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HomeMy WebLinkAbout11-06-08PETITION FOR PROBATE AND GRANT O:F LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Bernadine L. Mainhart File Number ?~ 08 0143 also known as ,Deceased Social Security dumber 196-22$396 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) ev cs ^ o ._, A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the °~ nom Dui--U1e ;I~ ~~ '. . last Will of the Decedent dated and codicil(s) dated O i.+ - `~~' Cn ~x~=~ C'J ' C'~ _;._ -~ (State relevant circumstances, e.g., renunciation, death of executor, etc) 3 ., a - C ~ Excerpt as follows, Decedent did not many, was not divorced, and did not have a child born or adopted after execution ~ instrum~s) o#recF for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ d ` '• Q B. Grant of Letters of Administration DBN Robert C. Reidenbach. Administrator died October 15.2006 (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente liter durante~ absentia; durance minoritate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by then following spouse (if any) and heirs: (If Administration, e.t.a. or d.b.n.e.t.a., enter date of Will in Section A above and complete list of heirs.) 3055 Flynn Roaci, Apartment 654 924 Allenview Diive State Comection,al Inst, Route 18 (Inmate ID#DA6638 (COMPLETE WALL CASES:) Attach additional streets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at 3463 Rimer Highwav Newville PA 17241-9460 W. Pennsboro Township Cumberland Counri (List street address, town/city, township, county, state, zip code) Decedent, then 78 years of age, died on 1/1112008 at Carlisle Regional Medical Center Cumberland Countv Carlisle PA 17013 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 10.000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 90.000.00 3463 Ritner Highway, Newville, W. Pennsboro Township, Newville, PA 17241-9460 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: A Signature Typed or printed name a~~d residence ~' - ~ Jane M. Alexander PA 17372 ~. Page 1 of 2 Form RW-02 rev. 10.13.06 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS 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 lmowledge 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. 1 Sworn to or afl firmed and subscribed befgre me the ~ day of For >;l~e Register of Jane 101. Alexander Signature of Persona! Representative ~ ~ a, ,---, , / © ~~ __. ~ _, Signature of Personal Representative Z File Number: X1-08-0143 ~ ~~7'1 Estate of B~madine ~,,. Mainhart ,Deceased ~. _., , _.~ ~--;-, == _ ~'-_~:J Social //Security Number: 196-22-8396 Date of Death: 1/11/20(!8 AND NOW, -LLfh - ~ `~ , 2~ , in consideration of the foregoing Petition, satisfactory proof having been presented before e, IS DECREED that Letters of Administration. DBN are hereby granted to Jane M. Alexander in the above estate and that the instrument(s) dated NIA described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES~X.-I 11d~~ l_/L.UUIy i " Register of Wills Letters ............................. $ -~c~. Short Certificate(s) •••••••••••• $ Attorney Signature: ~ .~ ~ , Renunciation(s) •••••••••••••••• $ ,;'- $ Attorney Name: f;' M I ander. Esquire ' .... $ ~ Supreme Court LD.~No .07355 .... $ •.•• $ Address: ~ ~ altinwreStreet .'-. $ 'll .