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Home My WebLink About03-22-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Lettt;rs as specified below, and in support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information Name: LINDA Z. PARTHEMORE a/k/a: a/k/a: LINDA ZEISLOFT PARTHEMORE a/k/a: Date of Death: 3/1 /2012 File No: 21-12- ~ "i (Assigned by Register) Social Security No: Age at death: 52 Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (State) with his/her last prlnClpal reSldenCe at 116 YORKSHIRE DR MECHANICSBURG 17055 LOWER ALLEN CUMBERLAND Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 1t6 YORKSHIRE DR MECHANICSBURG 17055 LOWER ALLEN CUMBERLAND PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania ................................All personal property If not domiciled in Pennsylvania .............................Personal property in Pennsylvania /f not domiciled in Pennsylvania .............................Personal property in County Value of r 1 st t P 1 $ 3.000 00 ea e a e m ennsy vanta ........................................................ „ ..... $ __ 118.000 00 TOTAL ESTIMATED VALIUE.... $ 121.000 00 Real estate in Pennsylvania situated at: 1074 LANCASTER BLVD MECHANICSBURG 17055 UPPER ALLEN CUMBERLAND (AttacJr additionaJsheets, ifnecessary.) Street address, Post Office and Zip Code City, Township or Borough County ^ A. Petition for Probate and Grant of Letters Testamentarv Petitioner(s) avers) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated thereto dated State relevant circumstances (eg. renunciation, death ofexecutor, etc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was not divorce divorce proceeding wherein the grounds for divome had been established as defined in 23 Pa. C.S. § 3323(8), and did adopted; and Decedent was neither the victim of a lulling nor ever adjudicated an incapacitated person. ^ NO EXCEPTIONS ^ EXCEPTIONS - and Codicil(s) r -. partktQ a pert~rng- ;child ~ or ter`; ~ ~ -_.; ® B. Petition for Grant of Letters of Administration (If applicable) A ~ ~ ``~ '~' c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, dt~pnte minorita If Administration, c.i:a. or d.b.n.c.>;a., enter date of Will in Section A above and complete list of heirs Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divora~ had been established as defined in 23 Pa. C.S. § 3323(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ^ NO EXCEPTIONS ®EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the folllowing spouse (if any) and heirs (attach additional sheets, if necessary): Name Relationship Address JEFFREY D. PARTHEMORE HUSBAND 116 YORKSHIRE DRIVE MECHANICSBURG PA 17055 EDWARD J. ZEISLOFT FATHER 680-16 GENEVA DRIVE MECHANICSBURG PA 17055 SHIRLEY M. ZEISLOFT MOTHER 680-16 GENAVA DRIVE MECHANICSBURG PA 17055 Form RW-02 rev. 10/11/201 / Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } ss: COUNTY OF CUMBERLAND } Official Use Only SEC„`; ~i;~~F~'~ . ~~ ~;E 0~ t , ~ ~~ ~ ~ ~~ i~n~ ~~ ~:~€ ~• ~ Petitioner(s) Printed Name Petitioner(s) Printed Address JEFFREY D. PARTHEMORE 116 YORKSHIRE DRIVE (~~.E~`t~K ~~' A 17055 MECHANICSBURG ~ ~~ CU~f~~=1~f a;~~ ~;G PA The Petitioner(s) above-named swear(s) or affirm(s) 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, the Petitioners) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~p~D~ `1{'~ :~ o~ ~0 ~.."~"y Date ~ me d y of ,~~~-- Date Date r the Regi per Date BOND Required: ^ YES NO To the Register of Wills: FEES: Please enter my appearance by my signa~ire below: Letters ....................... $ ~~CJ (s )Short Certificates(s) ...... ~~_ (~ )Renunciation(s) .......... !