HomeMy WebLinkAbout10-25-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYL VANIA
Estate of DOROTHY A. JUMPER
also known as
File Number :2/ - () 7 - ()9 -; J.
, Deceased
Social Security Number 202-20-5518
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 I are the
last Will of the Decedent dated and codicil(s) dated
named in the
(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 the instru!llent(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
~ B. Grant of Letters of Administration
(Ifapp/icable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritit~)
Petitioner(s) after a proper search has I 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.)
I Name Relationship Residence I
JOSEH MCCLEARY SON 136 SPRINGFIELD RD, NEWVILLE, P A 17241
BETTY BOYD DAUGHTER 20894 REMINGTON RD, SHADE GAP, 17255
BEVERL Y NYE DAUGHTER 214 MEANS HOLLOW RD, SHIPPENSBURG, P A 172
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his I her last principal residence at
134 SPRINGFIELD RD, NEWVILLE, P A WEST PENNSBORO TWP
(List street address, town/city, township, county, state, zip code)
Decedent, then 80
CARLISLE, P A
years of age, died on OCTOBER 4, 2007
at CARLISLE REGIONAL MEDICAL CENTER
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 PA) Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
16,000.00
110,000.00
situated as follows; 134- 136 SPRINGFIELD ROAD, NEWVILLE, P A 17241
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 fonn to
the undersigned:
T ed or rinted name and residence
SALLY J. WINDER
SALLY J. WINDER, 9974 MOLLY PITCHER HWY, SHIPPENSBURG, PA 17257
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
SS
COUNTY OF
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 Decedent, Petitioner(s) will well and truly
administer the estate according to law.
x
Sworn to or affirmed and subscribed
before me the ;;? s-t ~ day of
,dCul
Signature of Personal Representative
~i~'
I Signature of Personal Representative
File Number: <:!) I - 0 1- Or'l ~
Estate of DOROTHY A. JUMPER
, Deceased
Social Security Number: 202-20-5518 Date of Death: OCTOBER 4, 2007
AND NOW, -,I / iJY\bQ. L _ ,c:J(JCY'l ,in consideration of the foregoing Petition, satisfactory proof
having been presente before me, IT IS DECREED that Letters OF ADMINISTRA nON
are hereby granted to SALL Y J. WINDER
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of re
YS,OZJ
10. cD
r:5 0)
Attorney Signature:
FEES
(;7~)O ~.6U
01 0"-/
Letters ............... $
Short Certificate(s) . . ;~. . . $
Renunciation(s) j ',; "J" . . . . $
C I' .,. $
lL J1 ... $
.. . $
. .. $
... $
...$
.. . $
...$
.. . $ .
TOTAL . . . . . . . . . . . . . . $
Attorney Name:
Supreme Court J.D. No.:
~'f1o 6'-
tinLf jV)rjf~ RMftf ~
~~~f/t &1Jri
Address:
~ CV
?;) '-6:00
Telephone:
'li 1 ~3d--'147~
Form RW-Ol rev. 10.13.06
Page 2 of2
L()CAL REGISTRAR'S CERTIFICATION OF DEATH
IN ARNING It is illegal to duplicate IhlS C;{jPY oy photostat or photogmph.
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H105,143 REV 1112006
TYPE / PRINT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
~I-Ol- Sld-
)\
6. Dale 01 Binh (Monlh, day, year)
80
16, 1927
New Oxford, PA
8b. Counly DI Dealh
Bd. Facillly Name (II not instrtuhon, give slreet and number)
ional Medical Center
13. Decedent's Educallon (Speclly only highest grade completed)
Elementary / Secondary (0-12) College (1,4 or 5+)
8
Seamstress
. 16 Decedent's Mailing Add~ss (Street, crty ftown, slale, zip code)
~~~;:re~~:idence 178. Stale Pen n s y 1 van i a
17b, County Cumb e r 1 and
134 Springfield Road
t8. Fathe<'s Name (Firsl, m\\:ldle, iasl, su11ix)
202 - 10
4, Dale 01 Dealh (Month, day, year)
October 04, 2007
5518
14. Marital Sla\us: Married, Never Married,
Widowed, Divorced (SpeCIfy)
Widowed
17c.~Yes,DecedenIL",edin West pennsboro
17 d. 0 No, Decedent lived wrthin
Actual Limits of
Twp
City/Boro
20.. Informant's Name (Type / Print)
19, Mother's Name (First, middle, maiden surname)
M rtle Gertrude Marks
20t>.tnlormant'. Mailing Address (Slreel, city I lown, Slate, zip code)
144 Am Drive. Carlisle, PA 17013
21b. Date 01 Dlsposrtion (Month, day, year) 2lc Place 01 Disposllton (Name of cemetery, crematory or other place) 21d. Localton (Crty /town, slale, ZIP code)
Robert Theodore Roosevelt Bittin er
o Cremation 0 Donallon
2007
Rehoboth Cemeter
~ ,.. ......--?
