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HomeMy WebLinkAbout04-11-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Dais Ree Hawkins ,Deceased ESTATE NO: 21- ~L f ~ ' ~= ~~ l Estate of Y a/k/a: a/k/a: a/k/a: SS NO: 256-44-3829 Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "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 also) and aver that Petitioner(s) is/are entitled to the aforementioned Letters ~ udder ~? .~,.ro the last Will of the above-named Decedent, dated and codicil(s) dated `"~ ~ :~' ~ ~ _.. ;1 `^ ~' r"~ i~~i ~r . 7r~ ~ _. .. i I~ (State relevant circumstances, e.g. renunciation, death of executor, etc.) ' ,~ , c~ _fi Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after e~Z~oh~of the-,;. ~ ~ instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated persot~'anil was not.. ' ~~r ';~:~ party to a pending divorce proceeding at the time of death wherein grounds for divorce had been establhec~ as defiri~d in `:7 ~ 23 Pa. C.S.A. § 3323(8): ~a ~' 1~ B. Grant of Letters of Administration (If applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate) C. 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 and complete list of heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(8), except as follows: Name Address Relationship to Decedent Cheryl D. Hawkins 39 Herman Dr., Mechanicsburg, PA 17055 Daughter Carolyn D. PhIIIIpS 1027 Tuckawanna Dr. SW, Atlanta, GA 30311 Daughter Kevin G. Hawkins 39 Herman Drive, Mechanicsburg, PA 17055 Son L!SE ADDITIONAL SHEETS IF NECESSARY THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 939 Herman Drive, Mechanucsburg, PA 17055, Upper Allen Township, Cumberland County (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 79 years of age, died Estimated value of decedent's property at death: _lf domiciled in PA _If not domiciled in PA _If not domiciled in PA _Value of Real Estate in Pennsylvania 4/5/2011 Mechanicsburg, PA at (Month, Day, Year of death) (City and State where death occurred) All personal property $ 20,000.00_ Personal property in Pennsylvania $ _ Personal properly in County $ $ _ Total Estimated Value $ 20,000.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature(s) Name(s) & Mailing Address(es) 3~ N~~s,~ ~ ~6~,~ Pit ~~ s-~ Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 1 of'2 ~ ~'. - ~ a. OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania ~ SS County of Cumberland The Petitioner~'herein named swear or affirm that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(~j and that, as personal representatives of the Decedent, Petitioner~~will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ~~k%1 day of .~- ~~; ~~(~r~.~r'~~ ~ ~F= ~ 1 V II ~ _.--. ,._ ~ ~ mil .w r ~ j ~~ -~ _ J t ~ '~ 'F-~ 1 ~ _'7 For the Register ~ ~_> ~3 ~" - - y ..a,. DECREE OF PROBATE AND GRANT OF LETTERS :r ~{ ~~~ ~, ~,~ ~.., -~-~ Estate of Daisv Ree Hawkins ,Deceased File Number: 21- ~~L ~ ~ - ~f~4~~.