HomeMy WebLinkAbout11-21-08Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Marv A. Anderson No. 21-08-0615
also known as ,Deceased
Social Security No. 178-10-6260
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(COMPLETE "A' OR"B" BELOW:}
A. Probate and Grant of Letters and aver that Petitioner(s) islare the execut_ named in the Last Will of the
Decedent, dated and codicil(s) dated
8taM r"IweR d~unrfances, e.g., renund"tion, dletli of ezeata. etc.
Faccept as follows, l~cedent did not marry, was not divorced, and did not have a child bom or adopted after execuFan of the documents offered for probate;
was not the vic~kn of a la'Ning and was never adjudicated Incompetent
B. Grant of Letters of Administration
(d.b.aeta.: paksrde Ye; dunude abwntla; dwtnte m)roAbMS)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Wili and was survived by the following spouse (If any)
and heirs: ~,
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Name Rol Residence `^-
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James L. Anderson Son 275 Adams Road -~-_ ~i=- r":.~ fv
Breingevilte, PA 1803} . -' `_;; ,_._
Suzanne K. Hickes Daughter 7 Nicholas Drive
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Carlisle, PA 17015 ~ ~ `-
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T. Michael Andenfon Son 1798 Loa Cows Roads iv
Boca Raton FL 33486
(COMPLETE IN ALL CASES:} Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 7 Nicholas Drive.
Dickinson Township, Cumberland County, Pennsylvania 17015
aadY..c a..b...ndm.~D.i~
Decedent, then 88 years of age, died March 18, 2008, at Carlisle Resaional Medical Center. South Middleton Townshla. Cumberland County,
Pennsvivania
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Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property ..... ... ....................................... $ 19.000.00
(If not domiciled in PA) Personal property in Pennsylvania ....................................... S
(If not domicked in PA) Personal property in County ............................................. S
Value of real estate in Pennsyhrania ................................................................................. t
Total .... ................................................... ....................._....... 8 19o>z
Real Estate situated as follows: None
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of tatters in the appropriate
form to the undersigned:
S' nature T or Tinted rbwne and residence
~ ~ James L. Anderson
275 Adams Raod
Brein sv(Ile PA 16031
Foen aw4 Papi orors (redccant~-Ra. M2
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Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statemerrts 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 fa
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Sworn to and affirmed and subscribed ~~~ ~-
James L. Anderson
before me this _ ~~ day of ~
Estate of Marv A. Anderson Deceased
Social Security No: 178-10-6260 Date of Death: March 18.2008
AND NOW, ~, ? ~ ~ ~~~~~ , 2008, in consideration of the Petition on the reverse side
hereon, satisfactory proof ha ing been presented before me,
IT IS DECREED that Letters ^ Testamentary ~8.of Administration
dinat~ pendeala /le; tllaaala aEaeal4C d~1Uda nloedple
are hereby granted to James L. Anderson
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 of Decedent.
FEES
Letters........ ~~~..~.~~ .....
Short Certificate(s)......2....
Renunciation.......a2.......
Affidavit ( ) .................
Extra Pages ( )............
Codial ....................
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JCP Fee.. U:..t::f~ ........
Inventory ...................... .
Other ........................
TOTAL..........
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Regis6er of wRla
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$_„1` ~_ Attorney: Stephanie Kleinfelter. Esa. ~ 1 ` `~
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I.D. No: 80089 _`'
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$ Address: Keefer Wood Allen 8~ Raha l. LLP ~
635 N. 12~' Street. Suite 400. Lemoyne. PA 17043
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$ Telephone:717-901-7786
Foam RY1F1 Pape 2 of 2 (Yadc Count, • Rev. pf92
No. 21-08-0615
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee f~~r t!titi cir± ttc..)tc. `tifi.tff)
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f hip is to rerti;~,~ drat t1)e irlformatio(~ here giver) i
•orrectly ,opied ti-om an original Cerlilicate of Deat
luiy filed vGith n)c as Local Registrar. The origin;:
~ert;ficale will be forwarded to the State Vitt
2.ea)rd; C)ffi~e:iu permanent filin~~.
