HomeMy WebLinkAbout09-14-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of CATHERINE M. VARNHORN
also known as
COUNTY, PENNSYLVANIA
File Number 21--~ VO~~
,Deceased Social Security Number 216-03-6821
JOHN F. VARNHORN
Petitioner(s), who islare 18 years of age or older, apply(ies) for
(COMPLETE 'A' or '8' BELOW.)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) islare the named in the
last Will of the Decedent, dated and codicil(s) dated
State relevant circumstances, e. g., renunciation, death of executor, efc. ~ ~ ~,~ '~-',, ';
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the it~~~nt(s)~red ~' ~, ;
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: .~7 a} r-' = : =,-`~
- ~ c._:_~
~X B. Grant of Letters of Administration - ~
app rca e, en er: c..a.; ..n.c..a.; pe en e i e; uran e a sen ra; uran a moron a e N- )
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (~~if any) and h ~ (If
Administration, c. t. a. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.)
Suppress heirs for Section "B" (Grant)
Name Relationship Residence
JOHN F. VARNHORN Son Camp Hill, PA 17011
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his l her last principal residence at
Messiah Village, 222 Messiah Circle, Upper Allen Township, Cumberland County, PA 17055
(List street address, town/city, township, county, state, zip code)
Decedent, then 94 years of age, died on 08/03/2009 at Messiah Village
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 20,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 125,000.00
situated as follows: 15 FARGREEN ROAD, TOWNSHIP OF EAST PENNSBORO, CUMBERLAND COUNTY, PA
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:
Signa re Typed or printed name and residence
JOHN F. VARNHORN 991 COUNTRY CLUB ROAD
/' ~_ CAMP HILL, PA 17011
Form KW-UL Rev. 10-13-2006
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 1 of 2 /^\~
V
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,~edent, Petitioner will well and truly
administer the estate according to law. ~„ ~ ~ ~
Sworn to or affirmed and subscribed
Signature
9
before me this ~_ day of
9 '~2
1 F
For th Register
JOHN F.VARNHORN
Signature of Personal Representative
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of Personal
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File Number: 21-- (~ ' ag~j ~ ~ ~~ rv
p C.17
Estate of CATHERINE M. VARNHORN ,Deceased `~
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SociaiSefcurity Num~bJeor,:-,~,, 216-03-6821 Date of Death: 08/03/2009
AND NOW, r1 ~ ~~~YJ~--{ 141p~ 0~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to JOHN F. VARNHORN
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............................................ $ w
Short Certificate(s) ........................ $ ~ ~ .~
Renunciation(s) ............................. $
ffi.~ rah mn, $ .~ ~ ~
$
$
$
$
$
$
$
TOTAL .................................... $ ~ .
Supreme Court I.D. No.: 18039
Johnson Duffie
Address: 301 Market St.
PO Box 109
Lemoyne, PA 17043-0109
Telephone: (717) 761-4540
Form RW-U2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
Attorney Signature: -"" f~'~/ ~~a~`
Attorney Name: RICHARD W. STEWART
ice \~,~ ~~~ .~ _ -- - _ - _- _. _. - --- -. ~~ ~_ ~T % ~~ t~~..~
LOCAL RECaISTRAR'S CERTIFICA TION OF DEp,'TF9
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1 Name of DeceacvN IFisl. rxdde. last, sudnl 2. Sea 3. Social $e wKy Number 1. Dale d Deatlr (Mmm, day. yeap
Catherine M. Varnhorn Female 216 - 03 -- 6821 8/3/09
s Age (last BumdaYl unnr 1 year under 1 aay s. dale of inn IMonm. da .reap 7. ampan Ici and slaw «1a .
raa+ryl ea Place a Deam Icnerk oNy axt)
Momurs oar: Iwws IwnuMS ' " yWSgwL Other:
9 4 Yra 2 / 2 5 1 91 5 Ba 1 t i mo r e MD ^ mpaaenl ^ ER / OWpalienl ^ DOA g] Nurgng Nome ^ Resider¢e ^Omar . $pecily.
Bo Crony dl Deam tk. Ciry Boro. 7wp of Dealn Bd. F Nana II not Nsdwon,
~Y ( gwe strait arW mnrbap 9. Was Decedeld o1 Mrspann Origin? ~ No ^Ves 10. Race. Amerkan Groan, BwcA, Whne. ak.
