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HomeMy WebLinkAbout03-02-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of LESTER E. RUSSELL also known as COUNTY, PENNSYLVANIA File Number ~ ~ ~! / fJ Deceased Social Security Number 181-42-7670 Petitioner(s), who is/aze 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 c:a ~_w..~, ~rI ••,4Y7 ..,.~_ p ..::~ ---.. -, ?.~~ r ~..,..., (State relevant circumstances, e.g., renunciation, death ojexecutor, etc.) ~ ~,,,~, ,. a .. r,- Exce t as follows Decedent did not m P ~~ t~r~ P ~ arry, was not divorced and did not have a child born or ado fed after execution of the instrurz(s) offerec~~ 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; durante absentia; durante minoritate) Petitioner(s) after a proper seazch 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 AMYL ANDRADE DAUGHTER 11 School House Road, Newville, PA 17241 (COMPLETE WALL CASES.) AKach additJonal Skeels ijnecessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 15 School House Road Newville. PA 17241 (List street address, town/city, township, county, state, ztp code) Decedent, then 59 years of age, died on January 3, 2010 at Green Ridge Village, Newville, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 500.00 (If not domiciled in PA) Personal property in Pennsylvania $ 0.00 (If not domiciled in PA) Personal property in County $ 0.00 Value of real estate in Pennsylvania $ 0.00 situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the gant of Letters in the appropriate form to the undersigned: Si afore T d or Tinted name and residence 11 School House Road, Newville, PA 17241 Form RW-02 rev. 10.13.06 Page 1 of 2 G ~©7~ ~~ 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 before me the ~ day of ~~ ~~ ~/ ~ ~ ~ ~ For the Register Signature of Per 1 Representative Signature of Personal Representative Signature of Personal Representative File Number: ~ 1 ~ /~ " Z (,~ 9 Estate of LESTER E. RUSSELL ,Deceased p {+ "1 to ~ E 6.~,r: _. , -- ~' ~; "+ ~~~ O'~ ~ Social Security Number: 181-42-7670 Date of Death: JANUARY 3, 2010 AND NOW ~" 6 ® in consideration of the foregoing Petition, satisfactory proof having been presented before m , I IS DECREED that Letters of Administration are hereby granted to Amy j;~ Andrade in-the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of recor as the last Will (and Codicil(s)) f Decedent. r FEES $ ~~ ~~ Re o it Letters ............... Short Certificate(s) ........ $ / Z . ~`' Attorney Signature: G~ Renunciation(s) .......... $ f. ~~ Attorney Name: Andrew H. Shaw • • • $ -T - OU Supreme Court LD. No.: 87371 ... $ $ Address: 200 S. Spring Garden Street, Suite 11 • • • $ Carlisle, PA 17013 ... $ ... $ • ' ' $ Telephone: 717-243-7135 ... $ TOTAL .............. $ .