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HomeMy WebLinkAbout06-24-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA Estate of Mary Ann McHale Pile Number ~ ~ Q ~ L~ ~~ t1 also known as N/A Deceased Social Security Number 179-30-8187 Petitioner(s), who is/are IH years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) /^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / aze the Executor named in the last Will of the Decedent dated October 1, 1983 and codicil(s) dated N/A (SYate relevant circumstances, e.g., renunciative, death of exeMor, etc.) Except as follows, Decedent did not many, was not divorced, and did not have a child born 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: N/A B. Grant of Letters of Administration (/f applicable, enter- c.t.a.; d.b.n.c.t.a.; pendente life; duronte absentia; durance minoritate) `,; _''~ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ ~' N Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at ~, 1128 Columbus Avenue Apartment #4 Lemoyne, PA 17043 (List street address, tawn/city, township, county, stole, zip code) Decedent, then 72 yeazs of age, died on June 10, 2009 at Harrisburg Hospital Harrisburg, Dauphin County 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 $ 0.00 (If not domiciled in PA) Personal properly in County $ 0-~ Value of real estate in Pennsylvania $ 0.00 situated a<s follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: name and residence John M. McHale .r~ ~ ~ 51 Gladwyn Drive, Reading, PA 19606 Form RW-02 rev. 10.13.06 Page I of 2 Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) andheirs: (If Administration, c.t.a. ord. b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) C7 ~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland SS The Petitioner(s) above-named swear(s) or affirm(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 Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the ~ ~ day of r7"'' n~ ~ %~~ 19 + . (, ~/ Signatwe of Personal Representative `tTC ~ :~ 'T'f 1~3 _ ~S .C' r~-,-'._ t , ~~ i't C. For the Register Signature of Personal Representative - j 'i L y. r " 37 ~ (73 ~ _ r\t ~} h File Number: ~ ~ ~~~ ~ ~~ j Estate of Man' Ann McHale ,Deceased Social S_e~Jcurity N~u.,/mber: 179-30-8' 1~87"~ Date of Death: June 10, 2009 AND NOW, °t 1~~~ ~-i'! (~~t ~ ~ ~J ~'~~' ~G~ ~~ on~ideration of t~e foregoing Petition, satisfactory proof having been presented before e, IS are hereby granted to in the above estate and that the instrument(sl dated ~ / ~ ` described in the Petition be admitted to probate and filed of records as the last Will (and ~dicil(s)) of D~c~edent; ~ ~ FEES , ~ ~~it-"' `'i ~ JL~ vv Register of Is Letters .... ~~.i.U...... $ ~S Short Certificate(s) ... ~~ ... $ ~ - ~ Attorney Signature: /~ Renunciation( .......... $ ~- I IU~QT ~ . ZC1~ .j,,~d•{~-- $_-LV. U Attorney Name: ,_ ~ ~-~ T ... $ J •w Supreme Court LD. No.: ~~ ~~Q ~;lJ~ l1 ... $~~. ~~ / Address: ~3Op{ ~t ~'RkIO~~ R~~' ... $ ... $ ... $ _ y • • • $ Telephone: ~ (~ _ -7'7 ~ -~~ ~ ~ 1 ... TOTAL .............. $~~~ Form RW-02 rev. !0.13.06 Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF C?EATH WARNING: It is illegal to duplicate this copy by photostat or photar~raph., I=ec f(Tr this ccrtificat~~. S~i.OU I,~tip,1S t~ '7f PF~,~ ~,. .''`,rg~ ~, ~ z ~;fNt CrY,;„, ~I1~i~ i~, ;l, ~ctt , ia:)t ;h~: il~i~clr i<aiutl (1-arc ~i~ir: i~ t~))rcctl~ 13;Ti~.1 l.l~.);) .Ilk ~ni_rin ti ('-Iti)I~ate llf I)~at} I)U ~ tlltrrt >>?O 1..' ,t~ ~ l)~lll ~ r ItiTICa 117c' t~ I~i1?~l i.,ltl)1G1C1 1117-. ). Is)1 clftil'LI ' > illl til%12t` 1~;1~1 KCC(1('(~~ i d(IICI' I). aiC!-f t -^aai1 I I 'L P 1565.5669 l:crtilic~(ri~~n ti~nnhrr 1 a,7 REV t 1.2006 PE PRINT IN 'ERMANENT al.1~N INK i_ucal R~li~trt), L , rte ( _. n .] Tj (` :_'„ iTl ~f~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~~~{~ i - ' I ; ~ T 1 - CERTIFICATE OF DEATH ~~ ` (See instructions and examples on reverse) STATF FII F NIIMRFR -^~ fV Y~ t~ t,~ ~3 1--ry.q~yp-• .i p11~ 1Q_~' ~.)aEC ~»1lcl~ f""~: _ .7 ` .J I. Nun9 a Dxeawl IFrst, mlddw. usl. sotto) _- 2. Sea J. SacW Sxwry NumMr J Dean lMalm, Day. ~ . Mary Ann McHale Female 179 - 30 - 8187 /Q 5 Aga ILasl eavaayl Urban 1 eu Under I M 6. Dale of &nn IMOnIN, d . ear) 7 & laitl IG arW suN w Iw e count I 6a. PIx• ul Dwth Check oriel Menms DAYS Hours Hooter Hcsprlal: Omer '] Yrs. ~Inpalwnt ^ ER / Oulpolwnl ^ OOA ^ Nursay Hama ^ Resukrcw ^ OOwr ~ Speary'. d6. Gvunry cl Deam &. C,ry. doro. Trop. of Oeam BIf. FxlGry Name (If mt ~nsuwu9n, ryve sywt arb numyerl 3. 'Nas Dxedenl of Hlspanrc Orgrn? No ^ Yes -. A rrwrran Ir10an. RucR WIaN. arc. 10- R a I Y ~P e ~ S ~ , Dauphin Harrisburg Harrisburg Hospital Me arcan U to ~.b) White 11 Decedent s Usual O:cu anon INmtl a «wk o aw o wl aorta wwk rile. Do rwt sate rmaedl 12. Was DeceOea ever .n me 13. Deceunts Equcaeon ISpeary Dory nlgnest grans comp lelwl 14. Manul Subs: Manley, Never MarMO, 16. Sunning Spo use Ilf rode give nwben name) NIM a'NOrk Kab of Bu51MSS; Industry U.S Arm9tl Faces? ElBmenury I $econtlary (612) College (1-e or i.) Wboww. Dwacw ISpanhl u ^ Yee {c7 N~ 1 16 Daedenl S Mulug Aake551$UBeI, Clry ~ IOwn, stale Zlp 409) I! DlCedents Pennsylvania ~' aD aeyenl Actual ReslMnce t7a. Stale ITC DeceuM Lwed.n ^ Yes 1128 Columbus ave. I14 . Trop . ~ Tawnsnrpv I PA 17043 L 77d p1 No DecederN UveO wlmrn Lemo e nacounry rlymharlanrl Yn emoyne ActuuLrmrNOt cayreaa B Farar s Name )Frsl. nua1N. usl, radial Ig Homer's Name IFust, mgdw..malyen sumuM) 20a Informants Name IType ~ Pmn 20p. Inlormanl's Marring A11aew ISOeer my .lows, suN, zp codel John M. McHale Jr. 51 Gla Dr. Readin PA 19606 't a. Melnvtl of Orspostlrm ^ Cremxbn ^ Donation 