Cumberland U er Allen
~(LL S Id yes, syedly Cuban, (SPaddy)
l ~ Me><kan,PKerbl3icartHC) White
11 Decedents Usual tan KiM of war" dme d ngsl d de. Do not stale relied 12. Was Deeemd aver m pal 13. OendWd's Edralwn ( pnly hglwsl grade canp«ed) /4. Mahal Slat v: Marnnd, Navel Marred, 15. SunNrp Spouse (tl wdB, gwe nlaitlen hams)
Nird d Work Kua1 d Business I Indusay U. S. Awned Forces? Elementary / $rycdrMary (P12) Cdlege Ili « St) W~'e0. aVOf~ (Specwy)
Homemaker Own Home ^yBe ®~ 12 Widowed
I6 Decedents Maikng Address (Streit, riry / wwn style, zip code) Decedent's Penns 1 13d l3ecedeM
Y vania
991 Country Club Road AdualReaslence negate w.ina „e.^Vea.DecedeNElredm Twp
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Camp Hill
PA 17011
17b.D°unlY dwnd
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Cumberland
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18 Fallwr's Name (First. middle, last sWlu) 18. MaK«'s Name (First nadda, nwOen sumamel
Unavailable Matter'
20a INrxmant's Name (Type /Pmt)
20b. Inlamad's MaiNrng Adders 19ree1, dly! brM, stare, zp adel
John F, Varnhorn
991 Countr 1 m
21a Mellwd d Duposibm i ^ CrerrwKOn ^ Dorraaar 21 b. Daw of Otpnifion IMauh, day, year) 21c. PMCa o1 DlsposlKOll (Nacre d c«rldery, aemalory «dMl plan) 21d lncaenr (Gry /loan, sww, z9 aae)
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- .- FD 013239E 3401 Market St. Hill PA 17011
Currpww sax 2 ony wnen cedryaq
pvrysa:wn s nd arlade al tyre d deem w 27a. To tlw Desl d my knowledge, Hero attuned al tlw ImB, dale and place staled. (Sprw ure and hKe) 23b. license Numl>ar 13c. Daw
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aims 2a-2fi mull ce canpwwd by person 21. Tme d Deam 25. Data Prarwuked Deatl (Monet, day, Year) 26. Was Case Relerted w Medal Examref / C«mar br a Raisin Omer Bran Cremeam « DonHron?
wM prrxrarrces ceam ~ ` M ^Ves ^No
CAUSE OF DEATH (Sea Instruetlons and • s) s ApproxarWe Hlerval:
Kern 21 Pad 1. Emer dw ppylpa7L.gy;pk5 - rMSaasas. ilywlas, w canplicdlwns - tlal drectly caused me Beam. DO NOT eder terminal event rota as cardiac arrest, r Onset b DBath
respualuy arrest « vernacular fdriaatwn wimow showing Ina elnbyy. list ony ana uusa on each Yna I Pan d: Enter odwr ypplgp
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Duo w for as a consaquunco ull T ^ Nd Vr Wwu. M pepwn 13 days w t year
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^ 1Aalprm d proywnl wnxn aw pa,l year
3Pa Was an Amrysy
Ped„rrnad? 30b Were Autopsy FlWrgs
AvaiUde Prau to Cumpkliun 31 Manrer W Death
f 32a. Daw d Iryury (Munro, day, year) 32b. Dascabe How Irgiy Q:curred 3x. Pwca d Iry«y. liana Fnrm Sired, ieaory,
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[_] Yes I ,( No [] yes ^ No ^ AaWent ^ Pendny Invesegalron 32d. Time d Iryury 326. 4ryury W Work? 321.11 Transporwllon Iryury (Specdyf 32g L«atwn d Injury ISlrael, cay l I°wq sww)
T ^ Suv Me [~ CouW NaI 1n Datemurred ^Ves ^ N° ^ D^ver l Operalm ^ Passarger ^Pedesln:ui
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TO ma beH d my kn°wkdge deann «curred due w Uw causela) and roamer u aYled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~_ _ ~ _ ~
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• PronounCing aM cerntying pnyskian (Physawn GNh prGnounCwy dadll'~ arW teihlying to cause d tlealh) i ~ ,.
To Una best «my knowledge, dean atoned al Ina 4me, dale, and place, and due W Ina cwae(q and manner as saled_ _ _ _ _ _ _ _ _ _ _ _ ^
.~ 3x agree NriMai 73tl Dale ( ,day, year)
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On rove basis d aiamirulwn and I « investigatbn, w my opinion, deann «curred d the time, date, and plea, and dw m tM nusalal and marawr u Haled_ ^ `
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