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HomeMy WebLinkAbout12-02-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of William Eugene Snyder a/k/a: a/k/a: a/k/a: (Irapplicable, enter d.b.n., pendent life, durante absentia, durance minoritate) Petitioner(s) who is/are l 8 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. (co»~~ Part Cxrlso) -~, _ ~ ~r~ander ; ,~ the last Willto thet above?na ed Decedent tdated rementioned Letters and codictl s dated -; ~ ~ -~ • ~~ :;; () L> m I ~~_ rr3 ~ ~.? - (State relevant circumstances, e.g. renunciation, death of executor, etc.) ~ ~"} ~I } _~ Except as follows, Decedent did not many, was not divorced, and did not have a child born or adopted afte~e~cutton oft}te -- ~- instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated pei~on, and wa~tot a ~:~^, r_; party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in ...T' 23 Pa. C.S.A. § 3323(8): ~ B. Grant of Letters of Administration 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 (lf 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(8), except asfollows:- Name 6/18/2011 (Month, Day, Yeaz of death) Eileen S. Snyder , 05 Black Latch Lane, Camp Hill PA 17011 <ce~auunsm co uecea Spouse Thaddeus .Snyder 68 Holyoke Road, York PAa 17402 SOn Nathan Snyder 12 Bartlett Avenue, Dallastown PA 17313 Son Jason Snyder ~;cc ennrr.~wr,.r crrrr:-rte. 9 Crestview Drive, York PA 17402 SOn ~i.r~r, an r_r,. ~ .r i~r,L r, IJAKi Harrisburg Hospital, Harrisburg PA THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 405 Black Latch Lane Camp Hill PA 17011 Lower Allen Township (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 61 years of age, died Estimated value of decedent's property at death: If domiciled in PA _ If not domiciled in PA _lf not domiciled in PA -Value of Reai Estate in Pennsylvania (City and State where death occurred) All personal property $ 37,000.00 Personal property in Pennsylvania $ Personal property in County $ $ 140,000.00 Total Estimated Value $ 177,000.00 Deceased ESTATE NO: 21- {, - {~~~ ~aa SS NO: -42-5393 ent Location of Real Estate in Pennsylvania: (Provide full address if possible.) 49 Crestview Drive, York PA 17402 ,mot Signature(s) ~ `' Name(s) & Mailing Address(es) Eileen S. Snyder, 405 Black Latch Lane, Camp Hill PA 17011 Inb,.~... F..r.., Dl1r M .... ~a t 7 1c _ x~ ~< <~ ~~r ~,y ~wnoeuana ~ounry penning acuon by the Lourt Page I oft .~ t" ,, ~ ~ , , OATH OF PERSONAL REPRESENTATIVE {`t .-. ':t~ ,. i_'1 Commonwealth of Pennsylvania }.~ ' "'~^ ~ , County of Cumberland SS ~'~ ~~ '- '• .;- v~ The Petitioner(s) herein named swear or affirm that the statements in the I'oregb`itT~ Pek~~~orP~re 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 , ~~~~~t_ efore ethi ~ ~~~ ~~l~y of ~ ------_ / ____ t ~n t P R r<;~ro.. DECREE OF PROBATE AND GRANT OF LETTERS Estate of William Eu ene Sn der I.~ ,Deceased File Number: 21-__~_____ AND NOW, this ~-~~ the reverse side hereon, satr f tory proof havm bed en ~esen ~ j f ~ to consideration of the Petition on -Testamentary x of Administration g p ted before me, IT IS DECREED that Letters (If applicable, enter ct.a„ d.b.n., d.b.n.c.ta., etc.) are hereby granted to: Eileen S. Snyder the above estate and that instruments(s) dated to admitted to probate and filed of record as the last Will and Codicil(s) of Decedent ribed in the petition be Glenda Farner Strasbau h r ~~' ~ g , C~,~,~ Register of Wills ~. FEES: Letters ...... ..............