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Home My WebLink About06-05-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND--__---_ ____ COUNTY, PENNSYLVANIA r...~ Petitioner(s) named below, who is/are ] 8 years of age or older, apply(ies) for Letters as specif low, a~ in support thereof aver(s) the following and respectfully request(s) the grant of Letters in the app ,form ~~ ~ Decedent's Information `` ` ~ ~"' ; ~~' ;~ ~ cn z.. ~~, Name: JAMES M •_ MCGINNISS _ - File No: - i ~ ~-. - _ -- --- <-~ _ f l:~ a/k/a: _ (Assigned by sf~r) ~ -n - -- - - -- - - ~-= i~ Social Securi No: `-'~ Date of Death: 5 /_31 / 2 0.12 - __ __ -__-- - __ Age at death: 6 3_ '~ Decedent was domiciled at death in CU_M_BERLAND _ -County, PENNSYLVANIA --- _ (State) with his/her last principal residence at 1463_ CLOVER ROAD - __- . EASTT_-_--- PENNSBORO TWP. -- _-~UMBERLAND_________ Street address, Post Office and Zip Code City, Township or Borough County Decedent died at HOLY_ SPIRIT HOSPITAL__- EA-S_T__--PENNSBORO TWP ___ ___ _ _ _ CUMBERLAND PA - Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: Ijdomiciled in Pennsylvania .............................. ..All personal property $ - _8.8 ,_5 6 3 • D D Ijnot domiciled in Pennsylvania ........................... ..Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................... ..Personal property in County $ Value oJreal estate in Pennsylvania ........................ ...................................... $ - _ -2 D 8 , 8 D D • D D TOTAL ESTIMATED VALUE.... $ _ __ 297,.363 • DD Real estate in Pennsylvania situated at: 1463 CLOVER ROAD ___-___ ___-EAST PENNS_B_ORO _TWPCUMBERLAND_-__ (Attach addilionat sheets, if nece.c.rary.) Street address, Post Office and Zip Code City, Township or Borough County ^ A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated _ ___ _ -___. _____ __ and Codicil(s) thereto dated - - _ - _ - - - -- State relevant circumstances (e.g. renunciation, death ojexeeulor, etc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divorced, was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), and did not have a child born or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ^ NO EXCEPTIONS ^ EXCEPTIONS _ ._-- _- -_- -_____- _-_- -- __ _ ----_--____. ® B. Petition for Grant of Letters of Administration (If applicable) _--_ --_ -. _- - ___ _ ---___ __ ____- -___ c.t.a., d. b. n., d. b. n. c. t. a., pendente life, durante absentia, durante minoritate If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and comalete list of heirs. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g) 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 following spouse (if any) and heirs (attach additional sheets, if necessary): Name i _~,/~O~l~ S- ~~ ~1a~is s_ r /Jd w ~~~~ti~P plc (yi~a~rs Relationship. -~-- -q~ lL /~ ~A,// ~/f ~Ur' Add ~~5 !s r r! ~ rip _ - - -_ __ ress D ~ torn rzw-oz r~>.. to~ti~znu Page I of 2 Oath of Personal Representative COMMONWEALTH OF' PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND-_____-_ } Petitioner(s) Printed Name 128 MEYER OVAL MCGIN-N_ISS --___ PEARL RIVER ---_ r- ~-- -- - ---- - - -- -- _ - Official Use Only 1 i~~Zl/VT-{°~ rte. ". 