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Home My WebLink About03-24-11 'R IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ANGELICA PAPE a/k/a: a/k/a: a/k/a: SS NO: 171-01-9863 Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AI`1D "C" as applicable: ^ A. Probate and Grant of Letters Testamentary or ~ Administration c.t.a., or d.b.n.c.t.a. (complete Part C under and aver that Petitioner(s) is/are entitled to the aforementioned Letters and codicils dated the last Will of the above-named Decedent, 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 ~of.;the instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated ~on, and wnot a ~~ '.~ _ ~ party to a pending divorce proceeding at the time of death wherein grounds for divorce had been ei~shed as~~efined?~ -~ ~ f 23 Pa. C.S.A. § 3323(8): ~' ~ ~ - ., pal-- - . ~ B. Grant of Letters of Administration ,~ (If applicable, enter d.b.n., pendent lite, durante absentia, durantg.~i`t~te) _~ ;,. '~.~ C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived b r LL__ use if an and heirs (lf Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section Ad completst of ~-~ % U following spo ( y) heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pendifl~ divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(8), excerpt as follows: Decedent's Parents Deceased -Decedent Never Married/No Children Name Address Relationshi to Decedent James Pape ~ ~ ~ --2 Q ~ jf Brother _ Brother Frank Pape U - Z/ --p ,~~ - Brother Donald Pape nv~ t'' ZS -~U - iJSE ADDiT10NAI. SHEETS IF NECESSARY THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or priincipal residence At 514 9th Street, Borough of New Cumberland, Cumberland County, New Cumberland, PA 1707() _ (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) 73 ears of a e died 7/14/2010 at Abington Memorial Hospital Decedent, then y g , (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: ° ° All ersonal roe $ p2~ 0~0 _ -- Ifdomiciled in PA p p p '~' -- Ifnot domiciled in PA Personal property in Pennsylvania $ __ If not domiciled in PA Personal property in County $ ___ Value of Real Estate in Pennsylvania $ - - Total Estimated Value $ __ 0.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) FOR LITIGATION PURPOSES ONLY Signature(s) Name(s) c~c Mailing Address{es) ` ~,,,~~,,/ ~, PHILOMENA BROGAN - 514 9th St., New Cumberland, PA 17070 ~. Interim Form RW-02 revised 12.26. ] 0 by Cumberland County pending action by the Court Page 1 of 2 ~'~~1 -~ .. Deceased ESTATE NO: 21- (-" ` °~ OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania SS County of Cumberland = The Petitioner(s) herein named swear or affirm that the statements in the foregoing Petition tat:ive s ofthe correct to the best of the knowledge and belief of Petitioner(s) and that, as personal represen ( ) Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~ ~~~ da of before me this ~-~_ ~ ~ y A ,e "~ C~ `l ~~~, ~~~ _~ ~`` `` . ~? __ ~,,~.._ ` ~.. r ..., For the Register ~- -, ~ - ~: - ~ --~- DECREE OF PROBATE AND GRANT OF LETTERS `~ ~~Y_ r` . Estate of ANGELICA PAPS Deceased File Number: 21- -~, ~,~ : _~ ~a _.a ~,. ....-- i-..,~-.~ L,~ t ~} D NOW this ~ ' ~`~ day of ~ ~- ' G~e~.~', ~ ~~ i ( , in consideration of t:he Petition on AN IT IS DECREED that Letters the reverse side hereon, satisfactory proof aving been presented before m are hereby granted to: Testamentary x of Administration d.b.n.c.t.a., etc.) (If applicable, enter c.t.a., d.b.n., PHILOMENA BROGAN in described in thf; petition be the above estate and that instruments(s) dated admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. ~ ~ „~ -r ~ Y~ _7~ ~a~ ` enda Farner Strasbaugh, ~~• : ice. ~~~ Gl /~_. ~ j~ Register of Wills ;/ FEES• Signature of Couns wed to E~ ' earance Letters ....................