HomeMy WebLinkAbout07-08-11ESTATE OF IN THE COURT OF COMMON PLEAS
ANDREW T. TOWNE :CUMBERLAND COUNTY. PF,NNSYLVANIA
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ORPHANS' COURT DIVISIO~ ~ ;.. _~ '~,
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PETITION UNDER SECTION 3102 OF THE PROBATE, _ _ _ :. ~-
ESTATES AND FIDUCIARIES CODE FOR =`= - ~ ~~~~ -;
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SETTLEMENT OF SMALL ESTATE
TO THE HONORABLE JUDGES OF SAID COURT:
Amy J. Towne, your Petitioner, files this Petition for Settlement of a Small Estate under
the provisions of Section 3102 of the Probate, Estates and Fiduciaries Code and in support
thereof avers that:
(1) Your Petitioner, Amy J. Towne is a competent adult residing at ?00 Mooredale
Road, Carlisle, Pennsylvania 17013. and is the mother of the abo~~e decedent.
(2) Andrew T. Towne, died on March 6, 2011 at the age of 29 years, but prior thereto
lived and was domiciled at 200 Mooredale Road, Carlisle. Pennsylvania.
Cumberland County, Pennsylvania. A copy of decedent's Deatii Certificate is
attached hereto as Exhibit "A."
(3) Andrew T. Towne died without a Will. No Letters have been issued.
(4) Andrew T. Towne had no probate estate when he died other than the following:
Bank Accounts with Wachovia Bank with a value of $1,206.98. A copy of the
June. 2011 statement is attached hereto as Exhibit `B."
(5) The sole heirs and relationship to the decedent are as follows:
John Towne, Father
Amy J. Towne, Mother
(6) Your Petitioner avers that there are no creditors of the decedent and no claim
unpaid known to your Petitioner.
WHEREFORE, your Petitioner respectfully requests that an Order be made authorizing
Amy J. Towne to act as Fiduciary for tha Estate of Andrew T. Towne and close all accounts with
Wachovia Bank, pursuant to Section 3102 of the Probate, Estates and Fiduciaries Code.
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cus A. McKnight, I Esquire
Supreme Court I.D. No. 2 476
IRWIN & McKNIGHT, .C.
60 West Pomfr et
Carlisle, PA 17013
(717) 249-2353
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Amy J. Towne, being duly sworn according to law, deposes and says that the facts
contained in the foregoing Petition are true and correct to the best of her knowledge, information
and belief. ,~
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Am J. Towne
Sworn and subscribed before me
this ,.;~ ~ day of June, 2011.
COMMONWEALTH OF PENNSYLVANIA
%~~ t Notarial Seai
~` Karen S. Nosl, Notary PubUc
~~ _ ~'~ ~ Carlisle FSOro, CumbeHand County
Not PU 11C My Commission Expires Dec. 8, 2011
MEMBER, PENNSYLVANIA ASSOCU1TiON OF NOTARIES
06;''20;''2009 16:31 ?1?2414024 ~MVTOWNE
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(come, ANQREW T TOWNE (attowne~comcast net Edit )
You last logged on OZ/07f2011.
Checking, Savings, and Money Market Accounts
Account ..._.__ ____. .
Account - __...._,.... _....
Name Number Rosted
_._ .. Balance
cp XPRES
'3440
$73,13
Y~1 Y2SAVE
*Q417 $'131.89
PAGE 02.'' 06
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Total ; 5206.02
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See Instructions and examples on reverse) STATE FILE NUM6ER
1. Name of Decedent (Fuss, mitldla, last, suffix) 2. Sex 3. Social Security Number t. Date of Death (MOnlh, day, year)
Andrew T Towne Male 190 - 68 - 4728 March 6 2011
5. Aqe (Last Rinhday) under 1 year Untler 7 day fi. Dale of Blnh (Month, day, year) 7. Birthplace (City arW stale or foreign country) Ba. Place of Death (Check only one)
Monllrs Data Hours Mkwles HOeplml: DtnBC.
29 Jul 18, 19$1 Scottsdale, AZ ^Inpatienl ^ER/Outpatient ^DOA ^Nurs'ing Home Residence ^Other Speciy
60. County of Death &. City, Bor Tw of Death ed. Facility Name (If not insDlutien, give street and number) 9. Was Decetlenl of Hispanic Origin? ~ No ^ Yes 10. Race: American Intlian, Black, While, etc.
(II yes, speafy Cuban, (Spears)
Cumberland West Pennsboro 1064 Creek Road Mexican,PuenoRican,etc.) White
11. Decedent's Usual Occu alion KinU of work d one tlurin most of workin tile. Do not slate reliretl 12. Was Decedent ever in the 13. Decedent's Education (Specity Doty highest grade compl eted) 14. Marital Slalus: Married, Never Married, 15. Surviving Spo use (II wfe, yive maiden name)
Kintl nl Work Kind cl Busirass / IMuslry U.S. Armed Forces? Elementary /Secondary (0-12) College (1.4 or 5+) Widowetl, Divorcetl (SpeciryJ
Production Worker Rubber Mf ^YBe ~° 4 Never Married
76. Decedent's Mailing Atloress (Street city /town, stale, zip code) Decedent's Did Decedent
Deceaem used m Dickinson T„~
sate PA Live in a t7c
p ve:
Actual Residence na
200 Mooredale Road
PA 17015
Carlisle .