'h~(~i ~~ .i -~~~~-.~~~= S Pl~l 17r ~i. Petitioner(s) Printed Address ---_ __ _ r-. _;~-.~. . 1.'L.~1 \ .J: ~~ ~ 'p ., The Petiticner(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 Petitioner(s) will well and t my administer the estate according to law. Sworn io or~ffirmed and subscribed before Date - 6 -`s ~ lo~ . S~~2-c - _ ---. me thi -_ -day of ,~Y~ 2 0.12 Date _ j~j~- - BY~ !' ->ti ~~%~~~ ' ---~~J~~.~!~.~~~ 11D 1 - _ _ - Date ----. - -- - - For the Register _--_ Date BOND Required: ~~ YES ^ NO FEES: Letters ...................... $ ~ ~~ l~ . ( ~( )Short Certificates(s) ......~_ '_ ( j )Renunciation(s) .......... _~_`~~~ ( )Codicil(s) ............. . ( )Affidavit(s) ............. _ - -- Bond ......................... .~`_~; _~-'(-, Commission ................... . Other _ _ ......... To the Register of Wills: Please enter my appearance by my signature below: - r -- ---- Attorney Signature ~ -~ 1 Printed Name: LINU$_E_--_FENICLE_-_ Supreme Court ID Number: 2.0944 _ -__ Firm Name: REAGER & ADLER, PC --- Address: 23,3.1_ MARKET_STREET_- ______ CAMP .HILL _ -- -- - _ PA_ 17011- - - - - - • • • • • • • Phone: 717-763_1383 __ --- _ _ - .. --- - - -- --- -- • • • Fax: 717-730 7366 ..... L Automation Fee ......... Email: LFENICLEaREAGERADLERPC_~ COM -_ _ JCS Fee ....................... 2~~~• = i~-~-- _ - TOTAL ......................$ ~_- ~~C- DECREE OF THE REGISTER Estate of _J_A M E_S_ .M_-__M___C_G I N N I S S--_ a/k/a: f ~ : ,, ; File No: _~1 `_~~---~~ L~ ~- • )11 , AND NOW, _ __~_~ -~ ~C __ ~ _ __ - _--- ___ , j-"~ ~ .='~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters ~-=~~~~~~~ -~~~'~ ~f t~' i ~~~~ - _ -- . _-- _ - _ _ -are hereby granted to ~' ~C.~ I _l~Y _ lL'1~~, s ~r l ~ ] + ~- - - -- - - - __ _ _ _ - -__- _.__- -_ - _-_ __ ____ _ _ - - _ -__ ___-- in the above estate and (if applicable) 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 Decedant. l _- ~ , ~- ' _~ ~~ ~C_' ~_ _ ~~ C it ~~,k .,, ' C ~ '~ ~~~•--~~~~~~ Register of Wills Form RW-02 rev. l0%11.101 / ~ ~ ' ( C ~} ~~'°r 1 ..! ~t~_L~,L1 : ~~i i _ l.i {-'' oft r~ L01~;l~RAR'S C;ERTIFICATIOIV C)~ C1E~~"'~-1 W~? Irt,,w~'i~~al to duplicate this copy '~~ pFrotostat or t~h+~'~ur~s~~i:.,~, Ff~c i<_)~ chi. ';ertlficatc. `~6.0(X~~~ ~~~ '"~ ~~ ~~~ ~~ P I ~~~~A~~~~l/~~~,~i~p~ 183_9G_i0_?__ 9 Certifictm(x~ Numbs, ~C 'YPe/Print In Permanent ~II ~v{ ~~ .. ~1 ~~ (i 1 '~- ~_ ,~, ,1 I~P~~~I'JF p~.... I .~- yiy s ~ ~ ~. ®F~ ~~ t, I'' ~ .a .. [k.;.. r (t b, >1 i~ ,uc(i is ; ti L,it+ it ai ,~,. COMMONWEALTH OF PEN NSVLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS !`COT~C~!`ATC l'\ i; . .,,;rlnnatiOu here i,i~~en i nr~.,nel (eriiti~ t: of I)cath i ~(" t .~Cl~ t(. (he ~1£lfe '> 1id1 i~),,l~tnt ti ital. - -- - ~!J-k~1~0-4.112---- ~G~Z ~ l).