HomeMy WebLinkAbout11-24-08Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of THERESA BARRIS No `~ ~ - L~~~' ~ 1 ~~~
also known as
,Deceased Social Security No.200-32-5758
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 and aver that Petitioner(s) is/are the execut or named in the Last Will of the
~! Decedent, dated 01/16/1974 and codicil(s) dated N/A
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 documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
(~ B. Grant of Letters of Administration
~••! (c.t.a., d.b n.c t.a.: pendente life, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence
(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 100 Mt. Allen Drive, Mechanicsburg PA 17055
(list street, number and municipality)
Decedent, then 94 years of age, died December 16 , 2007 , at Messiah Village
Decedent at death owned property with estimated values as follows:
(if domiciled in PA) All personal property ....................
(if not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County .........
Value of real estate in Pennsylvania ....................................................................
Total ..........................................
Real Estate situated as follows:
(Location)
.............. 5 6,000.00
................. $_ 6,000.00
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:
Signature Typed or printed name and residence
Arthur R. Barris Jr. 312 S. 5th St. Indiana PA 15701
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I do hereby make, constitute and appoint my son, Arthur Robert Barris, Jr. ,
to be Executor of this my last Will and Testament In the event my son,
Arthur Robert Barris, Jr., should pre-decease me, or fail to
qualify for the appointment as Executor within thirty days after
my decease, then I do hereby make, constitute and appoint my
sox, Der_nis R. Barris to be Executor of this my last Will and
Testament.
IN WITNESS WHEREOF, I, THERESA BARRIS ,the
T~stat rix above named, have hereunto szcbscrlbed my name and affixed miy seal, the
16th dad of January in the year of our Lord one thousand nine hundred
Seventy-four . ----
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Signed, sealed, published and declared by the the above named Theresa Barris
as and for her last Will and Testament, in the presence of us, who have hereunto
subscribed o~.rr names at her requ t as witnesses thereto in the presence of
said testat rix and o f each other.
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69-CST-Will an~i Testament
Henry Hall, Inc., Indiana, Pa.
I, THERESA BARRIS ,of the Township of Rayne,
County of Indiana and State of Pennsylvania,
being of sound mind, memory and understanding, do make and publish this m~ last Will and Testa-
ment, hereb~~ revoking and making void all former Wills by me at any time heretofo~•e made.
FIRST: I direct the payment of all my just debts, funeral
expenses and costs of administering upon my estate,
by my Executor hereinafter named, as soon as cor~venient after
my decease.
SECOND: All the rest, residue and remaindez~ of my estate,
be the same real, personal or mixed, I give, devise and
bequeath to my children, RUTH MARIE DAY; ARTHUR ROBERT BARRIS, JR.,
BETTY LOU CRUMRINE and DENNIS R. BARRIS, share and share alike,
absolutely.
IO>.vrli Rr~' rn Ut)?t
LOCAL RE~STRAR'S CERTIFICATI~ OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P ~4C~7~C~~4
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will he forwarded to the State Vital
Record] Office for permanent filing.
Local Registrar
ev n zcc6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMEk'i OF HEALTH • VITAL RECORDS
'RINT IN
,NENr CERTIFICATE OF DEATH
K INK
(See instructions and examples Dn reverse) sTATF I=n F rill rnnaaR
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t. Name of Dececem IFvn, middle. last. sulfa) 2. Sex 3. Sonar Becudly Number 4. Dale of Oealn (Month, day, year)
Theresa Barris F 200 - 32 - 5758 December 16, 2007
6. Age lair &nhgayl Under 1 year UMer 1 tlay 6- Dale of Binh (Month, tlay year) '. Binhplaca IClly antl stale or for eign tour 80. P18oe of Deam (Check only one)
b~.,m Days NOUrs n~rs Hospital: Other:
94 vre. Ma 26 1913 Rossiter PA ^Invalient ^FH/ou:paliem ^DOS ~N~rei~gHOm: ^Residenee ^omar-spanry
9d. Courry cf Dea'.^. 3c. Gly. Boro. Twp. of Dea:h 0D. FacJily Name (Il net instilullon giv~ stre
t a
ria num
ber 9. Was Decedent of Hispanic Or gin? ®No ^Yes 1 U. Raze'. American Indan, Black. Whhe. etc.