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~oca] Ret.isu-:u Date Issued
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H705.1d3 REV 112(IW
TYPE / PRINT IN
PERMANENT
BU1CK INK
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
1. Name of Deceden! (First, midde, last, wmx) Z. Sex 3. Soil Security Number 4. Dare of Deelh (Month, day, year)
MARY A. ANDERSON Female 178 - 10 - 6260 March 18 2008
5. Age (Last Blrmday) Under 1 Year UrcMr i tlay 6. Date M Binh (Month, day, year) 7. eiNlphce (City and state a foreign country) 89. Piece of Death (Cherie Doty one)
88 Nonilre p•ya Hens N4Nee Hospital: Omer:
1919 Pinecroft
Pa
Sept 11
,
,
_
in fiant ^ER/0 ant ^DOA ^Nursin Nome
Yrs. pa' ufpati g ^ Residence ^Other-Specity:
8h. Counry of Death 8c. Gity, Bore, Twp. M Deam ed. FaiFry Name (If trot inslnulron, gNe sireel erd number) 9. Was Decedent W Fgspank t7riginT ~ No ^Ves 10. Race: Amemm~ Indian, Black, Whne, ek.
Cumberland South Middleton (if yes, speclty Cuban, (5peciM
Carlisle Regional Medical Center Mexican,PuenoRlmn,etc.j White
11. Decedem's Usual Oc tan KiM of work done dun most M vro ' IXe. Oo not state relked 12. Was Decedent ever in the 13. Demdenl's Education (Specity ony highest grade completed) 14. Marital Shlus: Married, Never Martled, 15. Surviving Spouse (if wife, give maiden Hemel
Khd el Work KirM or Busi s 14bustry US. Armed Faces? Elementary / SecaWary (0-12) College (1-4 or 5+) Widowed, Divorced (SpeclM
X-Ray Technician MaznafactutuTg ^Yaa ~N0 12 Widowed
1s. Decedents Hsiang Address (street, airy / rown, elate, dP a,da) DecedeM'e Did Decsaem
sate Pennsylvania uva m a 170. ®Yaa. Decedent Uved in Dickinson T
Adad Residence va
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7 Nicholas Drive .
Townshp?
Decedent Lpred wihin
17d
^NO
Carlisle, Pa 17015 .
,
nb. County CtmberlaTxi
Actual Limas of City / Bono
18. Felher's Name (Fkd, middle, last, 3u6b) 18. Mod1e('s NamB (First, midda, mddan SUmanOt
Perry Burkholder Bessie Parks
2w. IMOmrent's Name (Type / PnM) 20D. InlormenYS Meiling Adtlresa (Street, cqy I tvxn, sreta, zip coda)
Suza<uLe Hickes 7 Nicholas Drive Carlisle Pa 17015
21a. Method of Diapositlon ^ Crermgan ^ Doredon 21h. Date of D6sPOSition (Manor, day, Ymr) 21c. Place M Disposition (Name of cemetery crematory or dh« plea) 21 d. Lomtian lGN /town, date, zip cede}
$] 6Urid ~ Ramovd imm sale 'was crsrts6an or Donegan Amhaaaa
• March 25, 2008 Craansville Veterans Cemetery Crownswille, MD
^ Other - Spaci(y: i by Medical Fsaminari Caoner7 ^Ves ^ No
~ 22a Signature of rel Semen ' is acting as such) 22b. License Number 22c. Nome entl Address of Failay
FTr012909-L Carlisle
Pa 17013
Roman Funeral Home 255 York Road
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Oamplefa h 23et only Wien mNlying 23a. To the bell M my krwxledgs, deem acWrted at me lime. dale arA plate staled. ($ignaare &xt tine) 23b. License Numbef 23t. Dale Signed (MOnm, tlay year)
phyei ion is oat available al finis of deem to
mmly cause of death.
' Hero 2x26 mud be complmed by Parson 2+. Time of Deam 25. Date Prmmrced Dead (Ahmh, day, yam) 2fi. Waz Case Refanetl to Medical Examiner /Coroner /ar a Reason Omer man Cremation or Donetwn?
' who WOr1ounces deem. ` 1~ pM. ~ ^Yes
CAUSE OF DEATH (See iretrucriona and examples) r Alymalmate intend: Pan II: F~aer am« ' 26. Did Tobecm Use CmidoNa to Deam?
