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Home My WebLink About06-24-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate Of Beverly K. Cutchall a/k/a: a/k/a: a/k/a: Deceased ESTATE NO: 21- - ~~_ !Cr% i~ 1 ~ SS NO: 179-30-4732 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 __ _ under the last Will of the above-named Decedent, dated and codicil(s) 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 person, and was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in 23 Pa. C.S.A. § 3323(8): ~ ~ '~ ~ ^ B. Grant of Letters of Administration r~,.z c'_ ~;,-~ ;-~ (If applicable, enter d.b.n., pendent lite, durante absentia, durante m' .~ ~' ""f' . N ._-_ ; r---; C./? ,Z-. ,7C - ~. ~ , C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived by ~~~~ r ~-.. ,=_, 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 a,,~~"~~:~te Iis~Tof ~-'4` _`r:~ heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party_~t T' ending 'vore "`' C~" proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(g),~c~ pt as folld~vs:~~ r `. q ~ f Name Address Relationshi to Decedent Kenneth E. Cutchall 100 Fisher Road, York Haven, PA 17370 son Jeffrey L. Cutchall 1933 Sterretts Gap Rd, Carlisle, PA 17013 __ son Terry R. Cutchall 732 Forge Road, Carlisle, PA 17015 son Daniel L. Cutchall IiCG AIIIlIT1llAtAl C[Jti•c'7•C` rr. w7 r.~+rc+c+~r~~~ 0 Greenmeadows Dr., Carlisle, PA 17013 son - -- THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 346 C Street, Borough of Carlisle, Pennsylvania 17013 (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 71 years of age, died 6/13/2011 at Carlisle, PA __ (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: _If domiciled in PA All personal property $ ___ 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 $ 96,000.00 Total Estimated Value $ 9,3,500.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 346 C Street, Carlisle, PA 17013 ~`ignatu~~I ~ ~7 Namn(cl X, Moa:no A.~.1...,.,~~,..,~ --- - Kenneth E. Cutchall, 100 Fisher Road, York Haven, PA 17370 '' -ems- / C~~[.vL-~ ~~L Jeffrey L. Cutchall, 1933 Sterretts Gap Rd, Carlisle, PA 17013 Interim Fnnri RW-(1'? rev;cr•~i I ~ ~ti in h.; r~,~,,,ho.-i„~~i ~~~....,.. _.__a:~_ --~--- ,_ . , ., - rage I of Z 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 arf; 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 state accordin~to law. Sworn to or affirmed and subscribed before me this _.~1 ~-,>< d y of ~~ r _- - ~_:- _ ~ For the Register ~-8 ..._. :~ ~-ra ~' .~. DECREE OF PROBATE AND GRANT OF LETTERS ~,-r ; =~ ~-~ ._ ' -~ ; '=' ¢~. . ~ - Estate of Beverly K. Cutchall ,Deceased File Number: 21- ', ~~ ~'~_ - ~ ~ ~-~_ ;~ , ~~ • ~~ AND NOW, this 24th day of June, 2011 , in consideration o the Petit~~Q n on . the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED 1:hat Letters Testamentary x of Administration are hereby grantedl to: (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) Kenneth E. Cutchall and Jeffrey L. Cutchall 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. P _ ~_ Glenda Farner Strasbaugh ,~; ~, Register of Wills ~~~~>( r.~F~l(,~.~~, l.X ~~~~ '~-~-~ ~~~~~ FEES: ~~ ~ Letters ....................$ ~~C~ ~' Will ....................... Codicil(s) ................ (~) Short Certificates ( (_y ~ ~~ (~) Renunciations..... I ~ 7` _~~ Bond ............................ Other ............................. Signature of Counsel Req~xfred to Ent A Atty's Signature PRINTED Name: Andrew H. Shaw Supreme Court ID No.: 87371 Address: 200 S. Spring Garden Street, Suite 11 ................................. Automation FEE......... 5.00 JCS FEE .................. 23.50 Phone: TOTAL........... -~ ~ ~ Fax: Carlisle, PA 17013 717-243-7135 717-243-7872 Interim Form RW-OZ revised 1226.10 by Cumberland County pending action by the Court Pagz 2 of 2 Additional Information: Name Address Relationship to I)e~cedent Susan C. Morrison 22 Brian Drive, Carlisle, PA 17013 Daughter 11fIG ~t IC IJ is\' ,ii ~„ LC~-AL REGISTRAR'S CERTIFIC~ATII~N GF ~E~1t"T'R I~U~RNING: It is illegal to duplicate this copy b~ phato;s~~at or photograat~. Fcc t~>-- thiti cL•rtnticate_ "ti(~.Ofj P 17451496 --- __ CtrtifiL~atic)n ,"~'---r~~~~~(- ~, l r r,,,,;-,,, i,t~'~~~H 0~ p~- _ • i7i,, tl~i ~Itli~ I~;~~i -h~ iul~~)r-~~-.~ti~)n here t,~itien is ~j ` -_ _ ti tttt~^y~ti„ `' - -- /~~~ t li~i~i_ 1;`~ ~_+ (~I '~1 ,li i~~ill1 Ui'I~rli~1il~ ~ l ftlf-C~l~t' Of ~~~lt}1 ~~~ `l. r ` ,~~!~~,~ ,,~ ~~~- t~ll~ Ii1~tl tvltl~ ~ 1L. ~_l~t~;:i! fze««r-~ir. ~'E`~e c~ri~~nal rve ~Gr~ '~c ,'~ - ' ~'~' '~ ~~_~ (~(;fi~~~)IL, ~~ )~~ Fr( ~+rtia.:n-c1L~c~ t(1 the ~t~-~r' Vital ~, r>, i 2+:~ Z':,'~ tl•',_~~ I )I' s,,-_, .I~ ,~1-(lli.iti:'.(1t f~1~1-1t,_T_ ,_ l , , , l ~1c,-1 ~~~~~,~-~,3t;ll D~~tc ~~~(,-e~cl C7 ;r +.. ~ i;~ 't"1 ,-- ~a ~, ~ - , ~_:~ .- r:-.l f'1 ~ ~ _ ~.. ' ~ CA ) ~.~ ~ `~ a r~.: H105-143 REV 1112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH .VITAL RECORDS TYPE /PRINT IN PERMANENT CERTIFICATE OF DEATH BLACK INK (See Instructions and examples on reverse) STATE FILE NUMBER i. Name of Decedent (Frst, middle, Iasi, suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, da year Beverly K. Cutchall Female 1 79_ 30 _ 4732 June 1 3,~10~ 1 5. Age (Last Birthday) Under 1 ar Under 1 da 6. Date d Bits Monts, de , r 7. Birch p C and state or forei count 8a. Place of Death Check on one Months Deys Hours Minutes 71 1 0/ 2 6/ 1 9 3 9 Hospital: Other: - . Yrs. C h a mb e r s b u r g , P A ~ Inpatient ^ ER /Out anent ^ DOA ^ Nursin Home Bb. County of Death gc Ci , gyro T P 9 ^ Resklence ^ Other • Speuity: ry wp. of Death 8d. Facility Name (If not insdtuRon, give street aM number) 9. Was Decedent of Hispank: Origin? r~ ~ • No ^ Yes 10. Race: American Indian, Black, White, etc. Cumberland S. Middleton Twp Carlisle Re Tonal Medical (If yea,apecitycuben, (sue g Mexican, Puerto Rican, etc.) Whit e 11. Decedents Usual lion Kind of work done dud most of work' IRe. Do not state redr 12. Was Decedent ever in the 13. Decedents Education (Specify only highest grade completed) 14. Marital Status: Married, Never Marred, 15. Surviv'xtg Spouse (If wife, give maiden name) Kind o} Work Kind of Business/Industry U.S. Armed Forces? Elementary / Second~~(a12) College (1.4 Of 5+) Wxlowed, Divorced (Spea~lyJ office Manger Grocery store ^ Yes ~] Nd L Divorced C 16. Decedents Mailing Address (Street, city /town, state, zip code) Decedent's Did Decedent 346 C St. Carlisle, PA 1 701 3 ActuelResidence ,7a.state Pennsylvania Townshi 7 17c. ^ Yes, Decedent lived in _~ Twp „~~,nty Cumberland p ,7dX]No,DecedentLivedwithin Carlisle Actual Limits of City/Born 18. Father's Name (Fret, middle, last, suffix) 19 er's Name Fret mild aide ss John S. Truax ore~~e ~i~ir'~"~ Wilds 20a. Informant's Name (Type /Print) 