HomeMy WebLinkAbout09-14-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA '
Estate of RICK D. BAILEY File Number ~ ~ -' ~ 0
also known as
Deceased Social Security Number 176-52-0792
AMANDA RENA BAILEY
Petitioner(s), who is/are 18 yeazs of age or older, apply(ies) for: n °~
(COMPLETE 'A' or 'B' BELOW.) C O `~° _ ~ ,-'
C!) '" ~
3~t"j C*'i ~
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the _7 „t-- named4 ~tiet.;
last Will of the Decedent dated and codicil(s) dated ~ ~ ~ ~ .~ ~ + c ~7
_- ~ - '-~
.. `_ r:~t
C_> 0 -n ~ - ...r-~
-.. ~.}
(State relevant circumstances, e.g., renunciation, death of executor, etc.) ~7 ~ - t t
Exce t as follows, Decedent did not m `' `
p arty, was not divorced, and did not have a child born or adopted after execution oft~tt'e instrument(~gffered
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 life: durante absentia: durante minoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (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.)
Name Relationshi Residence
RICHARD DEAN BAILEY SON 44 CENTER ROAD, NEWVILLE, PA 17241
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at
44 CENTER ROAD. NEWVILLE. UPPER FRANKFORD TOWNSHIP, CUMBERLAND COUNTY. PENNSYLVANIA 17241
(List street address, town city, township, county, state, zip code)
Decedent, then 51 years of age, died on NLY 31, 2009 at CARLISLE REGIONAL MEDICAL CENTER,
CARLISLE. CUMBERLAND COUNTY. PENNSYLVANIA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 5,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 89,000.00
situated as follows: ~ CENTER ROAD, NEWVILLE, UPPER FRANKFORD TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA
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:
AMANDA RENA BAILEY, 44 CENTER ROAD, NEWVILLE, PA 17241
Form RW-02 rev. 10.13.06
Page 1 of 2
~~
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 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
before me the __~_~_~ day of
Fort Register
Signature of Personal Representative ~ (/j ~ '~
~~o`~
Jam. Al
File Number:
Estate of RICK D. BAILEY ,Deceased
c•t
-. .~
-~-;
}
Social Security Number: 176-52-0792 Date of Death:07/31/2009
AND NOW, ~ ~ _ , _~~, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT S DECRE that Letters OF ADMINISTRATION
are hereby granted to AMANDA RENA BAILEY
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of
FEES
Letters ...............
$ 210.00
Short Certificate(s) ........ $ 12.00
Renunciation(s) .......... $ 5.00
JCP $ 10.00
AUTOMATION FEE $ 5.00
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ 242.00
reco s e last Will (and Codicil(s)) of Dec ent.
Register of Wills
l
Attorney Signature: ~' ..~
Attorney Name: ROGER B. R ,ESQUIRE
Supreme Court I.D. No.: 6282
Address: 60 WEST POMFRET STREET
CARLISLE, PA 17013
Telephone:
(717)249-2353
Form RW-02 rev. 10.13.06 Page 2 of 2
C7 0 =' i
`~ ~.. ~ ~~. -`F
Signature of Personal Representative ~- ~ f13 ~ _~
x.1"7 -C7 tT1 ~~ _? '_ -'
_~i ~ C7 '9 t_,` ~ y
m ti ~-±^i
RENUNCIATION
n
Q
REGISTER OF WILLS '' __~~
CUMBERLAND COUNTY, PENNSYLVANIA :` ~ u~
;~-~,
_Q --~
a
Estate of RICK D. BAILEY
I, RICHARD DEAN BAILEY
nJ
o .-~
~ ~} ~=~
~ ~~ `:J
r°} ~ ~-r~
~ _:~ F~a
~: ~_~
_i ~a
~` ==
N °., ~ <~
41'1 - f
Q3
Deceased
in my capacity/relationship as
(Print Name)
SON/HEIR of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
AMANDA RENA BAILEY
(Date) (Signature)
44 .CENTER ROAD
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
(Street Address)
NEWVILLE, PA 17241
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
of
within on this _/'Y' day
Nofary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COPbMONWEALTH OF PENNSYLVANIA
Notarial Seal
Karen S. Noel, Notary Public
Carlisle Boro, Cumberland CouMY
MY Commission E~ires Dec. 8, 2011
Member, Pennsylvania Assoalation of Notaries
705.805 REV (01/07)
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 15729332
Certification Number
ri~'
it05-143 REV 11(1008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TMr~ERMA/rN~ENr~ CERTIFICATE OF DEATH
OLACIC ~ (See Instructions and examples on roverse)
STATE FILE NUMBER
~I
1
n °, :r
1 z C?
