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HomeMy WebLinkAbout08-27-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of JAMES M. HARTY also known as Deceased Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or'B' BELOW.) COUNTY, PENNSYLVANIA File Number ~~ U~ ~ O Social Security Number 342-20-7681 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the teamed in th_e_ last Will of the Decedent dated and codicil(s) dated G"~ ~~~ - ~~ -r „ i (State relevant circumstances, e.g., renunciation, death of executor, etc.) - - ~„_,: - _, Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of3rt~ ixtrst31tment~sj offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~;-~ ®/ B. Grant of Letters of Administration 'U (If applicable, enter: e.t.a.; d.b.n.c.t.a.; pendente file; 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, e.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Relationshi Residence CAROL D. HARTY DAUGHTER 429 GRUBB ST., MIDDLETOWN, PA 17057 DR. JAMES R. HARTY SON 1609 BUCKINGHAM RD., HARRISBURG, PA 17111 SUSAN H. GUASTELLA DAUGHTER 2131 UNION, LAFAYETTE, INDIANA 47904 (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at BETHANY VILLAGE, 325 WESLEY DRIVE, LOWER ALLEN TOWNSHIP, MECHANICSBURG, PA 17055 (List street address, town/city, township, county, state, zip code) Decedent, then 78 years of age, died on JULY 28, 2008 at 325 WESLEY DRIVE, LOWER ALLEN TOWNSHIP, MECHANICSBURG, PA 17055 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 13,000.00 (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 Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: ~1 :t Si ature T ed or rinted name and residence ~ CAROL D. HARTY, 429 GRUBB STREET, MIDDLETOWN, PA 17057 t Form R61! U2 rev. 10.13.06 PagO I 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. ~i Sworn tc or affirmed and subscribed l Signature of Persona[ Representative before me the _ a~ day of ~ ; !1 /01f~ spa Signature of Personal Representative ~'j <'=~~ _ c:~ - -¢ ~ ~~' .~ ~• - For the Register Signature of Personal Representative - ,_: r-- c: l . __ _ ~' , _ _..'. _._ :~ File Number: - '"~ •- rv - Estate of JAMES M. HARTY ,Deceased Social Se rity Number: 342-20-7681 Date of Death: JULY 28, 2008 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 CAROL D. HARTY in the above estate and that the instrument(s) dated N/A described in the Petition be admitted to probate and filed of reco d as the last 1(and Codicil s)) of Decedent. FEES Letters Q Register of Wills Short Certificate(s) ...°?... $ g Attorney Signature: Renunciations} , a....... $ ~D .. $ s ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ Attorney Name: THOMAS E. FLOWER Supreme Court I.D. No.: 83993 Address: 2109 MARKET STREET CAMP HILL, PA 17011 Telephone: 717-737-3405 For,,, Rw-oz rev. /0./3.06 Page 2 of 2 105.112 REV. 1/05 WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR (FEE FOR THIS TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. cERriFicnrE ss.oo~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS LOCAL REGISTRAR'S CERTIFICATION OF DEATH ~~~p~SN OF pFtiyt ll ~~~ ~c~J~ ~~ '~% /vi qa~ CEIRT. NO. T 6 2 0 ~ ~ ®® ~rFyoA\`~ ~ ~'-.' ~sj' 7- - ~+ q ~ P~~ Dale of Issue of This Certification Name of Decedent JAMES M • HARTY Frst Middle. Last Sex MATE Social Security No: - 342-20-7681. Date of Death 7-28-08 Date of Birth 2-04-30 Birthplace ILLINOIS Place of D~eathBETHANY VILLAGE 'RETIREMENT CUMBERLAND LOWER ALLEN TWP Pennsylvania Facility Name .CENTER County Ciry, By,©u9n o, Township Race WHITE Occupation SHEET METAL WORKER Armed Forces? (Yes or No) YES Decedent's Marital Status WIDOWED Mailing Address 429 GRUBB STREET MIDDLETOWN PA Number StreeF C!ty or Town State informant . CAROL HARTY Funeral Director BRENDAN J . McGLONE Name and Address of .Funeral. Establishment __ COBLE-REBER FUNERAL HOME, LTD. MIDDLETOWN PA Interval Between. 'Part I; Immediate Cause ; Onset and Death (a) INANITION (b) ADULT: FAILURE TO THRIVE lr.l SENILE DEMENTIA, ALZHEIMER ` S TYPE ~-3 ~ ~_ Part II -, (d) - i0ther Signi#icant Conditions a,, =~ :~. .+-' m ~ - ~« ` . ;t Manner o~f Death Natural ^K Accident Suicide ^ lj~ J "~_:~ ZA Describe how injury occurred:, ~~_.:: _~ Homicide ^ - tv Pending Investigation ^ --- Could not be Determined ^ Name and Title of Certifier JAMES R . HARTY, M . D . Address . PO BOX 168 HUMMELSTOWN (M.D., D_O., Coroner, M.E.) This is to certify that the information here given is correct y copied from an original certificate of death duly filed with-me as:Local Registrar. The original certificate will be forwarded to the Staite Vital Records Office for permanent filing. 36-338 oca7 Registrae of Urtaf Records DistricE No. 7-28-08 25 IRIS CIRCLE ELIZABETHTOWN Gate Received by Loca! Reyistrar Street Address Clry. Borough. Township ~'.. w ~ ~~ l~ ` ~ RENUNCIATION : ~ ~ ~ t (_C] G~ . !Tl (~~ i - -- --- ,~ REGISTER OF WILLS -' <"~ ~ ~ CUMBERLAND COUNTY, PENNSYLVANIA ~ ==, ~ _ --~ .. _ CV Estate of JAMES M. HARTY I, SUSAN H. GUASTELLA (Print Name) DAUGHTER AND HEIR Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to CAROL D. HARTY 8 2 0 , 2oog (Date) (Signature) 2131 UNION STREET (Street Address) LAFAYETTE, IN 47409 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills FormRW-06 rev. !0./3.06 Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes s ted within on this 2D'~'' day of n ~~~~s.~,af ZDOR Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) ~~~ cr~re ¢ OFFICIAL SEAL r DANIEL R. FLEMING ~ NOTARY PUBLIC-INDIANA TIPPECANOE COUNTY ~ ,.,. ~ My Comm. Expires 1a2a2008 RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of JAMES M. HARTY I, JAMES R. HARTY (Print Name) SON AND HEIR ~_: F~ -~~ c~ ~~ - ,a _~ xF- ._~-, ,-- ~_ ~_~ ~_ ~ r-- ' ~ r~ tv `'ji.` ~ > =~ ' -'`n -~ -~ ~ -- y. N . Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to CAROL D. HARTY 0 ' ~ ~ , 2008 (Date) Executed in Register's Office Sworn to or affirmed and subscribed before e this fi-~' dpay of , ~~• ~. (Signature) 1609 BUCKINGHAM ROAD (Street Address) HARRISBURG, PA 17111 (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunc'at~ n for the purpo s stated_}'~'ithin on this ~ day of ~~41 td~l: '.JQ Deputy for Register of Wills Form RW-06 rev. 10.!3.06 ~~~/i~,, Notary Public My Commission (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) ~~ ~N. NINA M FERR11 Notary F~~LiN~c NNOIIEHANNA 1WI.JIN~IATA COIMfII- My Commbdon Eatp~N Mater 21. ZOt 1