HomeMy WebLinkAbout05-19-10PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ROBIN A. GERHOLD
also known as
No. 21-10- ~,~ Z7
To:
Register of Wills for the
County of CUMBERLAND in the
Commonwealth of Pennsylvania
Deceased.
Social Seczzrity No. 168-60-1372
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, app/ LIED for letters of administration
(d.b.n.; pendente lice; durance absentia; durance minoritate) On the estate Of
the above decedent.
Decedent was domiciled at death in CUMBERLAND County, Permsylvania, with
h E~_ last family or principal residence at 204 S. ENOLA DR. EAST PENNSBORO TWP FNOLA PA
(list street, number, Twp. or Boro.)
Decedent, then 46 years of age, died 5/8/2010
at CANCER TREATMENT CENTERS OF AMERICA 331 E WYOMING AVE PHILADELPHIA PA
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ _ 10.000.00
(If not domiciled in Pa.) Personal property in Pennsylvania $ _
(If not domiciled in Pa.) Personal property in County $ _
Value of real estate in Pennsylvania $ _ 120.000 00
situated as follows:
204 S. ENOLA DRIVE ENOLA PA 17025
Petitioner S after a proper search ha VE ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
tvame Relationship Residence
10 ANNETTE DRIVE
DONALD W. MORGA FATHER ENOLA PA 17025
10 ANNETTE DRIVE
LINDA L. MORGAN MOT ER ENOLA PA 17025
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THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
~~~~- ~ ~~ 10 ANNETTE DRIVE
'w"^ ENOLA PA 17025
g DO LD W. MOR AN 10 ANNETTE DRIVE
ENOLA PA 17025
~„ LINDA L. MORGAN
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA l
COUNTY OF CUMBERLAND r SS
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The petitioner(s) above-named swear(s) or affirm(s) that the ~ ~-~~
statements in the foregoing petition are true and correct to the best _
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of the knowledge and belief of petitioner(s) and that as personal "`
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representative(s) of the above decedent petitioner(s) will well and - -
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truly administer the estate according to law.
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Sworn to or affirmed and subscribed
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before me this 1 JTH
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day of y
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"" ""~ ~ LINDA L. ORGAN ~
Regist e~~ °p
Estate Of ROBIN A. GERHOLD _ ~ Deceased
GRANT OF LETTERS OF ADMINISTRATI(JN
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AND NOW ~ ~'~v , in consideration of the petition on
the reverse side hereof, satisfactory roo having be n presented before me,
IT IS DECREED that DONALD W. MORGAN AND LINDA L MORGAN
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to '
DONALD W. MORGAN AND LINDA L. MORGAN
in the estate of ROBIN A. GERHOLD
Register of Wi(Is
Letters of Adminish•.at/ion
Short Certificates (`T ),
Re~n~~nciation . ,
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FEES
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MURREL R. WALJFF,~FS,
ATT~RN~Y (~up. Ct: LD. No.j
54 E. MAIN STREET
MECHANICSB RG PA 17055
ADDRESS
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Filed A•p. ,~ u 717-697-4650
PHONE
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy Lly photostat or photograph.
I~ee f(>r this I~ertifirate. Sh.OO
P 1617795
Ccrtifieati<m f'~urnhcr
rr~ # 3
SHOULD READ AS FOLLOWS:
I'hi~ i~ tl~ ct~rtjfv tfnn Ihr inYormation here gi~~en i~
citrrcctlt- cL3picd frL,m elf Ltriginnl Certifirfte tff Ueutl
dude Filed ~~~ith rife as 1_trcai IZegisU~ar. The tlrir~ina
rertil'iaue ~~;1? hr itn-~+~~u~ded u3 the State Vital
ReL•nrd; t)(li:~c inr „,L°rnr,fnenl filin~x.
