HomeMy WebLinkAbout12-17-07
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYL VANIA
REGISTER OF WILLS
O.C. No. ;)1 -0 7-lIcJ 5
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INRE: EDNA FARKAS,
DECEASED
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PETITION FOR CITATION
TO GRANT LETTERS OF ADMINISTRATION
PURSUANT TO 20 Pa. C. S. & 3155
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TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY:
The Petitioner, Presbyterian Homes Incorporated d/b/a Green Ridge Village
(/lPetitioner/l), a principal creditor of Edna Farkas, respectfully represents that:
1. Upon information and belief and to the extent of Petitioner's knowledge,
Edna Farkas (/lDecedent/l) died intestate on August 23, 2007. A Death Certificate is
attached hereto as Exhibit /I A./I
2. Upon information and belief, Decedent was survived by the following
heirs:
Melinda Hall (daughter)
64 Horsekiller Road
Shippensburg, P A 17257
Melissa Graham (daughter)
235 Mizzen A venue
Manahawkin, NJ 08050
3. Petitioner was a principal creditor of Decedent.
4. At the time of the death of Edna Farkas, an application for the receipt of
Medical Assistance benefits for the care and services provided to her by Petitioner was
pending before the Cumberland County Assistance Office of the Department of Public
Welfare of the Commonwealth of Pennsylvania.
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5. Petitioner desires to have Shaun E. O'Toole, Esquire (" Attorney O'Toole"),
appointed by the Court to administer the Estate of Edna Farkas for the purpose of
paying all debts owed by Decedent, qualifying the Decedent for the receipt of Medical
Assistance benefits, and distributing the balance of the estate pursuant to the intestate
laws of the Commonwealth of Pennsylvania.
6. Attorney O'Toole is a disinterested party who has no interest in the
outcome of the pending Medical Assistance appeal involving the Decedent.
WHEREFORE, Presbyterian Homes Incorporated d/b / a Green Ridge Village
respectfully requests that a Citation be issued to the heirs of the decedent to show cause,
if any, why Letters of Administration for the Estate of Edna Farkas should not be issued
to Shaun E. O'Toole, Esquire.
Respectfully submitted,
ScHU1JER BoGAR LLC
Dated: 111?!2lXJ+
~
By: .
Chadwick O. Bogar
Attorney J.D. No. 83755
(717) 909-5920
Maria G. Macus-Bryan
(717) 909-8640
Attorney J.D. No. 90947
417 Walnut Street, 4th Floor
Harrisburg, PA 17101
Fax (717) 909-5925
Attorneys for Petitioner
2
H105.905 REV/GrOG)
This ';S to certifY that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
/7 ~ ~d
C4Q ~ (J~~ lf~oL
No.
Frank Yeropoli
State Registrar
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
4198501
DEe 0 5 2007
Date
;f'\
H105-143 REV 11!2006
TYPE I PAINT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions end exemples on reverse)
079404
69
V<s.
-30 - 3104
Sa. Place 01 Death Check
HospItal: Other:
O'npalHmt OERI_nt OOOA ~U",ngHome O_noe OOltler.Soeclfy,
9.~=lg:icOrigin? XI No DVes 10.=~jndian.Black.W'hite,elc.
....,k:an,PuenoRk:an,otc.) White
t. Name 01 lJocedent (Rnll. _, 1ast,_1
SO. County of Death
CUnt>erland
'7b. County
PA
CuIltlerland
14. Merna! Slatus: Married, Never Married,
WIdowed, Divorced (Speci/j\
Widowed
DklDec:eder<
Uve ina
Township?
Decedent'.
ActuaIResidence 17a.Slate
17c.IXves,DeoedentLNed. South Newton ~.
