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HomeMy WebLinkAbout04-18-11PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Henry E. Mowers~Jr. No. /~I" ~ ~"~ ~3 also known as To: Deceased. Social Security No. Register of Wills for the county of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl I@S for letters of administration on the estate of (d.b.n.; pendente liter durante absentia; durante minoritate) the above decedent. Decedent was domiciled at death in Cumberland County, Penns lvania with h is last family or principal residence at 1860 Hunter DrIVe, Mechanicsburg, ~A 1 ~05Q . -~ Q-~(.~-C`'fj ~~ ~"~{ ~ C~- ~Q6~( ~t~L~~P~-~lisi~ tr et .n er,,~,wp. or~or_q~iiGC.~~~tJl.~/' `~~-~ ~j1p~4~' 81 , J ~• 4/5/2011 .GL ~ _1,1, ~ !'i*-+t~ ~ UJF~~/ n then ears of a e deed L(~!O Decede t at Silver ~ rin Townshi y g ~ a_S . ~.S -~3~-,3~ Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 2,500.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 330,000.00 situated as follows: 1860 Hunters Drive, Mechanicsburg, PA $160,000.00 1862 Hunters Drive, Mechanisburg, PA _ $120,000.00 Continued on a Separate Page Petitioner after a proper search has ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Kesidence 1864 Hunter Drive Hen D. Mowers son Mechanicsbur PA 17050 1862 Hunter Drive Sher Si nor dau hter Mechanicsbur PA 17050 20 Richard Road Susan Kaczerski dau hter Mechanicsbur PA 17050 ~ -~' ~ C"'} _ } r~-- ~.;, .w_ ~ ~~~ :.,t ~..1 v ~ ~ ,...~ .~ THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the ~~"~'z3 appropriate form to~he undersigned. /'' .% ( 1864 Hunter Drive -- ~~~ Mechanicsburg PA 17050 .. en ry owers .y ,-. ~~ ~~ ~~ ~ .o ~~ ;a ~w o c an .:~ r--. T~.~ ~, -~: ;-~, r....~_{ ~--~ '~7 r.` .y r --? -- ~ r~ ;~ _,..., .._w._} ~... ~~ tx.7 ~, ,- ;--r-t ~,~ O cw..~ .~ cf n~ Continuation of Petition for Grant of Letters of Administration Henry E. Mowers, Jr. Page 1 Real Estate in PA Three Square Hollow Road, Newburg, PA $50,000.00 TOTAL: $330,000.00 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF Cumberland Q ~ The petitioner(s) above-named swear(s) or affirm(s) that the ` 37 ~ -ca ~ ~ ~ n 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 above decedent petitioner(s) will well and ' ~~ c7 truly administer the estate according to law. `-~ ~~ -'~' ...~: ~/~ r1 ~ ~ / ~ ~' Sworn tcs or affirme subscribed bef me thi day of REgister i .~ No. ~21-a I- 093 Estate of Henry E Mowers, Jr. ,Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW ~~ , in consideration of the petition on the reverse side hereo ,satisfactory proof having been presented before me, T-r Ta r~~nn~CTl +l,~r r-,.,.~ a.~ ~ ~ 7 ~ ~,"_; ~. .~ .. -~-; _, _ .,f -~ r~ c: c.,~ ~ ::~ ~•w ~~~ ~) -n c~: 11 lU LLt/1W~..JL ~iaKa~ ---- is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Henry D Mowers in the estate of FEES ~L n•~j~, Letters of Administration . $ ~UV ~ Short Certificates ( ~) . $ -.~~. .C. ~`. ~...... $ ~a Renunciati n . • ,23.5Q ,~ ~c c TOTAL $ Filed A. D. ~ ' Q' Gerald J. S/~~~ 40486 ATTORNEY~3'tip. Ct. LD. No.) 414 Bridge Street New Cumberland PA 17070 717-774-7435 ADDRESS PHONE HIi15.tt(li RFC i!)1ltt'i LOCAL REGISTRAR'S CERTIFICATION C)F DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 17298881 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with n)e ~(~ Local Registrar. The original certificate will lit: i~urwarded to the State Vital Records Office ft~r permanent filing. /~,,,,,Z ~ AP 0 8 11 __ Local Fegistrar Date Issued ..~~ ,~~ry -~-~ C~ O ~) 7 1")~ "'O ~ { ~ l ) i~~C~ ; ~:.~~ j` i ,:.. .....V. --i ~.~ d - ~.. 