HomeMy WebLinkAbout03-17-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COiJNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT Off' LI:T'TERS
Estate of Kenneth Anthony Dottle
a/k/a:
a/k/a:
a/k/a:
SS NO: 191-40-8508
Pe ' Toner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
a plicable:
A. Probate and Grant of Letters Testamentary or pAdministration c.t.a., or d.b.n.c.t.a. (complete Part Calso)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters of Administration under
the last Will of the above-named Decedent, dated _ 7/22/2003 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(g):
^ B. Grant of Letters of Administration
(tt applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate)
C. 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 ir.~ Se;ction A 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:v
Address _ Relationshi to Decedent ;~,
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t1SE ADDITIONAL SHEETS IF NECESSARY - ~ ~; ~ ~ ~-
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THIS SECTION MUST BE COMPLETED: ~ ~ N ~ x
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residencf ~ ~
At 516 North Enola Drive, Enola, East Pennsboro Township, Cumberland County, Pennsylvania 17025
(Street address with Post Office and Zip Code, Municipality`. Township, Borough. City)
Decedent, then 60 years of age, died 2/9/2011 at Camp Hill, PA
Estimated value of decedent's property at death:
If domiciled in PA
If not domiciled in PA
_If not domiciled in PA
_Value of Real Estate in Pennsylvania
(Month, Day, Year of death)
Deceased ESTATE NO: 21- ~~ - ~ ~~
(City and State when death occurred)
All personal property $ ~~~.~2Q y
Personal property in Pennsylvania $ _
Personal property in County $ ---
$ -- -
Total Estimated Value $ ~ 0.00
Location of Real Estate in Pennsylvania: (Provide htll address if possible.)
Signatur s)
Name(s) & Mailing Address(es)
Adam E. Dottle, 516 North Enol<~ Drive, Enola, PA 17025
Daniel A. Dottle, 516 North Enola Drive, Enola, PA 17025
Interim Form RW-~12 revised 12?6 10 b Cumberland Count - ~
Y y pending action by the Court Page I of 2
II(1i111~ Rr~' ~~~i~n,
LOCAL REGISTRAR'S CERTIFICATION OF D~A1"~i
WARNING: It is illegal to duplicate this copy by photostat car photograph.
E;ec for this certificate. ~b.O(-
P 1704761,
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This is to certif°4 that the information here given is
correctly copied fr~lrn an original (certificate of Death
duly Filed with )nc: a~~ Local Registrar. The original
certificate. will he 1~t~rwarded to the State Vital
Records Office for permanent filing.
L~~ ~ FEB 1 ~ 2 11
--~--
l_.ocal Rc~~istr~(r ~' D~~te Issued
'; s~~H
T OF
Rl?(;URUC?I~ O1~1~I(;1~. OI~
2011 MAR 17
(;I,L:RK ~)I~
Oltl'I[;~NS (;C)UR'I'
CU~I1~1?Rl,AN1~ C(~UKT, PA
a43 REV 11x1008
PE I PRINT IN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH .VITAL RECORDS
'ERMANENi
BLACK INK CERTIFICATE OF DEATH
(See instructions and examples on reverse)
1. Noma d Deoaderd Fast, mddb, lest, sulAx) STATE FILE NUMBER
1~ e n n e t h A. D o t t i e 2• Sex 3. Sactlei Secudry Number 4. Dab d Death (Month, day, Year)
Male 19 1 _ 4Q __ 8508 February 9, 201 1
8. Age (Last Bkthdey) under 1 r Under 1 de 8. Date d Birth Month r 7. et and elate «
. yaeM Days HOUR MkxAes sun Be. Place d Deem Check on one
6 0 May 26, 1950 Hospital: ~ Otf>ar
Yrs. ESSl ~ ~ ~
' Bb. caxMy d Deem 8c. Cly, Boro, Twp. d Deem ^ Inpetbrd ~ER I outpetlent ^ DDA ^ Nurekg Home ^ Residence ^ other - Specify
~ Bd. FadlRy Name (H not InetltuUon, glue street end number) 9. Wes Deaderd M HlepaMC Odgin7
(l~iberland East Pemisboro ~ (d yes, specify Cuban, ~ No ^ Yes 10. Raga: American Indian, Black, white, em.