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Local Itc,_i~irzu~ llate [ssu~d
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PgINnN COMMONWEALTH OF PENNSYLVANIA • DEPgRTMENT OF HEALTH • VITAL RECORDS \? f
,ANENT n3 i % `t
K'"K CERTIFICATE OF DEATH N --
(See instructions and examples on reverse) _.t
1. Name of Decetlernl~(Fi_rs~t .middle. last, sufllel SPATE FILE NUMBER
Rest f tJ /~ 1=.t'~(Z~O`s-~ 2~ex 3 Social Security NUmher
~.J _ / .. 4. Date of Death IMomR day. year)
5. Age (Last Birthday) Under 1 year Under 7 day 6. Date of Birth (Month, day, year L ~r ~ t ' ~ - ~~ 1
xrmms Days Hours Minutes ) 7. Birthplace (City and state or forei n country) Ba. Place of Death (ChecN ony one) ~ G ~}
Yrs. Hospilal~ Other
~`= fiv Kam?` /~ /S,G,~ ,h ,
• 8b. County e! Death &. City, Boro, Twp. of Death ~ - •' 'C ~r' 'Inpatient ^ ER I Outpatient ^ DOA ^ Nursing Home ^ gesdence
6d. Facifty Name (II not nsftul on g ve sVeet and number) ^Oth ~ Specily
/ [ 9. Was Decedent of H spank Origin? x No vas
r /{L I~C'.~ /J , ~~ ~j ~~ x,/~- ~ f~ ~ CT JT / , (If yes, spec ly Cuban, ~ ^ 10 Race: gmerican Indian, Black, While. etc.
11. Decedent's Usual Oce Lion Kidd al work done dun ost of workin Ille. Do not slate retired 12. Was Decedent ever In Ihar ~~c 0¢nps E~i~ pn ~ ~ CY^fJ mri ~F~ Mexican, Pu no R'c arc.) (Sp~M
KIM of Work (Specity only highest grade coin I L.,1/7 ~~.
Kind of Business / IMuslry U.S. Armed Forces? p Bled) 14. Ma lal $IaRS: Monied, Never Married, t5. Survrvrng Spouse (II wife. give maden name)
,.:/ ~ ~ ~J ~,~-t T Elementary /Secondary (D-12) College (1 4 or 5.( W d wed, O'vorced (SpeciM
16. Decedent's Mailing Address (S1raQt, city! town. stale, rip code) Av<r„I(-
/ Decedent's - ~~ Did Decedent
t. ~ ` ' ~'~" ~' nor, ~ Actual gesldence t7a. Stale /n7
Live in a t 7c. ;`~" ^les, Decedent Lrvetl in ~_s~ ,G;- ,r7/t
~^ ~ ` /G' ' / ~T / ~CI VC ~- /~ ~ n Township? !1 t Twp.
77b. County `-~l.rYJ~C .fir d c~ 17d. ^ Wo, Decedent Lived within
18. Father's Name (First, fiddle, last, suMix) Actual Limits of
/~ 19 MDtner's Name First, middle, maiden surname) Cily I Boro
KlC:9C~/f. Gel ~iC'.'•' 4/1 1
20a. Informanfs Name (Type r Print) ~< ~7 C/ CL `.. ~. e ~V,.,
~',o ~~(~ 20b. Inlormant's Mailing Address (Slmm, city I town, stale, zip code)
- 2t a. M~et{1~pd of Disposition / ~~ ~~ iJi! , (m, / "' ,; ~~L ~j,~i' % / t ~, -
L•J Burial ! ^ Cremation ^ Donation 21 b. Data of Dis oeition Month, da , ear 21 c. Place of Dis osiWn Name of pemele J
^ Removal from Stale; Was Cremetlon or Donation Authorized P ( y Y I P ( ry, crematory or other plac=.) 21 tl. Location (City /town, stale. zip cotlel
^ Other - Speciy hY Medksl Examiner /Coroner? ^Yes ^ No w' J
22a. Signature of Funeral Serv a Licensee (or person acting as such) /~ `~~ ~ ~) C ` ` ~ •~~ ~ lf'P<7 `(-',rRe-~C'; ~ ~ '
22b. License Number 22c. Name and Address of Facility ~ 4~.ry7 ~r"~< v'"~ 4% / r
~ may. .mss ',~ ri •. _G,
Complete Items 23a~c only when cenitying 23a. a best of my knowledge, deaN occurred at me lime, date and place staled (Sgnature and lille~ v ~ ~~ La~(J•~ c /~G nk' z' "rT Cr- Y/ %~~
Iahyslcian is not available at lime of death l0 236. License Number
- cenity cause pl tlealh. 23c Dete S fined (Month day, year)
_ Items 24-26 must be compleletl oy person 24 Time of Death 25. Dale Prorwuncetl Dead (Month, day, y¢arl
who pronounces death.
