HomeMy WebLinkAbout07-26-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Margaret B. Brown
also known as
COUNTY, PENNSYLVANIA
File Number 21-11 ' ~~
,Deceased Social Security Number
Barbara T. Brown
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE `A' or `B' BELOW.)
® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the
last Will of the Decedent, dated 08/~2/200~ and codicil(s) dated
State relevant circumstances, e.g., renunciation, death of executor, etc.
After the execution of the documents offered for probate: Decedent did not marry; was not divorced; 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); did not have a child born or adopted; was not the victim of
a killing; and was never adjudicated an incapacitated person, except as follows:
^ B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pedente liter durante absentia; durante minoritate)
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 on Section A above 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:
Name Relationship Residence C"~ =~ ~-
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ ~' ~~~..
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at ~_
615 Harding Street, New Cumberland, East Pennsboro, Cumberland, PA 17070
(List street address, town/city, township, county, state, zip code)
Decedent, then ~_ years of age, died on 02/27/2011 at Holy Spirit Hospital, Cam_p_Hill, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 40,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 68,000.00
situated as follows:
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:
Signature Typed or printed name and residence
Barbara T. Brown 615 Harding Street
.~ New Cumberland, PA 17070
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Form RIA/-U2 Rev. 12-26-2006 (interim form, pending action by the Court) Copyright (c) 2010 form software only The Lackner Group, Inc. Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
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The Petitioner(s) above-named swear(s) or affirm(s) 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 ana subscribed ~
a~ G_1~
before me this ~ gay of
~ ~~
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Signature of Personal Representative Barbara T. Brown
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Signature of Personal Representative ~ ~ ~- -~-~ ; t-T
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Signature of Personal Representative ~ C1~ ~ ~ , ;-
Fier thQ FZegister +~+~ ~~'~`^Jy ~ ~ __-
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File Number: 21-11 ~`
Estate of Margaret B. Brown ,Deceased
Social Security Number: Date of Death: 02/27/2011
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AND NOW, ~ ~ / , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECR D that Letters Testamentary
are hereby granted to Barbara T Brown
in the above estate
and that the instrument(s) dated 08/02/2005 __ _ _
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ........................... ~ .......
Short Certificate(s).......... .......
Renun iation(s) ............../............
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$ Off-
s ~ as
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$ ,~~ ,~ V
$ `~ ; p D
Supreme Court I.D. No.: 4126
Address: 429 South 18th Street
Camp Hill, PA
Telephone: 717/730-7310
TOTAL.
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Form RW O2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
Nt[vrney rvarne• MlCnael L. tSangS
OCAL REGISTRAR'S CERTIFICATION ~)F DEATH
WARNING: It is illegal to duplicate this copy by 'photostat or photograph.
l=ee i~~r thi; certii~icate. `h6.O(?
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Certifif.~atit~n Ntunher
143 REV 1112008
PE / PRMIT IN
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
1. Noma d Decedent (Fkst, mkldb, lest, sulflx) ~ 2 Sex 3. Social Security Number 4. Date d Deadt (, ~Y, Year)
Margaret Beckley Brown Female 192 _ l~{ _ 7080 February 27, 2011
5. Age (Last Bhtltday) Undx 1 Under 1 des 8. Date d Birth 7. BI end state a Ba. Place d Death Check one
jlprshe Days Hour Mrnaas Hoaphel: Other:
88Yrs. March 20, 1922 Bridgeport , CT ®lnpatlem ^ ER I oulpetbnt ^ DOA ^ Nurektg Home ^ Resiaence ^ timer • Spedy:
Bb. County d Deelh 8c. C"y, Boro, Twp. d Dath 8d. FecBly Nerve Qf not ktsBbNon, glue street end number) 9. Wea Decedent d H~penk; Origin? No ^ Yes 10. Race: Amerk;en Indian, Black, White, etc.