~ AND NOW, this ~ ~~day of ~~~ r;_ I ~ ~ ~; 1 ~ , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary xx _ of Administration are hereby granted to: (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) Kevin G. Hawkins __ in the above estate and that instruments(s) dated described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbaugh, r~ { !~~~`' ~'v ~ ~ `% :.~ 'r ~ `~~ ~~ Register of Wills FEES: Signature of Counsel Required to Enter Appearance Letters ....................$ ~ L' ~ l,~ Will ....................... ~ Codicil(s) .............. . ((~) Short Certificates h (~) Renunciations..... ~~~,~ ~ ~1~ Bond ............................ Other ............................. Automation FEE......... 5.00 JCS FEE .................. 235( _ i 2~~ - ~' TOTAL ................ $ ~e '~~/)), 1 Atty's Signature ~ ~ 1 ~ L- PRINTED Name: William L. Grubb, Esq. Supreme Court ID No.: 72661 Address: 3803 Gettysburg Road Camp Hill, PA 17011 Phone: 717 763-5580 Fax: 717 763-6848 Interim Form RW-02 revised 1.2.26.10 by Cwnberland County pending action by the Court Page 2 of 2 GCAL REGISTRAR'S CERTIFICATIC-N C.)~ IDEATIH V'JARNING: lit is illegal to duplicate this ccip~r h~ photostat or phatagraph. I:ct, {~i~l th;~, ~ertiticate_ `;t~.(}U P __17 4~ 6 2 Q _~..__ Certifirat[[)Il Nulr~hel „~„rf,,,;,,, 1 ;u~~ ~~ tt, ti~ rtli~ ~sa[ t,~e ini~n~i~~~at~l~:1n hers ~~iver~ 15 ,~~~~,~N aF pf,~ r~. ,+ ;~ =.~ ~ n-1-~~ t'~ t.tt1) L~ 1,~ ~1 ,II I,ri~T~l~~ll l~ervitirate o(~ Death ,,~,~©•Z- Js; ~I;li~,~ {~It~~si ~~,~~~ rl,~ ..~ € rtca! Rt:~~,~i5h~~ar. ~I-he ~~ri~inal ,~ -~=1 ~...~TU~II'..itc' .~~11 3t~' ~!t~1~Arilyde~l tc7 the St,.tte. Vital ~~ ~i ~; . 2'\s ~: _'~'+. 1tt~~, (: 1~',,'i" ~ts~'~7t."-I1i;:i11t131 f1~111`~. ~, ~, , iiie~ ~~..-. y o . ~ - - - ~~~ .. . _. -ate ,, ~ ti,_ ,, _ r~ ~ ~ ~ +: T ~ t'~Jr _ :I'~ :h .."'. ' ~...~ t-.1 T - _' ~ - ...Sn ' .,...; ..:~ ~...- - T ,,~: _-.y , _ __ ~ i:,+'1 Q COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~.~~ ~ CERTIFICATE OF DEATH (See Instructions and oxamples on reverse) STATF FII F NI IuRFR Ht05-113 REV 112t]O6 TYPE ~ PRWT W PERMANENT BLACK INK Z~ 0 i~ ~~~) ~.LQ ~-.~a w U 1. Wow d Decedent (Fret, middle, Iasi, suffix) 2. sex 3. Sowl Secunry Number a. Dab a beam (Moon, day, year( Dais Ree Hawkins Female 256 - 44 - 3829 Aril 5 2011 5. Aye fleet Birmdey) Urldar t Undo t da 6. Data d Birth Manm, da . ar 7. lace G and sets «t« count I 6a Place a Deem Ctwck orwl 7 9 klorlew Days Fours Mvnrbs July 16 , 19 31 Oxford , AL Hosprlal: Ottwr Yrs ^ ,,,P,~,,, ^ ER Ou~atient ^ OOA ^ Nursng Fi«rw ResxyrKa ^ t>ttwr - SoerN ' fm. Coumy a Deem 6c. Cay, Bono, Twp. a Death 6d. faukry Nartw 111 not ~nsbWUOn, gwe street and nwroer, 9 was Decedent a Ms{wnK Ongn~ ~ No ^ Yes 10. Rea: Amencan trFdan, BWiI Why. et_ Cumberland Upper Allen Twp. 939 Herman Drive (tt yes. spscdy swan. Mexx:arl, Puerto R¢an, etc.( ISP•r+Yii Black I t Decedwu's Usual bon Kind of work dew d er most a kta. Do rat stale reared 12 Was Decedent ever n tM t J Decedent's EdutAfan ISpaary Dory roynest grade comp leted) 1 J Martel Sutus: MurwO. Never Mined. 