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HomeMy WebLinkAbout12-19-08~~.i -~"~ l Z~l(~ PETITION FOR GRANT OF LETTERS OF ADMINISTRATION PETITION FOR PROBATE and GRANT OF LETTERS Estate of FAYE H. SMITH also known as ,Deceased. To: Register of Wills County of Cumberland in the Social Security No. 179 - 30 - 3090 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner, who is 18 years of age or older, is the personal representative named in the last will of the above decedent, dated Decedent was domiciled at death in CARLISLE BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, with her last family or principal residence at 700 WALNUT BOTTOM ROAD, CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA 17013. Decedent, then 71 years of age, died OCTOBER 31, 2008 at FOREST PARK HEALTH CENTER, CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent. 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 situated as follows: $ 100,000.00 TOTAL $ 110,000.00 Petitioner, after a proper search, have ascertained that decedent left no will and was survived by the following next-of-kin: NAME RELATIONSHIP ADDRESS Stephen L. Smith Son P. O. Box 53 York Springs, PA 17372 WHEREFORE, petitioner respectfully requests the grant of letters of administration in the appropriate form to the undersigned. .~ __ . _.. _ .. STEP N L, SMITH cn P. O. Box 53 `~ t? a York Springs, PA 17372 `~~~~ - - ,: ~=, c OATH OF PERSONAL REPRESENTATIVE _ =' -- ~ _ _ -~ < ;`;-, .~ - - _ ~ COMMONWEALTH OF PENNSYLVANIA _ _' COUNTY OF CUMBERLAND 7 --1 w The petitioner above-named swears that the statements in the foregoing petition are true and correct to"'' the test of the krowi~:dge of petitioner and that as personal representative of the above decedent petitioner will welt and truly administer the estate according to law. Sworn to and sub~c~ribed °~--~ --~"'y~ ~ ~ ~.~ ~ ~ before me this ~_ day of STEPHEI~L. SI~- DECEMHER, X008. Register~,y~~~ ,1, Estate of FAYE H. SMITH, Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW, December~~ , 2008, in consideration of the petition attached hereto, satisfactory proof having been presented before me, IT IS DECREED that STEPHEN L. SMITH is entitled to Letters of Administration and in accord with that finding, Letters of Administration are hereby granted to STEPHEN H. SMITH in the estate of FAYE H. SMITH. FEES Probate, Letters, Etc. $ Zc~~' ~`~-' Short Certificates $ ZN ~~_, Renunciation $ TOTAL $ Z.et~i.~>y Filed: tZI ~~t~LF~ Register of Wills ,,~~~ ~ `i~ ~ _ FfAROLD S. IRWIN III (1 NO 64 South Pitt Street Carlisle, PA 17013 717-243-6090 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WIaRNING: It is illegal to duplicate this copy by photostat or photograph. )'ec fur this certificate, 56.00 1 his iS to cerUty tnat me uuormauon Here ~IVen is correctly copied lrom an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be t~>rwm-ded to the State Vital Records Otlice for permanent filing. P 14 9 5 9 5 ~~__ ~~ ~~~.