210. Date w Dlsposalon IManm, Day. year) 21c. Plxe of Orspovtwn INarM a tamale ry. nemalory a ether plxer 2ty. Loudon IOry ~ bwn. suN, cp cGde1 C~ aww CI Remora nomslale ~ waaeremationuDOnalionAWanzW ^ r ^ 6/16/2009 Resurrection Cemetery Harrisburg PA ay NstliW FaaminmlCaoMr? Yes No ^ C:nar ~ 3pec:h. ~ _za s,grdlwa al Fw,er ~ xnng a: ;,,0n, zo. Laenw NumOar zz~ .Name aw Atlaew a. Fxlllry Jesse H Geis a Funeral Home . ~ FD-014404-L . 2100 Linglestown RD. Harrisburg, PA 17110 CJnlpwl2 Hems .~ avy wn wrarylry 2Ja. Tc ;na yesl of my'nnowwyg9. yeah uccurrw al ttw Imw. Dale aM puce slale0. ISrgnaluN arYd utlel 27n. Lrcenw Namur 23c Dale Sgrw IMmm. daY. Yeul ;,nysK~an,s not avanaae al ume a uam to :emry taus! a ream. lams 3o-26 must u mmpieud oy parson U ..ma vt Ceam 25. 0' rvnwncw Dear IMOnm yay. Yearl ' z6 Was Case Relened 'o Mescal Examewr coroner a n Reason Glum ran GemaOm a Danalan? «rw pronounces xam. M. / /~ UO ^ Yw ~ No CAUSE OF DEATH (Ses iretruetlon n0 aaampNa) r Appranwle menal: Tan a Emer omen iW fica.r toner- s oar hound ~o xam. 29. Dd Tcwcco Use GGnlnW10 !o OaaNn Item 27 Pan I: Emer re cheat w events - mwaws nlur,es s canpralwns ~ mat dreary uuwd lM N. DO NOT enter lemma events s era e t Onsal :o Deam respaalory arrest. or .enlncuur fibnnau «Imoul stwwmg m etlobgy. List only aw eon each nM. / ~ ~ ~ Out rKa raswmg .n yw unMMing rauw given n Pan 1. ^ Yas ^ Prolsanly R'y yo ^ Urwawn XY i IMMEDIATE CAUSE ~F~na aware or [ 1/, I, ( ( ) 4MIlIM r¢swurg .n d9aml 1e ~ l r l -+ /r ~ /l ~ 1~ /~' 29. ;t Fenww. _~ (./ T i l ~ N a. ~ N Due l0 la as a <awpuence vll: a aeglw wane past year ^ Pregrwrd a bM a uam Sepuemuky :tat cal0in(Nls. rt any, n n O ^ Rawg 10 mB UUw sIB Oil ~inB d. ~ ~0 la d5 d COn MB 01 Enter lie UNDERLYING CAUSE qua 1' N9l pregrWN, IaA pr•gnara wrlhrl a2 yaYa [awaw a myry7w oNaraC 9w c events reswtvg .n Oaaml UST. W ~~ ^ ~ Due 'o la as a conseCuence op~ Na praq lMa, taA pragrura a3 do b 1 year d. Mta• Hun ^ UM1Jbwn y Me9nard warn me past year l0a Wei an AObpsy 300 'Nara Autopsy Finoalgs 71 ManMr of Deam 32a Daw of Iryury IMOnm, Day, lead 320. DescnM How'IMury I)uwre0 J2c. Plan of Irywy. MIXlN, Farm, Strse4 Factory, Penorrrwd? Arauow Pna to Cmpauon ®Nauual ^ 1lonacroe Oyrw Bwlang, et. ISper+h/ d Cause vl Deam? ^ vas ~ Nv ^ v ^ N ^ Accroent ^ Pwang Investlganon 32d_ 7inw W Iryury 32e. Iryury al Worav 32t. II iransponalwn Iryury 9nh1 32g. Locator a ~ ISuwl, ury wwn, soul as o ^ SurObB ^ CouW N01 M Delermne0 M ^ 4es ^ No ^ Onver; Operalw Q aswng9r ^ Plbeslfwn . Omer' Spaary: 33a Cennwr lawck aI.Y until 3b. Sgru re Tine OI Cwatwr • CMifyury phyakian IPnysa:un cenrrying rouse of deem «iwn argmar pnyscun has proMUrrcetl deem any ccrlWwleo'.lem 231 Ta IM MMC1 my aMwMdge, MaN occunsd yw to lM UUaela)any manMr a•SNI•d_________________________________ ^ . • PronnOrrOmg irld C•Mfyin9 