~ - tiseases, inNrbs, a canpk daa-Ihal6reNy cawed me daad+. DO NOT emer tamnal evems such m cardac artast, r pnaet b Deam
Pan I: Eller tl1e gDy6p(
ttan 27 hul trot resul&g in me urclsrlying cease given In Pan I. ^Yes p Probady
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rasOrralaY erred, a venldcWer ~Yledon wimM stewing Ns elidopy. Lid oMY one muse m each line. ^ No ~Unkrwwn
NAMEDMTE G1USE Fina~d 6eeese a ~/~{(/^') ~ ~ yap ~. I ~Y ~ ~'{ ~ ~ ~
Candaron redal'ag et a~m) -~ a
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~ed~q ro tlk mwe Yded an Ikie a. "ma"r'--
r ^ Nol pregnant, hul Pmgnanl within 42 days
Enter Ae UNDERLYING CAUSE Dua to or as a cons oQ: t ^ _
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- ^ Not Pragmnl, hW pregnam 43 dare ro 1 year
Hue ro (or as a cm equerce of): r AA ~ (
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d. r " ^ llnknown A pregnant wahn ax pad ymr
3De. Was an Auopsy 3tlb. Were Autopsy Fmtlinge 31. Manner of Deam 32a. Dare oI Inury (Month, day, year) 32b. Describe lbw Inryry Oaxmetl 32c. Plain at Injury: IbmB, Ferm, Street, Faday,
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Penormetl? Avaihde Pea M Completion
aI Cause M Deam? ~NaNMI ^ Hontlc de
-^ AoSd«N ^ Pendlry Imrealigafipn 32d. Tine d Injury 32e. injury a\ Wodc? 321. N Transponatbn Injury tspaaM 329. Lamtlan of Injury (Street. air /town, shtej
^ Yes ~Nc ^Yes ^ Nc
^Yes ^ No ^ Driver/ Operator ^ Passeipar ^Padesl' n
^ Suicide ^ Cpuk! NM be Determined M Omm'speah~
33a. CeriiTrer (check Doty one) 33b. SgnaNre end Tiae M Cenaier
Can'dy)ng piryeklan (Physidan cenaying muse of deem wirers anomer ptrydien has pralouncetl dorm ant mmpkled aem 23)
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dath or:mrsed dwbMe eauss(at arts mariner as smle~
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• Prawuncic rig and certNydM plrysiian (Ptrysadan bmh prawurag dorm aixl mnirying ro muse of dorm)
^ 33c. License Number 33d. Date Signed (Month. day Year)
, _ _ _ _ _ _
To Uro had al my klwwkdga,deafh awrreddiM tlma,dah,aM place, end dw to lh0 muaga7 aria manner es ~tetad,.__________
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• Mediae Examlrbr /Coroner
atlon, in my oplnkm, death occurred et the time, dare, ant plats, and sue m the ceuaa(a) aW manrxr ~ dated_ ^
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o Comphted Caum of Deam (hen 27) Typo I Pont
% Name and Address of Pers~n
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Dale Filetl (Monts ,
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35. R - r Signature?9~Dtar1~n
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Disposition Parma No, l./ 1 l ~~ I ~ ~~ ` t _ (~ n /L t '1 _ .~ v
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
;t;;te of ~.1ar/ A_ Anderson No.
~'.S~' ~KIIOS'~111 aS
Deceased
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Lett-~rs be issuer_I to James L Anderson. without bond.
1Nitness hand this ~~ day of November. 2008.
'.1 hael Andcr~o~i rSignature and AJdies~!
1 L ,Cows Ro ,<!
°. ,Paton. FL ~13a
S~~~om ko o+~ affir~i~er7 ~i~~c s~ihscribed
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20`''.".r+:.°¢% THOMAS R. KNISKERN
* * MY CDMMISSIDN 4 DD 364766
r ~ EXPIRES: January 17, 2009
'4rFo Bonded Thru Budget Notary Services
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Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
Estate of Marv A. Anderson
also known as
Deceased
N o.
The undersigned, Suzanne K. Hickes dau hter of
e ations ip apaaty
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters be issued to James L. Anderson. without bond,
Witness hand this day of November, 2008.
~~ ~ i
u nn Ickes
(Signature and Address)
7 Nich s Drive
Carlisl , PA 17015
COMMONWEALTH Ot= PEN
NSYLVANIA
Notarial Seal
Swom to or affirmed nd ubscribed
b fore me this ~ da
of Dernse ~ Beecher, Notary Public
~~~ BOfO~ Cumberland Cou
t
y
vember, 20 8. n
y
MY Commission Expires Dec. 1, 2010
I
I Member, Pennsylvania Association of Notaries
N tary Public
My Commission Expires:
(Signature ana sealaNotaryaoMer olfidal NOTE: Renunciations executed outside the Office of Register of
aeatireawaera^~~ st~eateor Wills are required to be notarized.
expiration of NdarYs aannusaion.)
Form RW41Daupftin Canty) -Rev. 992
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