HomeMy WebLinkAbout01-05-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of Wtlliam James Fenton, SR.
also known as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
COUNTY, PENNSYLVANIA
File Number (,G ~ ' ~(,/ ~'" ~V~~
Deceased Social Security Number
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
(State relevant circumstances, e.g., renunciation, 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
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
/~ B. Grant of Letters of Administration
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(If applicable, enter: c.t.a.; d.b.n.e.t a • pendente lit • d
named in the
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• •, e, urante absentia; aurante:»a~,oritateJ ~"' _ ; ~ :~7
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following sp~se (if any) ar~teirs: ~'(/~ c-"
Administration, c.t.a. or d. b. n. c. t. a., enter date of Wi!! in Section A above and complete list of heirs;) ~ -r` t
Name
Cynthia A Fenton
Elizabeth A Fenton
William James Fenton, Jr.
Daughter
Son
Relati
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Church of God Home Hanover St. Carlisle S Middleton Tw Cumberland Coun PA 17013
(List street address, town/eity, township. cozmty, state, zip code)
Decedent, then 71 years of age, died on October 2, 2009
Decedent at death owned property with estimated values as follows
133 Garland Dr„ Carlisle, PA 17013
133 Garland Dr., Carlisle, PA 17013
at Church of God Home Carlisle, PA
(If domiciled in PA) All personal property $ '0.00
(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:
Form RW-02 rev. 10.13.06
Page 1 of 2
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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:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
SS
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
fore me the ~~ day of
of Personal Representative
Signature of Personal Representative
Signature of Personal Representative
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Estate of William James Fenton, SR. ,Deceased
Social Security Number: 565-50-7
AND NOW, ~ Q
having been presented bef r me, IT IS DE
are hereby granted to Cm is A Fenton
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Date of Death:October 2, 2009
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_,c>~G7'lJ(JJ ; in consideration of the foregoing Petition, satisfactory proof
that Letters Administration
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of
FEES
Letters ............... $ ~ ~~
Short Certificate(s) ........ $
Renfu~nciation(s) .......... $
~A ~ ... $
... $
... $
... $
... $
... $
... $
... $ _
TOTAL .............. $ ~ 7,
as the last Will (and Codicil(s)) of
Attorney Signature:
Attorney Name: Tricia`D
Supreme Court I.D. No.: 83760
Address: 104 S Hanover St
in the above estate
Carlisle, PA 17013
Telephone: 717-243-7437
Form RW-02 rev. 10.13.06 Page 2 of 2
105.905 REV.(3/09) ~ _ ~ / ~ ~ ~ OQ
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of ealth, in accordance with
the Vital Statistics Law of 1953, as amended.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Linda A. Caniglia
State Registrar
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Htos~ws REV nrmBB
TYPE / PRIM IN
PERMANENT
BLACK INK
0
0
5265066
CORRECTED ITE11q
COMMONWEALTH OF F HEALTH • VITAL RECORDS
FEFg~. ~ ~ DATE: ~7/°`f/~'~ CERTIFICATE OF DEATH
(See Instructions and examples on reverse) ~r._~
NOV 0 42009
Date
...._.~ _ ..~,~ r~~„~. ~ ,,,..q. ~. nwnxl
2. Sex 3. SPCIaI SewMy Number 4. Date dDeam (Moron. a~', yNrL
WILLIAM JAMES FENTON SR. Male 565 50.7806 October 1
1009
,
5. Age (Last Birarfay) Under 1 ar UMa 1 da 8. Data o/ &nh (MOMh, da , r 7. Bi
(cny and ebb a brdgn counmy) Be. Place d DeaM (Clreck we)
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a ~ wa.e ~~~
on
71 A3,gitist 3. 1938 Seattle WA "08P's' otna
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Bb. County d Deem Bc. Ciry, Boo, Twp. d Deets ^ Irryasent ^ ER / Oulpetient ^ DOA u Nursing Harrw ^ Reaidarxe ^Om•r ~ Spedly:
Bo. FadRty Name (II nd nalidnbn, give street and amlbal
9. Wad Decetlent d Hispanb Origin? ®No ^ Yes 10. Race: Amerkan Indian, &ack, Vrhae, Na
Cumberland N.Middleton Tvape Church of God Home (n Yea,apeciycuban, IsPBC1f~
Mexican, puerW Rican, ate.) Whit e
11. Decrxlsnt's Uwd Oau Zion Kkxl d wok done moat d wall Be. De riot slab reared 12. Was Deoetlem Bvar m the 13. DeoedenYS EUrratbn (Specify omy hghe6t grade cangeted) 14. Mernal Sgtua: MadM
Nawr Maenad
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pouse (
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Elementary / SecorMery (0.12) College (t-4 ar Sa) Wkowed, Divorced (Spedl)1
Physician s Assist. Hea t~icare
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.YeS ^~ ___ ____2________ Married
Cynthia Washabaugh
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ress ISIreeL dtY /farm, sWe, alp code) DBCedeM'e dtl Decetlmt
Actual Reaitlence na. Sble Pennsylvania ^ yea DecetleM LNed in
133 Garland Drive ~~~
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Carlisle Pa 17013 nb.coaltyCumberland 17d.~NO,DecatlemLNetlwithin Carlisle
Aauai uMta d City / Bom
75. Femx'a Name (F'mt mitleb, lest, aulfix)
'
19. Mother
s Name (First mWtle, muMn aumeme)
Earl Fenton Maut~elene Smith
20a. IMamam's Name RYPe / Pdnq
20b. mlmrom's Meamg Atltlreu (Street, dry /town, state, >dP coda)
C nthia A
Fenton
.
