HomeMy WebLinkAbout06-14-12PETITION 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 Letters as specified below, and in support thereof aver(s) the
following and respectfully requests the grant of Letters in the appropriate form:
Judv L. Prescott
t]ecedent's Information
r
Name: Christopher D. Thorpe File No: 21-12 - ~.
aikla: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 06/08/2012 Age at Death: 55
Decedent was domiciled at death in Cumberland County, pq (State) with hisiher last
principal residence at 209 Touchstone Drive, Carlisle 17015 South Middleton Cumberland
Street address, Post Office and Zip Code City, Township or Borough Counfy
Decedent died at Carlisle Regional Medical Center, 366 Alexander Spring Carlisle 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 $ 40,000.00
--
Ifnot domiciled in Pennsylvania ................ Personal property in Pennsylvania $
Ifnot domiciled in Pennsylvania ................ Personal property in County $
Value of real estate in Pennsylvania ................................................................... $ 45,000.00
TOTAL ESTIMATED VALUE $ 85,000.00
Real estate in Pennsylvania situated at 11 Michaux Road, PA 17324 Gardners Cumberland
(Attach additional sheets, if necessary. )
Street address, Post Office and Zip Code
City, Township or Borough
^ A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated
thereto dated
County
tv
_~
-aqd
- ~ ~ ~-. r' ~ f'rl
State relevant circumstances (e. g., renuncrahon, death of executor, etc.) ~ - ~
~ _ _
Except as follows: after the execution of the instrument(s) offered for probate, Decedent did not marry, was not divor~,~as not a pt~ty to arRendfr~
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8), and d shave a chifE[born oIy -z-1
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. = .-.? ~-j
^ NO EXCEPTIONS ^ EXCEPTIONS ~,~ --, Q r` r'r'i
~~
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^X B. Petition for Grant of Letters of Administration (If applicable)
c. t. a., d. b. n., d. b. n. c. t. a., pedente lite, 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 complete list of heirs.
Except as follows: Decedent was not a party to.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 Relationship Address
Judy L. Prescott Spouse 209 Touchstone Drive
Carlisle PA 17015
Form RW-02 reg. 1o-11-zoo i
Copyright (c) 2011 form software only The Lackner Group, Inc.
Page 1 of 2 .~
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} $$:
COUNTY OF Cumberland } ._ cffi _~a o ~' i ,:
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Petitioner(s) Printed Name Petitioner(s) Printed Address
Judy L. Prescott 209 Touchstone Drive
Carlisle, PA 17015 OR~tr1J `~,~~~~,
t ne re>t>tonerts) aoove-names swear(s) or attirm(s) the statements in the foregoing Petition are true and correct to the best of the knowledge and
beliefi of Petitioner(s) and that, as Personal Representative(s) he Decede t, f~titioner(s) will well and truly administer the estate accordi g to I~w.
Sworn to cr affirmed and subscribed before V l~ ' `~ Date ~ ~ vZ
_ Date
BY 1 . ~ ~_~ 1 V t -~ ~''~1~ ~1~, ~ ~J ~ J I Date
For the ?eglster Date
BOND Required? ~ YES ~ NO
FEES:
Letters .......................................... $
( 3 )Short Certificate(s).........
( )Renunciation(s) ..............
( )Codicil(s) ........................
( )Affidavit(s) ......................
Bond .............................................
Commission ..................................
Other JCP
Automation Fee
Automation Fee ............................
JCS Fee .......................................
TOTAL .........................................
Attorney Signature:
9Cj ~~' ~~'~~TU-~'l~"~'" ~ r~-
Printed Name: George F Douglas, III Esq.
Supreme Court
ID Number: 61886
Firm Name: Salzmann Hughes, P.C.
Address: 354 Alexander Spring Road, Suite 1
Carlisle, PA 17015
Phone: 717-249-6333
Fax:
E-mail: gdouglas@salzmannhughes.com
DECREE OF THE REGISTER
Date of Death: 06/08/2012
Social Security No:
Estate of Christopher D. Thorpe File No: 21-12 -
a/k/a: 11
AND NOW, ~~ -"G, I - , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to Judy L. Prescott
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
210.00
To the Register of Wrlls:
Niease enter my appearance by my signature below:
12.00
23.50
5.00
$ 250.50
Will (end Codici-(s)) of
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Register of Wills T, )~ tT"~/~!,~/j~~,~ /~I/,-.~ '~J~~~~~~~,J ,
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Type/Print In COMMONWEALTH OF PEN NSV LVANIA OEPARTM ENT OF HEALTH • VITAL RECORDS
Permanent f"FRTI C~P'ATC AC II"1CATu
1. De edent's Legal Name (First, Midtlle. Last, Suffix) 2. Sex 3. Sorial Security Number, rv4. Date pf Death (MO/Day/Yr) (Spell Mo)
~
Christopl'iar D_ Tl-iorpe M 200
36 8583 June g, 2012
6a. Age-Las[ Birthday (Yrs) 6b. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Near) (Spell Month) 7a Birthylace ~rClty and State or Foreign Country)
(
1 nths Days Hours Minutes Carl1S
1e, PA
SS Mp Dec_ 28 , 1 °56
Zb. Birthplace (C°°ntv) Ctsnberland
8a. Residence (State or Foreign Country) ab. Residence (Street and Number -Include Apt No.) 8c. Dld Decedent Live in a nshlp?
