HomeMy WebLinkAbout07-31-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estateof_ Richard W. Lichtel
also known as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
Deceased
File Number ~ ~ ~ ~ 6~
Social Security Number
rv
A. Probate and Grant of Letters Testamentary and aver that Petitioners} is /are the ~ named in the
last Will of the Decedent dated and codicil(s) dated ~-" ~ :` ; ==
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(State relevant circumstances, e.g., renunciation, death of executor, etc.) ~`~ %` Y -
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Except as folllows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of~i4eanstrum:,rt~s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: -, -~
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B. Grant of Letters of Administration
(Lfapplicable, enter.• e.t.a.; d. b. n. c. t. a.; pendente liter durante absentia; durante minoritate)
Petitioner(s) after a proper search has 1 have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (l/~
Administration, c. t.a. or d. b. n. c.t.a., enter date of Will in Section A above and complete list of heirs.)
Beverly G. Lichtel Spouse ~ 118 North 26th Street Camp Hill, PA 17011
(COMPLETE [NALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
118 North 26th Street. Camn Hill umberland ounty PA 17011
(List street address, town/city, township, county, state, zip code)
Decedent, then 60 years of age, died on September 21, 2007 atHarrlSburct HOSAltal, Harrisburg,
Dau~~hin County, Pennsylvania.
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 PA) Personal property in County
Value of real estate in Pennsylvania
$ I~ZCD,Pc~
$_ 3~t O~tapo<~
situated as follows: t~:3 to{e~CSf"t ~ fry (es~o~'~G l ~ 1.k2~rn~ hoc: n'{-~ t 1~3 "tt_.a''CS f ca`Jt ~ ~ ~~/
den t 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 appropriate form to
the undersigned:
1 s nat re T ed or rinted name and residence
~ / Beverly G. Lichtel, 118 North 26th Street, Camp Hill, PA 17011
Form RW-OZ rev. 10.13.06 P2ge 1 Of 2
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 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 the ~ ~1 _ day of
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For 'the Register
S`isffature of Personal jkpresentative _ -
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Signature of Personal Representative
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Signature of Personal Representative -.... 1 LJ - `
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File Number: a ~ Q
Estate of Richard W. Lichtel ,Deceased
Social Security Number: ~ n , _ ~ F, - 4 G fl 4 Date of Death'Seotember 21, 2007
AND NOW, , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby ;granted to Beverly G Lichtel
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
Register of-W- ills/
Letters .. ,~1 ~ a~ .... $ ~~ l~V~'
Short CertilScate(s) ........ $ Attorney Signature:
Renunciati >n(s) .......... $ Andrew C. Sheely, Esquire
C ) $ / t) Attorney Name:
... $ ~ Supreme Court I.D. No.: 62469
$ Address: 127 South Market Street
... $
$ P.O. Box 95
' ' ' $ Mechanicsburg, PA 1701
... $
• • • $ Telephone: 717-697-7050
... $
TOTAL .............. $ /OS--__ _ ~
Form RW-02 rev. 10.13.06 Page 2 Of 2
!n5so; ttra rft4nril
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 13858792
Certification ?~tumber
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly tiled with me as Loca{ Registrar. The original
certificate will be forwarded t~ the State Vital
Records Office for permanent filing.
Local Registrar ~ Date issued
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REV ltnoo6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
PRINT IN
,ANENT CERTIFICATE OF DEATH 'U1
..K INK (See instructions and examples on reverse) ~ ~ ~ ~ ~~~ ~ 1
STATE FILE NUMBER
1. Name of Decedent (Fast, middle, lest, sulAx) 2. Sex 3. SodN Security Number 4. De of Death (Monet, day, year)
Richard W. Lichtel Male 205 -36 -4084 ~ it?~1'
5. Age (Last BirAday) Under 1 year Under 1 de 6. Data of Birth (Monet, day, year} 7. Birmplace (Clry and slate or lorei cam ) ea. Place of beam (Check on one)
14xaa DAYS Hourm kfiwl6 Hospital: Other'
60 Yrs. October 19 ,1946 Danville , Pa Inpatient ^ ER !Outpatient ^ DOA ^ Nursing Home ^ Residence ^Omer - Specity:
6b. County of Death &. Ciy, Boro, Twp. M Death Bd. Fedfiry Nema (II rpt iratAudon, give street and number} 9. Was Decedent of Hlspenk Origin? No ^ Yes 10. Race: A
m
erican Indian, Black, White, ek.
Harrisburg d~
ry
(Ayes, speciy Cuban, (S~ Wnl t e
Harrisburg Hospital Mexkan, Puerto Ricer, etc.)
11. DecedenCS Usual Ilon Kits of work tlone du ~ most of workin M1le. Do not state retired 12. Was Decedent ever in me 13. Decedent's Educatkm (Spedty only highest grade completed) 14. Martial Status: Msmed, Never Merced, 15. Surviving Spouse (II wile, give mavden name)
Kintl d Work Kind of Business / Indwtry U.S. Armed Faces? Elementary I Secondary (0-12) College (1.4 or 5+) Wldo'w~, Drvorcad (Speuty~
n'cs r cho 1 ^Yas ~k"p 4 married Beverl Nicholson
16. Decedent's MeilMg Atldresa (Street, city /lows, state, zip code) Decedent's Did Decedent
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Pa Li
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18 N~rr
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Actual Residence 17a. Sate
n a 17c. ^r-~Y~e~s, Decedem Uved in
DecedentLivedwithin Camp Hi Twp.
