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HomeMy WebLinkAbout09-24-09PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Kevin Charles McCready No. 2~ ~ Z ~~~ ~ ~~ ~~ ulso known as Deceased. Social Security No. 191-56-3300 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl .y for letters of administration on the estate of (d.b.n.: pendente liter durante absentia: durante minoritate) the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 12 Bottom Lane Newville PA 17241 (list street, number, Twp. or Boro.) Decedent, then 48 years of age, died 9/10/2009 at Hershey Medical Center Dauphin County. PA Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 2,500.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of'real estate in Pennsylvania $ 15.000.00 situated as follows: 12 Bottom Lane Newville PA 17241 Petitioner after a proper search ha ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Kesidence 310 Wildwood Lane Darlene W. McCread Mother Newville PA 17241 310 Wildwood Lane William McCread Jr. Father Newville PA 17241 Q `° `~; r~} 'r-.: 1'- _~ fl"I N _'~ ~. j ti '~ 73 _~ THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in theb appropriate form to the undersigned. c U -o ~ ~~ ~ ~/1'l c ~~ U c c :~ - y G G :~ C CG f O ~l ' I i "_ _ 7 r _~ -~ f OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA no q COUNTY OF Cumberland ~ SS ~ ~ _ ,=_~7 _, r-- -`q -r~, -~ , ~ , 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 ~.}n~G i ~ O r ~4 Estate Of Kevin Charles McCreadv ,Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW .~~ 1.~~..~ltit C1 0~.o+ot,~~-+-~Lcer~ ZUU ~ , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Darlene W. McCready and William McCready Jr. is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Darlene W. McCready and William McCreadv Jr. in the estate of Kevin Charles McCready Register of Wills ~~ ~' FEES William P. Douglas Letters of Administration . $ Short Certificates ( ). $ Renunciation . $ $ TOTAL $ Filed A. D. 7926 ATTORNEY (Sup. Ct. LD. No.) 43 W. South St. Carlisle _ PA 17013 ADDRESS 717-243-1790 P] {ONE ~ - 2u~`~ C ~S`1c~ LOCAL REGISTRAR'S CERTIFICATION (JF DEAT ~I WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.00 P 15729907 Certification Number H10.5-143 REV 11Y2006 TYPE / PRINT IN PERMANENT BLACK INK ~~ I~ v 0 This is to cclYily that the iniin~mation i~rrc Liven is correctly ~~opieil from aj(I ~r~~~~in~1i C'ertifi;,fle~~ ol~ Death riot}' filcrl ~~~ith me as 1~c.ll RegisU-ar. 711.: original certilicutc ~~ill he fur.~,u~dcd to the State Vital Record, Oil~icr i~,r Ilernrlncnl filing. ~~e ~~~~e~.ch~~~ e~ S E 1 ] 2009 Local Re~~istr.n~ Dale l~~sued ru r~ - C~ c~ © `° - -,.-~ ~ ~~~ ~ , r' (- N ~I ;1 .~- -. . ,;,-_ J~ ~,~ - ' l _A/ ~ ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) CTATF FII F NIIMRFR 1. Nana d DBCVtlenl (F'vsl, midrib, lest, wflix) 2. Sex 3. Social Secunry Number 4. Daro of Death (M<bm, tley, year) M - 6. Aga (Lest Birmday) Under 1 year nda 1 6. Dale d Binh (MOnm, day, year) 7. &m,dece (City end orate or forego ceunhy) ce. Place d Deam (Check only om) ~ - """"" °"' "°"'° "'"""` November 10, 1960 Carlisle, PA Hapnar omer Yrs. In tlenl pe ^ ER I Outpatient ^ DOA ^ Nursing Hone ^ Residence ^Omer- Specity: 80. County d Death Bc. City, Boro, Twp. d Deelh Bd. Fadliry Name (If nd hlstllugon, gNe sheet end number) 9. Was Decedent of H~spenk Origin? [~ Nc ^ Yes 10. Race: Amencen Indian, Black, White, dc. Dauphin Derry Twp (II yes, spaity Duran, (Speaty) M S Hershe Medical Center . . . y Mezicen,PlrerloRkan,el4) White 11. Decederz's Usual aen Kind d work done dud most d Nle. Do rot stria retlred 12. Woe Decedent ever in me 13. DecedenYa Educetian (Spaity Doty nghest grade mmproled) 14. Marital SbNs: Married, Never Monied, 15. SurvWing Spouse (II wile, gWe maiden name) Kkb d Work KYb d Business / Industry U.S. Amretl Fomes7 Elementary /Secondary (P12) College (1-4 or 5+~ Wxbwed, DNOrcetl (Sped/y) Receiving Giant Foods ^vea ®Np 12 Never Married 16. rs Mailing Address L9ree1, CnY /lows, slate, Eg clxle) Decetlerns Did Dxadenl 11 BOtLORI Lane Adrml Resitlerce 77a. 5Yele PA Live in a 17c. $~ veer, Decedent Lured in T i tr~cr Franlrfnrri rwp. Newville, PA 17241 Township? 