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HomeMy WebLinkAbout06-26-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Erika K. Cawley File Number ~ 1 ~ _ 1 0 F`~1~~ 220-44-1174 also known as ,Deceased Social Security Number Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) ® A. Probate and Grant of Letters Test~npent~ry ~ttd aver that Petitioner(s) is Nt~A e E Xe C ll t r 1 X named in the last Will of the Decedent dated M 3 r C h // , U U Oand codicil(s) dated / (State relevant circumstances, e.g., renunciation, death ojexecutor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adV ~ Ad after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durante absentia; durante minorita~_,, ...-~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followintse (if an~and hairs; (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.) ~-i .~Z ~ <sa -._ ~-- Name ~~ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumber 1 a nd County, Pennsylvania with his /her last principal residence at (List street address, town/city, township, county, state, zip code) Decedent, then 85 years of age, died on May 31 , 2009 at 1 0 Hickory COUrt Boi inq Springs, PA 7007 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 7 5 , 0 0 0 . 0 0 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 2 4 0, 0 0 0. 0 0 5 Kitszgll Drive Carlisle PA 17015 Total $315,000.00 situated as follows: ~ ~ Form RW-02 rev. 10.13.06 Page 1 of t Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF Cumberland , The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are 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 ~~~L mot!-Zl.~'L.d. `-' ~Jw~' t".~ ~/^ of da h Signature of Personal Representative C7 C Q ti-~ ~ c y before me t e ~ _ ~ z~ ~ _ ~-= J ne 2009 Si ature o Personal Re resentative ` i-n -r- -~- ~ ~._ /~ ~ Foi the Register Signature of Personal Representative ,_ ~ ;~, -; t =:>- C:~ C. - .Y-~ ~~ --- ~ ~ ~ ~1 ~ ~j`~~ File Number: Estate of Erika K. Cawley ,Deceased Social Security Number: e 2 2 0- 4 4 -1 1 7 4 Date of Death: May 31 , 2 0 0 9 AND NOW, ~~~ `~ ~ U- ~~~ ~~ in consideration of the foregoing Petition, satisfactory proof having been presented before me, IS DECREED that Letters Testamentary are hereby granted to Barbara Ceci 1 in the above estate and that the instrument(s) dated March 1 7~ 2 0 0 0 described in the Petition be admitted to probate and filed of re FEES 22 Letters ... S../~~,.~... u.^ $~,3~ti0 Short Certificate(s) ... ~P. , .. $ ~`f Renunciation(s) ........ ~; l l . .. $ .. $ 15 ~,~ CFA . ..$ ;~~~ ) . .. $ ~ `. . .. $ . .. $ . .. $ . .. $ . .. $ . .. $ TOTAL ............ .. $ `~lyvJ 0.00 Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Telephone: Anthony DeLuca, t;squire 18067 113 Front Street P.O. Box 358 Boiling Springs, PA 17007 717-258-6844 Form RW-02 rev. 10.13.06 Page 2 of 2 IO~.s(15 RLSb- IO!!0?l LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 This i~ to ccrtif~ that the inform:uion here ~;ven i correctly copie/.I From an original Certificate of Deatl duly- filed with me as local Rey*istr~~r. Chc oli~,ina certiticate wi!'s be ti>rwarded r~ the State Vita Records Oflicc I~Jr permanent tiling. ~ ~ ~.c~,~~~C"_ ,JUt~~049 Local Re<_istrar Date Lssued Certification Number H105-10.1 REV 11f200fi TYPE I PRINT IN (J (~ PERMANEM ~\ t. BLACK INK \ ~,\ c~ ~ ~ 5'3°I COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH .VITAL RECORDS CERTIFICATE OF DEATH i d I ~o is y r,.