HomeMy WebLinkAbout08-05-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Paul B. Lebo File Number 21-09- a"]3 ~
also known as
ecease Social Security 166-46-4038
Petitioner(s) who is/are 18 years of age or older, apply(ies) for:
[ ] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the
last Vlrll of the Decedent dated and codicil(s) dated
N/A
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state re evenat ctrcumstances, e.g. renunctatton, eat o executor, etc. ~ ~ ~. ',
rn ~ C7 GC"~ t > ,~
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of~rumen~(s) offered. -
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~r ~ ~7 C,YI - 3
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[Xj B. Grant of letters of Administration ~~~~ `~~'` ~~ ~°'
(If applicable enter: c.t.a.; .n.c.t.a.; en ente ite; urante a serttr~~ urante rninontate
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse any) an~eirs: ;(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.) ~ C,1't
John Lebo tsro[ner ~~tu+ xtver nena court, wntte Wait, ivtli ~iioi
Mary Lebo Sister 158 Central Avenue, St. Louis, MO 63119
Esther Dundore Sister
COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last principal residence at
ist street a ress, town city, towns ip, county, state, zip co e)
Decedent then
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.)
(If not domiciled in Pa.)
(If not domiciled in Pa.)
Value of real estate in Pennsylvania
25,000.00
situated as follows: 160 Faith Circle, Carlisle ,
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 annroariate form to the undersiened:
54 years of age died on 7/25/09 at Baltimore, Maryland
Page 1 of 2
OATH OF PERSONAL REPRESENTATIVE
COMMONWEATLH OF PENNSYLVANIA
coulv'rY of CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and corn
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 this ~ ~ ~jCt_(.,~ (~,
For the Register
File Number: ~.(- ~ - 7e~ f °a
Estate Of Paul B. Lebo
Social Security Number: 166-46-4038 Date of Death
7/25/09
AND NOW ~ ~ f , 20 U / in consideration of the Petition, satisfactory proof
having been presented be e IT IS DECREED that Letters of Administration
are hereby granted to ~Q h n L.~
in the above estate
FEES
Letters
Short Certificates
Renunciation
TOTAL.. .
Signature
Attorney Name
Sup. Ct. I.D. No
Address
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Register of Wills l~o~- ~1 ''~,~/
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Robert G. Frey
46397
5 South Hanover Street
Carlisle, Pennsylvania 17013
Telephone: (717) 243-5838
Deceased
Page 2 of 2
RENUNCIATION
In Re Estate of Paul B .Lebo
No. 21-09-
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned Mary Lebo Sister
(Name) (Releationship) (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s)
that Letters of Administration
be issued to John Lebo
WITNESS my hand this ~ day of ~~t, f~Y , 2009 .
Affirm-e~d and subscibed efore me this
-~~-day of ,
of Public
d /<'
Mary Leb
ADDRESS:
/s~ c~itrrt~~ t9y~~
ST ~ ~~ ~ ~~l/f
BRANDON C. WOOD
Notary Public -Notary Seal
State of Missouri
My Commission ExpKes Nov. 1, 2010
Commission # 06964912
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RENUNCIATION
In Re Estate of Paul B. Lebo
No. 21-09-
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned Esther Dundore Sister
(Name) (Releationship) (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s)
that Letters of Administration
be issued to John Lebo
fi
WITNESS my hand this ~ (day of ~ t~~ ~/ , 2009 .
Affedf.and subsci d b~fore me this
5 day of ,
bo
G~-
Notary Public
ENDY S. McIVER
NOTARY PUBLIC
BALTIMORE COUNTY
MARYLAND
My Commission Expires
-a~-~Lrz~
Esther Dundore
ADDRESS: C~ ~s 3 1~-r~c,h,~~ 1,,.wv~e.
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STATE OF MARYLAN~~'~r,=~i~c~'T~~~W-
Depa~-tment of Health and Mental Hygiene ~~r
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Division'of Vital Records .~~>,
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Please Type or Print in Black Indelible Ink. Ensure All Copies Are Legible. I„, .
