HomeMy WebLinkAbout07-26-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Catherine Anne Thomas
also known as Catherine A. Thomas
,Deceased
David D. Thomas
COUNTY, PENNSYLVANIA
File Number 21 - 11 -- U
Social Security Number 350-18-7836
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE `A' or `8' BELOW )
Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the
last Will of the Decedent dated 02/14/1979 and codicil(s) dated
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Bruce H. Thomas, the named Executor, died on 10/05/1983. David D. Thomas is the named alternate Executor. C r~ ""' ~? :=-:
f~rare re-evanr cucumsrances, e.g., renunaarron, aearn or execuror, erc.~ ~ .a.~ C ~-+-~ ±--~
After the execution of the documents offered for probate: Decedent did not mar ,was not divorced; was not a party to a Ivor roceead'm~._~.~_',
wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. 3323 (g); did not have a child born or a s noct victim of -, ';
a killing; and was never adjudicated an incapacitated person, except as follows: ~ ~ ~ ~ -_ ~ - ~ ~ -;
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B. Grant of Letters of Administration
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Petitioner(s~, after a proper search, has/have ascertained that Decedent left no Will and was survived by the following spo se (if any) an Irs (if
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will on Section A above and complete.list of heirs); was not the victim of a kllling; was ne er
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:
729 Bosler Av., Lemoyne, Lemoyne Borough, Cumberland County, PA 17043
(List street address, town/city, township, county, state, zip code)
Decedent, then $s years of age, died on 12/03/2010
at Golden Living, East Pennsboro Township, Cumberland County, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows: 729 Bosler Avenue, Lemoyne, PA
15,000.00
105,000.00
rrev. ~z-zazow pnrenm corm, penomy aawn Uy me i.uurq
Copyright (c) 2010 form software only The Lackner Group, Inc.
729 Bosler Avenue
Lemoyne, PA 17043
Page 1 of 2
(COMPLETE !N ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA } SS
CouNTY of Cumberland }
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to thee. 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 ~
Signature of Personal epresentative David D. Thomas
be a me this day of
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L , ~,~ ~j,l~, ~~~~( ~ Signature of Personal Representative
Signature of Personal Representative
File Number: 21 - 11 ~- (~ ~jp~
Estate of Catherine Anne Thomas ,Deceased
So ~al S curity umber: 350-18-7836 Date of Death: 12/03/2010
AND NOW, y , in consideration of the foregoing Petition, satisfactory proof
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having been prese d bef me, IT IS DECREED that Letters Testamentary
are hereby granted to David D. Thomas
in the above estate
and that the instrument(s) dated 02/14/1979
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES ~ ~ Cdr
Letters ............................................ $ ~ , ,
Short Certificate(s) ........................ $ `.~ ~ t°ti"
Renunciation(s) .............................. $
TOTAL.
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R ister of Wills
Attorney Signature: ~/~,,~, '{~. ~l~a-
Attorney Name: Debra K Wallet
Supreme Court I.D. No.: 23989
Law Offices of Debra K.'Wallet
Address: 24 North 32nd Street
Camp Hill, PA 17011
Telephone: 717/737-1300
Form RW-OY Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
105.905 REV.(3109)
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with
the Vital Statistics Law of 1953, as amended.
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WARNING: It is illegal to duplicate this copy by photostat or photograph.
~~4344~.
No.
Linda A. Caniglia
State Registrar
2010
DEC 24
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H105.143 REV 11/2008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~- ~---- «"t
HYPE 1 PWNT IN ~~
PEfiMNENT CERTIFICATE OF DEATH r~
BLACK INK
(See InatruCt(ons and axamoles on reversal _ r-•.
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1. Name of DeadeM (Fret, midde, last, sdfa) • Ser 3. Social Seariry Nrrdrer _ - _ -- ~ -~ 4, Date d Death (Month, day, yetir)
Catherine A
Thomas ~
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350 _ 1 8 ._ 7836 Dec. 3, 201 0
5. Age (last elMaay) Under 1 r Under 1 de 6. Date of Birth Month 7. SI ce Ci and stets or forty count Be. Place d Deatlt Check one'
_ Mmaia Days Hors MMas Hospital: Otl1er;
8 6 Y~ Aug . 1 7, 1 9 2 4 B a t h g a t e, S c o t t a n lnpatbM ^ ER /Outpatient ^ DDA Nursing Home ^ ReNderre ^ t]Iher .Specify:
9b. Canty d Death Bc. City, Boro, Twp. d Death Od. Fatility Name (H rot irtstkudon, give street end number) 9. Wee Decedent d Hbpartic Origin No ^ Yw 10. Race: Amerkan Indian, Bbdc, Wtim, etc.
