The URL can be used to link to this page

Home My WebLink About05-01-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of MARGARET HEDGES also known as File Number 1..\ \)~ bL\~U , 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 ~ ~ c= ~ ~g ::n W ; '-'-; ;::;5 (State relevant circumstances. e.g., renunciation, death of executor. etc.) F2 f;; -< ~'~ ,~E~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution~~~en:(s) offelf~ .~} for probate, was not the victim of a killing and was never adjudicated an incapacitated person: p~""'Fl ~ ;: ,~~:l --t .r:- ~_._. r~" jil .... to.,' I I (Ifapplicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)~ . - ,:~ o B. Grant of Letters of Administration 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.) C Name Relationshio Residence I ELIZABETH BULOTA SISTER 325 WESLEY DRIVE, MECHANICSBURG, P A 17055 (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principal residence at 325 WESLEY DRIVE. LOWER ALLEN TOWNSHIP (MECHANICSBURG MAIL). CUMBERLAND COUNTY. PA (List street address. town/city. township, county. state. zip code) Decedent, then 88 years of age, died on APRIL 10,2008 ALLEN TOWNSHIP. CUMBERLAND COUNTY at BETHANY VILLAGE, 325 WESLEY DRIVE, LOWER Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in P A) Personal property in Pennsylvania (If not domiciled in P A) Personal property in County Value ofreal estate in Pennsylvania 45,000.00 $ $ $ $ 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 Lettcrs in the appropriate form to the undersigned: T ed or rinted name and residence ELIZABETH BULOTA, 325 WESLEY DRIVE, APARTMENT #3209, <.:./ MECHANICSBURG, PA 17055 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. Swum to or affirmed and subscribed ~ _../~ ature of Pe onal Representative ~.- before me the Signature of Personal Representative r File Number: 1..-\ b~ t'-\'-6~ 80 ~.- :0 co\) $~~ ~05~ ~8~ , De~~d ~ ,....::. c:::::> c:::::> c:t) 3: :x:.. -< t ~-l. J Signature of Personal Representative ~~ Estate of MARGARET HEDGES .." :x r- Social Security Number: Date of Death: APRIL 10,2008 N en AND NOW, ~ 1.... \ having been presented before me, IT IS DECREED that Letters are hl~reby granted to ELIZABETH BULOTA , '2.Jt6 , in consideration of the foregoing Petition, satisfactory proof of ADMINISTRATION in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of re Letters ............... $ Short Certificate(s) . . .1.. ., $ Renunciat~io (s) .......... $ .)~-- .., $ . n-u ...$ .. . $ .. . $ .. . $ ...$ .. . $ .. . $ .. . $ TOTAL.. .. .. .. .. .. .. $~ 13 Cl0 ~ s)) of Decedem. ~ (>>d'..~ Register of Wills f ~7?~ FEES Attorney Signature: 10 ~ Attorney Name: THOMAS E. FLOWER Supreme Court I.D. No.: 83993 Address: SAlOIS, FLOWER & LlNDSA Y 2109 MARKET STREET CAMPHILL,PA 17011 Telephone: (717) 737 - 3405 --6':tl6'" Form RW-02 rev. 10./3.06 Page 2 of2 HIO:'iSO'1 RE\ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6,00 \\\I\I"(~(1\rOrpl;'--____, ~it~~~~. .",... . :t~~ !:Ii;'~' ":-, ' '\~~ ~ ~\:r:~:' ii;:~ ~ \ _'j-~]I . :' ~ \. * '''- . -,--: -. -"' I' * f - a.. . ....~,' \. rA~ '. /./~ \\' "', -9',()~ //u...\.~"" ---.-:"lMENT Ill{" ,I" """""/#/~/I1I"Jj' I' P 14329249 Certification Number This is to certify that the information here given is conectly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital ~s~c~permanent filing. , ~R1,2008/ Local Registrar (") ~O ~I ~ (") :!? hi r;~:o :z: (j):A 08~ (")c 9::0 - ..... :p. REV 11/2006 PRINT IN .1ANENT CK INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) 579 - 20 5. Age (Last Birthday) 1. Name of Decedent (First, middle, last, suffiX) Margaret Hedges 6. Dale of Birth (Moolh, day, year) January 22, 192 88 Bedford Co., VA Yrs. Cumberland Twp. ad. Fac~ity Name (If no! instijution, give street and number) Bethany Village 11, Decedent's Usual Occ lion Kind of work done durin mas! of wond life. Do not slate relired Kind of Work Kind of Business I Industry Teacher Education 12. Was Decedent ever in lhe U.S. Armed Forces? Dyes WNo Decedent's Actual Residence 17a. Stale 13. Decedent's Education (Specify only highest grade completed) Elementary I Secondary (0-12) College (1-4 or 5+) 12 6 Pennsylvania Cumberland 325 Wesley Drive Mechanicsburg, PA 17055 18, Father's Name (First, middlEl, last, suffix) William Elston Hedges 17b, County 19, Mother's Name (First, middle, maiden surname) Elizabeth Douglas 8434 ,...;) c:::> c:::> ClO ::It >>- -< , Date,-l~sued '''. , ; -~~ ~"' rr~; -) ~i~ rr'-i f':Fl :r ';::'.J C'C) '.