~' ( )Codicil(s) ............. . ( )Affidavit(s) ............ . Bond ......................... Commission ................... . Other Attorney Signature: Printed Name: MURREL R. WALTERS. III Supreme Court ID Number: 24849 ' ' ~ Firm Name: MURREL R. WALTERS. 111 ' ' ' Address: ATTORNEY AT LAW " " " " ' S4 E. MAIN STREET ' ' ' MECHANICSBURG PA 17055 Automation Fee ................ . JCS Fee ....................... TOTAL ......................$ Phone: S ~ Fax: - ~_ Email: 31 ~. SZS- 717-697-4650 717-697-9395 DECREE OF THE REGISTER Estate of LINDA Z. PARTHEMORE File No: 21-12- ~~ a/k/a: LINDA ZEISLOFT PARTHEMORE AND NOW, satisfactory proof ~~ J~~ ,~^~'~ , in consideration of the foregoing Petition, been presented before me, IT IS DECREED that Letters OF ADMINISTRATION are hereby granted to JEFFREY D. PARTHEMORE in the above estate and (if aonlicablel that the instrtunent(s) dated 't"1 G~ described in the Petition be admitted to probate and filed of record as the last Codicil(s)) of I~~gister of Wil ~ J f , Form RW-01 rev. 10/11/2011 / ~J J~/~ ~ e2of2 ~L --1 ~ ~ ~c~, ~---~~ LOCA~,iE~k$~I~R'S CERTIFICATION OF DES rH WARNI J~!~~~ille~f tdJduplicate this copy by photostat or p~hotograpl~, Fee for this certificate, $6.00 ?~!~'~~~ ~2 ~~ g~ 3~ CLERK Or ORPHAN'S COURT CIJMBFR~ ANA ~~ . PA _ P 18160917 Certification Number TV Pe/Print In Permanent / /] Black Ink This is tc certify tt~j. ~ the infornration here give^ it correctly i_opied froj,) an o~ iginal Certificate of Deatt duly filed with me ~(~ Local Re.~istrar. The origins certificate will be 'orwarded to the State Vita Records Office for il(~rmanent fi~ing. Local Registrar Date Issued COMMONWEALTH OF PEN N6VLVANiA . DEPARTMENT OF HEALTH .VITAL RECORDS CFRTIFIGATF AF nFATN 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/pay/Vr) (Spell Mo) Linda Zeisloft Parthemore Female 171 - 54 - 8524 March 1, 2012 Sa. Aga-Last Birthday (Yrs) 56. Under 1 Vear Sc. Vnder 1 Da 6. Date of Birth (MO/Day/Vea r) (Spell Month) 7a. Birthplace (City and stale or Foreign Country) Months Days Hours Minutes Bellefonte PA 52 July 25 , 1959 7b. Birthplace (County) ~`,E:iltr0 Ha. Residence (State or Foreign Country) Bb. Residence (Street and Number -Include Apt No.) 8c. Ditl Decedent Live in a Townshlp7 Penns lvania LOWer Allen tw ®Ves, decedent lived ln _ P. 116 Yorkshire Drive Bd. Resltlence (County) Cumberland Be. Residence (Zip Code) 1 705.5 QNO, decedent lived within Ilmits of city/born. 9. Ever In US Armed Forces? 10. Marital Status at Tlma of Death Married Q Widowed 11. SurvlVing Spouse•'s Name (H wife, give name prior to first marriage) Q Ves ~ No • Q Unknown Q Divorced Q Never Married Q Unknown Jeff :CE D . Par themore 12. Father's Name (First, Middle, Last, Suffx) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Edward Zeisloft Shirle ;Fisher 14a. Informant's Name 14b. Rel ationship [p Decedent 14c. Informant's Malting Address (Street and Number, City, State, 21p Codej ~ Jeffre D_ Parthemore Husband 116 Yorkshire Drive Mechanicsbur PA 1 C ..... ..................."""'"'---•-----------°-•----------... ...........---°-------~-°--....... ' ~ 1 a. P ace o ec on one ............ eat ................... ....... ..... If Death Occurred in a Hospital: ~ Inpatlent _ ~ . . . ......os its l:............. Hos ..............................