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~~~~~a~o A a~ (Spanh'
Cumberland Mechanicsburg ~ E S S
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t'1 V ( 1 ate.)
e White
11 D d ..'s Usual Cc n Wind ui wo k a e Bunn m r Ilfe. Do na state rel~redl
ce 2. Was Decederi ev r.:he 13. Decatlant's Etlucd on (Speofy o mgnest grade mmp leletll la. Mario Status Monied. Never Marra t6 Surv v~ng Spo use III wile, give maiden name)
Kina of 1VCrk
Klnd ci business: Industry U.S. Armed Forces? Elementary / Secontlary (0-12) College (1-4 or 6.) Witldwed Dlvora~tl (Sp•.city)
Ha)ternaker N/A ^vea pNri g Widowed
:6. Dacadares Mzdiny Atld s (Str6el c ry; town. state, rip ode)
100 Mt. Allen Drive, PO Box 2015 OecetlanCS
Actaal Rea~enre ,?a. sate Ditl Decedent
Pennsylvania Lida.n a „p. ^ Yes, Dedeaem uved in Twp
McChanlCSbU2'CJ
PA 17055-2015
t7b
County Cumberland r wnanip? rid. ^ rm. Daatlant wetl wimm
, . AnualL;miabr city;epro
19 Famers Name tFvst, mitlae. last, sufl'ul 19. Molhers'..s!le IFirst, meddle, maiden surname)
Daninic Poletto Mary Vinassi
20a In(ormanis Name IJYpe /Print) 20b.Inlormar a Malting AtlNass (Street, chy /town. elate. rip cotlel
Arthur R. Barris Jr. 312 S. 5th Street, Indiana, PA 15701
21 a. Method of Disposition ^ Cremabon ^ Dpraupn 2ID. Date of Disposaidn (Homo, day, year) 21 c. Place o'. ~ sposklon (Name al rernalery, crematory or moat place) 21 d. Ldcauon (city I town, state, zip code)
® Bohai ^ Removal tram State ;Was Cematlon or Donation Aumor2etl
^ Other-Spent': by Medial Eaami r/DOroror? ^Yes^Nd
DQC. 20
2007
St. BeLTlard lrPSllet
Indiana PA 1571
??a. Sign~ldlj d Funer I Senate U ens 'person 'gas 22b. License Number 22c. Name and Atldress el Facgny
- F'D 012301 L Robinson-L le Inc. 36 N. 7th Street Indiana PA 15701 i
Complete Ilene 23a~c only wfgn cemtying
pnysican is not avalaole ar time of deem to 23a. To 1M of my owledge, Beam occurred at me tune, daN and place stated. (Spnature arM litlel 23b. Liarwe Number 23c. Dale Signed (MOnm, day, year) ~.
I
amry m se a seam.
Hems 2G~2fi must be completed by person
h
tl
m 24. lime of D~e+a~th
~ 25. Dale Pro^rgWReO Dead (Month, day, year)
^ 26. Was Case flaterred Ic Madder Examiner; Coroner for a Reason Other flan Cremation or Doratbn?
w
o pronwnres
ea
. O M.
I / I O~ - / ~ ~ ~ (
~ ^ Yas ~ No
CAUSE OF DEATH (See Inetrucaons antl examples) .cproxlma a ntarval: Pad II' Enter omar sirxN ram mod Lions wn dbulinn to beam 26. Di0 Todarm Use Contnbule b DeaN7
Item T. Pan r Enter the than of evens- aaases, Injuries, or rompecatbns- mar dreNy caused da Beam. DO NOT enter terminal eve nts such as camlac arrest, poser to Deam but nor resutling In me undedyhg ease given -n Pan I. ^Yes ^ Plobady
respalory arrest, a vemricular libnllaeon without showilg the eliaogy. List only Ore cause on earn lire.