Complete Items 238'c only wtlen certilymg
phYSICian IS not available al tune 01 death to
cenify cause of death
230 To the best 01 my knowledge, dealh occur7ed t Ihe Itme, date and place stated. (Signature aoo IllIa)
6.'cJt( q.""7 I~ V/t/7 l!4LML
Items 24-26 musl be compieled by pelSOn
who pronounces death,
24, Time of Death
(;:O'f
25, Dale Pronounced Dead (Month, day, year)
t:t . M, I tJ - V - (..J 7
CAUSE OF DEATH (See Instructions and examples)
Item 27, Part I: Enter the ~ - dISeases, inluries, or complications - thai directly caused the death, DD NOT enter terminal evanls such as cardlllc arres\,
respiratory erresl, or venti~uiar librillalion without showing the eltology, LiSI o,ly one cause on each line
I Approximale interval
: Dnsello Dealh
I
I
: 2-'( itvS
I
: 'J e::<.0
lJo.rS
: f;7f;jf r1 '
~~d~~~;;jtn~1~ ~~~\ dlSe~
(2f(P iRftTOf? Y F11 L UJ2E
Due to (or as a consequence of)
~P(J
Due 10 (or as a consequence ot1 (;;r!. ~
() b ~{ c 'f--, \^- S I-e ..o.,Q , N-fM--
Due 10 (or as a consequence 01): U
d, U YPO re N\ 10/\)
Sequenltally list condrtlons, rt any,
~~t~:%~ J~D~~t~I~~"1:~~~t a
(disease 01 injury Ihat Inrtlateo Ihe
events resulting In death) LAST,
3Oa. Was an Aulopsy
Performed?
3Ob. Were Aulopsy Findings
Available PlIor to Completion
of Cause of Death?
31. Manner of Dealh
~Natural 0 Homicide
o Accidenl 0 Pending Investigation
o Suicide 0 Could Not be Delermlned
M,
o Yes ~o
DYe. 0 No
32d. T.me of Injury
z
g
o
~
35, Regislrar's Signature .and Dislr N
~
121/ I 2.1( ",
Disposition Pefmi1 No
Walnut Bottom, PA 17266
.' ?7?
St., Shi , PA 17257
23e. Date Signed (Month, day, year)
u7-V-07
26. Was Case Referred to Medical Examiner J Coroner for a Reason Other than Cremation Or Donation?
OVes ~
Par1l1: Enter other sioniflcanl condiiions r.onlributina 10 death,
bUI not resulting m the undenylng cause given in Pan I
2B, Old Tobacco Use Conlnbute 10 Death?
o Ves 0 Probably
No 0 Unknown
29, H Female:
~ Not pregnanl wilhin past year
o Pregnant altime of death
o Not pregnant, bu1 pregnanl whhln 42 days
of dealh
o Not pregnant, bul pregnanl 43 days 10 I year
belore dealh
o Unknown if pregnant withm the past year
320, Place 01 Injury: Home, Farm, Strcel, Factory,
OfI,ce BUlldmg, ele. (Specify)
{laY- ;1J~0-
32g. Location 01 InJUry (Streel, aly flown, slale)
c~lfLF) /f9 l-=t6t!:
ADDITIONAL HEIRS:
JUDY DERR, DAUGHTER, 38 RUSTIC DRIVE, SHIPPENSBURG, PA 17257
PENNY CaMERER, DAUGHTER, 144 AMY DRIVE, CARLISLE, PA 17013
DEBORAH PETERS, DAUGHTER, 50 TIFFANY DRIVE, SHIPPENSBURG, P A 17257
RICHARD CaMERER, SON, 9 NEIL RD, SHIPPENSBURG, PA 17257
LINDA CUMMINGS, DAUGHTER, 29 TIFFANY DRIVE, SHIPPENSBURG, PA 17257
RANDY CaMERER, SON, 1477 WOODS ROAD, SHIPPENSBURG, PA 17257
RENUNCIATION
Estate of DOROTHY A. JUMPER
No. cYJ - 01- ql;1
also known as
, Deceased
The undersigned, BEVERLY NYE, DAUGHTER
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. \I\,/INDER
hand this I ~ day of OCTOBER 2007
;<~:~~:;~y~ Lt 19Zff ~
214 MEANS HOLLOW RD, SHIPPENSBURG
(Address)
Witness MY
PA 17257
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this
()c/1J W
Ie:,
day of
NOTARIAL SEAL
.JEANNE M. ARNOLD, NO-
Southampton Twp., Fr8
My Commission Expir:
DUBUC
County
: 1 2, 2008
NOTARIAL SEAL
JEANNE i'v1. ARNOLD. NOTARY PUBLIC
Southampton TWf;.. Franklin County
My Commission Expires April 12, 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIA liON
Estate of DOROTHY A. JUMPER
No. .;21-0l-ql~
also known as
, Deceased
The undersigned, JOSEPH MCCLEARY, SON
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
hand this 10 day of OCTOBER , 2007
C1~r /J'Yf e~
S6SEPH MCCLEARY
136 SPRINGFIELD RD, NEWVILLE
(Address)
Witness MY
PA 17241
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this
JD
I
day of
I NOTARIAL SEAL
JEANNE M. ARNOLD, NOTARY PUBLIC
Southampton Twp., Franklin County
My COmml$Slon ExpIres April 12, 2006
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIA liON
Estate of DOROTHY A. JUMPER
No.CJJ -01- q 1 d-
also known as
, Deceased
The undersigned, BETTY BOYD, DAUGHTER
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Witness MY
be issued to SALLY J. WINDER
hand'this ) i) day of OCTOBER 2007
~ ~ J ~~ture)
BETTY BOYD
20894 REMINGTON RD, SHADE GAP
(Address)
PA 17255
Letters OF ADMINISTRATION
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this
QJvtP
~~ ju.