~ re Other Thsn H ...................................... Jlf Death Occurred Some he ~ ~~~ a ~~~~ ~ ty p pice Facill Decedent's Home Q Emergenry Room/Outpatient Q Dead on Arrival Q Nursing Home/LOn -Term Caro Facility Other (Specify) • aaa..~~~ T 15b. Facility Names (H not Institutlpn, give street and n tuber; 15 c. C(ty or Town, Stale, and Zip Code 35d. County of Death 116 Yorkshire Drive Mechanicsbur PA 1705'5 Cumberland ~, I6a. Method of Olspositlon ® Burial Q Cremation 16b. D to of Disposition 16c. Place of Dlsposltion (Name of cemetery, crematory, or other place) Q Removal from State Q Donation March 10 , M h b otner(speglfy) ec anics urg Cemetery 16d. location of Disposition (City or Town, Sate, and Zlp) M h b 17a. Signature f Fu ne rvice LI or Person in Charge of Interment 17b. License Number ~ ec anics urg, PA 17055 FD 013 340 L 17c. Name and Complete Address of Funeral Fadlity Parthemore FH & CS Inc. P.O _ Box 4 1 New Cumberland 1 ~ 1B. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check [he 20. Decedent's Race -Check ONE OR MORE races to indicate what r- highest degree or level of school completed a[ the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. Q 8th grade or less is Spanish/Hispanic/Latino. Check the "NO" ® White Q Korean Q No diploma, 9th - 12th grade box if Decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese Q Hlgh school graduate or GED completed ®®No, not Spanish/Hispa nlc/Latino Q American Indian or Alaska Native Q Other Asian Q Some colle e credit t n b d Q g , u o egree Yes, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawallan Q Associate degree (e.g. AA, A9) Q Yes, Puerto Rican Q Chinese Q Guamanian or Chamorro Bach l r' d ( BA AB BS e o s egree e.g. , , ) Q Ves, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other spenlsh/Hispanic/Latino 0 Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, Ed D) or Professional tlegree (Specify) Q Other (S I pec fy) . MO ODS OVM LLB 1D 21. Decedent's Single Race Self-Designation -Check ONLY ONE to Indicate what [he decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work Q White Q Japanese Q Samoan done Burin B most of working life. DO NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacific Islander Q American Indian or Alaska NatlVe QVletnamese QDOn'[Know/NOt SUre Res istered Nurses Q Asian Intlian Q Other ASlan Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawallan Q Other (Specify) Q Filipino Q Guamanian or Chamorro Healthcare ITEMS 23a - 29•d MUST BE COMPLETED 23a. Date P onounced Dea Mo Day r) 23 Signature o Person Pronouncing peach On y when applicable) 23c. Ucense Num er BY PERSON WHO PRONOUNCES OR ~ ~aot a ~ n CERTIFIES DEATH i ~ ~ R.~ s 3 ~~a~f 23d Da[ Si ed (M /Y ) 24 /D T f . g ey r O . ime o Bath c C t~ (.~ 25. Was Medics miner or Coro er Contacted? Q Ves No xa n CAUSE OF DEATH g f t pprox ma e 26. Part 1. Enter the chain of events-diseases, In)urles, or complications--that directly caused She death. DO NOT enter [ermtnal events such as cardiac arrest Interval: z respiratory arrest, or ventricular flbrlllation without showing the etlolo O NOT ABBREVIATE. Enter only one cause on a Ilne. Add additional lines if necessary Onset to Death ~,T~~p ~\ ( ~ ( aIL IMMEDIATE CAUSE ----------> a. ~CyVi~~~Q~ ~IQ _`C~~~ ~S (Final dlseate or condition Due to (or as a consequence of): resulting In death) b. Sequentially list condltlons, Due [o (or as a consequence of): If any, leading to the cause listed on line a. Enter the UNDERLYING CAUSE Due to (or as a consequence of): (disease or Injury that F Initiated