17d.O No,DeoedentliYed"",,n
ActualUmltsol
Twp
City/Born
o
III
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~
21.. Metf1cd 01 [);-"'"
o Burial 0 Romoval from Slats
o Other- Soeclfy'
220. Signa"reolFunanoI
. ~
CornpIeteItems23a~onIywhen~ 23a.To1he
physicianisnolavallableatlineofde8\hto
certify cause 01 death.
Items 24-26 musI be oompIeted by person
who pronounces_
2Ob. Intoonant's Mailktg Address (Street, city I town, stale, ~ code)
64 Horsekiller Rd., Shippensburg, 17257
2tc.Pfocaol_(Nameol_,crematory"-pIoce) 21d.Ulcation(City/loWn,.....ztp_1
Hoffman-Roth Funeral Home Carlisle, PA 17013
CAUSE 0 DEATH (_1_.
Item 'lJ, Part I: Enter the ~ - dlseases, ~ri88, or complications -1h8l dredIy Cll!J88d!he d8d\. NOT.... terminal events such as cardac arrest,
reepiratOly anwl.. or ventricUat' fb1IatIon wIIhoul showing the etiology. Us( <rij one cause on eecn line.
~~=)~ a Ull"\.~ Csan~
Due to (or as a consequence of):
A(:lproximaIelnterval:
Onsat " Daafl1
28. Did Tobacco Use ConIrIluIe 10 Death?
o Vas 0 p.-y
~ 0 Unknown
29. "Female:
o Notpregnant_pastyoar
0",-",_....01_
o NotJllVo'"l.bufpregnar!_42dajS
ofdlath
o Notpregnant,bufpregnant43daystolyosr
before_
o _,pregnant_the"",tyoar
32c=~,:r~)SIraet,Factory
_"'_,'""1,
Ieadno to the cauee listed on Ine a
Enls! to UIlDE1lLYING CAUSE
~~.~~
b.
Due to (or 88 a oonsequence 01):
Due to (or as a consequence of):
d.
I
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I,;}, I' I a.. I I I C:> I
32d. Time of Injury
32g.Ulcationollnjury(S1....,citylk>wn,_1
o Ves tNo
:n. Wore_ FndIngs
_Plfor"~
01 Causo 01 Daafl1'
OVes ONo
31, MInnel'oIOeath
~"' OH_
O-OPenclng,nvftligaficn
OSuicida OC"'-'dNotbeDofarminad
M.
3Oa. Was an Autopsy
parfonnad?
330. Certifia< (chocf< only 01101
CorIItyIntI ~ (Physicion canJlying causa 01_ _ anoIhar physlcIan has pronour<ad _.... <XJfl"!lIalad.om 23)
To"" boot" "'" _, _ _ cIua 10"" _.} and -- - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
_and_~(__pronouncing_andco1ifying"couseol_) -
To.......... ""'_,__ _""_,_ and~, and clualO""_.}and___ __ _ __ _ _ _ _ _ __ _ _ _ _ __ - 0
= =- ex: II'lCII or 1rMetIption, In my op6nkJn, deIth 0CClMftd It 1M 1ime,1Wa, Md pI8cI, Ind dullO the CMII8(1) IIl'Id mII1fItI'. tlItIcL 0
Disposition Permit No
H105.905 REV.l6/06\
This -is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
/2 ~ ~d
CdQ ~ a~YL tf~O~
No.
Frank Yeropoli
State Registrar
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
4198500
DEe 0 5 2007
Date
~
H105-143 REV 1112006
TYPE I PRiNT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions snd examples an reverse)
079404
1. Name or Oecedenl (First, midcIe, last, suffix)
3104
Jan. 22, 1938
Patterson,
Sa. Place 01 Death Check
Hospital: Other:
o '.....tien! 0 ER I OulpaIien' 0 OOA ~u~ng Home 0 Residence
9. ~~=g:icOrigin? Sf No 0 Yes
Mexican, Puerto Rican, etc.)
