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HomeMy WebLinkAbout10-14-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of James F. McCrory also known as COUNTY, PENNSYLnVANIA File Number 21-09- d-I (p3 ,Deceased Social Security Number 176-34-8325 Fay B. McCrory Petitioner(s), who is/are 1t3 years of age or older, appy(ies) for: (COMPLETE A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the last Will of the Decedent, dated and codicil(s) dated State relevant rtinumstances, e.g., renunaatbn, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: 0 B. Grant of Letters of Administration app rca e, en er. c..a.; ..n.c..a.; en r e; uran e a sen fa; uran a mrnon a e Petitioner(s) after a proper search has/have ascertained that Decedent left no Wiil and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. ord.b.n.c.t.a., enter date ofWil! in Section A above and complete list of heirs.) Suppress heirs for Section "B" (Grant) Name Relationship Residence Fay B. McCrory spouse 2144 Chestnut Street Camp Hill, PA 17011 t:~ N i ~ ~ ., ~ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ ~;;> " Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal resid~t~ at ~ ~ ?~ 2144 Chestnut Street, Camp Hill, Camp Hill Borough, Cumberland, PA 17011 ~ _~, `~° _-~~ `r- (List street address, town/ciry, township, county, state, zip code) ~~ "! -~ '-: _~ V `°~ Decedent, then 71 years of age, died on 09/21/2009 at 2144 Chestnut Street, Camp Hill, PA 17011 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 50,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 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: Signature Typed or printed name and residence Fay B. McCrory 2144 Chestnut Street Camp Hill, PA 17011 '~ ~.; 7~ ~ C r ~~ Form RW-02 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 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 Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed 1 ~~ ' v``` ""~ _ ~- It~ Slgntttire of Personal Representati Fay B. MCCfory before me this _,,"~ day of ~ w ~,°, Q a~, 9 Signature of Personal Representative , , ~ ~ ~ ~ ~~ '... For the Register Signature of Personal Representative ~ ~ ~• , •--~ ~~ ~ - -~ _~ . ` `W-_f - --..1 ' _ File Number: 21-09- ©q ~03 Estate of James F. McCrory ,Deceased Social~Serc~urit,~y Number: 176-34-8325 Date of Death: 09/21/2009 AND NOW, `-~~^"'~~ ~ ~ ao~g , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Fay B. McCrory 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 ....................................... ..... $ Q~ ~~ , Short Certificate(s) ................... . ,\ ..... $ ~ ~ ~U Attorne Si n t Register of Wills ~r1 ~~~ Ili Renunciation(s) ........................ ..... $ y g a ure: CP $ ~ ~ - (k~ Attorney Name: Michael L. Bangs ~~ma~-Im. $ 5. OCR Supreme Court I.D. No.: 41263 $ Address: 429 South 18th Street $ Camp Hill, PA 17011 $ Telephone: 717/730-7310 TOTAL ................................ .... $ Form RW-02 Rev. 10.3-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 .,~~,e~serv,. ,_- 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 15690595 Certification Number REV 112008 PRINT IN AANENT CK INN This is to certify that the information here given is correctYy copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. al R istrar Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See Instructions end examples on reverset ~O ~, ~ :! 'TJ -' -~ tom-. `~- rn ~- ~= -~ ~'t ra c~ 4 ~o Q C'7 -i r- x. rv ~) ~~+ I"r ~ "-`> C{) '~~ ;~:? _:.r ~~ - ':i ,_A "F'7 .. F"1 t. Name d Deaden (Fkal, coddle. Md, aAw) 2. Sea 3. Sodel Seaay Number A. Dille of Deasn (Monet, nay, Year) James F McCro ' . Male 176 - 34 - 8325 Se tember 21 2009 5. Age (LW arotmyl Ural , v Uabr I mY 6. Deb d BuAt (Modh, ,yea 7. ( era able a fee' Be. Place d Drm Check an one 71 N•ww ~ r~.r 1lwptlal: Omen Yra. June 7 ,1938 Ames ,Iowa ^ hpeasnl ^ ER! Oulpetlenl ^ DOA ^ Naekg Home By Rriaena ^Other . Speciy: ' Bb. County d Deem Bc. City, Born, Twp. d Death Bd. FaaYy Name (Aral inalautlm, gNe abed entl number) 9. Wee Decedent d Hbgnlc Orign? t~ No ^ Yes 10. Race: Amerken Imsan, Bock, WtAle, etc. • (II yr, w«dy Cuban. ISpeg~p Cumberland Camp Hill 2144 Chestnut Street Meaian,PwrroRaan,etc.) Wrlite 11. Daatlerah Uddl Kind d arak tlarb mod d Me. Do nd ama retlretl 12. Wes Decedent ever in ttte 13. Deatlenrs Edtaelbn (Speedy any nlgned Breda conpleletl) 14. McMd Sblus Merde4 Never Marred, 16. SVrvmng Spouse (if wife give maaen name) , Kea d Wade Kea d Budror / age U.S. Amid Forces? Ebmenbry /Secondary 1612) College (1 ~ or 5+) Waowed, Divorced (SpalYly) Professor Lebanon Va le ^Yr C&+D 5+ Married Fa Burros ' 18. Deatlerw a MdNg Addrra (Street, cky /lam. stab, ail Code) Detedenra ° a D~~' Adwl Reeawae 17a. Slab Pa r m 2144 Chestnut Street T ? "° ^ Y"` DeatliN1-""'l" Twp. ownship De ~n auwd wmkn ~p Hi l l • ,~ cDDmy Cumberland , 7tl. ~ ~l City / Sao ,18. Ferrara Name (Fad, mitlde, Mat, suAM) 19. Mdtter'e Name (Fhd, mldtlb, meaen aumeme) John R. McCro Ruth 20e. IMOnroM'a Narro (Type / Pd,q 20b. IMamaaa Maiartg Adtlrer (Shrl, dry /town, able, zq mtla) Fa B. McCro 2144 Chestnut tee - z1a. Metlae d Dbpaaon ~CremaAOn ^ Donetlon 21h. Dent d ^ BtaMl ^ Rengvd ham State t DMDOdtlort (Momh, day, year) 21c. PMa of DMpoNAOrt (Name d amelery, aanabry a odor Place) ale. LoaAan (Chy /lawn. sMb, zip code) (AaaCmtMkrraDOnafbnAalhalyd ^ ,d Holli er Cremato ^ °"'"' °j'1Aid~''E'°"tl""/D°`°""? Yr "° Mt Holl S rin s Pa d Srtrvla Lianeea a q ecfxq a uch) 22b. Licerbe Number 22c. Name end Address of FecAiy ' - 011654-L ers-Hamer Funeral om Darobb oily when arsying ptryaiden M nd evrbde d fine d deem ro 23a. To me bed d my kraWedge, Beam Occurred d me Ame, deb antl ilea debd. (signaM era AIM) 23b. License Number 23c. Date Sigtetl (Monet. tlaY. year) c«uy