HomeMy WebLinkAbout03-11-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of IVY A. PAULL
also known as
COUNTY, PENNSYLVANIA
File Number ~ ~ _ l y r ~ L~U
Deceased Social Security Number 180-10-5701
Petitioner(s), who is/are 18 years of age or older, apply(ies) for: tV
(COMPLETE 'A' or 'B' BELOW.) o
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
~-
-rf
(State relevant circumstances, e.g., renunciation, death of executor, etc.) `~~~"' ~ _ :~~ C~7
Except as follows, Decedent did not marry, was not divorced, and did not have a child tom or adopted after execution the instruments) offlc
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: t~
B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.r.a.; pendente life; durance absentia; durance 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
GEORGENE E. JANTOS DAUGHTER (Only Child) 145 EWE RD., MECHANICSBURG, PA 17055
Note: Decedent's husband, George Paull, Predeceased
Decedent on February 21, 1989
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at
145 EWE ROAD. MECHANICSBURG, LOWER ALLEN TOWNSHIP, CUMBERLAND COUNTY, PA 17055
(List street address, town/city, township, county, state, zip code)
Decedent, then 91 years of age, died on JANUARY 1 Q, 2010 at COUNTRY MEADOWS, Camp Hill, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 1,000.00
(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:
GEORGENE E. JANTOS, 145 Ewe Road, Mechanicsburg, PA 17055
Form RW-02 rev. 10.13.06 Page 1 of 2
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 axed subscribed
before me he ~_ day of
For the Register
Signature of
Signature of Personal Representative
Signature of Personal Representative
c~
--
~ ~ ~
b~ _ •,'~Q
~Y
File Number: ~~~/~ ^ OZ~~
Estate of IVY A. PAULL ,Deceased
Social Security Number: 180-10-5701 Date of Death: JANUARY 10, 2010
AND NOW, ~ie~ l"1'~e~ ~~~ 20(b , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters OF ADMINISTRATION
are hereby granted to GEORGENE E. JANTOS
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 ............... $ ~ ,u~
Short Certificate(s) ........ $ ~ ~ . °y
Renunciation(s) .......... $ "~-
~ ... $ 2.~ ~ sa
` ... $ ~~
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ 7 _ ~ ~.
Attorney Signature:
Address: 3901 Mazket Street
Telephone:
Camp Hill, PA 17011-4227
717-737-0464
Form RW-02 rev. 10.13.06 Page 2 of 2
Supreme Court I.D. No.: X3788
105.905 1tEV.lil09? _. __. ~ ,> _.
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with
the Vital Statistics Law of 1953, as amended. .~ ~ ^ ~ ~ ~ ~ ~~~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~
G~
!.8':i '
~ ~
ap
~
'~' '" S ~Q
0
--~
c._ z ~r°
~t:d_l ;_t_J
,.,~ ~,~~
~ cr, _~
~_' ~,-~ ~ 5 2 2
l.. _' .-~
ti.
'~
0~
~ U
Linda A. Caniglia
State Registraz
FHB 18 2010
Date
H1D5'1° ~' mood CORRECTED ITEM / 4 ~20a COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE~~rtN F~ pATE:2-16-10 bas L
~~« PEI; Fib ~ DATE: ~~7~o CERTIFlCATE OF DEATH oO~~QL
(See Instructions and examples on reverse) ~.,~ cn F ea wreFa O U
w
W
,. Nmw d oeaaed 1~a mbae, id, aarwl I A. Paull
~y 2 sa
Female 9. social Seaair NurBer
180 _ 10 _5701 4. pee a peae pben~, ay, yar1
January 10, 2010
S Ape (tad Eiirdey) UMw 1 UMw t & Dde d aM r. and deb a 8a Pin d Ded~ Gwdt me
91 lbnbe 0•da Hwee erase
October 28
1918
Reading
PA HoepiW: Otlw: Assisted Living
y" , , ^ ^ ER l o~.ba ^ ~ ^ ~ ~ ^ ~ ~.
