HomeMy WebLinkAbout10-13-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Michael C. Sharp
also known as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
COUNTY, PENNSYLVANIA
File Number _ ,~' (~ ~ f Cj ~ `~
Deceased Social Security Number
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of the Decedent dated teamed in the
and codicil(s) dated ~ ~ ,.: _a
J V
(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 of the ~nstxttmen~J offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - ---
--~
®/ B. Grant of Letters of Administration -~ r ~y
(If applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente life; 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, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.)
- --- xesraence
Ryan Shumberger son 49 Summerfield Drive, Carlisle, PA 17015
(COMPLETE INALL CASES.•) Attach additional sheets if necessary.
Decedent w s d micile at d ath in Cumberland Coun Pe}}nsylvania with his /her last principal residence at
rc rte r ~s e'_ ('~ w ~er(a~~ Ni¢ i 7e r ~
(Ltst street address town/crty townshrp county, state, rp code)
Decedent, then 54 years of age, died on September 23, 2008 at 313 Arch Street, Carlisle, Cumberland County
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 200 000.00
(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:
Si nature T ed or rinted name and residence
~~~~ Ryan Shumberger, 49 Summerfield Drive, Carlisle, PA 17015
Form RW-02 rev. /0.!3.06
Page I of 2
U
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 , ~j/r,~U/ 6~tn~%~l/I~
' ~ Stgn ure of Personal Representattve
b re e the __1 Q,____._ day of
~~-~ ~~
Signature of Personal Representative
~v
F~ the Reg, Signature of Personal Representative ~ `~
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File Number: --~•
r~~l -o~~U~S - I Q' t S ' -`~'
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Estate of Michael C. Sharp y- t~
Deceased
Social Security Number: 2~09-46-0080 ~~~~c Date of Death: September 23 2008
AND NOW, ~-1 ~ ~.C~l,~ O , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to Ryan ShumberQer
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 Wily (and Codic~(~)) of Decedent.
L FEES r~/
~- 00
(
etters ......... o
...... $ ~G
Short Certificate(s) .. w . , . $
Renunciati (s) .. ........ $
r
. $ ~• GU
... $ ~~
... $
... $
... $
... $
... $
... $
... $
TOTAL ....... ....... $ S, ~ -e-e~'
Form RW-02 rev. 10.13.06
Attomey Signature:
Attorney Name:
l "1
Taylor P. Andrews, Esquire
Supreme Court LD. No.; 15641
Address: 78 West Pomfret Street
Carlisle, PA 17013
Telephone: 717-243 -0123
Page 2 of 2
OCAL REGISTRAR'S CERTIFIC,r~TION OF DEATH ~~~ 101 S
WARNING: It is illegal to duplicate this cope by photostat or photograph.
Fee for this certificate, $6.00
P 148065 ~
Certification Number
This is to certify that (he information here given is
correctly copied trorn an original. Certificate of Death
duly filed with me as Local Registrar. The original
.crtificate will be linwarded to the State Vital
Records Office ii>r ITermanent filing.
a • ~@.a~~~a~D S_ 2 7 20~ N
r"Deal Registrar ~~ ~~' Date Issued
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TYPE! PRINT IN ~ _., --- ,
Htos.ta Rlsv nrzpos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS _
PERMANENT J ~~
BLACK INK CORONER'S CERTIFICATE OF DEATH ~"__.i
/131-359 (See instructions and examples on reverse) =~
1. Name a DeredaM (Rrsl mgme, last surly) STATE FILE NUMBER ~~
Michael C Sharp z. se. 3. sPCrel secuMy Namner
1 e 20 9 4. Data or Beam (bloom, der, years
S. AgelLaalBiMday) lKtdarlyear UMerlda flDaleaBkm(Mmth,day,year) 7a -46 -0080 September 23, 2008
kaalw Oam Nrawa Miw4. nhpmce (Cory and state a roei mmlryl Be plea a Death (check Doty ore)
54 yet February 6, Hospml. Omar
1954 Carlisle, Pa
aa. coaay of Daam ec. c' Rnm, w, a Deam ^ lnpaliem ^ ER / Ouryanenl ^ DOA ^ NumMg Home ®Rasidarma
~ I • nd. FaaNly Name (n nd immulbn, give slreM and number) ^Omer -;peat':
'" Cumberland s. was Deceaem or wapenic odgim ~NO vee
Car l i s 1 e OI res. aleay aeon. ^ 1D. Rau: amencan Inman, ltmcp whoa, em.
tt. Daceeer,ls uaaal ocm, Iron Kma of work done dada most a wona tiro. oo net area mmee t z. w 1 Decedent arehm m t rears Eeaurkn Meyican, Pueno Rican. ero.) (sv+aM
White
Klnd of Work Kind of Business /Industry U.S. Armetl Fwees? (SPaoiN oMy highest grade completed) 14. Mantel Status: Merded, Never Marred, 15. SurviNn
Database AdDdnistrator CoDCLnnvgP,al[h of PA Elemenmry! secotwary (o-t2l calege (1a or u) wigowed, Divorced (spec/rye s spouse (n w;re, sire maiden name)
ts. Decedanra MaiRrq Address (greet ay /town. stale, ap Dodo) ^ Yes ®No
Daoaaanrs Never Married
313 Arch Street Aaaal Residence na. able' Pecrosylvania Did ~eceeem
LNe m a 77c. ^ vas, Decedent LNed in
Carlisle Pa 17013 nb. coany Qmberland rowna^'p? Twp.
