Loading...
HomeMy WebLinkAbout02-02-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF ~.-~ ~h`~~~ C, _ COUNTY, PENNSYLVANIA `~ File Number ~ ~ C ~ ~' ~ ~~~ Estate of 1'~~'t1 `-- .\-r't~ ~ also known as y 1 ~,,t.._j _ ~~- ~ ~C'I..~ ~' ( •~ rt ~~ ,Deceased Social Securit Number Petitioner(s), who is/are l3 years of age or older, apply(esl for: (COr6IPLETE 'A' or 'B' BELOW:) ~.~~, C~ ~-~- v~ named in the A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the N last Will of [he Decedent dated ~~~ ti 1 ~~ and codicil(s) dated o ~ r j (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~~ r ~ r Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of t]~~ -~ent(s~fered C:7 ~ fot• probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~~ ~ ~ _ ^ B. Grant of Letters of Administration ~ '? - ~ (lfapplicab[e, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durmue absentia; dairante minoritnte) ~ 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 above and complete list of heirs.) Name Re (COiY1PLETE !N ALL CASES:) Attach additional sheers if necessary. iciled at ~eath in County, with his /her last principal residence at (l,Lst sn~eet adtL~ess, [own/cigt township, count), °, zip code) ears of a e died on at ' -G r ~Qr~ '~'~J ~~~~ +~r~ t '~J Decedent, then ~_ Y g ~ c, 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 t d miciled in PA) Personal property in County $ ~...~ ~;G ~; . ~:. $ -~ ( no o $ Value of real estate in Pennsylvania situated as follows: Wherefore, Petitione )respectfully quest(s) the(( ro e o~ the last W ill and C//odicil(s) presented with this~Pet~ition and the grant of Letters in the appropriate form to the undersigned: ~ , ~~.._ t~~ ~~s-a l ~~ r~v_T 1 J~3'~'~'~u"~~~ ~r~ tS~P 1 `;~A ~~i.~~ or printed name and residence Page 1 of 2 FormR6V-02 rev. 10.13.06 Oath of Personal Kepresentatlve C0~4~lONWEALTH OF PENNSYLVANIA t,~ J~ _ ,, ,~I S S COUNTY OF ~,~0 XY1~2~~ ~ t ~I ~ The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tine and cot,:ect to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will wel! and truly administer the estate according to law. Sworn to or aft rn~ed and subscribed before me t!te p( day of ~~ n'n~ Y (' "/ n i~ _ --~ For the Register of Personal Representative Si~nnture of Personal Representntive Sig~iature ojPersona! Representative -r~ ; ~ ~': ---~- ;- t ' N _ _- _..; _, :. _;~ 1~~ ~ ; N CD File Number: o~' ~ y ( `-'' l D~ Estate of (~X' I ~ ~ / Y I ~~ / ~ ~~~ ~ ~~> Deceased Social Security Number: v~a 7 ~~ ~~) ~ Date of Death: AND NOW, ~/~ ~ ~ ~~~yC~r~, ~ in con ideration of he foregoing Petition, satisfactory proof having been presented before n T IS DECREED that Letters ~~~ ) YJ, `~ --- are hereby granted to ~ ~ /.~ ~ ~ I ~ L-- - in the above estate and t!~at the instrument(s) dated -.