- ~ 0.00 Form RW-02 rev. 10.13.06 Page 2 of 2 RENfUNCIATION REGISTER OF WILLS CUMBER;Z,~AND Cp~'I'y, PENNSYLVANIA Estate of Lester E. Russell child Deceased I, Gregory Russell „~ in my capacity/relationship as (Prtet Name) of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Amy C. Andrade ii~~7. (Dore) m~1. ~~(~ ~ ~r . (Sneer ~ididreas) e ono ,~ ~~ ~go~~ (Chy. Stme. ZJp) ~~ ~ ~e$~.41E1'~R O,~C6 Sworn to or affirmed and subscribed before me this day of Deputy for Register of WiIIs F aecuted out o,~`'Reg~ster's Obi ce Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation ~or the purposes stated within on this ~ 9 day of=..)~n ~~ r to o20 / ~ ~ry Publlc . y Commission Expires• ~ ~ ~~~/~~~ 1~ csis~a~ ~,a s~ ofxotary or other o qualified to ednuntat~r moths. Shore date of ex~itatian afNotruy's Coromiseioa.) Form RtY-06 rev lQ13.Od l -~o To 2~ 9 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 16053345 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. Local Registrar Date Issued 1losia3 AEV 11/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE/PRINT IN PERMANENT BucK INK CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE FILE NUMBER 1. Name d Decedem (Brat, rtYdde, feat. aullx) 2. Sex 3. Social Secaity Nanber 4. Date a Deem (Month, day, Year) Lester E. Russell male 181 _ 42_ 7670 ~ 5. Age (Lea BirtlMey) Under 1 Undo 1 8. DaN a Birth (Morah, ) 7. Bidhpba (' end aab a ) Ba. Place a Death (Check one) - 5 9 ~'"'" °rys "°"' "'"'"°' 11 / 6/ 19 5 0 Car l i s l e P A "°°~"'~ 1y1~ - Yre. ^ Inpatlea ^ ER / Outpatlenl ^ DOA 1J Nureag liana ^ Residence ^Omx • Spedly; ' lNr. Caunry a Deem 8c. Cny, Born, Two. a Death 8d. FadN1y Name (H na irgtlbrnorr, give greet end rentba) 9. Was Decedent a HlaPertic OrlglnT No I ® ^ Yes 10. Roca: Amerkxrr htdan, Black. WMte, sa. Cumberland West Pennsboro ~/ (nreaapeafYCuben. ( ~ d / f~a Mexican, Puerto Rican, etc.) W~'1 ~t e 11. DeoedsM'e ueW Kira a wok done moat a Ne. Do net s1W 12. was Dscedertl ever a the 13. Decedents (Spedry any hiplwa grade cwrtplelsd) 14. Mona SI81U6; Married, Never Herded, 15. SurvNkp Sparse (n wile, ghre maiden name) Kind d Wak Kira d Buanep / Inaaay U.S. Armed Forrxs4 E~r10ery / Secondsry (612) Colsge (1-4 «5r) widowed. DNaced (5pecMy) Maintenance PA Turn ike ^Y~ ~~ 12 Divorced - I6. Deaderd'a Mei4q Address (Sheet, dh / awn. stab, zp ~) Deceden's 15 School House Road ' RBader1B 17a~ ~ P A -~ 17c. (~ res, Decedent lived Yf West Pennsboro Twp N e ti. v i l l e P A 17 2 41 17b. Courry Cumberland TONY nd. ^ No, Decederd Uved wltlrkl Adua lJmib d Cly /Born 18. Famer's Name (Brat, nridde, last, at/Rx) 19. Homer's Name (Kral, middle, maiden aumeme) Henry L. Russell Dorothy M Wright z0a. IrdonnerrTa Name (Type / Prkd) 20b. Inlormere's McNnp Address (Sheet, city /town. stela, zip coda) Amy Andrade 11 School House Rd Newville PA 17241 21a Method a Dmpoeltan ®Cremamn ^ Doruroon 21D. Date a • (~ aY. Y•&) 21c. I'koe a Dlapaeitlon (Name a c•n~', aemet«y «other Pte) 21d. Loatlat ( /a~m elate, xip ) ^ ~' ^ Rem hen seb w.. cree^non « Dartlon Autlrodaed. 