~Q , 7 ~ ~ M. M^7 ~g •lsj t~ 26. Was Case Relener~Metlical Examiner! Coroner for a Reason Other than Cremation or Donations
CAUSE OF DEATH (See instructions and examples) ^Yes .Q'Va
Item 27. Pan I. Enter the cha ~ of ~ ~ -diseases, Injures, or complications -that directly caused the death. DO NOT enter terminal events such as cardiac arrest, r Approximate Interval: Pan I I: Einar others T t andirons c ntri6 t d t
respiratory arrest, or ventricular librllalion without showing the etiology. List only one cause on each line. 1pn I^zn c ~-~Lh~ 28. D it Tobacco Use contribute to Death?
r Onset to Death but not resullirg the undedyinq cause given I Pan I. ^Yes ^ P badly
IMMEDIATE CAUSE !Final disease or
contlrion resulting in ddeath) L yH~ HA-JC IT \L ~ e~(~ ~ ' ~ ^ unknown
-~ a r
Due to (or as a consequence op ~F {A/.~ CECl ~EP`~S~ ('~~AaJC,E2. 29. If Female.
Seq emialy list coMitions, it any, b -~j~, MOw~tA •~- [~ o pregnant within past year
Ieadirg to the cause listed on line a. ^
Enter the UNDERLYING CAUSE Due to for as a consequence ol): Pregnant at lime of death
(disease or injury Mat initialed the ,~_
events resulting m Beam) LAST c- ^ Nol pregnant, but pregnant within 42 days
Due to for as a consequerxx ofj. of death
d' r [] Not pregnant, but pregnant 43 days l0 1 year
30a. Was an Aut r belore tlealh
Performed?may 30b. W¢re Autopsy Findirgs 31. Manner of Death 32a. Dale of Injury (Month, day, year) 32h. Describe How Injury Occurred ^ Unknown if pregnant withn the past year
Available Prior to Completron
of Cause of Dearh~ aWrai ^ Homicide 32c. Place of Injury. Home, Fann, Street, Factory,
Office Building, etc. (SpecilyJ
^ Yes o ^ yes ~ ^ Accident ^ Pending Invesligalbn 32tl. Tim¢ of Injury 32e. Injury al Wwk? 321. II Trensponation Injury (Spec
^ Suicide ^ Could Nat be Delermined ^ ye$ Driver I h1 32g. Location of Injury (Street, city I town, stare)
33a. Certifier (check only one) M ^ No ^ Operator ^ passenger ^pedesMan
^ Other - Specity-
• Certlfying physician (Physician ceroying cause of tlealh when another physician has pronounced tlealh and completed Item 23) 336. Signature (~
Ta the best of my knowledge, death occurred due to the cause(s) and manner as slated_ _ _ _ _ _ _ _ _ _ _ _ M •~
• Pronoundng arM certitying physcian (Physician both pronouncirg death and cenitying to cause of tlealh) `-"-- - ^ ,
To the hest of my Nnowkdge, death occurred at the time, date, and place, and due to Me cause(s) and manner as sated_ _ _ _ _ 33c. Lice se Numb r
• Medical Examiner! Coroner _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33d. Date, Snigne~d (Month, day, year)
_ On the basis of examination and / or Investigation, in my opinion, death occurred at the time, date, and place, and due to the causa(sl and manner as stated_ ^ M~~3 `~ ~~ 1~' ~~ ~~ . ZG `Q
34 Name and Address cl Person Wh dnpl tact Cause o! Death (Item 271 Type ; Print
35. Registrars Sl ture and District umb¢r 1 ~FF2C~ ~ o~ ~t s M~
I / I a I ~ ~ 36. Date Filed (MOnM, day, year) ~O C A,NL~,~
1331 c. u~YOUnaA/C^I /RUC T-2E~LTaka~ T
/, `,.5 / p/d titWDE~Dht l.4 '~{ Ar t°tl2`~ ~Ew~c,~2 eE ~wElitc.4
Disposition Permit No. C, • , ~ O~ ~ LS