15 Survrvng Spo use ..M rode. V^'• maiden rwnwl KaW d W«k Kud a Bustrwss, Irldutry U S. Armed Faces? Elementary /Secondary (a12) Ct>uege (1-4 « 5+) WiOOwed, Drv«ad (Specdyl Self Emplo ed Health ^ Yes ®No 12 2 Widowed 16. DeceOenrs sAaltirg Address (Street, ury r town, stay, zp rpael 939 Herman Drive Decedent's Dd Decedent ActualRrislderra ,Ta.state Pennsylvania Llwina ,?dggYef,~~r„~,+,~„ Upper Allen Twp - Mechanicsbur PA 17055 lrvWwlrwl to Counry Cumberland T°"'r~'p' ,?d 0 r g, ~/~ Lymtsa Aclual 18. FWIFefs Narrw (First. nadda, last. sulfa) 19 Mottwfs Narrw (First, rnrdW, rtiaden surname, Charles McMurra Blanche Conte 2W Worrttertrs NarM (Type /Pmt) 20D Inf«mam's Maikg AOOreas (SUaI oly + town. stew, ztp coda) Carolyn Phillips 1027 Tuckawanna Drive, SW, Atlanta, GA 30311 2ta. MWhod a Dwposl0on + ®Crematan ^ Donation 21b Date d Disposlbon IMmm. Oay, yeul 2 tc. Plan a D~sposmon (Name a cemetery, crematory «orwr OWce, 21d. location iCiry/ttx•n, star, LD w0e) ^ B«w ^ R«novelrr«nstate ~ waCnrnMbnaOawUonAWFOrlred~ ~ _ -~ _ a ~, ~ ~ Cremation Society of PA Harrisburg PA 17109 ^ ~ ^ Orwr - t by trledkN EsamYwrlCarorw? Yes • , 22a. sry"a°"' Furwnl Serra t.rar~e. t« persm acDrtg as suGl l z2b. LKenss Nlaro.r zzc Wme an0 Adaess a Faalry Auer Cremation Services o f PA - - FD-013376-L 4100 Jonestown Road, Harrisburg, PA 17109 Conglar z3a< only raying z3a To rw tru a my wraan.dga m ocarred a m. time, der and pee. sited. ( bee and tea) 23b. Lama Number 23c. Day sanw (Moor,. der. r•rt ptysnan a na avaiabr at tme a seam a certly cwse d ryam. U ~ 1f• `-- 5 a v~ - 11e1t1{ 2428 mat W wrripleled by Person 2a. 7vrr d Deam 25. Dead (Mmm, day, Pearl 26 was Case Rele t m d o Medical Exanurw i Coroner fora Orw Om Crenurm « Onrbn? rota praratrFCec dean. AA ~. M. lll nny .. --- ^ Ves ~7 No ` CAUSE OF DEATH (See Inatruetbns red etumpMe) ~ Approumate „rival Pan It Enter odwr 28- Dd Tobacco Use CdntrOtae b beam? ilern 27. Part l: E1Ner rw Cbaln of events - diseases. . « oornpkcabons -due Ouettry ausW tM deem. DO NOT enW rmlrw events such as carder arrest. ~ Onset to beam a,t not resunng „ rw WbedYn9 cause green „Part I. ^ Yes ^ Probably napiratary arrest « ventrlCUlar fiDrdlaDOn arNaut St10WYlg rte etiology. Let only one cause do 9er31 rw. r r ^ Nb ^ UrtknDwn YNIEDIA~~ Foal asease « r corldROn „ ~) ~[~~ ~~ /~ Iif ~ 1 --~ a. dr'h I/u-4~- LL ' 1 lJG ' 29. II FsmaM: ^ N r r1 Dw b (a ore a consegwna a): 1 r a pregnar w .F ptat r+er ^ Pre rwra at urea d dean W rwnditiorw. A arty, D a r b g ^ Due a (« as a mnsepwrlce al: , ErtW UNDERLYMIG CCAUSE Nd pragrwll OUI ggwrlt wrran e2 days (disease « xyley mat nmaad tM c r evens nwlsty n loam) LAST. a seam ^ Uue a (« ore a wnsegwnce op: r Nor pwgwrll but preyriaM a3 days b t year + ~ d. ~ melon dean ^ lMWlo+n A pegnerr wlfln rw pM Year 30s. Was an Autopsy 30D Were Aulopey FnOUtps 31 beam 32a.Daw d Iryury tMOnm, day, You) 320. Descnbe Flow Iryury Occurred 32e. Plan a kMay Flortw, Fame Sreal FtsOOry, Pertomwd? AvaJable Pray a Completan W l ^ H a OMKa gyp' ~~ (~) of Cause a beam? Wra omrcl e fO~' ^ Yas CL rvo ^ Yes ^ No ^ Arxidant ^ PrNldhg Investigation 32d. TstN d IrM1++Y 32e. kyury al Work? 321 r Transp«tation tn~ey (Spec+Nl 32g. Loabon d irMuy IStreal, ary /town. stab) ^ Sulcge ^ Could Not M Delamurwd M ^Yas ^ No ^ Dmer I Operator ^ Passenger ^ PoOestnan . Other -Spec'+A'_. 