.
,
.
Cumberland mwnsmp7 nd. ^ Nn, oe°adenl Li,etl wimm
17b. County
, Actud Limits of city, BOm
I8. Famar's Name (First, middle, Ian, suffix(
W
T
h 18. Mother's Name (First, middle, maiden surname)
Bra
alone
J
Am
owne
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.
Jo .
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y
20a. Informant's Name ;Type! Print) - ZOD. Informant's Mailing Address (Street, city I town, stale, zip code)
John Towne 200 Mooredale Road, Carlisle, PA 17015
21 a. Method °f Disposaion t ~] Cremalan ^ Donation 21D Dale of Disposdan (Month, day, ear)
March 9
201 21c. Place of Disposition (Name of cemetery, crematory or other place)
Hoffman-Roth Funeral Home & 21tl. Location (City I town, slate, zip cotle)
^ Burial ^ Removal fromSlale ~ WasCremationorponatienAUthodzed , Carlisle, PA 17013
^ Other - Specify: I Dy Medlcal Examiner I Coroner? Yes ^ No Cremato
22a. Si I re of Funeral Service C ensee (or person acting as such) 22byigepsGNiynpgp
144E 22c. Name antl Address or Facility Hof fman-Roth Funeral Home & Crematory
. '. '
Complet Items 23at only when cane Ing 23a. To me bas tNe lime, dale and place stated. (Signature and line) 23b. License Number 23c. Dale Signed (Month, day, year)
physici is not avahabla al lime of tleath to
cenity cause of death.
Items 24-26 must Da completed by person 24. Time of Death 25. Dale Pronounced Dead (Month, tlay, year) 26. Was Case Referred to Medlcal Examiner I Coroner for a Reason Other Inan Cremation or Donation?
w°n pr°nnunnaadeam A rx. 6:00 A M. March 6 2011 vea p"°
CAUSE OF DEATH (See Instru<tlone and examples) r Approximate interval: Part II: Enter omer s'ori ficam contirons conldbul nu to deem, 28. Did Tobacco Use C°ntnbute t° Dealn7
Item 27. Pan k Enter Ina cha n of events -diseases, Injuries, or complications - Thal dlractty caused the death. DO NOT enter terminal events such as cardiac arrest, Onset to Deam but not resWUng in the underlying cause given In Pan I. ^ Yes ^ Poobably
respiratory arrest, or ventricular librillalion wimout showing the etiology. List only on e cause an each line. ~ ^ No ^ Unknown
IMMEDIATE CAUSEtFinal disease or
condi6a, rseuumgmdaam)
_ ~ a. Seizure Disorder r
r
Insulin Dependent 29. II Female:
^
Due to (or as a consequence oQ: i Diabetes Me 111 t uS Nol pregnant within past year
^ P
t
l
f d
h
Sequentially list condmons, it any p. regnan
a
ume o
eat
leadin9Blo the cause listed on line a,
Dua to (or as a consequence oQ: I ^ Nol pregnant, but pregnant witnin 42 days
Enter the UNDERLYING CAUSE
(disease or In(ury that ~ndialetl the c I
I
r
of death
events resulkng m tleam) LAST.
t
D
r ^ No1 pregnam, but pregnant 43 days 101 year
o (or as a consequence oQ.
ue r before death
d. I ^ Unknown h pregnant wrtnin the past year
30a. Was an Autopsy 30b. Ware Autopsy Findings 3t. Manner of Deam 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occunetl 32c. Place of Injury. Home Farm. SIreeL Factory,
Performed? Available Prior Io Completicn
of Cause of Deam?
~ Natural ^ Homklde
Otlke Bunting, etc. (Specity)
^ AccaeN ^ Pending Investigabon 32d. Time of Injury 32e. Injury a1 WorkT 321. If Transponalron Injury (Specify) 32g. Locati o Injury (Ire !town, slate)
^ Yes ~ No ^ Yes ^ No
^ Suicide ^ Could Not be Determined
^ Yes ^ No
^ Dover /Operator ^ Passenger ^Pedesuian
M ^Other- SO~iy:
33a Ceni6er (cDeck orny one) 33b, Signature and Title oftwNNc,-
• Cenlrying physician iPhysician cenilying cause of tleam when another physician has pronounced death and completed Item 23)
To me hest of my knowledge, tleath occurred due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~ Coroner
• Pronouncing end cenifying physlclan (Physician Dam pronouncmg death antl cenilying to cause of death)
^ 33c. License Number 33tl. Date Signed (Month, Day, year)
To tho best of my knowledge, Beam occurred al the time, date, end place, and due
• MedlcelExaminerlCoroner to the cauae(sj and manner es stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ March $, 2011
On me basis of examinatlan and / or Investigation, In my opinion, death accurretl et the Ilma, date, end place, and due to the cause(s) end manner ae stated_ ~ ~ N nd es f Per W Completed se of D to (Item 27) Tyae I Pnnl
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`X_ 1 r+ 36. Ie Filed OAOnth, tlay, year) 6375 Basehore Rd., Suite 1~1
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