T°
PA Yes, de~etlent eyed .n
South Middleton tH,p_
atl. Resmenae (county) 209 Touchstone Dr _ - -
CUm~JE-r lag-1(_~ R
R
id
Zi
C
e.
es
ence (
p
ode) Q No, decedent lived within limits of ity/born.
rr
9. Ev n VS Armed Forces? 10 Marital Status at Time of Death $]Nlla d ~ Widowed ]. t. Su rviv ng Spouse's Name (If wife, give a prior to first m age?
nom err
r
Q V
$}9JO ~ Unknown Q Divorced Q Never Marrietl
O Vnkn .7ud L _ Pres ~pr'~-
w
12. Father's Name (First, Middle, L t, Suffix)
13. Mother's Name P o First Marriage (First
Middle
La
,t)
,
,
_
£2on_~1d D . Thorpe , Sr. _ Audrey ~p1ay
14a. Informant's Name 14 b
Relationshi
t
D
d
4
'
.
p
o
ece
ent
Judy L
Prescott Wife 1
c. Informant
s Mailing Address (Street a d Number, Cicy, State Zip Code?
209 T
C
0
_
ouchstone Dr_
arlisle, PA 1/Ol5
Ci
~ ........................................ ............ ........ .........................................
If Death Occu
d i
H
I
i ... 15 a. Place o Death (Ghee only one
""
"'-. ... .. ........ ......... .
..
_
° rre
n a
os
p
ta Inpatient ..... .-.. ............. .....
a
.
If Death Occurred Somewhere Other Tharl Hospital ~] Hospi e Facility [`J Decedent's Home
~ Emergency Room/Outpatient Q Dead on Arrival
. ~ Nursing Home/Long-Term Care Facility ~ Other (Specify)
156 Facility Name (If not institution, give treet and tuber;
15c. City or Town, State, d Zip Code 16d County of Death
Carlisle Regional Medical Center Carlisle, PA 17013 Cumberland
16a. Method of Dispositlon ~ Burial ~ Cremation 166. Date of Disposition 16c. Place of Disposition (Name of cemetery
cremato
or
th
l
m ,
ry,
o
er p
ace)
Q Re al From Sta ~ Donation
potner(speclfy> 6/1l/2012 Evans Crerrlation SerViCf_s
Z 16d. LocaCion of Dispositlon (City or Town, State, and Zip) 1]a. Si of F al Service Licen Perso Char a of I
gn
g mermen 176. License Number
d Leo1a, PA
~
0 FD 012633 L
17c- Name and Complete Address of Funeral Facility
wing Brothers Funeral Home, Snc_ 630 S. Hanover St_ Carrlisle, PA 17013
18. Decedent's Ed ucatlon -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to indicate what
`- highest degree or level of school completed at 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 "N O" Q'VL"/hite Q Korean
~ No diploma, 9th - 12th grade b -f de edent Is not Spanish/Hispanic/Latino. ~ Black or African Arnerlcan 0 Vietnamese
Q Hlgh school graduate or GED completed [~TJ O, not Spanish/Hispanic/Latinp Q American Indian or Alaska Native 0 Other Asian
~
~
6ome c°Ilege credit, but no degree Q Ves, Mexican, Mexican American, Chicano 0 Asian Indian Q Native Hawaiian
Q Associate degree (e.g. AA, A
Sg Q Ves, Pue o Rican 0 Chinese ~ Guamanian or Cha mono
'
A
~ Bachelor
s degree (e.E~O A, ,
BS) Ves, Cuban 0 pino Q Samoan
'
l
I
Q Master
s degree (e-g. A, M5, Eng, MEd, MSW, MBA) ~ Yes, other Spanish/Hispanic/Latino 0 Ja
panese Q Other Pacific: Isla
d
n
er
Doctorate (e.g. PhD, EdO) or Professional degree
(Specify)
~ Oth
(S
lf
_
er
p ec
y)
(e. Mp, ppS, DV M, LLB, JD)
21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent co n.sidered himself or herself to be 22a
Decedent's U
l O
-
sua
ccupation -Indicate type of work
[xVrhiTe ~ Japanese 0 Samoan d
d
one
u ng most of working life- DO NOT USE RETIRED.
