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HomeMy WebLinkAbout11-17-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND ', Estate of PATRICIA A. COX also known as COUNTY, PENNSYLVANIA File Number d ~- ~ 9- ~0 ~ S Deceased Social Security Number 182-34-4639 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the last Will of the Decedent dated and codicil(s) dated w x - ; ~aumed {~ ~~ r- _. (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~' .. ",~ t:J ,,,e 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: B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d. b. n. c. t. a.; pendente life; durance 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.) Amy L. Felton Daughter Unit 7, 1102 Market Street, New Cumberland PA 17070 (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at Unit 7 1102 Market Street New Cumberland PA 17070 (List street address, town/city, township, county, state, zip code) Decedent, then 67 years of age, died on November 8, 2009 at Holy Spirit Hospital, Camp Hill, Pennsylvania 17011 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 175,000.00 (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: Borough of New Cumberland, New Cumberland, 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: FormRW-01 rev. lo./3.06 Page 1 oft Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA 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 Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~ ' {~ Signature of Personal Repres live N b~e~f"o~ re me the ~ day of ~ o° 1 VfJ VQm~QR1 w ;a a~9 Signature of Personal Representative r~t-.•~ I ~„~ For the Register Signature of Personal Representative © ~ ' '_ -' ~~~ ~ t -,_ ~ -1 ~"t .: -_~ __ , a 1- U9 - Ivt~5 w . File Number: Estate of PATRICIA A. COX ,Deceased Social Security Number: 182-34-4639 Date of Death: November 8, 2009 AND NOW, ~ ~ y~n,lpg.~~n_ ~ -"I , z~-, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to AMY L. FELTON in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of rec rd as the last W' (and Codi il(s)) of Decedent. FEES 3 1 ~ ~~ egister of Wills Letters ............... $ Short Certificate(s) ........ $ 2`e3 • UO Attorney Signature: ', Renunciation(s) .......... $ teven Howell, Es uire ~~ • • • $'b ,Q~ Attorney Name: 9 ~! A~~f~mo-~l y`n • • • $ rJ ~ O~ Supreme Court LD. No.: 62063 ... $ ' $ Address: Howell Law Firm ... $ 619 Bridge Street ... $ $ New Cumberland, PA 17070 ' ' ' $ Telephone: (717) 770-1277 Voice; (717) 770-1278 Fax ... $ TOTAL .............. $ 3 5 3 .~ ~~ Form RW-02 rev. !0.!3.06 Page 2 of 2 _ _ 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 15692114 Certification Number This is to certify that the information here given is correctly 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. !~~ a NO~i ~ ~h~ Local Registrar Date Issued !z7 ~~~ CO ~~ ~~ C C V 3 _ ~. ;, r ' , _ f +~"F'! c', •:, t,. REV tt2BOe COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS I PR91T IN ,~ n,M CERTIFICATE OF DEATH (See instructions end exampbs on reverse) sretc cu c w wnco w 1. Name d Dedadeat (Feet, ngtlde, kM, ad1M) 2. Su 3. Saofel Bearay Nunber 4. DeM of DaeM (MOmh, deY, year) Patricia A. Cox female 1 - - November 8, 2009 5. Aq (l>m y) UMU 1 Under 7 5. Dek d Binh 7. and sate a Be. Place d Dutll Check orb Altnaa ~ Haxt MkwAr Hoedtal; OMer: 6i7 vra. July 21, 1942 Lebanon , PA ®Mpe1Md ^ ER / ouyugent ^ DW ^ Nureng iwr ^ Receeua ^ omer -spay: BD. Couay d !DaM &. Cgy, Sao, Twp. of DuM 8d. Fuggy Name (II rlal NNmNion, 9N• greN and nlaMa) 9. Wore D•uded d H' k ? 111. Race: American Indian, Black, Whit, em. ~^ ~^ ® No ^ Yee Cumberland E. Pennsboro 'Itap. Hol S irit Hos ital (0we'eP~D~a°' ls0°"~ Y P P Meaicen, PI1aM roan, ek.) white 11. tNl W d wok dons mrt d gb. Do not state re16etl 12. Wr Decedent ever n tl1e 13. DecedenYa FAucatipn (Spedly any tdgheet Bade cwnpleted) 11. MerIW Sleua: Menied. Neva Memed, 15. $urNWng Spouse (N wife, give maiden name) ~ sy Licer- C'Q d Wod Kind d Brerullrueby U.S. Amid Faces? Ekanenery / Sewridery (0-12) Cdlege (1d a 5+) WUowed, Divested (SpeoyJ Healthcare ^ v« Q Na 12 2 divorced 18. Decedent M•S^0 Addren (Street, agYltoan, eleM, bP soda) 11,2 Market Street, No. 7 DendenYe Did Dendue Ath»IRUidence tTa. slate Pennsylvania l;wna 17c.