•.. $ PA 17019 .... $ $ Telephone: (717) 432-4514 TOTAL ............................. $ 0~ Form RW-02 rev. 10.13.06 Page 2 of 2 illc,.f ~ .. ;..; ,-, ~ (~ ,1~ ~ ~ C:N ~: _ C;, y ~ LOCAL REGISTRAR'S CERTIFICATION IMF DEA1'1-1 1NARNING: It is illegal to duplicate this copy by photostat ar photograph. ~ Fee for this certificate, $6.00 P 14806902__ Certification Number H106-143 REV 112D06 TYPE /PRINT IN PERMANENT BUCN INK This is to certify that the intornlation sere given is correctly copied from an originrtl Certificate of Death duly filed with me :,s Loca] Registrar. The original certificate will be for,~~arded to the State Vital ~(~Records Office fo(r~h-ermanent iilin~~. C~~~1~~0JS-R\c~_~e~ite:~ Q~~`// 17 JI~QB l.oril Re~,istrar -1- Dais: Is-sued ra °~ ~ r --f A -, s ' Gi Cx :_ c i ~' r ~~~ Q1 ";'? ~~ ~ ~ ~ `, ~ ' 3 tn t T COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE FILE NUMBER 1. Name of Decetlml (First mkdm, msi suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year) Robert C. Reidenbach Jr. Male 509 -58 - 7442 October 15, 2008 5. Age (Last Binhtlay) Under I year UnMr 1 day 6. Dale of Binh (Month, tley, year) 7. Binhplece (City ant state a foreign country) Ba. Plop of Death (Check only we) Abntlw Wye Haan Mlman FioeDi191: Dther. November 8 1952 Ft . Indiantown Gap -55 Yrs Inpatient ^ ER / owPer it ^ DDA ^ Nursing Home ^ Residerke ^OMer - Specity: Bb. Cony of DeaM &. City, Boro, Twp. of Death 6d. Facility Name (If nd'valllaion, give street end armher) 9. Was Decadent of hispanic Origin? ®No ^Ves 10. Race: American Indian, Black, White, ek. Dau Min P Det-t-t~ T~tvn "J "['~ .S. Hershey Medical Center J (N yea, apePily taboo, M (Spealy exican, Pueno Rican, etc.) Whlte 17. DaedenYs Uwal lion Kind of woh d op du' most of wwki life. Do not smm retiretl 12. Wes Decadent aver in Ma 13. DaptlenYs Etlupaon (Specity Dory highest grade comp mled) t4. Marital Status: Marred, Never ManieQ 16. Surviving Spo use (II wife, give maiden name) KMd a Wank N1M of Business / Indaby U.S. Armed Forces? Elementary / S oetlery (0.12) College (1 d or 5a) Wltlowetl, Divorcetl (Specil)) Sales Electronics ^Ves ®Ne ~ L M,srried Barbara Justice 16. Decedent's Mailing Address (Shad, chy 1 tam, state, zip code) Decedent's Ditl Deptlent y~ PA Li M 77 W. Mdln St• ve AdualResidenca 17a.Slate a 17o1U Yss DecedemUVedin silver SEIL'T1'lg TwP. stOWn PA 17072 Newkin Townenip7 17d. ^ No, Decedent Livetl within t7d ca,nty Cumberland g Aaaal Limdaa Ciry/BOro 16. FBMeis Name (Frsl, mktlle, Iasi suffix) 19. Mothefs Nama (Firs gridtlle, maitlen I m Robert C. Reidenbach Sr. Bernadine Woo~. g 2W. Inlormant'e Name (Type / Pdnl) Barbara Reidenbach 26b. Inlonpnl's Meiling Adtlres¢ (Street tlty /lows, style, Tip todeJ 77 W. Main St.r New Kingstown PA 17072 21 a. IASlhotl d Dispoeilion ~] Cremellon ^ Doplion 21 b. Dab a Dlsposilian (Month, tley, rear) 21c. Plop a Disposidon (Name Of cemetery, aemday or oMer plop) 21 d. Loplgn (city /town, amts, zip Code) ^ Burin ^ RenwvallromSmla I WaaCremetlonarlYonstknAaharmetl October 17 2008 Hoffman-Roth E1]Tleral Hlxne & Carlisle PA ^ olMr ~ speay . ey N.alpl Ex.mher / corartan yea ^ Np 22e. S~ d Furreml Service ~ I person ac ~ as suM) 22b. License NMMer 22c. Name and Address of FedNy Hof fman-Roth Fun~era Home & Crematory (_s~i' 013144E Carykt Mare 23ac Doty when cer6lyirq 23a. To the best a my knowledge, death oxurred at Me time, date