-,'1 :4:~ ,...~ f'l" r'. C..') <=J '. ,I -0 :x z:- N U1 \)\.-\~\Sl Other: ~ Nursing Home D Residence DOther. Specify 9. Was Decedent of Hispanic Origin? gg No 0 Yes 10. Race: American Indian. Black. While. elc ~:~~j,~~~:~;"CI (SpecifYI white 21c. Place of Disposition (Name of cemetery, crematory Of oth9l" place) Evans Crematory 14. Marital Status: Married, Never Married, Widowed, Divorced (spec;f'/) Never Married Did Decedent Uve ina Township? 17c. G9 Yes, Decedent Lived in 17d.D No, Decedenl Lived wi1hin Actual Limilsof Lower Allen Twp City/Bora Elizabeth Bulota 2Ob. Informant's Mailing Address (Street, city I town, slate, zip code) 325 Wesley Drive, Apt. 3209, Mechanicsburg, PA 17055 24. Time of Death :5: /0 CAuse OF DEATH (See Instructions and examples) Item 27. Part!: Enter the cbain.~ - diseases, injuries. or compticahons -that directly caused the death. 00 NOT enter terminal events such as cardiac arrest, respjralory arre>1, or ventricular fibrillation without showing the etiology. List only one cause on each line. 21d. Location (City / town, state, zip cocIe) Schaefferstown, PA 17088 230. Ucense Number Inc., P.O. Box 431, New Cumberland, PA 17070 jr.?N'J.11 l(..;? l 26. Was Case Referred to Medical Examiner / Coroner lor a Reason Other than Cremation or Donation? Dyes DNo j) la l<>.e.k:h m-e Hi Ius =~~Il~~~~~~)dise~ LJ~O~1:?1' S-I S Approximate interval: Part II: Enter other sioniflCanl conditions conlributina to death, 28. Did Tobacco Use Contribute to Death? Onset to Death but nol resulting in the underlying cause given in Part I 0 Yes D Probably ~ No D Uoknowo Sequentially fist condlions, if any, ~a::~~o :r:~~I'W~ru~~ a. (disease or irnury lhal inilialedthe events resulling In death) LAST. Due ~or as a consequence of): b. 1~c:::tJAL. CAt..CUL.\ Due to (or as a COnsequence of): ~""wo. 31'l"'0Y1 ~5 Due to (or as a consequence of): 3Oa. Was an Autopsy Perlormed? 31. Manner of Death [gI Natural D Hom_ O Accident 0 Pending Investigation D Suicide 0 Couid Not be Determined 3Ob. Were Autopsy Findings I~va~able Prior 10 Completion I)f Cause 01 Death? Dyes ~No DYes DNo 32d. Time of Injury 29, I! Female ~ Not pregnant within past year o Pregnant at lime of death o Not pregnant, but pregnant within 42 days ofdealtl o Not pregnant. but pregnan! 43 days to 1 year before death o Unknown il pregnant within the paSI year 32c. Place of Injury: Home. Farm, Street, Factory. Office Building, etc. (Specify) M, 321. If Transportation Injury (Specify) o Driver f Operator 0 Passenger DPedestrian DOlher ' Specify: 33b Signature and Tille of Certifier ~ fa . (-Iv fY\() ~ 33a. Certifier (check only one) Certffying physician (Physician certifying cause of death when another physician has prOOO1.lnced death and completed llem 23) To !tie best of my knowledge, death occurred due to the eaule(s) and manner as stated_ _ _ _ _... _ _ _ _... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ M ~~~:u:~~~fa~~ :~~1:.~~a~:u~:: :hu~~:n:::::c~~:rt:;iol~:~~:a~~ manner as stated.. _ _ _ _ _ _ _ _ _ _ _ _... _ _ _... 0 ~~~:~~:~sm~":~~~;::~ and I or investigation, in my opinion, death occurred at the time, date, and place, and due 10 the cause(s)and manner as stated... 0 329. Location of Injury (Street, city/lown, state) 33c. License Number N'P4Z-1C{$O ~,Registrar's S;Z" aod I:lri~r~ Io? I / joi I / ( Disposition Permit No. n, q S 34, Name and Address of Person Who Completed Cause of Death (Ilem 27) Type I Print NQ""'~"" J+oooIAo..,..plAor 3.. S'c. "O'I'nd (~... tJ , I 2.00<0