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Home My WebLink About02-20-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of LARRY L. LAUGHMAN also known as File Number 21 08 /~I , Deceased Social Security Number /? ' . Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW:) D 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 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 instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: 00 B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.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, 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 Relationshin Residence I 66 East Main Street Kathv Laul!hman Snouse Walnut Bottom PA 17266 66 East Main Street , Shalvn Laul!hman Daul1hter Walnut Bottom , , PA 17266 ,':c,,: .. -.-.- (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. r,,-"', c..:.:- Decedent was domiciled at death in Cumberland 66 East Main Street Walnut Bottom (List street address, town/city, township, county, state, zip code) County, Pennsylvania, with his / her last principal residence at P A 17266 South Newton Township . ,--I ( ... '. ~.. Decedent, then 36 Walnut Bottom years of age, died on 2/12/2008 at Walnut Bottom Road South Newton Township PA 17266 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 P A) Personal property in County Value of real estate in Pennsylvania Walnut Bottom, South Newton Township $ $ $ $ 10.000.00 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: Typed or printed name and residence Kathy Laughman 66 East Main Street Walnut Bottom 717-530-5015 PA 17266 Form RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND 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. Sworn to or affirmed and subscribed ZO+k..... day of (;.l~pi;,~-=' Signature of Personal Representative Foe th~ Reg~te< ~ Signature of Personal Representative l::~_:. r-,.) \._1 File Number: 21 OK I cg-, Estate of LARRY L. LAUGHMAN , Decea~ecr '~~.~, Social Security Number: Date of Death: 2/12/2008 AND NOW, ~d)jlH~ &Q ,dm~, m oon,ide<ation of the foeegoing Petition, ,.ti,faotm1' pmof having been presented before me, I S DECREED that Letters of AdmInIstratIOn are hereby granted to Kathy Laughman 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. ~ ~lJ)clQ ~ Jtlla60h~ 'jlor ~ ,Itd- D~ Register of Wills (^?~J,-i {" /2- FEES Letters ............................. Short Certificate(s) ............ Renunciation(s) ................ ~~ p... u-xc ('(',.c.:i I 0'(\ 1...\5 -DO \to .DD Attorney Signature: TOTAL ............................. $ $ $ $ $ $ $ $ $ $ $ $ $ 1lJ, <X.) io.oo S.Cu Attorney Name: Christopher E. Rice. Esquire Supreme Court LD. No.: 90916 Address: 10 East High Street Carlisle PA 17013 Telephone: 717-243-3341 Form RW-02 rev. lO.13.06 Page 2 of2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. p 14125613 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. ~ee for this certificate, So.OO 2008 Certification Number M_...., '......; c~ H105.144 REV 111200fl TYPE I PRINT IN PERMANENT BLACK INK 1/31-216 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See Instructions and examples on reverse) :"_'-~ 36 VB. Sep. 27, 1971 Carlisle, PA 4. Date 01 Death (Month, day, year) February 12, 2008 1. Name of Dec:edEln (Fnt. middle, last, sufllx) Larry S.AIJO(Lut"_) L Laughman 6. Date of Birth (Month, 7. BlI1hplace(Ci \ . 8b. County of Death Cumberland ad. Facility Name (tf not institution, give street and nllllber) 1600 Block Walnut Bottom Road 17b. County Penn!=;ylvRniR Cumberland 14. Marital Status: Married, Never Married, 15. Surviving Spouse (If wife, ~ maiden name) W_Divon:edISpeclfj\ married Old Oocedont Uvena Township? 17C.Uves,DecedenlUvadln ~nl1t-h 17d.D No, Oeoedent Uv9d within AclualUmIIsof N,:::awt-nn Twp. 11. Decedent's Usual rnosI 01 life. Do not date re KlrldofWork Kn:lotBusiness/lndustry die mechanic electronics . 16. Decedent's Mailing Mlress (Street. city (town, state, zip code) 66 E. Main St. Walnut Bottom, PA 17266 12. Was 0eceden18Wl1' in the U.S. Armed Fol'C8ll? Dv" [jNo Oecedenfs AcIualResidence 17a.Stale City/Born 18. Falher', Name (Firsl. middle, last, su"bc) Charles Laughman 208. Informant's Name (Type I Print) Kathy Laughman 19, Mother's Name (Arst. middle, maiden surname) hirl Orner 2Ob. Informant's MaIlIng Address (Street, city I town, slate, zip code) 22c. Name and Address of Facilly offman-Roth Funeral Hom PA PA 17013 'sle Items 24-28 must be oompIlMed by pef'SOl1 24. TIme of Death P rx . 25. Date Pronouoced Dead (Month, day, year) ..."""""",,- 10:15 P. M. February 12, 2008 CAUSE OF DEATH (See Instructions and examples) Item 27. Part I: Enlerlhe cbIIn....IIl...- cheeses, injuries. orCOfJllllcations-thal rhctIy caused the death. 00 ooT enter lemll\al events such as canlac arrest, respiratory lUT'8St, orventriaJarfibrflation without showlng the etiology. Ustonly one cause on each line. 26. Was Case AelemKI to Medcal Examiner I Coroner lor a Aea&OIl Other than Cremation or Donallon? ~v" DNo DLWasanAutopSy p- d. 3Ob._"'__ AvailablePriol'IoCompletlon alCalJllllofOealh? ~v" 0 No 31. Manner of Death 0-'" 0- ~_ DPeo<Iog....1Igo1ion o Suicide 0 GaUd Not be Determined Approllmate Interval: Part II: Erw oIher simlftcant corllItions cmtributinCl 10 dBalh 28. Did Tobacco Use ContritxJte to Death? Onsello Death but oat resulting In the underlying cause given in Part L 0 Yes 0 Probably DNo DU"""",," 29.11 Female: o Notpregnanlwllhlnpastyear o PregnanlllttineofdElalh o Notp<ognont....p<ognont_<2days ot....~ o Nolp<ognont....pl8!>l8nt43daysl1>'_ -.....~ DlJnl<oown'pl8!>l8_....,1Ile"",,,,, 32c. Place of Injury: Home, Farm, Street, Faotory. "'""-,otc~lal Road ~=~=)~ ~~'~::;a. = UNDERLYING CAUSe =-,,:,~~~1Ile Hp.~n TrAumA Due to (or as a 'consequence 00: b. Snowmobile Crash Due to (or as a consequence of): Due 10 (or as a consequence ofl: ffi iil ~ ~ ! 'li(v" 0 No Newville, PA Coroner atu~~~~,-~ Id-. II I d I \ 101 33d.Data_IMonth,,,",."'" February 14, 2008 34. Name and Address of Person 'Nho Completed Cause of Death (Item 27) TVPB/PrilI Michael L. Norris, Coroner 6375 Basehore Roadr Suite #1 Mechanicsbur PA 7050 Disposition Permit No.