ant place smmd. ISigplure end Olle) 23b. license NumMr 23c. Date Signed (Mallh, tley, year] physkim q na evalada at lima of tleaM to ceraty cause a dpm. aema 24,26 muss M cmipletetl by person 24. T of Death 26. Dam Prorwurrcetl Dead (Month, day, year) 2fi. Wes Case Referred to Medical Examiner /Coroner for a Reason Other then Cremaliw or Donation? who PrwWUnces opm. 2 NA. M. O C1'ObC K \ 7 2c~08 ®Ves ^ No CAUSE OF DEATH (See InatruCtlone and examples) r Approximate imenal: Part II: Emer aher sjg[~Mpnl nxttlMaa cpnldbukno to death, 2fi. Did Tahacp Use Contribute to Death? Item 27. Pan I: Enter me chain of evema - diseases, injuries, a prtlplications - Thal direaly caused Ihs OeeM. W NOT enter temurel evems such es pNiec arrest, Onset to Death hw na resudirx in the untle I dying cause given in Pan L ^ Yes ^ Probabty reegrelay arrest, a ventdwmr IMnlladon caiman showing the arbbgy. Llsl Doty one cause an oath line. ^ No ~~Nrrown INNEDIATE CAUBE FxW disease or t''~s wrQlgn mewling in ~ath) _~ a ~NTRA CERE B.V-ate HEMOR2NAG~ 29. If Female: ^ Due to (ar as a consequence oq: Na pregnant wilhln past year Seprregntally Ap ard6as, it arty, b. r m tlt e ~ a ~ ^ Pregnant at time a Beam Dua to (w as a consequence op: l ntar me E U N DER LYING CAU E ^ Na pregrmnl, Wt pregnant within 42 dsys (dwaee w inpay Mal irrMlad tlb evanm rewNng n tlpM) UST. o of deaM Due to (w ae a pns uenp o : eq D Na ^ pregrenl, but pregnant 43 daYS to 1 year tl. l before death ^ Unkrwvm n pregnant within Me past year 30a. Wes an Autopsy 33b. Were Auopsy Rrdkgs 31. Manner of Death 32a. Dale a Injury (Month, tley, year) 32b. Describe How Injury Occurred 32c. Place of Inryry: Home, Farts, SIreeL Factory, Penomretl? Avaimwe Prror to Carpletbn yn Natural ^ Homidtle OMks Building, etc. /Specify) a Coup a DaeM? 'P' ^ Ves ~NO ^Ves ~NO ^ Axbent ^ Pentlirg (nveellgalgrl 32tl. Time a Injury 32e. Injury al Work? 321. II Transponalion Injury (Speciry) 32g. Lacelbn of Injury (SIreeL city I tam, slate) ^ SukiM ^ Cadd Nol M Delerminetl ^ Yes ^ No ^ Driver I Ope2tw ^ Passenger ^Peda;tnan M ^Other ~ Spai/y 33a CerliHer (aretlc Dory care) 33b. Sgnelu re and Ttlle of Cenifier • Certllying phyaklan (Physkan cenilying cease al pant when another pnysip9n has prorrwrme0 dpM antl rongmletl Item 23) ^ ' To tM Mat of my kn[wnadge, death occunetl due to the pusa(al and menrrx as amtad_________________________________ ^ ~ ~G M • y~ • Prwwunang and cendying physklan (Physician MM pronowx:ing pent antl cenirying to cause of deaM) To the best of my knowbtlge, dplh rweuned al tM time, date, end plop, end due to IM cauw(s) antl manner as amted (~ 33c. License NumMr 33d. Date Sigr d (MOnM, day, year) ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Neakel Paamlpr /Coroner (T M~ 'y ~ S ~ ~ OCio k~ tY g 5 Zoos On the bads of examiretbn and / or inveatigatkn, in mY opinbn, tleeM opumed at the lime, date, eM place, and due to the pose(s) antl manner as smted_ ^ , 36 Neme erd Address of Person Who C~mpleletl Cause of DeaM Ptem 27) Type I 1 Hershe Medtcal CtI M S 35. Regislrafs g Di N '~ 1 38. Dale Fsetl (Mmth, da , ypr) y y ' . . NAftASanH~ SF~SSA~ Hershey PA 17033 ~ I I I~ I 10 1 , eATrrkvy LLA ~H V lA DisPOalllon Permit No, ~~53 f i ~~ Before the Register of Wills of Cumberland County, Pennsylvania Estate of Bernadine L. Mainhart No. 21-08-0143 deceased Renunciation In re Estate of Bernadine L. Mainhart, deceased To the Register of Wills of Cumberland County, Pennsylvania, On February 11, 2008 Grant of Letters of Administration was. given to Robert C. Reidenbach. The said Robert C. Reidenbach died October 15, 2008. ~.