(iL f,s(,v( State File Number: 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3 Social Security Number 4 D f . . ate o Death (MO/Day/Yr) (Spelt Mo) James M. McGinniss male 209-38-8587 Ma 31 2012 6a. Age-Last Birthday (Yrs) 56. Under 1 Vear Sc. Under 1 Da 6. Date of Birth (Mq/Day/Year) (Spell Month) 7a. BIrthE>lace (City antl State Foreign Country) Months Days Hours Minutes Pittsbur Pa 63 Februar 25 1949 ?b Birth lace (cgi, ) . p nty Alle hen Ba. Residence (State or Foreign Gou ntry) Sb. Residence (Street antl Number -Include Apt No.) 8c. Did Decedent Live in a Township? Pa Ves, decedent lived In P'ACt Penn ~l-u-irn [wp. Bd. Reese (c ntY) 146 Clover Road Cumeber~and 8e. Residence (Zip Code) ENO, decedent lived within limits of city/born. _ 9. Ever in US~~rc~iArmed Forces? 30. Marital Status at Ti o f Death ~ Married ~ Widowed 11. Surviving Spouse's Name (If wife m~~ess give name prior to first ma i . ~ ~~ , rr age) ~ Yes Ip No ~ Unknown ~ pivorced L~45tvev r Married ~ Unknow 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Kathleen Hannon 14a. rmant s Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code1 El M Gi i 0 eanor c nn s Sister 128 Meyer Oval Pearl River, NY 1096.7 C s .......................................................... ...................................... If Death Occurred . In a Hospital: ~ ~Inpatle nt .. SSa. P ace o Deat Check on y one) ....... ...... ...... .... ........ ...... .......... ........... .................. ......... - . If D h ` ~ _ ° Emergency Room/Outpatient ~ Dead o A i l .... eat Occurred Somewhere Other Than a Hospital: ~ H OSpice Facility ~ Decedent's Home °d n rr va 15 b. Facility Name (If not Institution, give street and number; ~ ~ Nursing Home/Long-Term Care Facility Other (Specify) lSC. City or Town, State, d Zip Code 15d County of Death Hol S irit Hos ital . Hill Pa 17011 Cumberland m 16a. Method of Disposition Burial 0 Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemete cremato th l [~ Removal from State ~ Donation ry, ry, or o er p ace) Other (Specify) June 6 2012 St John t S Cemeter 2 16d. Location of Disposition (City or Town, Stale, and Zip) of Funeral Service Licensee or Person in Charge of Interment 1?b. License Number ~ Norwalk Gt . 011654-L 17c. Name and Complete Address of Funeral Facility M ers-Harner F~lneral Home Inc 1903 Market Street Carn Hill Pa 17011 ~ 1B. Decedent's Education -Check the box Ghat best describes the 19. Decedent of Hispanic prlgin -Check the 20. Decedent's Race -Check ONE OR MORE races to indicate what i- highest degree or level of school completed at the time of death. box that best describes whether the decedent t h e decedent considered himself or herself to be , u~,a . ~ Bth grade or less Is Spanish/Hispanic/Latin O. Check the "N O" ILZ White ~ Korean Q No diploma, 9th - 12th grade box iF decedent Is not Spanish/Hispanic/Latino. ~ Black or African American ~ Vietnamese ~ High school graduate or GED completed ~Nq, not Spanish/Hispanic/Latino 0 American Indian or Alaska Native ~ Other Asian ~ Some college credit, but no degree 0 Yes, Mexican, Mexican American, Chicano ~ Asian Indian ~ Native Hawaiian A ssociate degree (e.g. AA, AS) Q Yes, Puerto Rican 0 ~ Chinese ~ Guamanian or Cha mono [xBachelor's de ree (e BA AB B,: g .g. , , ) Yes, Cuban Q Filipino ~ Samoan Q Master' d O s egree (e.g. MA, M5, MEng, MEd, MSW, MBA) Ves, other 5 ~ pants h/Hispanic/Latino 0 Japanese ~ Other Pacific Islander ~ Dpctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (S if _ pec y) . MD, DDS OVM, LLB, JD 21.