HomeMy WebLinkAbout07-29-11T RT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Ili THE COU REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
ESTATE NO: 21-• 1 f~ ~ ~~~
Kathryn W . Fetrow ,Deceased
Estate of
a/k/a:
a/k/a: SS NO: :195-16-4577
a/k/a:
who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
Pettttoner(s)
applicable:
Grant of Letters Testamentary or ClAdministration c.t.a., or d.b.n.c.t.a. (complete Part C ulnder
Q A. Probate and
and aver that Petitioner(s) is/are entitled to that fdorementioned Letters and codicil(s) dated
the last Will of the above-named Decedent, d
(State relevant circumstances, e.g. renunciation, death of executor, etc.)
lows Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the
Except as fol ,
ments offered for probate; was not the victim of a killing, was never adjudd for divorce had been establ~e das defit~ in
instru
party to a pending divorce proceeding at the time of death wherein groun ~ -r-~ c_..
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23 Pa. C.S.A. § 3323(8): `n
~ fV
^ B. Grant of Letters of Administration ~
(If applicable, enter d.b.n., pendent lite, durante absentia, durante mino ~
...r.~ ~~
/have ascertained that Decedent left no Will and was survived by the=~Q to list o
C. Petitioner(s), after a proper search, has
n and heirs (If Administration c.t.a. or d.b.n.c.t.a., enter date of Will in no ~ n a ant o~ending di~nee
following spouse (tf a y)
heirs); was not the victim of a killing; was never adju e t bl-shed aspprovided iin 23 ~Pa. C S A. § 3323(8), except as follows~~'
nrnceedina wherein grounds for divorce had been
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THIS SECTION MUST BE COMPLETED:
tniciled at death in Cumberland County, Pennsylvania, with his/her last family or principal resi ence
Decedent was do
At 5000 Creekview Road Mechanoffib and zip COOdeO, Mun cipal~ty: TownshipSBorough, city)
(Street address with Pos Mechanicsburg, PA
87 ears of age, died 7/11/2011 at
Decedent, then _______ y (Month, Day, Year of death) (City and State where death occurred)
Estimated value of decedent's property at death: $ 10,000.00
All personal property $
_If domiciled in PA personal property in Pennsylvania
If not domiciled in PA Personal property in County $
If not domiciled in PA $ 500,000.00
Value of Real Estate in Pennsylvania Total Estimated Value $ 510,000.00
Provide full address if possible.) 4900 & 5000 Creekview Rd, Mech,PA(Hampden Twp)
Location of Real Estate in Pennsylvania ( 104 7 Brentwater Road, (E . P ennsboro Twp)
Name(s) & Mailing Addressees)
Signature PA 17055
Edward P. Fetrow,5016 Woodbox Lane,Mechanicsburg,
Hill, PA 17011
Karen A. Fetrow, 10 Stone Spring Lane, Camp
.~.
Page 1 of 2
lnterim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court
USE ADDITIU~At. ~nr,r. r ~ 11~ z.L~L~-~• --- -
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OATH OF PERSONAL REPRESENTATIVE n o r.,.
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lvania $S ~
Commonwealth of Pennsy ~ ~ ~ ~
of Cumberland ~ ~~~ C~ ~ ~.
County ,.-~ a -r, ~
e anc~
the statements in the foregoing petitioner ,
etitioner(s) herein named swear or affirm that ner s and that, as personal represer~tive(s) of to
The P
ect to the best of the knowledge and belief of Pet1 the estate accor g to law.
corr will well and truly adminlster
Decedent, Petitioner(s)
S~,orn to or affirmed and subscribed
t ~' f ~ ~.~.~~ Grin
e me his ~ d y'Q ~ G.~,~,~ ~ -
be ~/ ~/
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Register
F PROBATE AND GRANT OF LETTERS
DECREE O
Estate of Kath n W . Fetrow
ND NOW, this ~ daY of July
A roof having
the reverse side hereon, satisfactory p
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' e Number: 21-
, Deceased Fil
2011 , in consideration of the Petition on
been presented before me, IT IS DECREED that Letters
are hereby granted to:
licable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
x Testamentary of Adminlstratlon (lf app in
Edward P. Fetrow and Karen A. Fetrow described •111 the petition be
dated 9/30/2008 .
the above estate and that instruments(s) ~
and filed of record as the last Will and Codicil(s) of Decedent.
admitted to probate ~~
~.,.
Glenda Farner Strasbaugh,
Register of Wills
FEES:
$ 460.00
Letters .................. 15.00
Will.. .................
Codicil(s) ............... 40.00
(10) Short Certificates
( )Renunciations.......
Bond .............
