HomeMy WebLinkAbout11-07-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANi IA
Estate of Mabel M. Mitchell File Number 21 - j~ (',~(~~-1
also known as
,Deceased Social Security Number 578-24-8866
John L. Mitchell
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or `8' 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 and codicil(s) dated
Charles J Mitchell and T Donlev Mitchell two of D '' +'° ~^^~ have renounced their right to administer the Estate in favor of John L.
Mitchell. one of the Decedent's sons.
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 life; 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: No Exce tions ,
;^~ «:__. -ice
Relationship Residence ° ~
Name ,.
Charles J. Mitchell Son 602 Lake Meade Drr$e-'~' ~`~ _:.:
r--
East Berlin, PA 1736=9 m ~
John L. Mitchell Son 934 Woodridge Drive,` ' ~_
.-
PA 17 --' } _
T. Donley Mitchell Son 335 4th Street --''~_~~ ~~ _ -r;
N C m rl P 7
-- ---,
(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
___ .. ... ~.__~_ ~_..a n....n~hr.rn Tnwnchin Cumberland Countv. PA 17025
(List street address, town/city, township, county, state, zip code)
934 Woodridge Drive, Enola, East Pennsboro Township, Cumberland
Decedent, then 100 years of age, died on ~5I29/2011 at County PA 17025 -
Decedent at death owned property with estimated values as follows: 11,600.00
(If domiciled in PA) All personal property $ -
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
Total 11,600.00
situated as follows:
rLy
None
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
Signature Typed or printed name and residence
John L. Mitchell 934 Woodbridge Drive
~~_, ~~ „ ,~ Enola, PA 17025
~ ~7 ~I ,--~~- Goa-~ (717) 732-9163
Form RW 02 Rev. 12-26-2010 (interim form, pending acfion by the Court) Copyright (c) 2006 form software only The Lackner Group, Inc. rage ~ u. ~
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
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 and subscribed
`l ~ ~ da of
before me this Y
~~1 - - t ~~~~~ L,
Forth Register
Signature of Personal Representative - ~ ~~
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Signature of Personal Representative ~ ;xt
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File Number:
Estate of
Representative John L. Mitchell
21 ' ~+-
nnanPi M_ Mitchell
Social Security Nu~`m1'ber: 578-24-8866 Date of Death: 05129/2011
AND NOW, r ~ f1~ 1 ~~~ N~ Vf' lY1 ~"7~Y" ~--~ (~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to h L 1 in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES / ~ ,-, .-..~
Letters .......................................... $ C Q 1 !~ . ,'~ .~
~/ ~
Short Certificate(s) ....................... $ ,~t ( %, ~~~L.
Renunciation(s) ............................ $ ~ ~~, (_~'~~
`_ ,.
$
$
Att
Supreme Court I.D. No.: 205966
Bogar & Hipp Law Offices
Address: One West Main Street
Shiremanstown, PA 17011
$
$ Telephone:
TOTAL ................................... $ -i; x . ~)
,Deceased
717-737-8761
Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
Form RW-02 Rev. ro-~s-zoos
Attorney Name: Lauren E BOgar
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
_ _.a ....., ..lee nn rnvnrewl _. ~.. ~ .,, ,..nom.,
2. Sex 3. Sadal Security Number 4. Date of Deam (MOnm, tlay, year)
suflx)
last
t (FrsL mire
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d
66 5/29 2011
,
.
en
ece
i. Name o
Mitchell Female 578 - 24 -88
Mabel
1 Urrtler t d0. 6. Date d BiM Monm, d0. , e 7 Birth ce C 0.M state or lorei ceu 6a. Place d Deam Check one
U t
er
5. Age (last Bldhtlay)
Hospital: Other
Months DeYa Han Mnutes
4 / 7 / 1 91 1 B e 1 f on t e , P A ^ tnpatrera ^ ER y ougatiam ^ DOA ^ Nursing Hane ~7 Ras;aenca ^ omar spadM
1 0 0
Yrs. ? 10. Race. AmanUn Indlan, Black, White, etc.
6b. County of Deam &. CM• Bao, Twp. of Deam etl. FacPiry Name Qf not insHtuOOn, give sneer and number) 9. Was Decetlent of H'epank: Odgin. ~] No ^ Ves
(d Yes, sPecdY Cuban, (SpeCilyri
Mexican, Pump Rkan, etc) Wh 1 t e
Cumberland East Pennsboro 934 Woodbridge .Drive
Ne maiden name)
6, vide
i
5
s
wrg
pouse
. g
urv
e ado ppmplered i4 MariW Sbtus Martied. Never Mametl ,6
Decedents Usual tan Kind of work tlona Bunn most of workin Ire. Do Trot stare retired t2. Was Decedent ever in me t3. Decedents Etlucadon (Specity mN high s gr Witlowetl ~ (SpeciyJ
1 t
'
.