iB. Famets Name (R51, middle, m51, suniq 17d. [~ No, De adenl Lrved wnhin
Aaual Umim a Car1131e Cly / Bore
Jaares Sharp ts. Mothers Noma (Rmt mkkle, maiden samame)
20a. Inlonnanrs Noma (rype / Prinq Cdt11er1I1e .SIILith
Ryan Shtmberger zob. mmmmnrs Maalr~ Admesa (so-ea, ay I mwn, smle, zp coda)
21a. Method of Dispoaitlon ~aenenon 49 SLnmerfield Drive, Carlisle, Pa 17015
^ Donation 21b. Dale of poainon (Name of tamale
• ^ ^ r Bunn ^ Removal Irom Smle ;Wee Crametbn a Doretlan Aumodxed oepoannn (Monet, day, year) 21 c. Place of De ry, crematory a other place) 21tl. Location C' /town, stale, v aitle
' ; byMedkelEy.minarrCOrpe(! ®vaa^No Sept 28, 2008 Hollinger Funeral Home & Cremato (M P )
- ~ zza.~"a °fera~^^~ +++1 aaingassua,) zzb.LkenseNUmber rY ~• Mt. Holly Springs, Pa 17065
a - - FD-012909-L 22c. Name ant Address of FaaNly
Ronan Funeral Hare 255 York goad, Carlisle, Pa 17013
amplete z3a<oay wnen urmtdng z3a. T me heal or my knowle[Ige, loam orm,rree al me area, data and place:mead. Ispretam and tarot
physiaen is nal evallabM ar time a daeM to 23b. License Number
certlty cause a deem. 23c. Date Signetl (Month, day year)
Imma 2428 must ba oxnpaea by person 24. Tree of DeaM 25. Dam Pnaeurced peed Mmm, da
• who proreua;es deem 1 oAL1~X I y, year) 26. Was Case Reaerred to Medical Examter /Coroner for a Reason Other than Cremation or Donation?
~tff P M~ Se tember 25 2008 ®vaa ^No
Imm 27. Pen I' Enter me chain of eve m _ CAUSE OF DEATN (Sae inatructlona ant exemplea)
' diseases, injuries, ar comp6calpns -that dt+cny auead de Oealh. DO NOT abler IBrmirlal evenm.wch as wNiec armal, r Approyxnete interval: Pan II: Enter aher
respirerory erred, or renlnwmr fibnmlion wilMm showing the eoobgy. Ust Dray one cause on Bash ane. Onset ro beam but not msuM ~ ~ ~ 28. Dq Tabaxo Use Caandae to Deem?
ro tld~A~resAti g$E IFinal ~~ ar ng in ne uMedyirg cause given in Pan I. ^ Yes ^ Probahty
deem --~ Autoerotic As h ^~ ^unknown
is
a. Due b (or as a consequence oft: 29. n Female:
Sequeniaay list catdnons, n any, N. ^ Na preynem wimin pare year
Io ma uaae Iwea an and a.
Enter UNDERLYING CAUSE Due to (or as a consequence all: ^ Pregrent at tirre a deem
(~~saem&a oerAipjury that innialetl the
ng in deem) LAST. p~ ^ Na pregnant, but M
Due to (or as a wnsequeree off: Pregne waMn 42 tleys
a death
d. t ^ Na Pregnant nut pregraM 43 tlays ro 1 year
3qe. Was an Amopsy 3gb. Ware AuWpsy FiMangs 31. Mamter of Dean ' ^etare d++l^
Padomeda Avekbb Prgr to Complelbn 32a. Date d Iryury (Monet, day, Year) 32n. DescrMe Ffow Injury Occunetl ^ Unknown n pregnant wthin ma pant year
acaaaeaoaama ^Nawral ^Hmnioroe Sept.23, 2008 Hanging durin Autoerotic Activity ~a'moeolmtury.lime,Farm.greatFadory,
^ Yes ®~ ^vaa ^ No ~ Aalmnt ^ Penmrv Irwaangauon 3zd rma a lMay Sze In a at won? 321. n r g Grace ~~~. ac IsveaYrl Home
^ smme ^ coam Not ba Delertnired 10 : OOApMrx ^ veary rmsaamlron Iniun lsperary/ 32g. Lowlwn of Injury (great. ciy /fawn, 9atel
®w ^D~ OperelW ^Paaaengar ^Peeeaman Arch Street, Carlisle, PA
33a caroller (dted Dory one) soar",SgeaH:
D•NNring I>tyelaen (pny,tya„ un;I>1rq uasa a eeam wean anahar Mrsiden I,,, Prona,,,ud ream am 33b. spnamre and role of certihar
Tome east a my knowledge, de.m acumd eue ro He uue+(q end nenner se e+tad_ _ _ : _ completed Item 23)
• Pronouns end prtNyl^Y phytlclan (Physidan hdh rmourcin -'-"------------ -
P gdaemandceniynglocateaadsem) ___________ ^ Coroner
To tM Lest a my kmwkdge, seam occumetl at me one, dale, and plea, and due ro me 33c. License Number
°w aNdlgl EnminN I Comer oeuega) and manner u emtetL" _ _ _ _ _ _ _ _ _ _ ^ 33d. Dam Sigr:ed (bloom, daY. year)
On the base a examlalton end / a Investlg+Hon, in my oplNOn, deem oaurrea at ne Hms, date, and plea, and due ro the _ - _ _ _ --
aaaq+Jenamanner++ahro0_ ^ Se tember 26, 2008
~ ay. Reg. r sigrmtura a{~,~p~~ N tuner {~ 34. Noma and aadmas al Persm woo camplamd caaee a Deem (nom 271 type / pore
a - • •, C,)1„-_••LL Fikd(Monmtlayyea) Michael L. Norris, Coroner
~"l~ Icy I I I r~ I I I n I 6375 Base}LOre Road gg iito ;all
Mec antes ur PA I70~'0
Dispasilbn Permit NO. _ ~ `., 0~7 3 tP l tl