33a. CeMw Icnecx anty anal 33b Sgnawre and T. 1 mbar l,ertAyiny phyeicran iPnysruan ceniryvg rouse a loam wrwn anomer pnysx:usn has pronounced deem era comported hem 231 , To dw bat d my knowledge, death occurred rMw to tM r:wse(s) and manner a sued _ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - Pronolneinq and eereMyirp phyeieun,Physrcwn Dom proraurcng Deem and arblyng a cause d deem) 33c. Ucensa N r 330. Dau m. day. sear, • To tM bat d my krFOwrdge, deem ouum0 at Uw Urrw, dw, end pace. and due to tM r;auee(s) and manner a stste0 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ IledkN FsanFirler f Cororwr o \ • ~ Q Q %Zj 1 3C~ ~ j~ 1 On Ilw beau d eaaminatbn and! «mveNiyM in my opinion, deatli occtura0 at tM time, t1W, arw pea, and dw to tM csueys) and manner ostaled- ^ 3a Narrw and Adyes-sTa Person Woo Cortglawd Cause a Deam IDem 27) Type r Pmt _ G ( / 1 R 36 ~ (L . cyxw @-1 N ~ C T . egis s e tU - F+~ ~a ~ ~ ~ ~ ~ ~ 76. =w F (Homo. Day. y.arl ~ ~1 i. Z tl , (Z ~,Y-~ ~~- S . e. 0 DrSpOSrDdn Parrot No. 0 619 3 7 0 s~. --.. ~~ ~--- RENUNCIATION REGISTER OF WILLS CUMBERLND COUNTY, PENNSYLVANIA [7Q ~ ~ ,~~ +~~ ' ~l~ _~ - t~ ~ C7 ~,1 : , 7 ~.. . ... ~ r~-~ _. ,.1. ,•'\ f _ t ~ ~1 1 ~~ '~i ;, ~., Estate of DAISY REE HAWKINS ,Deceased 1, Cheryl D. Hawkins , in my ~e'~~relationship 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 Kevin G. Hawkins (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Form RW-06 rev. 10.13.06 N / (Signature) 939 Herman Drive (Street Address) Mechanicsburg, PA 17055 (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 -1~- day of ~1~ :~~tl ota Public ~~, ommission Expires: r!I c-~C ~~;t ~~' (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) { s~,,~~~c,~~,n.arc~`T^.f t1 p` ~'~~df~:~YL~,~i~9'A r e<:t~.at ~~~ 1'~, #~s~r°~~.>:~r~, ~1~,)~~ry F'tlblic 11-,~er t ",rlg'?•~. r~%; ~ ; F+~`pe'?~~¢r.+rRC± trk?t~rR~/ ~ ~":,.~ ~ ~ia"1?1}'Mt , r. f! ~ ~ ~1si ra:~, ~,c~.:3, :~?~`1 "1 a "+`''.. g'.1~:~! V90f"r36~ 1 ~~~ i ~..~r1 C i iuL'~c3iI.~S RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA C7 .-- ~ 7 `~~"~ '-, ~~ ,_~ .. =-, . _- ~~ „.:~ ~ __l .. ;, ~~~ ~~ ~„~ i •a.s ~.~,. ~7 F'j_ ~ T:l f ~:~ t .: ._ E? _. ._ L .) -~, ~°~~ Estate of DAISY REE HAWKINS ,Deceased I, Carolyn D. Phillips , in my-~~a:~'~relationship 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 Kevin G. Hawkins ~i-- ~~ (Date) ~~~~ , c ~~~ (Signature) ` 1027 Tuckawanna Dr. SW (Street Address) Atlanta, GA 30311 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Form RW-06 rev. 10.13.06 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 ~ r day f ?. i ~ ~~~~ I I ~_ ota Public My ommission Expires: C) G~-t;b~< ~ .~ , .ZG~ t j (Signature and Seal of Notary or other ot~'icial qualified to administer oaths. Show date of expiration of Notary's Commission.) ~`~~4~MCai3`1`rr_,~?.~;~~1 fJF P~~~I~I~YLVAf~~IA Fr~n~na f.. t-lar~.ati e, ~J~N QUbIiC U~~ar A~lnn `~~n~::., t~ta!~~~rtand ~r~ty l~w7y C`J~?71f5.~ii~?!"i t~~€q'~'..ra ~~C:~. ~, ~~~ ~ I~err;hsr, F`znnsylvania As~ociafion c~i ~fntaries