20b. Informants Mailing Address (Sheet, city /town, state, zip code) Kenneth E. Cutchall 100 Fisher Road, York Haven, PA 17370 21a. Method of Disposition t ®Crerttation ^ Donetbn 21b. Dale of Disposition (Month, day, year) 21c. Place of Disposition (Name of pmete cremat • ry, ory or other place) 21d. Location (City/town, state, zip code) Buda? ^ Rertaval from State r Was Cremetkm a Donadon Authorized ° r 17065 ^ other-s rbrMediplF.xamirtar/cororter? C~Yes^rk; 6/14/2011 Hollinger Crematory Mt.HollySprings,PA • 22a. Sign lure of Funeral S Licensee (or person acting as such) 22b. License Number 22c. Name and Address of Facility a ~ - ~•` 011589E ollingerFH&CrematoryMt.HollySprings,PA. 17065 Complete items 23ac onty when prtityirg 23a. To the best of my knowledge, death occurred at the 8me, date and place stated. (Signature and fRle) physidan is not available at time of death to 23b. License Number ~3c. Date Signed (Month, day, year) CertRy cause of death. • 24. Time of Oeath Items 24-26 must be completed by person 25. Date Pronou Read (Month, day, year) • who pronounces death. ~ 1 2~ ~ M r 1 ` 26. W~-a-s,/Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? v `~ \ ~ 134" Yes ^ No CAUSE OF DEATH (See Instructions and examples) r Approximate interval: Part II: Enter other sionifaant ~itio • --hib d'nq to tlgy 28. Dtd Tobaccro Use ConMbute to Death? Rem 27. Part I: Enter the chain of events -diseases, injudes, a complicedons -that drectly caused the death. DO NOT enter terminal events such as cardiac arrest, r Onset to Death but not resulting in the underlying reuse given in Part I. r~-~~~ respiratory arrest, or ventricular 8bdllatbn wRhaa showing the etiology. List onty one cause on each line. r .~LTYes ^ Probably IMMEDIATE CAUSE IFnal disease or ~ No ^ Unknown condftion resulting in death) _~ a ~ e L' e,~ ~~ /` n ~ -- / ^' S)-,1 W~ \ ~ 1 l.~.r~ ~`L 29. It F male: Due to (or as a consequence oQ: r ~ ~ Not pregnant within past year S~epuentiallIyy Est condRiona, if ant, leadirp to dte puss listed on line a. b' i J ~rJ S. ~ ^ Pregnant at time of death Enter the UNDERLYING CAUSE Due to (or as a consequence of): i (disease or inryry that inRiated the r - ^ Not pregnant, but pregnant within 42 days events resultlng in death) LAST. c• ' of death i Due to (m as a consequence of): r ^ Not pregnant, but pregnant 43 days to 1 year • d. ~ balsa death t ^ Unkrawn if pregnant within the past year 30a. Was an Autopsy 30b. Were Autopsy Endings 31. Manner of Death 32a. Date of Injury (Montle, day, year) 32b. Describe How Injury Occurred Pedonned? Available Prior to Completion 32c. Place of Injury: Home, Farm, Street, Factory, of Cause of Death? ^ ^ Homicide Office Building, etc. (Spea'ly) ^ No 9 age' 1 ry 32f. If Trans rtatbn In'u S ^ Yes ^ ^ Yes ^ Acodent ^ Pendin Inves' tan 32d. Time of Injury 32e. In u at Work? po I ry (P~h) 32g. Loption of injury (Street, city /town, state) ^ Suicide ^ Could Not be Determined M ^ Yes ^ No ^ Dnver/Operator ^ Passenger ^ pedestrian Other - Speci/y: 33a. Certifier (check only one) _ 33b. Signature and f Certifier / • CertRying phyeklan (Physician prtitying puss d death when araNer physician has pronourxxfd death and compleletl Item 23) ~ iCL/`----- To the best of my krawbdge, death occurred due to the cause(s) and manner as stated _ _ _ _ • Pronouncing and certHying phyeiUan (Physician both pronouncing