Loading...
HomeMy WebLinkAbout12-18-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Richard C. Spahr, Jr. also known as File Number .~~ ~} ~ ta~D`~ Deceased Social Security Number 196-50-3702 Petitioner(s), who isJare 18 years of age or older, apply(ies) for: (CDMPLETE 'A' or 'B' BELOW:) © A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is l are the last Will of the Decedent dated and codicil(s) dated (State relevant circunatances, 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 oil for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ' ""' named in the c~~ C~ r-T -=' n if~ offered '~3 ~ ~ ~ _ ' B. C'rant of Letters of Administration "'t Qfappllcable, enter: c.t.a.; d.b.n.c.ta.; pendentelite; duranteabsentia; durcr~n:znoritate) O -- J 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 a&ove and complete list of heirs.) ~_ Name Relationshi Residence Patty K.:,pahr spouse 4072 Seneca Ave., Camp Hill, PA 17011 Randy E. Spahr son 4389 Winnefield Drive, Dover, PA 17315 (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his l her last principal residence at 4072 oeneca venue Camp Hill Lower Allen Township Cumberland County Pennsylvania 17011 (List street address, town/czry, township, cor~nry, state, zip code) Decedent, then 49 years of age, died on Nov. ~ 2008 at 4072 Seneca Ave., Camp Hili, PA 1701 ] Decedent nt death owned property with estimated values as follows: (If domiciled in PA) All persona] property $ 3.000.00 (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 ~~~ ~ ~~ 4072 Seneca Avenue, Camp Hill, PA 17011 Frn rn R G4'- 02 ~ ev. 1 x.13.06 Page ] of 2 i~~ ~~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNT' 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 cr ,affirmed and subscribed before me the ~~ day of ~~ - ,~ r ; For the Register i r c~--+ Signature offers al Representative C Q m t~ ~ f'*~ % ~ ~..? ~ Signature of Personal Representative ~~?'~ p f~^, ^,C - ~_:~ C~ CD 1t~'" Signature of Personal Representative ; ~ ~ ~ ~ ~ -+i File Number: c~ ~ ~ D ,~~~ Estate of Richard C. Spahr, Jr. ,Deceased Social Security Number: 196-50-3702 Date of Death: Nov. 30, 2008 AND NOW, ~ t ~ ~)~~~1~~ , ~~~~, in c nsiderati n of the foregoing Petition, satisfactory proof having been presented befo ~ e, IT IS DECREED that Letters ~~ , `~-fV`~`~ C,l '11 are hereby granted to Patty K. Spahr 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 Wil~ (and Codicil(s)~of Decedent FEES Letters ...J. ,.OaU ..... $ 3~ Short Certificate(s) ..~ .... $ i a Renunciations ... ~ ...... $ S ... $ ... $ ... $ ... $ ... $ ... $ ... $ cC „e..~~ TOTAL .............. $ ~9 Z ' of Attorney Signature: l_9-~ ~~li1 • `1)CY . `' ~ Attorney Name: William L. Grubb Supreme Court I.D. No.: 72661 Address: 3803 Gettysburg Road Camp Hill, PA 1701 ] Telephone: 717 763-5580 Form RW-02 rev. 10. /3.06 Page 2 Of 2' LUC1~L RECiSTRAR'S CERTi~ICATItJN O~ QE~.T~# WARNING: it is illegal to duplicate this copy ay photostat or photos +•~ph. Fee i'or this certii~izut~. X6.00 `_P ~_481~573__ Certificat~olt '~(n;1be1 ~' - r ~M ~~p 71'I, 1.S ([= i {;' '4 k LI,3~ tR(U7 'l Itl )1'. }1LIc' r?fi~(] 1 tt,~F.p,~ ~~~y _~ curl ctl} :(~)vc(S 1 ~)n <:%~ ~I) ~in<,} ' i~tiL.itc cot he<4tl t ,~~~ ~ ~~~\~ L.~ IIUi\ t11c'tl Ytlti? i. ;i.~ I_l rxrll. (lt'el~ ~;-i1. 311 L' ayl-1?-]1113 o ~ a,~ c~ t)f~cxltc ,ti r i ~ ~ ti?rth t(eil ttf t;;<~ titan Viu3 ~ ,, -~~~ Rek Trct~ Ci"(_:~ (,1 ~,-e)~n)~ f) ant ill%n~' ~~ ~. ,~.:_ ~~~ , ,, ~ ~ /~ DEC 0 3 2008 ~ • C~.+ C~ /'y C.7O - ~~ 1J 7 ~..7 ~~~~ •' t. ~' 1'~ ~~~yy..