HomeMy WebLinkAbout06-18-09PETITION FOR GRANT OF LETTERS OF ADMI aSTRATION
Estate of BETTY S. HERMAN No. 21 09 - ~5
also known as To:
Register of Wills for the
Deceased. County of CUMBERLAND in the
Social Security No. 169-24-5480 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl lies for letters of administration
on the estate of
(d.b.n.; pendente life; durante absentia; durante minoritate)
the above decedent.
Decedent was domiciled at death in CARLISLE BOROUGH County, Pennsylvania, with
her last family or principal residence at 855 WEST NOR(THSS TREmber,CwpRor B of PA 17013
Decedent, then 81 years of age, died 6/912009
at HOLY SPIRIT HOSPITAL CAMP HILL PA 17011
Decedent at death owned property with estimated values as follows: 415.000.00
(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 $ 180.000.00
Value of real estate in Pennsylvania
situated ass fo~~o oTU eTR~~T cARUSLE. PA 17013 _
Petitioner er after a proper search ha s ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs: Residence
Name Relationship
570 OLD QUAKER ROAD
700 WALNUT BOTTOM ROAD
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THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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ARY E. G~TZ f
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LEWISBERRY PA 17339
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ~ SS
The petitioner(s) above-named sweaz(s) or affum(s) that the
statements in the foregoing petition aze true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed' d subscribed
before me this _.____~,_ day of
JUNE 2009.
Register
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No. 21 -09- b~J1a~
Estate of BETTY S. HERMAN ,Deceased
GRANT OF LETTERS OF ADMINISTRATION
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AND NOW JUNE .2009
in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that MARY E. GETZ
is/aze entitled to Letters of Administration, and in accord with such finding, Letters of Administration
aze hereby granted to
MARY E. GETZ
in the estate of BETTY S. HERMAN
Register of Wilis ,~J ,~ ~
FEES
Letters of Administration SgS,L~c : $ ~~C
Short Certificates (6 ) .. _ $ a
Renunciation .... $ j~
TOTAL $
Filed ~-
............ A. D. ~ (~y
64 SOUT
CARLISLE PA 17013
ADDRESS
717-243-6090
PHONE
AriUxtvl: (Sup. Ct. LD. o.)
H PITT STR
105.805 REV (01!071
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P ~ s/~~t.l'lf ~~
This is to certily that the information here given
correctly copied from an original Certificate of Deai
duly filed with me as Local Registrar. The origin
certificate will he forwarded to the State Vit
Records Oftice for permanent filing.
L-~ix~ ~~~a~.c~~ Jebe.~r J U 1 2 2~K
Local Registrar Date Issued
Certification Number
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H705.141 REV 112008
7VPE /PRIM IN
PERMANENT
BLACK INK
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS '-~~ -
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CORONER'S CERTIFICATE OF DEATH ~ ~ _
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(See instructions and examples on reverse! b -
1. Nona d Detedenl (Prat. nedde, last, adAx) 2. Sex 3. Sadm Sacuny Numb« 4. Data d Deah (MOnM
,
Betty J Herman Female 169 - 24 -5480 June 9, 2009
s. Aga (Last BklMtay) Untler 1 year Under 1 day fi. Date d BirM (Month, m .year) 7. &rMplaca ICBY ant acre or ) sa. Place d Death (Check oa)
81 ~"` °'Y' '"" ""1°" OCt. 4, 1927 Hospnab goer.
y"' Shermansdale PA ianl ^ER/Oulpeeent ^DOA ^NurekgHOme ^Residence ^OMer-Spedly
W. County d DeaM &. Clry, Bo T Death Ba. FazYily Name (II nd insetul'pn, give sheet ant number) 9. Was Decedent d Hrepenic Or'~n? No ^ Yes 10. Race: American Inden, Slack
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Cumberland East Pennsboro Holy Spirit Hospital Iltyes,spedryCUwn, (~M
Mezicen, Pano Ricen, etc.) white
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11. Deadenl
s Usual tlon Kid d waAc mw mom d Are. Do not s@te 12. Was Decedent ever in the /3. Decemnt's Education (Speciry Dory highest gram completed) 14. Marital SaNS: Monied Never Mertied, 15. Surviving Spouse (A vote, give maiden name)
IOM d W«k Kintl d Bueiress / IMUary U.S. Armed F«~? Erementary /Secondary (0-12) CoAege (1d or 5t) ~ow'~~ DNaced IsP xah')
u 1 Technician Naval t ^rw f3r,o 2 Widowed
16. Deamnl's Meing Address (Street, dry /town. ame, zq coda) Decedent's Did Decedent
855 W. North St. AdualReaidance ,?a.srere Pennsvlvania wane no.^vea
DeammL;xeae
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Carlisle PA 17013 1n.c«~y Cumberland T°w"'n~? ,Td.CYNO,Deaa.ntlNadwmanCarlisle
Adam limas of CAy /
16. FeMefe Name (Fret, midge, last, sulPot) 18. Mdher'e Name (Fret, midda, medN1 Sumeme)
Louis A. Smile Mar -Black
20a. In(omieMa Name (Typo /Pant) 20b. Inl«manl's McAing Adttrees (Street, dry /lam, state, zip age)
Mar E. Getz 570 Old uaker Rd. Lewisberry, PA 17339
21a. MatMq d Dlapossion ^ Gsmsson ^ D«xtian
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2v. Slgrekua d F«erm Service licensee (« as such)
''~~~ 22D. Lcense Numb« 22c. Name ant Amreea d FB[Aily 630 S . Hanover S t .
~ FD-138548 Ewin Brothers Funeral Home Carlisle PA 17013
Cornplae Items 23ec prig when wdilylrp
phryitlen re rot eveAebh a time d math ro 23a To Ue beet al my kmaedge, mall aminetl m tle tme, dare ant place mated. (agorae ant WI 23b. License Numwr 23c. Date signed (MOnM, der, Year)
awry duce d man.
hens 2426 mull w anpleletl M perem 24. nine d DeaM 25. Date Pmnamad Dead (MmM, dry, year) 28. Wes Casa Rmerred to Medical Examiner /Coroner for s Reason gher Men Cremetbn « Donawn?
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CAUSE OF DEAT}A (Sea InstrxwYlotro and examples) , Appreximae kdarvm:
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30a. Was en Autapay
Perl«lad7 306. Were Auropry Rxhgs
AveAede Plkr ro Catpktl«I 31. Manner d Oeetli 328. Date d Iryury (Homo. mY. reaA 326. Describe How InWry Oaurretl 32c. Plea d Irdury: Mama, Farm. Slreei Factory,
dcewedoeaM? ^
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Nurs in Home
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psa"a° pca'Id"d6a°e'en"1a° 8:35 P M. ^Vas'~ ^Gg~^~• « ^P'seanga` pP<aammn Grandon Way, Mechanicsburg, PA
33e. Certifier (duck ody me) 33b. signature arltl nlle
• l:er8lyilrg P6Y~•n (P6Yadan ~ryh9 awe d mall wren anaer pnysidan nos prarounced deaM ant cenpleted Item 23) 1
Coroner
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aeuse(t)elam.nlwr as ctaetC-----------------^ 33c. Liarse Number 33d. Ome SIV~ea (MOmh. mY, Year)
• MaakalEumirr/C«onx June 11, 2009
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