HomeMy WebLinkAbout06-01-09REGISTER OF WILLS OF C ~LIy /3~G.~~.~ COUNTY, PENNSYLVANIA
Estate of -TK.Y1C ~ ~!
also !mown as
Deceased
File Number a I - d 9 ~SV3
Social Security Number ~ ~1 ~ ` ZZ " g 9
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or '.I~' 13ELON4)
® A. Probate and Grant of Letters Testamentary and aver that Petitioner( is /ire the LC~'c°-Ct(.r!'t X named in the
last Will of the Decedent dated Tall. 3t BOO;' srx3-e~diaii{-s~-dated
(State relevnnt circumstances, e.g., renunciation, depth of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: NONE
^ B. Grant of Letters of Administration
(lfnpplicable, enter: c.t.n.; d.b.n.c.t.a.; pendentelite; durmueabsentia; durnntenrinoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Wil] and was survived by the following spouse (if any) and }lefts: (If
Administration, c. t. a. ord.b.n.c.t.a., enter date of GVill in Section A above and complete list of heirs.) ~ )
n `I'
Name Relationshi Residence ":^ r---
r~
(COMPLETE IN,4LL CASES:) Attach additional s/teets if necessary. _ ==`j ;~
Decedent was domiciled at deatlJ in Cltm ~!A'~4,ng~ County, Pennsylvania with ~ii~r6her last principal residence at ~k 8 .T~¢
(List street «ddress, town/cit]~22township, court:j~, stole, zip code) • (/
Decedent, then ~ T years of age, died on rn 7 ~~ at ~6~ pS,tT.u2 ~petC~y Mt°-~1 ~S~t~t j'+Q
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Persona] property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
g /o~ a00- s °
e
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Vdill and Codicil(s) presented with this Petition and the gran! of Letters in the appropriate form to
the undersigned:
or printed name and residence
X -, ' C~nec ~ Smt~/
t,, ~71~ C~ _- ~_. /b8 ~ttrze lC~crcd, l"~c~lics6u~ . ~~ ~'7 d s a
Fa~m R61'-0? rev. 10.13.06 Page 1 Of 2
Oath of Personal Representative
COMMONZ~tEALTH OF PENNSYLVANIA
SS
COUNTY OF t/ ~- rVl ~ I'LL /a-/U,D •
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con-ect to the best of
the ]rnowledge 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 or affirnled and subscribed X G2 ~~ V
Signntw•e ojPersona! Representapve
befo e me the ~ day of C'ft-~20L /R. Srn/ Th/ '~"'
(~"`~ ~ ~
Signnnu-e ojPersonnl Representative ~-, =p ~ _
r- -
e i T9 ~
- For the Register Signnnu•e ojPersmin! Representntive = ~ `-
`~~ -- ~.~
File Number: ~ "' ~ 9 "' L~ ~-~J~=-~ -
Estate of fu he ~ ~ ~~ ,Deceased
Social Security~Number: ~ (9 ~ " ZZ - g g&S Date of Death: {~i' 7 zao 9
AND NOW, ~~( ~ 6 F ~.1(.Z.l/CC~ , ~, in consideration of the foregoing Petition, satisfactory proof
having been presenterj tief~/r-~c me, IT IS )ECREE) thzt Letters JCS MCi'!ft /' N
are hereby granted to C4.Mb ~ ~ • Sir, ~ ~~?.
in the above estate
and that the instrument(s) dated J"kr1. 3, 200/
described in the Petition be admitted to probate and filed of record ~sthe last Will
F'IEES ~~~rl/'yi o
Letters .... IUi Gl ~~!... $ ~~
Short Certificate(s) ..~.... $ ~ ~ Attorney Signature:
Renunciations ......... $ Attorney Name:
• • • $ / V Supreme Court I.D. No.
.. $ ca
$ Address:
... $
... $
.. $
$ Telephone:
... $
TOTAL .............. $~
s))
of N'ills
C'~tur/es E: ~~/~l~/s
.35/.3
~ Cho user ~c~
777 76('D.Zo~
Fam R6V-U? rer. l0.l3.OG Page 2 of 2
105.805 RBV (0 V07)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, 56.00
~~~
Certification Number
This is to certify that the information here given is
correctly copied 1i~om an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will he forwarded to the State Vital
Records Office for permanent filing.
Deal Registrar Date (slued
t l -;
-~
T ~ ~~r
_~ C.__
..', E''
- ... _.a
1
.~l\
: -__
,
( _
{...~
`, _ y
la . .
