Loading...
HomeMy WebLinkAbout07-02-12Reset PETITION 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 request(s) the grant of Letters in the appropriate form: Decedent's Information Name: DAKOTA RYMAN a/k/a: a/k/a: a/lJa: Date of Death: JUNE 4, 2012 File No: (J1 ~ '' ~ a - -y~-p+ S (Assigned by Register) Social Security No: 228-77-4453 Age at death: 15 Decedent was domiciled at death in CUMBERLAND County, pENNSYLVANTA (State) with his/her last principal residence at 808 PINE ROAD 17015 CARLISLE CUMBERLAND Street address, Post Omce and Zip Code City, Township or Borough County Decedent died at PINE ROAD 17015 CARLISLE CUMBERLAND PA Street address, Post Omce and Zip Code City, Township or Borough County State Estimate of value of decedent's properly at death: If domiciled in Pennsy[vania ........................... . All personal property $ /jnot domiciled in Pennsylvania ....................... . Personal properly in Pennsylvania $ Ifnot domiciled in Pennsylvania ....................... . Personal property in County $ Value ojreal estate in Pennsylvania ..................... ................................... . $ TOTAL ESTIMATED VALUE... . $ 0.00 Real estate in Pennsylvania situated at: (Attach additional sheets, iJ'necessary.) Street address, Poat Ofnce and Zip Code City, Township or Q 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 thereto dated r.a County r,~ :3 State releveot circumstaocea (eg. renunciadon, death of execuror, eta) v C'; , r. _, ~"" Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was not divbrOcas not ate= to a.~e,•{~~'y"~g divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g)~d did not ha~ra chi~iliOnnor adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. - ~~ O t -T o NO EXCEPTTONS ©EXCEPTIONS B. Petition for Grant of Letters of Administration (tf applicable) c.t.a, d.b.n., d.b.n.c. t.a., pendente llte, durance absentia, durance minorfmce If Administration, c.t.a. or db.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 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 Q 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 addltianal sheers, if necessary): Name ReletionsAi Address JESSIE TAYLOR MOTHER 808 PINE ROAD, CARLISLE, PA 17015 JAMES RYMAN, 11 FATHER 524 BRANCH STREET, STRASBURG, VA 22657 Form ew-os rev. mnfrzau Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND Official [Use Only Petitioner(s) Printed Name Petitioner(s) Printed Address PSS/e ~ wr w~ ~rtic ~a'. ,~, ,.~ J70/S CUMBERLAND , 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 Petitioner(s) twill w,,ell and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~DLk¢ pp ;A,~TL Date '~ - ~ ~ / 02 me th~Ley da of J~~ ~ Date By:/ /~[~Q1M_,L~ Date he Regis(er Dale BOND Required: Q YES ~O FEES: Letters ...................... $ (S )Short Certificate(s)...... C~ ( / )Renunciation(s)......... ,T ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commissio .... ............ Other ~ ~ ........ /,~ Automation Fee ............... ..~ ~- JCS Fee ..................... ~.~` TOTAL ..................... $ ~--8~8 ~3 ~ 5~ To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature I~ /V~ ~~ " Printed a e: -)1~d/d Vyl ~ We to 5 )y Supreme o urt ~ ID Number ~0 ~2~ 1 Firm Name: /-- LJ frrt5~a°IG ~' ~~ Address: tiioo IV. ~ n5b/~~ , r '][O Phone: ~~~-Z3$~165, Fax: ~Z Email: J We1rt5 c% WC DECREE OF THE REGISTER Estate of DAKOTA RYMAN File No:~ - I ~ ~ ~oS a/k/a: AND NOW, satisfactory proof presented before me, IT _ are hereby granted to the instrument(s) dated ~ ~ (,L described in the Petition be admired to probate and filed X. , in co r ration of fore oing Petition, that Letters . Y~'t~ ~ ~ _, i he above estate and (if applicable) that Form Rw-oz rev. tonuzon ' "T'aQe2 oft LO~GFFAR'S CERTIFICATION OF DEATH WAFt(~(i1~ri_If (~' iIJ~~'~'I to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ~~~~'~~~ -~ Q~ (0' ~ 4 oRPi=u~~s cout,r CUMBERLAND Co.. PA _P 18488111 Ir Certification Number Pe/pNnt In l/3;_264 This is W certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar The original certificate will be forwarded to the State Vital Records Office for permanent filing. L~6ix~te.~~l-0ac~~+t,~ra~' JIi~J 5 -/2012 Local Registrar Date Issued COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ V ITAL pECOP05 reerGU~ar - -- -~ st•t•FIIe NUmb•,: 1. D•cetlen<'s Leg•1 Name (GIrsC Mietlle, Last, SuMx) Z. ser 3ec1e15•curlry Numbe, A. O•te of Oeatn (Me/Day r) (Spell Moj 3 Dakota C R an. Male June 4 2012 s q a. 3 {.-Lane elNna.y Irra sb. Una., a Ye.. e. arena, v o one or Blrcn Imo/o.y/Y..N Isp.n Men[m T.. rtna.e. (aN a .Igo eeemryl B' al na s ~1 Moncnz D.v3 He 15 era mote 0 Au uas 163 1996 36. 6IrcLpNC. Ieeenryl . R.aPleAence txae e. Gorel{n cnr.nt.Y) ab. peslaenc• (Etr et area NumOerv Incluee qpt Ne.) ac. O a Dec. a.ne uve In. TnwnznlpP e Rd _ Yea, tlec•tlene Ilyetl In _ Di YiRBOn M, e. pesltlance (county) l3~a PiR@ B Be. Raaltlence (Zip Cetle) ~ No, eecea•n<Iluetl wlMln limits of city/baPe 9 I E V . . ver n S grmee Gorcesi 1D. .Neal s[etur e<Tlme of O•atM1 Q M rrletl Q W we 31. survlyln{ Sppuse'3 Name Ill wife, glue name pNO, to flrs<marNa ~ Ves ~ ] N e) O V k g g a n nown 0 Olye rcee ~(i N ,lee ~ Vnknew - Sv Fa[M1e,'s Neme Glrst, Mletlle, Las[, Suffla) 13. Meths ' N me Prier <e Ghat M ring. IFl,at Mratlle LasU a , , Jam@a Micha@1 R n Jeasi@ Ma Huly@r ' Sqa. Inbrm•nt a Name 19 b. pel•tlonaM1ip to Decetlen< lac. Inlormant's M•Iling Atltlteas (E area Numb•r, CIN en el J@saie H_ Taylor moth er 608 Pi. a d_ R , Carlisle PA 1 015 7 S n - ....o. .......-~Y ....................... ....... .............................. ..........:~.....«.~.....:.:..... r nD..m oeppr..a In•Hpawtal: r]~Inp.<i.nt liy Dean oapmee some ............. ..... ......... ...... .... ...........i_~; ..... wM1erc OMer Then • Hosplt• t~ MosPrca Fa II ~~~-~~~~~ '~"~"~"--"""""'"" Oec¢ea t' H Ct n . em. Rppm . Emer area /OUtpetl•n[ 0 Oeatl on grrlyl I Nursin Home/Lore -Te,m Cere F•clllt OSM1a, (E pedhj ural Road lsb m . F. l[v N.me Bi net mzepunpn, aloe Wren ana numbs, se. ah ormwn, st.c., .na ap acne s c S . opnN PG De.