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HomeMy WebLinkAbout04-04-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Estate of Edwin Gregory Biddle also known as COUNTY, PENNSYLVANIA File Number ~~' ~ UL~D ' v3 ~~ Deceased Social Security Number Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) ^ 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 (SYate relevant circumstances, e.g., renunciation, death of executor, etcf Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution for probate, was not the victim of a killing and was never adjudicated an incapacitated person: Q B. Grant of Letters of Administration (If applicable, enter: c.t.a.; db.n.c.t.a. ~ pendente Iite• durance absentia• dvr~e named in the ~. C_ •';. -°--~ off =_~, t_.. 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.) Mazgret Biddle Saunders Daughter PSC 78 Box 6726, APO AP 96326 Mark Gregory Biddle Son 18 Altoona Ave (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 18 Altoona Avenue, Enola, PA, East Pennsboro Township Cumberland Countv PA 17025 (List street address, town/city, township, county, state, zip code) Decedent, then 65 years of age, died on 25 Mazch 2008 at Milton Hershey Medical Center, Hershey PA Decedent at death owned property with estimated values as follows: '~~ (If domiciled in PA) All personal property S )~J (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: ' i~, l~ l.. T ~ r, t~3:~ ~/ Form RW-01 rev. 10.13.06 Page 1 of 2 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: OCAL REGISTRAR'S CERTIFICATION OF DEATH ~ ~ ~~ 1 WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 1412166 Certification Number 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. LGn~ ~ ~ ~ AR ?~ 6 20(~ Local Registrar Date Issued PRINT IN REV n/zoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS .K INK tANENT CERTIFICATE OF DEATH (See instructions and examples on reverse) ~ m r. r _~ !~ ~ ~ , , ; , "~yy~w ~/~ ~ (~~ ~ ,.r - n ~ti ~ ~ ~ ~.. `i !r~ ~ ` ,. ~i z-- r_ . rTl .:J C'_~ ' ~ ea 1. Name of Decedent (First, mitldle, lass, suffix) STATE FILE NUMBER Edwin G , B 1 d d 1 e 2 Sex 3 Social Security Number 4. Date of Death (Month, tlay, year) Male 412- 66 _0877 March 25, 2008 5. Age (Last BinlMay) Under 1 year Under 1 day 6. Date of Birth (Month, day, year) 7. Binhplare (City antl slate or foreign country) fie. Place of Death (Check Doty one) - 6 5 ~mra Dan rwiaa Naulea 5/27/42 Tennessee "°~P"~I aher Yrs. f~ Bb. Coun of Death LaMnpetienl ^ ER /Outpatient ^ DOA ^ Nursing Home ^ gesi0ence ^Other - Specify: N 8c. Ciry, Boro, Twp. of Death Bd. Fegldy Neme (tt not asmubm, gNe sbeet and number) 9. Was Decedent of Hispanic Origin? ~ No ^Yes 10. pace: American Indian, Black, White, etc. Daup in Derry TVJp. . S. Hershey Medical Center (If yes, spedty Cuban, (SpectiM Mexican, Pueno Rican, etc.) White 11, Decetlem's Usual Omu tan Kintl of work tlone moll of world life. Do mt state retked 12. Wes Decedent ever in the 13. Decedem's Eduratan (Speciry only highest grade completed) 14. Marital Status: Mamed, Never Married, i6. Surviving Spouse (II wife, give maiden name) Kind of Work KirM of Business /Industry U.S. Armed Forces? Elementary! Secondary (0-12) College (1-0 or 5+) Widowed, Divorced (Speci/y Telecommunicati n Arm [~'es ^No U NK 16. Decedent's Meili Atldress (SIreeL Ciry /town, state, zp coda) - W 1 d O W e d Decedent's Did Decedent 18 A toona Ave. Aq°alRasidanca T7a.Slale Pennsvlvania Townishp „c.[]~Yes,DecedemLivedin East Pennsboro Tw Enola, PA 17025 17b, County Cumberland ? rid.^No, Decedent wed wima p 18. Father's Name (First, middle, IasL suffix) Aqua) Limits of Ciry / ~ o Sterling J . Biddle 19. Mother's Name (First, mitltlle, maiden surname) 20a. Informant's Name (Type /Print) Mark E, Biddle 21 a. Melnod of Dispositon [~Grernatbn ^ Donadon 216. Dale of D' Ispwilion (Month, day, ye ^ Burial ^ Removal Irpn State ;Was Cremation or Donator AtdhorUed / / ^ fiber' ~h~ % by Metllcal Examiner I CoroneR ~J vas ^ No 3 2 7 0 8 22a. Sgnature of F er I Serve L~ensee~ girg 22b. License Number 22c. Name and ~ ~ ~ --~ ~ FD01 4993 Complete Items c Doty when cenitying 23a. To the best 01 my kmwletlge, tleath occurred at Me time, date and place stated. (Signature and title) physaun is n available at lime of tleath to certay cause of death. Margaret L, Gregory 20b. Informant's Mailing Adtlress (Saeel, city /town, state, zip cotle) 18 Altoona Ave. Enola, PA 17025 21c. Place of Disposition (Name of cemetery, crematory or omer pWcaJ 21 d. Location (Ciry I town, state, zip code) Evans Cremation Service Leola, PA SpfFagliry u Ivan unera ome 