-'- -Z7 <
~
' _~ ~
{'{
('{ _
e
~
I '- { 3 ~ 3
..
J
f
'"7 ( 1
1. Name d Deadre (Feat nadde, rq, ad8z) 2. Sex 3. Sarl SeaeBy Number 4. Deb d DeffiIt pApM. day. year)
B ile le 176 - 52 -0792 Jul 31 2009
5. Ap 1Laa BaatlaY) Darr t lAtlx 1 8. Daaa d B4m (Math, da .year) 7. ar8plwa ( and acre a rrei9+ ) rye. Pre d Deem (heck one
Mwae OeYe tau, ewer Fbepnel: Omen
51 Yre. December 28 1957 Carlisle PA d ^ER/odpatara ^oon ^wree~9 HaM ^R.etlake pom.r-SwOny
eb. carer d o~m ec. ay, Bao, crop. a Deem ea. Fecay wrtw In na eanmdm, ga shsa area nnbe0 9. wee Daeaeaa d HrperJC Od9b? w ^ vsa tD. Rex: Arrrdan hart. era. wNr, see
In yea. saedb caert, (SPa+M
• Cumber and S. Middleton Tw arlisle Re Tonal Medical Center ""''mn~F°°n~em) white
11. DecwdaKS lrvW Ki4 d wak dae mat d Yk. Do red eW t2 Wes DeaOait swr r tlta 13. Deadern'e Edreatlon (Spedry aey Mgheal ryede aaripetetl) 1d. MMrI Staae: MadM, rover MerrNd, 15. SuMVirp Spouse (n wile, give rnaden name)
Intl d WaA aatl d asawe / bdr6y U.S. Armed Widowed, Divorced (SyvetlM
Eiemerimry / Sacaridery (0.12) Coeega (1 d a 5r)
1 ^v« w 1 Never Married
- 18. DaoeOBnfe MYrp Address (Steel, cnY / bwn, emr, a1P code) Oeadenl's
te Pennsylvania ,taC~yeaoeadaelAwdn tapper Frankford TMa
44 Center Rd ~ l?a
Uved wNai
,ro
ca,nly Cumberland 'td ^
Newville PA 17241 .
AWdUiar d
Cily/Bda
18. Faewh NeeM (FM, nedga, rat sadl 19. Momale Nara (Bret nado., nrMai amaa)
William -Bails Frances -Sheriff
zoa Idonnenys Nrre (ryp. / PMd) 20b. hilamed's Maing Addne. (Street dy / b.n, sMr, dP axr)
Frances S. Bails 3510 Enola Rd. Carlisle PA 17015
2fa Metlcdd04pallbn ~ CrenWiat ^Derreon 21b. bard Dlepaitlaf (Harm, day.yeer) 21a t§wdDrpodpon gWneaY, aarnebrpaama pre) 21d lcaea lCnv/b.n, elae,>iP adal
^ ^~ p R.movellraaSrr { rawE,r w../°a~caa.roA"~ed[~Yea^w Au ust 3 2009 Evans Cremation Services Leola PA
. 22a 3gleao d Faisal Servlu Uamee la .oulg.e arA) 22b. ucaw Naha zzc. Noma rtl Address d Fir 630 S . Hanover St .
- -~• FD-138548 Ewin Brothers Funeral Home Carlisle PA 17013
ConpW trnr 2Tec ady wlen 23e. To me leq d cry rowrtlpe, aaln a4vred tl de tlns, der aM pea erW. (SIpMAae and url 23b. license Numbx 23c Dale Sipied (Monet, dry, y~
payeiaai r red aweelle atrw a dam b
amly nmea a deYO
Nana 2428 mu4 ha an'41•ted M D~ 24. tone d Daum , j
y
'
'` 25. DaM Pmnaawed Lkad (MOM. dry, yeaQ ~ 26. Was Cw Rerrted b MsaW Baaner / Caarr br a Raeean Odrr men Cmutlon a Dwatlm7
^Y
~
- wM prma.aee dM f'
f
M.
// • ,Tu c 3f< Zoo B° •
CAUSE of DEATH (sea Irestruetlorn arw seuleeplN) a ApproerlMe eyaeal: Pan ll: Ereer seta 2& oM Tobeaw Ire cased. b Dent?