43 REV 11!2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS RMANENT" CERTIFICATE OF DEATH LACK INK (See Instructions and examules on reverse) ~~TeTe eu a en wneo 1 Noma o1 Decedark (Flrsl A ril 5, 2011 Aga (Last Birthday) 5 Under 1 Under 1 da 8. Dare of BMh Month, da 7. BIM erd erete «I coon 8a. Place of Deem Check one . t~s pays Hoes 6Bnaes Hoepltal: Other • $ 1 y~ December 9, 1929 Harrisburg, PA ^ Inpadent ^ ER ! Outpatient ^ DOA ®Nursing Home ^ Residence ^ Deter -Specify: 8b. County of Deem 8c. City, Boro, Twp. of Duch 8d. Faculty Name (knot irutltuNon, 9W street and number) 9. Wes Decedent of Hboank: Origin? ®llp [~ Yes 10. Race: American Indian, Bieck, White, etc. (It yes, spectly Cuban. (Speal)q • Ctmoberland Silver Spring Tiap. Brid s of Bent Creek Mexksn, Puerto Rlcari, el°.) White 11. Decedents Usual Kind of work d one du moat of Ike. Do not state re 12. Was Decedent ever M the 13. Decedenya Educetbn (Spedly only hlghut grade completed) 14. Markel Status: Mewled, Never Martled, 15. Survhiing Spouse (If wile, give maiden name) Di d f S Kfnd of Work Kind Busineasl Industry U.S. Amred Forces? Elementary I Secondary (0.12) College (t-4 a 5+) vorce ( pec y) Painter M. Gor~on & Sons Inc. ~]Ye8 ^ ~ 12 Widowed • 18. Decedents MaiNng Address (Strut, city 1 town, state, zip code) Decedents Did Decedent ~,7,,,.,.,,i Decedent Lived In "m"E^`eri Twp 17c ~ Yes R PA n' I f360 Hunter Dr . . . , eskbrae 17a. State Actual owmehlp? T vedwkhin CuQlberland 17d.^N o Dec ed t l • Mechanicsburg, PA 17050 A ~ ~ o f u 17b.Coumry CitylBoro 18. Famels Name (Post, middle, last, suffix) 78. Mothers Name (Flret, mddle, maiden surname) Henry E. Irbwers Sr. Zoe Ham 20a. InfarrtrarN's Name (Type I Print) 20b. Informants McNfng Address (Street, city /town, state, zIp code) Henry D. rowers 1864 Hunter Dr. Mechanicsbur PA 17050 21a. Memod of Disposition . r ^ Cremation ^ Donaton 21b. Date of Dlspoakion (Month, day, year) 21c. Plea of lrepoakbn (Name of cemetery, crertratory or other place) ltd. Location (City /town, state, zip code) • A•thort~d^ ^ ~ ~Bpdal ^ Removallromsrere ~ ~u April 9, 2011 Stone church Cemetery Silver Spring Ttap. PA 17025 Y~ ~ ~~ ~ ^ ~ 22a. SigneMe of F«brel Service (« parson actlrg u such) 22b. lJcertae Number 22c. Name arM Addroea of FadNly • ~ FD 012774-L Richardson FLmeral Home Inc. 29 S. Enola Dr. Enola, PA 17025 CompNts ibme 23ac ony when certllying 23e. To the mY am occurted at the tlme, dent and stared. (Signature and tltle) 23b. Lk;enu Number 23c. Date Signed (Month, day, year) phyaidmr k ma avaNdtb a, tkne of deem to ~ V~ ~ 1 ~ ^~ 0 y t 5 1 ~ ~ty eves a death. V • kertrs 24-26 must ~ ~~~ by ~~ 24. Tone of Death 25. Date Prawunced Dud (Morkh, day, year) 28. Was Case Referred to Medkal Examiner 1 Coroner for a Reason Other than Cremation or Donation? ^ who prerauncu death. 1 1 1, l0 M. 0 `~ ~ D 5 ~ (I Yea CAUSE OF DEATH (See Inetn~ctbns end examples) r Approzlmate Imerval: Item 27. Pen I: Enter the chain of events - diausea, kry'unes, or cortrplicatlons • that directly caused the duet. DO NOT enter terminal events such u cardlec artesl, r Onset re Death Pen II: Enter other but not resuking in the underlying cause given In Pen t. 28. Did Tobacco Use Contribute to bath? ' ^ Yes ^ Probably respkatory artist. « ventricular fibdlktbn wilhart ahowing the bgY. List only one cause on each Ikre. ~ ' ' ^ No ^~ Unknown 7 ~ INMEDUTE CAUSE fFlnel disuu or /~ G„P r ' dee ( r condtlon resuttirg In m) a % ~/~ ~ i 1~_i7~ f `~_ /~y y~~/-~ '•-~~ ~ ~ - ' ' 29. If Female: ^ Not pregnant within past yur _~ to (« u a cansequerae of): ~ ^ Pregnant et thne of death ~ k ~Y~r uY b ~ ~~~ ithi 42 d ^ , ~ . b the eauee Na1ed an ~e a. Due to (« as a consequence of): r ~ Not pregnant, but pregnant w n ays of death t3rbr lg4DERlYINO CAUSE (dfuue a~y mat