The URL can be used to link to this page

Home My WebLink About05-30-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of David. W. Russell also known as File Number ~ \ at C;bC\U , Deceased Social Security Number 202-46-7330 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 (State relevant circumstances. e.g., renunciation, death of e.xecutor, etc.) C) C~ I..J , '. "T1 , "71 --;::0 . ,~,.,~: ;-J"1 ~ <.= - named in the . i I , ; ::::::: . ") Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution9~~~stru~t(S) 6ffer~' for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ...; :'0 - . ,'.c- t" ~ -< W i'l. ) ., r'7l Pendente lite IX.J B. Grant of Letters of Administration ~~ -"-1 L.) (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 of Will in Section A above and complete list of heirs.) r Name Relationship Residence I Victoria Russell Wife 644 West Louther Street, Carlisle, P A 17013 (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in Cumberland 644 West Louther Street. Carlisle. P A 17013 (List street address, town/city, township, county, state, zip code) County, Pennsylvania with his I her last principal residence at Decedent, then 48 years of age, died on April 17, 2008 at M.S. Hershey Medical Center 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 P A) Personal property in County Value of real estate in Pennsylvania -() -0_ $ $ $ $ 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: Si nature ( ~,jt,-(;(~L/ {p '--(/. Form RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative C0M110NWEAL TH 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 ofPetitioner(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 S worn to or affmned and subscribed ~D day of , ;2J)bg --/- }. ~ /1-. . ,~ " /).1} ~ ~CX' UGvv,().J) .-SLJ.d/ Signature of Personal Representative Signature of Personal Representative Signature of Personal Representative o C;o . :0 ~'~~O '-~. I-'~ --.7'"rll \"'-..) = c.:;:;.::) = ::x :c.. -c:: W '- J,j . , File Number: d.. \ (J ~ \J ~Ji\L\ (.~' ~f) . '---I } )ia :::Jl:: =0 -'-1 ':! r ",,; . , Estate of David. W. Russell , Deceased w Social Security Number: 202-46-7330 Date of Death: April 17. 2008 AND NOW, having been presented before me, IT IS DECREED that Letters are hereby granted to Victoria Russell , in consideration of the foregoing Petition, satisfactory proof of Administration Pendente lite 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 1.D 00 Letters ...~...... $ Short Certificate(s) . . . . . . . . $ 'fa /" Attorney Signature: Renunciation(s) .......... $ Richard P. Mislitsky JLP iu ... $ ID Attorney Name: Ai' $ S Supreme Court I.D. No.: 28123 $ 1 West High Street, Suite 208 $ Address: $ PO Box 1290 $ $ Carlisle, PA 17013 $ Telephone: 717-241-6363 $ TOTAL ............. . $ ~-u:mr' FormRW-02 rev. 10.13.06 Page 2 of2 If':;.~():'i RF\ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. 2'ee for this certificate, S6.00 ~~,; 111;i'(~\1" Of pi;,-----. \\'~~'''.,.- l ~ .. V...t,':. l~_V .!\' . ~\ ~~( '~' ,~ . \~~ ~ ~~-tA~: ,I~~ ':::. \-- , ____., i '" ~ *'': . '~.' "c .', *~ -.:::2\ .~^"""""". ,"""- ,I "\ ~ '. /~",l "'- "'%'--- "~ " ~~--~l,ifENf~\~;"l "'-""0'#1111#11'" 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 14329694 Certification Number ~ /J; ~~~"APi 2 1 io08 Local Registrar ---.. ~ Date Issued ~ Cj ~ ,..- c.:::t ~ '--:;;0 = ;;:;~ 3: -" c~ > '1:; r-= -< '-;.-f'T1 W . :::n y /, (~;(~ --,,-""- :t:Bo .....;:;:,;. Ii -~--, N w REV 11.12006 PAINT IN IANENT ~K INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NUMBER ~ \ ()<6 6 s~L\ 1. Name of Decedent (FIISf, micldle, last, suffix) David W. Russell 202 - 46 7330 4. Date of Death (Month, day, year) April 17, 2008 5. Age (Last Birthday) 5. Dale 01 Birth (Month, da, ear) Other: 48 V<s. 8b. County 01 Death Cumberland, PA o Re"""""e DOthIN' Spoo~, IJ No 0 Yes 10. Race; American Indian, Black, White, efc. ( $pscif/l White 11. Decedenrs Usual Occ lion Kind of work done d Kind of Work Forklift Driver . 