Mn n. vent Baa me mYe.daym-aeeaeee~ rF.r0. a artgMeBaa-mr aremy quad ma deft DD Not reertemtlrd erenr aedl ae cerdac aired, r Orwl b Deem hd red rewllkq r die andedM+4 ease gran h vert L ^ Yee ^ Piebedy
re.
;
tbbg/. LrlmN ma
auameeOb l
m
e
e
reePR+mn'srred,«werbWrMMtlan wend eMrhg ^NO fiMU,,...~
~1'"'~'"„
/
/9
p
Q
y~ ,, ~(/~
~a~pU~
/
,
mWai nraYr9m Rw daeeeea Yl.~~"1~.~?Y ^~~Z- ~J,d,~/1 ~.~LC/""' `_'-~~t'~~ f'.f ~ ~
aeeal) _~ a
1 ~ / /
lri i/Z°~Y' ~LZ,'f L(-Y~ 29.nFmr:
^ Nd
a
hi
i
.
r
oar (a as a Oonsequena d): r
t
SeprlW M md8vet, M ay, b.
L
TC. /t'~~^~(~t/ gnpw
"
n DW Ysr
l
^ Preprd atlme dtlceN
b iw sues rMd an ix a r
Brier IMDFALYlq CAUSE Due b (a ae a op: r
~
: ^ Na prplwd, M papud w81in J2 days
dd
m
Ideeeae ainnsy ~ri9tled me ~_ ; ~il~ 1 `
L- ee
-
2renr rexmngn )LAST Darola aeaaonse4ance oQ: ; ^ ~ ~~~b'~
d. v
e ^ tAdtrawn 8 preptra wNii me pdt roar
30a Wr n AWpay 30D. Were Adapry Fnldaga 31. Mr.rr d Dean 32a. Der d Irseq (MoM, ay, year) 32b. Descrba How Injey Occaretl 32c OIAEe () Stnu, Facbry,
Pedomud? Avairbr Pdab Canpeaon
d Case d Dsem7 A-,~~ ^Fiwrnade
~we
1~.,,r'
^Yae
no
^ Yes ^ H° ^ Aaidera ^ v~q 32d Tme d blury 32e. Yljury at WorK.+ 321. n Trmepartla Iryury ISWayy9 329. Lawnm d blur (street dY I ben. sari
IYf
n
^ SukMe ^ CaJd Nd oa DeMmInM ^ w ^ Driver / Cpaielar ^ vasswgx ^Pedeehrn
^ Ya
M ~-
33a CeroMer (~ aM' a»I
ad deem end an
lMad Mm 23)
n
auv
h
tl
kt
a
3~. tNed
g
;
assn w
at em
w paa
en
r pra
• CetWylag PM~^ I~Y~ cMdYx9 ntv
To tlM WetdnrybaleepA e.tln assn.a vac to ylr awWe)rd nrr.wr.rMrl-"----___--'--_'--------------- ^
• Pmiancrq rq ardryrp pMaee IPnymaen Ddn praueeeq seem end aMytq b sae a deahl _ _ _ _ _ _ _
To ale Msldmy bgrerdgs,d.m oaurea.e n. aae~aa..re p.ae,.nee.wme e.na.l.nd maarr.c,rrd_---------- 33c.
~i ~9~$ =L 33d. Dee Sgried IMaim, day. year)
~G{LY 3jr ~Gl~
McAal ExrntrerlCaonw
Dn me 0ed. d eumNa{rn YW 1 a 1mv.npWOn, b my opnbn, eetlh aaurad e1 me 11me, rice, eM psa, end sue b the aauele) emi nuniur ec erted_ ^
34. Name rtl Aaarees d rasa Who CanpeM Ceae d Deem (lrm 27f Typo / PrM
~•rG ~J "Zl---
~11
~
•
~ Free i mr
r«o .
i
~ ;
Q .
S`
~~
r ~
3s. w9:n-ra
l.~C[1k1c1`D~~~ I ~I ~
I ~ i [ I Q I
P ,
.~ ~~ j~'lr~->ro4.-~S' r. .~c~_ /~O/
,
.
-
DrpaiBon Parton No. ~ l ~ b 1 gv1`j
This is to certify that the information here given
correctly copied from an original Certificate of Deat
duly filed with me as Local Registrar. The origin
certificate will be forwarded to the State Vita
Records Office for permanent filing.
L~sit~ ~~~-e~a.c~i~c,-~De,~-a~x•' IM~ 2~ 2C~1
Local Registrar Date Issued