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HomeMy WebLinkAbout09-17-08PETITION FOR PROBATE AND GRANT OF LETTERS REGIS~R OF WILLS OF ~_~x~1~.~1 ~ COUNTY, PENNSYLVANIA Estate of ~p N (a ~,~~(~..~ N-r- p ~ File Number O~ ~ -~ ~R- O~ 7 also known as Deceased Social Security Number ~ 1 ;) - JS~ 5 C~~, 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 Will of the Decedent dated and codicil(s) dated (State relevant circumstances, e.g., renunciation,l~ death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after for probate, was not the victim of a killing and was never adjudicated an incapacitated, person: B. Grant of Letters of Administration "~ (Ifapplicable, enter: c.t.a.; d.b.n.c.t.a.; ~endente lire; durance absentia; dur~te minaritate) .... Petitioner(s) aftet• a proper search has /have ascertained that Decedent left no Will anc~ was survived by the following spouse (if any) a d heirs: (If ' Administration, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~~0-3 i?o58 (List sheet oddness, sown/city, township, county, state, zip code) with his /her last principal residence at Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal prop,lerty (If not domiciled in PA) Personal propert}~ in Pennsylvania (If not domiciled in PA) Personal propertyl, in County Value of real estate in Pennsylvania situated as follows: named in the >0 ~ - 1 ' ,,~® 1 ~ ~ rumeatEs) offered , - $ ~ ~(Jd. w Form R6V-0? rev. 10.13.06 P3b0 1 Of 2 (COMPLETE IN ALL CASES:) Attach additional sl:eels if necessary, Decedent, then .~ years of age, died on5~ I r~ 02 t Mf~Tj(b(('. C~ ~.~ ~-{ L}~•'~ 5-~I~ tC~ 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: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA ~~ ~~~ SS COUNTY OF ~/ ' 1,, The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con•ect to the best of the knowledge and belief of Petitioner(s) and that, as personal representative($) of the Decedent, Petitioner(s) will well and tnzly administer the estate according to law. Sworn to or affirm/ed and subscribed before me the I ~~ day of For the egister Signature of Signature ojPersaial Representative Signature ojPersonal Representative C7 sv ~ C~ 1 n ~ _ 1 ~ ~q~- ~G~r~ i `-~~~ "'tt ~~ SJ ~ - - D .. -- !V File Number: ~ I ~O9 Estate of n Q l -~" ~ 1 ~ ~ ~n ,Deceased Social Security Number: ~ 7 "~~A " ~ ~J Date of Death: `-'1 ` I V ~V AND NOW, ~ T ~ , c~(,/~ , in cons'~deration of the foregoing Petition, satisfactory proof having been presented before me, I IS DECREED that Letters lJ`F ~d ~ i n i strati ~ are hereby granted to _ QI' U - ~ rr~Obl 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 VI,7i11(and Codicil(s)) of Decedent. FEES Letters ............... $ ~V• Short Certificate(s) ........ $ , Renunciation(s) .......... $ ... $ $ ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ Register ojWills Attorney Signature: Attorney Name: Supreme Court L1~. No.: Address: Telephone: Form RW-0. rev. IOJ3At; Page 2 of 2 ~nc snc vc~- ~m w"~ - - LOCAL REGISTRAR'S CERTIFICATION OF DEATh# WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 1480637 Certification Number ,,em/"""""~--- This is to certify that the information here given is N,apay,r_.