' 9x Cony d peen 8c sly, Boo, Twp. d pane 80. Fady time (nnd ireAbn, ve• eaataM nuroerl r. Wa Deeded d Hbpedc Qgi2 ®Nb ^ Ya 10. Rea: Amedoen brain, aad, Ydde, ek
e Cumberland Hampden Twp. Country Meadows 1 ~, del 1~ White
11.OecsdareUwd dworkdme mold ie. Dorouii 12 Wa Decedad ever b rw 13 peadwd'a Edeatlm (Spedry ay N~wd prle caryibd) 14. Wad SbYre: WdeQ Near,.Menied, 18. SunNirp Spauee (8 wne, pee maiden rra)
10nd Wark Kndd I
Sales~ad 5ttal
y e U.S. Amwd Faca2 Widmad, Diwrced (Sped-i
°~ $e' ~~~ ~ na a s'- Widowed
^Ya ®No
- ,B.DeoederfsWipAedea(SDeel,drylbwn,dde,apmde) ,, nasbi PA ~i nalBYea,oecededuweab Lower Allen Twp, r
~
Mechan csburg
PA 17055 tn.caay Cumberland rew~ip2 nd. ^ ~a da~Hn
, gryl9oa
18. Patois Name 1~ middle, owl euAia-
Wafter Heim 18. Wriw'e Name Ir+r midde, mdden auname)
Maud Heroine
za. ndormmfa Name (type 1 Pml) 20A bbrmsfa Wisp Aabea (sbal, dr Ibm, dde,:4 code)
Georgene Jantos 145 Eve Road Mechanicsburg, PA 17055
21aWModdpiepoeam a ®Crenietlm ^Darnm 2ID.Debdpipaam(Nadr,dry,ysr- 21eF'woedDkpoatlmlNemedamMaY,aaaldYadlwPlecel 21QWcronlCArlba4Ab,a'Pmb)
^ &'"l ^ "'"'°"'lDoined' "'~w"~1onaDoa'°n"d
^ pwr. a braederisiwlClwawrT ~ Ya^ No Janus 12, 2010
ry Evans Cremation Service Leola PA 17540
,
22a d la poem adip a eudr) 22b. ticewe Numbr 22c Nra end Adana d Rriej
. ~ ; j/~,d~ Ronald R. Klee, Jr FD-012490-L I(lee Funeral Home 8 Cremation Services One East Lancaster Avenue ShiNington, PA 19607
1rrw23ecadrwha
ptryddninclwaiaderliwddWrb 29aTotlwhed
~~
/0
~
1~4d%',I~
~,~y~ ~0
~~ ~1
/v '
i7v
Hera 24,28 mud De canBiYd y peraan
~~ 24. Tea d Deeb
«
'~y~ 25. Deb pad INmM, dy, year)
sofa
~d 28. Wa Cea Adened b Wad FYairiw I tsar br a Ream Onw tlim lSemrm a Donnm2
^
. , Ya ~~
CAUSE OF DEATH (8.o bttreeabra and aranpla) , Approdnri Yinwt Parl n: Ede one 28. Dld Tdrea Ua CadibuM b Dari2
nem2r.F'r11:EnMir~abie-dare,iry'uiee,ormrpfcaforr•1WdndNamedrudalhDONOrenMbrrn:Wevaaeuchaardiecrred, i OadbpeeM
' butndrauinpitlrurideryiptaue~
~°n i F'M i•
P
^ Ya ^
mba6y
raperay md, a emhbrr IMiaYm wanA ebowYp M aYdog. lid ady
me use m exfi iw.
r
r ,-
,
/
^ No W~berr
_
midimr°°ilMgn~,) -~ a l.Ar4rc Nyep~~. ~ 29.N
Web (a a a mwoquwa dI: r
btomdaww,iay, b. ~ ~
a
~ preOrdwiibpalyear
^Pdy~rlrtYaddalh
^
Web (a a a mneegien dl: ~
Ii~EERLY"a CAUSE Nd pnprrr, hd pnpird wide Pt dye
~ ~ryay ~ ~ a i
n~6Y i d deeii
^
pue b (a a a carepwo oQ: r Nd prepwl, bd pdpm143 dye b i tar
~
d ~ baba doe
^ Urbprml
re
M
ihbtM
Y
r p
p
w
p
yer
301 ~en~ 90hWedAu~ 31.Wmer 32aMeed~(Airib,dry,yeeq 92b.DaabHOwbM•rOauM g,
~
H ~,,ygpry,
~
dCrwdDeaM NYad ^H°n1pb ~
O
aoe
^ Y
N ^ Y
N ^ Aoolded ^ Pn3ep lneefprm 32d Tyne d ~•P 32a b~•r rWoKl 921. r Trrwpairm Mun' f~M 92p lee0m d'n}ry (~ dhl b'm, ode)
r
o a
o ^ Su4dde ^ Cadd Nd M DelpneYrd ^ Ya ^ No ^ Drier/ppwra ^ F'aawper ^
-l Oiwr • spaaYr
33a CrWer (~ •dT ~) 39b. SIpWe end Tae d
• OrWpYppYpleMlPlyeidnaraligoueddeahwMnardwpNydnhapnawnaddalhagownplNediem23)
~
Teaebatdryibwidp,deMexmeddwbbauy~rMarwrrMrW.-------°----°°--------------- ~
• -roeaaraei^dar~pr,dd.tPD~ddanDaD~a~a~npaen.rdanyipbo..aadnl _
~
~~
~,r~
rowMdelgYrowYdp.deaieaoenedruri~e,deb,udpia~aMAralrtarya-adbrwrrdaed------------------ ^ 0 c 3c1 C lll ~~O
• wealm.rlcaaw
OwlebrbelevhaiandlaMaiptYa,Yraryapbin,daaammdabNeaee,dale,eNpiea,nddablMeaae~-WwnwrrdMed. ^ 91.w~end dpi,1Mp~~,p~gwedpeairlimT!)Tpe/RM
7 4 O
l2Kh•
l'
K
r
9S Reygale 94wM•• end grid 0 6 ~, ~
~ I I I I T~ I
96. pre Nahdr.Yw1 Q
j
. t~
J~{ f
v
k" 4 ~ Pe PLNt C fl t,t N Ro ~ /,
_ 2 20 o c~1eN, r~1 rr1 p,4 r 9~r f
~~ 0429041