~p• Holy Spirit Hospital Mexlan, Puerto Rkxtn, etc.) (
• 1 t. Deadenre Ueud tlon Kind d work done dud most d wo We. Do rat state re 12. Wee Decedent ever In dte 13. Decedents Eduatbn ~ to
KIr~o1 Work KYrdof Business/Industry U.S. Armed Forcea9 (~N only hlgfreet greds completed) 14. Marital statue: Mertisd, Never Merded, 15. surviving spouse (II wtle, give rtralden name)
CID Special Agent U. S. Army ®Yee ^ No Ebmenbry ! fry 1x12) College (1-4 « s+) w+dowed, ~Ivaroed ~soaalri
1 B. Decedents Melting Address (street, dry! town, ebb, zip code) 2 D1vorCE'~I
516 Abrth Enola Drive Die PA Dw Decedent
Actual Residence 17a. Sbte Uve in a ~] y~ pfd Lived in East Pennsbro
Enola, PA 17025 17Q'
~ rland Towrnhip7 17d. ^ NoDa ~
17b. Cou TN'P.
18. Father's Name (Flry, middle,b~ wfRx) ~ 1 Boro
Kenneth T. I~7ttle 19. Momera Name (Flrst, middle, maiden aumeme) --
2l>a. hdormanrs Name (Type / Pdnt) Dell Braum
ISObe 1 M. Ibt t le lob. Inlormenre MaWng Addreae (street, dN /town, stab, ;dp Dods)
540 Belmont Drive Harrisbur PA 17112
~ 21a. Memod d DlspoaMiort ~ ^ Crematbn ^ Donation 21b. Date d Dlepoeltlom (Monet,
,-, ® Burial ^ Removal from Stab r Wu CremHbn « Donatlon ~', Y••r) 21c. Place d Dlepoeitlon (Name d cemetery, crertnbry a other place) 21 d L
228. 31grwWre d Funerel Licernee
- t
ph ~ 'ronot a aA~l~et tlr~ne d deatl, h
oxUly cause d deem.
Ibrru 24-28 mwt be by Person
who praauras deem.
. ovation (city l town, state, zip cods)
r by Memai ExamMur/Cororrr? ^ Y~,^ rto February ] 6, 2011 Indiantown Gap National CeIDete~
(« ~""' °~ ~ ~^) z2n. Llcenae Number z2c. Noma end Addreae d Fadtlry - Anrivll le PA 17003
FD 0]2774-L 'chardson Funeral Home Inc. 29 South F,no:La Drive Errol
23e. To me best d my ,death occurred at the tlme, date end place ebbd. (Signature and tltle)
23b. tkense Number 23c. Date Signed (Monet, day, year)
24. Tana of Deem 25.~ Prangrrcad Dead (Monet, day, year)
/O~ RM. ~ 2oI
CAUSE OF DEATH (See I~etrucUone and sxtsmplee)
Ibm 27. Part I: Eller the ~ d everts - diseases, InJudes, « compgcationa .mat direoty ceuaed the deem. DO NOT enter bm>iny events such es caraec artest,
reepiretory array, «ventriader Abriledon witFaut yawing me etk>togy. Lly only one cause on each Ifne.
MM~EDUITE CAUSE (Flnei disease «
oond rosdbrg n deem) _~ a. /Yl(7 D ~ G ~ / o / L
~ /rr /'
Duero (« ea a ov,~yua~ o,t,
Yet conditlaa, k erry, b.
ErMx bl1NDERLYMO CAUSE a Due to « ac a
( cornequerxxr of):
(dbaeae «InjurY mat Irdtlebd tlx3
evems resrdtlng m deem) LAST. c.
Due to (or u a conaequerae oil:
d.
30e.1 ~~A~opsy 3pb. Were Autopsy Findings 31. Mamer of Deem
AveYebb Prbr to ComPletfon
~~/ d Cause d D,ee-m, ,?/ 'T-~ Neturel ^ Homicide
^ Yes L~J No ^ Yes L_fNo ^ Accident ^ Pending Imreatlgstion
^ Suidde ^ Could Not be Determined
~' Was ~• Refemad b Medrxl Examiner /Coroner for a Reason Omer men Cromatbn or Danetbn7
^ Yes ^ NO
Onset to Deeth but rat resulting in the u sues
^d•dYbg gNen in Pert 1.
