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HomeMy WebLinkAbout07-02-12~ ~; , _ ,~-~c_ l CERTIFICATIO~i OF ~ OTICE UrDER Pa. O.C. Rule ~.6(a) z REGISTER OF 'a~iLLS ~tii~at"4,~~t~.~~ CO~~~ITY, PE~~S~~Lti".~NI,-~ Name of Decedent: ~,nt~~ j C~,,,~ ~.~~ Date of Death: I~3--~'D•-J' Fiiz NrimhPr ~~`3~t~" ,~j Qt~_ `~}(e Date Letters Granted To the Register: 1 certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~ I ~-- Name: Address: r'Itll~l.C©:~ f~J~...,_;l 1 s~[•l~_ ~ 'tJ~n~,~ 1~~~.D r~Ar'..~~ 1 ~','on~~n~F.C.f~J.CeS'l~-, y 1.05'-~-, (IJmore space is needed, attach separate sheet.) Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except: Date ~~'~~~ ~ :i' _:a' G~ rjj ~ - ~ :_' , --~~ : ~_~ ~ _ Y, 6~- C".i /~ V ~ ~~r ` ---° cox C.~ Fornr RW"-08 rer. !0.13.06 ~~LL N l ~AY r~ ~ .n MY' .V~/~%] Signature ojPerson Filing this Form ~ r,~ ~~~ ~~~~ f' I Capacity: ersonal Representative Q Counsel Name ojPerson Frting this form ~ ~~~ ~Gti..•.e,~ r . Address 6ti t, 1~ ~?U~l~ ~a~-~t31 -U~11~ T'elcphone ( Tai 6/25/12 Ms. Glenda Strasbaugh: I am writing to address the request for the Certificate of Notice under Rule 5.6(a). I have filled out the requested paper to the best of my ability although there are sections that I don't have answers for. I am referring to the request for a file number which I do not have and I have no idea what letters granted is referring to. I want to notify you that my mother, Carol Jane Coston, was no longer a resident of Pennsylvania at the time of her death. 1 moved my mother to Baton Rouge, La. at her request and due to her failing health at the end of October. She lived in my residence at 11808 Dame Dr., Baton Rouge, La. because she could no longer care for herself. I am the Independent Administrator of her estate and everyone in her (my) family has been notified of her death. I have completed succession papers as well as papers giving me permission to be the Independent Administrator. I am not planning to file a succession in Pennsylvania since she was no longer a resident there. I am including a copy of her death certificate from Louisiana, my Independent Administrator authorization, and a copy of my marriage license to show where my name changed from Linda Ducote to Linda Whall on 12/3/11. Linda Whall LETTERS OF INDEPENDENT ADMINISTRATION IN THE MATTER OF THE SUCCESSION OF CAROL JANE COSTON PROBATE NO. ~'" ~~ 19th JUDICIAL DISTRICT COURT