$ 260.00 Will ....... ............... .. Codicil(s) ................. (4) Short Certificates 16.00 (3) Renunciations....... 15.00 Bond ........................... .. Other ......................•----•- Automation FE:E......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ 319.50 Signature of Counsel Required ter Appearance Atty's PRINTED Name: Wanda S. Ware Supreme Court ID No.: 41705 Address: 212 North Queen Street Lancaster, PA 17603 Phone: 717-299-3726 Fax: 717-299-1811 Interim Form RW'-OZ revised I?.?6_ l0 by Cumberland County pending action by the Court Page 2 oft LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~~ee °~x this cert;fieatt ``;6.00 P 17514402 Cet~tii~icattion i~urnber ~I~hi~ i> to ~~;:i~~ !h.u the ini~~(~Inzui;rr t~ler~^ riven i ax~rectl}~ ~f?)~iL ~ ~rt~n: Dui t>I-i~~inal C~eliil~i~ate ~f Dead dtliv f~lai •,~iti? I `,L~ a~: Lural Ke;~i,tiar, The ty/~i~~ina te1-tsficat~ ~„~ ~ ~~~ icln~~~udet~t do the StLlte Vita ~ ~Re•czTr~l~ Off~ir:~ i it ;~ennanent I~ilinr. L,Lrc~(1 l~ttf ~I~iL,,l~ 1>ar~~ ltisue;~ ~`,_x? C7~ _.,_, , -~-, ~~ C? ~~ , -~,~ r- ~ r> ~-~-- ~ t^.> -- <;~; ~ _} Ca "~'~ .s _ etas-t43 REV tlrzoos TYPE /PRINT IN PERMANENT BLACK iNK .1 ~I z COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ~'° --rT CERTIFICATE OF DEATH C4 (See instructions and examples on reverse) STATE FILE NUMBER 1. Name of Decedent (First, middle. last, suffix) 2. Sex 3. Social Secunry Number le or DeaN (MmN, ar) ~ (, • hkr.Pe 201 - 42 -5393 ~ 4~ 5 Age (Lass BiMdayl Under 1 ear Under 1 as 6. Date of BiM Month, da , ear 7. BiM lace Ci aM sUte or forei n count fie. PWce of Death Check onl one Montns Days Hours MnMes Hospital: Other. G 1 Vra. Apa,ie 24, 1950 G ebu PA Inpatient ^ ER /Outpatient ^ DOA ^ Nursing fiane ^ Residence ^ ONer -Specify: Bb. County of Death Bc. City, Boro. Trop. of DeaM Bd. FaciNry Name (If not institution, give street aM number) 9. Was Decedent of Hispank Orgin? ~ No ^ Yes 10. Race: American Indian, Black, White, el (If yes, specity Cuban, (SpeciM Ha7i/I.(/JbU~ ~Mwc Hanlf.(/buncl f10epltr~P Mexican, Puerto Rican, etc.) Decedent's Usual Occu ation Kind of work tlone du' most of wo Nie. Do not stale retired 17 12. Was DecetleM ever In the 13. Decedent's Educatbn ISpeciry only highest grade Wtnpleted) 14. Marital Status: Martkd, Never Martie4 15. Surviving Spouse (p rode, give maiden name) . Kind of Work Kind ol8usiness/Industry D ivo rc ed lSpeciy/ r U.S. Armed Fo ce s? Elementary /Secondary (012) College (1-4 or 5+) Widowed, n' Sa,ePrS Can~.tnuct;inn SuppP,i.eh . ^ .` .y JJ r y ~ ^ Yes YJ No 1 ~,V4l.C1L F.c.P.een .S. ~{w•Y-'~~n , sale, zip cgle) l la wn A dr ess (Sh~ul . a ty tti. Un:wkrids Matl~ny J Uecedanl's UiJ Decedent PA Llve in a 17 d i ®Y D d t Li (JU1Piz A P POH TfA ~ n T nD ~_ ~~ n0 ~_ , r ~ l~ ' ' 405 ~'.tC 1ttteh 1n . . * - c. es, ece en ve n wp Actual Residence 17a. State Township? nt Li ithi 17d ^ N D d tl H.e.Z2, PA 17011 ve o, ece e w 17b County rrm76Pn Pond Actual Limits of n CAyl Borc t6. Father's Name f Flrsi, middle, last suKx) 19. Mother's Name (First, middle, maiden sumartre) gee Jacob den Dofiis F.~izabeth • 20a. Informant's Name (Type I PnnQ 20b. Informant's Mailing Address (Street city /town. slate. zip code) Efkeen S. den 405 BPncfz Latch 1n H.iX,P PA 17011 21 a. Method of Disposition ^ Cremalbn ^ Donation 21 h. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or oUer place) 21 d. Laation (City I town, state, zip code) Burial ^ Rertwval from Stale r Was Cramatbn or Donation ANhorimd ^ • ^ Other ~ S r M' Medial ExaminarlCoroner? ^Ves No June 23 2011 , Re~.t Huven Cemet Hanovetc PA 17331 lcen (orsuch) w 22a. Sgnature of Funeral Se 22h. License Number 22c. Name and Address of Facility ~ 013564-L Inc 302 L UJ Feihex Funetuz2 Home W New Ux <ond PA 17350 ~ ~ , . . . , , Complete items 23a-c Doty when certifying 23a. To Ore hest of my knowledge, death occurretl at Ne time, tlate and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year) physician is not available at time of death to cenity cause of deaN. Hems 24-26 must be completed by person 24. i 7 D N ~ 25. Date P need Dead (Month, day, yea A / 26. Was Case Referred to Ical Examin ^ er I Coroner for a Reason Other than Cremation or Donation? who pronounces tleath. ~ M, V / Yes 0 CAUSE OF DEATH (See Instructions a examples) r Approximate interval Pan II: Enter other s an front conditions cantnbutin q to death 2B. Did Tobaso llse Contribute to Death? Item 27. Pan 1. Enter the chain of events -diseases, injwies, or cortplirations ~ Nat directly causetl the des NOT enter terminal events such as cardiac arrest, r Onset to Death li but not resulting in the underlying rouse given k PaA I. ^ yes Probably ne. respnatory arrest, or ventricular fibrillaban t snowing Ne etiology. List mly one rouse each ^ Unknown IMMEDIATE CAUSE (IFinal disease or r If Female: condition resulting in deaNl _ ~ a i N t n t Ml t Due to (r nce of ~ t 55ee~g entiaNy list contlitions, it any, b preg an w n pas year o ^ PregraM at dme of deaN ^ leading to the rouse listetl on line a. pue to or as a copse uence o Enter the UNDERLYING CAUSE ( q ~~ Not Pregnant but pregnant within 42 days d tleaN (disease or injury Nat initiated Ne c t ^ N b events resulting In death) LAST. ' Due to (or as a consequence oq: d pregtant o ut Pregnant 43 days to 1 year before deaN ^ Unknown 4 pegnam wiNln Ne past ear . y 30a. Was an Autopsy 30b. Were Amopsy Findings 31. Manner of DeaN 32a. Date of Injury (MOnN, day, year) 32b. Describe How Inlury Occurretl 32c. Place of Injury: Home, Farm, Street, Factory, PeAOmwd? Available Prior to Completbn of Cause of DeaN? ~~~~ lldNatural ^ Hankide Ogice BuiUing, ek. (Specify/ ^ A«idant ^ Pending Investigation 32tl. Time of Injury 32e. Injury at Work? 321 II Transponatbn Injury (SpecAy1 32g. Location of injury (Street, city /town, state) ^ Yes ~.f0o ^ Yes ^ No ^Ves ^ No ^ Driven Operator ^ Passenger ^ Pedestrian ^ Suicide ^ Could Not be Determined M ^ Omer -Specify: 33a. Gunther (check only one) 33b. Si9nawre and Titte of Ce fie • Certifying phyeklen (ftlrysiuUn cmlityng cmuo nl Ooalh wMn Wkldler physkiun has qunuutcod Uuulh orb catpkrlud Ilum 231 ^ deaN occurted tlue to IM ceuee(sl and rrunner v salted knowled be t f m e T th ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ y g , o e s o • Prorauncing sod cenity4rrg pnysklan (Pnysklen boN pronormckrg deaN and ceniying to cause of deaN) y kense plDml~ ' / y ate Signed (Mon To iM best of my knowledge, death occurrM at the tirtw, dale, and plan, arM due to the caucu(s) and manner as etated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ i lC onx • M dk l E ~ ~ ~ z ~ - Q ~0 / / ner or e a xam On the W eta of examirution aM / or inventi albn, {n m o inlon, death occurrM at the time, dale, and place, and due to the cau and manner as stated_ ^ 9 Y P ~(c) 34 ,, q ~nd /tlr of Person W om late of aN ~ ( p~ T ,,~~ng1J. yn~/ /~ / j ~ ( ~ (Y Cix V / n ~ / !N / ~/ V - Data Fi (MonN da ear) 36 ~ / ~ T 35. is Signature orb Disumber -/ ~.