51 N, Enola Dr, Enola, PA 17025 23b. License Number 23c. Date Signed IMonth, day, year) Items 2/-26 must be mnpleted by parson 24_ T~ of Death r~ r..1 26. Date Prmaxx;ed DeaO (Month, day, year) who Pronounces death. r' ,-~, 'i 2 ~ 1 I M. M a (L. ~- }1 2 J , Z. (.x V ~, CAUSE OF DEATH (See InatrucNOna and ezampka) Item 27. Pan I: Enter the plain of event -diseases, injudes, or canpkcatans -mat directly caused the death. DO NDT enter temknal events such as caNiac anent, i Approumata interval: respiratory arrest, or ventraular li6naaaon without showing Ne elakgy. List mly one cause on each Ilre. r Onset to Death IMMEDIATE CAUSE (Final tlisease or t mrrtlitim resuaing in death) t -~ a. _RQSp,tARY~ FCIWr6 AbJrC' SQ Zr„Zf wr.~ ,I~ Srn211 LE11 Lv,1~ ctl rcC~' Due to (or as a consequence op. t Sequentially kst mMitims, it any 6, it ; S ` ~~ /r ia' F G 71 v; ~ r lead"aq to the cause lMedmlae a. i ~ ACV i1 ~lLhd6r'1 ~ RTl@U'v14)11Q ~ Enter Nle UNDERLYING CAUSE Due to (o as a cpnsequence op. r (daease or injury met initiated the . ~ r YC «0.11 1 r events resulting m death) LAST. c~ N ~ ~ R SC[l t1 c(C.~Y~i }D (.nZiY1C f h Q Yu' p ~ D e to (o as sequence oU. 7 t d. 30a. a oa~~lopsy 30b. Were Autopsy Fad'xg5 31. Manna~.of Death 32a. Dale of Injury (Month, tla , ' Availede Prior to Completion ,"/ Y Year) 32b, Desaibe Few Injury Occuned of Cause Death? Natural ^ Homicide es ^ No ~ ^ Acgtlent ^ Pend I 32d T fI 126. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? ^Yes ^No II: Eller gher;_g ifr?nt mMkans mold .cy ; to desm, but not msuAirtg in the uMerying Dune given in Pen I. Ves ^ No rig nveslgatxxt ime o nlury 32e. Injury at Wod? 32f. II Tran SuEtide slwrtalion Inlury (sa~nhl 32g. Lateran of Injury ^ ^ Coultl Not be Determined ~~ ^Yes ^ No ^ Driver / Oparetor ^ Passenger ^Pedestnan 28. Da Tobamo Use Cmtnhula to Death? ^ Ves ~ Probably ^ N ^ Unknown 29. tt Femala: ^ Not pregnant within past year ^ Pregnant at time q death ^ Not pregnant. but pregnant wnhin 42 days of deem ^ Not pregnant. but pregnant 43 tlays fo 7 year before tlealh ^ Unknown if pregnant wilMn Iha past year 32c. Place of Injury: hlorne, Farm, Street, Factory. Oaae Buiaing, eta (SpecryJ town, sate) 33a. Cenifier (check only one) Ulnner - s'peciry7 330, Signature antl Ttle of Certifier • Certdying physlcten (Physician certitying cause of dean when amther physidan has Dmnounced death and mmpleletl Item 23) + ~~ ~ / - O L To the beet of my knowledge, death occurred due to the cause(s) and manner as staterL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ Ou r'lF. ~'1 b C ` Pronoundng and cerlltying phyakian (Physician 6dh pronoungng death and cenitying to cause of death) To tl1e best of my knowledge, death xcurred at the time, date, all place, arM due to the cause(s) and manner as sletetl_ _ _ _ _ _ _ _ ^ 33c. License Number 33d. Date Sgned (Mmth, day, year) Medkal Examiner/Coroner _-_---_--~ (,~~1 vl) Zdj 5 On the basis of examinelion and / or Investigation, In my aplnlon, death occurred at the time, date, and place, end due to the cauae(s) and manner as stated_ ^ 3I ~ 7 ~) z U ()"}~ 35. Registrar' gnature and D 34. Name and Atltlress of Person Who Completetl Cause of Death (Item 27) Type / n ~ u~ I =~ I ~ I ~I ~ I ~ I ~~~Z~'d~~~' S i, rJ ; A H t,l> D ~ ~•S. Hershey Medical Ctr. Hershey, PA 17033 Disposition Permit No. N O O Oath of Personal Representative t ~ s ~ ~~> COMMONWEALTH OF PENNSYLVANIA ~ ~~ IV h ~ ' COUNTY OF Cumberland ~ ~ f: ,_ ~? The Petitioner(s) above-Hamad sweaz(s) or affirm(s) that [he statements in the foregoing Petition are the Imowledge and belief of Petiti tru~and correct~he .' r') best of oner(s) and that, as personal representative(s) of [he Decedent, Petitioner(s) will well administer the estate according to law. and trul y Swom [o or affirmed and subscribed before me the `~~ dd`ay of ~W8 ~~ ~ For the Register !~ Signprure ofPKq~nd Representative Sigttature afPersond Represemmive File Number: c>2~-at~c~S-(1~7~ Estate of Edwin (3regory Biddle Deceased Social Security Number: 412-66-0877 Date of Dea[h:25 Mazch 2008 AND NOW, having been presented before me, IT IS DECREED [hat Letters m consideration of the foregoing Petition, satisfactory proof are hereby granted to and that the instrument(s) dated in the above estate described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............ ... $ Short Certificate(s) ... ..... $ Renunciation(s) ..... ..... $ Attorney Signature: .. $ Attorney Name: ' ' $ Supreme Court I.D. No.: .. $ Address: .. $ .$ -_ $ Telephone: TOTAL ........... ... $ 0.00 Form RW-02 rev. !0.13.06 Register of Willa Page 2 of 2