awe d arm. • Mrw 2a-2811eb1 DB arrlplNr by pereon ~ 2A. Time d Deem 25. Date Pranaeaed Dead (MOmh, day, year) 28. Wea Case Rebned to Medcel Esemind 15ororor for a Reason Omer men Cremation a porotion? wro praaunae death. M. ^ Yet ^ NO CAUSE OF DEAI'N (Sae Inatrucslona acrd sramplsa) r Apgosimele iaervd: Part N: Ema olM ' 28. Did Tdoeca Use Corttribne to Deem? eem 27. Pert C Enter the men d evwrw - tlirrr, kYtaaba, a minppcetlorr -mat daectly quaetl dte tlrtlt. DO NOT drr termnel evade each r ardec anent, r 1Drod ro poem but not restAhtp in me urtdertyktp our given in Pert I. ^ Yes ^ Probemy reepkNO cared a vemrkaMr ehr9Ma n itl N t l m ry , w o a e aw rg a e,bbgy LMI Doty one Huse on rm Xne. r r ^ No ^ Unknown e111EDIATE CAUSE fM1ial dMeese a (~ ~ ~ /~ ~ ~ ~ ~ y - arldAon reeuAetg n deem) _~ a ~ ~L T+ A( •a"CJ~ r 29 A FemaM: r ~ . . ` V ) ~~J+W Dw to (a r a oQ: ~ ^ Not pregnant within peal year $ aq ~ r~I~el N W mrsT4ae it ~ ~ ~ ~ ~~ , b_ -+' ~'r~ ^ Pregnant el lime of death M ~ g l ~e ~ i ~ ~ ' ~- ` , ry ~ ` a ~ Dw ro la as a consegwnte EiXer Ile DICE ~ CAU$ _ ~ ^ Not pregnant but pregnant w9Nn 62 days ~~ ~ ~ ~ kM)eL1AedS c, i of tleem Due to (a as a consequerae pry: r ~ Not pregnant, but pregnant 43 Days to 1 year d. ~ before deem ^ Unknown s Dregnenl wihin the pass year 31k. Wee n Aubgy 300. Were Adogy Fraigs 31. Manner d Deem 32e. Dent d Iryury (Monet, tley, year) 32b. Describe How k4«Y Occurted 32c. PMa d In1ury. Home. Fertn. Sheet, Factory, PMamed7 AvaASble Poor b CompleAOn Iq d Caws d Deem? ysY NaWrel ^ Homicide OBia Buiaing, etc. lSpeaNl ^ Yes ~ No ^ Yr ~NO ^ Aoddenl ^ Panting InvedpaAm 32tl. Tkro d kytgy 32e. Iryury at Work? 321. A Trempablbn hQury /Spedly) 02g. Laalbn o1 Iryury ISheet,ciry I town, sMte) ^ Vas ^ No ^ Omer I Operate ~ Pe ^Pedrhian ^ Sdcitle ^ Codd Nol be Debmsrted M Omx~Spedy~ 33a CerAfier (dbdt ody pro) 33ti, SigwMre ant T d • CMMMng pNyaldr IPhysiodt ardYM9 awe d tlrm wMn eratlxr pMyeicien hoe pronounced deem entl conplded Item 23) To the had d b Ne d tl d d `s ~ • my raw ge, r r ocoare w b tlr aur(a) era manror r etatwL _ """""""""""""""' ^ • Pronorercit ens rartlyY b ekJen (Ph i b b tl o - \ g q p y /a c n a t praaa q arm and cenAyiq ro ear d deem) To tlr baddmy bgwbdpe,rMem oaaMdmetlnra,hb, rd pMa,aM ew to theawae)eM mennerrabted__________________^ • Meelnl ESamabrlCaonar 33c. Number p O~~w ~" ~ sA 93d. Dde Signed ( ,day, ye ^~,e ~ (Yl On IM b N d M d nt I / l. ~ e e rerrr a on a a ro+••tleatlort, In my rplnbn, drm aavmd r Ma tlme, dda, eM pea, ant dw to tlw arrr(a) ant maroar r slatae_ ^ ~. p• ~ Atltlrrs d Peman Wta CmgMtetl G~` d DeaM (A a m 27) Typ e 1. Pdnl Registrar's ~ nee ant Di ~ rte/ 38 Fd D ~ ~ / sZ .r . ~. S • ~~ ~'~ ~.~+`~•~'• ~+~+. )a+`~ (~ j ~ / I ~ I I I . e ad ( day, year) ~~ ~~' ~ t•'t~4sfi1 9 ~ . S ~u~ 'W` l4•¢ ~ ~ 1~ `~ i O > - rp i . 3a t r ~ v DisposAion PermA No. //c ~~ ~ ~(J Gl