__~~'~ 4'-_ ~~~ ---~- ~- -- ~ -- described in the Petition be admitted to probate and filed of record s the last Will ( 1 Codicil(s)) of~ cedent., FEES S ~/ . ~ Register of Wills yt Letters .. `~ . (.. • .. ~ $ ~ / Short Certificate(s) . ~..... $~ Attorney Signature: Renunciation(s) .......... $ ~~Pr v ... $ ~v yv ... $ :~ .. $ - .. $ ... $ ... $ ... $ ... -~_ TOTAL .............. $~ Attorney Name: Supreme Court I.D. No.: Address: Telephone: Page 2 of 2 r~~rm Rw-o? rev. l0.13 or LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. x+6.00 _ P 1503728 Certification tiumber H105-143 REV 11/2006 TYPE /PRINT IN PERMANENT RLACK INK 0 This is to certify that the information here Given is correctly copied frond an ori~~inal Certificate of Death duly filed with me as Leal] Registrar. 'I•he original certificate will he f~>rwarded to the State Vital Records Office for permanent filing. L ~xir~~ ~.c~~`cz~X'• ~A~ 2 ©/2009 Local Registrar Date (slued In ~~ 4 ~ ~ "•~ a - ~ N r- .~~ ~-/ Z ` r ~ v ~j ~..• e " ~' ,.= . N . '? . -y COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ) CERTIFICATE OF DEATH (See Instructions and examples on reverse) Mares ~„ ~ a,,,,,a~o ~ 1 rl Ci ('~ \ \1 \_ D 1. Name d Decedent (RrsL middle, last, eumxl 2. Sex 3. Sodel Secaay Number 4. Dale d Deam IMmth, tlaY. year) Male 204 - 03 - 7893 Jan. 19, 2009 5. Aga (Last BiMxlay) Under 1 year UrMa 1 day 6. Dale of BiM (Monet, ar) 7. Bidhplace (Gty antl state a iasi9n canhy) 8e. Place of Dxth (Check Doty one) 87 kannw 11at* Hass tiwlea Hospital: O~ym~er Aug • 10 Y 1921 Duncannon / PA , Yre. ^ Inpatient ^ ER / Oulpadenl ^ OOA 1=}Nursing Home ^ Rasitlenca ^Otl»r ~ty Bb. County d Death fic. City, Boro, Twp, of Deam 6d. FaWty Hams (If nd kWlkltion, yve street erld number) 9. Was D«etlenl of Hispank Ongm? ~] No ^ Vas 10. Race: Amerkan Indan, aack, White, etc. Cumberland Carlisle Forest Park Health Center (aYx•apedhYC"ben, ( Whit Maxkan, Puente Rim,. da.) e 11. Decetlenl's Usual Oxu Ibn Kexl d wale tlas tlurm must d Me. Do nd state reared 12. Was Oecetlenl ever in Ibe 13. DecetlenYS Etluw9on (Spedty Doty highest gretle wmpleted) 14. Madhl SaWS: Herded, Never MameQ 15. Suaivirg Spouse (II vote, give maiden name) KiM d Wale KiM d Busirrex / Irdushy U.S. Armed Folces? Elemenhry / Secontlary (0.12) Cdlege (1-4 or 5~) Wb0^'ed• DNarcea ISpery'M ®Yx ^Na 10 Widowed 16. D«edenYS Ma9ing Address (Street dtY / bwn, slate, >!P code) Decetlalt's Did Decedent PA 216 Walnut Bottom Rd . Actual Residence 17a. sate Lwa ~ a nt. ^ Yea, Decedent urea k, Tip. Carlisle, PA 17013 Cumberland T°""'a''e? ,7d.®No, Ikcedalt Livetl walxn Carlisle 17°x°°nty Actual LmMad ckyrl9aro i6. Famars Name (Fret, mitldre, rest Sulflxl 19. MomeYS Name (Fxsl, midde, maitlen xmarx) Harry L. Fritz Mabel A. Peterman 20e. InformenYS Name (TYPe /Print) 20b. IMamaMS Madrg Address (Street, beY / hmn, shh, zq coda) Rose Ann Fritz 216 Walnut Bottom Rd., Carlisle, PA 17013 21 e. Memotl d Disposaun I ®Garelion ^ Danstion 21b. Dale d Disposdion (Mmm, day, year) z1c. Place d Disposllim (Name d csmdey. u«natay «ahar pace) z1d. Locatbn (Gry /loan, stare. ap cede) ^ Bunal ^ RemowalhomSrete Iwr «DonuonAUthodzed Jan 21Y 2009 Hoffman R t h Fun al Home & ^ Omer - Speciy- ~ q' MMinl Examiner/ CmanR Yes ^ No . e~ ~ o nc Carlisle, PA 17013 zza sg"a«re d " (" person adkg as eudq 22b. utel~e Number ~ 22c. Name antl Atldreaa d Faa9ity Hof fman-Roth Flaneral Home & Crematory, Inc . 