HomeMy WebLinkAbout04-19-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
~p PETITION FOR PROBATE AND GRANT OF LETTERS // ,, ~~
Estate of ~ ~+~1 ~1 N` ~O~nO'~l ~~ ,Deceased ESTATE NO:_21- ~ f ' `i `~
a/k/a:
a/k/a:
a/k/a:
SS NO: ~~~?' ~~ _ `~'3`~02
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 Calso)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters t? -_._ ul~de~;
the last Will of the above-named Decedent, dated and codicil(s) dated ~ '
7 T c~--~ --~-- --'
(State relevant circumstances, e.g. renunciation, death of executor, etc.) ~ , ~ ~
Except as follows, Decedent did not m `
arty, was not divorced, and did not have a child born or adopted~e~ e'~ecuUetr of the
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated'pon, and..was not a ~^t~
party to a pending divorce proceeding at the time of death wherein grounds for divorce had bee~~stablished as define' ~~
23 Pa. C.S.A. § 3323(g):
1~ B. Grant of Letters of Administration
(If applicable, enter d.b.n., pendent lite, durante absentia, durance 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(g), except as follows:-
ale ~ ~ • C r o ~ ~ °~t ~~~
3s ~ - ~ o S~. ~ ; e. P ~ ~lnl~ Kelationshi to Deced~
w i~ E
IICF AflrliTl(1NA1 cucc~rc rc ntc~cec.nv
ent
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence
At ~??,S yJ• uG~.~ ~rt ° ('R R~-lC1 ~ Qft (~~ I'3
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then .3~ years of age, died ~~ ~~~ a ~r~ at _ ~ra}tilv,S~O moo, hon1~~1
(Month, Day, eaz of death) (City and Stat where d ath occurred)
Estimated value of decedent's property at death:
_If domiciled in PA All personal property $ ~ r(~(~ , U'~,
_If not 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 $ _: , GL^u• CL
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s) Name(s) & Mailin¢ Address(es)
1~tL(~~,~ Ci. ~Ae~ot~i~ ~~.
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Inirrim Fnrm RW_M ro..;ooA M ~~ tot.., l~......t.e_t..-a n_. _.~. _.._~: C~~, ~ ~ PH i~o1~3
~...~o~.., w~~uy Ncuumg ucuon uy the tour[ Page 1 oft
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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 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
(~'~ n _
bef e t is , " 1' ' 1 day of ~ ~ ~=- _°- ~ ~ ~ ~~
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For the Register '~ ~- , -~
c.~ ~~
_. .Y.~
DECREE OF PROBATE AND GRANT OF LETTERS
7_alb b
Estate of horn mc~ I ~ . CA..rltlldl ~ ?veceased File Number: 21-~_-~?
AND NOW, this ~~day of ~~ I I ~ ~~ ~ ~ , in consideration of the Petition on
the reverse side hereon, satisfactory proof- a ing been presented before me, IT IS DECREED that Letters
-Testamentary /of Administration are hereby granted to:
' ~ ,. ~ (~ ~ ~, n A _ (Itapp~icable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
~ " ' ~ in
the above estat 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 Strasbaug 4 ~? ~ U'~G ~ k~.'0--.
Register of Wills
FEES: Signature of Counsel Required to Enter Appearance
Letters ....................$ r~ ~
Will ......................
Codicil(s).
r,~j) Short Certificates ~ . fx.}
( )Renunciations.......
Bond ............................
Other .............................
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.50
(p0.
TOTAL ................ $
Atty's Signature
PRINTED Name:
Supreme Court ID No.:
Address:
Phone:
Fax:
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court
Page 2 of 2
lly.<.I~~ Rl.~ UI'0-, ~ _
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this ceriifirlte, 56.00
_ P 174.50549
Certification ~~Iumber
"This i~~ to certif, than the infornn)ti;in here given
con-ectly coped from an ori~*in.~l Certificate of Dea
duly filed 4~ i.h me a~ Local Re~~is;rar~. The origin
certificate ~-~li he timu~~u-ded tt+ the State Vit
Records OI'i~i~.~e 'car perma))ent filing**.