~~ C,~ ..y~~ C:J ~~ -~ . ~~ {ra. :~ --~ (See instruct ons an examp es on reverse) STATE FILE NUMBER ~, -_ r.~y i^~• c... ;t~: t'.. C71 +, ~-' , - ~~._~ 1. Noma of Decedent (Rrsb midde, len, sud'a) 2. Sex 3. Socisl Security Number 4. Date of Deam (Monty, day, year) Ca 1 Female 220 - 44 -1174 Ma 31 2009 5. Ags (Lan Bkmday) Under 1 Untler t da e. Date al Beth Mam, ~ , 7. BIM ace C' and stale or fan n m 8a. Pleca M Dsem Check on aw . r p Wars Mnume Hospital: other: B5 Monsw o (,7 yrs. Apri 1 27 , 1924 Germany ^ Inpatient ^ ER /Outpatient ^ DOA ^ Nursing Hasa p l Residence ^ Omer - Specity'. Sh. Canty d Deem Bc. City, eoro, Twp. of Death fid. Faciltly Name (If riot ImAtudon, lMve street and number) 9. Was Decedent of Hispenk Origin? No ^ Yes 10. Race: American In6an, Black, Whits, etc. Cumberland S. Middleton 10 Hickory Court 01 yes, spedfy Cuban, (Specify) Mexican, Puerto Rican, etc.) White 1 t, Decedents Uwal Oca Aso Kind of work dare d un most of world IHe. Do rat state retiretl 12. Was Deceden ever in the 73. Decetlenl's Edrralion (Spedry arty highest gmtle comp leted) 14. Marital Status: Merced, Never Married, 15. Surviving Spa ce (If wife, give maiden name) Khd of Work Kind of Business/Indunry U.S. Am~ed Forces? Elementary /Secondary (o-12) College (1d or 5+) Widowed, DNoroed /SpearyJ ^ vas Nn 12 W1dOWed • 16. Decedent's Mailing Address (Street, city I tam, state, zip code) Decedents pA Di0 Decedent Li i S Middleton 10 Hickory Court ve . ns t7c vas, Decedent Lived in Twp. AcMUal Reshence 17a. Stela Cumber and T°'""~'ip? ~ Boiling Springs, PA 17007 ,Td. No, Decedent LNed wtlnin 17b. County Aaual Limbs of Ciryleoro 18. Fathefs Name (First, middle, hsl, sulAx) 19. Mathefs Name (First, middle, maiden sumama) Christof Mattern Anna Kirchgessner 2w. Inlortnent's Name (Type /Prim) 20b. InfarmanYS Mailing Atldress (Street, dry / rown, state, zip cads) Barbara Cecil 10 Hicko Court, Boiling Sprin s, PA 17007 l pd of Di$p o 21 a. M e t SAlm ^ Cremallen ^ Donation 21 b. Dols of Dispositlm (Mom, day, year) 21c. Place of Dispontim (Name M cemetery, ttematory a other place) 27 tl. Location (City l town, slate, zip cotle) I I ~ kk ~~ l ley Banal yL Removal Irom Stale r Wee Cremnion or DonMlon Authahed • June 5, 2009 Restlawn Memorial Gardens LaVale , MD ^ Omer- S ' by Metllen ExaminerlCaonx7 ^ Yas^ No 22a. Sigrw I Se ' Lirarwee (ar rson 'rg as wch) ~ . 22b License Number 013144E 22c. Name and Atltlress of Facility Hoffman-Roth Funeral Home & Crematory, Inc ~ • ~~ // Comphle Bms 23a-c ay when cenityirg 23e. To the bell of my knowledge, death occurred at me ame, date ark place stated. (S'gnature and tithe) 23b. Licerae Number 23c. Date Signed (Math, day, year) physitiar~i5 not available at time a deem ro cerolY cdwa of death. ~ hems 2x26 must be completed M person 24. Time of Deam 25. Dale Pronanced Dead (Month, day, year) 2fi. Was Cese Referred to MedMal Examiner I Coroner fa a Reason Other than Cremation w Ometion? • rota lxoraunces deem. 7:35 AM td. 5/31/09 ^ Yes C$No CAUSE OF DEATH (See InatruMlons and examples) r Appreximate interval: Pen II: Enter odwr sioiu~ nt mnd'moris mntr~utino to deem 28. Did Tobacco Use Contribute to Death? sari 27. Pan I: Enter me dta n m events -diseases, InjWas, or camplkaAms -that Erectly ®wad