HomeMy WebLinkAbout06-26-08REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
PETITION FOR GRANT OF LETTERS
Estate of HELEN E. HARTER njo. 21 ' Q~ ' ~ ~~
also known as
,Deceased Social Security No.172019050
Petitioner(s), who is/are 18 years of age or older, apply(ies) for
(COMPLETE "A" OR "B" BELOW:)
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A. Probate and Grant of Letters and aver that Petitioner(s) islare the execut _ n~gted in the Lust Wil( of the
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Decedent, dated and codicil(s) dated G ~ N r
Decedent was a widow. ~ ~ -
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State relevant circumstances, e.g., renunciation, death of executor, etc- ~ - f , '~
Except as follows, Decedent did not marry, was not divorced and did not have a child bocn or adopted after execution of the dodum~nts offered
for probate; was not the victim of a killing and was never adjudicated incapacitated: ' `
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B. Grant of Letters of Administration ~' c`'}
(c.t.a., d.b.n.c.t.a.: pendente lice. durante absentia; durante minoritate)
Petitioner(s) after a proper search haslhave ascertained the Decedent !eft no Wilt and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence _~
THOMAS R. HARTER SON 513 WEST BROAD STREET APT 703
FALLS CHURCH VA 22046
DOUGLAS J. HARTER SON 9 WEST PINE STREET
ENC)LA, PA 17025
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at 2100 Bent Creek Boulevard (Silver Spring Townshi
(list street, number and municipality)
Decedent, then 102 years of age, died June 15 , 2008 , at 2100 Bent Creek Boulevard, Silver Spring Twp.
(location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA) All personal property ......................................... $ 25,000.00
(if not domiciled in PA) Personal property in Pennsylvania ....................
(lf not domiciled in PA) Personal property in County ..............................
Value of real estate in Pennsylvania ........................................................................................ $ 120,000.00
Total ..................................................................................................................... $ 145,000.00
Real Estate situated as follows:
9110 E. CUMBERLAND ROAD, ENOLA, PA
Wherefore, Petitioners} respectfully request(s) the probate of the Last WiII and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Signatu~e Typed or printecV name and residence
DOUGLAS J. HARTER
9 WEST PINE STREET
ENOLA PA 17025
717 732-2650
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Oath of Personal Representative
Commonwealth of Pennsylvania
COUnty Of Cumberland
The Petitioner(s) above-named swear(s) and affirm(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) wi11 well and truly administer the esta ccording to la r ~~~~~-~
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Sworn to and affirmed and subscribed ~ r
D UGLA .HARTS ~? =: ^~
before me this 26th day of f ` ~ `
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J u e 2 8 -'~ ,--tz
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DECREE OF REGISTER OF WILLS OF CUMBERLAND COUNTY, PENIVSYLVANIA
Estate of HELEN E HARTER Deceased No. ~ ` " ~ ~ ~ ~ ~~
also known as
Social Security No: 172019050 Date of Death: 6/15/2008
AND NOW, JUNE 2008 , in con:>ideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ^ Testamentary ~1 of Administration
(c.t.a., d.b.n.c.t.; pendente liter durante absentia; durante minoritate)
are hereby granted to DOUGLAS J. HARTER
in the above estate and that the instrument(s), if any, dated N/A
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........ly-S,.~OG,_ ~-o $ 2.~P~ • ~,.~
Short Certificate(s) ..... ~~. .
Renunciation ..................~....
Affidavit ( ) ....................
Extra Pages ( )............
Z ~
$ J.~
$
(i-
of Wills ~ r
Attorney
CodlCll ................................. $
JCP Fee ................................. $ 1 ~. ~~
tnventory & Tax Forms ............. $
Other .....`..:rr:~-.L
TOTAL ..
$ 5.00
$ ~~-. ~c
Attorney: CHARLES E. PETRIE.