17d. ~ No, Decedent Wed within ,ro. cgpnn Cumberland ACIU9l umm of cdry Bgfq l8. FedleYS Name (Flrsl, rNtldle, lest, wfNxl 19. Mother's Name (First, mitldb, maiden surname) William McCready Darlene Wolf 20a. InlomrBnYe Name (Type! Pnnl) Crai Bo d 2tlh. InlormanYS MeiNng Adtlress (Blmel, my /lows, stale, zip code) 1 g y 2 Bottom Lane, Newvi:Lley PA 17241 2ta. Menrod of Disposition ®14emaeon ^ Donation 21 b. Dale d Dispositgn (Morn, day, year) 21c. Pb o DI tan Name d cemaro cremal spwi ry, Dry or other place) ~ m 21 tl. Location (Coy /town, stele, zip cotla) ^ Bu~ ^ RemovellromSYat yCr°^yg ellgdz¢d aO o A Sept. 14, 2009 Ho~ man- oth Funeral Home & C li l PA 17013 ^ ~ ~ zemiror/C r n er ®Yes^Ne ar s e, 228. Service ~ acdngaawch) 22b.LlcenaeNumber 224 Name and Address alFecilily Hoffman-Roth Funeral Home & Crematory, Inc - 138504 219 N H gmw 23a cerNtyeg 23a. To IM bell d myxnowledge, tleath occurted el the tlme, date eM dace slated. (Siglenxa aM tltla) 23b. License Numher 23c. Date Sgned (Monts, day, year) dryaiden n not av t rime d aem to [erNly cause of daalh. Items 2426 must be mmddea by person 2<. Tana of Dea M 25. Dale Prorouncetl Dced (Month, ~y, year) tl 26. Was Case Referred to Medical Examiner /Coroner br a Reason Other then Cremelbn a Donation? wtb Pronounces death. > ,( ~ / - J / M' N l V aa0 ^ Yes ~ No CAUSE OF DEATH (See Inatructlon entl exampbe) , Approximate Interval. Pan II: Enter other yjgljhcanl condiliorls cemnbudng to death, 28. Did Tobecce Use Cannburo ro Deem? Ilan 27. Part t. Eder the cheln of events - diseesas, Injuries, a cvrnplicetbns - Ihel eireclty Ceased the tleath. DO NOT enter lerminel events such es cardiac ertesl, Onset to DeaN but not rewlfi the under) rg In yirg Cause given in Pan I. ^ Yes ^ Probably respbabry artesl, or vauricdar fibmletbn without showing the etbbgy. List only are cause on each tlre. ^ No U k IMMEpATE CAUSE IRnel asaase a - ^ ''''~~~ n nown 7 / ~ cadilion revelling rc1 eamj ~~ e ~ 1l(~ FA~ S ~7 y(( Y ~ {~ 29. II Femek: ~, . 1 . . /~/ E ~,~ '~/ l lit r //- ue to (or as a sequence oQ: r i ^ Not pregnant wihin past year Sapratlialry ist mndltiors, H arty, b_ ~ leednlo b the pwa kstad an Noe e. U ^ Pregnant at 6m¢ of death Due to Erax 8re UNDERLYING CAUSE (or as a consequence ot): ^ Nat rraM, hw pr egnam wimkl 42 days ~ (tlbeese a uqury ttlal kaliated the c erarm rewnmg w edam) usT. of deaU i Due to (or as a consequence op: ^ Nol pregnant but pregnem a3 tlays 1¢ 1 year n m d m d. e re ee ^ Unlawwn d pregred wimp th pall year 30e. urea en Aulopey 3tlb. Were Autopsy Fbdings 31. Maxpr of Deem 32e. Dale of InJury (M¢Mh, day, year) 32b. Dexfie How Injury Occurretl 32c. Place of Injury Hone, Fenn, Street Fecbry Penormed7 Aveaabb Pda N Campleaon ®Nelusl ^ Flwnlotle , Ofice BuiMirg, etc. (Specify) a caaee d Deem? ^ Ves ~ No ^ Yea ^ N¢ ^ Accitlan ^ P¢ntling Imrealigelion 32tl. Time d Injury 32e. Injury at Work? 321. It Tranaponalbn Injury (Spax'lyJ 329. Laelbn of Inury (greet city / burn, sbta) ^ Suicide ^ Cadd Nol he Derormined ^ Yes ^ N4 ^ Dmer / Operet« ^ Pessagar ^Pedesban M ^Dmer - Spedry: ~~ CBi1iY (~' orA' °ne) 33b. Signature antl Ttle d erMia • CMllylrq phyakisn (Physiaen cenilydrg cause of dealn when soothe physloen nos pr«wurxxrd deem arts mmpbled Item 23) To dM bestrimy kraMadgs, dots eaumad due to tlro uuaa(c)and manner ea et+bd_________________________________ ^ - • Pronqunchtg antl cMdMM physiden (Physitian born pralwrzxg deem eM caiMM to cause d deaM) rn To Ble hW d my knowledge, dum atoned et the time, OMs, end plan, and due to the muse(s) and manner w stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ICI McMml ExemmalCOroner • 33c. Lkeae Numher y QT D/I/ bI 33d. Date reed ( Dorn, day, year) L/ /D D / On the DaNa d axaminatlal and / a Inveatlgatbn, In my oplnbn, dmin acurred et me rime, tlab, and place, end rive to the muags) and manner as orated- ^ ~ Name aM Address d Pervert Who Co~ndeled Cause of Deem (Ite m 27) Type I Print 35. RegisM tyre arts p~ um ~- 1- cR~ I - kle > ~ I l 1 ~ I i I n I paro Fled (MOdh, day, year) ~ N~, / ~ , /~J, ,,f ~ ~ M. S. Hershey Medical Ctr. ///~JJd~ ~,,G/ Wt'I Q~ a . r 6 , Hershey, PA 17033 Disposilbn Parmn No. - ~] ~ Oy~~ J