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HomeMy WebLinkAbout01-14-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Estate of Luther Dean Jumper COUNTY, PENNSYLVANIA File Number ~ ~ ' 1 ~ ~ W ~~ also known as ,Deceased Social Security Number 172-36-0828 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: r-a (COMPLETE 'A' or 'B' BELOW.) ~-~, ~,,,,,,-' ; ; ^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the "" -~~ amed in the, ._v~r~ ~. ,.f ,~ last Will of the Decedent dated and codicil(s) dated ' ?-t ~` p r.~„~ c~: ~% '~ (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 of-~~i#istrument(~ offere~l~-a for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ ty /^ B. Grant of Letters of Administration (If applicable, enter: c. t. a.; d.b.n.c.t.a.; pendente life; durante 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.) Name Relationshi Residence Michelle L. Thrush Daughter 2 James Court, Carlisle, PA 17015 Brandi K. Thrush Daughter 24 Chestnut Street, Newville, PA 17241 James A. Gross Step-Son 101 Army Heritage Drive, Carlisle, PA 17013 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 101 Army Heritage Drive Carlisle Middlesex Township Cumberland County, Pennyslvania, 17013. (List street address, town/city, township, county, state, zip code) Decedent, then 62 years of age, died on November 29, 2009 at 1136 Rockledge Drive, Carlisle, Pennsylvania, 17015. Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (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: $ 10,000.00 $ 0.00 $ 0.00 $ 0.00 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: or printed name and residence James A. Gross, 101 Army Heritage Drive, Carlisle, Pennsylvania, 17013. Form RW-02 rev. 10.13.06 Page 1 of 2 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 before me the ~ ~~~ day of ,~v~o For the Register sv Signature of Personal Representative ~ ~ ~ ~ ~ ~-- ~ } ' ±% ~ ,, ...~, ~-~-y ;. , Signature of Personal Representative . ?' ~°,~i ~.~ ~~ ~~~~ . ,~~, c--,~ . ~ ._ ~:_ _> ~, - _, ~ .~ ~ ~ ---r-, Signature of Personal Representative ~ ~ ~ ~ ~ '~' •• File Number: o~ 1 - l C7 Estate of Luther Dean Jumper ,Deceased Social Security Number: 172-36-0828 Date of Death: ~ ~ - Z~L' •-~ in consideration of the fore oin Petition satisfacto roof AND NOW, ' U g g rY p having been prese before me, IT DECREED that Letters of Administration are hereby granted to James A. Gross 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 ............... $ !'t 5 . C~ Short Certificate(s) ........ $ ~ . CEO Renunciation(s) .......... $ ~ • v~ ,--r ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $Ql • ~ in the above estate ~~~, iGl13t. Reg Attorney Signature: Attorney Name: __~ L. Griffie Y Supreme Court I.D. No.: 34349 Address: Griffie and Associates 200 North Hanover Street Carlisle, PA 17013 Telephone: (717) 243-5551 Form RW-02 rev. 10.13.06 Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $6.00 P 15932694 Certification Number a d H106.144 REV 11/2006 TYPE/PRINT IN PERMANENT BUCK INK ~E~~_~ ~n ~~ I~ 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. ~~~ ~~ ~ ~~ ~t~~b~~ o~c / Focal Registrar Date Issued na ~Q c~ .'X. .;e S` ~ 1 a~ ~ r r _) r 4 ~ -~ __I .. `i`I ~) ~.., .