Rlack or African America Q Korean ~ Other Pa ci (IC Islander r
0 American Indian or Alaska Native ~ Vietnamese 0 Don't Know/Nat Sure ASS 1
t
S
r
a
t l0n SU
y
. rV1S0
qq
~ Asian Indian 0 Other Asian Q Refused 226~
g _y~J~t~~ ddy
g
y
~ Chinese ~ Native Hawaiian ~
h
s
y
C~
~r
Ot
er (Specify) _
L
OllLI7
11
C11
LOn TWA _
p Finpinp p Gna manlan Pr cnamprrq - Municipal Authority
ITEMS 23a - 23d MUST RE COMPLETEp 23a. Date Pronounced Dead (MO/pay/Yr) 23b. Signature of Person Pronouncing Death (Only when applicablr_) 23c. License Number
BY PERSON WHO PRONOUNCES OR
CERTIFIES DEATH CO ~ j Z _
23d- Date 51 ned (MO/Day/Yr) 24. Time of Death ~ ~~ Os ~~ t'lf~07
w & IZ O 3 (Z zs. 5 Medical Examiner pr cprpner comaotea? p ves
CAUSE OF DEATH
Approximate
26. Part I. Enter the chain oY_e nts-diseases, injuries, or complications--that directly caused the dpa[h. DO NOT en r terminal events s ch as cardiac a E Interval:
a
t
r
respiratory arrest, or ventri
lai fibrillation without showing The etiology. DO NOT ABB RF VIATE. Enter only one causr_ on a line. Add
a dditio nal lines
if necessary Onset To Death
IMMEDIATE CAUSE --------- -----? a. _ _ ~ and I ~ A-f'r t_t }
__
(Final disease o condition Due to (o as a consequence ot): - -
resulting in death) 5-~-~
Sequentially list co ndltio ns, Due o (or as a consequ nee of):
e
if any, leading to the cause 'r/
listed on line a. Enter the __ 1 y\lo,vf ~vA }• ) ; 5.,,
-
`
UNDERLVING CAUSE Duet as a cons nee ~ - -
° (° - equ - of).
(dis ury that
n
_ Initiated tha
e nts resulting d.
p
In death) LAST.
Due to (o as a consequence of):
S 26. Part II. Enter other si¢nif is c nditions c ntrib utina t d th but opt resu Ming i the underlying cause given in Part I 2 J- Was a utopsy perfor ed?
~ ~ Yes N°
Were a opsy findings ailable
'a
v To co plet the c ~f death?
a
.J ~ Yes
~o
29. If Female:
o 30. Did Tobacco Use Contribute to Death?
~ Nat pregnant within past y -ar Q Yes ~ Probabl 31.--~MCa'nner of Death
e
~ :•a ural ~ Homicid
^
e
Pregnant at time of death
~NO ~ Unkno ~ Accident ~ Pendin
I
ti
i
r- g
nves
gat
on
0 Not pregnant, but pregnant within 42 days of death
Q Not pregnant, but pregnant 43 days t 1 year before death 32. Date of In'pr ~ Suicide 0 Copld not be determined
° J V (MO/Day/Yr) (Spell Month)
Q Unknown if pregnant within the past
year 33. Time of Injury
34. Place of Int y (e g. home; constru coon site, Farm, school) 5. I.oca[ion of Injury (Street and Number, City. State, Zip Coc1e)
l
36. Injury at Work 37. If Tra nspn rta[ron njury, 5 ecify: 38. Describe How Injury Occurred:
~ Driver/Operator
O Pedestrian
Y
o 0 Passenger 0 Other (Specify)
39a- Certifier (Check only one): --
Q C rtifying physician - To the best of my knowledge, death o red duet the c e(s) and m ed
y
n
p
s
~onouncing 8 Certifying physician - To the best of my knowledge, death occur ed
at the t a
d a
e, nd place and due to the c e(s) and manna s Led
Q M
di
l E
i
e
e
ca
xam
ner/Coroner ~- On the basis of examinati ,and/or rove Ligation, in my opinlpn
de th
occu rred at the time, date, and place, and due to the cause(s) and manner statetl
s
Signature of certifier: J
Title °f certifier: p 2 License Number: ~_f~] I V p"~
39b. Name, Address and ip Co ie of Perso Co pleting Cause of DeaTh (Item 26) 39c. D e 5 :ed (MO/Day/Yr)
E-E
5
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~
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,asZT,..L.a.v
I
. m_C
C
A/
L~-~ ~f/ i~o 3
~
& Iz
40. Registrar's District tuber 41
Regi r s Sl
n atu re
a
-
g
oz. -~ ~o
~
= 42. Re 'stray File Date (MO/Day Yr)
"
.~
o
~ -
43. Amendments cc~n ~ B
a o i ~
_~~~~~ ~~ H10S-143
Disposition Permit No
REV O]/2011