~NO~ 4/zoos Certification Number Local Registrar Date Issued rv c~ ~, ~. © ~, - , ~, ~- -„ r~ r_ ;-r-i _ -.j~-i ;t .tee, _ ~ _ I D W •~ Ntosta3 REV nntws COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE /PRIM IN PERMANEM CERTIFICATE OF DEATH BLACK INK (See inshuCtions and examples on reverse) STATE FILE NUMBER f w 1. Name a D«amnt IRrd, midde, led, s~xl 2. Sax 3. Social Secuay Number 4. Dale of Deem (Month, day, year) Fa a H. Smith 1 179 -30 - c s. Aga (Lad aroday) um« 1 year unmr t day s. Data a Rirtn (MOnm, day, yeal 7. elMplew (c' are:rata «tor d~ cm,evy) ea Place a Deem (clack enry we) Nonw t>m rtovrs tawms Ib9pIbC , Olmr: 71 Yre. Jan . 2 6 , 1 9 3 7 Gardners P a . ^ Irpemnl ^ ER / amatrent ^ DOA 1C] Nursing Home ^ Reddawa ^omar. speary as. C«xdy d Daam &. firy, Roro, Twp, a Deem Bd. Faa71y Name (lf iel Inaglution, gHe sued eM number) 9. Wes Decemnl d Mispank Origin? ~ No ^ Ves 10. Race: Amarxan IwFen, Rbck, Whtle, ek. Cumberland Carlisle Forest Park Health Center III yes, NtedN Cuban, Mexken.PUennRken,eb.) (Speaiy) White 11. Oarotlaa's Usual lion Kind of work d one duri most d wa ' Ne. Do not stab retired 12. Was Decedent ever in ma 13. Decedent's Educelbn (Spedly only hghesl gram comp leted) 11. Mentd Saxe: Mamed, Never Mambd, 15. SurvNing Spo use (g wile, give rtabsn name) Kintl d Wank Kind a Buaimss / IMustry U.S. Armed Farces? Elementary / Secondary (012) Cdlege (1-4 or 5.) WimweQ Diwmed (Spsdry) Dispatcher Bus Lines ^Y~ C~N^ 12 7ivorced w 16. DecemnYS Mdbq Address (Street. city /tam, stele. zip code) Decedent's Did Decedent ~ w i Pa ' 700 Walnut Bottom Road e na „p. A<h,d Reeidenre 17a. ante . Yes, Decedent Livad n Tvq. T hi T Carlisle Pa 17013 owns p a"'d'""I'i^ Carlisle 17b.c^unty Cumberland 17tl~ , . /~ ~ GN 18. FemeYS Name (Fred, midtlb, bet, safe) 19. Momal6 Name (Fast, midde, meitlen sumallla) Donald Hask 11 Grace Lobou h 20a. Intamumfs Nama (Type / PrIM) 200. IaermeM'9 McMng Address (Strad, csY f bsvn, stele, a9 Cade) Steve L. Smith P.O.Box 53 York S rin s Pa. 17372 21a. Memos d Diepoae0n ^ crd,wim ^ Daetlon 2tb. Dde d gapmition IMmm, day, year) 21c. Place d ObpmXbn (Name a cemetery. «metory «ah« pecel ltd. l.oca0on (City I torn, date, a4 coda) ® eadd ^ Remevalxomaare ~ w, CrsmalbnaDonetlonAUmedmO M Nov 5 2008 Uriah Church Cemeter y Gardners Pa 1 7324 edkelEmnMrlCaroroR ^ree^N^ ^ aher-spaary: , by . , , . 22a Spreture d Fwerel Servke licemea (« person acing as such) zzb. Lltxsae Nunber 2zc. Noma am AdAaae a FadN'ry 5 01 N B a 1 t i more Ave - - ~=~ ~,° FD-011 589-L . . Hollinger FH/Crematory Inc. Mt.Holl S rings Pa. 17065 Carpble hems 23ac oNy when wANhg a. Tome bed d my knowiedge, Beam occurM d tle tlme, dde ant pbce dabd. (Siyeaee ant itle) 23b. Lkense Number 23c. Date Signed (Month, day, year) plrysiian b not avaXade et time d deem b ~~~ : ~ ?2 i~n~j~~a~a ~ 1o0~' 3i h t CJ cerllly wpeddeem. ~.