HomeMy WebLinkAbout09-01-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of MARY E. EICHHORN File Number 21 ~ .
also known as
Deceased Social Security Number 578-32-5010
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW.)
Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of the Decedent dated 6/3/93 named in the
and codicil(s) dated NONE
(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 instrument(s) offered
for probate, was not the victim of a killing, was never adjudicated incapacitated, and was not a party to a pending divorce proceeding at the time
of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g):
Not applicable
^ B. Grant of Letters of Administration
(If applicable, enter: c. t. a.; d.b.n.c.t.a.; pendente 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 in Section A above and complete list of heirs.)
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(COMPLETE INALL CASES:) Attach additional sheets if necessary. -z' `'~~
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Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at
1 Lon sdorf Wa Carlisle PA 17015 So. Middleton Tw .
(List street address, town/city, township, county, state, yip code)
Decedent, then 89 years of age, died on 8/20/11 at Cumberland Crosin~s
1 Lon sdorf Wa Carlisle PA 17015
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 300 000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal properly in County $
Value of real estate in Pennsylvania $
None
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
Patrick R. Eichhorn
408 Glenn Avenue
Typed or printed name and residence
Form RW-02 rev. 10.13.06 Page 1 of 2
_:~
Oath of Personal Representative =,~ ~ ~~~ ~ ~ ~ _~
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COMMONWEALTH OF PENNSYLVANIA .`LL' =~ ~ ..~ - -
COUNTY OF CUMBERLAND -, ~~ `~-~ -*~
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are trued correct t~ e be~C-tom
~~.~ a ,
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.
Signature of Personal Representative
Patrick R. Eichhorn
Signature of Personal Representative
Signature of Personal Representative
File Number: 21 ~' ~/'" !l ~ `T
Estate of MARY E. EICHHORN ,Deceased
Social Se rity Number: 578-32-5010 Date of Death: 8/20/11
AND NOW, , 2011 , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Patrick R. Eichhorn
in the above estate
and that the instrument(s) dated 6/3/1993
described in the Petition be admitted to probate and filed of record as the last Will (and G.nd;~;~~~» ..f nP,.A,~a~
FEES
Letters ~ ` ~
Short Certificate(s) ...~..... $ ~ . ~
Re unciation(s) ................ $
.... $ 0
,~.~ .... $ 'v
TOTAL ................
.... $
.... $
.... $
.... $
.... $
.... $
.... $ -
Attorney Signature:
Attorney Name:
Address:
Telephone:
c~
10 E High St
Carlisle
PA 17013
717-243-3341
Form RW-02 rev. 10.13.06
Page 2 of 2
Sworn to or affirmed aid subscribed
Supreme Court I.D. No.: 29943
105.805 REV (01/071
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
This is to certify that the information here given i~
correctly copied from an original Certificate of Deat duly filed with me as :Local Registrar. The origina certificate will be forwarded to the State Vital
Records Office for permanent filing.
P 1727719
Ccrnficahon Numbcr
L~~ve. ~~ AU 2
~" ~ 2 2111
Local Registrar Date Issued
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H105.143 REV 11/2008
TYPE /PRINT IN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEA
'
PERMANENT
BucK lwc LTH • VITAL RECORDS
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CERTIFICATE OF DEATH
(See instructions and examples on reverse) ~ • ~
1. Name rn Decedent (First middle, last, suffix) STATE FILE NUMBER
Mary Elizabeth EiChhorn 2• sax
Female 3. soael Security Number 4. Data of Deam (Monet, day, year)
- 5. Ape (Lest Birtlldey)
89 yrs
urxbr 1
"bm~
r
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under 1
H
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6. Dare a Birth Month, de , r
7. BI ana were a
ceu 578 - 32 - 5010
ee
Piece rn Deem ch
c Au ust 20, 2011
.
Y
Wrs
Jan. 25, 1922
Cohasset, MA .
e
k one
Hospital:
)
`
rs.
!!b. County a Deem
•
8c. City, Born, Twp. of Deem
~• F
acdity Name (lt not kremutron, give street end number) Deter:
^ InpeOent ^ ER / Outpatient ^ DOA ®Nuraing Home ^ Residence
^ Omer
1 Cumberland S . Middleton Twp. Cumberland Corssings Retr . 9. Wu Decedent of HispeMc Origin?
(lt yes, spedfy caben. ~ "~ ^Yes 10. Race: American Indian, Bleclc, white, ero.
• 11. Decxdent'a Usual Lion Kerd rn work done
Khd a work
du ' moat rn Ilte. Do na stale re
12. Was Decedent ever In the
13. Decedent's Educadat (Spedfy qtly Ngtrest
rede cont Mexican, Puerto Rican, ero.) (~~ White
b
d
Admin. A5S].3taflt
Kind rn Busirtees /Industry
US Government
U.S. Armed Forces?