__
L''
M10:143 REV 11:2006
TYPE r PRIN7 mJ
PERMANENT
&ACK INK
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See inshuctions and ercamelen no rawnrenY
n t it !~ ~r--.~~
t. Name of Decedera lfusl, muds. last, wdix) ' JIAIt FIEt NUM BER 0/ \ ~I ( l/,~`/~
2. Sex 3. Social Secudy Number 4. Date d beam (M«ah, bay, year)
P Deitch Female 198 - 22 - 9985 May 7
2009
5. Aye (Last &Mday) Under 1 year Uflder 1 Oay 6. Date d BiM (MOnm, day, ear) 7. &nbplace lCi am stale «
N
~wdryl e
a. Place d Deam (treacle one) ,
Mwey wrs ~ awwys Ylosgw: Omar: }}(A{
87 yrs. April 6, 1922 Stl~s Strang ~•/ ~ ^mpatied ^ER/Outpatient ^DOA ^Nursbg Mary L7 Residence ^Oyyr-Speed
C
60.
ounty d Dsam &. City. Bono, Twp. of Deam 9d. FacYey Name IX not nsMdion y
, Ova West and «arlber) 9. Was Decedent d FGSpanic Orgn7 ~ No ^ Yes t0. Race: Amercan neon
Bladt Wtwe
Hc
Cumberland Silver S vin 168 State
' ,
,
.
(N Yes, spedry Cubarr, ISPecilyl
Road Mexican,PuenoRkan,ek) White
11. Decedad
s Usual KM d w«a Oory most d Iqe. Do wt sUy retlrm 12. Wes Decedent aver m Vy
U.S. Armed F«ces7
Kuy d Work ltim d &ISayss / Irlduslr /3. Decwd«q's Education (Speedy only hiphesl gads conpktm) 11. Marital 5,nas: Alenled, Never Married, 15 Survrvuq Spays Q1 wile, glue magen rums)
Wid
D
y
Cook Food Service ^Yas ®No owW,
ivorced (Slydrll
Elementary / SecwMary (0-121 Caeege 11 ~ «Sa)
10 Widowed
76. Decedent's Matlvq AdMess (Street, My /town, slate, zp easel Decedent's
°
e°a"
168 State Road AdaalRaaiderce na stale Pennsvlvania ~l
a
„~ ~Cj y~ ~~,,,Li„~~, Silver Spring
Mechanicsburg, PA 17050 nb coa,ly Cumberland T"a"p? ,7d ^ Na,Deamenturedwal.n Twp
18. famei s Name (First, mitltle, last, wdu) Adual t;laa d aY, Boa
'
nk P
F
tt
i 1q. Homer
s Nang (First, middle, mrden sumarne)
ra
o
e
er Dessa F,sheLnan
20x. INOnnanl's Name (Type / Pmq 20b. WamMN's MaYirg Address (Shed, dry / bwn, Hate, zp cods)
1 Ann Smith 168 State Road Mechanicsbur PA 17055
z,a. Hamm d Disposaw ^ crenMtiw ^ Donation z1b. Date d oispo~saon (Homo. day, yearl ztc. Pwoe a Disposiliorl (Name d romeyry, aemet«y «aMyr 1~1 z1a. Location Iciy / awn, stay, w woe)
I~ Banal ^ Removal from Seale
Was GemaUon a DonaWn Auth«iud
^ ~r.speay bYHadicelExamwrVC«orer? ^Yas^Nd Ma 11
2009 Triodes S ri Cemete Mechanicsbur PA
zza s L « rson acting tie euchl zzb. Ibense NuNyr
~ za. Noma and Adaeea d Fedgy g ~a~'lest pplaza W
y
FD - 014889 Mal zzi Funeral Home Mechanicsburg, P~
17055
C <mry wiyn
physraan u not avaWble al time d am b 23x. To ry best my ledge, tleam aaurted at me time, dale am place staled. (Sgytiae am Mlle)
~' LkB1W NIA 2 Dale Signed (Abrgll, daY Yea')
ceniro coals d mom. ,t'nl S e~5 e7a p ~ .~ o ~/
Hems 2126 must ce mnpeyd M persw
~ who prwa«w:as deem 2d. TUne d beam 25. Day P (H«dh, day, Year)
~ 26. Was Casa Relerrm b Modest Examiner / C«oner br a Reason man CtMrati«I «Donelyn7
. M.
r
~Q
^Yas ~No
RUSE OF DEATH (Sea Insirudlone and exemtabe) r Approxanale nynn: Pen II: Error aryr ' ~ ~ " 9alm. 2B. Did Tmaoco lhs C«mbM k Daam?