^YU, Decedent LNed in T •a. Nelw Cumberland PA 17070 Tom, t7b.camy Cumberland ne.®NO,DendenttiveaMlMn New Cumberland , AcNel Lenga d City/t)Orp 18. FatlleYS N}ma (Fast, ngdee, Oat sulDx) 19. MalheYe Nuns (Flat, midde, meidu eumerrl Ralph Quarry Anna Kristovensky 20e. kdamanda Name (Type / Prkdl 29b. InbrmanYS McNirp Address (Steel, airy /lpvn, slate, zp code) Amy L. Felton 1102 Market Street, No. 7, New Cumberland, PA 17070 21a. Muhod ,Disposition i ^ Crerrietlon ^ ~e~ 21b. Data d psposigon (Momh, day, year) 21t. Plus d Dispoeilron (Name d cemdery, crematory or orbs decal 21d. Laatun (City/ roan, state, zq code) ® BuaW ^ Renuval kom Shte i Wr Cnrnatbn W D4rdan AuMOrked ^~,,,,_ ~byMMkNEaamaralCaorr? ^vu^rao November 12,2009 Holy Cross Cemetery Lebanon, PA 17046 22a d person atdeq r oath) 22b. Lirmr NuMa 22c. Name ar Admees d Facgiry FD 013 340 L Parthemore FH & CS Inc. P.O. Box 431 New Cumberland PA 17070 CmglMe' 23ea ady+Mi artilykp 23a. To the but d my knowledge, drm occurred at me tlme, derv er place strted. (SigneWre end Duel 236. Licata Nurer 23c. Dale signed (Monts, day, year) phyaiuvi le avMebb el lime d deem ro 4rDry nlme tluM. ganp 21-28 W carnpleled by person 24. Thne d Deem ~, r 25. Dale Praglsaed Dud ( M, Y~ Year) 2a. Wr Cue Rdarred ro Med'icel Esemna !Corona tar a Reason Other Men Cremegon or Donegan? a/n pmw~e deem. \ . ~, M. ~ l ,~ v 4~ ^ Vu ®.No CAUSE OF DEATH (Sao InstrucNOna one axampNS) imale Muval: Pen II: Errr omu 23. Did Tobeca the Connhule to DrM? IMn 27. PBA II Enler tlN gBain~i.mroma- eeeasee, k+pnles, a nrr4enngar - ma 6nceY aeueed tlw dsem. DO NDT ants Nndnel events such u nrdec urea, r Onut ro DuM ~ but not reedDrp n Me ureenyeg taus gNai n Put I. ^ Yas ^ Prohaby .. respaatay areal, a venhiager PodMeDOn aiMat showep the eliolopy. list ady ono tune on each leis. t ~ ^ No ^ Unknown WYFDUTEUSE IFirol eanee a ,h [; ` i tarietlon r n ) ~ 7 29. II Femab: i yv,~+•7/Ze:. lE~t `~7 4 /..~ ~ -~ a. i ^ N Due to (a a tmaequence d¢ i d pregrM wgh n pew year ^ Pregiem at tkne d deem oataew, g em, e. Jqo ~1 ~6 Ir_ / u~a. n /a n .re ~ i • ~ ~ r ~ a ^ r ~ Due to (a ee a uence op: 7 ~ E ~YM S CA US E Noi pragnaa, wt pregnant wean /2 days r (deuce a mat irgYWd me 01 deem t ewes M n death) LAST. ~ Owe b (w r a wnaeQUence o4: ~ Na pregnant, but pregnen143 days ro 1 yur before drm e. r r ^ Unkrwn d pregrWrd willan me past year 30s. Wr en 30D. Wee Autopsy Fndirpe 31. Manner d Deets 32e. Deb d Inhay (Monet, day, year) 32b. Describe Flow Mjury Dawned 32c. Plan of nlury: Home, Fem, Street factory, AvseebN Pdorro Caryleun ^NeNel ^liorliiede Office Bulking. ek. (Seedy) d cra. a DuM? ^ Vu ®No ^ Yr ^ No ^ Acaduv ^ Perdinp Imeetlpetlar 32d. Tens d eyury 32e. InHay al WorKl 321. g Trureponatlon Iryury (SpetlyJ 32g. Lmagan of iMury (Street City 1 roan. sprat ^ SukUe ^ Could Not W Delemaied ^ ~ ^ Yu ^ DMar/gpereta ^ Paaeengsr ^ PedeWlen M OMs-Spedry: 33e. CergMr (drdr any ore) 33b. SlgnMUre rlr Tr d CiiefiPr -• • C•nNYlrq plryakirl (Phyaitien nr0'lyirp our d deem wMn anoxia P6Yeieui hu pmnaalced deem arld mn4leted Ilem 23) To Wudmy tnorWlpti daaM oamae dr to its cauaya)and evtnuralehd_________________________________ ^ r • ~rg and rrtllykg pNTaleW IPtra'eaen bdh pronoawng duM end catllying ro our d deem) T b u d d lh d l tl tk d t ts l M d M h le 'l e ^ 39c. Licuw Narer 33x. a Slgrtl Mnm, Eey, year) o e my aa occurre a ra rre, a e, ar p an, a r t e oase(s) and mrater r ale0ed_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ re• • B•• Ya~cY ErrrMa•lCaorr • 1~ Y r,C ~ L•; (J ~ `r ~, On dr 6aeM Ofaumkrllon erdla MnroWgatloryMmy opkao•I, doom sawed al the ter,daM, rdplar, ender to Ma uuaa(s)aM mam~ratMad_ ^ 34. N rw rM Ad Per d na d em Wha CmgleMl CaucadDeem (Item 27)Typa/Pnnl ~v 35. Reyaheta end Dhbia 38. Dale ( day, f ~ y > ~ " ~ ~/ (J /"'r9 t--GV G~1 t! : G~1. ,e~ ~% E. 1`~"/ 0 + '~'~ ~ ~. /~; U,All~v d U Dlapasigm Pemgt No. r L~ I C 9~{ y