~~. `'~ ~- ~ - _ ~ ~ ; IEV 11/2W6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS 'RINT IN ANENT CORONER'S CERTIFICATE OF DEATH 1., x INK ~ ~ _/ n~ (See instructions and examples on reverse) srnrE FILE NukneER ~ ~ C ~ 1 4 )~ ~~ 1. Name pt Decedent (First, mMMe, last, suffix) 2. Sax 9. Soclel Security Number 4. Date of Death (Momh, tlay, year) Richard C Spahr . ale 196 - 50 -3702 November 30, 2008 5. Age (Last Bidhday) UMer 1 year Under 1 da 6. Dale of Binh (Hoorn, day, year) 7. Birmplace (City and state or fo rei country) 8a. Place of Death (Check Dory one) 49 Manma oar: Narc Minty„ Hpapial: omer yrs January 8, 1959 Mechanicsburg,PA ^,npabem ^ER/Outpatient ^DOA r~ ^Nursing Hame ~Resid~nce ^omer. Specify. 6b. County of Death &. City, Bor w of Death 8d, Facility Name (II not instaution, give street and number) 9. Was Decadent of Hispanic Origin? No {] Yes 10. Race: American IMian, Black, White. etc. (If yes, spectty Cuban, (Specify/ Cumberland Lower Allen 4072 Seneca Ave Mexican, Pueno Rican, etc.) whit e 11. Deceden's Usual Occu tan Kind of work d one dodo most of world life Do not slate retired 12. Was Decedent ever in the 13. Decedent's Education (Specify only highest grade compl eted) 14. Marital Status: Married, Never Married, 15. Surviving Spo use (II wile, give maiden name) Kind of Work KIM of Rosiness / IMuslry U.S. Armed Forces/ Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Dlvorccd (Speplry) maint. ~anito townshi ^Yea ~Nb 12 married Patty Collins 16. Decedent's Mailing Address (Street city /town, state, zip cotle) Decedent's Did Decedent pq Slate Pennsylvania LWe in a „~ Decedem Lived a Lower A 11 a n Aqua/ Residence IIa Yes 4072 Seneca Ave. , , . , Twp Townanip? C u m b e r t a n~ rid. ^"°' Decedent uved wthin C a m o H i 11 , P A 17 01 1 ,7b. county Actual Limits of city % Bnr° 78. Father's Name (First. middle, last sufllx) Richard C. Spahr 19. Mother's Name (First, middle, maiden surname) Elizabeth Starr 20a. fnlonnant's Name (Type (PnM) Patty Spahr 20b. IMormanys Mailing Address SlreeL city / awn, sate, zi code P.O. Box 2 2, Mt. ~Io~ly Sprin3s,PA 17065 21 a. Method of Disposition Gemalan ^ Donatbn ~ 21b. Date of Dispositron (Month, day, year) 21c. Place of Disposdion {Name of cemetery, crematory or o111er pace) ltd. Laation /City /town, state, zip code) 1 6 5 ^ Burial ^ Removal horn State i Was Cremation or DoneYton Authorized 2 0 0 8 3 Dec H o 11 i n g e r Crematory t . H o 11 y Springs , P A ^ Olner -Specify: by Medical Exeminer (Coroner? ~ Yas ^ No , . 22a. ~re of Funer Servae Licensee (or person acting as such) 720. licatue Number 22c. Name antl Address of Fanliry Qt FD-013153-L Musselman FH&CS,324 Hummel. Av2.,Lemoyn'a,?A 17043 plate Items 23ac Doty when certifying 23a. To the best of my knowledge, death occurred at the time, date aM place stated. (Signature and title) 23b. license Number 23c. Dale Signed (Month, day, year) • physician a not available at tiros of tleam to certlty rouse of death. Items 24-26 must he completed by parson 24. 