Other ............................
.....................
Automation FEE......... 5.00
JCS FEE .................. 23.50
$ 543.50
TOTAL ...............
d~ to Ente Appearance
Signature of Counsel Rectum
Atty's Signature
~`,, ,
p~N~~ Name; Ftbbert C. Saidis, Es .
Supreme Court ID No.: 21458
Address:
Phone:
Fax:
635 North 12th Street, 4th Floor
Lemo ne, PA 17043
717-61_ 2-580
717-312-5805
Page 2 of 2
Interim Form RW-02 revised 1226.10 by Cumberland County pending action by the Court
p5 REV (OVUM
,S CERTIFICAI"ION OF DEATH
L~~'~~" REG~STRAR his co by photostat or photograph.
WARNING: It is illegal to duplicate t pY
for this certificate, $b•00
P 17557598
Certification Nwnber
iEV 1112006
oRINT IN
ANENT
:K INK
t. Name d Decedent (Fist, nxddh, last, suMrx)
Kathryn W. Fetrow
Under 1 ar Ur>der 1 day
5. Age 11as1 glAtWay) ~~ Hours Minces
Money
ENS ~~
~ia
,*
~~:
This is to certify that .he inicrrr~~atitm )~~ ~ given )s
correctly copied from ~jn (Irigiral ~eltiS)~at,c of Death
duly tiled with me, as Lc cal I~e~~i~trar. ~i~l~~' original
certificate will be flrr~ ~~(•d~Ri tcl the `Mate Vital
ecords ~f ~ic~,t~W' pe) m~(nerit fi! ink:.
/~' ' l//LZ~~.I~
~'~-' ~ ~ JU 1 2 011
Date Issued
Local Registrar
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HEALTH • VITAL RECORDS
ALTH OF PENNSYLVANIA •
COMMONWE
TE OF DEATH
CERTIFICA
ER
STATE FILE NUMB
(See instructions and examples on reverse) q
Dare of Death (Month, day, year)
2. Sex 3. Social Security Number
Female 195 - 16 - 4577 .
July 11,
201
_
Yrs.
Bc. City, Boro, Twp. of Death
Bb. County of Death
Cumberland Upper Allen 'Itap .
It. Decedent's Usual lion Kind of work done Burin most of world Me. Do not slate ref
Industry
nes
gd of
Kind of Work t
~
v .
T ~Ca
J
Treasurer .,
I..JU
1 s Mailing res¢ (Street, city 1 town, state, zip code)
~~ Cree~cvie
w PA•
~
Mechanicsbur , 17055
18. Faltbr's Name FusL rnidnte• lest, suffix)
Paul Wo~.f e
20e. informant's Name (Type 1 Pdn1)
Edward Fetrow
-~-- pA ^ Inpatient ^ EP. I Outpatient ^ DOA Nursing Home U Residence UDmer • spernry
r 11 1923 Shiremanstown 10 Race: American Indian, Black, White, etc.
g. Was Decedent of Hispanic Origin? ~No ^Yes (SpedM
6d. Fertility Name (II not institution, gNe street end number) (II yea, specify Cuban, White
/I ~ ~ Q Mexican, Puerto Rican, etc.)
e~ (~ Y v 14. Marital Status: Mamed, Never Married, 15. Surviving Spouse (II wile, give maiden name)
12. Was Decedent ever in the 13. nl's Education (Specify only highest grade completed) Widowed, D'~vorced (SpecilN
U.S. Armed Forces? Elementary I Secondary (412) College (1.4 or 5+) Widowed
^Yes ®No 12 Did Decedent Hafi)pden _Twp.
Decedent's pA live In a 17c. ®Yes, Decedent Lived in
Actual Residence 17a. Slate Township? 17d. ^ No, Decedent Uved within Coy I Bore
bar land Actual Limits of
17b. County Cum
19. Mother's IFtrsL middle, rtralden surname)
Be~va Wolf e
20b. Intom,artt's MaOfng Address (SVeel, dly 1 town, stale, zip code) g PA 17055
5016 Woodbox In., Mechanicsbur ,
21 d. Locatan (City 1 town, state, zip code)
21b Date o1 Disposition (Month, day, Year) 21c. Place of Dispositon (Name of cenrelery, crematory or other place)
21 a. Method or Dispo:Nbn
^ BuAal ^ Removal,rom State
Cremation ^ Donation ~ jyt .
rs
~ ~ °o~"° Yea ^ No ul 13 2011 Holl~
r Funeral Home Inc .
l
011 1
^ Other • Spedry: e
_~ne
?2b. License Nurt~er 22c. Name and Address of Fad
fly 1 0
-
22a. Ftater~ 1903 Market t •
23b, license Number 23c. Date Signed (Month, day, year)
• , nature and Iltle)
To the bast d my furowledge, death occuned at the bme, dale and place stated. leg
23a
nation
D
Complete Mama 23e~e onty wtren ceAMYmg
hyaigan is not aveAabte al time of death to
.
