HomeMy WebLinkAbout05-14-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY,PENNSYLV~A
Estate of MArlene McCarthv
also known as
MArlene McCarthv
Diane L Cline
File Number
JI.{)f- 053iP
, 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
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(State relevant circumstances, e.g., renunciation, death of executor, etc.):: -,~ C) :::: >,,~ ,7:5
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution o-f ilJtftiii;trumc:At(s) 0~~1t,;';;
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: :_~, ~ ~ .. ~_~-: :="?,
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[Z] B. Grant of Letters of Administration C . ('"~)
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; dul:Je:jle-minoritate ..
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Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) <irt:! heirs:(ij'
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete /ist of heirs)
Name
Relationshi
Residence
PA 1705
PA 1702
PA 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
60 Glendale Drive Mechanicsbura PA 17050 Silver Sorina Two
(List street address, townlcity, township, county, state, zip code)
Decedent, then 81
Silver Sorina Townshio
years of age, died on 5/9/2008 at 60 Glendale Drive
Mechanicsbura
PA 17050
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 PA) Personal property in County
Value ofreal estate in Pennsylvania
$
$
$
$
500.000.00
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
Diane L Cline
73 Nailor Road Dillsbur
PA 17019
Form RW-02 rev. 10.13.06
Page 1 of2
Continuation of Petition for Probate and Grant of Letters
M Arlene McCarthy
Decedent Name
Page 1
202-20-3868
Social Security Number
Surviving Heirs
I
Name
Relationship Residence j
73 Nailor Road
dauahter Dillsbura PA 17019
67 Millers Gap Road
dauahter Enola PA 17025
Diane L Cline
Marilvn L McCarthv-Wadlinaer
Oath of Personal Representative
COMMONWEALTII OF PENNSYL VANIA
: SS
COUNTY OF CUMBERLAND
The Petitioner(s) above-named swear(s) or affmn(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
Sworn to or affirmed and subscribed
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day of
~!f.!Mi!J!..:tL-?~ane L Cline
Signature oj Personal Representative
File Number:
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Signature oj Personal Representative
Estate of MArlene McCarthv
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AND NOW,
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having been presented before me, T I
are hereby granted to Diane L Cline
Date of Death: 5/9/2008
,2008 , in consideration of the foregoing Petition, satisfactory proof
D that Letters of Administration
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.
FEES l!:bO da, I 10!7J1iJ{) JIM JJ }y',)jJ?Ifi J - A-~
'-.J Register oj Wills 0 LJXJ ;, C/ Ul
Letters ............................. $ 410.00 ~ r~' 0
Short Certificate(s) I(.?.(f!.~~ $ 40.00 Attorney Signature: ~~1'..;.,-
Renunciation(s) ................ $ 15.00
Attorney Name: Jan wn
Automation Fee $ 5.00
JCP Fee $ 10.00
$
$
$
$
$
$
$
TOTAL ............................. $
Supreme Court LD. No.: 67993
Address:
845 Sir Thomas Court Suite 12
Harrisbura
PA
17109
Telephone:
717-541-5550
480.00
Form RW-02 rev. /0.13.06
Page 2 of2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
P 14583113
--.::.......:... ~ J..u.., ~511), f" g
~cal Registrar d Date Issued
Certification Number
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ll'PE, PRINT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FilE NUMBER
1 Ntime 01 Decedent (fKst middle, Iasl, sulti.,
M. Arlene McCarthy
6 Date 01 Birth (Mooth, day, year)
4. Date 01 Death (Month, day, ye<u)
May 9, 2008
- 3868
5 Age (la.!.l Birthday)
Sa. Place at Dealh {Check only onel
Hospital: Other
o lnpalienl 0 ER I Oulpdllenl OOOA 0 Nursmg Home ~Siden'e
9 (~~= t:~~c OriglO? JiJNo 0 Yes
Mekican. Puerto Rican. ale,)
81
September 29,1926
Harrrlsburg, Pennsylvania
Yrs
8b. County oj Dealh
DOthH . Specl~
10 Race- Azooncan Indian. Black, White, elC
ISpec'/)1 White
8d Faciltty Name (II not lflStitutlon, give street and nurrtJer)
60 Glendale Road
Cumberland
11, Decedent's Usual Oc lion (Kind 01 wol1r. done durin mosl of WOl ute 00 not slate retired
Kind 01 Wol1r. Kind 01 Business I Industry
Homemaker Own Home
12. Was Decedent ever in Ihe
US Aimed FOfc~s?
Dv" filJ.No
Decedenl's
AclualResidencB 17a State
13, Decedent's Education (Specify only highest grade COmpleted)
Elementary J Secondary (0-12) College (1-4 or 5t)
12
14. Marital Slalus Married. Never Married
W"'9""'. ",,0<C'" 1$peaM
Widowed
. 16 Oocedenls MailtogAddress (Streel. city / IOwn, slale, zip code)
60 Glendale Drive
Mechanicsburg, PA 17050
Did Decadenl
liveina
Township?