Item 27. Pan L Enter dy f~aILL9L-YeOLS - dseases. ti4«ys, « carWkauons - mat drecey caused me Beam. DD NDT enter yr any such as cardiac arcesl. Onset b b
m
respuabry anon, «venldcular 6brYlatron wetwd wirg me etakgy. Ud only cause w exh Wy. ea
but nd resWinq n me urltleAyirp ease even n Pan L ^ Yp ^ PrWdgY
~
IWIEDIATE CAUSE IfinW bxase « ~
~ r No ^ l/Mrnwn
r
oondtiorl n m
rasuXSlp des ~ -' a.
,Q AI ~___-
~~
L
~ 2B.q em W'.
r
Duo ro (« as a con '~'-'T'
E'a`
G ^ Nd prequel roam pall year
xn~*u~Y tiu wndnons, a any. B.
leadrcp b ma Dose asyd w tiro a.
Due to (« as a cons
E
m ^ Pregwd ar Imo d Beam
aqunnce op:
iger
e UNDERIYWG CAUSE
d
m
i
a
•
r r
^ Nd Dregau. Od prequnt wmen a2 de s
I
waw a ~ry
et
rw
K
d me
c.
events rewlNg tit deem) IASi.
I d seam
Due W 1« as a wryequerlce oq: I
t ^ Na pequnl, bd prequnt 93 Days b 1 year
d. ~ before deem
^ n a Prequel won" me pav Year
30x. Was an Autopsy 30b. Were Auopsy FYldrgs 31. Manner d Death 32x. Dale d I
Pedomxd'r Available Prbr y Completive ryay (Mash, day, Year) 370. Des<Me Flew Injury Occurred 32c. Plate d aM«Y: pony, Farm. Street, Fa 1ory.
w Cause d Deam? Natural ^ Homkye ~' Buidelp, ~ (Spe«hl
.~(
^ Yes yCl No ^ Yes ^ No ^ Aa+~r11 ^ Pending Inrestga0ar 32d tune d Iryury
""~ 32e. pyury at WakT 321. If Transparlaoon Irpay (SPer'lh/ 32q. location d injury (SUeel, dry / kwn, Hale)
~
^ Su~cye ^ Could NoI be Determinm ^ Yes ^ No ^ Dnv« /Operates ^ Passenger edasbian
M
Otlrer ~ Spea7y-
\
33a ced6w Irhedl «qr' «yl
• Certiryirg phyakian (PnysKyn wdtying taros d dram when anodyl phys'wian Has Dralourced loam and cwlplete0 Hem 23) 33b. SigrlaNre and 7 '.
/
Tome Feet d my tinowlWye, loam owurted dw b the Gase(s) am mamyr tie slated„ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Pronwrlcn
ant certi
in
n
ki
Ph
a
b
m
_ _ _ _ _ _ ~
_ _ _ - _ _ - - _ _ _ n
~j
~ v i7 ~ //
q
ry
g p
y:
an I
ysr
an
o
pmnourx:iny Beam am cenrfyinq to cause d deaml
To the Cyst d m luyw
Y lady.. loam OaCYlred n tM 111118, my, Md pyCa, em else 10111. NYaelal ant rrynnM u soya_
• Medical Examiner / C««w
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. NumOer
~
~~ ~ ceY~
On tly Dasia of axamuution anti / a nvesliyalkn, m mr opinion, death occurred at uy Ume, gala, and plxa, and sue to
the eeueps) anti nwuw u swad_ ^ ~
~ N
ame
a
m
A
d
deo d wson yd Cause d Deem (He m 271 Type P'
u Re 's Sgnd«e am Dislnd Nu
~ 36. Dale Filed (M«dh, my, year) 1~
r
r
~
.
~
- l~~ 1 1 I
I 1 I x~.l ~• at 310 IaTbs C~a ~~erl M~nicsbLUg, i7z1 1'7050
U v DlSpowknPefmllNO. 03186`.32
LAST WILL AND TESTAMENT OF .TUNE P. DEITCH
I, JUNE P. DEITCH, of Monroe Township, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do make, publish and declare this my Last
Will and Testament, hereby revoking and making void any and all prior Wills by me at any time
heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as
the same can conveniently be done.