^ Y
®
Secatdary (D-12)
Elemen 1 1 g
p
y
)
Coflege (1.4 or 5+) 14. Merflel Status: Marled, Never Married,
Wkbwed, DNorced (SP~NI 15. Surviving Spouse (It woe, give maiden name)
• rus rg~ /town, state, zip code)
18 Of1~~"rt9~pr ,~y W'd~7
S L ea
Ne
Decedents 2
Di WidOWed
• Carlisle r PA 170
15 d Decedent
Actual Residence 17a.State PA uveina South Middleton
n.,.~~ Township'+ 17c. ®Yes, Decedent Lived in Tw
Cumberl
d
' p
an
17b. County
17d. ^ No, Decedent Lived wlthin
18. Father
s Name (Frst middle, fast, suffix)
Patrick Tenney Acual Limits rn CirylBoro
18. Mother's Name (First middle, makkn surname)
2oa. lntgmant's Name (Type /Print) Rose James
Kathy Wilson lob. Informant's Meiling Address (Street dry I rown, state, zip code)
21a. Method of Disposition
•
^ Cremation ^ p
g
21 b
D
501 Garland Drive, Carlisle, PA 17013
°
^ Burial ^ RemoveliramStare gg
on
~ wu «Dorte6onatdhorl:ed
E=eminer/Cororte
? ^
^ .
ate of Dispwifion (Monet, day, year)
Aug. 23, 2011 21 c. Place of Diaposltron (Name of cemete cremaro q Deter ace
St. Patrick Catholic Chur
h
21d.Location(City/kwm,state,:ipcoee)
• •
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22a. Signelu Funeral Se q person actirxl u such) Yee
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22b
Lk:ense N
umber c Carlisle, PA 17013
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138504 22c. Name and Address of Facility
Hoffman-Roth Funeral Home & Cremato
0"~a !~ 23ac tx+rdtylrx~
plryaiden m rrot availede time rn deem ro
cerely ease of deem. 23a. To the best of my know(edge, deem occtmed at the time, date and place stated. (Si~ahxe and tlde)
~! J 23b. L~enae Number
~i~ < ;y
ear
SI~ (
n
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flame 2426
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24
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~Y, Y
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mus
me o
eem
be completed by person
wAa pronourrcas daa6r. //-~~~ ~ M
V ~ -
25. Date Pronounced toad (J~Aonm, de year)
~ .~ /~ 26. Wes Case Referted to Medical Examiner /Coroner iq a Reason Other man CremaBOn or Donadon7
( ~ if / ^ Yea ~ No
CAUSE OF DEATH (See Instructions and examples) r Approximate interval:
Item 27. PaA I: Enter me dteirt of events -diseases, injuries q complkk~tions ,mat dam, cawed me deem. DO NOT enter terminal events such as cardiac artest r
respiratory crest q ventricular fbntla8on witfatd stewing Ote edorogy List pMy one cave pt each line
Onset to team Pan II: Enter other sldrlifkent rxxdiflons mnhiM~snc to deem 28. Did Tobacco Use Contribute to Deam?
but not resulting in me underlyin
caus
i
I
P
. i
IYNEDIATE CAUSE Fetal dsease q r
resulting in beam) ~Gjt yet o~ c q g
e g
ven
n
ert I. ^~yes~^ Probably
L"f No ^ Unknown
_~ e. r
3 tc.rat..(Ss [
~f(~ ~/Yo~~J 29
IIF
Due to (or as a consequence of). r
bt mrxitlons, fl arty, b
i .
pregnant wMkt
i Not past yur
.
Erxar bUNDEYNN3 CAl1SE a Duero q u e r
( ~oneegaer~ca eQ: , ^ Pregnant at time a deem
resttltlrtg~ ~ p$ ~ c. ~ ^ Na Pregnant but pregnant wimin 42 days
Due to (q u a consequerx» of): r
d. i
a deem
^ Nrn pre~anl, but pregnan143 days ro 1 year
30a. Wu an Autopsy
Performed?
30b. Were Aulopey FYxirgs
Available Prig ro Completbn r
31. Manner of Dum r
32a. Date a Injury (Monet, day, yur) 32b. Describe How Injury CCarrted' before deem
^ Unknown p pregnant wlthin me past year
,~, /
^ Y L~
rn cause rn Deem?