~DVa~.Tecedent's Single Race Self-Designation -Check ONLV ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent s Usual Occupation -Indicate type of work Whit ld e ~ Japanese 0 Samoan tlone during most of working life. DO NOT USE RETIRED. ~ Black or African American ~ Korean 0 Oth P ifi I l er ac c s ander Q American Indian or Alaska Native ~ Vietnamese ~ Don't Know/Not Sure IT Manes 2r ~ Asian Indian ~ Other Asian ~ Refused 22b. Kind of Business/Industry Q Chinese ~ Native Hawaiian 0 Other (Specify) ~ FIIIPino ~ Guamanian or Chamorro ITEMS 23a - 23d MUST BE COMPLETED BY PERSON WHO PRONOUNCES OR 23a. Date Pronotttyyy~~i d ggqqead Mo Day/Yr) / - ~. 23b. 51 n re of Perso atu Death (On ly when aPPlicable) 23c. License Number CERTIFIES DEATH ~~ 1- ( ZV J ^ ~ 23d. D to gne (MO/Day/V r) 24. Time of Dea h v 1./V' / V , r/'J Y ~~V 25. Was Medical miner Or Coroner Contacted? Q Ves No CAUSE OF DEATH Ap^roximate 26. Part 1. Enter the chain of events--diseases, injuries, or tom plicatl0 ns--that directly caused the death. DO NOT enter terminal events such as ca rtliac arrest I t l erva : respiratory arrest, or ventricular fibrilla ~ IthouC showin the etiology. DO NOT ABBREVIATE. Enter only one cause on a line- Add additional lines if necessary Onset to Death IMMEDIATE CAUSE - ---------- --> a. ~/Yf f ~ / i/~O /- " /(///LOYv// /a' /p /l//~~~ '''/n~__ ~ ~ ~tNVW (Final disease or condition Due to ( s quence of): - as resulting in death) ~ ,t _ .M ~ _! ~ b. f,/(J-J L`Yt/~ cS ~~Ti6C ~7E1y,,,C~J ___ Sequentially list co ntlitlo ns, Due to (or a nseq uence of): if any, leading to the cause ~ .n _ j ~y3 ~ ~~ ~s ,~ ~ ~~ listed on Ilne a. Enter the ? G ~ ~" Z/ !/ ~~'J c UNDERLYING CAUSE sequence of): ~ - ue W ~ (disease or Injury that ('~j~. ~ ~ ~ ~ ~ ~~ ~~ F ~~~ Initiated the events resulting d, d(j ~~ 7~ /'V/: in death) LAST. Duet as a con --- -- o (o sequence of): S 26. Part 11. Enter other signif'c ndltio n[rib urine to d th but not resulting In the underlying cause given in Part I 27. Was autopsy pe rtq etl? ~ ~ D Yes fd Np 2g. Were autopsy findings a aila ble -~ <o to mple[e the taus of death? V a O Ves No 29. If Female: E 30. Ditl Tobacco Use Contribute to Death? 31. Manner of Death Q Not pregnant within past year S ~ Yes ~ Probably Natural micitle ~ Pregnant at time of death O O m Accident Pendin Investi ~ Not pregnant, but pregnant within 42 tlays of death 0 NO 0 Unknown ~ O t' F- Suicide Could not be dete minetl ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In ~ ~ jury (Mo/Day/Vr) (Spell Month) ~ Unknown If pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zlp Codel 36. Injury at Work 37. If Tra nsportatlon Injury, Specify: 38. Describe How Injury Occurred: ~ Ves p Drwer/operacpr ~ Pedestrian ~ No 0 Passenger 0 Other (Specify) 39a. Certifier (Check only one): ~ Certifying physician - To the best of my knowledge, death o red due to the c se(s) and m stated ~ Pronouncing 8. Certifying physician - To the best Of my