138425 - ~ - Compete Items 23ac any what ceMMn9 2 . To me best d my . asset accurmd al me fine, dale aM pace slated. (Signanxe antl Gael 236. Lkrense Nunber 23c. Data Sigrletl (Monet, daY, Ysar) physidana nett evaaeble al ame d dxm to f ~~ _ ~ ~ ~ ,~-~ ` ceMry tauxdeeam. .{~ .~ s ~ J ~ :3SSCG SL / t v2vn ` Items 2426 must be mnpleled by person 24. T d Deem 25. Date Pronounced Dead (Mmm, day, yxr) 28. Wss Cxe Ralerretl to Medicel Examiner l Corona fora eason Other Cremalbn «DOnatlon? wM Mamlmcx deem. /~ M. ~ ~ ~U ~ ^Yes ~No CAUSE OF OFJITH (See instructlo ~ rsA examples) , Approximate mlerval: Man 27. Pad L Enter the g118R-(ffi'~64-diseases, irpuries, a cempicadas-mat direly caused me deem. W NOT aver lamirml evenN such as ardhc Goes), I Onsd to Deem Pad II: Enta amen Si]IId18nt mndliare mddbugn m de m bed nd I68atklg M me undedl"ng case gNen m Ped I. 28. Did Tabecce Use CaMrL«e to Oath? ^Yes ^ Prabedy respkalary anxL a venlrkslrer fmri9atlan wthW stxmirq the etidogY. Lill aMy one cause m each foe. ~ No ^ Unlmown MYEdATE CAUSE FMd disease a / / 7 ~ ^ /_ cerl5fis resulting in ~xml f /[ {Y7 LL: ~ ~ r1 % !LL Cf //6 ~ v I~ ~ ~ ~//( r 2 29.6 Female: ~ _~ a. ~ I G ,y , /,L~ _ Due «as a fAnl9equerlce an: r ~ ~l~ / ~ ^ Nd pregnant witlen past Year ,t ~~ '1//!J j C i L SeasntlW fid mll5lions, d erry, D. ~;rL! / LI .(:' ~!!SG 1 r 1~daq to tthhe reuse Natetl m tlne a Gl~ N/1 L'L 1~ G C~(I ~(/I[~ ^ Pregnant at time of tlsam . Enbr me UNDEBLYMG CAUSE Due t /TJ~ar u9 oQ: J ~ ~ ' ~ C,~C ` ^ Nd gagnanL Iwl pregnant wimin a2 tlays (6sxx aMjury met initlatatl the o. ..~iLGL1 L^ ` G-! 1,a[ L~/2- (,C events rewNlg tlxlM LAST. of deem Dx lq (« as a consequence on: ^ Nd Megnant• bd pegneM 43 days h 1 year d bebre deem ^ Unlmown it pregrsM wimm me past year 30e. Was an AMapsy 30b. Ware AMapsy FirnM1rlgs 31. Marma d Deem 32a Gate d Injury (Monet, day, Year) 326. Descnbe How Injury Ocaned 32u Place d Injury: Hanes, Farm, S/ael, Faday, Pedamed? Available Prig to C«npeaal ,p~ Natural ^ HomzMe Omce BuNdln9. eN. (Spem7y) d coax d Deem? ~I ~! ^ Yes l~Ll No ^ vas ^ Na ^ Acddent ^ Pax<ing Imestlgagon 32d. Time d Irqury 32e. Injury at Wodc? 321. If Tlarspodation Injury (Speciry) 329. Lacatim of InNN (Sped, tilt /town, stale) G ^ Sukfde ^ CaAd Nd be Ddennined ^Yes ^ No ^ mar / Operat« ^ Passager ^Pedesldan M Other-Speaty: a3a. cem6m Icheck Gay Gael 33b. s. as rde d codmer • Certlryln9 PNYs~a^ (PhYSklen xray+n9 faux d deem when endher MYs~a has prmoax:ed axm aM cenlpreted Item 23) To the lratdmy lmowbdga,axm ocarteddx to aK raa.e(„and menrl«xa1.oad.--------------------------------J~ - r~/t. .CK N/'r - • Pr«auneing and certllying prryaleian (Physiden both proroaxhg deem and c•mMn9 to ceux d axMl TatMbeddm lororvted a de m o d dtl B d h d l M d t t M ^ 33c. L'censa Number 33tl. Dols Sgcetl (Monet, day, Yxr) y , e ecum le me, a , an p ace,a ue o he exee(e)ar mercer es staled__________________ 9 N JL J 7~ L • Medlcel Examiner/caronan O th b d d i tb d I M tl ti i i ^ 43 ~5~ r [ iN Gf Z!] n e e s axam na n an or vx ge on, n mY apn onL dxm occurred d tlrc time, doh, arltl pace, abe due la the caux(s) and manner as ehte0- 34. Name and Atldreea of Perm WM Dongrelal Ceux d Dxlh (Item 27) Type /Print 35. Repdrar's spa aM Dia r ~ I I I ~ I I C> I - [ ~ lc ~'- ~ .pate Fletl (Monet, day, Ysar) ~~ d A• D~)i l µ..