+ Elementary I Secondary (0.12) Cdlepe (1-4 or 5«)
Kind of Work KirA Of Businessl Industry U.S. Amwd Faces
2 Widowed
Nurse Medical ^ Yes ®t~
Decedents DitlD~"' rv East Pennsboro
P e nn s v 1 v an i a Live re a t 7c. L4Yes, Decedent Lrvetl in TwP
Decedent's Malting Address (Sheet, city I town, sate, zip Cale)
t6
.
Actual Res~tlerrce 170.. State
934 Woodbridge Dr-'tee Cumberland T~"ns"'°? t7d'^"°.Dacadan'u°aawa"'n
f CM1yI Boro
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l li
s o
ctua
m
17b. Counry
Eno 10. P A 1 7 0 2 5
tg. Moltrefs Nano (First, mitldle, maiden surreme)
s.FamefsName(Flrst.midae,lasesulfix) Annie M. Donley
Geor e C. Kramer
rnde)
t
t
i
I
200.. InfortnanYS Name (Type I PrinQ e, z
p
town, s
a
20b. InfomranYs Maitirg Addess (Sheet, dry
934 Woodbridge Dr. Enola, PA 170
John L. Mitchell
aaY Year)
Date of Disposition (MOnm
210 21c. PWCe of Disposition (Nacre d cemetery, crematory a dha Dom) ltd. Locaron (City I [own, state, zip code)
,
.
21 a. M~~~e,lmlotl of Dlsposaion ^ Cremation ^ Donai'wn
tsy Burial ^ Removal hen ~ Was Crernelbn or Donator ANhozlzed
IExamirroryceranel! ^ves^N° 6/4/2011
('aj[Ip ~ 1 701 1
Rollin Green Memorial Park Hill PA
^ Dina
'as such) 22b. License Number 22c. Name 0.M Adtlress of Fadkry Neill Funeral Hone, Inc
~ 220.. Signature Df Fu cal
3401 Market St. Camp Hill PA 17011
~
`;~.., FD 013239 L
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23c. Date Signed IMpmh, tlay. year)
Uceruse Number
230
/
.
t onN vtren certdy'm9 230.. To nre knowledge. deem ec time, date 0.M place stated. lSk3nature arA inlet
Cornprere items
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~ L M et ~ dG L G 1 I
f deem to
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t ti
il
hk
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7
a
me o
a
physican is ava
wit-~Gf
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carBN r0. of tleam.
Case Pefemetl to Medial Examirer I Corona fa a Reason Omer Than Crenaton a Donation?
26.
O
24. Time of peaj ate Pronounced Daad (MaM, Z y Yrerl
Items 24-26 must be mmplered oV person ! ^1 Yes ~ No
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loam
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.
,
.
wrw prawurv:es
CAUSE OF DEAIH (See lnstruetlone and ezampk~) r Approximate interval: Pan II: Enter other ~ nd nt axreiti x cr++ ~GM1 n0. to tl am 2B. Did Tobacco Use Cannibute to Deam?
en in Part I.
t m Deam bN nd resulting in me untlertying cause 9iv ^ Yes Probaby
O
i
t
nse
ac arres
,
Item 27. Pad I: Enter the chain devents -diseases, injuries, a mmpli®tions - mat dredN caused Hre deem. DO NOT enter terminal evenYS such as card
~ No ^ Unknown
resphatpry arrest, a ventriaAar 6bnlletion with t shoving me etidogy. List anN one cause on earn line.
IMMEDUITE CAUSE IFinal tisease or NY1 29. rlf-F~e/male'.
/ T J ti~ /7- [sue Nd Pregnant wimin past year
~ /%~//C/
in deem)
ditim resultin
.
g
cm
_~ a.