My Commission Expires:
Jo
day of
~O{) 7
~
NOTARIAL SEAL 1
JEANNE M. ARNOLD. NOTARY PUBLIC I
i
Southampton Twp, Franklin County
My Commission Expires J\prii 12, 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIA liON
Estate of DOROTHY A. JUMPER
c2 1- ol- C(7 J..
No.
also known as
I Deceased
The undersigned, LINDA CUMMINGS, DAUGHTER
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
hand this I 0 day of OCTOBER I 2007
/) r ~
0-~'UitL(jJI11J~'
LINDA CUMMINGS
29 TIFFANY DRIVE, SHIPPENSBURG
(Address)
VYjtness MY
PA 17257
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this
O&1ibU
/0
day of
NOTARIAL SEAL I
JEANNE M. ARNOLD, NOTARY PUBLIC I
Southampton Two., Franklin County
My Commission Expires April 12, 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIATION
Estate of DOROTHY A. JUMPER
No. ;)J- tJl- 97 ~
also known as
, Deceased
The undersigned, DEBORAH PETERS, DAUGHTER
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
hand this / 0 day of OCTOBER 2007
...J;)~ /lJ., j( - ~
(Signature)
DEBORAH PETERS
50 TIFFANY DRIVE, SHIPPENSBURG
(Address)
. Witness MY
PA 17257
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this
10
day of
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTARIAL SEAL
JEANNE M. ARNOLD. NOTARY PUBLIC
Southampton Twp., Franklin County
My Commission ExpIres. April 12, ~006
tside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIATION
Estate of DOROTHY A. JUMPER
c:2J - 6l- q1~
No.
also known as
1 Deceased
The undersigned, RICHARD COMERER, SON
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
hand this /D/,,)~J%O~
~~A }/
, (Signature) _____
Witness MY
RICHARD COMERER
9 NEIL RD. SHIPPENSBURG
(Address)
PA 17257
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this J D
day of
NOTARIAL SEAL
JEANNE M. ARNOLD. NOTARY PUBLIC
Southampton Twp.. Franklin County
My Commission Expires April 12. 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIA liON
Estate of DOROTHY A. JUMPER
62/- (J7- 97~
No. __
also known as
, Deceased
The undersigned,RANDY COMERER, SON
of
(Relationship)
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
hand this I D day of OCTOBER , 2007 .
~F:~
RANDY OMERER
1477 WOODS RD. SHIPPENSBURG
(Address)
Witness MY
PA 17257
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this /0
()ch5bt-/
day of
Not ry Public
ommission Expires:
i NOTARIAL SEAL
JEANNE ;1,1 ARNOLD. NOTARY PUBLIC
Southampton Twp.. Franklin County
My Commission ~xplres April 12, 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
RENUNCIATION
Estate of DOROTHY A. JUMPER
No. d.J - 67-9/ d
also known as
, Deceased
The undersigned, PENNY COMERER, DAUGHTER
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
Witness MY
2007
PENNY COME R
144 AMY DRIVE, CARLISLE
(Address)
PA 17013
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this
/D
day of
NOTARIAL SEAL
JEANNE M. ARNOLD. NOTARY PUBLIC
Southampton Two.. Franklin County
My Commission .',;xpires April 12, 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
Estate of DOROTHY A. JUMPER
RENUNCIA liON
No. d I - 0 (- q 7 J
also known as
I Deceased
The undersigned, JUDY DERR, DAUGHTER
(Relationship)
of
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to SALLY J. WINDER
hand this / 0 day of OCTOBER I 2007
Ju{/::;I Ii. ~ )IS;9natureJ
38 RUSTIC DRIVE, SHIPPENSBURG
(Address)
Witness MY
PA 17257
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this ;' D
NOTARIAL SEAL
JEANNE M ARNOLD. NOTARY PUBLIC
SouthRmoton TW[l.. Franklin County
My Commission Expires April 12. 2008
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3