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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF \VfLLS OF GvYl bet' Icvn J
COUNTY, PENNSYL V At\T\
Estate ut_ J.l4~~'+-~___ R, '])lA.Yl V\
File Number
a \ O\) 6tlv
also known aJ .
, Deceased
Social Security Number
Petltioner(sL '.\hu is/~lrc 18 years of age or older, apply(ies) for:
(COJ/PLCl'! '.,1' or 'W BELOW:)
~,\. Pro!Jak and Gralll of Lcltc s Tes amenlary and aver that Petitioner(s) is I are the
last \\111 <)[ (i"" i ),:ced"nt Jated 0 I'" Ll8' and codicil(s) dated
~ Xi.. CM.fo.-
named in the
(State releval/t circumstal/ces, e.g, rel/ullciatiall. death oj executor. etc)
Except as folloxs, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for prObJle, was not the victim of a killing and was never adjudicated an incapacitated person:
D B. Grant of Letters of Administration
(If applicable, ell tel': ct,a.; db.n.ct.a.: pendente lite; durGlue abselltia; durante millarilate)
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.o.llcJa., eWer date of Will in Section A above and complete list of heirs.)
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Allach additiollal sheets if Ilecessary.
Deceqept was dpmieiled at death in ~..."" bu/t01..J
vUe T;f,.- ~42.., l . .
(List streel "ddress, towl/lcity. township, COt Ilty. Slate, zip code)
Decedent, then
1;;...
years of age, died on ~ If Si.2o 05' at f/-o Iv
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5,) lr', -f /~5,;,lpj
I I
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(lfnot domiciled in PAl Personal property in Pennsylvania
(I f not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
u:; L-t i
$ SOt),OV
$
$
$
~.+ ~"tA1.:L 0; J Y"O
situated as follows:
. COO j 13 10D c C4.+ Cree!
; Ylten"sf
Wherefore, Pelltioner(s} respectfully request(s) the probate oftbe last Will and Codicil(s) presented witb this Petition and the grant of Letters in the appropriate form Ie
the undersigned:
CaM1
'-'dry dol' printed',narne"&",,,e;;sidence
II ,(; ,-, ,_. '-.J!. I: ..../
WI . ])~~>,-,)~)'.~~d~d~ er ~e ~) 1-1111 ?A. 170/1
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Form RW.1J2 1'('" IIJ /306
Page 1 of2
Oath of Personal Representative
COMMONW EA!. r:! ui !)E;\J1\iS YL VANIA
COUNT'z'OF _~~
SS
Tiw [)~!i:.")I;CII i :lb.)'." .[:.:::;c:d ".\(,i'I(';) l'l' 11"::1111(5) that the statements in the foregoing Petition are true and cOITect to the best of
l.i);: k i:\J\'
Jllll hc:lidof Pctltiun<::r(,; and tbt, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
adn~inister the estate according to law.
,1 ~
~ ~(J:t111J/lO?1 11--]J~
19nature of Persol/al Rep;-esentllllve
Sworn to or affirmed and subscribed
before me the -fi- day of
~~~~cm5
~_~l-,~~ \ .1..->--
. r the Register
Sigl1u:ure of F\.T,,>'ond Representative
Sig!ldture Q/ Perso/la! Representative
File Number:
d. \
68 D\/ ~Q
Estate of ~)~\\Q. ~ .'Dv-..'\\ Yl
~S () \ "I '\tt)
AND NOW, ~e b~(0l ~O , dto'3
having been presented before me, IT IS ~ECREED that Letters
are hereby granted to ~ ~ "" ~~ '"
Social Security Number:
Date of Death:
, Deceased
I ~\D<S;
, in consideration of the foregoing Petition, satisfactory proof
\e~~e.01~\''j
in the above estate
and that the instrument(s) dated
descnbed III tIle PetItlOn be admltted to probate and filed ofrecord as the last ~d COdlCtI(S)~"Of Dec,e~ent. .. "
Lett" , ... . .~.~ $ ~ ~J00L ~~,~QlLI~~r
Short Certificate(s) " .~" , :;; cg
Renunciation(s) . , . . . . . . :;;
0, \~ $
~? $
~-\u $
$
$
:;;
$
:;;
$
TOTAL ............. $ ~~
O<.--b ~_ \'
llo I l~~3
Attomey Signature:
\S
\0
s;-
Attomey Name:
Supreme Court LD. No.:
Address:
<'I...j
it, r ):"' -
~. :'dC
Telephone:
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1.::; 1
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FOIIII R W-OJ '"1' /0./3 0(;
Page2of2
H jO).YU5i'vlS REV,(5-0SI
This is 10 certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records 1ll 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.
