HomeMy WebLinkAbout06-23-08PETITION POIZ PI20BATE AND OItANT OJE LETTERS
REGISTER OF WILLS OF Cll/yl,QE~L,i¢/V.l~ COUNTY, PENNSYLVANIA
Estate of ~~1~'1~L°I/ K. EG/?1CS File Number ~, ~ tJ ~\(~U~~
also known as c~~
Deceased Social Security Number a.Da `~ 7'e" 6~ 73
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 W i11 of the Decedent dated _ and codicil(s) dated
named in the
E.3 c-s --
C ~ cs3
(State relevant circumstances, e.g., renunciation, death of executor, etc.) ? -1 ~ ~_ ~ , _
- ~ ";:"
Except as follows, Decedent did not marry, was no[ divorced, and did not have a child born or adopted after execuriori=o~'t~x sttstturtis3tt(s) offered~`i
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - ,
_.~_
:[3. Grant of Letters of Administration -'mot ~ " ;
(lfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendentelite; duranteabsentia; dura~tteminoritate)~
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.)
(CON,!PLETE IN ALL CASES:) Attach additional s/:eets if necessary.
Decedent was
(List street address, town/city,
at death i
count), state, zip code)
with his !-i+gt last principal residence at !I 7 EIlS
Decedent, then Jr.3 years of age, died on ~~~-~ psi Z~0 at /~7 ~ ~114in Jf~ ~C~j~1l CS~tiv~~ /~j~ /70,sf
Decedent at death owned property with estimated values as follows: / ~/
(If domiciled in PA) All personal property $ /CSS //l6tl~SODO.Gb
(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:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Vdill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
X c ~~.,ar- 4SL
or printed name and residence
Form RVY-O3 ren. 10.13.06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF C1R./1113E'~~f'/~~
The Petitioner(~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 of Petitioner~j and that, as persona] representativef~ of the Decedent, Petitioner(~l will well and truly
administer the estate according to law.
Sworn to or affirnzed and subscribed
befi~re me the ~_ day of
,~
For the Register
Signature of Personal Representative rr.a
RD13E~T %f• Eft/y1ES c?
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Signature oJPersa,a! Representative 7 ~, ,
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Signature of Persona! Representative ~
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File Number:
Estate of /` /¢/Y~~ ~• E~•~~ ,Deceased
Social Security Number: t;7~4Z- yd- 6/73 Date of Death: ma^~ ~s; zs70,~
,AND NOW, ~in consideration of the fore oin Petition satisfacto ro f
,~, ~L~~~ g g ryp o
having been presented befor me, IT IS DECREED that Letters __ p,~{ /7r[/I9i/lic5/7t71)Oit
are hereby granted to ~0 ~Gr't A• • ~Q/flCs
and that the instrument(s) dated
in the above estate
described in the Petition be admitted to probate and filed of rec as the ast 1(and Codicil s)) of pecede t.
FEES ~ ~ U
Letters ...... ~~. ~:~ . $ 3b Register ojWills ~/f~,/
Shorn Certificate(s) ....~... $ ~ a+ Attorney Signature: ~/~ T` /~L~E%~=ll~
Renunciation(s) ......
-~P
~~
• • . $ + ® Attorney Name:
• • • $ 5 Supreme Court I.D. No.
... $
$ Address:
...$
...$
...$
' ' ' $ Telephone:
... $
TOTAL .............. $
(~f1~'74S ~ ~lie~dt 11l
3&S/3
CQ ~~'llSer ~d
~re~,~;~~u~, n~ ~ 70~
7/7~ 7~ 6 -0 ~o ~
F~,~n, Rw-va rev. 10.13.OG Page 2 of 2
u; an> lzr~~ lovo;~
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, 56.00
~t~3~453~
Certification Number
r-•.,
C'-j c=,
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i ~7 ~~ - 1
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fhis is to certiftir that the information here given is
correctly copied-f(om an original Certificate of Dea(h
iuly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
records Office for }?ermanent filing.
~. ~E~..C~'~~yA~ 1 8~ 2n08
~ocal Registrar Date Issued
Nt05.1M REV t,/1W8 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
N RI~ENMIN CORONER'S CERTIFICATE OF DEATH
BLACK INK ~~ ~ ~ ,~ ~ ~ (See instructions and examples on reverse
STATE FlI E NLIA1eER
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1. Name d DeamwY (FNaI. n,dde, bN, sugd) ~ 2. Sex 3. $acW Sealdy Nun+Gw 4. l~ a Dwlh (Mpeh, daY, Y~1
Randall K Eames Male 202 -46 - 6173 March 15, 2008
s. Age (lap BadideYl IArdu 1 lAider 1 B. Dpe d Bbtlr (MOnN, day, 7. BkMple a ~A alma a Ba. 1'laro a OeaM (CMac ab)
53 "1wei °"' '"" ""'" June 30, 1954 Mechanicsburg are
Yrs. Q ^Inpetlad ^ER/Dulpatlpd ^DDA ^NUrshp Ftama ^(lgrr-Sppdy:
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Bn. cwaY a oeph ec. Boo . d Deem ea. Faalay Nrre 01 na iiretl6rem, give soap am aamery 9. was Deddas a Nrpnm QfginT ~No ^ vas m. Red: Aarerinn 6aen, Brad, wNr, ac
Cumberland Mechanicsburg 117 East Main Street Meddn,Riab~,em.) ( White
Decedars'a lbuel am d woe dale mon a fro. Do riot slab
ri 12 wee Daddea ever in tlr 13. Deddenl'a EdArdon (Speak/ Day Nglrel9ade ~nderodl 1<. Meap Srohr: Mrded, Nsvx Marled. 15. Sunivirp Spare (K wlb, 9Ne maiden name)
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Knd a ware aim d arewae / ulduay U.S Amrd FadaT wmovreA, ~~ (
Elemenmry / SecoMery (0-12) Cdroge (14 a Sr)
Laborer General Coast ^Y•e $lNa 12 rs. Single
_ 18. DeddpMs MpWgAONeae (Sees. alY / mvm, stem. dp coda)
117 East Main street DeddpiCs
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Mechanicsburg, Pa. 17055 ~
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Ronald R Eames Kutz Ho kins
Zoe. Inbmea'a Name (TYp• / Pda) lob. hilamanYe Madeg Address (Saest, dry / Mm, Pero, dp code)
Robert A. Eames Old Grove Road Mechanicsburg, Pa. 17055
2tu. Mptrd a D'epaMon [~CmmeWn ^ Danetlan 216. Deb a Obpdma~ (Marl, daY, Yepl 21c. Pbd d Dispoeitlm (Npna a cemetery, ardmry a Ma pbd) 21d Lodtlan (GlY / rosn, amts, zp Dods)
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g Mt.Holly Spgs.Pa. 170
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22a sgdme a Farrp servid tidneee (a perm aaeq ge eud) 22b. License Nana 22c. Name arm Ached a Foam 5 Q 1 N . Baltimore Ave .
_ ~ y'` D-011:189-L Hollin er FH Cremator Inc. Mt. Holt S rings,Pa. 17065
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