~1'~.p\TH OF pfy'yf- correctly copied from an original Certificate of Death l duly filed with me as Local Registrar. The original ~ _ ~ a certificate will be forwarded to the State Vital Records Office for permanent filing. *' v ~~ O T'A'.` _ ~ ~ ~ ~ _ - ' '~ 99ja1ENT OF~~~'°~1 SE 1 Y 2008 ~~""""""~~ Local Registrar Date Issued c cr a' C~ ~ ~ cn rT; ~'-. ~ n C"~ ~~m 'L3 L ; ,~~ ` ~ - ~ , J - C ~ ~ ~ ~' _ , N H10S143 REV 11/2008 ' rYPE/PRbeT IN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT F HEALTH • VfrAL RECORDS - eLAcNwK CERTIFICATE OF DEATH (See inatructlona and examples on Iroverse) t. Nun d Da«darY (Hp, nid0e, rd, gaga) STATE FILE NUMBER Donald E. Brinton z'$B1 3'~s°°'"N"'"n6ef aDtleaoetlntMa,m,aeyyearl Mal 173 - 38- 5895 „~„ O s. Ape ttetl arob.r) Unax t Untler 1 a.y s. Dab a ei~m tMOnm, ,revel 7. Bi 1 and wre a can l s.. Prca d Dam Iclrck onl 60 Marry tre Hoe. "`'"° October 6 1947 "°'P"°' ~•~ rr. CarlislePA r - eb. ca,ey d Oeem ea cny Born, Twp. a Deem m. F Name Itt na I«nanion, ^ Inpetlenl ^ ER / a,petlent ^ ooA LrJNaraeg ran ^ Redderce ^olnar ~ Spedy: Cumberland r-' eN. etrM end nuroer) s. w„ Oecedanl a waa.do oripn7 Na ^ v„ tD. Race: anMCen Imo, Rrck, wnee, etc. S: Middleton Manor Care Health Services (Llaxnkenwerlo ~,ero.) t 11. DeaAeMe UMitl IDrd d wok can mctl a Xe. Do nd slate reHatl 12. wee Dendenl ever r tlr 13. DenderN'e EdteNOn (Speay ony t praa. caryrletl) 11. Medltl Salus Hurled Never Medea Whit e Ionaawoa ICFda / us amrdF Ermentery / Slea2aMery (0.12) ollepe (1 d a s. VlMoeretl. DNamed (Specr7y~ 15. SurAving Spouse (N mle, pre maiden nme) Laborer Janitoriauppl' s ^r„ araee ) • ,s.oenanreMeian(,Aaneaa(sn„tar/an.dare.:bcoael Widower Dendenl'e 430 First S t . Aawl Redd„n na. sue PA L°"waDee°°m nc. ^ re:, oenaara ue.e n Carlisle 17013 „b.c„e„y um er an I T0W"e"P? 1e. pa,N~~ Carlisle rwp te. Fu,ra Name tFN.c mMae, raL ,a1y,1 Aclutl umu of ~, / eom Leroy H. Brinton 18'"'°"'°fe"'""1 rd, mtlDle, maaen wmemel aro~lPaa Dorot y Myers 2Da. Iamnua'e Nun Mary L. MOppin 2ro.mromrnre ~ Aedeee t51ae6 dN/town, arr,i coda) 57 E.jLouther St., ~arlisle PA 17013 21a. Manna a Depnl6on ^Cremean ^ Danetlan 216.Oer d Diepoalaon (Haan, hy, year) 21 c. Plea of (Name d cemtl ® B«fY ^ Remove ham Slate Nra Crrrwlm « Dorraon AutlgHad wry, aarnlory a anx pace) 21d. location tciry / lam, data, dp Heel ^ °m"•~n'. brMedrelEaaakrr/C«onu7 ^r„p,a September 15 200 Cumberland Valley Mem. Gardens Carlisle PA 22a 5gWae a F Ia peaon utip„autlQ _ _ 22e.NemeuM,Wy„adFaany o man- of unera ome rematory ~ "~ ~~' 219 N. Hanover t., CArlisle PA 17013 Conprr Mne 23ec tidy wMn caaly:g 23a To tlr tad d my Maavhdpe, seam occurred tl me tlme, der mid pace sutra. (sipiehn end anal pHMdn Y M evule6r tl tlma d deem ro ~' \ 236. Lanee NuniMr 23c. Dols ~ aeaee d a.m. ~~t.r,' ~ i'~J ~ p sgne (Hawn, ear. r/ al N.me 2x-28 raml M anpldsd by persm 20. rn d Deem 25. oar Piarucaa Dana ~ ~~ ~ GD IS `~ (Ot ~~ IMmm, mn y„r) veto Pnraew a.tln. ~: CS M. ~ '~37n-FJF /vr ,~~)g '~.. ~~ p r~ ~R~y'~ Eremarer / canny a a Reagan omen men cremation «Ibnethn? Aan 27. PM I: Eau ih urn d manM _ CAUSE OF OEATH (Bee Inetructloro erM ~.empsy °4 deeeeea, MMre, aaenplntlen -YW derdy uaeea me d„m. W NOT ado rmfiw evsrir ouch ee wrtsc a ~ r kaarval: Pad II: Enrr ahar 2B. Dld iobeaw Uwe Contrkw ro Deem7 repa/~eFFyayyr emd, a veddaaer Poraeaon wpnaN dvuip dr albrpy lit any ale Huse m each ir. "'d ; ond.. o„m as nt reeauq in m. aMerlylnp non guar, In P.n~L ^ r„ ^ p,cb,yr r wIGIP n seem) ~ a r ~-yfo ^ thiMlown i e. ~ y +-/ Ciw~v. C ~/ r 29. II Femur: ad caiduar,e ~Y. p, ~~ 1 r -T_ ^ Na papvM wimF prd y„r b Cnre urea on it a. r ^ P Enter UNDERLTNiS G1UBE Due r (or„a aarequence aJ: ~ -_y_.__ nprm at an d awtn term. a eyuy art aYIWy ma ever,6 rarMiq n deem) LAST. c. t '.. ^ Nd I>teWm. ha gegrm witlan 42 deya Due to la„a nnasprrin al: a aam a. ', ^ Na Iae9nem, as pagrnl as aeye r t year i ' bees deem 30e. Wren Aulaply 306. weaAUrpy FMnBe 31. Mrvw a 32a. Dar d ^ UNUgwn N IaeYnen wMan tlr Pad year Pedanrd! AreYde Poor b CanplNkn _ / Mary lMmm, deY. Year) 326. Dawt6e How I~u~y' OccVred In~u d Cause d D„m? LFI'~had ^ NmadOe I ~ OMn dYldYp. eu. (SpseYyl ~' Pettey, ^ tee ^ roe ^ ~ ^ Aoddenl ^ PanunBlrnestlBaNOn Sze. ran a I nor Sze. Mar at woAP azt. rc r urn Iryay lsFaaryl 32p. Laaeon a l ^ sulcpe ^ caNa Na 6e Dtlenninetl ^ r„ ^ No ^ Dd"ef opna ^ I'eeeengar ^Pedaetrn Mary target ay/ awn, deal 93e. Car4rtdrek gayanl M. ~. ' De^tNaw pryeraart (PnyeNaen nMy6q ease d seem when erntner pndderi tw panaaiced deem uM ,~ /O ro we bed a my Nrrwledpe, seem ocaana sue b the urwete) eM nrrlnr„sEeled_ _ -- - _ - congletee Nam 23) ' ratMpp,aana ~MnY PM•rien lPhl'ddui bom piwruntlrq enm ens ouMy:g to aelredeeaml --------------------- mylorwrape,aaemoa«nanar~me,deg,tryp.n, ud anbur tetra yq ens msnnar„abre_-_-'-----'--'--'- ^ ~ 33tl. DUe ea tMoah, den ) • Meaktl Eaemarr/Cor«rr _lSq~' ~`O Dn ar MN. a.wnNrtwa ens r a Inwdlgeam m mr oparn, ae.m oeeurea et Ur tmr, der,.na pea, .m en ro ar awrgq anti mennx.. sulea_ ^ (fib (O ~ t T - L G{ c~r 31. Name Atlheu of are Wlp canprrQ used m 27) type / Print l.~ arvld~r t- ~Sarryg ~uistwi`~e, Dll.~': ~ !~-i. IaL I ~ lad I t I ~ I tle tMatln,eey,yeap I,56 Ashton St. , Carlisle PA 17013 ~, / Oiapoeltbn Pemel No. -==~ ~ ~ (~ RENUNCIATION GISTER OF WALLS COUNTY,I PENNSYLVANIA _D~D~I'~37 Estate of I, (Print N n c~ F"J ~ -z; . _ _ r~ , - _ ; `' -_' e ' V ~ ~ -~_ N ,Deceased ame) _ in my capacity/relationship as ~ ~`~' of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that T.etterc hP ;~~„P,~ *„ Executes in' Register's Off.•ce Sworn t© or=af~'u~ned and Sy~bscribed bef m tlai ~. ~'/~i day Deputy fo e ' to of Wills Executed out of Register's Office Befpre the undersigned personally appeared the party executing this renunciation and certified that ~e or she executed the renunciation for the purpjoses stated within on this day of Notary Public My commission Expires: (Signatµre and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 a ~.s~ ~~~ ,~;~ ~ (Strut Address) Ud1~~,~v. ~~ 1~7OS~ (Crty,iState, Zrp)