PARISH OF EAST BATON ROUGE STATE OF LOUISIANA This shall certify to all whom it may concern, that an application was made to the Honorable Nineteenth Judicial District Court for said parish by LINDA COSTON WHALL to be appointed and confirmed as Independent Administrator of the Estate of Carol Jane Coston, deceased. NOW KNOW YE, That the said LINDA COSTON WHALL has been and is hereby appointed and confirmed as Independent Administrator of the Estate of Carol Jane Coston, deceased, and that she has fulfilled all of the requisites of the law. Given under my hand and seal/of our Nineteenth Judicial District Court, at Baton Rouge, Louisiana, this ~~ day of , ~{9`l , 2012. (LG~ ~ m = Deputy r ao ~_ =_ CERTIFIED .°'a.- TRUE COPY ~_ o ~_ MAR ~ ~ ~0~~ DEPUTY CLERK OF C R 2332131 I .DOC LICENSE 745-87 nrn GROOM BRIDE STATE OF LOUISIANA CERTIFICATE OF MARRIAGE STATE NOE 1 ~ T WHALL PHILIP BARD 2. USUAI. RFSIDENCE-CfiY,TUWN.OR LOCAII(lN }. IS RESIDENCE INSIDE. J. PARIS WCUUNTY S, STATE 11808 DAME DR BATON ROUGE 70818 CfIYLIAtII'S? YES [x] NO [ ] EBR LOUISIANA 4. Rn('E 7. UA7"E OF BIRTH (hLnnlr-Day~l'carl N, ti fA76 0F• IIIHTII r if mu in US.A.. Narue (',wnuv, WHITE APRIL 03, 1953 ASHLAND KENTUCKY 9. FATHER • NAME m. STATE: OF BIRTH Elf nd in I I. MO'1'tIEN ~ MAIUEN NAME 12- STnIE OF BIRI'FI 11f na in RALPH FRENCH WHALL L'S.A_NankCnunvyt DENISE BARD usa_Namee~,ml~l PUERTO RICO FRANCE t7A. LAST NAh1E OI' DHIDE I i(I. FIRST NASIE ITC. SEC'UNU N.AMB 17D. MAIDFiN NAME(If Ai(Ic,cnq DUCOTE LINDA CAROLYN COSTON I~. USUAL RESIDENCE-CRl'. TOWN.OR LOC'ATICIN 15. IS RFSIDBNL'.E INSIUF 16. PARISII/('OUN7}' 11. STATE 11808 DAME DR BATON ROUGE 70818 cITYt.IM1llTSr EBR LOUISIANA YES [xJ NO [ ] IN. RACE 11. UAE OF BIKTII (Month-UapYearl 2n. SLATE. OF BIRTH UI nn( in U.S.A.. Name C'uun(ryl WHITE JANUARY 23, 1960 BATON ROUGE LOUISIANA 21. FATIiER - NnME '_. STATC• OF BIRTH (If mx In T 2a. MOTHER'S MAIDEN NAME -'a. STATE OF BIRTH (If mx m D.SA., Name Cuu,wyl L1.S.A.. Name CwmryJ MARLIN EDWIN COSTON LOUISIANA CAROL p.CHENBA.CH PENNSYLVAIviA COVENANT 24A. Covenant Marriage: YES [ ] NO [X] p(yex, complrtc the folluwin¢ surtcmcnt.) MARRIAGES We and do hereby declare our intent to contract a Covenann Marriage ¢nd, accordingly, have executed a dzclaration of invent attached hereto. VN'E HEREBY CERTIFY TNAT THE INI~1Rh1ATION PROVIDED IS CORRF:CI'TO THE: HF-ST OF OtiR KNOWLF]XiE.\NU ¢I AND THAT WHERE I-TlEE l'O MARRY UNDER THE l.