^ Pregnam ar kma d seam
w,e to (or as a conaaquenpe oQ:
^ Nd pmgnenL oN pregnant wimin 42 days
5eo enaalryry ari cprrtli6prw, rf any, b
d death
a
°°,
ng re me cause FateO °^ tare a' Due to (or as a consequence op:
Enter me UNDERLYING CAUSE
^ Not Dmgnanl, but pregnant 43 tlays tp i year
(tl6ease or injury mat initiated the
c.
am
b
f
l
'
e
ore
o
m deaml usr.
evems rewnirg
Due tp (or as a consequence o0:
^ Unkrwwrr d pregnant whin the past year
tl
r
. d Desaibe How Injury Occunetl
32b 32c. Place of Injury: Home, Farm, Sheet Factory,
30a. Was an 0.NOpsY
Pedonnetl? Fndlrgs
30b. Were Autopsy
Available Prbr to Completion ,
31 ~M,a~nner of Deam
'
dd
l ^ H
'N ay, year)
320.. Dale d Injury (Manor, . Office Building, etc. (Speay)
-
/~
of Cause d Deam? om
i
e
aWra
Ly
^ Accident ^ Pending InvesligaHOn
32C. Time of Injury
32e In' t Work?
fury a
32f If Transportation Injury 13D%ytyl
erate ^ Passenger ^ Pedestrian
l O
^ Dr
329. Location or injury (Strcet, city I town. state)
~
,
^ Vas l1Q No ^ Vu ^ No ^ Yes ^ No rver
p
^ Suk:kle ^ CouW Not be Determined M. ^ Oprer - Syxrcily'
'
33b. Signature d Idle of Ceralier
33e- Cemrer (check onN one,
ician cenMlrg cause d deem when anomer physican has pronounced dean 0.M canplered Item 23)
Ph
i
i ~
~ / /
~ ~ //A' ~~~~ ~ -
ys
an (
c
• Certitying phys
To me best d my knowledge, deem xeurted due to the cause(s) antl menrar u stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~. L'icense Number 33d. Date Signed (MOnm, tlay, Year)
• Pronouncing and certitying Dhysicren (Physician boor prorouncirg deem end rartiyirg to rouse of death)
death occurred at the time, date, and place, antl due b the tause(6) and manner as sWed- - - - - - - - - - - - - - - - - - ^
knowledge
d {l _ ~ Z. ~}~ ~~ € 3~ • % ~~
,
my
7o the beat
• Medkal EXamlrrerl Coroner date, and pace, end due to the cause(s) antl menmr as sretad_ ^
in my pplnbn, death occurred al the Hma,
atlon
d / or investl
i 34. Name 0.M Address of Person WM Cortpletetl Cause of Deam 11rem 27) Type I Print
,
g
on an
On the basis of examinat LY1~OU~/lFi/frrAxv' /NHG xi.i -J {~JT)t/t Ulf~sd
35. R Ys Signature acrd District Number. - , j~ I j I 'd I ( I r,~ I 3fi. Date Fibd (MOnm, day, year)
~ /N ~ ~ ~ L, + I y~ `~
7'~ j J OLi i ~y ~ / i~ L/ // C 7r%: y' /~"~+ ~ ~ /t ' j~%/~ ~ L '
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~ ` P V DisposNOn Permit No..,<w /~ ~ / -1 7
RENUNCIATION
--:<<C->
i _ r--
'`;. F rl i
REGISTER OF WILLS ~ - ~ _' "
CUMBERLAND COUNTY, PENNSYLVANIA ~ `- ` ' -
- ~"
i7 ,_,
-.
Estate of
I, Charles J. Mitchell
(Print Name)
Son
Mabel M. Mitchell
Deceased
in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
John L. Mitchell
(Date)
/v-~i- !1
n ^~
(Signature)
335 4th Street
(Street Address)
New Cumberland, PA 17070
(City, State, Zip)
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 ~ 1 s ~ day
of C~ ~~ ~.•x:~r- ~.~ 1 I
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
.~OMNiONWEALTH OF PENNSYLVANIA
Notarial Seal
Bonnie E. Brubaker, Notary Public
Fairview Twp., York County
My Commission Expires Jan. 6, 2013
Member, Pennsylvania Association of Notaries
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of
1, T. D
Mitchell
(Pant Name)
Son
Mabel M. Mitchell
Deceased
in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
John L. Mitchell
~~ ~'~ ~
(Dated (Signature)
60L Lake Meade Drive
(Street Address)
East Berlin, PA 17316
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
NO~Z
DIANE MONTGOMERY, NOTARY PUBLIC
HIREMANSTOWN BORO, CUMBERLAND COU
MtY CQ~~^hr9iSSI0N EXPIRES AUGUST 3, 2013
Form RW-06 rev. 10.13.06
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
purpos stated within on this ~~~~ day
of der- ~~/%
/~
Notary Public
My Commission Expires: ~/:3~~%i
(Signature and Seal of Notary or other official~alified to --
administer oaths. Show date of expiration of ~ ~rgjs Commission.) - ~`~`
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