I.D. No: 29029
Address: 3528 BRISBAN STREET
HARRISBURG PA 17111
Telephone: X717) 561-1939
DATE FILED: 6/26/2008
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t(II` SII:. RI-A 1111 'il
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat for photograph.
fee for this certificate. ~6.OU
Certifiea~ion ,'~'umhcr
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This is to crrtity that the information here given is
correctly copied from an original Certificate of Death
dui}~ filed ~r~ith me as Local Registrar. The original
certificate ~ti~ill he tin~warded to the State Vital
Records (~ffiec for permanent tiling
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Local Re~~ish~ar Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH +~ Q ~+
(See instructions and examples on reverse) sTATE FaE NUMBER 2 ~ ' L C] ~ (J
t. Name d Decedent (First, m'Itldle, Iasi, suffix) 2. Sex 3. Social Security Number 4 Date of Deam (Month, tlay, year)
Helen E. Harter Female 172 -01 " 9050 June 15, 2008
5. Age (Last Birthday) Under 1 year IJndar 1 day 6. Dale of Bidh (Month, day, year) 7. Bidhplace Ciry and state or fore country) 8a. Place of Deayn (Check Dory one)
Momrw 0avs Hours Minwas Hospital. Other.
102 Y~ Sept 9, 1905 Reinerton, Pa ^Inpalienl p ^DOA]Nursing Hgme ^Resbence ^Olher-
^ ER /Out atienl Specify:
&s. County of Death Sc. City, Bor Twp. f Death Sd. Faglhy Name QI not mslitudon, give street and number) 9. Was Decedent of Hispanic Origin? ~ No ^ Yes 10. Race: American Indian, Black, While, etc.
(II yes. specify Cuban, (Specity)
Cumberland Silver Spring Brid es at Bent Creek Max'pan,PgadDR;gan,alq.) White
11. Decedents Usual Oca Iron Kintl of wont d one tlurin moss of world tile. Do Iat state retired 12. Was Decedent ever in the 13. Decedents Education (Speciy only highest grade cgmp letetl) 14. Marital Stasis: Married Never Marded. 15. Surviving Spo use (II wife. give maiden name)
KiM of Work Kind of Business /Industry US. Armed Forces? Elementary /Secondary (D-12) College (1-4 or 5i) Wld°wetl, Divorced (Speedy,
Homemaker []vea [y~Nq Widow
16. Decedents Mailing Address (SlreeC city I town. stela. zip code) Decedent's Did Decedent
Stale P e n n s v l va n i a Liue in a 17c
Aduel Residence t 7a
S i l y e r
ri n Y l n Q T
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cedent Li
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2100 Bent Creek Blvd, .
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Township?
d ,7d. ^ "p. D~edenl LN¢d within
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cgan
Cumberl
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ry
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Adual Limits of Gry I Born
18. Famer's Name (First, middle, las4 sudixj 19. Mdher's Name (RBL rtridMe, maitlen surname)
Charles En lisp Anne Miller
20a. InfonnanYS Name (type t Print) 206. Inl¢rmanl's Meiling Address Sreet, clry /town, state, zip codel
Douglas Harter 9 W. Pine ~t., Enola, Pa 17025
21a. Method of DislaosRion Cremation ^ Donation
~ 21b. Dale d Dispositbn (Month, day, year) 21c. Place of Dispos4ion (Name of cemetery, crematory or other place) 2f d. Location (City /sown, stale, zip code)
^ Burial ^ Removal Imm Slate
! Was Cremetbn or Donation AuRwrized
^ other-s r ; byMedicalEramind/corgner? Yea^Np 6 1 7 08 Evans Cremation Service Leola Pa
22a. Sgnalu o Fune Se ' ' ensee per ~ as such) 22b License Number ) 22c. Name and Address of Fadlity S u 11 i va n F u ne r a 1 Home
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Canpete It s 23a-c ony when cerfilying 23a. To the best of my knowledge, deem Declared al the time, date and place stated. (Signature and tillel 230. License Number 23c. Dale Signed (Month, day, year)
physican 5 rid available at lime of death to
cenfry cause of death.
Items 24-26 must be completetl try person 24. Time of Death 25. Date Pronounced Dead (Month, day, year) 26. Was Case Referred to Medical Examiner /Coroner for a Beason Other than Cremation or Donation?
wt'° prgrwunDea loam. 5.5 5 M. 6 1 5 0 8 ^ Yes ~ "°
CAUSE OF DEATH (See Instructions end examples) I Approximate mtervaC Pad II: Enter Omer si°nifranl tond'dions mntd6ul_0g to death, 28. Did Tobacco Use ConlribWe to Deelh?
