HomeMy WebLinkAbout10-03-11
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PE1'~~jYLVA~A ~:~ ;~'=;
REGISTER OF WILLS ~~c, ~ ' ` t'
PETITION FOR PROBATE AND GRANT OF LETTERS ~ ^' ~~ ~ t -
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Estate of Lorraine A. Goforth ,Deceased ESTATE NO. 21~ "`-' ~ ~ .-, " -
a/k/a: SS NO: 165-3$ 0890 ` ~ ~~
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Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLE'FE'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 under
the last Will of the above-named Decedent, dated 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(8):
O B. Grant of Letters of Administration
(If applicable, enter d.b.n., pendent Iite, durance 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(8), except as follows:-
Name
Address Relationship to Decedent
Donald R. Liddick 3 Pine Hill Road, Enola, PA 17025 Brother
David Liddick usquehanna Avenue, Apt 204, Enola, PA 17025 Brother
Wayne Liddick P 3139, 1111 Altamont Blvd, Frackville, PA 17931 Brother
l''SE ADDITIONAL StIEF.TS IF NECESSAR1'
THI5 SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland Cotlnty, Pennsylvania, with his/her last family or principal residence
At 6007 Mockingbird Drive, Mechanicsburg, Hampden Township. PA 17050
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then 65 years of age, died 7/22/2011 at Harrisburg, PA
(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 Personal property in Pennsylvania $
[f not domiciled in PA Personal property in County $
-Value of Real Estate in Pennsylvania $
Total Estimated Value $ ~C7i? A.00
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Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Name(s) & i~tailing Address(es)
Signature(s)
73 Pine Hill Road, Enola, PA 17025
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action b}' the Court Page I of 2
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OATH OF PERSONAL REPRESENTATIVE n ~~~
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Commonwealth of Pennsylvania SS ~~ m , ~
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The Petitioner(s) herein named swear or affirm that the statements in the foregoing Pe~tlon are tr~ile
anc~~ C-t-a,
correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representativ~'(s ) of the
Decedent, Petitioner(s) will well and truly administer the estate according to law.
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Estate of Lorraine A. Goforth ,Deceased File Number: 21- ,~_-~C~
AND NOW, this I ~ lda of
Y ~~ (T ~C~ C ~.1 ~G~ I o~ , in consideration of the Petition on
the reverse side hereon atisfactory proof having been presented before me, IT IS DECREED that Letters
___Testamentary ~ of Administration are hereby granted to:
(If applicable, enter c.t.s., d.b.n., d.b.n.c.t.a., etc.)
Donald R. Liddick to
the above estate and that instruments(s) dated described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
Glenda Farner rasbaugh, , -..-' ,
Register of Wills -~ ~ ~`'(C~~' ~C~ G ~~
DECREE OF PROBATE AND GRANT OF LETTERS
FEES: Signature of Counsel Required to Enter Appearance
Sworn to or affirmed and subscribed
Letters ....................$ ~~J~ ~~,`;
will ........................
Codicil(s) .................
(~j) Short Certificates c9 ~ ~
(I) Renunciations....... !) - ~ )
Bond ............................ V
Other ............................
.................................
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.5_0
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TOTAL ................$ X8:-56--
Atty's Signature
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PRINTED Name: Steven R. Snyder, Esquire
Supreme Court ID No.: 90994
Address: 155 South Hanover Street
Carlisle, PA 17013
Phone: 717-241-6070
FaX: 717-240-6878
Interim Form RW'-02 reeised 1226.10 by Cumberland County pending action by the Court
Page 2 of 2
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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 1772331
"Chic is to e:ertify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me a~ Local Registrar. The original
certificate will be forwarded to the State Vital
5 Records Office for permanent filing.
C ~ir~~~t+~•c~e~~a~c° JlJ'~ 2 2011
Local Registrar Date Issued
Certification Number
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H10S7e3 REV 112008
TYPE t PRINT IN
PERMANENT
BUCK INK
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
fSee instructions and exemDlss on revaraeY
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1. Nacre d Decedent (Fret, nedde, 4e1, aaaNl 2. Sea 3. Burial Secuay Number ` . 14 . V.^ d. e a (M«dh,
Lorraine A. Goforth Female 165 -38 - 0890 Q~~
9. lee (t.a elmn.r) antler i under 1 B. Dale a Btrm Momh, T. ana alaM « Ba Pence a Deem crux ar
Mdr• Den Haas Mnnes H~ospit/al Omer:
65Yre. Dec. 15 1945 Mechanicsbur PA Ll~l'~padant ^ER, ou~atiea ^DOA ^
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axg Home ^Raitleme ^Olher. BPaciN:
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af. Coumy d Deem m, Tvq. d Daath 8d. FedHly Name QI nd bsmutlm, g6e abeet arM number) 9. Wee Decedent d fYePeak Origin? lJUag ^ y~ 10. Race: American Mden, Black, WKile, ek.
(II yea, elydly Cuban, (Spea'M
Dauphin Harrisburg Harrisburg Hospital M.ab.^.PaamRKan,a~.) White
11. Decedent's IlNgl Kintl d work done mat d Ile Da not eteb re 12. Wee Deudenl ewr F tlr /3. Decedenra F.Mcetim (3padty oar higheel grade anglebd) 14. Meael Srlm: Menfeq Never MertieQ 15. SuMrng Spouse (Ii wile, gNe mdden dame)
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18. Fetlrra Name (Fuq, netltlk, teal wMx) 19. Homers Noma (Fret, middle, mdden eumeme)
Helen L. Scott
20e. Mdomrnys Name (Type / Pdnn lob. InlamenYS MaNFg Adhess (Sheet oKY / tarn, err, »D code)
Donald R Liddick
21a. Memod of OhpoNtlan ®CnMim ^ Danetim 216. Dtle a DlapoNtim IMaah, day, year) 21c. Race d
DLyoeBbn (Name dcazueary, aemebry a dfrr place) 21d. Lmatlon (City/bwn, stare, zq mtle)
^ BudY ^ Removalfrom Bmr i
Wee Cronrtldn«OtxuWn AWMnd
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To UM b.eaa9'ki•rdadg•, deem aaurted Hihe tlme, tleee, erM pra,ur tlusrtlr
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