Cumberland East Pennsboro Golden Living ('
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11. DacedenYa Usuel lion KirW d work done du moat d workin lib. Do not slate retI 12. Was Decedent ever in the 13. DecedeM'a Edlrcetlon (Sprrcity only highest grade completed) 14. Marital Smhrs: Mprtied, Never Married, 15. Surviving Spouse (If wfe, give maiden name)
Kind d Wark Knd d Business/ IrWUStry U.S. Amred F a? Ele mry /Secondary (0.12) Cdbge (1.4 w 5t) Wb0W8d' DWotced (SP~+M
'
homemaker own home ~ widowed
^Yes ~
16. DecedenYS Melting Address (Sheet, cfry /town, stem, rip code) DecedeM'a Penns 1 V a n 1 a Did Decedent
Y
729 Bosley Ave. Aqual Residence 17a. State
Llve in a 170. ^ Yes, Decedent Lived in Twp,
Cum er an Tower"p?
n A 1 7 0 4 3 17b. County 17d. °, Decedent Lived wthin Lr?m0 ne
dual Limits d Y Gty /~
,B. Fatlmrs Name (First„ mlddb, met atrfYor) M i c h a e 1 Canning 19. Mothels Name (Flral mkide, maiden sumertra)
Ann
20a. InfonnaM's Nertre (Type I Print)
Michael Thomas 20b. InfomtaM's Mailkq Address (Street, city /town, stab, zip cads)
729 Bosley Ave.,Lemoyne,PA 17043
21 a. Metlrod d DbPosiOon r ^ Crematon ^ Dabtion
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M zt b. Dam d Diepaifon (MOntn, say, year)
2010
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7 21c. Piece d Disposition (Name of artretary, aematory or other place)
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Hill C
t 21d. Lacaaon (Chy /town, amts, zip code) 1 7 0 1 1
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~ ^ r - ay Yadlal Examkrsr/Caonert ^ Yea^ No ec.
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ery Lower Allen
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d F libena9e (a perean acting ea ouch) 22b. license Number 22c. Name and Addrase of Fadity
FD-013163-L M(zsselman FH&CS,324 Hummel Ave.,Lemoyne,PA 17043
imrta 23ec oriy vMen wrtlyMq
ptryabbn b not awilable at dme d seam to 23e. To the best d my Imowledge, death aaurred at the time, date and place stated. (Signalwe and Htb) 23b. License Number 23c. Date Signed (MOrdh, day, year)
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tlMy Y4.~ mu& be compbbd br ~~ 24.7'ime of Deets 25. Date Pronounced Deed (Month, day, year) 26. Wae Casa Referred to MrMical Examiner /Coroner
~ who pragrrrces deetlr. Q ~ d Sr ~-t M. ~et,2 M Igt.,{ ~ . Z_O 1 d ^ Yes ~No fa a Reason Other than Cremation or Donation?
CAUSE OF DEATH (See Irotructlona and examples) , Approximeb interval: Part II: Enbrother '
Item ?7. Pert I: Enter the chsirr d events -diseases, injuries, a compicatiau - that drecly eased the death. DO NOT enbr terminal events such es ardiac arteal, r Onset ro Death but nd reauleng in dye underlying sues given in pen I. 28. Did Tobacco Use Corttrlbum m eM?
^ Yes
^ Probabl
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respiratory arrest, a ventricular fibriWtion wittaut showing the efokrgy. Lill Doty are caws on each tine. r
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SWEDUITE ((
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^ No ~Unkrtovm
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m~aeI d~saese a
condlbn ng in rlaelh)
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2g. H Femeb:
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fl.9 :ey . • ~ ~n / v! `~ ~ ''
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Duero (a as a cerrsaquarxe of): r Not pregraml wHhin peat year
uantiWH fat cardiHap, H arty, b. i
ro the cave Paled on ins e ^ Pregnant et tlme of dptlr
. Due to (a as a con
Ettbr IINDERLYIN(i CAUSE sequence of): ~ ^ Not pregnant, but pr nom within 42 da
eg Ys
(disease a inMxy that inPoemd the r
everas resultng in dwth) LAST. c' r d death
^
Due to (a ea a consequence d): r
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r Not pregnant, but pregnant43 days to i year
before death
^ Unkrown H pregnant wHhro are past year
30a, Was an Autopsy 30b. Were Autopsy Find(ngs 31. Man d Death 32a. Dem of Injury (Month, day, year) 32b. Describe How brjury Occurted 32c. Plea d Iryury: Fiume, Farm, Street, Factory,
Parlomrd? Awimde Prior ro Canpletion
Nawral ^ Homicide Olfroe Building, efc (Specilyl
d cause of Death?