~
No.
~)/~
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
Charles Hardester
State Registrar
0659947
AUO 272005
Date
o
:~Q
-ri
Yrs
.:J.. \ 0')5 O\llo
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
H105.143 Rev. 2/87
1""O'ElPRINT
IN
PERMANENT
BLACK INK
NAME OF DECEDENT (First, Middle, last)
1.
AGE (Last Birthday)
Juanita Ruth Dunn
SEX
2. Female
BIRTHPLAC~ (City and F H
State or Foretgn Country) HOSPl At
7Lewistown,' PA ;:......00
FACJUTY NAME (If not instrtution, give street ano number)
SOCIAL SECURITY NUMBER
3. 325 01
S.
COUNTY OF DEATH
92
EFlIOulpdMt 0
DOAO
cJI
lb. Cumberland
DECEDENT'S USUAL OCCUPATION
(~r~~;~~~dr:e~~r'~d'}t
110. Administrative 11b. Health Care
DECEDENT'S MAILING ADDRESS (Street, CitylTown, State, Zip Code) DECEDENT'S
4305 Motter Lane ~~~~~~
Camp Hill, PA 17011 ~~~~)s
8c.
East Pennsboro
White
KIND OF BUSINESS I INDUSTRY
MARITAL STATUS - Married. SURVIVING SPOUSE
Never Married, WdOWed, (If wife , give maiden name)
o;",rced (S"",,fy)
14. Married 1S.Cameron M. Dunn
17c. m Yes, decedent lived in Hampden twp
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w
u
w
o
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z
17b. County
Cumberland
o;d
decedent
live ina
township?
17d. 0 ~~h~~:7~i~~ of
citylboro
Charles W. Buntin
Cameron M.
51
if>
co
if)
<(
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<(
&.
23b. 23c.
WAS CASE REFERRED TO A MEDICAL EXAMINER ICORONER?
28. Yes IX! JL No D
: Approximate PART II: Other significant conditions contributing 10 death. bul
. interval no! resulting in the underlying cause given in PART I
: onset and ceaU",
DATE PRONOUNCED DEAD (Month, Day, Year)
25. July 15, 2005
27. PART I: Ent.r the d...MS, Injuries Of complle.ltions wtlkJl caused the d..... Do not enter the mode of dYIn9, such.s c.erdillc or T'ftplnltory.nest, shock or he.,. h1ilure.
u.t only Ofl. c.eu.. on Meh line.
r-.
DUE TO (OR,6,5 A CONSEQUENCE OF)
Sequentially list conditions
if any, leading to immediate
. cause Enter UNOERL YtNG
CAUSE (Disease Of injury
. that inWatea events
resulting on death) LAST
WAS AN AUTOPSY ~RE AUTOpsy FINDINGS
PERFORMED? AVAILABlE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
E
DUE TO ( AS A CONS QVEN E OF):
MANNER OF OEA TH
Suicide
Oil
o
o
DATE OF INJURY
(Month, Day, Year)
TIME OF INJURy
INJURY AT 'NORK? DESCRIBE HOW INJURY OCCURRED
Natural
Accident
Homicide
o
o M
o :~CE OF INJURY - At home, ::~, street, factory. ofIi~
building, etc. (Speclfy)
300.
"MEDICAL EXAMINER/CORONER
On the b.sls of ex.mlnatlon 'nd/or InveBtlgltlon,ln my opinion, de.th occurred.t the time, dlte, and place, and due to the causel(') .nd
m.""er.sttllted.. .............. ....".. '
311.