knowledge, death occurred at the t me, date, and place, and due to the cause(s) and manner staled ~ Medic l E i a xam m ner/Corone - the basis o e ination, and or IDyestigaiion, in my opinion, death tl at the time, date, and place, and due to the cause(s) and rated / y v_v/, Signature of certifier: ~ J Title of certifle r: /'//./)//^, ry~ ~( ~(^ ""'~' License Number: ~V Zt/117~ 39 ~.la me, Address and Zip Code of Pers n Completin f D h Item 26) 39c t ( _ _ jY 1 r /4 ~ r t ~ 3 S / i - ~a ~ - ' ~~ ~ ~~~ ~~~ Z i V ~ / T / ~TyYe~/~ /1 ~ S ~ L iLL: ~- l ~O ~ 40. Registrar s DIS[rlct Number 41 R¢gistra r' i-a ~~ . r 42. Registrar File Data' (M /Day/Vr) 43.Amendments ~ ~ ~~~~ Disposition Permit No. ~7~/y J /-_ ~ _ H105-143 REV 07/2D11 RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA ?~f~ JUG -5 Phi 12~ 54 ,~ (~JIVI~RI.AND CO., P,~ Estate of TAMES MICHAEL MCGINNISS ,Deceased I, ~/ Cv ~/Y~v~~s Lrint Name) / , in my capacity/relationship as S~S J ~~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to l____ r~ ~~ ~ ~ ~/ z. (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 ,~ ~ 2~ ~~ (Signature) (Street Address) ~~5 ~~~~~~h! ~~ ~5~~~/ (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 .4TH day Of JUNE , 212 , otary Public [y Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) _ ~OMMONWF,ALTH OF PENNSYLVANIA Notarial Seal Deborah L. Brenneman, Notary Public Camp hull Boro, Cumberland County My Commissbn E>~ires June 18, 2014 Member, PennsVNanla Assodatbn of Notaries RENUNCIATION L~l1 JUN -5 Phi (2~ 54 REGISTER OF WILLS ~~`~"~~~~ ~ ~~" "~';~ CU~J~r CUMBERLAND COUNTY, PENNSYLVANI~~~RLAJVD CO., PA .-~ >' - l 2 - y~ Estate of JAMES MICHAEL MCGINNISS ,Deceased I, THOMAS MCGINNISS , in my capacity/relationship as (Print .Name) BROTHER of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to (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.!3.06 ~_ ''_.. (Signature) a 7~3 ~L lL't~~~~/ / ~,~~ (Street Address) ~, TTS G~~r~h ~~ ~~:~y/ (City, Sdale, ZipJ 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 4TH day of , X012 . otary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) CONIMONWFALTH OF PENNSYLVANIA Notarial Seal 9eborah L. Brenneman, Notary Public Camp HIII 8oro, Cumberland County My Ccxnmission Expires June 18, 2014 Member, PennSVlvania Association of Notaries ~~t~}';'~ , ,`r;ii i C' RENUNCIATION {~;. , REGISTER OF WILLS (~Pf-~J'~ ~~uR~ ~JMBERLAND COUNTY, PENNSYLVANIAF~,.ANQ CO., PA Estate of JAMES MICHAEL MCGINNISS ,Deceased I, KATHLEEN H A D D O W , in my capacity/relationship as (Print Name) SISTER of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to girl' ~ « v ~~ (Dat '~ 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 ,~ i ; -~ ' -- ignatureJ (Street Address) ,/ ~j ~ / ~ , (_~~ (City, Sta~/Lip) 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 4TH day Of JUNE , 2012 . C 7` N tart' Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) ,n+Gfv~rl°.ALTH OF PENNSYLVANIA .__~ Neal Public ,I Deborah t.. Brenneman, Notary Camp Hill Boro, Cumberland County My tommisslon ExpUes lone 18, 2014 Member, pennsvlva~ia Assodation of Notaries