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Home My WebLink About08-16-11. _ , IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of Loretta ]. McIvor a/k/a: a/k/a: a/k/a: SS NO: 195-32-2680 Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: ~ A. Probate and Grant of Letters Testamentary or ^ Administration c.t.a., or d.b.n.c;.t.a. (complete Part C also) and aver that Petitioner(s) is/are entitled to the aforementioned Letters the last Will of the above-named Decedent, dated 11/2/2006 under 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 (If 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 in Section 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: Deceased ESTATE NO: 21- ~ 1 - Q ~ l~ Name Address Relationshi to Decedent :~~ :_-~ C.J~~~-'- 1 f USE ADDITIONAL SHEETS [F NECESSARY _ '~`:r p .. THIS SECTION MUST BE COMPLETED: ;=~~ ~'~~ ~ ,~ Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family ot~rlncipal re ~denc ~y__.. ~~ At 1105 Oak Lane New Cumberland PA 17070 ~~-- ~'~ p (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) ~~ Decedent, then 70 years of age, died 8/7/2011 at New Cumberland, Pennsylvania (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: _If domiciled in PA All personal property If not domiciled in PA '~ 225,000.00 - Personal property in Pennsylvania _!f not domiciled in PA Personal property in County '6 _Value of Real Estate in Pennsylvania S Total Estimated Value 9~ 225,000.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 1105 Oak Lane, New Cumberland, PA 17070 Signature(s) Name(s) & Mailing Address(es) (Robert C. McIvor - 2509 Garrison Ave., Harrisburg, PA 17110 Interim Form RW-02 revised 12.26:10 by Cumberland County pending action by the Court Page 1 of 2 ~. • OATH OF PERSONAL REPRESENTATIVE J ~'~y9 Commonwealth of Pennsylvania `'Q ~~-- `~'' • SS ~~ ~, ~•--r-, County of Cumberland ' ~ ' '~ ~.~ :~? Ty r-- ~°~ -;: ; The Petitioner(s) herein named swear or affirm that the statements in ` ''~ ~~ ~ ~ ~` correct to the best of the knowledge and belief of Petitioner(s) and that aso a going Petrt>!on~ true arm ~: ; ~ _ ' _.. ti . Decedent, Petitioner(s) will well and truly administer the estate accordin p oral repres~~t~ive(s) oche t_-= g to law. `"~ ~~.. Sworn to or affirmed and subscribed . ., ~~ ~ ~~'tC be m •~~ e this ~-~=-~----day o ..~ ~f . l-;~; r the Register DECREE OF PROBATE AND GRANT OF LETTERS Estate of Loretta ). McIvor ,Deceased File Number: 21- 1~ _ / rh - GC AND NOW, this / ~ day of ~f (,~ the reverse side ~+~ ~~ , in consideration of the P hereon, satisfactory proof havi been presented before me, IT IS DECREED thateLetters n x Testamentary of Administration (If applicable, enter c.t.a., a.b.,,., a.b.n.c.r.a., ~t~.1 are hereby granted to: Robert C. cIv r the above estate and that instruments(s) dated _ admitted to probate and filed of record as the last ~ in described in thepetition be 11 a d Codicil(s) of Decedent. 7~~ ends Farner Strasb gh, ,'~ Register of Wills ~,~~G~G~/~ FEES: Letters ....................$ ~ r ~~ Will ....................... Co 'cil(s) ............... ( Short Certificates ~~ ( )Renunciations....... Bond ............................ Other ............................ ................................. ................................. Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ ' ~J+ ~C1 Signature of Counsel Required to Enter Appearance Atty's Signature PRINTED Name: Bar_ b_imple-Sullivan, Esquire Supreme Court ID No.: 3231; Address: Phone: Fax: 549 Bridge Street New Cumberland, PA 17070 (717) 774-]1445 (717) 774-7059 Interim Fonn RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 ~-i~_a~ ~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 17~28~1~ Certification Number REV 1t/2oos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS /PRINT IN ,'~ ",~ CORONER'S CERTIFICATE OF DEATH ~I33-078 (See instructions and examples on reverse) ~r.T~ This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. /~ ~"~ A 0 9 2011 Local Registrar Date Issued C7 - ~::ry ._ _. ~- (-~ 'fi`t L+`~ "r~ cu c w woco ~! 1. Name d DeCederd (Flret, mkldle, last, suffix) 2. Sex 3. Sadal Securtry Number 4. Date of Death (Month, day, year) Loretta J Mc Ivor Female 195 - 32 ~- 2680 Au ust 7, 2011 5. Age (Last Birthday) Under 1 r Under t de 6. Dated Birth Monts, de , r) 7. Blrtfplace end slate a f ) 6a. Place of Death (Check on areJ Monte Days moue Mtxrto Hospital: Other: 70 vra. January 29, 1941 Andersonburg, PA ^Ir,p~n, ^ERIOutpetlent ^DOA ^NursingHome ®Residence ^other.spaalfy: 8b. County d Deem 8c. C' Boro Twp. d Death Bd. Facility Name (M not institution, gNe street and number) 9. Wes Decedent d Hiapanb Origin? ®No ^ Yes 10. Race: Amencan.lndian, Black, whRe, etc. Cumberland New Cumberland 1105 Oak Lane ('f yea,apeaHycuban, Mexksn, Puerto Rkan, etc.) (~;~ White 11. Decederrl't Usual Kkrd d work d ais d u most d INe. Do rat state reti 12. Wes Decedent ever in the 13. DecedenPs Education (Specify Doty highest grade comp leted) 14 Marital Status: Mnmed Never Manned 15 S iN S If f KrM d Watt ICawf d Business I Industry U.S. Amred Forces? Elementary /Secondary (0.12) Colbge (1.4 or 5+) , , , ~rr0°"~~ Di'r0~ (~~ . urv ng pouse ( wi e, give maiden name) Production Worker Manufacturing ^rea ~Na 12 Widowed 16. Decedent's Mdtirrg Address (Street, dty /town, state, zip coda) OecedenYa Did Decedent Pennsylvania 1105 Oak Lane Aduel Reakence ne. sbb the In a Twp 1~c. ^ Yom, Decedent lived m New Cumberland, PA 17070 1ro.County Cumberland Tarn,ehro? ,7d.~] No,DededentLNedwitirfn New Cumberland ActualUmiLaar cfiy/~ 18. Fettrer's Name (First, middle, last, su86r) 1g. Mdher's Name (Flret, middle, maiden aumeme) Max Joseph Kistler Alice Cora Sancierson 20a. MfomrenPs Marne (Type 1 Print) 20b. InfomrenPa Melting Address (Street, dtY I town, state, zip axle) Robert C. Mclvor 2509 Garrison Avenue;, Harrisburg, PA 17110 21 a. Method d Disposfibn ®Crematan ^ Donation 21 b. Date d Disposition (Month, day, year) 21 c. Place of Disposition (Name d cemetery, crematory a other place) 21 d. Location (City /town, state, zip code) ^ Burial ^ RenavalfromStete ~ woCrernatbnorponatbnAufhortzW ^ Othor - Sped/y: by Medcal Examiner / Cororrer? Yes ^ No August. 9, 2011 Evans Cremator y Schaefferstown PA 17088 ~ 22a. Signature d (or person actlng as such) 22b. Lkerree Ntanber 22c. Name and Address of Facility FS 012 849 L Parthemore FH & CS, Inc., P.O. Aox 431, New Cumberland, PA 17070 Conplele Rams certilying 23a. To the best d my knowledge, death occurred at the time, date and place stated, (Signaturo and tltle) 23b. tJcenee Numtrer 23c. Date Signed (Month day Year) phyetden w not a t time d death to , , certlfy rxrres d death. p~ 24.28 rtxrBt be ~~~ ~, ~~ 2a. Tana of Death Ap rx . 