HomeMy WebLinkAbout09-11-09PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of AUDREY M. WENTZ No, 21 - 09 - ~~~5
also known as To:
Register of Wills for the
Deceased. County of CUMBERLAND ~ the
Social Security No. 202-20-2520 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
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Your petitioner(s), who is/are 18 years of age or older, appl Iles for letters of administr , ' ~
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(d.b.n.; pendente liter durante absentia; durante minoritate)
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Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, ~ a~ c ~ ~ <, -,
her last family or principal residence at 1975 WENTZ RD. ENOLA. HAMPDEN TWP ENOL.~ ~ ~ r;
(list street, number, Twp. or BoroJ ~ =-t -= ~.'
Decedent, then 82 years of age, died 8/27/2009 tV >
at 1975 WENTZ ROAD, ENOLA. PA 17025. ~ '
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ 21.000.00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ 90.000.00
situated as follows:
1975 WENTZ ROAD, ENOLA, PA 17025
Petitioner er after a proper search has ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name
RONALD E. WENTZ Relationship
SON Residence
340 FOX HOLLOW
SHERMANSALE PA 17090
ROGER A. WENTZ
SON 219S2NDST
HIGHSPIRE PA 17034
HILDA G. PRESTON
DAUGHTER 1925 WENTZ ROAD
ENOtr4 PA 17025
CYNTHIA D. ZEARING
DAUGHTER 267 REDWOOD LANE
CARLISLE PA 17013
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
RONALD E. WENTZ
b
340 FOX HOLLOW OAD
SHERMANSDALE PA 17090
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
CUMBERLAND SS
COUNTY OF
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 above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affume and subscribed
before me this ~~`~- day of r
S PTEM 20
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No. 21 - 09 - ~ s~
Estate of AUDREY M. WENTZ ,Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW SEPTEMBER ~ ~ .2009 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that RONALD E. WENTZ
is/are entitled to Letters of Administration, and in accord with such fording, Letters of Administration
are hereby granted to
RONALD E. WENTZ
in the estate of
FEES
Letters of Administration .. $
Short Certificates (s ) . .. $
Renunciation . .. $
TOTAL $
Filed .. .. ..... .. ... A. D.
HA OLD . IR III 299 0
ATTORNE up. Ct. .D. No.)
64 SOUTH PITT STREET
CARLISLE PA 17013
ADDxESs
717-243-6090
PHONE
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LOCAL REGISTRAR S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
Certification Number
This is to certify that the information here given is
correctly copied 15-oln an original Certificate of Death
dal}' filed with me as Local Registrar. The original
certil7rltc will he lorwarded to the State Vital
Records Office for perrnanent filing.
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Local F:eglstrar Date Issued
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3 REV ltrzoo6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
/PRINT IN
4CKNNK CERTIFICATE OF DEATH
(See instructions and examples on reverse) GTATF FII F NI IxIRFC
I. rvame al uecedenl 11-1mL mimle, bsl, suAiz) 2. Sex 3. Social Securay Number 4. Date of Death (Month, day, year)
Audrey M . Wentz
Fenale 202 - 20 - 2520 August 27, 2009
5. Age (Lest Binhtlay) Under 1 year Under 1 tlay 6. Date of BirBl (Monty, day, ar) 7. Blnhplace (City and stale « Igebn country) 6a. Place of Death (Check only one)
Manse Days Moue Mkzaas
kbspilal: Other:
82 yrs
July 18, 1927 SLmmerdale, PA
,
^mpeaent ^ERlOulpatlent ^DOA
^ Nureing Homo g] Residence ^Other-Specif
:
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ounty o1 Death &. Ciry, Boro, Twp. of Death fid Fedliry Name QI net il¢IiNlion, give atreel and numbeQ 9. Was Decedent d Hlspank Origin? ®No ^ Ves 10
Rac
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mer
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ian, Black, While, etc.
' (Byes. 9paGty Cohen, (SPa4yM
CLanberland Hampden 'ILrp. 1975 Wentz Lane
Mexican, Pueno Rlran, aM.) White
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11. Decedent
s Usual tion N
IM d work done du ~ npsl d w«Idn ufe. Do not state reli 12. Was Decedent ever In the 13. Decedent's Educalbn (Spedly Doty highest grade completed) 14. Madtal Status: Mamed. Never Mooted, 15. Surviving Spouse (II wife, give maiden name)
Kind of Work Kind of Business / Intlustry U.S. Amred forces?
w
ldpwed,DlVprLed s r»
Elementary /Secondary (0-12) College (td or 5r) (Peci
cook Public Schools
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^Yes
NO 8 Widowed
i6. Decedent's Mailing Adtlress (Street, city! town, stile, zip code) Decetlent's Did Decedent
Actual Residence 17e. Slate LNe m a I-1~1Tpd
17c ~ vas, Decedam uyee in en
1975 Wentz Lane
Twp
Cimlberland Tewnsm ?