Cumberland E. Pennsboro
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y P it Hos ital
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Mexken, Puerto Ricers, etc.) (
Whit e
11. DeoedertYs Usual tbn Kind d work d one du most d 16e. Do not ebb 12. Was Decedent ever In the 13. Decedent's Edttcetlon (Spedly tiny hlgtteet grade cornp bted) 14. MarIW Statue: Manled, Never Mertied, 15. Surviving Spo use (If wde, give marten name)
Kind d Work Kind d Budrtas l Irtdtetry U.S. Armed Forces? Ehmentary I Secondary (0.12) College (1-4 or 5t) ' Divorced (sae~M
Teacher Education ^Ya ®No 12 4 Widowed
t6. DecedenYs Marmtg Addraa (Street, dh' /town, sbte, rip cone) DecedenYe
Adusl Residence 17a
State Pennsylvania ua'raDee dent 17c
^ Yea
Decadent Lived in Twp
615 Harding Street
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PA 17070
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Cumberland T0N1~ip? 1~d.®Nb,DeceeentLivedwi"dn
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18. Fetlter'e Name (First, rtrdrle, bet, suffix) 1g. Motlter'a Name (First, midde, meMxt sumeme)
Mor a1 Henr Peter Beckley Emma Mai Thorn
20e. Informant's Noma (Type /Prim) 20b. IrtformenPe McMMtg Addreea (Stree4 dtY /town, state, zip code)
Git~ er. A', Brown 615 Harding Street, 'New Cumberland, PA 17070
21 a Method d Dispositlon i ®Creme6on ^ pc„a"re, 21 b. Date d Dlepoeitlon (Mordh, day, year) 21c. Place d Dbpositbn (Name d cemetery, crematory or other place) 21 d. Locators (City 1 town, state, zp code)
^ Burial ^ Removal hom State r Wa Crenrtlart or DorrBon AtdhorWd
^ ~,„r. rbylrsdwF.x.ma»r/Corortar4 t~lva^No
March 1
, 2011
Evans Crematory
Schaeffertown, PA 17088
22a. F Liarteee or person acdng a such) 22b. Lloenee Number 22c. Name and Address d FedNly
- (H-~ FD 012 848 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
Corrplets items 23ae when csrtllying 23a. To the d my know4edge, dam ocwrred at Ihs dine, date and place elated (Signaturo end tltle) 23b. License Number 23c. Date Signed (Momh, day, Year)
phyafciert b rtd eveYeble at time d death to
oxl8y ceua d death.
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IMrm 24.28 must ~ ~ ~, ~~ 24. Tlma d Death 25. Date P Dead (March, ,year) 28. Was Ceee Referred to Medkxl Examiner /Coroner for a Reason Otlrer Crematbn or Donation?
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CAUSE OF DFJ1 (Sea Instruotbns and oxsmples) r Approximeb Marvel: Part 11: Enter dher 26. Did Tobacco Use Contribute to Death? -
Item 27. Pert I: Fatbr the ~ -diseases, injuries, or cartlpdce0orta - Ihet dkecdy caused the death. DO NOT enter bmtlnel everts each u cerdec arrest, ~ Onset to Death but nd readtlng in the undedyktg cause given In Part I. ^ Yes ^ Probabty
respiratory arrest, or ventricular tibriNatlon w"had slawKtg the etbbgy. LIM tiny one on each Ikre. r
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^ Pregnant at time d death
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Ertbr bUNDERLYMO CABS a. Duero (or as a cortsequerv>a oft: ~ Not pregnant, but pregnant within 42 days
of death
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before death
^ Unknown 'rf pregnant within ttte past
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30e. Was an Autopsy 30b. Were Autopsy Findings 31. Manner of Death 32e. Date of Injury (Month, day, year) 32b. Describe How Injury Occurted 32c. Plea of Injury: Home, Farm, Street, Factory,
Pedorrrted? Available Prbr to Conpbtlon
d Cause d Oath?
^ Natural ^ Homicide Office Building, etc. (Specify)
^ Y
^ N ^ Y
^ N ^ Acddent ^ Perdhtg Irwestigetion 32d. Tkne d Injury 32e. Injury et Wodc? 321. "Trerleportatlan Injury (Specly) 32p. Location d injury (Street, sty I town, state)
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^ Suicide ^ Could Not be Determined
^ Yes ^ No
^ Driver /Operator ^ Passenger ^ Pedestrian
M. Other • SPerhlc
33a. Cer00x (check arty one)
ease d death when anotl>ar
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ek9ert has
ronounced death and cort
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To fM bast of my IawwAadpa, death occurred dw to tits awe(s) and manner a abbd _ _ _ - - - _
- - - - - - - - - - - - - - - - - - - - - - - - - -
Pr01fOtMlChtg std artifylrg phyekJart (Pltyaiden botlt pronourxirtg death end rx.A"yinq to r~uw d death)
^ 33c. Ucenae Number 33d. Dart Sklned (Month, dyay, year)
To fM bat of my knowNdga, daaM occurred at tM flora, dale, and pba, end dw to tlta cwae(e) and manner u atetad_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• MedlcM ExamlrterlCo-ortsr 1V1
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On tlr beet of sxamlrwtlort and / or Invastlgatbn, In my opinion, death occurred at the tote, deb, an
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pla~e, and dw b 1M awe(s) and mariner a atated_ ^ 34. Name
ress d Person Who CAmplete~ ~
d Death (11am 2~ Type I Pdnt
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