}K'S DI' TFIIS STATE. SIGNATURE 3. GROOM'S SIG . B• ~ 2G. BRIDE'S 51GNATL' , LICENSE TO MARRY C CEREMONY RECORDING OFFICAL i CEREMONY CANNOT BE PERFORMED PRIOR TO: NOVEMBER 25, 2011 10:52 AM GROOM BRIDE SGK SSNS Perron Duly Au,hunrcd w Perru a Mar,iaEC Cnemon>' Under Ilx l~wa nl'Ix s(we ur LrwFCia,a - - DECEMBER 22, 2011 11:59 P.M. 2N. SUBSCRIBED TO AND SWORN TO BEFORE: MEONrMonm.Day.Ye><1 2011 NOVEMBER 22 Z9.' YATURC: OF ISSC,N(i OFFICIAI. ~:~ -- ~ IU. TiTt.E OFISSUING pFFlC1AL DEPUTY CLERK , By: SONIA G. KINCHEN '~.. ]I. PARISH ;?. CITY ON TO}l'N 11. TIME OF ISSUE EAST BATON ROUGE BATON ROUGE 10:52 AM .lt.I CERTIFY THAT TIiF.A60VE NAMED PERSONS W'EHE MARRIEb ON: (Man(h. Duy. Yeart JS. WHERE MARRIED-Crl'1'. TOWN. OR IACATION ]U. PARISH l ~~ ~~~ 37.SK' AT11RE 'P' L' ION}' JN. NAME(Tylx/prin0 Jv. TITLE! AB.AUURESS OF PERSON I'1: nHMING CER \ N}' (Slree(a,ul V ,dxr eu Rual Rowe NumMr. City ur"awn. S,a(c.'Llp ('axkJ ~ I ''~ ' ~ ~~ ~ ~ ~~~ ~ ~ S 1 ~ Z 1 ~ tFva lIA. GR 'S IGt~7' E 1 1 ~- s ~ ~ ~ SIB. BRIDE'S fNA'I'l1RF. { 5 F _, I ~ q ~ 1 ~T Ey~: - ~s - a2A. SI , NA/T 1Rr: OF WIT S TO CF FTIONY - j ~ a.6. SIGNATU/RG WITNESS TO CF.REM(rN-Y OI' t / ,4••'D ~ / J). SIGNAT JRE OF L A RECORDING DF}lC L - u. DATE FlLED (Mnmh lh y. Yrul DEC 's 3 Z~~~ NO.OFTHIS MARRIAGE IF PREVIOUSLY MARRIED GATE EDUCATION • CIRCLE HIGHEST GRADE COMPLETED Isl. ?nd, n.•. (SEx:cih'1 Lasl hlurtiape Ended by- Dculh, Mumh Ye:u Elementary 0, 1, 2, 3, 4...or 8 HighSchool 1, 2, 3 or 4 Collage 1. 2, 3, 4 or 5 2ND DiY,xee. w nnnl,Iln<nl (slxeiryl DIVORCE 09 2006 ON E NO.OF THIS MARRIAGE IF PREVIOUSLY MARRIED DATE EDUCATION -CIRCLE HIGHEST GRADE COMPLETED Isl. b,d. c(.. (spedly, Lus+ xl,rria~ Enncd h) • [r<:,m. M,x,d, Year Elementary D. 1, 2, 3, 4...or B HighSchool 1, 2, 3 or 4 College 1, 2, 3, 4 or 5 2ND Uivr"`.~''"-'"""'nx""sr`'"'>'' 06 20D6 FOUR DIVORCE enn>„nF„ine,w..xna"ExlseRel:,d.,n.hiP NONE Gnwni a S,x.'ial S.xvrllr Numhr 230-66-8770 439-25-0102 TO 6E RETURNED TO ISSUING G>-FICE G`' OFFICIANT lNITHIN 1D DAPS CAF CEREMONY PNS~S IBNBI aNN, OFFICE OF PuDUC MEAITN. VITAL nECOROS RE61STAY ~. ~ t ~ ~ ~, ~- ~~ ;~- J' ~ ~ ~~ .~~ ~.`~ 1215614 !V~I1~11 9 ~ T F_ ~ ^,, f~fa°'I ~' / ~r ~~ THIS RECORD IS VALID FOR DEATH ONLY - _ _. . _ _ _ _ __ IMPORTANT: STATE OF LOUISIANA PRINT Or TYPE, biaOk Mk 1317041 CERTIFICATE OF DEATH or TWbpn mantletay BIRTH No. ru G nl„ ,,, py5 5 ~~ ~ a NAME OF DEGEOENT 1B. FIRST NAME A iG MIDDLE NAME ! 