2.
I hereby give and bequeath as a charitable contribution to the Mechanicsburg Brethren in
Christ Church (1050 South York Street, Mechanicsburg, Pennsylvania), the sum of five thousand
($5,000.00) dollars.
3.
I give, devise and bequeath all the rest, residue, and remainder of my estate, real, personal
and mixed, whatsoever and wheresoever situate to my daughter, CAROL A. SMITH, ner stir~es.
4.
I nominate, constitute and appoint my daughter, CAROL A. SMITH, to be the Executrix of
this, my Last Will and Testament. In the event that she should predecease me or for any reason be
unwilling or unable to act as such Executrix, I nominate, constitute and appoint HARRY M.
SMITH to be Executor in her place and stead. In the event that he should predecease me or for any
reason be unwilling or unable to act as such Executor, I nominate, constitute and appoint
DOUGLAS SMITH to be Executor in his place and stead. In the event that he should predecease
me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute and
appoint CATHY JO SHELLY to be Executrix in his place and stead. I further direct that they
shall not be required to file bond or other security in the Office of the Register of Wills for the
purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~~ day of
rd-~~' , A.D. 200 I _~
c ~_-
~~u ~~c-~'L (SEAL)
JU ~. DEITC
Signed, sealed, published and declared by the above-named JOHN W. DEITCH, as and
for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in
the presence of each other, have hereunto ub ribed our~mes as itnesses.
,~.~. / ~-
iv
1~ i ~'~ ~ 1-;Uu
,J._,..
a , ~~., 003
OATI~ OF NON-SUBSCRIBING WI'T'NESS(ES)
REGISTER OF WILLS
C ~h113E~ZL~¢yV~ COUNTY, PENNSYLVANIA
Estate of ~u ~ ~• 1~~1 ~h ,Deceased
~/`o~ ~: sili-~ and ,
$eing duly qualified according to law, depose(s) and say(s) that sheLhe~- was~P~P well-
acquainted with .~Gf I2E ~ ~ei ~~ and arr~~e• familiar
with the handwriting and signature of the decedent, and that the signature of ~~enL° ~ Q~e ~ ~~
to the foregoing instrument .purporting to be the Last Will and TestamenLu of ,TG[~.e /~
~~,, f"e ~ is in .k~}ier own proper handwriting.
~~_
//"
K -. ~7~ ~ ~~" y
(Signature) /l _ ~I ~,• StKt~..~
168 ~5.4~f~.~ fro
(Street Address)
~2Ch u,~t - e5 b u.rG . ~~ I ~ o S~
(Cite, State, Zip)
Execacted in Rebiste~•'s Offzce
Sworn to or affirmedss and subscribed
befor e this I day
of , ~ ~ .
eputy fbr Register o~~,rills
(Signature)
(Scree! Address)
(ctry, state, zlp)
Farnt a u%o~ rev. l 0.13.06
i~ \ Q~1 OS~'~
OATH OF SUBSCRIBIl~G WITNESS(ES) ~--~
w~
T -,
REGISTER OF WILLS ~=~ ~ ;;
,,
C ~ n? 13 E~2~/F.~ COUNTY, PENNSYLVANIA ~ ~- ' ==~
,_ ~;:_ ;
=a
c~
Estate of ~`~ he ~ ~e,~"G~,
_._.,
_:;
~__
~_=
~.. .
Deceased
~~k~~PS F, cSljiE~ll~S ~ ,{~rel~-a subscribing witness to
(Print Nmue/sJ
the J8[Will -B-Eadici~(~}presented herewith,~{~eing duly qualified according to law, depose(s) and
say(s) that .shed he /~~c was present and saw the above Tr~~Testatrix sign the same
and that slrc->~ he 1~ signed the same and that sl3e-/ he y signed as a witness at the request of
the ~es#atarr~Testatrix in herJ-~ presence and in the presence of each other.
~~
X
(Si/gaaaae) C'h~~„~CS )F~ /S, ~1~u~[Q/5 ~ (Siguatw•e)
l0 ClDCts~r I[OIXc!
(Stree! Address)
/1~lc~i~,n,csbu.,~, 6~~- r 7 osf
(City, State, Zip)
(Street Address)
(Cit)y, State, Zip)
Execaated in Register's Office
Sworn to or affirmed and subscribed
befo ie this day
of (~A1..P ,, ~~.
E~:ecaated oast of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
Notary Public
My Conunission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form R61'-03 rev. 10.13.06