<b 800 81ock of Pin¢ Road Carliale3 PA 17015 Cumberland ~ va.. MetM1ea of DppeNmn p Burial c,.m.aen Sae- D•t. er Dlapospmn ~R.mpyal rrpm st.c. p Doneemn ap. PLCe m wappsremn (Name m..mecerv. =rem•tprv, or pm.. place) v June 6, 201 oto, r Pe I 3tover Funeral H ome and Crematory, Inc _ sol m T t Lee•n Sae. DI o lacy pr awn, sc. ., .na zlPj a, sign a er Pp .r.I se v n 's rye pi In t vb. L e Nu b ,a Strasburg VA 2265'7 138504 vp. rv•m..na epmpLte gaarcaa et Genera F•elnry tit SB. o.e.aenrs Eaep.ne ~c C S 21 No Hanove ptr t Ca 1 al e PA 1 013 M1ecklM1e EOw tna beat aascNbea tM1e 9. Oecaa•n<e panic Orgln-CM1ecktne 3D tl ' o e en[ ap ek elcet•wM1a< to ni{M1estee[re•er level oG ichea cpmpletetl at the tlme e3ee•M. bowtn•<best tlescrlbea wheM•r<M1e aeceeent [M1 tle e O c• ce ent conele rca Flmsell or M1ers ell to be. 0 BM gratle or I•sa la E anl3h/Hlapanlc/Latino. CM1eck Ne "Na' WM1pe e ® ~ K r n $I No^IPIO a, 9tM1- Z<M1 graE De b nlf eece sere Is tie scnaol g t SPanIxM1/Hlip•nlc/Latlna. ~ BI•c gM1lc n q m l•<etl r o W yo, net panlah/HI paenl m atln 0 qm n Intllan r Alaska Natlye ~ OMeaASI• ~ som le ge C e ee xl n q •rlcan Chl l c g e en e , c•np ~ gsl•n l ~ gsspN•<• e e (•. q91 n n O N•Nye Xawalsn ~ Y P art ~lcen u R tl Q B '3 ae{ree (e.g 0 Gu•m•nlvn pr cn•merro Bq, qB, Bal ~ Yes Cuban 0 F ll nu e e , i P el s ~ M ame•n 'i a•gree I .fl. Mq, Ms, MEn{, MEe, MSW, MBgI 0 Yas, other sp•nlrM1/NIS e ~ s P nlc/Latlna ~~• nee O D bar Patine lNana.. O D <•1•.e. ono EaDl er Proresapnal aegree (s ' peclNl O oener 1!:peNNj r MO OO3 OVM L 10 cea•n<'a single R•c•Sel1-D sl{n• n-Check ONLY ONEtp lntllc•te wna<the tlecetlent censlee,etl M1lmiel/er M1erselG <e be. Z e. 0ecatlen<'s USUaI OCCUp•tle -Intllc•te ty adwotk i e 3 e p O nee apane 0 5 moan Bone tluNry mast pi wo,king IIGe^DO NOT u3E RETIRED. 0 BI•ck er AGNC•n acl Sl o tler m t W/N ` s ~ A e,le•n Intllan a O D gl•aka Native 0 V etn $tUd@nt. nR K o o are elan ~oMe Asian ORefue.s O 33b. Klntl ei BUirnesa/Inaua<ry Chlnese O Nxro. H.wal.n D Dmer ( penryl O Fluplne OG rcn.m ublic P school a re pronounce Dee rtV 6RSON WNO PRONOV NCEa OR EO Z3e. O• e Mp Dey r 33 . Signature a person Gmnouncing De•t Only w en app Ica le 3c Lle•nae Num e r CERTGIES OEgT1 .Tlln@ ~4• 2012 33tl. Date 51{natl (MO/Oey/Vr) a. Tlm•ei OeatM1 A rox. 3:15 P.M. a. wa3 M.mea EK.mmer or eerene, eentaea> ve{ O Np CAUSE OF DEATH AP^to m 3 tote tree vnev n -als•• a lµ)url r mpllcatlon -tha[e lr ttlyc se e the tl •u nth. DO NOT en[er te,minal events sucM1 a tl j Ste D p E s ca, lac arrest c Ito ryl resplr• cry ar 3<, er ve trlcular llbrlll•tlan Itnou anpwlry <M1a etblory. ONOi qBB EVIq En[e,e on•cause . my Il aa e on• ne III A .mprona rem nn ceaa•rv i reset <e Dean 0 IMmsOIATE CqusE -------------> a. Muls spin Traumas iC Ins ur Sa t e:urthli m e .m~ neluon oue o (o,.a a epnseer..nce erL j I r n. MoCOr Vehicle