$ Atty's Sig! Will ....................... Codicil(s) ............... PRINTED ( )Short Certificates ( )Renunciations....... Supreme C Bond ............................ Address: Other ............................ Automation FEE......... 5.00 JCS FEE .................. 23.50 Phone: Fax: TOTAL ................$ 28.50 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court ~_~._~- e: ] N R. ZONAP ESQUIRE NO.: 19632 __ 17 S. 2ND STREET, 6TH FLOOR HARRISBURG, PA 17101 717-233-1000 717-233-6740 __ Page 2 of 2 I ~ 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 =r~ , ~;;r~~~/ the Vital Statistics Law of 1153, as amended. ,,~/~~" ~~~ ~~,,.-,1~7 ~,_ ~- ~. ~ rt.- =;- ._,. _ ~ ,.: ~ ct ', r ~~` ~~ ~.._.~ 1.,.. ~~ i:.L~ WARNING: It is illegal to duplicate this copy by photostat or photograph. -Q; 4- - a~,y~~ ~~H OF p N "~- ~,.~ ~ ~,o ~ hs` : Manna O' Rei!ll y Matthew ~ ; Acting State F:eg>strar ~~ MAR 18 2011 ~~_. :.: ~l +..,C ~ '-9TMENT O~~rrrrr _ --- No. H105.144 REV 1112006 TYPE! PRINT IN PERMANENT MCC 2010-1155 BLACK INK 1. Name al Decedent (First, midde, last, sufz) 5. Age (Last Birthday) Under 1 year un 73 r/h~ pays Hours Yrs. Date COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~~ CORONER'S CERTIFICATE OF DEATH (See instructions and examples on reverse) sTATE FILE NUMBER _ _ 2. Sex 3. Sopal Security Number 4. Date of Death (Month, day, year) Female 171 - O1- 9863 July 14, x010 lay 6. Date of Bidh (Month, day, year) 7. Bidhplace (City and state or foreign country) 6a. Place of Death (Check only one) Hospital: Omer ~~ August 12 , 1936 Saz leton, PA ~] Inpatient ^ ER I Outpatient ^ DOA ^ Nursing Home ^ Residence ^Other • Specify: 9. Was Decedent of Hispanic Odgin? ®No ^ Yes 10. Race: Americen Indian, &ack, White, etc. ' Bb. County of Deam 8c. City, Boro, Twp. of Deam 6d. Faulity Name (ff not institution, give street and number) pf yes, specify Cuban, (SP~M (6 Abin ton Memorial Hospital Montgomery Abington Township g Mexican, Puedo Rican, etc.) White 11. Decedent's Usual Occu tan Kind of work done duds most of life. Do not state retire 12. Was Decedent ever in the 13. Decedent's Educelan (Specity onty highest grade completed) 14. ~t~D voMrced Mgr Married, 15. Surviving Spouse Qf wife, give maiden name) Kind of Work Kind of Bustrress 1 Industry U.S. Armed Forces? Elementary I Secondary (0-12) College (1-4 or 5+) Never Worked Never Worked ^Yes Cho 12 Never Married D~edent's PA Did Decedent • 16. Decedents Maiing Address (Street, city 1 town, state, zip code) live in a 17c, ^ Yes, Decedent Lived in Twp. Actual Residence 17a. State er aII Township? ~ New Cumberland 514 9th Street nd. No, Decedent Lived within _ Ciry 1 Boro 17b. County Actual Umils of • New Cumberland PA 17070 18. Earner's Name (First, middle, last, suffix) 19. Mother's Name (First, middle, maiden surname) H Frank Pape Josephine (Stish) Pape p4 206. Informants Mailing Address (Street, aly 1 town, state, zip code) H 2Oa. Informant's Name (Type 1 Pdnt) w Philomena Brogan 514 9th Street New Cumberland PA 17070 (~ 21a. Memod of Disposition ~ ^ Cremation ^ Donates 21 b. Date of Dispostion (Monet, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 21 d. Locates (City I town, state, zip code) • ~ Budal ^ RemovalfromSlate ;was Cremation orponatlonAuthorized July 17, 2010 Most Precious Blood Cemetery Ha2;letOn, PA 18201 ~n ^ Other - Specity: ; by Medical Exeminer I Coroner? ^ Yes ^ No • 22a. Signature of Funeral Service Licensee (or person acting as such) 22b. License