phyflCNlr IPnySNUn OOm prOrlOUwng Mam aM CBNfYmg 10 Cde59 01 Owm) • Ip T V t m d t IM li M t W Nd d d l WnMr , ^ / ~ y ~1 '~ ' / 330 a Syw0lMmm. daY. ylal ~ 1 mY now ge. occurre a me, o N a n aN, any p ace, and dw Io lM uuaNsl and manner ae fNNd_ _ _ _ _ _ _ _ _ _ _ I8! ~~_~__~ • wdKxFaararwryca9Mr • / / r / / ~ / / s/ / ) / / G V On nw MW a eaamrMtwn aM 1 a mreatigatbn, m my opnion, dam occurred M lM tlrtw, daN, and plea, any dw t o IM uuaa(al and mama as stated. ^ ys ,N Ada w of/P e/rson WM l C 7f~e m I l m 27 p•. PrvN a ~~ ~~ ~ ^ Ra s -s Sgrutura D"V Nu I ~I ~ ~I ~~ !6 Oa FiNd I m daY. Veen / i ,,,/ - 0' U ~ DlapostMn Parma Db a 3s~go3 I, Mary Ann McHale, residing at 3817 Griffin Lane, Harrisburg, in the County of Dauphin, State of Pennsylvania, at the age of forty-six, and being of sound and disposing mind and memory, do hereby declare this to be my last will and testament, hereby revoking all former wills by me heretofore made, I give devise and bequeath all my property, real, personal and mixed, wheresoever located, to my sister, Virginia M. McHale, to have and to hold as her property absolutely. In the event my sister and I should die simultaneously, or that she should pre-decease me, I give, devise and bequeath 1 all my property, real, personal and mixed, wheresoever located, to my brother, John M. McHale, to have and to hold as his property absolutely, It is my express desire and wish that all terminal illness expenses, together with funeral expenses, be paid in full before the distribution of the assets of my estate, I hereby appoint my brother, John M. McHale, ~ as sole executrix of this my last will and testament, without bond; In witness whereof, I have affixed my hand and seal this lst day of October, 1983 .~ .~~ J; r. ~, . ,t .P. r v ~.~Y ~ Cr ....a. (SEAL) (SEAL) Wittnessed this day October 1, 1983 ~~ ~' =o ,~ ~ -~- ~ - ~: ~ -~ ~ _x,-, ~ ~- ... _.:-,,~ ~~-:, r ' _J ~_ =~ ~ ~ _- `~° , ~ , OATH OF NON-SUBSCRIBING ~'ITNESS(ES) REGISTER OF WILLS C`~nr~(3~W~p COUTITY, PENNSYLVAIvTI_A Estate of ~~R'S 1~~~'`t ~~ ~L~ ,Deceased ~O N~ (~1. ~1 ~1-~AL~e. and ~1S~~~t OS~ _l_(hmA e.~.tt~-~ ~ct~A ~~ (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with ~1AR`t ~Nti1 ~~~~~'~ and am/are familiar with the handwriting and signature of the decedent, and that the signature of rYWR'~ J~~- ~k-~IA~~-- to the foregoing instrument purporting to be the Last Will and Testament/Codicil of rnAIZ`~ ANN '~c~~R~- is in his/her own proper handwriting. (Si~~ a u'e) (St~~ eet Address) (~q! Mate, ZTp) Execlcted in Register's Office Sworn to or affirmed and subscribed before me this ~`~ day ,~ G2 ~' 7 of t,tn( , ~ ~ Deputy fo Register f Wills ~~ (Signature) ~~/,~~ (Street Address) (Cky, State, Zip) ~.~ ~' -- O ~~ - ~' ~`_ c7 ., ~ ~~ r-- .. r-rt ~ - _ ~'~ L v-~ ~ rv o~ Form R61~'-04 rev. 10.13.Oh