~- .- 1 , u e. c tlena 2A-28 mud be campbted by person - l m h 24. Time of Deem ss ~ 28. Dsle Prwwurxed Dead (MUnm, der, Yearl f 28. was case Relerretl m Medical Examiner / coroner br a Beeson Omd man Cremation ^r Donation? w epr«eurxea d . i, : PM. ulz~-1 3~ atoo5 Oc ^Y~ ~"~ CAUSE OF DEATH (Sea InatrucNona arM examples) r Appmximale interval: Pan II: Enter Diner simifxanl cadliaa mnhihutpgJp tleam 2B. qd Tobacco Use Conbbute to Death? Item 27. Part I: Enter me 7eb d evens -daeasea, inlums, «campiratlore -md tlrectly caiaed re deem. W NDT enter remiinel events such as cartlec arrest, r Onsd b Deem Wt not rasuMng in the unmdyig ratne given n Pen I. ^ Yes ^ Probedy resPiralaY erred, «vedmdd AbrNetlon wNaN sYassirg the dxtbgy. I6t anty one Huse an each Yoe. t m~idE'do~n ~esJ~iq n ~~N~ _' a. ~ ~„^"-`_' ~[y~'/l.L i 29. If Female: ( ' Due m (a as a coneepence dl: ~ FoTpregtent wimb pad year ~ + ssquenuaW Ad ca~dkkm, a any, b. ~ v1...a-- NaMO rethe reuse 164a on ins a ^ Pregrlem al rhos ol,feelh , Enlx Ste UNDEHLYWD CAUSE Due b ( a of): ~ ^ Nd preyanl, bd Dreg^ad within 02 tlays (Assess a'n' mal'riAdad me ~~ t evanm ranumg m death) USL ~ d death Dus b w as a consequencre oQ: ~ ^ Nd pregiun41x0 Dregnanl 13 days to t yesr d. before mom ^ Urtkrewn d OrePtdM wiNb lha past year 30e. Was en Adapsy 30b. Ware Aubpay Rntliigs 31. Mower d Deem :32a. Date d Inyury (Month, day. Year) 32b. Describe lbw Injury Occurred 3zc. Place al Injlxy: Hama, Fatm, Smd, Factory, Pemmietl9 Avatlabb Prbr b Compkxiw d cause a Deem? ~x,rel ^ II«nlcide ORxe Suidi ek. ^9. (SD~~hI ^ Yes ~10 ^ Yea [i]~lo ^ Aadmnl ^ Perxfirg Invesligetlm 32tl. rime of Inpxy 32e. Injury at WaA? 321. If Tmmpalaxm Iry«y (Sped/yl 32g. Loratlon of Inryry (Strad, city /town, date) ^ Sukide ^ Could Nd m Delemuied ^ Yes ^ No ^ DrNer / Opeml« ^ Passdlger ^Pamsttien M OOer ~ SPeaT)': 33e. CerMbr (check oNy ens) 33b. Sgmwre and rob a C,Mifer • c.rxFybg phy,dN.n (Plrydcien certiying cease a deem wnen aremer pnysidw~ nee taanwwad deem and competetl Item z3) - /~ To tM beNamylmorlsdgs,dMhoeaumsd due to tM nuas(s)arM manner ea dared.•--------------------'-'-----____ - ~^ • Pronouncing ant cMMyNq physkren (Physkbn Odh praiaxidig mdh erq c«mYHg to cause a mein) To tle beta m ltnowlsd e d th d l ih m d re d re nt d il ^ 3&. Lke umber 330. Date SIgnW (MOwh, mY~ Y~r) g , ea xeums e a na, s , en p ce,a ueb e rause(sl and mewrer as shred__________________ Y ~7 ~s / ~q (~ Z Medial Examiner/Coroner • ~ (> Lx ~ / U ~ /v f111 L/ d _ °,,/ On the bade a examlMOOn and / « investigation, In my opinbn, death occurred d me dine, mre, and Dren, and due to the Causa(S) and Mannar as areled_ ^ ~. Name ant Adtlww ~% Wjp C«npbled Cause of Deem lltem 2]) Type / PrNN %. Registrar's 9!d Die~tysrt~e~ :Date Fled (Mmm, my year) a ~/ , D c ~' . l! /G F/ 5 ~ Dislasxbn Permit No. _ _ ~.~Ot/~ l