2s. Date Pronouraed Dead (Month, day, year) 26. Wes Ceae Referred to Medical Examiner /Coroner for a Reason other than Crematlon or Donatbn? who prorrotea~a death. 12:3 0 P M. Au US t 7 , 2 011 ^ Yes ^ No CAUSE OF DEATH (Sss Instructions end exemp4q) r Approximate interval: Item 27. Part I: Eder the drain devents - dneasea, injuries, a compl~ations -that dkedty caused the death. DO NOT enter tenninel events such as cardiac arrest, r Onset to Death Pen II: Eller direr ' but not resulting in the underlying cause given in PeA I. 28. Did Tobacco Use Contribute to Death? ^ Yes ^ Probably respiratory anesl, a ventriwlar fibrNietlon without showing fire etbbgy. List ody one cause on each Ito. ~ IAMIEDIATE CAUSE (Rod disease a r ^ No ^ Unkrawn cardtlfonreaultlngindeam) ~ a. Probable Myocardial Infarction ~ Remote M:I 2g. If Female: ^ Due to (or as a consequera:e of): ~ Nd pregnant within pest year sagtrerttlal~lietcorx>roar~,nanv, b. Atherosclerotic Cardiovascular Disease m ~~ on ~ a' Diabetes Mellitus ^ Pregnantattimeofaeath Due to (a es a consequence op: r Eller IpIDERLYN46 CAUSE r ^ Not pregnant, bd pregnant wfifxn 42 days ~~~ a r r of death Due to (a as a cons uence o : a4 f) r ^ Not pregnant, but pregnant 43 days to 1 year d, r r before death ^ Unknown ti pregnant within the pest year 30a. Was en AUapay Perlomrad? 30b. Were Autopsy F~nga Available Prior to Completion 31. Harmer of Death 32a. Date d Injury (Modh, day, Year) 32b. Desaibe How I ' Occurred MurY 32c. me Street, Factory, d ry of Cause d Death? ®Naturel ^ Homicide j Ortice Bull in g, etc ^ Yes ®No ^ Yes ^ No ^ Accident ^ Pending Investigatbn 32d. Time d Injury 32e. Injury at Work'1 32t. If Transportation Injury (Sperdfy) 32g. Location d Injury (Street, dry /town, state) ^ Sukide ^ Could Not be Detemrined ^ Yea ^ No ^ Drivx I Operator ^ Passenger ^Pedestnan M Other • Specify: 33e. Certllbr (check anty one) 33b. Signature Ce ' ~hMg Phf~~ IPhY cedrY~9 d death when araNer physidan free pronounced death and conpleted item 23) To 1MbeNdm y kno+vlsdpe, deefh oxurrod due to the eaute(s) and manner ore abad_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ,/ Chief Deputy Coroner ~ (~ • Pronourtekrp and ce-fllyirrg physician (Physidan both prorauncinp death end certllyirq to cause d death) To the bM d my ggwNdge, death oxurred at tM tlma, date, end place, and due to 1M slice(s) and manner o sated- - - - - - - - - - - - - - - - -- ^ 33c. License Number 33d. Date Signed (Month, day, Year) • t,Ndical lexamlrrsr / coroner On Ure trop of examlmtlon and / a Invotlgetlon M m o inbn death occurred t th ti d b d l d d >ai August 8 , 2 011. , y p , a e me, e , en p ace, an w to the eausa(a) end manner u efatsd- 34, rase of Person Wpp ~,~ted Celiac ~,pe~y~ (Itgm 2 Type / P t ~ 35.Registrar's5 DistiidN ~ I>~a ( d~Y r~~) 1taLLileW J. JLOLler, C:[11eL llE:pLl y Coroner 6375 B h R d S i ~I1 -~ l ~I l ~I / I ~ I , // ~~9 ase ore oa , u te M h i b P 17050 ~ ec an cs urg, a. Dispositlon PemtR No. I O 4 ~ t ~ .