die deem. DO NOT enter lenninal evens wch es cardiac arrest Ousel ro Deam Nn rat resWlmg in me wtledying cause gNen n Part I. ^ yes Pro6aMy resgratary arten, or ventricular AbnAatim without showing me etiobgy. Lin onry ono cause m each Ime. ^ Unknown 0 IMMEDUITE CAUSE Final disease or ' Carido-Respiratory Arrest 5/31/09 ~ 29. A Female: ~ amditiaraawmgln eam) -~ a. ~rva ra nam wimin eat ear Dw ro (or as a rrsmlwrrce oq: i ith M t C t o p g p y ^ Pregnant at time of deem as s e as on A w C $Saeooaamialryry NSt mrMitima,darry, 6 7.35 AM ^ . kedrg to the use listed m Ilne a. Enter me UNDERLYING CAUSE Due to (a as a caruequsnce ofJ: Not pregnant, but pregnant wihin 42 days of deem (disease a Injury met initiated the o' ^ N vents rewmrg In deem) LABT. Due to (or as a consequence op: ot pregnant, but pregnant 43 days to t year before deem d ^ Unknown H pre nant within dw est ear . g p y 30a. Was an ANOpry 300. Wem Autopsy Fillings 31. Mannar d Death 32a. Date of Inlury (Month, day, year) 326. Describe Haw Inlury Occuned f lnq ~ H ane, F Streel, Factory, 32c. ~ o amt Penanned? Available Prbr ro Completion a Cause of Deem? ~ Natural ^ Hemiode ~ u s B ~J ^ Aaddent ^ Pend'vg Invesbgatim 32d. Time al Injury 32e. Injury al Werk7 32t. II Transportation Inlury (Spea'ryJ 32g. Laation of injury (Sten, city /town, state) ^ Yes ~ No ^ Yes ^ No ^ Yes ^ No ^ Dmer/Opereta ^ Passenger ^ Pedestrian ^ Sukide ^ Coum Not be Dnennirwd M ^ Otlrer - Speciyy: 33a. Certitia (check Dory ono) 336. Signature • Certeying phyaklen (Physbien cerefyirg muss d deem when aromer physician tors pronounced deem and completed Item 23) death oaurrW due to the nusa(a) all manner ea stated h t f Mo led e T th - I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ es o my w g , o e • Pronouneing all nrdlylM phynchn (Phyeicien 6om prawurwmg deem and carlAyng to rouse of deem) ^ 33c. Li 33d. Date Sigrred jMOnm, may, Year) it ~'' to tM best of my lmmrledge, deaM oceunad n the time, doh, erM Place, antl due ro the owe(s) antl manner as sated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ mine /Coroner • M di l E Mp 064519-L p "~ xa r e a On the heals of examiwbonantl / or InvasUgetbn, in my opinion, tleMh oaurrM et the time, due, antl place, and dw to the ceuae(s) antl manrrer as shred ^ 3A. Name and Adtlress of Pasm Who Completed Cause m Death (Item 2'~ Ty /Print '~ MD ' as lc Al nd r S 35. RegiswYs and Dis ' ~I t 16 I ~~ L~ Il I 36. Date Filed (Mona, day, year) e^ , . exa e p 419 Village Drivex Suite 6, Carlisle, PA 17015 . ~ ~„ Disposition Permit Na.`~J ~ ~ ~-/~~ `~ .~ OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Erika K. Cawley ,Deceased Anthony L. DeLuca, Esquire and Barbara Cecil (each) being duly qualified according to law, depose(s) and say(s) that ~~§ /they X~ were well- acquainted with Erika K. Cawley and mare familiar with the handwriting and signature of the decedent, and that the signature of Erika K. Cawley to the foregoing instrument purporting to be the Last Will and Testament/~~~r~ of Erika K Cawley is in l~/her own proper handwriting. ignaletre) (S reef Address) (City, Slate, lip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~~ day 1 1 f / ~l` /~y of /~.~°at Z ! . Deputy (Signah~re) (Street Address) --.~ (City, State, ZipJ ~~ Wills ~ "=-` ~~ ~~ ~ ~~ ~ ~'' _~ ~ U~ ~ c > - ~; . --~ ~.~ ~, Fnrm RW-04 rev. 10.13.06