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HomeMy WebLinkAbout03-04-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of LUKE S. BASSLER File Number J. \ U(; O'dL\: u also known as , Deceased Social Security Number 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 / 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: o 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 a/Will in Section A above and complete list a/heirs.) c= Name Relationship Residence I HARR Y 1. BASSLER, III FATHER 36 WOBURN ABBEY AVE., CAMP HILL, PA 17011 MARIAN J. BASSLER MOTHER 36 WOBURN ABBEY AVE., CAMP HILL, PA 17011 STEPHEN E. BASSLER BROTHER 36 WOBURN ABBEY AVE., CAMP HILL, PA 17011 (COMP1.ETE IN A1.L CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principal residence at 36 WOBURN ABBEY AVENUE, CAMP HILL. EAST PENNSBORO TOWNSHIP, CUMBERLAND COUNTY, PA 17011 (List street address, town!city. township. county, state, zip code) Decedent, then 21 PENNS YL VANIA years of age, died on FEBRUARY 8, 2008 at EAST ARMAGH TOWNSHIP, MIFFLIN COUNTY, Decedent at death owned property with estimated values as follows: (If domiciled in PA) 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 150,000.00 $ $ $ $ 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: ~ !17!rDeLfJ/h T ed or rinted name and residence HARRY 1. BASSLER, III, 36 WOBURN ABBEY AVENUE, CAMP HILL, PA 17011 MARIAN J. BASSLER, 36 WOBURN ABBEY AVENUE, CAMP HILL, PA 17011 Form RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYL VANIA 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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. before me the L.-/ Sworn to or affirmed and subscribed ~(J:Ch, / '; J, Signature of Personal Representative File Number: d \ 6 8 Od'-t"-.J Estate of LUKE S. BASSLER , Deceased Social Security Number: Date of Death: FEBRUARY 8, 2008 AND NOW, fYlo r ell ~ , ;JOLJ({ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters OF ADMINISTRATION are hereby granted to HARRY J. BASSLER. III AND MARIAN J. BASSLER in the above estate and that the instrument(s) dated N/A described in the Petition be admitted to probate and filed of rec~r1 as the ~Iast :~( and Codicil~ ) of De~edent. FEES ~ Yh_ :;]1V(f/L . Register of Wills 10.00 5.00 Attorney Name: Letters ............... $ Short Certificate(s) . .(4). . . $ Renunciation(s) .......... $ JCP . . . $ AUTOMATION FEE . . . $ .. . $ .. . $ .. . $ .. . $ .. . $ . .. $ .. . $ TOTAL .... . . . . . . . . . . $ 260.00 16.00 Attorney Signature: Supreme Court I.D. No.: 78627 Address: 940 CENTURY DRIVE. SUITE B MECHANICSBURG, PA 17055 Telephone: 717-766-7702 291.00 Form RW-02 rev. 10.13.06 Page 2 of2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fcc ,'or Ihi, eerlil ,:al<:'. "('.00 ",iiti~.(f~QF'pj;}~ ..' ..l. \.'. . ~D(;I, '" <,~\ ~~ / -<, J> -~2~\ i,,'<::;/ ...o.a. '\~<' ~'~~. .""..&:.~\ !~~. ......77,' I~<::)i. ~.~~1 \~ t-l....~::~ . . -' :.b~1 \~ *(~' >:,>~,"'. ~/' *~1 \~~"" ~", ~ '"*' '. ...... ~ ,y '<-,"<,,'f/Mnil i\ V:~':'~;~ ~!!!.!!!!!!-:!!