--- ~~~~~._AP 1 ~ 2G1
Local Registrar Date Issued
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BLACK INK
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See InstrvetiDns and examples nn reversal STATE FILE NUMBER
1. Name d Decedem (FrsL mMdle, pp, Wfrc) 2. Sr 3, Socel Securely NuPoar 1. Date d Deets (Monti, dry, yrr)
Rommel N. Canonizado M 186 - 78 - 9392 February 27, 2011
s. Age (last eld+myl under 1 yea uroa 1 a tl. Date d solo (MaT, ~. Bhtlglea (Clly aral9lw « ~ ea. Plea a Dear clNw one
"ap1Ai` °m°`
Monw. °"` "°"` raver Phili
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32 ra. 4/14/1978 Castillejas, ®Inpalied ^ERr Ou~allNl ^DOA ^NUrskp Nana ^Resideas ^Op1er-Spedy:
m. Cady d Dear &. C'y. eao, 7wp. d Dear ad. FedYly Name (K nol kaTUam, pNa pop and amber) 9. Wr Oecedard d Hhpalc Origin? ®No ^ Yr 19. Race: Anedan F~dan, Black, WNte, ek.
Dauphin
Harrisburg
Harrisburg Hospital I9 yss, 0.xdN calm.
McKkan,PuarroRkan,ek.) (SPAY)
Pacific Island
11. Deadml'e Ueud Knd d work d ab rtpel d Ha. Do not vets 12. Wr Decred mar T the 13 Deadanfs Eduaam (Spaity «dy hiphep grade arnp kted) i4. Medal Slalue: Uertkd, Never Wined, 15. SuMving Spa up (X wits, gwe maiEr name)
ICptl d Wok Kird d Beeler I Irdupry U.S. Amed Fares? Elementary I Seraxdary (O12) College (1 a «St) W'dOMBd• ~~ (~~
HiLift rotor G' t Distribution ^~ 2 Married Mellany V. Gamulo
- 16. Deadawe MrdFp Addmr (SSeeL dty 1 EoM4 sam, z4 ode) DeadeM'c Did Decadnrl
PA
235 W. North .St. AuralRride«e 17a stw
17a^Yes, Decedad Lwed'n Tay.
ow s
Y
- Carlisle, PA 17013 l
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,yb.~,a,y Cumberland ,7d. ~
LhetlxiTh Carlisle
d
cav! eao
1S PeTa's Name (Rol, nldde, ~ rurlAxl 19. MdhMe N«a 9irs4 rnNde, widen eunma)
Ramiro - Canonizado Ebel Y. Navalta
20e. laanrd'e Nor (%M I PrM) 29n. kdoma8a MWktg Aaldrcr (SVrL dylbwn, pale, np eels)
Mellan V. Canonizado 235 W. North St. Carlisle PA 0
21a. MelhoO d OuPaNbn ~ ®Cnanalian ^ DaNaon 21b. Deb d DkspaNa (MOM, day, Ya«1 21c. Play d Digosllbn (Name d amahry, aemaay a alhar place) 21tl. Locatlon IDryltawrl, etch, dp coda)
^ 13uiel ^ Removal hour sMh I Wr cnmatlon « Doraon Adh«ird
- ^ oTar-sP~y: • byMe6epEranlnrlC«onr? ~Yae^Na
3/4/2011
Evans Cremation Services
Leola, PA
22e. SlpnNm d Fuarp Llamas la Pawn 1 226. lianas NuMer 22c Name ad Addmr d Faciy
- - FD 012633 L Rain Brothers Funeral Hr~, Inc., Carlisle, PA 17013
<ony when certllyYg 23a. To to bap d my kivMedge acnared al as tlnw, dab and daa sta1W. (Sipidura and allel 23b. ucenr Number 23c. Data Signed IMaT, daY, year)
physuen a nol avalebb p sure d drT m
amn/ rase d seen.