death and prtifying to puss of death) 33c. License Number 33d. Date Signed (Month, day, year) To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) arts manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ ~ ~~~~ ° Medics? Examiner/Coroner (,/\'\ , I "~ ~ ~ ~ (~ (,L i I ) w w On the basis of examination and / or investigation, in my opinion, death occurtad at the time, date, and place, and due to the cause(s) and manner as statetL. ^ ° 34. Name and Address of Person Who C fed Cause of Death (Item 27) Type /Print ~ 35. R strar e9i ura and D~ rict e L L~ i~ ~ ~ ~ r+-~ •^e ;Ire r t,` a ~~ 36. ate FWed (Month, da , ear Z J ~c~/1.a •j v'a ~~1 ~~~ Disposition PennR No: _- ~~r: ~~Qrl RENUNCIATION ~> rte; '~-- x, REGISTER OF WILLS ~ - CUMBERLAND COUNTY PENNSYLVANIA ~-` ~, ~ ~--i ~~ =- -:. ~ ~' , . ~i c~ .~ m ~. r .~ Estate of Beverly K. Cutchall son I, Daniel L. Cutchall (Print Name) Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Kenneth E. Cutchall and Jeffrey L. Cutchal l (Date) ~~ (Signature) 20 Greenmeadows Drive (Street Address) Carlisle, PA 17013 (City, State, 7_ip) 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 renunc;iation for the purposes stated within on this _~y-.;i ~~;~ day of ~ cam- v~_ ` , -~ o' ~ ~l ,~ /' ./. _ar Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) ~IMMONWEALTH OF PENNSYLVANIA COM NWE,gLr~ pp pENNSYLVANI Andr+eW H. Shaw Seat NoLartal Sear „~~ C~rNSIe ~, Public Sarah D. D an, N Publi~~ ~ IOn E~gJk+eg Nov. iC8 p 4 Carlisle Boro, and County ~ ~ Com P Nov. 5, i!01;3 R 1rlvAN><l1 ~~ ~ ~~~ Mem ennsvivanla As Ion of Nat:aries RENUNCIATION ~- - ~-~- ~ ~~ ~"' _ REGISTER OF WILLS f='t~':~ CUMBERLAND COUNTY, PENNSYLVANIA ~ `~'~~ r~~ ~T' ~'°' _~ 1- I ~ - 7~ 1 I _ -~ ...~ ~ ~ ~- __ ~~ -~= t-ri ~-- ~-n .~ ~- Estate of Beverly K. Cutchall Deceased I, Terry R. Cutchall in my capacity,/relationship as (Print Name) son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Kenneth E. Cutchall a n d Jeffrey L. C u t c h a l l (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 ;~ (Signature) 732 Forge Road (Street Address) Carlisle, PA 17015 (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 ~ '~ `> ~` day of _ ~ ,n ~ , -~ ~ ~ I N~Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PENNSYLV~ANIfA Notarial5eal Sarah D. Dieckman, Notary Public Carlisle Boro, Cumberland County' My Commission Expires Nov. 5, 2013 Member. Pennsylvania Association of N(rtarles ~) RENUNCIATION ~ z~ -~. ~~rn :%'_ Cii ~ REGISTER OF WILLS '~~_%~->~ CUMBERLAND COUNTY, PENNSYLVANIA '~:~ ~' p b -.^ ,-=~ ~ - ~ ~ - l ~~ ~ I Estate of Beverly K. Cutchall I, Susan C. Morrison (Print Name) :r ...-,. `... ~_.. ~ r~ .~-" - _.. .~~ _ ___:::y -~ _ _,_, --~ ~__ ~.~ ~ Deceased in my capacity/relationship as daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Kenneth E. Cutchall and Jeffrey L. C u t c h a 11 1 (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills ~y (Signature) 22 Brian Drive (Street Address) Carlisle, PA 17013 (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 ~~ ~ S ~ day of ~ ~.,~-, ~ '~ ~ t ~ ~_ -~ ==_~." y Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary•'s, Commission.) COMMONWEALThi OF PENNSYLVAf~IIA Notarial Seai Sarah D. Dieckman, Notary Public Form RW-06 rev. /0.13.06 Carlisle Boro, CumbeHand County My Commission Expires Nov. 5, 2013 _ Member. Pennsvlvanfa Association of Notaries;