Crash I ee s uennelly ua Pnaple De p (p. as a cwa.w.me oil: i m :. ` t v. Laamg ECne eau i v <. a e on one .. near me p. g V NOERLYINO UVSE a (er as a (m: mjp Duet cpna.ypence eq: i a<e . Imn me ey. x .esenmv a- a h z I z v.m lL Encereme oboe non ...wane m cne u.meNVingnar.:e {Nan In p.N I a az <op3v rro.m.aT o v. 2B. W rev yal•bl• [ e ehe cause o/ae•[ni o 39.1(Fe ~V es ale: Np 30 DIa n N r . TO acco VSeC tNbut. to Veani 31. ManneroG OeatM1 .b ms:;„Yea o y o P, ° `:<< m: el: z & k^ µ^ Naaa o H mlela. o P , I e o No o ure e N e{a e al l b t o pa p n o gn.n<, r.e Prasn.n<whnln as a.v. er scan u O s ine~ nbv. tie e.m~n.a Q N Cpregnan[,but p,egnan<93 tl•yv <p 3yeerbaorc ee•M Da of ln)ury lMO/Oay/Vr)(Spell ManM) 0 c le t Z Q Vnknown li pregn•ntwltM1ln the P•st Year JLLnC /Ia 2012 33. Tlmeatlnlury a. plea ns laurv a.a. Home conatrr,ctlon ape. sarm.:eneep . Loea n oG Inp.rv ISnea ana Nr.mber, otv, sAt.<e. zip ce el - 1 P . M 35 e Rural Road 800 Block o£ Pine Road. Carlisle3 PA 17015 36. In1uryrt Work r et nlNury. 3peclN: c,Ibe Mpw lnlury OCCUrretl: 36 p y ~rv D Orlev/ova tie. ~tP.a.a.Ia^ p Paaa n Pedes sr is n. Ssruck by Vehicle e, O Gt .r lsP nN) C a. <ercip•r lC eck only one) 39 0 C rtlNing pnyslclan -TO <M1e beat e<my knewletlge, tle•tM1 eccu,rea sue [n the c•uaaa) ene manner st•t•tl O P n tit a ciryi I - rp cn r yo^ Pwl e ofle, ao I`o ,.ea a cn e a sera, .m Pmc .tie sue m tn sels M.mca Evmineei/ l ei at o s e a Ten a sG e ~ [ e Ii'~as N ..n / Imes Alen. In m e Inlon. tie. eb occu rea at en. Im e. a a e a y e, e• ne PI c tie tlu e w [M1~ cau Anne. at. Sels) ene m te0 e o1 certlfl•r: s one ei p.rc Acting Coroner_ robe,: s p 39b.wme. gaarcaa.na zip cane ei Per3on cemplecm{c.pae Pi Dean(pem zal ass ore oa u e of snea (Me/Dav vN M tthew S. Stoner3 Acting Coroner 3 a s PA 170 O ane 5 2012 er eB a[r•r ~ir•W rsw ~^ ego •, Gr ~e o OeY . ~ 93.gmentlments Dlipo3ltlon Permit Ne. (~ pt ~kJ kQO._) H1O5-193 REV OT/2011 ;,:~~ ~ ~ ~ ;.. cwt r i '~ 4 ,~,tlr ~~~~' ~ ~ ~r.: , (~ ,~ ,.:_~' R~' RE~L`rCI~TIO Estate of Cl1MBPRU~D CO. ~ PA ~_ ~GISTER OF 1~~"ILLS ~,,.n6e,r~u COINTY, PEN~iSYLVANIA YYt41l J-~- Deceased in my capacity/relationship as ~~~ (Print Name) ' ' of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Jesse I~~Y Tr~lo~ (Date) Executed in Register's Office Sworn to or affirmed and subscribed before rie this day of Deputy for Register of Wills - ,~ gnatureJ / Q /' 5~ ~r ~C7r'GNC~ ~T. (Street AddreasJ Sf~asdur5 r Va_ ~o~~ 5~ (City, State. ZipJ Executed out oJRegister's Ojfiee Before the undersigned personally appeared the party e~:ecuting this renunciation and certified that he or she executed the renunciation for the purposes stated within on this ,~_ day of .~-t~--~1r~ a.01'.] ,, ,,,, ttttttr,r tN ., v ~y y~®; ~_ 3 ''~ ~ , , ion S. ~` ' ~~ `\\ ~f1111 1\\~\~ ~~-~J.P ~a~VY K7.r ~ Notary Public -t o~a'1 ~ 3 1 My Commission Expires: y~3o \aD1~ (Signature and Seal of No[ary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-O6 rev. /0.13.06