~~ J . f'V ~.,~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See Instructions and examples on reverse) CTATF FII a NI IuRFR 1. Nero d Readers (FkM, middle, rM, eulnx) 2. Sex 3. Sodel Secudy Nurdrer 4. Dale d Deans (Mona,, day, year) Luther D Jumper Male 172 - 36 -0828 November 29, 2009 5. Ape (Wt Bkttldey) Urdr 1 Under 1 8. Dale d Bhnl Madh, de , 7. and arete a 8a. Prea d Death Check ale) 6 2 eblaa °"' "°"' wiedee Aril 7 , 19 4 7 p Carlisle , PA "°°Pael' Other: Yre. ^ inpeaad ^ ER r oulpea.d ^ ooa ^ NuraMg Noes liaiderae ^om.r - sv«aN: Sb. Coady d l1eMA Bc. City, Twp. Deets 8d. FadNly Name (a rat trudMWon, give street and nunlbx) 9. Was Decadent d FNapadc Odgk1T ~ No ^ Yes 10. Roca: Arradan hWirl, Black, wNre, ek:. Cumberland South Middleton 1136 Rockledge Drive (nya,.p.dycaban, (Spady) Mexban, Puerto Rican, eb.) White 11. Daesderlya Ural IOrxf d wodl daa mats d We.'Do rat erere 12. Wa Deadest ever b as 13. Deaded'e Eduadal (may ~ hlplaet ~° ~) 14. Merkel Sreka: Mertied, Nevi Marrrd, 16. Surviving Space (n wife, give meklen rams) ,try Klnd d wak KxM d BueNles 11 U.S. Amad Faas7 Elementary !Secondary (0-12) Cdkpe (1-4 a 5r) Widowed, Dkrortred (Spsd/y) ter son Construction ^Ya ®No 10 Divt,roed 18. DeoeerlYt Makhp Addrw (Shed, dty / bwo, erere, ?4 coda) Decedent's pA Did Decedent 101 Army Heritage Drive Aalual Reekkaae i?a. Stare ~'• h a 17c. ~J Ya, Decedent owed in NLi ddl Pax T„4, Carlisle, PA 17013 uredwlalr ,Tb.Canty C>~nberlarid Ta""'°'*'T i7d.^ d CNy / Bao 1B. Fatller's Name (FkM, nlidde, wet. euar) Miley H. Jumper 19, Mortar's Name (Fkel, middle, rtleMen wmanle) Ruth V. Hock 20e. htlosned'e Name (type / Pddl 20b. Irlfararlfa MMWq Addraa (Street, dy / taus, state, aP code) James Gross 101 Army Heritage Drive, Carlisle, PA 17013 21e. Metflod d Drpotlaon ^ Daraaon 21 b. Date d Dbpoeitlon (Maxh, day, year) 21a Pros d Drpoekbn (Named arrW a Oster cam', aY Waa) 21d. Locatbn (City /town, Mare, bP code) ^ BlxiM ^ Rerravd from Slate ^ ~,„r . Mhs Crrmtlon a Dontllorl Aunarlad ,,,b,q, , c«~T ~Ya ^,~ Deetsnber 5 , 2009 Evans Cre3nation Services Leola , PA 22a. a tlcrma eudl) z20. Ilrxnee Number 22c. Name and Addrea d FadMy swing Brothers Funeral Hcime Inc . - FD012633L 630 South Hanover Street, Carlisle, PA 17013 Conglere Irene 29s•c oNy wtan aertllyMp 23a To tla bets d my ,death accused et the dme, dale end pre erered. (Sigraklrs end tltle) 23b. Uana Number 23c. Date Signed (Month. day, year) phyaiGarl r not evMrble M ame d dent b gray ala. a eam. Irna 21.28 mots be cartiprered by parson 24. Tkne d Death 25. Date ProraUrlaed Deed (Modh, day. year) 26. Wes Case Rererred b Med~M Exarrlklef / Canner for a Reason Oaler tllan Cremation a Done6onT wlapraaaaadaal. 11:00 P. M, November 30, 2009 ~va ^No ttem 27. PeA I: Erllr ar ffi1b,lzLltl~l6 - daaa, Yrjurbs, orUlcamgk~ oru~-arts directly . DOaNOT enter tertNnal averse such as ceMac aseM, ~ r kservel: Orxat b web PaA II: Eder other ' ~ not IBSIIIang M ale undedytrlg Caua given b PaA I. 28. DM Tobago Use Caaibde to Deen1T ^ Yea ^ Probably reepirebry aseM, a ventrkxafar fWrMatbn wklald ehowkg tla etlollgy. Lrt sly as cause on each Ike. i TE CAUSE FhN dreae a r ^ No ^ Unknown ~radlNpinrSeatl,) _~ a. Occlusive Coronary Artery Disease ; Alcohol Abuse zs•nF: Due b (a a a oonaequrla of): ~ ^ Nd pregnant allhkl pest year SagwnaeAy Irt wMaorr, n arty. b. ~ b the ceuee asred on Itrle a. ^ Pregnant M tlrne d death FJlar UNDERLYIIW CAUSE Due b (a a a coraaquerae d): ~ ^ Nd pregrws, but pregnrs waNn 