the events rosulting d. ~ in death) LAST. Due to (or as a consequence of S S 26. PeR II. Enter other t tl n ri i but no[ resulting in the underlying cause given in Part 1 27. Was a autopsy p rformed7 n Yez No ,~ 28. Were autopsy ftndings available yyp to co plefe the cause of death? Q Yes Q No 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death ~'~JO t pregnant within past year Q Yes Q Probably ~'1Vaturel Q Homicide ' e Q Pr gnant at tlma of tleath ~a1Vo Q Unknown Q Accident Q Pending Investigation ~ Q Not pregnant, but pregnant within 42 days of death Q Suicide Q Could not be determined Q Not pregnant, but pregnant 43 days to 1 year before tleatF 32. Date of Injury (MO/Day/Yr) (Spell Month) Q Vnknown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construRion site; farm; school) 35. Loca[lon of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Yes Q Driver/Operator Q PedestNan No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): ertifying physician - To the best of my knowledge, death o cu rred due to the cause(s) and manner stated Pr i 8 C rti i h i i c onounc ng . o ng p ys c an -TO t 1 my kno l dg , d th occurred at tM [Imo, date, and place, and due to the cause(s) and manner stated Q Medical Examiner/ - On the of a atlon, end or inyestlgPtion, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner stated ~~ ] Signature of certifier. ~ i Tltie of certifier: ~ ~ License Number: ~ D ~ 0 3O~~2E 39b. Name, Ad ress n 21p Code of Parson Completing C f Deat~iltem 26) D j b 39c. Date Signed (MO/pay/Yr) 3401 N. etirov~+.S~./: ~M1e c'+-++~zlci MA 'IA~ris ~ P. 1110 3-2-ZO1~-- 40. Reglstra is District Number 41. Registrar's Slgnst 4 Reglatrar Flie Dsfe Mo Dsy r ~.~-aim ~/~ ao ~ z 43. Amendments Dlsposltion Permit No.~iJLJ, l n 12.~~ H105-143 REV 07/2011 OS 2. ~ ~~~:~~~'- '~f'l~~C.l1f ~~;r~ RENUNCIATION .~'~!2 F~~~ 22 ~'~~ ~~ 38 CLERK OF REGISTER OF WILLS ORPHAN'S COURT rrtIMF~F~l ~A;i) ~;1, PA. CUMBERLAND COUNTY, PENNSYLVANff~ Estate Of LINDA Z. PARTHEMORE ,Deceased I, EDWARD J. ZEISLOFT , iin my capacity/relationship as (Print Name) FATHER of the above Decedent:, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ,~ / Zv ~yZ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06 /~~/~ ~jytiZ`,~r A (Signature) 680-16 GENEVA DRIVE (Street Address) MECHANICSBURG PA 17055 (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 renun~}ation for the purpo s state within on this ^"~ `~' day of ,~. r Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date o1' expiration of Notary's Commission.) NOTARIAL SEAL. DIANE M SMITH Notary Public MECHIWICSBURG BORO, CUMBERLAND CNTY My Commfsslon Expires Jun 22, 2012 "~2 ~iR 22 ~~~ 8~ 38 RENUNCIATION CLERK OF REGISTER OF WILLS ((;; C}RPH~N'S CnURT CUMBERLAND COUNTY, PENNSYLVANLA ~ ~~?`~1 ~-~~~ PA Estate of LINDA Z. PARTHEMORE ,Deceased I, SHIRLEY M. ZEISLOFT , in my capacity/relationship as (Print Name) MOTHER of the above Decedent:, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~2 a ~i Z (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , ~1 ~)-L. Q.c.,sr (Signature) ~ 680-16 GENEVA DRIVE (Street Address) MECHANICSBURG PA 17055 (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 renunciati n for the purposes stated within on this day of ~ ~-- , _ "tom . Cam- ~~ _ o~7u Deputy for Register of Wills Form RW-06 rev. 10.13.06 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.) NOTARIAL SEAL DIANE M SMITH Noto-y Public Ml3CHANICSBURG BORO, CUMBERLAND CN1Y My Commission Expires Jun 22, 2012