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Home My WebLink About07-18-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of William H. Burdick, Sr. File Number 21-08- `~ ~(. also known as ecease Social Security 067-20-6784 Petitioner(s) who is/are 18 years of ase or older, apply(ies) for: [ ] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the last Will of the Decedent dated and codicil(s) dated (state re evenat ctrcumstances, e.g. renunctatton, eat o executor, etc. Except as follows, Decedent did not marry, 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 killing and was never adjudicated an incapacitated person: [X] $. Grant of letters of Administration (If applicable enter: c.t.a.; .n.c.t.a.; en ente ite; airante a sentia; atrante miooritate) Petitioner(s) after a proper search haslhave 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.) 1V ame xeiauonsnl tcesiaence an a re~man au ter rm oa ar is e, Charles E. Burdick Son 270 Green Hill Road, Newville PA 17241 William H. Burdick, II Son 197 Big Spring Terrace, Newville, PA 17241 COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last principal residence at 3286 S rin Road Carlisle, PA 17013 Middlesex Townshi ( is1 street a ress, town city, towns ip, coamty, state, zip co e) Decedent then 79 vears of age died on 7/1/08 3286 Spring Road, Carlisle, PA 17013 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) (If not domiciled in Pa.) (If not domiciled in Pa.) Value of real estate in Pennsvlvania situated as follows: Dc~ O, 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 a ro riate form to the undersisned: ,.-, isnature voe or armte name an ress ence ~" '" 3286 S rin Road, Carlisle, PA 17013 \J ,~ - J4 ~ ~ ~ ~~ Charles E. Burdick 270 Green Hill Road, Newville PA 17241 /~/~. G ~ cIJC;` i.-.r •~--~ ~ ~ ~'l~-}~(' ~.~_~~ William H. Burdick, II 197 Bie Snrin~ Terrace. Newville. PA 17241 ~ ~ ~~ !~= r ~ `~ ~ ~ ~-.. 3 .~` Page 1 of 2 OATH OF PERSONAL REPRESENTATIVE COMMONWEATLH OF PENNSYLVANIA CouNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and torte 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_ Sworn to or affirmed and subscribed before me this I ~~~` ~~l..t_I ~ ~Q~_ ~ ~ ~ For the Register File Number: 21 ~ O ~ ~~ L.Q, I ~..~ ~ ~~ Estate Of William H. Burdick, Sr. , Dec -v ~ rte- Social Securit Number: 067-20-6784 Date of Death ' `' ~' ~ y ~. ~ ~ ~ Jul~;1, 2008 ~o~ -e cam=- ___ AND NOW J,~,llLa I $ , 20~in consideration of the Petition, sati~etory ptt'6'of having been presented before me, IT IS DECREED that Letters of Administration p~ are hereby granted to Tanya M. Greiman Charles E. Burdick William H. Burdick, II in the above estate and that the instrument(s) dated described in thte Petition to be admitted to probate and filed of record as the las Will (and Codicil(s) cf_Decedent) 1 ~Q,~ FEES Letters ~-n , fl~ Signature Attorney Name Register of Wills ~,r- Robert G. Frey Short Certificates ZCj. 00 Sup. Ct. LD. No Renunciation ~,t-~p • rj, ~p Address: J C.P lam. o-o TOTAL... ~~ , Q~ 46397 5 South Hanover Street Carlisle, Pennsylvania 17013 Telephone: (717) 243-5838 'P Page 2 of 2 William H. Burdick, II 111,<.,vn5 Ric ~nt'II^I LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.00 ~ 14649054 Certification Number e!