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State of Maryland /Department of Health and Mental Hygiene
Certificate of Death Reg. No. _
1. Decedent's Name (First, Middle, Last) 2. pate of Deaffi 3. Time of Death.
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~ L Month Da Year
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~~ 4a. Facility Name (ll not institution, give street and number) 4b. City, Town, or Location of Death 4c. County of Death
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_ _ 5. Social Security Number 6. Sex 7. Age (In yrs. last birthday) n er -ear n er g rs. g, Date of Birth 9. Birthplace (State or Foreign
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166-46-4038 1~ M 2^ F Yrs
54 Months Days Hours Min. (Month, Day, Year) Country)
Usual Residence of Decedent
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a~~ t0a. State 10b. County t Ocr City, Towi>\or Location 10d. Inside City Limits
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Cumberland
Carlisle
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W ° 160 Faith Circle 17013 USA
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11. Marital Status 12. Was Decedent Ever in U.S. 13. Was Decedent of His anlc OrI lnT S eci Yes or No-
P 9 (P fY 14. Race - American Indian,
~, ~ 3 Armed Forces? If Yas, speclfy Cuban, Mexican, Puerto Rican, etc.) Black, White, etc.
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~. 1 ~NeverMarried 2^ Married 1 []Yes 2®No
If Yes, Give
1^Yas $f~1No Speclly:
3pecity: White
~ ~ Q 3 ^ Widowed 4 ^ Divorced Year or Dates:
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r~ "~ v a ,d„ 1$. Decedent's Education 16a. Decedent's Usual Occupation 16b. Kind of Buslness/Industry
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M d (Speci/y only highest grade completed) (Give kind of work done during most of tvorking
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Elementary/Secondary (0-12) Cdlege (1-4or 5+) fi/e. DO NOT use refired)
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or Steel Mill
c o m f7. Fathers Name (First, Middle, Last) 18. Mother's Name (First, Middle, Maiden Surname)
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~ George Oren Lebo Gayle Esther
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s Name/Relationship (Type. Print) 19b. Mailing Address (Street and Number or Rura! Route Number, City or Town, State, Zip Code)
, John Lebo / Borhter 2204 River Bend Court
White Hall
NID 21161
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9 ^ Burial 2 ~CremaUo~
3 ^~ emoval from State cemetery,.crematory or other place).
Ardetlt Cremator
7/30/2009
Hanover
MD
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4^Donation 5 ^Oher S eci y ,
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°''' 22. Name and Address of Facility
~o E ~ ~ i ~ Maryland Cremation Services
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y 23a. Part 1. Enter the disease, or com Itcations that caused the death. Do not enter the mode of d m such as cardiac or res veto arrest,
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IF FEMALE:
23b. Was decedent pregnant
23c. If yes, outcome of regnancy `:
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V In the past 12 months? 1 ^ Li birch 2 Fetal death 3 ^ Ectppic pregnancy
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~~~ $ a ~ Part IL Other significant condFtions coniribuUng to death but. not resulting in the underlying cause given in.Part 1. 23e. Did tobacco use contribute to the cause of death?
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examiner? 26. Place of Death Check on! one
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HospitaL• 1 Inpatient 2^ ER/0utpatleht 3^ DOA
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m m C 27 Maryry~~er of Death 28a. Date of In ury
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~ 28d. Describe how injury occurred
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28e. Place of Injury - Af home, farm, street, factory, office
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28f. Location (Street and Number or Rural Route Number,
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hysician: To the best of my knowledge, death occunred at the time, date and place, and due to the cause(s) and manner as stated.
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xaminer: On Uta basis of examination andksr Investigation, ih my opinion, death occurred at the Ume, date and place, and due to the cause(s)
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3 H ~ ~ 29b. Signature and title of certifier 29c. Ucense number 29d. Date signed (Month, Day, Year)
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- 31. Date filed) (Month! Day,. fear) 32. strers Signature-
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Rev1/018815
Date Issued /
July 31, 2009
I fitKtCY I;tKIIrY If1Al IIYIS
ORIGINAL A TRUE-COPY OF A RECORD ON FILE IN THE
DIVISION OF VITAL RECORDS.
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DO NOTACCEPT UNLESS ON SECURITY PARER WITH SEAL
OF VITAL RECORDS CLEAREY EMBOSSED. ''
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