HomeMy WebLinkAbout05-12-08
PETITIOI' FOR PROBATE AND GRANT OF LETTERS
REGISTER OF VILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
Es ate of Kathryn Bowman Zeigler
als known as
File Number
'1 \ O~ DS 7!::;
, Deceased
Social Security Number 189-09-1409
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Pe itioner(s), who is/are 18 years of ag or older, apply(ies) for:
(C JMPLETE 'A' or 'B' BELOW:)
[ A. Probate and Grant of Lettel Testamentary and aver that Petitioner(s) is / are the
la Will of the Decedent dated and codicil(s) dated
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Ex ept as follows, Decedent did not ml ITy, 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 kill ng and was never adjudicated an incapacitated person:
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(State relevant circumstances, e.g., renunciation, death of executor, etc.)
({ B. Grant of Letters of Administ tion
(If applicable. enter: c.t.a.; d,b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
P titioner(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
A ministration. c.t.a. or d.b.n.c.t.a.. e er date of Will in Section A above and complete list of heirs.)
I
Name
RelationshiD
Residence
300 Beverly Road, Camp Hill. PA 17011
I
eon J. Zeigler
Spouse
(l OMPLETE IN ALL CASES:) Att eh additional sheets ifnecessary.
Deee.dent was doiniciled at death i Cumberland
3 0 Beverlv Road Camn Hill Cumbl land County, PA 17011
(1 ~t street address, town/city, township. c unty, state. zip code)
County, Pennsylvania with his / her last principal residence at
, De(;edent, then '89
P ~nsvlvania 17011
years fage, died on April 19, 2008
at 300 Beverly Road, Camp Hill, Cumberland County,
Decedent at death owned property with estimated values as follows:
(If domiciled in P '\) All personal property
(If not domiciled n P A) Personal property in Pennsylvania
(!fnot domiciled n PA) Personal property in County
Value of real esta e in Pennsylvania
$
$
$
$
30,000.00
s tuated as follows:
\ herefore, Petitioner(s) respectfully requ st(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
t e undersigned:
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Sienature
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Tvoed or Drinted name and residence
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Ronald L. Zeigler, 4412 Bossler Road, Elizabethtown, P A 17022
orm RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
C MMONWEALTH OF PENNS LV ANIA
C UNTY OF CUMBERLAND
SS
The Petitioner(s) above-named wear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
th knowledge and belief ofPetiti er(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
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Signature oj Personal Represent e
Signature oj Personal Representative
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Signature oj Personal Representative
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File Number:
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. n Bowman Zeigler
, Deceased
: 189-09-1409 Date of Death: April 19, 2008
AND NOW, I L ,2OV ~, in consideration ofthe foregoing Petition, satisfactory proof
h ving been presented before me, IS DECREED that Letters of Administration
ar hereby granted to Ronald L. Zigler
in the above estate
a d that the instrument(s) dated
d scribed in the Petition be admitt d to probate and filed of record
FEES
L tters ...... J(J/?o,l). $
S ort Certificate(s) . . . ,( . . . $
Rnunp~ .1... $
.. . $
$
$
. .. $
.. . $
.. . $
.. . $
$
$
TOTAL . . . . . . . . . . . . . . $
F rm RW-02 rev. /0.13.06
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Supreme Court LD. No.: 7232
Address:
3631 North Front Street
Harrisburg,PA 17110-1533
Telephone:
(717)236-9577
Page 2 of2
Hl05~lJ" RE\' tlll!O !
LOCAL R
GISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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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. APR 2 2 2008
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Local Registrar Date Issued
Fee for this erti fi. ,1[(' S.h, i)O
REV 1112006
! PRINT IN
oJlANENT
CKINK
()oQlr3L
ONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FILE NUM
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3. Social SectJrily Number
I ~9- (JC1- /'/09
Ba. Place 01 Death (Check only one)
Hospital: Other:
o Inpatient 0 ER f Outpatient 0 DOA 0 Nursing Home ~ Residence
9, Was Decedent of Hispanic Origin? No 0 Yes
C 11 tJll' Ji 1 i.L (If yes. specify Cuban,
PI) Mexican, Puerto Rican, etc.)