} ~ Q . M _ ~~.-° ~ ` _ IJ.J ~ J ~ C`` J rJ~-u; ~ C..: o~ v ['his is to certify that the information here given is :orrectly copied from an original Certificate of Death Iuly tiled with me as Local Registrar. The original ;ertificate will be forwarded to the State Vital Zecords Office for permanent filing. A • ~e,.~c~ J~dL 1 / 2008 .~ocal Registrar Date Issued D I M11p-1d3 REY 112006 y, .~ 2 5~,~ ~ ~ COMMONWE TH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE /PRINT IN ~,,, 1 ~ ~h-._ ^' PERMANENT Ti' 1 CERTIFICATE OF DEATH BLACK INK \ 0 ~ ~~ ~ ~ G '1 ~ d~ C ry. ~ See instructions and exam lee on reverse ~ .~ ~~ ~ ~ r ~e~ b' ( P ) STATE FILE NUMBER 1. Name d Decetlera (Feel, midde, 1x51, sullix) 2. Sex 3. Social Security Number d. Date of Death (Month, tley, year) William H. Burdick, Sr. M 201 - 10 - 0174 July 1, 2008 5. Age (Last Binhtley) UMer 1 year U«br 1 day 6. Date of Binh (Month, day, year) 7. antpba (City eM stele «toreign country) faa. Place of Deem (Chad only one) Mmlm Days Hours MI',Nn Hosplbl: Omer: 79 Yrs. 12 19 1928 Johnson Clt A1Y ^mpatienl ^ER /Oulpelbm ^DOA ^NUrsing Hame L2g Rasiderrte ^Other-Specity: 9b. Counry of Deelh &. City, Boro, iwp. of Death M. Facility Neme 111 not instilulion, give street aM number) 9. Was DecMenl of Hlspank Origin? [~Na ^Ves 10. Race: American Indian, &azk, While, etc. (If yea, speciN Cuban, (Spedry9 Cumberland Middlesex 3286 Spring Road Mexican, Puerto Rican, eta) White 11. Decedents Usual Octu Iqn KIM of work d one duM moll d wo ' Ida. Do ml stale retired 12. Was Decedent ever in the 13. Decetlenl's Edualbn (Specify only highest grade comp latetl) 14. Marital Status: Married, Never Martiad, 15. Surviving Spo use (II wife, give maiden name) Kkd d WoA KiM of Business I IMUSIry US. Armed F«ces? Elementary 1 Secontlary (0-12) College (1-4 or 5*) WldowM, Divorcetl ISpecry) lectronics En ineer Electronics ^Ye5 ®Na 4 Divorced - 16. Decedent's Meazlg Address (S1reeL dY /Town, stale, tip coda) Decedent's Did Decedent PA Live in a na Da nom L1yee m Middlesex Tw ®ves A t l R kk a n Si l p g 328 6 S rin Rd. p. . , ua es m e. a e c Townsnp? 17tl. ^ Na, Deceent Livetl wknin m Clmiberland c t7b Carlisle PA 17013 oa y . Adaal urdla of city/BOro 16. Father's Name (First, midde, last, su6ix) 19. Mother's Name (FIrsL middle, maiden surname) William C. Burdick Margaret A. Brant 20a. Inlormanfs Name (type I Print) 200. Infortnanl'S Melling AMress (Street, City I lawn, state, Zp rotle) Tan M. Greiman 3286 Spring Rd., Carlisle, PA 17013 I 21 a. MethM of Dbposition ~{Cremefion ^ Donation 21 b. Date of Dlsposilbn (Month, day, year) 21 c. Place of Disposition (Neme d cemetery, crematory «dher place) 21tl. Location (City /town, slate, zip cotle) ^ ^rBusn~^ RemovellromSlale byaMetlrkeltExamMerlCOOronx7~d~[fives^No 7~2~2008 Evans Crl3nation Services Leola, PA 22a. Signalise d F ~ Licereee (« person I 220. license Number 22c. Noma aM Address of Facildy - FD 012633 L Ewin Brothers Fluieral Home, Inc., Carlisle, PA 17013 Complete Items 23ac anN when ceralyirg Dnysidan h not avaibbb al erne d Oeelh to 23a. To are bell d knowledge, occur el de lima, tlale aM DI l_ase^d. (Sgnalure eM tale) ~ ~ y / 230. Ucame NumOer 23c. Dale Signetl (Mon1h, day, year) '~, ]7 rj ceniN cause d dale. ' ` ~~~ ~ ~ ~ ~ ~ ~ - V 3 Items 2126 must be Campbletl M pers«r 24. Time of Deam C . Date Prerpunced Dead (Momh, tlay r) /~ ` 26. Was Case RefarrM to al Examiner / Canner for a Reason OMer than Cremation ar Donation? ~.. who pmrounces death. Q. us ~ • M. ~. I - V 5'~' a O V~ ^ Yes CAUSE OF DEATH (See inatructlona and ezemplea) I Approximate Interval: Pan II: Enter other sbnificanl conditions canlnhltlire to deem, 2B. Did Tobacco Use Contribute b Death? Item 27. Pan 1: Emer the dMhl d events -diseases, injuries, «comDlMalions - mat tliredy ausetl Me tleath. DO NOT enter larmlrel even6 such as Niac arrest, Onset b DeaN but not resulting in the underlying cause given in Pan I. ^ Vas ^ Pmbabty '~.. respiratory enasl, a ventncuL r fibn///l~~ylati«t wahoul 9howing the 9lidogy. List arty ono cause on each line. ^ No ^ lMknown IMMEDIATE CAUSE (Fires dse ' a. ~ ~ ~~ /~p_ /y m ,) a ~ ~ / (') ,y , I ~~ ~ I ' A' //T' ; cadapn resuarcg in deem) L~IU 1 L :J S (, 8(•~ V " ~"r/~ 29. If Female: ^ Due to (or as a consequerke oq: r ~ r " Nol pregrem wimin pall year ^ Pregnant al erne of tleath SequeaivN list wMitbns, it any, b. I ,~ y.f (fi ~..y~ ~ badsrg m the cause Ibtetl an line s. Due to for as a mn e d n I Ent me UNDERLYING CAUSE ~~ I~ / ~ j~ ^ Not pregnant, WI pregnant wilhb 42 days ,.I I, p ) 1 '71 ~~~ ~dseaze a inryry Ihal inaiatetl the a (~ /r l tj 0 [~ }~{yv Ci"( )J ~ yJ S ~W f'"~i ~~ Y fi7"Y )~ b resuldr n aeaml usT of death g . Duo to for as a conseguerla ^ Not pregrent, but pregnant 43 tleys l01 year d. before tleath ^ Unkrwwm a pregrem within are past year 30a. Was an Aulapay 30b. Ware Autopsy RMrgs 31. Me Deem 32a. Data d Inury IMOmm, day, year) 32b, Describe How Inryry Occumetl 32c. Place of Injury: Hama. Farm, Sbeel, Fad«y, Perlomed? Available Prior b Compblion of Cause of Deem? NeNrel ^ ~~ Oaice Buildng, dc. (Speciryl ,~ / ^ Ves O ^ Vas ^ No ^ ~~1 ^ PerM11g Investigatgn 32d. Time of Injury 32e. Injury el WoM? 321. If Transponadon Inlu7 (SPAN) 32g. LoCalbn d Iniurv (Slree1• city /town, sbla) ~ ^ Suidde ^ Codtl Na be DetemlinM ^Ves ^ No ^ OrNer I Opereta ^ Passenger ^Pedestrian M ^Omer ~ SDedly 33a. CerAfier (mad anty one) • Certllykp phYSkian (PhYSwran aniying cause of death when another pnysidan has Ororxxtrced deem aM completed Item 23) 33b. Signature aM TAIe of Cadaier . ~ To INe beet of my knowbdge, tlaeM ocamed due to the auae(s) end manner ee afNe1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , - ' • Pronouncing and anitying physician (Phys'lcbn both proroawing dea!h antl ceNlyng la cause d death) ^ 33c. License bar 33d. Date Sign (Month, day. years ' io IM heal of my krewlatlge, tleath occurred at Ma Uma, dale, aM plea, antl due to Ile cause(s) aM manner es sfated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medial Examiner/Coroner {Yl 6'tl ~ } 7j ~ b ~ ti ' On the basis of examinat io n aM I or invesllgaaon, in my opinion, tlalh accurted al the lime, tlete, arld pbca, and tlue to the cause(s) antl manner as sbted_ ^ ~d Name aM A res9pl Per n Wno Comple Cause of DeaU Illem 2]) Type / Prin t f ~ ~ / ~ 36. R ' t 's S'lgrewre DislrlFr rv(urlber *', . !" 36. at FiIM IMOnIh, day, Year) i ~ y ~ . a mom.. C ' ~ ~~ 7 i~ - 4~• ~G.LCk~ I~. I 1 la. I ~ 16 I l.C-~ ~kr iM1 • ~ 1 o Dlsposilion Perna No. ~a+~C71