^
" ^ ^ I~omblde
^ A 'd
^
32d Time f I ' 32c. Piece rn M)ury: flortre, Farm. Street Factory,
Olfxe Bu6ding, etc. (Spapyyl
en
tie No Yes ^ No ~~ t Pending Irwubgetfon o nlml' 32e. Injury et Work? 32f. If Trensportadon Injury (SpealyJ 32g. Locaton rn injury (Street, city /town, stale)
^ Suicide ^ Couk1 Not be Determined M ^Yes ^ No ^ DrlverlOperetor ^ Passenger ^ Pedestrian
33a. Certifier (check ordy one) ~& - Spedly.
• GYMS PhY•~+ (PhYslaen certltying cause a deem when another 33b. signet a rme pf serener ,/
To the bat rn my knowledge, dam oxunad due to tM a ~~~~ ~ p~'~ deem and cgnpbled Item 23) ( /: _ ~ 1 ._ // /~~ /2i,~-,/~.~ ~ ,y~ AAI~
• use(a)andmannarustatad--------------------------------- - (i(~'c• f["Xl CG-vt('~-/~~ Iv..~4
Prorwuncing end certgytng t*rskfam (Phyaiaen born prgwundrg deem emd cordfying to caws of deem
w To tM beat of my knowlsdga, deem oaumd at the rime, date, and place, end due to the ) - ^ 33c. me mbe~ ~ ~ ~ ~ ~ ~ 33d. Date S' (Mon Z Year)
° • Medcal Examner/Coroner cease(s) and manner u atsted_ _ _ _ _ _ _ /J / J / ,,.., •
5; On the bas4 of examinadon end / or Invesd bn, In - - - - - - - - - - ~ (,/ `~~ 2 ~~/
° gat my opinion, death occurred at the time, dab, and place, ant due to tM cauee(a) end menrar tie stated., ^ 34. Name end Address rn
o Who Completed Cause a De
~, 35. Registrar' re erb 5n1 UC•rnZ7) Typd/ Pdnl
~-~~ l~,-L~-L~-~l~.J ~L - ~~•fc /~'lx~ct,~,, Ivficj']aeJ, McLaughlin, MD
~ - ~ _ ~- r~C , Date Filed (Monet, day, year) ~Eark Ave .
Disposition Permit No. ~ Co. ~ Q ~.~
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LAST WILL AND TE ~~ ~
STAMENT ~ } ` _~
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I, Mary E. Eichhorn, of South Middleton Township, Cumberland
County, Pennsylvania, being of sound and disposing memory and
understanding, declare the following to be my last will and
testament, hereby revoking any and all wills heretofore made by me.
Item I. I direct my executor hereinafter named to pay all my
debts and funeral expenses.
Item II. I hereby give, devise and bequeath all my property, real
and personal, to my children; Theodore, Patrick, Kathleen, William,
Dorothy, Mary and John in equal shares. If any of my children should
predecease me, then, their share shall go to the issue of their body,
per stirpes.
Item III. I hereby nominate and appoint Patrick R. Eichhorn, to
serve as executor, and direct that said individual be permitted to
serve without bond. In the event he is unable or unwilling to serve in
said capacity, I hereby nominate and appoint Dorothy Basehore to
serve in said capacity without bond.
In Witness Whereof, I hereunto set my hand and seal this _ ~~`~' day
of 1993.
~; , ~ ~
;.
Mary E. ichhorn
Signed, sealed, published and declared by the above named to
as and for their last will and testament wh stator,
o at their request, in
their presence, in our presence, and in the presence of each o
have hereunto subscribed our names as att ther
esting witnesses:
s
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We ,and ~_
~-- t h e
witnesses whose na s are signed to the attached or fore oin
instrument, bein dul g g
g y qualified according to law, do depose and say
that we -s~~ere present and saw the testator sign and execute the
instrument as their last will, and that it was signed willingly and
executed as their last will and that it was done freely and
voluntarily for the purposes therein contained, that each of us in the
hearing and sight of the testator signed the will as witnesses; and
that to the best of our knowledge, the testator was, at that time, 18
or more years of age, of sound mind and under no constraint or undue
influence.
~~
Sworn to and subscribed before
me this ~ day of A~~._.., 1993.
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Notary
NOTi4R1A1. SEAL
MtM M. CoM, Nowry PubNa
Ba+0. Cwnberl~nd Qoway
Canmbstnrt 14, i~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
1, Mary E. Eichhorn, whose name is signed to the
foregoing instrument, having been dul attached or
y qualified according to law, do
hereby acknowledge tha# I signed and executed the instru
last will, that I signed it willing) and th ment as my
and voluntary act for th y at, I signed ~t as my free
e purposes therein expressed.
;, , ~, ~~ ~
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Ma E. ichhorn
Sworn to and subscribed before
me this ~ day of ,-~~-~--~._._
~,..,. r, 1993
~ ~._.
Notary
NorA~r. sou.
Anus M. Cod, Notary Public
C~rfisls ~ Cun~rland Counttr
~~~ Jut t4, #893