2„ LA-E OF DEATH (Md4N, DaY. Ysul Coston Carol Achenbach C~eCfrA-k~' lV(Zpt! T8 HWR OF pEATN ]. SE% A RACE ISPU,ry YaHS, BAG, ,rcl 5. MARRAL STATUS ISPSRh MumQ 6. b'.'?.v ~.vINO E?::USE ;4 Wive, rAVe MagM NaRM) -(T~50Ctm Female Whit MuIMO, WgBN.O. DNacMI e Widowed None ). BIRTN IMmn, DaY. Yur, M. yGE R V AR EARS I S. BIRTNPLACE ;C~:r a~a s:a:e o• co.a.~~ Camlry) R V MONTHS ppvS June 17, 1930 gl I I HOURS TNHTJTES I , Sunbury, Pennsylvania 10. USUAL OL(:uPATKIN IKm d rron Eaa, Bwvq Rau d Y.orlrvrp W. 11. KIND OF BUSMESSBNWbtAY S' :NIC ORK31N? t2 O: H . . NEVER ^FSPh nNS~ , Nurse Medical No 13. EVER M VS. ARMED FORCES?!VEb Br NO) IK. bOGAL bECURRY NUMBER FTF TI r: :• DNLV 4iGH ,T r e T m Yes 184-24-4759 ELEMENT,wnsf voARr ;are) ~ COLLEGE (ba. 5.) IBA. P A 2 HOSPITAL 1 ^ MPATIENL 2 ^ ER /OUTPATIENT 3 ~ OOA NON~NOSPITAL a ^ NURSING NOEIF E ~ RES CENCC 5 ~ OTHER A 168. NAME OF FACIVTY (a rld F iauirty, yes Mn,l aaus,s Pr Isrationl u I '~5 ~E OF DEATH IN CITY uMlTS? Iv EG a NO) Hospice of Baton Rouge j Yes TA. CRY, TOVM OR LOUTK)N D< CEATN .I..ah CF DEaTN Baton Rouge ~ East Baton Rouge eA. 3TAEET ADORE.SS 01 rural apacsy ru.u uM nwwr e. aoBnnl 11608 Dame Drive aBO. PAn:SH OF n[SIDCNCE - aF6IGFNLE i,~. - .~ East Baton Rouge ~ Louisiana rBO. USUAL RESIDENCE OF DECEDENT Cay.IPwn M ktuian) •B 1BE.IIP CODE F. RESICENLE INSIDE LRV LufRS? (vf5 or ND) Baton Rouge 70818 i No ]A. FATXER'S LAST NAME FIRST MIppLE rBB. FATHEP'b RACE OF BiP*n 19C. STATE Achenbach William Unknown Pennsylvania AA. MOTHERS MAIDEN NAME FIRST MIDDLE 208. MOTHERS PLACE OF 6!H.-H 2OC. STATE Morgan Dorothy Unknown Pennsylvania Linda tdhall ittl08 Dame Drive I - - -- --"' -~' Baton Roue Louisiana 70818 Dec. 10, 2011 , 2A. METHOD OF DISPpbR10N 238. DATE THEREOF 22C NAME ANp LOCAT'~O.V OF LEMETERr OP CREMATOWUM IM,nA, Dar v,M) EverO~e en Cremator UL 2 CREMATIJN ] PEMWAL OTHER g y E"~ ® ^ ' ^ Dec. 15, 2011 Denham S tin s Louisiana 70726 2]A SrGNATUPE AND ADDRESS OF FUN ML DIRECTOR 238. FACruTV NUMiEP 3L. UCENSE NUMBER Greenoaks Funeral Home ~~_n~ 9595 Florida Blvd. 2279 i E-2460 ]f~"-~ Baton Rouge, LA 70815 2`a`:=,:;1;'s David B. Mac Neal SA. BURVLTMNSR PERMIT 258. PARISH OF ISSVE 25L. DATE Oi ISSUE B NA 0= :Ol',PL aEGlbtAaP ® 0975407 I East Baton Rouge Dec. 12, 2011 ~c; -~~ ~ a 1'li-~ ~ a 1 -!r ZT. MANNER GF DEATH "°°i°^" 1 I~: naTUR.LL 2 ^ ACCIDENT ] ^ SUICIDE a ^ MpIIGDE E ^ PENDING :rvVESTiLA'•Jr: a n UNO! ERNINEO 2aA. WTE OF INIUPY (MCrrIN.Ory~, Yfear) 2BB. TIME OF Y{IUPY 2BD. INNRY AT VppN 2BO. DESLRrBE NOW !IUURY OCCUrrHEG ryE5 a NO) 28E PLACE W INJURY ISwPry st tN•.x, I,mr, Nnory. snM u<.) 