-~., , The undersigned, Debra E. Riley; of the above decedent, hereby renouric`~e the right to administer the estate and respectfully reque`~tsthat Letters of Administration DBN be issued to Jane M. Alexander. Signature Typed Name: Debra E. Riley Address: 3055 Flynn Road, Apt. B54 Dothan, AL 36303 Sworn to or affirmed~d subscribed before me this ~D day of _ , 2008. o o ~" z ~~:~ 1 t`7~ `i 1 ® (~ j , ~ ~ C r_7 ,J (Deputy) aster o Wills or ~~m, ~ r`~ ~ aT~ _ ~ ~. t10TARY PUBLIC STATE OF ALABAMA AT IARCiF ~ ~ -~' MY COMMISSION EXPIRES: Oct 14, 2012 W + _w BdNOFC~ TNRU NOTARY Pl18LIC UNDERWRITER.;1 _ .~ O ,^~ , --, ~.1-C.~~J i ~ ~ Before the Register of Wills of Cumberland County, Pennsylvania Estate of Bernadine L. Mainhart deceased No. 21-OS-0143 Renunciation In re Estate of Bernadine L. Mainhart, deceased To the Register of Wills of Cumberland County, Pennsylvania, In re Estate of Bernadine L. Mainhart, deceased, On Februan~ 11, 2008 Grant of Letters of Administration was given to Robert C. Reidenbach. The raid Robert C. Reidenbach died October I5, 2008. " ~~'~ r The undersigned, Thomas W. Reidenbach,' of the above decedent, hereby renounct~'the right to administer the estate and respectfully request~~-at Letters of Administration DBN be issued to Jane M. Alexander. `~~et~ttssrrc J . t~ =~: NOTARY ,. ~. a.• ~~ ~i~~0.9~?HOp~,Z~~•' ~4` °~ a°` Signature Typed Name: Thomas W. Reidenbach Address: 924 Allenview Drive Mechanicsburg, PA 17055 Sworn to or affirmed and subscribed before me this a ~ day of ~ ~~ 2 ~ , 2008. (Deputy) Reg~tero~' Wills or Notary Public MATTHEW P. SMITH CPT, JA Judge Advocate O a ~' .-: .. _ a ~ r `~' ` tx O - c~, 3 .:' ~ _ . i - ' Gn { T- < T 1 ~ C~~' C3 Z ''r ~ t =~~ c=. w ~- ate. ;:~ ~, ~; ~+ Before the Register of Wills of Cumberland County, Pennsylvania Estate of Bernadine L. Mainhart : No. 21-OS-0143 deceased Renunciation In re Estate of Bernadine L. Mainhart, deceased To the Register of Wills of Cumberland County, Pennsylvania, In re Estate of Bernadine L. Mainhart, deceased, On Februac~i 1 1, 2008 Grant of Letters of Administration was given to Robert C. Reidenbach. The said Robert C. Reidenbach died October 15, 2008. ~~ ,~... ~:.,L. The undersigned, David A. Reidenbach, of the above decedent, hereby renounce.: ~" the right to administer the estate and respectfully requestthat Letters of Administration DBN be issued to Jane M. Alexander. Commonwealth of Pennsylvania County of Sworn to or at~irmed ands bscribed before th~ ~-~-y of ~~ , 2008. '~~ ~-~.iC4u ~~~c~N Signature Typed Name: David A.. Reidenbach Address: State Correcto~inal Inst. Route 18 (Inmate ID#DA6638 Albion, PA 16475 (~3eputy) Register of ills or j'NOtary PUbI1C COMMONWEALTH OF PENNSYLVANIA ,;,, ~,,,.,,,, Notarial Seal ~, -_ ~ Jo Anne R. Bickel, Notary Public Conneaut Twp., Erie County ' ~~ N -'~~, ~ ~-~ My Commission Expires Sept. 23, 2010 ' : j ~ Member, Pennsylvs.nia fssocfation of Notaries y ,~ •a Q ~ ~- '" e t ~', ~'~0~ Q'~~ o -.- : ~ _;. n v ~~ ~; ~ 1 ` vi x ~ r c r ' t~ ^ ~ ..Q <' :• r ' * ~ -,fi - ,~ ~ a r ~ _ --r, O . • W i ~~. O E~1 ~ r ~.