32e. Date d InJury (Monet, day, year) 32b. Describe How Ir~ury occurred
Time d In)ury 32e. In)ury at WodCl 3zf. h T -'
reneportation Injury (SpeclyJ
^ y ^ ^ Drtverloperst« ^ P ^
^ Yes ^ Probably
^ No ^ Unkrawn
29. I} Female:
^ Not pregnant witltin pay year
^ Pregnant at tlrne of deem
^ Not pregnant, but pregnant within 42 days
of death
^ NW pregnant, but pregnant 43 days to i year
berore deem
^ Unknown tl pregnant wkhkr the pest year
32c. Plea of Inpry: Horne, Fenn, Street, Factory,
office Bulldhg, etc. (SpeNy)
32g. Loatlm d in)ury (street, city /town, state)
M. es No aseenger Pede:rtrtan
33a. Certllbr (dredc only errs) Omer • SpeW/y.•
• T~r~ (Phyycbn certgykg cause d deem when arather completed Item 23) 33b• Signature and Tttle d CertHbr
my loawbdgs, deaM aeeurnd due to tM physicbn hea prmaxad deem and
awe(s) end manner ae etabd _ _ _ _ _ _ _ _ ~l_ _ J
• PronouneNp ~ ~YMg PhY~Mr (Physiden bom pronoanctrrg deem and arUlykq t0 erne ddeem) _ _ _ _ _ _ _ _ _ _ _ _ _ _._ _ _ _ _ _ _ _ _ _ _ 33c. license Number ~'!7
" TYedkal Examher/Coroner dsetlr oaurred tl fM tlme, deb, and pba, and dw fo the auas(e) and manner s ehbd_ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ /~, 33d. Date Signed (Monet, y, year)
on tlu bpb of esrMnalion and / or in - - - - ~ /i " ~ 277 i 2 ~~ // /
M rrry opinion, death ocarrred at the time, dab, end plea, end dw to the awe(s) and manner a sbbd„ ^ 34. Name end Address d Person Who
~, s Completed d Deem ibm 27) / Pdnt
38 ~ ~~(G~~.eiW ` lJ~f' N/ /17~
C~~~ r
~. ~ ~ I Q~' ~ ' , I FtlDd (Month, day, Yarl
C ~ ~ ~~ ~
Disposition Permit No. ~~ ~ ~ s~ { ~~
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 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 and subscribed
b f re me this ~ ~~~` ~ day of
~.
For the Register ;~
~_
~,... ,
DECREE OF PROBATE AND GRANT OF LETTERS
Estate of C~~r I J~e~~'F ~ (-~t~l ~'r~~ ~~ ~ f' ,Deceased File Number: 21-~_ (( - ~
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AND NOW, this ~'
~ ~~ day of ~,'~~.~'~(',~-l , c~ C~: ~~ ~ , in consideration of the Petition on
the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters
Testamentary of Administration are hereby granted to:
(If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
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.
1n
t ,- ,
~~.~ ~ ~1 C~-G' ~~ - ~:t/2. / ~ - ~ 1 l~.~J Jae l _ t.
Glenda Farner Strasbaug , ~~~ ~ ~~~_,~C'I'l~ '~bc_E_1~~-~-
Register of Wills
FEES:
Letters ....................$ ~ ~. ~~
Will ....................... _ ~ ~_ (~
Codicil(s) .............. .
(~(~r_,) Short Certificates 1. s C~ .
( )Renunciations.......
Bond .............................
Other .............................
.................................
Automation FEE......... 5.00
JCS FEE .................. 23.50
~r7~. S~~
TOTAL ................ $ ~:§6-
Signature of Counsel Required to Enter Appearance
Atty's Signature
PRINTED Name:
Supreme Court ID No.
Address:
Phone: _
Fax:
I
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
i
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
~1 ~~~" ~?~~I'
Estate of KENNETH ANTHONY DOTTLE
I, PATRICIA L. SIMMONS
(Print Name)
EXECUTRIX
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Deceased
in my capacity/relationship as
of the abo~ e Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
~dln `~ ~' l
ADAM E. DOTTLE and~~LA. DOTTLE
S
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(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
0~ ~- ~ ~`M ~c M _
(Signature) _____
4900 DL iYIAS STREET
(.Street Addressi
COLL~Il~IBUS, GA ~ 1907
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certif ed
that he or she executed the renunci~ ion for the
purposes stated within on this _ uay
of ~ ~ ~ / /
Notary _ i
My Cc~rT mission E. ;pi s: /~~~'~~/
(Signature an i Se,al of Notary or othar official gaalified to
admmistea~ oat^s Show date of e~:piration of Notar}'s Cor.~mission.l
Fnrm RW-06 rev. 10.13.06
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND
COUNTY, PENNSYLVANIA
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Estate of KENNETH ANTHONY DOTTLE _ ,Deceased
I, ISOBEL DOTTLE _., in my capacity/relationship as
(Print Name)
EXECUTOR of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
ADAM E. DOTTLE and DANNY A. DOTTLE, sole heirs
(Illate)
(Signature)
540 BELMONT L)RIVE
(Street Address)
HARRISBURCi,1'A 17112
(City, State, Zips
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
day
of ,
Deputy for Register of Wills
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 7~ day
of _~,-~ '~ _ c20 I ~
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
adm-nister oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
M~~~ ~~
~iKAN M HUOdON
M~ Pr01ic
~OiWiEA P~AItTOM TWP DAN CNTY
M~ COAMIIi~fiOA E>epi1M OCt 12.201 ~