~,QS I ~T I I I L? I t? (.j I • w,. u I -~ V ~ , y, y . Q C~ ~ .20 / l ~~ ~~J ~ ~ ~ q GI.dCJL.. ~~ / / t- Disposition Permit No. ~f~ r5~1 ~ . ~. F~t` f '_ ' (-' 1 _ . ,. ' d RENUNCIATION CL~~~C C~ _ ~ ,n REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of William Eugene Snyder Deceased ~~ I, Thaddeus,je'Snyder , in my capacity/relationship as (Print Name) Administrator/Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Eileen S. Snyder >l/ z 1 ~ ~ (Dale) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills ___~~'/ -- (Signature) ~ ~3~~s/~lt,,~r~ ,,~- (Street Address) //~~ ~~4 /'4 ~ ~ y'v Z (City, State, Zip) 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 sf day of ,~y~ h C! ~ / / Notary Public My Commission Expires: (Signature ar$(9Eell~KiMIIN~I~LdFbt~!Fr administe oaths. Shuw date{r5®e6i ui'Notary's Co mission.) Lana F. &enneman, NaRary Public Manchester 7wp., Ycxk county CAmmissWn Expires Oct. 19, 2014 Member. PG!nn~?~brsfi. A~'~d.aCler~ e•f r~c?fi~riE~~ Form RW-06 rev. 10.13.06 '~~ ~~f" ~_.> `~ .. ~_.,l RENUNCIATION REGISTER OF WILLS CUMBERLAND ULE~' ~~~ GRPF{~,~1'~ ^~^ w Cl~~r"f~~f't ~ ~J 1' ~ ~p/' COUNTY, PENNSYLVANIA Estate of William Eugene Snyder Deceased I, Nathan Snyder , in my capacity/relationship as (Print Name) Administrator/Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Eileen S. Snyder _~ _c-- (Date) (Signature) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day 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 purpos s stated within on this i ~ ~~ day Notary Public My Commission Expires: (Signature and Sea! o; Notary or other official qualified to administer oaths. Shov<~ date of expiration of Notary's Commission.) Form RW-06 rev. IOJ3.06 ~~ 1, ~~ ~f~~r t.~/~ (S/tJ/r'e~et Address) ////J S (City, State, Zip) COMMONWEALTH OF PENNSYLVANIA Notarial Seal Lana E. Brenneman, Notary Public Manchester Twp., York County My Commission Expires act. 19, 2014 M9m~r r~Fa+%nra,~l..ro~~3 1<enriafinn of Nntarie~ ~, . f 1 ;t -'..., _. RENUNCIATION .+~ ! ~~ GLr~~ ~~ REGISTER OF WILLS ~~~~~~;~~`, f ,~~; ~_ ~ ~TpA CUMBERLAND COUNTY, PENNSYLVANIA~`'l~`r~-~?! :, ;, . ,, ; Estate of William Eugene Snyder ,Deceased I, Jason Snyder , in my capacity/relationship as ("Print Name) Administrator/Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Eileen S. Snyder (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this /5~ `'~'~' day of~~'~i~ bey z~ it . Deputy for Register of Wills (Signature 9 CreS~Ul ~ W > ~" (Street Address) ~~~~~ ; ~~ 1~7~C)~ (City. State, Zip) 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 ~S~` day of 7'~~~c~ 1~- z D l l Notary blic My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date ofexpiration of Notary's Commission.) coMMONwEALTM of PENNS~.v~w~ Form RW-06 rev. 10.13.06 Notarial seal Lana E. Brenneman, Notary Public Manchester Twp., York County My CommisslOn Expires Oct. 19, 2014 Member. P?~~Nhtanla Acscxiatlon of Notaries