w demo 2429 mat be oanplMad ry paean 2a. Time d DrT 25. Daa Pranouiad Dead (W III day. yer) 26. \Wa C•sa Referred to Fk6al Erminer l Coma for a Reason Other tlm fkemadon «Daretbn7
vets pmaanas arT. 05:38 A M. February 27, 2011 I~rr ^No
CAUSE OF DEATH (Sts NrsWCtlona and anmpba) r Ayp«dMe be9rvel: PN 11: Enar rAar 29. DM Toha¢o the CamEir to Dealh7
sure 21. Part Y. Fsbr Te dmF d esrh -drras, kjuies, a mmpkaaar-Tp decay cased Ta era. W NDT soar lanninp merle can r ardac ameL r Orwl b DrT hd nd maAkq n aw vaedyklg aux given n Pad I. ^ Yr ^ PmbeUy
meq«wR amp. «vaddmla Podlaaari wlaiod eAa+g the ecology. lNl ody one rnee a each re.
^ No ~ llnkavm
BIYEDIATE CAUSE fFYW Aseer «
cadeonreankpw ) -~ a. Complications Of Systemic Shock
zs.nFemale:
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Dam (« m a arwµMrce orl: r
Nd pepwl wIINn Wp year
^ Pr•
am p lime d aeaT
Sapa~a~ kp caMlions. tl rY. b. i
3
le A
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rq b I
anse ipbd. LAtIS~E a~ Dr b (a as a amaWanCe oQ: ~
Eia ^ Nd WeAUra. dA pmTuM wtlhn 12 days
(Mrr a'ry'lry Tel tla a r
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awnb maMY
n drT) T d death
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Due m (« as a taaequence oQ: r ^ Nd pngant, W Ve9«^I r3 days b 1 yrr
1
d. r bdore drT
^ lNaviown tl pmgnem wMkn Na pap year
3oe Wr r Aulopy San. Wsn Aukpy Faaarge 31. Maurer d DpT SJa Dee d In)uy (Mots, dry, year) 37L. Deecdbe Flow InMay Oaumd 32:. Flea d Njury: Hero. Fam, Sleep, Feclay,
Parl«med? Avalatla Pda b Caiplaion
rp ^ Flomidde
®Nr ORa Buedng, ale. (SperAyyy)
d Cwr d OeaT7 1
® Yr ^ No ®Yr ^ No
^ Myyam ^ PeMp ImeelipeYOn
321. T d Iryuy
3za. kyuy al Work? 321. tl Tmapodstlon Iniuy (SPadM
92p. Laaem d kO+Y (Slap, dlY / lorwr, slab)
^ Slidde ^ Dald Nd he Oetennlad ^ yes ^ No ^ dMr / Oparaa ^ Peawper ^PatlaeMr
M Oaar- Spedy:
33t CadW (tladcary ar)
pdal9'nYpdan aarxyiq era d drT when amTa I>fnaldan nr p«loanad daMh ad aarykled gem 29)
T
• D«tlMnW 330. ~ rd.dcentl ,,
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To U« nap d my trnwMdga, daaT oaumad dw b tla care(s) aM mrm« r efaMd.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~,
Lisa A. Potteiger, Chief Deputy
• Pr«c«rdn9 nd artllYkl9 PMakir (Pl7pda^ bdh prarouKila drT atl adilykg b are d tlaph)
l
^ 33e. llronee Number .Dale Signed (Mats, dry, year)
aEad__________________
To melarldnq kmwNdge,drT appends TS tlma, rYle, and Wea0. and drroNe aur(a)ald mamerr a April B, 2011
• YedkM Eard«rl Corarar
On Te bow d aaadaplon arts I «YnnNlgplork M my opiN«y daaM oaurred al1M tlma, daY, antl pha, arts dw b tlr awe(s) arq mm~x a eewrL ®
~. Name eM Addm d Peas Who CdryrklM Gras d OeeT (Item 27) Type / Print
Pottei
Lisa A
er
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l ~ I U I
I d l f l 2
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Kk ~ ~x l~ ~ ~~ g
.
1271 south gem street
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~ r~ Harrisbu PA 17111
D~Oplbn Permk No.. (}> (O" I ~ ~(