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Home My WebLink About05-27-09PETITION FOR PROBATE AND GRANT OF LETTERS Register of Wills of Cumberland County, Pennsylvania Estate of PEGGY A. STERMER File No. ~~ ^ t~v~9 ' ~'T ~ / Deceased Social Security No. 209-50-7646 BARRY STERMER Petitioner, who is 18 years of age or older, applies for: (COMPLETE "A" OR "B" BELOW:) ^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the Last Will of the Decedent, dated and codicils(s) dated _ estate relevant circumstances, e.g. renunciation, death of Executor, etc. r-ra Except as follows, Decedent did not marry, was not divorced, and did not have a child born or a~pted aftel~xecution of the instrument(s) offered for probate; was not the victim of a killing and was never adjudicated arz-~apacita#~d person:.-- -..; _ ~> _ ,,. r-- _ ~, ~ ~ _ -r B. Grant of Letters of Administration r (if applicable, enter: c.t.a.; d.b.n.c.t.a.; pendent elite; durante absentia; duC~tte mihoritate Petitioner, after a proper search has ascertained that Decedent left no Will and was survived byalse heirs listsd below. Barry Stermer, requests that Letters of Administration be granted to him, the Petitioner. Barry Stermer, the f~etitioner, is the Surviving Spouse and Heir of the Estate Name Relationshi Residence BARRY STERMER HUSBAND 500 Pawnee Drive Mechanicsbur , PA 17050 AMANDA HOPE STERMER DAUGHTER 500 Pawnee Drive Mechanicsbur , PA 17050 NICHOLAS ANDREW STERMER SON 500 Pawnee Drive irn~eoi cTC i~~ ni i nn ccc~. n Mechanicsbur , PA 17050 _ ~~~•~~ ~~ ~ ~ ~~...~~ ~.n.aw~. nuau ~ auunwi iai aneeu n Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 500 Pawnee Drive Mechanicsburg Hampden Township Cumberland County PA 17050 (List street, address, town/city, county, state, zip code) Decedent, then 46 years of age, died on January 9, 2007 at Holy Spirit Hospital Camp Hill PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property .....................................................................$ LITIGATION (If not domiciled in PA) Personal property in Pennsylvania .....................................$ (If not domiciled in PA) Personal property in County ....................................................$ Value of real estate in Pennsylvania ......................................................................................................................$ Total ......................................................................................................... $ LITIGATION Real Estate situated as Wherefore, Petitioner respectfully requests the grant of Letters in the appropriate form to the undersigned: Si nature T ed or tinted name and residence Barry Stermer 500 Pawnee Drive Mechanicsburg, PA 17050 . -.-.--r Oath of Personal Representative ~ ~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND r'~ '`~"'~ `~'` ~~ ~ _ The Petitioner above-named swears or affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate according to law. Sworn to and affirmed and subscribed Before me this ~ / ~ day of 2009. File No Social Security No: 209-50-7646 Date of Death: January 9 2007 AND NOW, n(~ '~ 2009, in consideration of the foregoing Petition, satisfactory proof having been presen d before me, IT IS DECREED that Letters of Administration are hereby granted to BARRY STERMER in the above estate . FEES Estate of PEGGY A. STERMER ,Deceased. /4. BARR STERME a2/- C~9- ~~'~ Letters ........................... $ c~~, Go Short Certificate(s) Renunciation .............. Affidavit ( ) .................. Extra Pages ( )....... Codicil ............................ JCP Fee ....................... Inventory ...................... Other .............................. ~ $ S-~ $ }S~, ~ $_ 1 b. ~ ~~1~-% J .cS~ of Wil/s Attorney Signat Attorney: HO E .JOHNSON I.D. No: 0 40 Address: John on_ D ffiF? ~tawart R ~n r v~ 3v i iviarKei Jireei b' U t3ox 109 Lemoyne PA 17043 TOTAL......... $ ~~ Telephone: 717-761-4540 105.805 REV 1105 This is to certify that the information here given is con-ectly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ~, ~7-~~7 WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 L~~ ~ t,~ Loeai Registrar P 13~U486~ No. Date ~7 .= -- c7 r: - "Y IEV n/2oo6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ' 4NENT - -- >RwnN CORONER'S CERTIFICATE OF DEATH ~ ~'~ KINK -_..~.,__.. ,/...~ _. _ dE9(1_4~(1 (See instructions and examples on reverse) ~r.r~ ~„ ~,,,,,,,,~„ -, ,--.: ~ ,_ r -. 1. Name of Decedent (First, middle, last, suffix) 2. Sex 3. Sadel Secudry Number ,t - - - , 4. Dam of (MOmm, tlay, yeayY-' Peggy A Stermer Female 209 _ 50 _ 7646 .L~nt~yry 9, ~7 5. Age (Lazt Birthtlay) Under 1 year Under 1 day 6. Date of Binh (Month, day, year) 7. &rthplace (Ciry aM stem or foreign country) Ba. Place of Deam (Check only one) j-:> 46 MontFa Days Ncurs MlnNes Jan. 26, 1960 Hospital: Other ' Yrs. Harrisbur Pa ^ In ti t ~ ER /O i ^ ^ , pa en utpat ent DOA Nursing Home ^ Residence LJ OUer - Spaciy: 86. County of Death Bc. City, Bo T t Death !b. Facility Name (If not institution, give rival and number) 9. Was Decadent of Hapanic Origin? ~] No ^Ves 10. Race American Indian, Black, Whae, ek. Cumberland East Pennsboro (It yes, specify Cuban, (S~~ Holy Spirit Hospital Mexican, Puerto Rican,ek.) White 11. Decedents Usual lkcu tan Kind of work done dun most of waltin Me. Oa not state retired 12. Was Decedent ever in the 13. Decedent's Education (Spedty only highest grade completed) 14. Mental Status: Martied, Never Martied, 15. Surviving Spouse (tt wife, give maiden name) Hind of Work Kind of Busiress /industry U.S. Armed Forces? Elementary /Secondary (0.12) College (1 d or 5+) Widowed, Divorced (Speciy)~ Artist Stermer Desi ns ^Vea ~No 4 Married Barry Stermer 16. Decedent's Mailing Address (Breei city I town, state, zip code) Decedent's P Did Decedem a Actuei Residence 178. State 17c" Yes Decedent Lived in H en 500 Pawnee Drive Mechanicsbur Pa 17050 =T , ~, T Township? 176. coumy Cumberland 17d. ^ No, Decedent Lived within Actual Lurks of Ciry / Boro 16. Famer's Name (First rtidtlb, last, suffuc) 19. Mothers Name (RrsL middle, maiden surname) Charles Shuler III Gretchen Stoner 20a. Inmrmant's Name (type /Print) ZOb. InformanYS Meiling Address (Brest; city /town, slam, zip code) Barry Stermer 500 Pawnee. Drive Mechanicsburg,Pa 17050 21a. Memod o/ Disposition i Cremation ^ Donatbn 2I6. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory a other place) 21d. Locedon (Ciry /town, state, zip code) ^ Burial ^ Removal from Bate ~ Was Cremalbn or Donation Authorized ^ other-spedry: ; 6yMedkalExammeNCaroneR Vea^Na ~ d Hollin~'er~Crematory ` Mt Holly Springs,Pa tore rot Service ~ person acting as such) 22b. License Number 22c. Name and Adtlress of Fadliry ~- ` Mar e t S t ree t - 011654-L Myers-Hamer Funeral Home `Inc Cam Hill, Pa 17011 Ca~eta Items 23at onty when cerNtymg 23a. To me best of my kmwNdge, death occurred al dre 9me, date end piers stated. (Bgnature antl title) 23b. Lcense Number 23c. Date Signed (Month, day, year) physiden rs not available of lime of deem to _ cemty cause of deem. Items 24-26 must be completed q' parson 24. Tme of Death 26. Dam Pronourw:ed Dead (Monet, day, year) 26. W Case R erted to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? wtaprnnmmnaaeaam. 9:59 P. M. January 9, 2007 id ~ves~^No CAUSE OF DEATH (See inetruetions and examples) t Approximate interval: Pan IC Enter Deter =ianifi eat aMN c .mnl' vine to d ,tee^M, 2B. Did Tobacco Use Contribute to Deam? Item 27. Pan L Emer the Mom of evenn -diseases, injures, or coriplicafions - mat dreary caused the deem. DO NO7 enter terminal events such as caroiac artest. r Onset to Death bN not resumng in the undedying cause given in Pan I. ^ Vas ^ Probably respiratory avast or ventricular tilMtlafion caiman showing the e[bbgy. List only one raua on each fine. t r RAMEDIATE CAUSE (Final disease or ' ^ Na ^ Unknown condkian resulfing in deem) _~ a. Pendin>; Investigation ~ - 2s.uFemale: Due to (or as a consequence oQ: ^ Not pregnant wthin past year SequenOeMy kst conditions, r any, p ~ leadrcq to tM pose listed on Nne a ^ Pregnant at time of death . Due to (or as a cron uence o Enter the UNDERLYING CAUSE ~ f1~ ~ ^ Not pregnant, but pregnant within 42 days (dsease a injury that initiated me t, r events resumng in death) LAST. of death Due to (or as a consequence oq: r ^ Not pregnant bet pregnant 43 days 101 year d. r belore deem ^ Unknown if pregnant within the past year 30a. Was m Aulapsy 30b. Were Autopsy Flndim~s 31. Manner of Deam 32a. Date of injury (Month, day, year) 326. Descrilxs How Injury Occurtetl 32c. Race of Injury Hane, Farm, Breet, Factory, Perortned? Available Prior to Completion ^ NaNrol ^ Hanidtle Office BuiMi etc S ~' ~ (~~) of Cause of Deam? Ves ^ No ^ Vas ~No ^ Accident ~Pendrg Investigation 32d. Tme d Inryry 32e. Injury at Work? 32f. II Transponatlon Injury (Speczrty) 32g. Location of Injury (Brat, dty /town, slate) ^ Suidde ^ Could Nol be Driernine0 ^Ves ^ No ^ Dmrer/Opereta ^ Passenger ^Pederirian M ^Omer - SpenYy: 33a. Canifier (check only one) 33b. Signature an n' • Certllying phyaklan (Physidan ceniying rouse of death cater another physxtlan has pronourxstl tlam antl completed Item 23) CO T One Y - To the bat of my knowledge,dnm attuned due to the atue(sl and manneru Malad_______________'---__------------ ^ • PronooMing and antiying physician (Physidan both prawundng dam and cedtying m cause of deem) To the bat of m knowled e deaM attuned N the tlme dam and nd d t tM d l f d ^ l .License Number 33d. Date Signetl IMmm, day, Year) y g , , , ans, e oe o auae(c) an manner es s e e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ P • MedkNFsammerlCoroner On the Geis of exeminalbn end ! or invatigatbn, in my opinbn, deM occurred at the time, dam, end plate, end due b the ceuee(s) and manner a sated_ ~, January 11, 2007 ' ~ argAddras,of Pg~son 1 ~p Can and Cause ~eal~ ttan 2 T /Pint Cha2 l L 1VOTT IS l ) r~ Yp' 35. Registrols S' u and Dishid / •) I n ~ / 4~ 0^ - l I I I I I 36. Date sled( day, year) L o . . , . O neY 6375 Basehore Road gt~ to Ili M h i b P 17 5 / fn 2pp J ec an cs urg, A 0 t V Disposhlon Permfl No. ~/ /(/ ( ~Q t~