13. Decedenrs Educalion (Specify only highest grade completed) 14. Marital Status: Married, Never Married,
Elementary I Secondary (O-12) College (1-4 or 5+) Widowed, Divorced (Specify)
IZ MR~fjED
PE7VNS YI- U//1J14
(Jt!frJJ3E1( ,(AIII;)
DOtoor' Speci~'
10. Race: American lndiant Black, White. etc.
(SpecifJ?
LIJ H iIE
17b. C<>oo~
17c, 0 Yes, Decedent Uvecl in
17d. Qg' No, Dececlentlived within
Actual Limits o!
LEON J: ZE;'{/i.EIC
Twp
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City/Bora
19. Mother's Name (Rrst, middle, maiden surname)
ElJ/Tlf V.
2Ob. Informant's Mailing Address (Street, city flown, state, zip codB~?
300 .!3EtJEJeLY Ii: Off!)
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C/J/lJ/J illLL P/4
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22c. Name and Address qJ Faci~ty
t.o,O,{'VILLE k;>n/JJEL
21 d. Location (City I town, state, lip code)
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21b. Date 01 Disposition (Month, day, yea~
308. Was an Aulops
Pertormed?
3Qb. Were Autopsy Findings
Available Prior 10 Completion
01 Cause of Death?
31. Manner of Death
~atural
I Approximate inlerval: Part II: Enter other sIonificant conditions coolributino to death, 28. Did Tobacco Use Conlribule to Death?
Onset to Death but not resulting in the underlying cause given in Part I 0 Yes 0 Probably
'fil No D Unknown
29. If Female:
~ Not pregnant within past year
tJ Pregnant at lime 01 death
o Not pregnant, but pregnant within 42 days
01 death
o Not pregnant, but pregnant 43 days to 1 year
befOl'e death
o Unknown ij pregnant within lhe past year
32c. Place of tni~ry: Home, Farm, Street, Factory,
Office BuildIng, elc. (Specify)
Due to (or as a consequence 01)'
d.
Dves ~
D Ves D No
32d. Time 01 Injury
33d. Dale Signed (Month, day, year)
/1f'/i / ,i? 1/ ZoC' Y'
321. II Transportation Injury (Specify)
o Driver I Operator 0 Passenger 0 Pedestrian
M. DOtOOr' Specify:
33a. Certifier (ell only one) 330. Signature and TrtIe of CertifiG/#;:
Certifyl phyllelarl (Physician certifying cause 01 death when another physician s pronounced death and completed Item 23) ....
To the be of my knowledge, death occurred due to the cause{s) and man al silted- - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - 'f!!
Pronou n9 and enrtifylng physician (Physician both pronouncing death and 'lying to cause 01 death) 33c. License Number
To the t 01 my knowtedge, death occurred It the time, date, and place, an due to the C8Use{S) and manner as sblted.. - - - - - - - - - - - - - - - - - 0 ;It tJ d It> 1 l r 6
~:I ISm~":~,~n:= and f or investlg.tion, In my opinion, death oce ed at the time, date, and place, and due to the eause(a) and manner 8S stated.. 0
35, Aegislrar'sSi
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34. Name and ;,,~r .!'fr~~ com~ted~U;,~ Ilf"l \IlW" ~ ~ I POOL
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Disposition Permit No,
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RENUNCIATION
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REGISTER OF WILLS,
CUMBERLAND COUNTY PENNSYLVANIA
,
Estate of Kathryn Bow n Zeigler
I, Leon 1. Zeigler
(Prin Name)
spouse
c.n
-.J
, Deceased
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of t Decedent and respectfully request that Letters be issued to
Ronald L. Zeigler
5 I~ {J9
(Date)
Executed in Register's 0 Ice
Sworn to or affirmed and
before me this
of
ubscribed
day
Deputy for Register of Wi Is
Form RW-06 rev. 10,13.06
(sr,""w,,~ft;v
.5/ I)./OY/
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300 Beverly Road
(Street Address)
Camp Hill, PA 17011
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
t he 0 she executed the renunciation for the
t d within on this MaR day
(srgmwre ~d S~I of No'"", o<o<hcr offid.' ~~\? ~
administer oaths. Show date of expiration of Notary's Commission.)
P lr
My Commission Expires:
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NOTARiM. Sf.il , .';
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g;ln 1'\11 1\.~~f\.1 .,...~. i. .... "', .
L.em~ Bortl. Cumt.,I~tl~I.";;; ~~0;,mt~", ~
Yu commlssIOn'tJq'Ji;~S F~1b, llJ,10J:J
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