~ . , ,J, 0.~,c . s~e k . (x} s~3 1J ~li~.a.,~..e_ (~u< l~D~l r In PN -~O4 Disposition PennR No. ~ ~ l.t`) I 0 -I I~~ N o - _, ~ro Y~ -~ ~ t - +_ LAST WILL AND TESTAMENT c ~ ~'^' -o - ~ ' =_ OF ©c N .V ~r MERL L. FRITZ --+ N ~- ~ I, MERL L. FRITZ, of 216 Walnut Bottom Road, Carlisle, Cumberland County, Pennsylvania 17013 , being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making null and void all Wills, codicils and instruments of like manner and effect by me at any time heretofore made. ITEM I. I direct my personal representative hereinafter named to pay all of my just debts and funeral expenses as soon after my decease as convenient. ITEM II. I give, devise and bequeath all of my property, real, personal and mixed, whatsover situate, to my daughter, ROSE ANN FRITZ, provided she survives me for a period of thirty (30) days. ITEM III. I nominate, constitute and appoint my daughter, ROSE ANN FRITZ to be the Executrix of this my Last Will and Testament, said Executrix to serve without bond. In addition to the powers vested in my said Executrix by law, I hereby authorize and empower my said Executrix without license of Court, to sell, convey, mortgage, invest, reinvest, exchange, manage, control, or otherwise deal with any and all property, real or personal, comprising my Estate and any purchaser shall have no obligation to see the application of the purchase money therefor. IN WITNESS WHEREOF, I, MERL L. FRITZ, have hereunto set my hand and ~+. seal to this, my Last Will and Testament, written on these two (2) pages, this 5 day of ~ :~c... , 2002. ;~--~ ,__ MERL L. F TZ Signed, sealed, published and declared by the above-named MERL L. FRITZ, as and for his Last Will and Testament, in our presence and at his request, and in the presence of each other, have affixed our hands as subscribing witnesses hereto. Of COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF ~ ~-'~ ~~ r~ ) I, MERL L. FRITZ, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes herein expressed. Sworn or affirmed to and acknowledged before me, by MERL L. FRITZ, the testator, this ~~ day of ~~ ~.~ , 2002. ~, RL L. F TZ Nota Pub ' c --- .-~._.__.._.___.__--..-_.._.._1 i4U~i:~a~,~~~ ~~~~~ Jf1L~Y GOLDRIf~t;, i~;,t~iry FttbEic Clty of Harrisburg, l3auGijr~ Cn., PA ~My Commission Exs~r~;v~ Eat~v`0?, 215 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF ~ ~~'`^-`~~i"~ ) We, ~~,q~ ~ h ~ . ~, ~ and ~~.... `~c , ~n~ ~ ~--~o.~, , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will; that MERL L. FRITZ, signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed, that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by ''~/,e r,~~-y, ~ , ~~1 ~~ and _ESc~..., ~ . 2 ~~, `~..~; ~-l~c~-~,~~e witnesses, this day of '~:-~ ~~..`...~~~ 2002. r, a NN-dry Pu lic ~,__._-- ~~ Pv~J'(~1~~if~L ,;;=ray JOOY GO! aRiP~G, N;~p;acy Puy}!ic City of Harnsbur0, D^at+~hi~ Co., PA My Comm'-ssion Exp«es ~Zov. R3, 2~5 / ,// r-- ~ ~ %j ~~( i es