Number 22c. Name and Address of Fadlity • ~ 014776-L Joseph A. Moran F.H. Inc., 229 W. 12th St., Hazleton, PA 18201 23b. License Number lac. Date Signed (Month, day, year) Canplete Items 23ac only when certifying 23a. To the best of my knowledge, deam occurred at me time, date and place stated, (Signature and title) physician is not available at time of Beam to certity cause of deam. • 24. Time o1 Death 25. Date Pronounced Dead (Monet, day, year) 26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation or Donation? Items 24.26 must be completed by person 12:26 P JUIy 14, 2010 pfj Yes ^ No ,• who pronounces death. M. CAUSE OF DEATH (See instructions and examples) t Approximate interval; Part II: Enter other sienificent conditions contributi09 to deam 28. Did Tobacco Use Contribute to Deam? Yes Probably Item 27. Pad I: Enier the n f n -diseases, injudes, or complications - mat directly caused the death. DO NOT enter terminal events such as cerdiac arrest, ~ Onset to Deam but not resuNng in the underlying cause given in Parl I. ^ ^ respiratory arrest, or ventrlcular f~brlllation without showing the etiology. List only one cause on each line. n ~] No ^ Unknown r IMMEDIATE CAUSE (Final disease or PNEUMONIA r MAXILLOFACIAL FRACTURES ?9. If Female: cenddion resulting mdeath) -~ a i ~ Not pregnant within past year Due to (or as a consequence of): i ^ Pregnant at time of deam Sequentially list condffans, ff any, b. n [] Not pregnant, but pregnant wima 42 days leading to the ease listed on line a. n Enter the UNDERLYING CAUSE Due to (or as a consequence oq: n of death ' (disease or injury that initiated the c r events resuffmg m death) UtST. n ^ Not pregnant, but pregnant 43 days to 1 year • Due to (or as a consequence oft: n before deam n • d r ^ Unknown if pregnant within the past year 32c. Place of Injury: Home, Farts, Street, Factory, 30a. Was an Autopsy 30b. Were Autopsy Rndings 31. Manner of Death 32a. Date of Iri ury (Monet, day, year) 32b. Describe How Inju Occurred Office Building, etc. (Speciy) d Pedormed? Available PdortoComplefion Jul ~, 2010 Same Leve~ Fall Nursing Home Q of Cause of Death? ^ Natural ^ Homicide d 32d. Time of I 'u 32e. Injury at Work? 321. It Transportation Injury (Specify) 32g. Location of Injury (Street, city 1 town, state) ^ Yes ®No ^ Yes ®No ~ Aceident ^ Pending Irnesfigation M ry rY~ 773 Sumneytown PiN;e, Lansdale, PA 11:00 A ^ Yes (~ No ^ Driven Operator ^ Passenger ^Pedesldan m ^ Suicide ^ Could Not be Determined M. Other - S v ^ p~lY y 33b. Si lure an dle of rlffi m 33a.Certitier(checkonlyone) CORONER Q Certifying physlclan (Physaian certifying cause of death when aralher physican tras pronounrx•d deam and cempleted Item 23) ' To the best of my knowledge, death occurred due to the teasels) and manner as stated- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ^ 33d. Date Si sect Monet, day, year) • Pronouncing and cedNying physician (Physidan both pronourxing death and certifying to cause of death) 33c. Ucense Number 9 ( z To the best of my knoNledge, death occurred at the time, date, and place, and due to the cause(s) and manner as sated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ M D 033656E J U ly 20, 2010 o Medical Examiner 1 Coroner ~ On the basis of examination and 1 or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as stated_ 34, Name and Address of Person Who Completed Cause of Deam (Item 27) Type I Print ° ~- 36. Date Fled(kbnth,day,year) WALTER I. HOFMAN, M.D. 0 35. Registrar' a and Distral Number / / pp a ~ r I ~ I `~ I ~ l O l 41 7-~ 3 "02 t~/C7 Montgomery County, Norristown, PA 19404 /ALB Zx/ 7 ` Disposition Permit No. ~({~ ~~