Irritlabd tl» ~ ; r~p7.S ~P~J/9 ~ 41 ^ Not nant 43 da s to 1 ear nant but re re evenre reetdYry' In deem) LAST: y p g y p g , • Due to (« as a consequence of): r r before deem Unknown N pregnant within tire pest year • d r 30a. Wu an Aubpey 30b. Were Autopsy Fndinge 31. Marxrer of Dom 32e. Dare of Iryury (Month, day, yur) 32b. Ducrlbe How Injury tkcurted 32c. Place of Injury: Home, Farm, Street, Factory, Office BuiWing, etc. (Spedfy) PeAom>ad? Avetiatke Prbr to Completbn f D m? f C ®Naturel ^ Homldde ause o ee o ^ Accident ^ Pendng Investlgetlan 32d. Time of Injury 32e. InJury at Work? 321. tl Tranaponatlon InJury (Spscly) 32g. Location of inJury (Street, city /town, stale) ^ Yes ^ No ^ Yes ^ No ^ Yes ^ No ^ Orfver/Operetor ^ Passenger ^ Pedestrian ^ Suicide ^ Couk1 Not be Delertnlned M Omer - Speary: ~ Certlfbr ( ooh ~) 33b. Signature erd Tice of CertNler ~ /'/ j /f7 ( fj' ! /~I • Certkying physklan (Ptrysician cenilyirg cause of duet when another physician has pronowtced deem and twmpbted kern 23) d V , /, - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - To 1M but of my Wrowbdga, loth oceurrod due to tM cauu(s) end nwurar u etab 33c. lkenu Number 33d. Date Signed (Monet. day, year) PrortoUncing and oartllying phyabbn (Pfrysiclen tz>th pronouncing deem and certllyYg to cause of death) ^ ~ '~ ' To the but of my IotoraledP, dent axurred et the time, date, end pka, and dw to the cauaa(a) and manner u ateted _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ /) /y ~ v v y,~ ~ ~~ ~ • Mledksl ExamMsrlCor«tar lAt 1M lwb of azaminatbn and / or Invatlgatlon, In my oplnbn, death occurred at the tlma, dab, and place, and dw b the cauu(s) end manner u atsted_ ^ 34/®~ar~u~~ddhupf Person 1NhO t r Caugtl of Deem (Item 27) Type I Print ' ~. Registrar and 38 Date ( day, yeah / Dlsposkbn Parton No. © ~) v ~ J n '~:::-: -~ ~ RENUNCIATION ,,,~ ~" ~'~' " ~,,,0 ,..._.. ~ .~ ~`~ ~ ~' - ~ ~ C ) .`.~ ~ ~~~ ~a "-; ~ REGISTER OF WILLS ~~ ,~, ~--~ .~., Cumberland COUNTY, PENNSsi'LVANIA :~ ~ ~' ~ -~ ~ `,~ I_ ~_~ 93 ~ ~, ... "T i Estate of Henry E Mowers, Jr _- ,Deceased I, Sher Signor _ __ , in my capacity/relationship as (Paint 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 Henry D Mowers . ,~ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of (Signature) 1862 Hunter Drive (Street Address) Mechancisburp PA 17050 (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 renun ion for the ses state within. on th' ~ day of ~ ~ ~ . of blic My Commission Expires: nJoc~. ~` S, ~ o ~`~ (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Deputy for Register of Wills COMMONWEALTH OF PENNSYlVAN1A NOTARIAL SERI Mary C Signor. Notary Pubiic East Penn~b~, Cumb~rl~htl CCyunty My Co1Am11iloi111 Noy~mb~t ~ S, X011 Form RW-Ob rev. 1(I. l3.Or5 RENUNCIATION ~ c ~',. ~w ~~ ~~~" , _ t ~ '` ~ ~~ "~ REGISTER OF WILLS m = =' _ ~ ~ , ~ ' Cumberland COUNTY PENNSYLVANIA `- ' ~n~ - , -~ ` _a ~ ~ ~~ ,~ r ~t'~1 T 21-11- d 9.~ _ .~ f ~ .. ~:-~ ~~ --~ ~_. ,~:. Estate of Henry E Mowers, Jr. ,Deceased I, Susan Kaczerski , in my capacity/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 Henry D. Mowers ~ /~ I1 (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of . Deputy for Register of Wills (signature 20 Richard Road (Street Adatress) Mechancisburg PA 17050 (City, Slate, 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 _~ day of , COMMONWEALTH OF PENNSYLVANIA N TARIAL SEAL o Public KITTY M. GLASSER y Commission '~~;SPRING TOWNSHIP CUMBERLAND COUNTY MY COMMISSION EXPIRES JULY 29, 2012 (Signature and 5ea1 of Notary or other official qualifie io •~--_..,..,,,`_ administer oaths. Show date of expiration of Notary's Commission.) Form RW'-06 rev. 111.13.06