Cum rand T""mh'p? T7d.L9uvp
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ounty Actual Umits of CdY f gpm
16. FaDwr's Name (First, midde, IasL suffix) 19. Mother's Narre (Flrst miDde, meirlen surname)
L.Ward Lichtel Kathr Reese
20a. mSamant's Name (T !Print}
Beverly )chtel 20b. In n s Ilm ADdre ( t fawn slate, zip coda)
~~~i~ort~b~.~ Street Camp Hill, Pa 17011
21 a. Memad of Disposition ^ CremaAOn ^ DonaAOn 21 b. Dale d Disposition (Monet, day, year) 21c. Place of Dieposilbn (Name of camels cremat
ry, Dry or Deter place)
21d. Loratlon (City 7 rown, state, zip code)
Bartel ^ Removal tram Sate ;Was Ctamelion a Donation Aultadzed
^ Other-Specify: ~ byktedlcalExaminer/Coroner? ^vea^Np
September 26,200 f
St John s Cemetery
Shiremanstown,Pa
22a. signs Furrerel S ~ Uansee «person acting each) 22b. license Number 22c. Name ant Address of FadAty 1903 Market S tree t
~ 011654-L Myers-Horner Funeral Home Inc Cam Hill Pa 17011
Complete A c oNy when g 23e. o the bed of my deem oa:uned at me tlmePDat -place smtm. (Signature ant AAe) 236. Lcense Number 23c. Date Signed (MOnm, day, year)
phyeidan u ml available at Ama of death to
CBnity Caused death. ~- ~. ~~ ~~ //// 1
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Items 24-26 must be wmpleted M p,rson 24. Time W Deam ~('''
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' 25. Da ronaxtced Dead (MOMA, day, year)
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~ 28. Was Case Referred to Medical Examiner /Coroner for a Reason Omer than Cremation or Donation?
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who pronamces deem. M.
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CAUSE OF DEATH (See Inabuetlona d examples) I Approximate interval: Pan II: Emer dher SI1MfiC9M rxxrdtiona conhibuAno to deem, 26. Did Tpbearo Use CoMnbute to Deam?
Aem 27. Pan I: Enter tM cheki d events -Diseases. kyunes, «mmpkaliau - Mal dracdy cawed Are deem. DO NOT enter temknal events such as cardlec arrest r Onset b Deam but nd resugktg to me undedyirg cause given m Pan 1. ^ Yes ^ Probably
respkatory anesl, or ventrkular AbrlNatkn wiltaut showing the aaoVogy. List Dory one caws on ettfi kite. ~
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^ No ~, Unkmwn
IMMEDIATE CAUSE (Kral disease or
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mnAbon reaullin9 m deem) -~ a _ _ j 1 s ~1 "'~-v y~- ~ C.- f r~~-v K./ ~ ~ ~ L~ ~ ~
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~~ 2s. A Female:
Dw to (or aq4s a// consyeq,.u~ence o[p: .. i
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nant at time of tl
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a. Dw to (or as a con
Enter the UNDERLYING CAUSE sequence of): ~
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^ Not pregnant, but pregnant within 42 days
(disease « inplry mat inNel¢d he o r
events resuPong In deaM) LAS. r ~~ /'Y _~)/K~`..T! C4 of death
Due to (or as a consequence op: r
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'~c'~ ~ r `" ~ 3 ^ Nol pregnant, bN pregnant 43 days to 1 year
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n d pregnant within the past year
30e. Was an Autopsy 30b. Were AWq>sy F'rtdinge 31. Mercer d Deam 32a. Date of injury (Monts, day, year) 32b. Describe How Injury Occurred 32c. Place of Injury: Home, Farm, SreeL Factory,
Perbrmetl? Available Prior to Completion
^ Natural ^ Homicide OAlce Builtling, etc. (Specify)
d Cawe d Deam?
1
^ Yea ~TCI No
^ Vas ^ N° ^ AcdtlaM ^ Pendng Inveskgetkm 32d. Time d Inryry 32e. Injury at Work? 321. II Transponatlon Injury (spac,'fyJ 32g. Locatbn of Injury (Sheet, city I sown, stale)
YYY~~~ ^ Suidde ^ Could N« ae Determined ^ Ves ^ No ^ Driver / Operat« ^ Passerv~ar ^Pedestdan
M Omer - Spscity~
33a. Certifier (dreck onM onej
• CalMlying physiclen (Physitien certilyklg cause d Deam when anaher physidan has prerounced death and axnpletetl Hem 23) 33b. Sgnature ant TNeaH I
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To H1e heat d my knowledge, deem occurred due to Ale cause(s) end mantlar as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
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• Pronouncing end nrmlitn9 physkian (Physidan bom pronouncing death ant ceMtying to cause d deaM)
To the hest of my knowledge, tlealn ocourtsd at the Ilme, dale, eM Place, and due to tM cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~
• Medlcel Examiner I Cooney 33c. License Number . - 33tl. Dale Signed (Month, day, year)
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On me baste of esaminrnlon and / Cr invesngetion, In my oplnlon, death occurred at the time, date, and place, and due to the cause(s) and manner as sMted_ ^ 34 Name ant Address oI Pereo Who Compl//ete//d Cause of Dee he 27) Type/ Priyf ~'
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