ P1 c-> N :P>o -- -lo. o .&:- -..J ,-- ..".~ Estate of A\ \ J. reo{ Ll Bo.-v-~<<- R. , Deceased I, T V-'v\.o{ ~ -=rO?o-....("v'e~ 5 h.C^-v--F , in my capacity/relationship as (Print ame) c\ o..~ h~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to eh 0....--. \ -e.s fY\.. ~V\ e. V" -Tn '" (Date) IO{3((Ol 'f 1-\ 6--(- r-~? b LA. ~ (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 3 \ st day of Oc\-o~e..v- , zoofJ ~~ C.J1~ Notary Public 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.) Form RW-06 rev. 10.13.06 COMMONWEALTH Of PENNSYLVANIA NOTARIAl SEAL TAMICA C. GOODSON, Notary Public: Susquehanna Twp., Dauphin County My Commission Elpires Oct. 6, 2010 RENUNCIATION Estate of MIL J r ~j t3,c;;q ~ E /2.. o ~TJ ;t~ F2 . ~ \~;~ ~~ J~?: :JJ }2.---j r-..> = 0=:> -..J c::::T ;"1' \) REGI~TER OF WILLS ('u tv! t~..... La.,nJ COUNTY, PENNSYL VANIA N ).:>00 :JC L, 9 .s::-? "';'-Deceased' I, f)at/I) I. (Print Name) !Jel/()1t'A , in my capacity/relationship as ,~ ~,.; of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Ch'.IJ~ Lt: S /'? i3Jfe Nt::.~ ,Tz. (Street Address) II"JtIl ;r6u~ (City, State, Zip) X f~/L-RA (SIgnature) SB09 /YI,!IoH /)tf, ~ .J 11-/-()7 (D;te) ITII ~ . Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills /" Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renuncwion for the pu es st within on this / day of ' , ;;&07 . COMMONWEALTH OF PENNSYLVANIA Notarial Seal !y Public Lower Swatara Twp., Dauphin County Commission Expires May 8. 2011 em er, ennsylvania Association of Notaries (Signature and Seal of Notary or other official qualified to administer oaths, Show date of expiration of Notary's Commission.) Form RW-06 rev, 10,13.06 RENUNCIATION o 0,S3~ - --'- ') ~~:~; ~'-'-:::D C/)~ .- jQ, .)~ -] "-~- --'~'~ -0 ~;:., ....:> = C:::JI --J c:::J \'Tl CJ :P"' :Jt '2 ~ -J REGISTER OF WILLS L.umg/;RLI9AJ(J COUNTY, PENNSYLVANIA N Estate of /11 LOt( EO L. 13/1~NE ~ , Deceased I, UJ~ /f/ tIJ Y Eo (Print Name) ,/;J.Ak4<4/TE R J11 / LiE /( , in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to C'#/ld/L?.5 JrJ ,.q7l/?;JE~ o~ (( / 1- D /- :2 007 (Date) ;;J!~['. ~ 1-- tJJ I L/ '-I tfj 5-treet (Street Address) X Jl{uJ ('~I1A/3E4CVJc1/ fJ II /7070 (City, State, ZIp) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunc~~pon for the p rpo es sta ed w)hin on this / day o II IA Nota.rjaLSeal ~. SuSariE: J'i:uiesko, Nota.ry Public ., phin County My Commission Expires May 8, 2011 PlRifilhsylvania Association of Notaries (Signature and Soal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06