VINEDIATE CAUSE IFInal disease or ^ ~ ^ ~o~
LSI^'
conddlon restating in tleam) _' _ ~' / v ~ LvGJ rL .Jx 'LL ti l'j g Cr J..O
a. /
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[-j) n L M Ll <'lr YN /.Q 29 If F
D e to for as a consequence d).
segaemlauy osl conaadns, 9 any a
leaoin to me cause tistea on one a.
L J /U;? I C /f U (~r~1 Nol pregnant within past year
^ Pregnant al IMB d deem
D~~a to o• a: a mree
mete UNDERLYIilG CAUSE ( quence oN:
^ pre 1,bM
Na gr~.n paynam w,u.n e2 eays
Iaseas¢ a inN+7 mat imiated the
c.
vents rewltirg In tlerih)UST.
C'(lC~/~+'c(%Ci~ C/)1~.j~G{G. of tlealh
Due m (or a5 a mnsequerke op'. ^ Nol pregnant, dtl pegrant 43 daYS m 1 year
d. /~'I~L-~yvlt/ ~ - Oelore tleam
^ unknown a pregam wnmm ma last year
30a. Was an Autopsy 300. Were Autopsy Flrx1ngs 31
. M
anner of Death 32a. Date of Injury (Monet, tlay, year) 32D. Describe How Ir;..ry Ocarretl 32c. Place OI Inury: Horrw, Farm, $aeel, Facbry,
Penorrrced? AvarWble Prmr to Completion ,~
,/
L;I NaWral ^ Homidltle
' Ofllce Builarg, etc. (Spea(yJ
of Cause of Death ~
~ u
^Yes Q' • df c ~ Yes ~] Nc ^ Acntlent ^ Pantling Investigat'Ibn 32d. Time d Injury 32e. Injury al Work? 3Y'. l TransponaAOn Injury (SpeCAyf y2y. Lowlan of Inµuy ($Ire91, city! mwn, stale)
^ Suitide ^ Caltl Nol de Demrmmetl ^ Ye5 ^ No f_I Driver. Operates ^ Passenger ^Pedesman
M [, ,mar~Specfry
33a. Comfier Icnecx Dray one) 33b. SIgr181ura and Pde of Cellar
• CMiTying physician IPnyvcian cenitying cause OI tleath when another physican has pronounced beam anb completeb Item 23) ~ ^ / / ~'l
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To the best of my knpwbtlge, tleam Occurred tlue to Uw auselsf antl manner as Watetl________________ ________________ 1 .
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• Pronouncing antl renirying pbyslcian (Physcian Ooth prorKUrw:ng eealh and cenitying to cause of deem)
io me best of my kMwktlge
tleam occurrM ri the lime
tlrie
and
lace
tl tl
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th
d 33c. Llmnse Number 33tl. Date Signed (Monet. tlay year)
,
,
,
p
, an
ue
o
e cause(s) an
manner es rite4
• Medial Exemirrerl Coroner _ _ _ _ _ _ _ _ _ _ _
------
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on me bays of examination anb I armvashgatlon, in my winion, Beam omurroa at the time, data. antl vlaa, one aae tp the ousels) aria manner as smrob_ ~
~ Noma and Aaaress of Persm who compiataa Lase of Deam pra m 2?'. Tyce; Pnm
9S Regsu igna anb Dist umoer
~ 9fi-Date Filatl lM n
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-~ DiapaampnPermnNd 0091621
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUj°j1+~~ COUNTY, PENNSYLVANIA
Estate of ~~jE1~2E5l~} ~i~iQ /,j ,Deceased
~v ~v~ s ~. t3/9RR /S and f~U~ fYl , !7~ ~/
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well-
acquainted with ~~/ij~2~~iC1- ~~~1'Q /S and am/are familiar
with the handwriting and signature of the decedent, and that the signature of ~ Tai ~~3i~f- /~.4~2~ ~ S
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
~~5i4 ~~R/2/ S is in his/her own prod
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(Street Addre )
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(City, e, Zip)
Executed in Register's Office
Sworn to or affir
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before me this i,~ ~~ da ~
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Deputy for Register of Wi s -a--~
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Form RW-04 rev. 10.!3.06
~a8 ~lsy~x,~ Grp fZv~,o
(Street Address)
~IS~e ~ , ~~ /~33~
(City, Slate, ZiP)