28F. LOCATION (Bowl. Nurtpe a• Aarel naae. L.rY i'anan, SMrei 29A I CERTIFY THAT I ATTENDED AND THAT DEATH OCCURRED 298. SIGNATURE OF PMYbILMN OP CORONER! 29L. DATE THE DECEDENT ON THE OAIE ANO HOUR IMmIM Dry, Yea,) STpiEO ABOVE DUE i0 THE FPM TO CAUSES PND IN THE MANNER SO STATED. h iat a~ae~~ gal ID~.u~u / Ta, e_ ~ Nti`, _ (2l +c{ a; ~ ~ 29D TYPE OR PRINT NAME rW0 TIRE OF PNrSIC4w OR CORONER M-E. ADpR~E-b15~OF PNYbICIAN OR CORONER F ~i~eorgc pou5lr{s Sa- ,Mb -t3'13 PcA Ii,;~c (2d t'~.i~nt ,lo>ti'~c, L~4 'toSvS b.PAT.i. ENTERTHE DISEASES. INSJWESOR COMPLICATIONS THATGVSED MEDEATH.WNpT EMERTHE MppE OF DYING .~-_ APPpO%IMATE SUCH A9 GROIAC OR PESP:MRJRY ARREST DR HEART FAhURE. U8T ONLY ONE CAUSE ON EACH uNE. INTERVAL BETW cEN ONSET A VD DEATn ~ . - = CAUSE rFY„I _ ~hd Si'Gy~ ~t (~osG.rC cr•ri0. re'h'c'?t+l~'olt cLt , .MJE cnB,r~:F. a DuE TO(DR ASa CONSEQUENCE OFI______________ _ _ _ _ _ _ _ __ __ ____ ___ rsauBV+C-m tluln ) ® ~smulNW a-DUE ________ ________ _______.____-----_--'' _--__ __- . A+Y TO TOP A8 A LONSECV ENLE 0:7 MNI^E LP dr:msLLale ouF. UNDEf6YIND CAUSE rMr _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ IONSaM W M6vy MR DUE TO TOR Ab A CONSEIXIENCE OF) siYarsE evua nwNq n tl.,ml IAbi a a._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ DPARL II. OTHER SKiNiFK;ANt CONDITIONSCWJTPIBUTiNp TO DEATH 31. IF DECEASED WAS .YAb P'. AUTCPbv 326. WERE AUTOPSY EWDINGb BUT NOT RESULTING MTHE UNDERLYING CAVSE IN PART I. FEMALE Ipa9. WpS 5NE I32 _PFOPMEJ? I AVAIVBLE PPIOH TO PREGNANT IN THE LAST F it COMRETIDN OF CAUSE L W DYYS) OF DEATH? ~ ^ T~.~ ^ D~.r : ~ .A n NF o DP, ~ ~.a ~ No ~ Y., o NP PHS 16 - (REV. D4r04) OFFICE OF PUBLIC HEALTH - VRAL RECORDS REGISTRY iN ACCORDANCE WITH LSA-A 5. 40:50~(C), I CERTIFY THAT THE ABOVE IS A TRUE AND CORRECT CDPY OF A DEATH CERTIFICATE TIN Ycusroor ~~ I CERTIFY THAT THIS IS A TRUE AND -- CORRECT COPY OF A CERTIFICATE OR - LDCAtRECISTRAR-- -- / ~NH-Opy '~ DOCUMENT REGISTERED WITH THE ~ ?`'' ~~ \~ VITAL RECORDS REGISTRY OF THE DEC 2 ~ 2U11 ~ ~ '~ •s r\ STATE OF LOUISIANA, PURSUANT TO ~` '~ LSA - R.S.40:32, ET SEQ. ;,~ ~• ~~ ~ - ~` I ~ ~~//f/////t ~~ 4E a ~ ~/` ~ ~ ~ o 01 s ~ p ~ P ~ - STATE REGISTRAR .~.