Item 27. Pad I: Enter the chain olevents -diseases, mjunes, or mnWlicatbre -That drectly caused me death. W NOT enter terminal events suU as cardiac artest Onsd to Death Wf oat resulting in me mdedying cause given in Part I. ^ Yes ^ Pmbady
respiratory anesl. or ventricular fib atpn without showing a eddogy. Ust Hone cause on each Ilne.
^ No ^ Unknown
IMMEDIATE CAUSE fFnal disease or
d ~~((..~~
fArldhprl resUlarlg in eaml ~' a ~ V
~
29. If Female:
^
Due as a consequenpe o0: N°I pregnant within past year
Sequentially usl conditions, it any. p I ^ Pregnant at Time of death
leading 10 the cause Baled on line a. Due la (or ee a sequence of): I
Enlar the UNDERLYING CAUSE r ^ Not pregnant, but pregnant wittun 42 days
(disease or inlury that mitiatetl the ° r
events resultHrg m tleaM) LAST of death
.
Due l0 (or as a consequence Of).
^ Nat pregnant, but pregnant 43 days 1° 1 year
d. 1 before death
^ Unknown it pregnant within the pass year
30e. Was an ANppey 30b. Were ANOpsy Findings 31. Manner of Death 32a. Date of Injury (MOnm, day, year) 32h. Describe How Injury Occunetl 32c. Place of Injury: Home, Farm. Street, Factory.
Pedormed? Available Prior I¢ Completion
^
^ Olflce Building, etc. (Specify)
of Cause of Death Nawral
Homicitle
^ Yes o ^ Yes .1x6
^ Accident ^ Pending Invesligalbn
32d. Time of Injury
32e. Inryry al Work?
321. tl TmnsDOrtation Injury (SpecityJ
3.!g. Location of Injury (Street city (town. stale)
^ :'~uiade ^ Could Not be Detemnnetl ^ Yes ^ No ^ Dover /Operator ^ Passenger ^ Pedeslnan
M ^ Other ~ Speciy: f--~
33a. Certiller (check only qnd) ~'' ' 33h. i nature
• CerldyNa} physician (Physcian ceditying cause of death when another physician has pronounced death antl completed Item 23) ~ _ 1P..
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fi the hest of my knowledge, tleath occurred tlue to the nausNs) antl manrr4r as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~~O
• Pronouncing antl cenitying physician (Physician bdh pronoundng death and certifying to cause of death)
To the heal of my knowledge, death occurred M the lime, dale, arrd place, and due to the cause(s) and manner as atatad_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 3'c. pi(' nse~~r•~ _ _„ ~ / . le Signed IMOntn d y, year)
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• Medical Examiner/COrorrer
On the basis of examination and / or investlgatlon, in my opinion, death occurred m
time, sate, antl place, antl tlue to the cause(s) arM manner as sated- ^ `
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34.
and Ad ress
ed Cause of Dealn (Item 7j Typ /Print
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35. Reglsvar's Signatur n District Numb /y''--' n / 36 D to etl (Mon day, year) ~
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V Disposilicn Permit No. ("~J ~,~~Y . 3
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
RENUNCIATION
Estate of HELEN E. HARTER No. ?-1' ~ R ' LG' ~ ~
also known as
,Deceased
The undersigned, son of
(Relationship) (Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters of Administration be issued to DOUGLAS J. HARTER
Witness my hand this 23rd day of June :?008
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Sworn to or aff+rmed and subscribed
before me this ,~.?,~ day of
(Address)
{Signature)
(Address)
COMMONWEALTH OC~ PENNSYLVANIA
/~J~.,w ~l r, v y Notarial seat
/ li..e_.f~i~ ~i~~C~ ~E. Petrie, Notary Public
P Bono, Da County
NOtary PUbIIC ~ MY Canmission Expires Jan.27, 2049
My Commission EXpIreS: ~~ ~~Q ~ Member, Pennsv±vania t~su,~l:~flon of Notaries
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
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(Signature)
513 WEST BROAD STREET APT. 703