REGISTR)R1 SIGNATU~ ~
33. ~/<%
"
~~VPI/"( I
YesO NoD
30<.
Yes 0 No IKJ
Yes 0
NO[j
Pending Investigation
Could not be determined
28a. 28b.
CERTIFIER (Check only one)
.~;~~F~GJ~nl~~~~~:rhC:C~~~~uS: t~f 8:'ea~~~~:r~:~~x~~a~ ~~~~.?,~~~~~.~~~~~,i,t~~.~~).,.
29.
.PRONOUNClNG AND CERnFYING PHYSICIAN (Physician both pronouncing death and cert;fying 10 cause of death)
To the beat of my knowledge, de.th occurred at the time, date, .nd place, and due to the CIUHS(I) Ind mlnner IS stated.
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LAST WILL
I, JUANITA R. DUNN, of South Middleton Township,
Cumberland County, Pennsylvania, declare this to be my Last
Will and revoke any wills previously made by me.
I. I direct that any and all inheritance, estate and
transfer taxes imposed upon my estate passing under my will
or otherwise, shall be paid out of the principal of my
residuary estate.
(.~) ~ ,
II. I devise and bequeath the residue of my estaIt,e 0("
whatever nature or wherever situated to my husband, C~~ero~;
M. Dunn.
",1
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III.
,,I
I f my husband, Cameron M. Dunn, does not "survi V fib
U:
me,
I devise and bequeath my estate to my son, Craig C.
Dunn.
IV. In the event my son, Craig C. Dunn, does not
survive me, I bequeath my estate in equal shares to Cynthia
CG-.<--" C{,.v.,( &, .") 'f _<=C>
Adams Dunn, Hererr-ea~~&ll~, Nancy Jean Johnson, Helen
Dunbar and Carolyn Kennedy, or to the survivors.
In the
ev~len'-€atherine Kelly predec~me, hel:' share shall
goYonec"son,Patl7i ek ReI i~
~\
V.
I appoint my husband, Cameron M. Dunn, to be
executor of this my Last Will.
In the event he fails to
qualify or ceases to act, then I appoint my son, Craig C.
Dunn to be executor. If he fails to qualify then I appoint
.... /7
~/7
~
VI. I direct that my personal representative need not
file bond in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal this 16th day of October, 1998.
I
.' 1--.
--6. "{fa,/ c:.t:1 d:..
/ / ,
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The preceding instrument consisting of two (2) page(s)
was on the date thereof signed, published and declared by
JUANITA R. DUNN, the testator herein, as and for her Last
Will, in the presence of us, who at her request, in her
presence, and in the presence of each other, have subscribed
our names as witnesses
hereto.
~~r~~~
STATE OF PENNSYLVANIA
. .
. .
SS
COUNTY OF CUMBERLAND
We, JUANITA R. DUNN, Frances H. Del Duca and Carol A.
Treaster, the testator and witnesses, respectively, whose
names are signed to the attached or foregoing instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the testator signed and executed the
instrument as her Last Will and that she had signed
willingly, and that she executed it as her free and
voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the
testator, signed the will as witness and that to the best of
Her knowledge the testator was at that time eighteen years
of age or older, of sound mind and under no constraint or
undue influence.
'I ('
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~<c7:7.."f[; -:(, C);/.dC'.I"'~/
/ Testator
~. iL . " ~
/' L:-<$/-k"'- r /;;11<.;;20"'---
~itness '
CCQ~ 'A :-~v~~ A
Witness
SUBSCRIBED, sworn to and acknowledged before me by
the testator, and subscribed and sworn to before me by Carol
A. Treaster and Frances H. Del Duca this 16th day of
october, 1998.
~~ffitf{lA~iV~
Notary b l.C
NOTARIAL SEAL
SH~~I:~LEVENGER, NOTARY PUBLIC l
M rough, Cumberland COUllW 1
Y CommIssIon expires March 5, 2000