.
o
26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation or
p
- csAMY cause d deedt• 25. Date Dead (Month, Bey, Year) ^Yes ~ No
~
Mema 24-26 must be cpnpleled by Person
th 24. Tama of Death
~ 0 ~ ~ ~l M. ~ ~ ~ ~ ~! ~
o U t Approximate interval: PaA II: Enter dher ' ce~ ~ .
to PaA
derNin
28. Did Tobacco Use Contribute to Death .
YeS Probably
I. ^ ^
.
• yytq pref1pW10aa dea g
but not reauMing in the tut
CAUSE OF DEATH (See i^atructfons a^d examplsa)
DO NOT enter terminal events such as cardiac arrest, ; Onset to Death
death
d Il ^ No (~Unkrrown
.
ya
diseases, injuries, a oontDkcaMOf^' taa1 ntrerdy cause
Item 27. PaA I: Enter the Ust only one cause tM each Mne. r a ,p ~.
UI showing the ebologY• r / f /`-y
Mho
a ventricular flbrlMation w
enest 29. It Female:
~~ pregnant within pall year
,
respkatory
MIMEDIATE CAUSE ~srel disease or ,
M
r if . !-.~
~ C~G7 i`-
~r/,~ r
^ Pregnant al time d death
ithm 42 days
t
eard9on resuning m ant) _~
r
r as a consequence o0:
vr
^ Not pregnant, !wt pregnan
Due to (o
r of death
~~ condAior•, M arty,
~a~rq to caws Mated on Mite a. b, r
Due to (or as a consequence oq: r
r
^ Not pregnant, but pregnant 43 days to year
before death
Fier Brs I1NpERLYMHi CAUSE
n~a
M~ ~detarrn LAtadT a r
c r
a consequence of): r
^ Unknown it pregnant within the past year
t
F
eV~g reall
~ Due to (or as ory,
ac
32c. Place of Injury: Home, Farm, Street,
• d.
32a. Date of Injury (Month, day, Year) 32b. Describe How Injury Occurred OMice Building, etc. (Speciyl
30b. Were Autopsy Fkdlrgs 31. Manner of Death
Spa. Was an Autopsy Street, city 1 town, state)
PaAormed? Available Prig b Completbn R71 Natural ^ H°rn~ ~ Mtbn Injury (SpecfM 32g. Locatkm o1 In'ryry
Inury el Work. 321. It Tranapo
32e
~A!
.
r Peclestden
32d. Time of Inury
of Cause d Death?
^ Aunt ^ Pending Investigelion ^Yes ^ No ^ DrWer I Operetor ^ Paaserga ^
^ ya ~ ^ Yas ^ No ^ Suidde ^ Could Nol be Determined M. Olrufr ' ~°~''
lure and Tale of CeAitbr
33a. CeAMfer (dreGr onhy one) (clan has Pronounced death and completed Item 23) Month, da ear
• CerUlyln9 PhYskhe (PlrYsktian ceNlying caws of death when aridtrer phys - - - - - - - - - - - - - - - - - - 33d. Date Signed ( Y~ Y 1
death occu^ed due to the puae(s) and manner a stahtL - - - - - - - - - - - 33c. Licen~se wNumber -- /y `/Z /~
To tM bast of my knowledge, xoan both prorwuncrn9 desN and ceANykrg to cause of death) - - - _ _ _ _ ~ /~ .]c.~~Q ~4[~ / /
prorwuneirp artd carlilying physkhn (Phys" (~
1o tM bast of my Wtov+l~9s~ death occurred at lha time, date, and place, and dw to the cause(s) and mannH sa sta - - .. - - - - - - - - 1 Print
• IWdkal fxamirlar 1 Coroner 34. Name and Address of Person Who Completed Cause_ d Death (`Item, 27) TYDa
On the bash of exeminatlon and 1 or inveatigatbn, in my opinion, death occurred N the time, dale, end pleee, and dw to the puae(s) and manner u stated_ ^ ~-fin n /~~ ~~~/~ ~s-C y
36. Date FI . (Mon , Bey, Yaar) ~UZJ ~~~ !¢Z~Q!'G r/.1~ ICJ
35. Registrar's re and Disbicr r / I~ ~ II ~ I I I ~~ ~ ~ ~d I~
Disposition Parma No. ni~~ ~41 ~+'