42 deya ~a ~~ a r r d death Dueb aaa ( ~r••glwa• ~~ r ^ Nd greyness, but preened 13 days b 1 year d. ' ^ Unknown n prepaid wkdn as pets year 3oe. was an Aubpey PedamadT 30b. ware Auhlpsy Fbdrge Avakede Pea b Cornpleaon 31. Mrtrar d Deanl 32a. Dare d ~urY (Marsh, day, year) 32b. Daalbe How In)ury Ocalrred 32c. Pia d ~ StrsN, Faday, d Ceues d Deaa1T ~ ~~ ^ ItonYade , ~ OHIa % ^ Yee ~No ^ Yee ^ No ^ Acddent ^ P~q ~ 32d. Time d klNsy 32e. InJtay M WorkT 32f. a Treaparetbn kQuy (Spedfy) 32g. l.oaaon d It~ury (Brest, cay / kem, Mate) ^ 3ukide ^ Calkl Nd W Deterrrlirlad ^ Ya ^ No ^ DrNer I Operate ^ Psssagr ^PedeMrrrl M Other • Specly: 33e. CeMkr (cheek asy aa) 33b. SgnNaa end • CerlMytrlp ptlyekrn (Phydden aAaykp aae d deal when enonar phygden has prorloaaed death and artlpleNd Item 2s) CO rove r Tonabardmywlowrap.,deetlloaureddwrottaerae(s)rldnrrearasOMed-__^----------------------------- ^ - • ANY ~ artMf'kq pM•~ (Plysidm bcai pranaldiq death end aedkykq b awes d deal) To the beq of ry Imowrdpe, deem aaxrrted at na Nnla, dNe, and plea, ad due ro na eras(,) and rranrar a srered.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. Lberlee rknlber sae. Dee Signed (Marts, day, yaw) • M.diar Ex.rrrtr,.N C«anr On na bar d exanrkrtlon and / a inwatgatlon h m o Ydon deetll occurred M tla th d re d r d d re h December 2 , 2 00 9 , y p , e. a , an e a, an ue t e quays) and mwar a arered_ erg Addraa ~srsan 1~qa q Q~h /rea ~~ yra [tae ld ~ ~ 11 1` m ~ Type / Prht ~~ ~~esed'`~''"'r) L . iV O C 1.0 r OII S , 6 375 Basehore Road, Suite ~/1 Ln? I I I~ I t 10 I - Mechanicsburg, PA 17050 DrpaldalPemlkNo. ~ t1`t1)~bS~~- RENUNCIATION ~? fv a ,~~~ _~. c~ __y. -, , ~. ~ r -, ~ l-~ REGISTER OF WILLS ' ~ ~-' ~ -- i ~ ` Cumberland COUNTY, PENNSYLVANIA I..i...r M~~. ~ -=~ ~ `~''.~" ~ r..j '. ..t c ~ . , ~-A _... lr J e ~ ~ . .~ ~ ~t ,. ~ • • "~ = r " t`V p Estate of Luther Dean Jumper ,Deceased I, Michelle L. Thrush , in my ~ostelationship as (Print Name) Daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to James A. Gross (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills ~- (Signatur 2 James Court (Street Address) Carlisle, PA 17015 (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 for the purposes stated within on this ` day of ~ wi~a 02~ % D r" ~ Notary Publ~~ My Commission Expires: (Signature and Seal of Notary or other official qualified to ~Y 1 ~= administer oaths. Show date of expiration of Notary's Commission. ) ~r ~~ C~lM• My ConMrNa~~+n ExpkN .lon ~. !/1! Form RW-06 rev. 10.13.06 aOA~' SON Ski j ~J~~ ~1~'1 ~t~t~t ~~ .~i11i1'lIMC~i RENUNCIATION c7 ~' 1 REGISTER OF WILLS ~ ~ - ~ , .., -;... Cumberland COUNTY, PENNSYLVANIA F ~ ~ ~ ~ i _, ° ~., a ~, . , ., ~ - -u • ` ~ C- } Estate of Luther Dean Jumper n;'Deceased I, Brandi K. Thrush , in my gairelationship as (Print Name) Daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to James A. Gross (Date) (Signature) ~, 24 Chestnut Street Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills (Street Address) Newville, PA 17241 (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 for the purposes stated within on this ~ ~l-h day of t~~-~ ~d 1 D NotaZy P~i~ic My Comm><ssion Expires: (Signature and Seal of Notary or other official qualified to _~ administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 tA~ 1~AMM+O~! r,~ ~r 4 re! . ~ +~. awpM! aa+wi~ra-~-