16. Decedent's Mailing Address (Street, city I town, state, zip code) 644 West Louther Street Carlisle, PA 17013 18. Father's Name (Rrst, middle. last, suffix) William F. Russell 12. Was Decedent ever in the U.S, Armed Forces? DVes iJlINo 13. Decedent's Education (Specify only highesf glade completed) Elementary f Secondary (a-t2) College (1-4 or 5+) 12 14. Marital Status: Married, Never Married, Widowed, DM",:ed (Specif/l Married Did Decedent Live in a Township? Victoria Sweeney -', ActualResidence '7a.State -'pennsylvania 'lb. Coun~ Cumberland 19, Mother's Name (First, middle, maiden surname) Ma Halter 17c.D Yes, Decedent Lived in '7d.1X! No,_/Uvedwi1/lin Actual Umits of Twp Carlisle City f Boro 2Ob. Informant's Mailing Address (Street, city I town, state, zip code) 644 West Louther Street, Carlisle. PA 17013 21c. Place of DIsposition {Name or cemetery, crematory (J( othef pIace~ 21d. location (City I town, stale, zip code) Cremation Society of PA Auer Memorial Home and 4100 Jonestown Road Harrishur 23b. license Number 26. Was Case Referred to Medical Examiner I Coroner 10f a Reason Other than Cremation or Donation? Dyes DNo 17109 Inc. 23e. Date Signed (Month, day, year) =~J.~S: '~ldise~ a. !'{"II\(\' \i\i\-th \'M.U1 Di~ Due to (Of as a consequence o~: b. D~ ~~~~nseq~~~ry Vm) Q~'){ f:o.t\u.xt.. Approximate intelVat: Part II: Enter other sianiflC3nt conditklns contritxmnQ to death. 28. Did TObacco Use Conlribute 10 Dealh? Onset to Death but no! resufting in the undertyinq cause given in Part ) 0 Yes 0 Ptobabty o No 0 Unknown 29. If Female: o Not pregnant within pasl year o Pregnant at time 01 death o Not pregnant. but pregnant within 42 days of death o Not pregnant, but pregnant 43 days 10 1 year betore death o Unknown il pregnanl within the past year 32c. = ~u\::f~: ~';j Street. Faclort, Sequerrtiallylist cooditions,if any, ~~o~~,~~~~a (disease or il]ury lhat ioitiateclthe events resulling In death) LAST. c. Due to (or as a consequence of) d. DVes ~ o Ves 0 No 31. Manner of Death ~nli 0 Hom_ 0- 0 P6f1<ing Invest~tion o Su_ 0 C<l\Jid Not be Delerm<oed 32d. TIme 01 Injury 32g. location 01 Injury (Street city Ilown, stale) 3Oa. Was an Autopsy Pertormed? 3Ob. W9fe Autopsy Findngs Available Prior 10 Comp/etfon of Cause of Death? M. 330. Cerlii1e< (cIle<:k only one) Certftylng physlelan (Physician certifying cause of death when another phys1cian has pront)U1'lCed death and completed Item 23) Tottlt best of my knowtedge, death otCurreddut to thecause(.~1tKI manner as stated-..... _.. _.... _ _.... _ _....... _.... _.. _..... _... _...... _... 0 ~;:u::~t~ =::oe~r:= :;I::::n~;~~:'~~~o~:=~~~~ manner as slated.... ........ .... .... .. _.... .... .. _ 0 =~~":~~= and I or Investigation, In my opinion, death occuned at the tlmt'!, dste, and pMce, and due 10 the cause{s) and manner as stated_ 0 I~/I~I/I/I 3&::. license Number 33d. Dale Signed \Monlh, day, year) ff\,y't0C\~2 4\n to~ 34. Name and Address 01 PerSOll Who Completed Cause 01 Death (lIem 27\ Type I ~. S. Hershey Medical elf. ~\\M ~ Hershey, PA 17033 ,....'__..~a;..." O......iINn 01 9';981 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 knowh:dge 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. S worn to or affmned ami subscribed YM,^-~J ~D da'{.;of , ;ll)t)D Signature of Personal Representative before me the Signature of Personal Representative For the" Register Signature of Personal Representative o C;o . ~D (~] TO .~'" r-n :.;--" ~-r-; r-.:> = C.:::.:J = ::!\t :0- -< w , " . '::._~ ..J .L,) '.-t File Number: d.. \ C)t \J5~~ ',,)q _~ ':=d :5J ...-; - :n:: N Estate of David. W. Russell , Deceased w Social S"urity N umbe" 202-46-7330 ~ Date of Death: April 17, 2008 AND NOW, ('~ 1-.. , Jf5b , in wnsiderntion of thdocegoing Petition, "ti,factocy pwof having been presented before me, IT IS DECREED that Letters of Administration Pendente lite are hereby granted to Victoria Russell in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of r FEES )..D clJ Letters ...~...... $ Short Ce:rtificate(s) . . . . . . " $ 1-a .'It Attorney Signature: Renunciation(s) .......... $ Richard P. Mislitsky JLPb ... $ ID Attorney Name: J~' $ S- Supreme Court LD. No.: 28123 $ 1 West High Street, Suite 208 $ Address: $ PO Box 1290 $ $ Carlisle, PAl 70 13 $ Telephone: 717-241-6363 $ TOTAL . . . . . . . . ~ . . . . . $ ~-mrrr-' Form RW-02 rev. 10.13.06 Page 2 of2