-~ , "J 1 /1') q3 L! -(i 4' :.;. L ".j \. t Certificdtl\'!i ;\Iumher Thi, is tu ~'enir) tlidl lhe inionn:lli('n her<: gi\cn I ~'oITectjy c(lf1ied Ir'lfn an original Certificate of Deat duJ, filed wilh ile a" LOl'aJ RCi.!:\irar. The oni!in. ,:ertificillt' \\tll he jUr\\arded 'I.) thl' Slate ViI. Rel"Ords Office h r permancllt filing. ~~t f1aiJ~~~-2iJ ~-.LQL Local ~P:t::;::-~ Date Issued HlllS.144 REV 1'_ lYPf I PRINT IN PERMANENT ' IllACKINK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE ALE NUMBER o ~ O;lL\V 1. Nameol_(ArsI,_,Iast,_) 5. Age (last Binhday) 21"... 811. County 01 o.a.. Luke S. Bassler 6. DaI8 01_ (Month, day, art 7.Birl!1place(C andslal80r October 12,1986 Harrisburg, PA Miff/In East Arrnagh ad, FaciityName (0001_, givo_and~ U.S. Highway 322 E. Arrnagh Twp. 11. Decedent'sUsualOc KindIi'Wort College Student mosl d life. Do not state retired Kind 01_1 IndusUy Higher Education 12. Wu Decedent 8V8f in the U.S. Anned f0lt0S1 o v.. III No 0ec8d0nl'. ActuaIResidflnce 17a.State PA , Cumberland . 16.Decedent'IMailingj~(Slreet,city/toM'\.aaate,zipcod&) 36 Wobum Abbey Ave Camp Hill, PA 17011 16 F....... Name (1'''', _, Iast,_) 17b. County 16._.Name(FIrs1,_,_"""""1 Harry Bassler 66- 1534 00lh0t. SpadIy: 10. Raco:_-,-,-,8Ic. (Spoor)! White Oid_ lNe~. 17c.00 V..,_lMod~ T_1 17d.o No, _lMod_ Adu8I '- 01 East Pennsboro Twp. ClyIBoro Marian Kupchlnsky 2Ob.lntonnart.MaiIing_(-'cilyl_,_,Z\l_1 36 Wobum Abbey Ave Camp Hili, PA 17011 !Jl ::> ~ I ApproximaIeIn!8lv8l: I OnseUo 0eaIh I I , : MinJt~ , I , , , , , I I I 200.1_. Name (Type 1 Print) 21c,PI8aoolOioposilion(Nameol_,_or_"...) Evans Cremation Service 21d. Ulc8don (CIy 1_ _ Z\l-l Leola, PA 17540 220. Namo and _ 01 FaciiIy Gilbert L. Dalley Funeral Home 650 South 28th St. Harrisburg, PA 17103 231>. Lico!nM _ 230. _ SIgnad (Month, day, yell) 338. Criior (dlICk orOf ono) . =::''::'"'':::-==:''~",~~':~~~_~_~~~u___mu__m__ 0 ~ ~andCOl1lfytng~(PI1yolcIanboOhprollOUlldng_""tol1iIyInQIo"""'oI_) 330. .....N...... 33d.Il8I8S1gnad(_day,j08/) T."'_oImy~__"""_,d8Io,andploco.anddue"""COllI8(.)and__..oloI8cL________.________ 0 ' Fp-......... 00 ~ . __/cew- ~UULT , On ""..... of -- and/", ~ In my opkIIan, - --.. '" -, daI8, "'" ploco, and due" '" COllI8(.)and --.. oloI8cL it 34. Name anl_... 01_ WIIo CompIoIod Causa 01 Ilea.. (118I1127) Type 1 Prilt 24. rN118 01 o.a.. M. GAUSE OF DEATH (See InatrucUons and exam lea) _'0. Parlt em.ll18l:1l1iu1tmll11-_ ...,..,or__-lhlIldllucdyc:ausod..._. 00 NOT ..."_8V8f'ISsuch....-....... .......tory....., or__........JIIclwinQ...oIioIogy. Ustorqono""",,,,_ ino. =~=~ .. MJltiple ~ Pra:taes Doe to (or aa a COO58QU8fICe ot): =101_, 'any, to cause kted on line 8. em. UIIOfIll.YING CAUSE t="~nu:..~~'" b. Due to (or as a consequence 01): c. Due to lor as a consequeoce 01): d. n. W...AuIopsy Fincings A_Priorlo~ of Causa 01 Deafh? KI V.. 0 No 31. MaIno< 01 DeaOl 0....... 0- rx- oP8lldinQlnv8Sligallon 0- oCouldNolb8~ 30L Was an_ P- ~V.. 0 No I ~ ~ 26. Was Caae _ 10 _ E_I CoIorw "". RaIson Olhot Ih8n c--... Donadon? xxv.. 0 No Part II: Enter 0Iher sKnficanI mnlIIInn& 00I'lIriUin0 10 d88Ib 28. Did Td:lecco lJae ConIrIIue b Death? butnol""*i1g~"'iIIIdol1yingC8US8givon~P8I1I. 0 V.. oP.-oy ON<> o~ 29.0_: o NoI__pastyaar o ~""'0I_ o NoI_,but___<2days ol_ D NoI_buI_43doyslolyoar -- o~I__"'""yoar 320:. PI8ao 0I1rPY: _, Fann, s..at. F"""Y, 0lIica IluIdk1g. "'. (SpedIy) 3211. Ulc8don 01 k1juIy (-. cily 1-. ) lE Hoy. 322 E. ~ 'll:wHtip ,Mifflih._ . ,~ 1;(,~.;2j ,J.,,'1, ""","'ion P."", No 00 (.,(-1 L( I 35. RogsIrar'. ~