14. Marltal~: Married, Never Married,
WKlowed. OMl,ced (Speciljj
Widowed
Do"..,. Specify:
10. Race: American Indian, Black. White, ete
(SpeciIjj
6. Dale 01 Birth (Month. da .
7...rthplacel .
17b. County
PA
Cunberland
O~ Decedort
Uveina
Township?
White
Decedent',
ActualAesidence 17a.Slale
18. Father's Name (FIrSt, middle, last, suffix)
Arthur Pearson
208. Infomlant's Name (Type f Print)
Melinda A. Hall
17c.XXVes._LNedO South Newton Twp.
17d.D No,OecedentliYedwithin
ActuaIUmilsof
Top
Crty/Boro
~
~
O!
218. Method 01 Disposition
o Burial 0 Remov~ from Slat.
o OItler- Spodfy:
228. Signatt.nol Funeral
~
~ ,_ 23a~ any _ ce<1lly~ 23a To ""
physici8n is not avallable at time 01 death 10
ce<1lly cause 01_.
1tem124-26 must be completed by person 2~'rlJl'l8 01 Death
who pronour<ee _ nppn>)< I m
CAUSE 0 DEATH (See lnatructlone .
11em27. Part I: Enl8I'the~-dae8ses.il'1jOOe&,orCOl'J1lhC8tion8-thatdirecUyOlllJMdthed88ltt NOTenterteminallMlfltssuchascardacarrest,
respifatory arrest. orY8l1lricUar fibrIIatIon wilhouI showfIg the etiology. List~ one aut on eactllne.
=~=>,Iee"''''';' a. Lt.IlJ \ ~ Lea r. lJ--....
Due to (or as a oonsequence of):
Ma
2Ob. Informant's MaIlIng AdO'ess (Street. city I town. stats, zip cocIe)
64 Horseki11er Rd., Shippensburg, PA 17257
21d. Location (City !town, state. zip code)
Carlisle, 17013
!
15
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I ~ II I al I I C> I
I Approximate Interval:
: Onsel to De81h
,
,
,
,
,
,
,
.
,
,
,
I
,
,
,
28. Did Tobacco Use Contribute to Death?
o Vas OProbaIIIy
~o OUnknown
29. n FtmeIe:
o NoIP<09f1ll1ll_peslyea,
o PTagnenlet'nIO"dea'"
o NoIpoagnanl,butP<09f1lllllwithin"'days
ol_
D Not pregl8.nt, but Pfl91&n143 days to 1 year
""""-
o Unknown nJll8lJ1an1withi,,,,,peslyaer
32c~~~:r~j- Fedorf,
~listcondlllons,Wany.
il c:aueellst8donMnea.
Enlar UNDEIILY1NG CAUSE
l.':" ~.":..,"!'mr
b.
Due to (or as B conseqoence 01):
Due to (Of as a eoo&eqU8l"lCe of):
301. Was an Autopsy
-
d.
3OIl.WoraAulopeyF1ncfngs
A__\O~
at Cause at 0eIIh?
ovostNo
DYes ONo
31. Manneral Death
~O-
0-1 o PaodinglnYastigation
o SliOde O~NoIbeOetaIlllined
32d. Time of Injury
3211. location 01 'VIIStreet, orty I lown. staI.)
M.
338. CeI1ifier (check any one)
c.tIfylag ~ (__""""dea"'_ eno!he'physlcia' haspoooour<ad _and_110m2')
To thtbelt of my 1lnowIIdgI." accurNd clue totht ClUM(I) InCI "*"*.......... -........ -.... -.... -.... -.. - -.... - -.. -.. -...... -..
=:~"='=:::=~~~=loro~=mInMr"""'''_''''''''_''''''_'''''''''''' 0
= =- n: Ind I OJ inveItigIdon, tn my opInton, dNth occurred It the,,,,,, dMe,lI'IIl pIIce, II'IIl cluI to the ClUM(I} II'IIl manner..1IIted.. 0
DIspositIon Permit No