^ Yes No ^ Yes ^ No
^ Axitlent ^ Pendng Investigaam
32d. Time of Injury
32a. Injury at WaKI
32f. H Trerapormtion Irr)ury (Specfy)
32g. Loadoh d injury (S1reeL city /town, smm)
^ Suidde ^ Could Nd be Debrrtdned ^ Vas ^ No ^ Dmrer/ Operebr ^ Peaeenger ^ Pedestrian
M ^ Other - SPadry.'
33a. Grfilbr (dock only one)
33b. Signature TijwBfGAlfier
• Csrdfykp phpkbn (Pnyairaan artityirg suss d deem wtren another
physician has gonourced death end canplated Imrn 23)
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TolMbeatMmykrowkadge,tloaMOaumdduetotMauaa(s-andmmrrarasstated'--------------'------------ ^
Pranouroing and ceAirying physidan (Physiden both proratndrg deaM and artHying to ease d death) 33a Liaree Number 33d. Dam Signed (Month, MY, Year)
To the boat of my Ymowbdge, daaM oaumd at the tlms, dam, and pbce, and dw m the cauae(a) end manner as abted _ _ _ _ _ _ _ _ _ _ _ ^
• M.ew Ezaminar/coroner - - - - - - - ~
rvr'v 'L 3 '-r FS 3 ~ .-- G
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On tlu Mob d axaminetionand / « imaatlgtlbn, In my opinbn, death oec«red at the lima, dam, end plea, end tlw ro the auaa(s) end manner as stamtL ^ 34. Name and Addre~s
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35. FiegsM/s ~ and District r 38. Dam Fled (Monet. der, rod ~
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Disposition Permit No. L ~ / ~ N f
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OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Catherine Anne Thomas
Deceased
~R ~! ~ ~ ~ . Fl'S ~1c ~' and ~ ~G/,y,G.~ V..~. ~at~ i4.~
(Print Name/s) (Pnnf Names)
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were wel!-
acquainted with Catherine Anne Thomas
and am/are familiar
with the handwriting and signature of the decedent, and that the signature of Catherine Anne Thomas
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
Catherine Anne Thomas
(Signature)
(Street Address)
(City, State, Zip)
Executed in Register's Office
Sworn to or affirm a ~~ubscribed
bef re e,th i d y
of
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tv for R ister Its
is in his/her own proper handwriting.
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(Signature)
~~.?~ 6r•~r ~.J ST.
(Street Address)
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(City, State, Zip)
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Form RW-O4 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.
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LAST WILL AND TESTAMENT OF CATHERINE ANNE- THOMAS ~ . ~- fff
I , CATHERINE ANNE THOMAS , a resident of~ 7 2 9 Bos ler Avenue ,
Lemoyne, Cumberland County, Pennsylvania, being c-f sound mind, memory
and understanding, do make, publish and declare this as and for My Last
Will and Testament, hereby revoking and making null and void any and all
[dills and Testaments , or writings , in the nature thereof by me at any
time heretofore made .
ITEM I - I direct my hereinafter named. Executor to pay all my
just debts and expenses as soon as m.ay be conveniently done after my death.
ITEM II - I give, devise and bequeath my entire estate, what-
ever the nature of such property may be, whether real, personal or mixed
and wheresoever situate, unto my husband, BRUCE H:. THOMAS.
IfiEM TII - In the event my husband, should predecease me, then
and in that event, I give, devise and bequeath my entire estate, whatever
the nature of such property may be, whether real, personal or mixed, and
wheresoever situate unto my three (3) sons , TIMOTHY H . THOMAS , BRUCE M.
THOMAS and DAVID ll. THOMAS, share and share alike, or to the survivors
of them.
ITEM IV - I nominate , constitute and appoint my husband , BRUCE
H. THOMAS, as Executor of this My Last Will and 'T'estament. In the event
my husband should predecease me, I then nominate, constitute and appoint
my son, DAVID D. THOMAS, as Executor of this My bast Will and Testament.
IN WITNESS j~-iEREOF, I have hereunto set: my hand and seal to my
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above Will, consisting of this One (1) typewritten page, this~~ .day of
February, A. D. One Thousand Nine Hundred. Seventy-nine (1979).
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CA.THE RINI. NE T OMAS
Signed, sealed., published and declared by the above named Testatrix, as
and for her Last Will and Testament, in our presenc e, who, in her presence,
at her request, and in the presence of each othez-, have hereunto set our
hands as attesti ng witness~~s..~~ ,~~~~,..~~~~~f~
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