133 Garland Drive, Carlisle, Pa 17013
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atnmdDielx>amon ^cremdkx, ^DOretbn ztb.Dabd
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tocar (ciy / town
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Wed Crem.non or 13rNNIbn Au1MdxM Oc t
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lndiantown Ga
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^ °H1ef - SwPM: M Medlcet Eaemepr / ComnmT ^ vas ^ Nd P ry AnTTVil le, Pa
• 228. Slgm are? Sa ' son asap r each) 22b. Licema Number 22c Name erM Atltlreu d Fadlily
- -39.~ia~ Fes-012909-L Ronan bluaeral Hie, 255 York Road Carlisle, Pa 17013
Complete 23eo ody when ceniryng
' 23a. To de best of my knowbtlge, deem ocwmtl at me tlme, eats and pbce sbted. (Sgreture and title)
physkian
w not evaitlsb et time d Oeelh to
P.rby ~ a dam. -
~~ P~'~g,R C. ~ODJ t AI?SG ~ ~ 23b. Beene Number 23c. Date Slgnaf (Mmm, day, year)
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Time d Deem (! A 55 ~} Z ~ 1 IJC~b~f 2 iZotstj
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mm De cangNed M person
Wlm nalalnaa'de~m. .
26. Date Prmwnced Deed (Mmm, day, yea
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~ ~ ~ 26. Wee case Reterretl m Metlicd Examiner / Coroner br a Reason Oma than Cremation or Daatlon?
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CAUSE OF DEATH (See Inetruedone erq exempau) + pppopmeb IntrlNel: Part II: Enbr Omer ' '
dam 27. pan I: Enta IhB dlaln d events -diseases, inludas, a complkxM;an -met dlre fly posed me loam. DO NOT enter femarwl ewres Such tie cerdac enesL
25. dtl Tabasco Use Cannbda m Oaem7
Orreel ro Deem but nd reeu10
re6pirfMary aneaL a vBnlricuW !b llaam winlwl sMwWlg the etiobg/. tip only one ®w al each arse. rp in tM untledying cause ghwn in pen L ^ Yea ^ Probe
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rs/,~~~j~~7 29. If Pamela:
Due ~ a ^ Nd PragnaM wiMan put year
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DERLYMO CAUSE a Du a mnseq
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(aw~m reWrorg mewl h~ etetl fhe p ~ /~ ~GC+a'L~i ^ Na pregmnt. bd Preplan? witNn 42 days
LAST
Due ~ 8 mnsepuence oq. of death
t~ bM pregnant 43 days ro 1 year
d. i ^
bafae tlealh
30a Po omred?~ 30b. Awnabr m Coro 31. M rer d Deem 32e. Dale d Inury (Month, my, Year) 32b. Describe How Injury Occunetl ^ Urtnown it preglleM wNMn me pap year
Pbam
Netwal 32c. Place d Iryay: Home. Perm, SreeL Factory,
of Cause d Death? ^ Homkitla Ogica BuiM' eta (S
mg. P~NI
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^ Yes X No ^ Vu ^ Na ^ Aoddant ^ Pending Investigation 32d. Thee d InNn/ 32e. Injury et Work? 321. II TraneponatiM lnju7 (SDetiNl 32g. Location of Injury (Street, cny I town, atek!)
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^ Suk;ge ^ CAUM Nd be Delerminatl M ^ Yes ^ No ^ Odwr I Operator ^ Passa,ga ^Petlestdan
Omer ~ Speciy:
330. Certifier (snack only one)
330. SigneWre itle of CCC,~~Ynlier
• CerlHying physklan (PhysbHn oenilying cause of deelh wnen enolha PhYaiobn Has Ixonouncetl death anA complaetl Ibm 23) ~ ~+?~
To tM Oast of my knowdWgs, deNh xwrretl are fo the caues(s) erq manner as mtad
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_ _ _ _ _ _ _ _ _ _ _ _ _
• Pronouneing and eertnylrq phyraden (Phyaknn bdh Pronaxnrp death antl oerlaybg la muse d deem) _ _ _ _ _ _ _ _.- _' _ _ _ _ _ _ _ . _ 33c. Ucanae Number
To the bsH of my knowledge, death occurtM n tM time, date, entl place, and dw to the uues(a) arts mentor u slebrL _ _ _ _ _ _ _ _ _
^ 33tl. Date Sxpled (MOnm. daY. year?
_ _ _ _ _ _ _ _
• Medkel Examiner / Cororror P't D 0 3 $.Y7$ ~ ICj ~ ~„' O
On me Dasie d enrMnellon end / or inwsgganon, in my Opinlal, deem oceurred N the SrM, date, end plea, end due to Iha nose(s) end manner as sbletl_ ^
34 Name end A~ddr~esgd`per1wn!LWM C}om~ple~ted Ceus>a Hof Deem (Ibm 27) Type! Prim
35. Regisu nature arltl Distn~Jlorrlbar to Filed (Maim
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RENUNCIATION .
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REGISTER OF WILLS
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PENNSYLVANIA
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Estate of VU 1 ~ ~ I df lrn-- ~ rYI.Z S ~-.~ n ~ S r
,Deceased
I' ~ 17 A ~~ ~ i--~~~~ , in my capacity/relationshi as
(Print Name) h
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
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~~S~a-y t v
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
bef me this ~~~ day
of 1, ~ ~~
Deputy for Register o ills
ignature)
(3,~ Garla n a( ~r
(Street Address)
Car•I, s l e. s ~r4 1~~ l 3
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation r the
pu oses stated within on this _'~ day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration ofNotary's Commission.)
Form RW-06 rev. 10.13.06