71me of Death 25. Date Prorwunced Dead (Month, day, year) 26. Was Case Referred to Medcal Examiner 1 Coroner for a Reason Other roan Cremation or Donationn ' wlo pronounces death. A X 2'00 A ""' December 1, 2008 Yes ^No CAUSE OF DEATH (See Instructions antl examples) r Approximate interval: Pan IC Enter other siwificant co~ldfons contrbutino to death, 28. Did Tobaccro Use Contribute to Death? Item 27. Pan I: Enter the chain of events -diseases, injures, a cmWlications -that directly wusetl tna death. DO NOT emer terminal events such as cardiac arrest, ~ Onset to OeaN bN imt rasuBing in the undedying cause given in Pan I. ^ Yes ^ Probabty respiratory arrest a ventricular fibillalion wnhom showing the etaagy. List oMy one cause on Bach line. n ^ No ^ Unknown IMMEDIATE CAUSE (Final disease a d condition resulting in Bath) _~ a. Hanging i 29. If Female: ^ Due 10 (a as a consequence of): 1 Not pregnant within past year ^ Pregnant at time of death Sequentially list croMaions, if any, D. ~ leadingg to Me cause lidetl on line a. Due to (or as a consequence oi): EMerthe UNDERLYING CAUSE r ^ Nol pregnant, but pregnam wimm 42 days (disease or injury that indicted t~ C n h LAST of tleam . events resuttin n deat 9 ~ ) Due 10 for as a consequence oD' ^ Not pregnant but pregnant 43 days to t year d. before death ^ Unknown it pregnant within the pall year 30a. Was an Autopsy 30b. Were Autopsy Findings 31. Manner of Death 32a. Data of Injuy (Hoorn, day, year) 32b. Describe How Injury Occuued 32c. Place of Injury: Home, Fann, Slreel, Factory, Pedormed? Available Piror to Completion or cable pr Deem? ^Nata21 ^HOmaide Nov 30 2008 Intentional Han in Odae /ding, etc. (Specityj ~ome ^ Yes (~ No ^ Yes ^ No ^ Accident ^ Pendng Investigation 32d. Tare of In'ryry 32e, Injury at Work? 32f. If Tmnsportati°n Injury (Speaty/ 32g. Location q mryry (S1reeL city 1 sown, stale) ~seaida ^CouldNOtbeDetednine0 pp>g 2:OOA ^rea I~N° ^ Driver /Operator ^ Passenger ^Pedestnan Seneca ve Camp Hill PA M ^Other - Specity: 33a. Cedifar (Check only one) 33b. Signature aM TiC9 C O r O n e r • Cenitying pnysican (Physician certiying cause of death wren atother pnysaian has pronounced dealn aM canpkted Item 23) - To tM beat of mY knowledge, death occurced due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • Pronouncing end canltying physician (Physcian both pronouncing death and cediyirg to cause d death) ^ 33c. License Number 33d. Date Signed (Month day, year) To the hest of my knowledge, death acurced at me time, dale, and place, are due to the cause(s) and manner es stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ December 1 , 2008 • NxdicalExamirerlCoroner Dn the bads of examination and I or Invedigatlan, In my opinion, death occurred at the tune, date, aM place, and due to the tause{sJ aM manner as stafM_ ^ 34 Neme and Address of Person Who Completetl Gause o1 Death (Item 2T1 Type % Print Norris Coroner l L Mi h 35. Regt r and I ~I fl r~l ~I ~ I r~F~~~`i~e~~_ , . ae c 637 Basehore Road gg to ~I1 ~ ~~f - 70 Mec anicsbur PA Disposnlon Parma No. O J O ('l l ~_ C ~~~ ~. ! m _ ~ ~"~ ..~ ~ RENUNCIATION ~;~ ~7 ~ ... -- ~~ ~' cc - REGISTER OF WILLS c`~C>T' ~C _~ . CUMBERLAND COUNTY, PENNSYLVANIA :.~~ , `'~ o ~ ..i Estate of Richard C. Spahr Deceased T, Randy E. Spahr , in my capacitylrelationship as (Print Name) son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Patty K. Spahr '~~ / (Dote Executed in Register's Office Sworn to or affirmed and subscribed before nle this day of , 4389 Wynnefield Drive (Street Address) Dover, PA 17315 (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this ~ ~l day of 7~.L~~~C ~, ~-C~``~j Deputy for Register of Wills Form :?C4=06 r~eti°°. l0. {3.06 Notar}~ Public \ My Commission Expires: (S~gnahu; and Seal of Notary or other otticial qualified w administer oaths. Shops date of expiration of tiotarv's Cnmmis,ion_) COMMQNWFAITH OF PENNSYi..VANIA Nofianal Seal Veda L. Fteider, Notary Public City (3f York, York County My ~rnrnissicm F~irps f3ec. 8, 21711 Membar, Penrsylwaria ~,rv,ucia2ian of tJotaries