1 / 4 / 2 010 Hollinger Crematory ~( ~o l Y y Spring s ^ peter - sP~r• M Medael exenrror / ca«r•rr ,~ Yea CJ la r ~ ~ 17 0 6 5 - - °a («I~e~ FD 1 895 L ~~et?tral Home Inc 1 Big Spring Ave Newville PA 17241 carpNle Ibnre 23ec only when 23a. To me hest a my a,owledye, death occrered a me time, deb and place sued. (SlgruMe and title) phyNcisn b na avalebb a tlm. d seen, 23b. Uenee Number penny sues a deal,. ~; y~ (.- ~ . ,j~vvLxc-lY_.C-Y ~- 23c. Dale signed (uann,, dax Year) Ilema 24.26 mwt be mmplaad by person 24. Tune of Deem zs. Dab Praoreced Dead (Monet, day, year) 26. was Case Referred a Medical Examiner / Canner t« a Reason other then Crenranon a Donatlon? who Prarrouraa deem. / : d~',S' am M. h~~~ 3 ~j/ 0 ^Y~ ^No cause of oeat>FI (see l end exempts) Hem 2T. Pen I: Eder the ~, - dam, Hurbe, a oompfr"tlorm - ma dlracny arced the deem. DO MOT order temrlna event arrdt as ardec arrest, ~ woe (nterva: PaA II: Ertbr other 28.Ok1 Tobacco use Cortbidrb b Ikelh4 respiraay arrest, a venhkxrbr tlbdle9on wntaut elrovMp the etlobgy. Lbt any ab sues on each Mrs. r Orxra b Death ba rat resultlrq ht the underlyktg ease gNen b Pert I. ^ Yes ^ Prabeby MMEDIATE CAUSE ((Fxsy~J disease a c t^-~ i ^ ~ ^ lJrtloroaat J oorrdltlon reerMirg M tleelhl -~ a. ~ r Q ~'G~( ~C '~ ~j 1 ~yG~ .yc~,~ r Due to a u a ~ 29. n Fenxrle: ( ~ ~• r ^ Nd pregrxm wnNn Pea Year ~~~ mrtdllore n ^ Pregnant a tlme a deem uedrq b care Yebd on Y~rte a. b' ~ ~~F~nbr Ere lIIDERLYMp CAUSE Due to (a ae a cormequenos oQ: r ,v - iverxe reeuq n d~seth~ °• i ^ Nol prepnent, but prepnea w~nhin 42 days Due a (a as a corgequena an: r ^ Na pregrwrt, but • d. i pregnant 43 days a 1 year J r baore dalh 31b. PWu A~ulapey 30b. Y Aubpey Rrxlrga 31,~M,,an/ner of Deem 32a. Date d Injuy (Monet. day, year) 32b. Deeabe How u)ury Occurred ^ lJnknam n prepwird wnMn me pea year ~~~ iQ ~xal ^ Fbnicide ~ ~ ~ ~, ~~ ~, Pettey, d cause a Deem? ^ re. ~ ^ rs No ^ A~bern ^ P~9 tmreatlganort 32d. erne a a)ay Sze. I a work4 3z1. n r ^ ^ salads ^ Coed Na I» DebnNned ^ tea ^ No ^ Ddva // aNrY (~Y! ^P 32g. Leaner d ~' (Brea, cnr / awn, ebb) M. ~_ 33e. Certllbr (check ary one) . ' ~Yhq PhY•I~n (PhY~n n9 awe a deem when anomer Physician hea pronaarced deem and mrnpbted nom 23) ~- To tlw bast a my lugwadgs, dsalr occurred due to yN aros(e) end mamx as etebd- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ _. ~ 4 . ' Irr9 and o.nnYMq PhY~ (Phyacien tom pnxaundrg cam and axtifykrg to awe a deem) To nb best o1 my atowbdgs, dwm occurted et the time, dNa, and Pus, end sue to tits ease(s) end mmx ae sbted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. 33d. Date slpned (Monet, day, yeer) • bees xernkrenon end / « imangetwn. In mY oplMon, seem ooeared et the net.. sate. ,rw Pleee. era due a ma a D O i Q ~ r ~ - L i / ~~ ~ O use(s) arrd manner es atsted_ ^ 34. Name and Address a person who rl ComPbted Ceuce a Deem (Item 2~ Type /Print - ~ ` _ _ re ~ ~~~ v I _ I 1 I ~ I 36. Fled Monet. daY. Yom) \ ~ ~~ j Duposltan PerrMt No. C~~-33~-LO` -