PA
Cumberland
Silver Spring
17c~ Yes, Decedent lr.ed 10
17d, 0 No, Decedent LIVed wilhifi
AclualUnilsol
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17b. Counly
18 Fdrher'S Name (First rrooo:tlll, Ids!. slJlIlx)
CIlYIBOh)
19. Molher's Name (FiliI. l1\IddIe, rnalO&n surname)
Robert Arnold
Mary Unknown
20<1. Informant's Name {Type I Pnnt)
2Ob. Inlormant's Mailing Address (Slreet, city I town, slate, zip coda)
73 Nailor Road DiIIsburg, PA 17019
Diane McCarthy-Cline
21c. Place of Disposition (Name 01 cemetery, cremaloly VI" oIt'Mir place)
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21d, localion (City flown, slate. Zip code)
Mechanicsburg, Pa. 17055
Chestnut Hill Cemetery
22c, Name and Address 01 FiCl/ity
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
23b, license Number
{2AJ d0,5308 L
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26. Was Case Referred to Medical EXClminer I CO({lrl8f IOf a Aeasofl Other than ~remahofl or Donahoo?
DVe, [3No
I ApptolUmaleinlerviIJ
: Ooselto Dvalh
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Pal1lJ:EnWlClher~~~lIL.QIiI}, 26 DId TobacGO UseConlllbWI 10 Oea1tl1
bul rIOt fe~lIlting In the undeflying cause giYeflIfl Pan I 0 Yes 0 Prob<ltlly
o No 0 Ull~noW/l
29IlF8tlIaIe
o Not pregnantwiUkn past year
D Pfegnanl aI brne 01 dealh
o Notpre;,jfldntbul:pregnarilwtltltn42day5
oIdEalh
o Not p<ego;ant bul pregnant 43 aay:> lO 1 year
belewe dealh
o Unknown it pregmmt w4hiflthe past )'ear
32c. Place of Injury' Home. Farm, Slro&l, Factory,
OfIlCeBul/dlng,elc,(Spmfy)
~~;eE~~~~~llose~
L~J III l"nll nI IWVW !trr:rtr
Due to (or as a consequence Of): ll..- - - - - l.
@~m ~>>W
Due 10 (or as a consequex:e ~)
f:t 1'Z-~)YWY'J
Due to IOf as a con!.Elquence (1)
S.:quenllaUy li$tcondtoons, rtany,
kladmg 10 1he cause ~sled 00 kne a
fnler tle UHDEAlYWG CAUSE
ldlsease orill/Uf}' thai irullaledltle
events resulllng 11\ deathl LASt
30a Was an Iwtopsy
Fert"rmed?
JOb Were Aulopsy FiOOngs
A~aitable PriOf 10 CornpleliorJ
of Cause 01 Dealh?
31. Manner 01 Deatl1
o Nalllfdl D~lornicide
o ACCI(jent 0 PerK1lng In.-e!.lrgallOfl 32d TUM ollnlury
32a. Date 01 Injury iMonlh, day, year)
DVe, ~N'
Dye; ON<>
o SlIiclOO 0 Could Nol be Dellmninad
M
33aCerufier (chadlonlyOO(j)
C.rUfylng pIl)'siCian (PhySlCiitn certifying cause of (j(;alh whto alli.lttlf:r plll'siclan has plOnuunCt'CI cte<lltJ dnd compleled Item 231
To the bHI oj my knowleOliJll. dNth occuned due to the cau&e(s) and manner as stated.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
;;O;::'I~': ~:'~::C~~:':I:~ 1::~i=:rll~~in~;:C~~~~~iD!~~~:~~j~~~ manner as slaled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
~a1~:::'m::~;:'7o:. and I Dr invtsl)goition, in my Dplfliofl, death occuued lit the lime, date, and place, and due 10 lhe causeis) and manoer- ar. ltated_ 0
33d, Dille Signed (1\onll1, dav, yearl
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RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
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Estate of MArlene McCarthv
I, Kenneth L McCarthy
(Print Name)
Co-Administrator and son
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, Deceased
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, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
Diane L Cline
administer the Estate of the Decedent and respectfully request that Letters be issued to
5 -/C(- 08
(Date)
Executed in Register's Office
Sworn to or affirme and subscribed
before me this day
of 1lAAIt
Form RW-06 rev. 10_13.06
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G gnature) Ii
1642 Holtz Road
(Street Address)
Enola
(City, State. Zip)
PA 17025
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
RENUNCIATION
CUMBERLAND
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
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Estate of MArlene McCarthv
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I, Carolyn L BishoD
(Print Name)
Co-Administrator and dauahter
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate ofthe Decedent and respectfully request that Letters be issued to
Diane L Cline
(kI~
659 Saw Mill Road
(Street Address)
Mechanicsbura
(City, State, Zip)
PA 17055
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciatttn for the
purposes stated within on this I t..J day
of May , 2008
4df~J1)~ C ' kl~
tary ubhc
My Commission Expires:
Deputy for Register of Wills
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
HOWIIAL SIAl.
JACQUIt_ A ICIUY
Notory PubIc
CnvOll~, DAIWH'N COUMy
My Comm.1IIon Expire, Dee: 17, 2011
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
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Estate of M Arlene McCarthy
, Deceased
I, Marilyn L McCarthy-Wadlinaer
(Print Name)
Co-Administrator and daughter
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate ofthe Decedent and respectfully request that Letters be issued to
Diane L Cline
S-/'r/ocf
(Date) /
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(Signature) (j
67 Millers GaD Road
(Street Address)
Enola
(City, State. Zip)
PA 17025
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunc)if.re for the
purposes stated within on this day
of May , 2008
Deputy for Register of Wills
1;:~~aN.4
. ot Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
HOlARW. SIAl.
JACQUlLtNI A KILLY
NotQ'Y Public
CflY OF HARtlSlURe, DAUPHIN COUNTY
My Comm"'lOn ExPl,.. Dee 17,2011