17b. County P 17d. ^ No, Decedent Lived wilMn
1
Amuel Limits of Cily !Boro
16. Father's Name (First, middle, lass, suKZ)
19. Mdhefs Nama (Frsl mitldle, maiden surname)
Paul H. Potteiger Grace E. potter
20a. Informam's Nama (type I Pnnl)
Ronald Wentz 20b. Inlormanl's Mailing Address (Slreel, sly /lows, slate, zip code
340 Fox Hollow Rd. SheTmans Da~e, PA 17090
21 a. Method of Dlsposilion ~ ®Crematbn ^ Donation 216. Dale of Disposton (Month, day, year) 27c Place of Dlspositlon (Nama of cemetery, tremolo or omen lace
ry P ) 21 d. Lacanon (Clry I mwn, state, zip code)
^ Banal ^ Removal Irom Stale ~ Wes Cremation or Donetlon Authorized
^ Olner-Speay I byMediealExaminer/Coroner? wee^No Se tenUer 1, 2009 Hollinger Crematory Mt• Idly Springs, PA 17065
22a. Signature of F,,uneral rviceycensee (« person ec9ng as such) 22h. Ucense Number 22c. Name end Atldress of Fadllry
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FD 012774-L Richardson Funeral Home Inc. 29 S. Enola Dr. Enola, PA 17025
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Complete Items 23at Doty when cenirymg 23a To the b f my knowledge, tleath a«urt et Ina tlrre, tlate aM place slated. (Signature aM Mle) 23b. Lk:ense Number
physldan Is rlol available al time of deem to 23c
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{ Date Signed
(MOnlh, day, year)
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y causedtleath.
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Time of Death
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tems 24-26 must be completed by person 25. Dat ed Dead (Month, tlay, year) 26. Was Case gelertetl to Medical Examiner /Coroner for a ReA on Other than Cremation or Donation?
who Pronourxxz tleatR
lJ ' tT ~ ~ M. ~G ~~"1~ ~ ~ .2.{"` l~Cl ^Yes No
CAUSE OF DEATH (See lnstru ctlons and axe lea)
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nterval:
Item 27. PaA I: Enter the chain d eyenh - dseases, Injunes, «complkatbns -that directly caused the de91h. DO NOT enter lenninal events such ea cardlec
t Part II: Enl« dlwr 91onlfcaM c«Malons ca tnwa no to tl •m
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26. Did Tobarco Use C«Inbule to Deelh?
arres
,
respiratory arrest, «ventdcdar fb 1lation wahout showing me etiology. Us1
ch rme. ~ Onset to Death
grit' one ease on
ea bW nd resulthg In the underlying cause gNen In Pan I. ^Yes ^ Probably
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IMMEDIATE CAUSE (Final disease « ~ ~ i
condition resulling m death) ~ ~y~7 (7 r ^ No ^ Unknown
-~ a' - -Il ! Y~ YL~yG~ I
Due Ip (or as a consequence oq
~`b' 29. II Female:
.
Sequentially fist lions
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' n ^ Not pregnant within past year
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lead'ug to Ne cause listetl « line a. h. i
Enter the UNDERLYING CAUSE Due to (« as a consequence oq ^ Pregnant at lime of death
.
(asease or injury Thal ingialed the i
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^ Not Pregnant, hd Pregnant within 42 days
vents resulting in tleath] LAST.
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Due to (or as a consequence olj of tleath
.
d' ^ Not pregnant, but pregnant 43 days l0 1 year
I ~ belore death
^ Unknown it pregnant within the past year
30a. Was an Autopsy 30h. Were Autopry Findings 31. Manner of Death 32a. Data of Injury (Momh, day, year) 32h. Descrate How Injury Oavned
P
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Available Prior to ComDlelien 32c. Place of Injury: Home, Farm, Sueel, Factory,
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of Cause d Death? at
Homicide ~ Dame Building, etc. (SpeciyJ
[.Wes ^ No ^Yes ^ No ^ Acdtlent ^ Pending Invesligalion 32d. Time of Injury 32e. Injury al WoM7 321. II Trensponellon Injury (SpecityJ 32g. Location of Injury (Slreel coy 1 town, stale)
^ Suicide ^ Could Nel he Determined ^Yes ^ No ^ Driver/ Operator ^ Passenger ^Pedestnen
M' ^Other - SperAly
33a. Certifier (check any one) ~
33b. Signature Tale pl Certig~r
• Cenilylrg physician (Physician cenilying ease of death when another physidan has pmnouxad tleath and completed Item 23)
To the best of my knowledge, death aeeurted due to Ina ease(s) and manner as eraled
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_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Prolrouneing and eertityNlg Phy9icIan (PM/sldan fwlh prondmdng death and certiying to reuse of death) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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To the best of my knowledge, deaN occurred at the time, date, and place, and due to the cause(s) aM mann« m slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ n ; 33d. Dale SignedlMan h, day, year)-+
• Medical Examiner I C«orer - " ~ ~~
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On the basis of examinatlon arM / or imestig9lion, in my opinion
death occurred al tM Ilme
date
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p
ace, an
ue to the cause(s) end manner m slated_ ^
34. Name and Atltlress of Person Who Completed Cause of Death (Item 27) T e /p ps I -•
35. Register's Signature and Distrkl Number 38 Q
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~I Disposition Pertnll No. ~ ~ ~ t:i !~~ "' ~-f /
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
RENUNCIATION G
Estate of AUDREY M. WENTZ No. 21 09 - p ~~
also known as
,Deceased
The undersigned children of
(Relationship) (Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
HILDA G. PRESTON
Letters of Administration
be issued to RONALD E. WENTZ
Witness my hand this day of SEPTEMBER , 2009
(Signature)
ROGER A. WENTZ
219 South 2nd Street, Highspire PA 17034
(Address)
Sworn to or affirmed and subscribed
before me this_1-day of
Notary Public
My Commission E ~res
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
COIvQvIONWEALTH OF PENNSYLVANIA
~ NOTARIAL SEAL
farold S. hwin lii, Esq, Notary Public
Carlisle, Cumberland County
Nlly~ommisaiat e F 06, 2011
PA 17025
267 Redwood Lane, Carlisle PA 17013
(Address)
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NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
CYNTHIA D. ZEARING