HomeMy WebLinkAbout07-07-12Reset
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF 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 Inf rmation
Name: /9/1/G~ 7'HpMhrr K~C-KL£,~
a/k/a:
a/k/a:
a/k/a:
Date of Death: ~'/ o b' ?~!/
Decedent was domiciled at death in C Vln tSEI~L
principal residence at /o/ N>~7NP/I~.~~E ~ rte_er_
Street uddrn0. Post lMice and Zip Code ri r t
Decedent died at / D / Mott-z/t ~/t /N~ S~iC.~~
Street address, Post Ofriee aed Zip Code
Esrimate of value of decedent's property at death
File No: ~ ~ 1 ~ _ ~ ' v
(Assigned by Register)
Age at death: ~ 9
County, P~rf ~/vp,~ll (scare) with his/her last
'j p/ City, Township of Borough / Cono
City, Towoship or Boroul, County Sate
IjdornkUed in Pennsylvania .................. .......... All personal property $
Ijnot domiciled in Pennsy[swnia .............. .......... Personal Property in Pennsylvania $
/jnot dontklled in Pennsylvania .............. .......... Personal Property in County $
Valae ojreal estate in Pennsylvania ............ ............................................ . $ O.O
TOTAL ESTIMATED VALUE... . $ 0.00
Rent estate in Pennsylvania situated at:
(Anach additional sheen, ifnecessaryJ
Street address, Post Otlke and Zip Cade City, 7ownshlp or Borough
^ A. Petition for Probate and Grant of Letters Testsmentarv
Petitioner(s) aver(s) hdshe/they is/are the Executor(s) named in the last Will of the Decedent, dated
thereto dated
County
and Codicil(s)
Sgte relevaet circutmhern (eg. renunrladon, death of execumr, ere)
Except as follows: after the exaufion ofthe instrument(s)offered forprobateDaedent did notmany, was notdivorced, was notapariytoapendiog
divorce proceeding wherein the grounds for divorce had ban established u defined in 23 Pa. C.S. § 3323(8), and did not have a child bom or
adopted; and Daedent was neither the victim of a killing oar ever adjudicated an incapacitated person.
Q NO EXCEPTIONS Q EXCEPTIONS
® B. Petition for Crant of Letters of Administration (If applicable)
c.t.a., d.b.n., d.6.n.e.ta., pendants lire, durante absentia, durante minoritate
If Administration, c.ta or db.n.c.Ra., 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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
NO EXCEPTIONS Q EXCEPTIONS Q
Petitioner(s), after a proper search has/have ascertained that Decedent left no W ill and was
additional sheets, ijnecessary):
C:
(aarr~
--'
^r~
Name Relatioashi Address J ~,:
~= a
~ -
_y - ~,
W
rii
c~
C
,,
~,
Cr~i
Form RW-01 rev. lonvaou Page 1 of 2
Oath of Personal Representative r 'a[ u°e °"ly
F~fCU ~I,;Fr') ~;~ r1CE~
COMMONWEALTH OF PENNSYLVANIA } ~ 6 y-S~~ RE
/ / / } ss: ~ 9s
COUNTY OF ~/Jh 6Ch!/[NG } ~ ~L~123 ~{: 43
Petitioner(s) Printed Name Petitioner(s) Printed Address
i/fo~inS Lai K~=t'~~c 7a~ HAM«~~,.~ Ave "' f'a o.tr
BERIAN~ ••
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 /~boner(s)~wt well an ly nister the estate accordin~ to taw.
Sworn to or affirmed d subscribed before •~~!'~'~"' ~~~~~"flete O 7// 7 ~~f Z
~ da of Date
me 's
Date
r he Reglsrer Date
BOND Required: AYES NO To The Regla/er of W71/a:
FEES: Please eater my appearance by my signature below:
Letters ...................... S
(~ )Short Certificate(s)..... .
( { )Renunciation(s)........ .
( )Codicil(s) ............ .
(- )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ........
Automation Fee .............. .
7CS Fee . ................... .
TOTAL ..................... S~
G~., s
Attorney Signature:
Printed Name•
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
C~`,, . DECREE OF THE REGISTER
Estate of~~„Y~( i V ~111'V~(gg `~QL~,~O,~
a{k/a:
AND NOW, a0 } ~ , in consideration of the foregoing Petition,
satisfactory proof ha ng en presented before me, IT IS DECREED that Letters _
are hereby granted to ~,mrnc~n e . o ~(~
in the above estate and (if applicable) that
the instmment(s) dated IQ ~0.
described in the Petition be admitted to
File No: ~ I I ~ - r
as the last (Will (and
F~ Rw-oa rev. lon/noil {~ Page 2 of 2
-,t.-~~;~,,'~' ~fu;,av
~t~..~.~,.. ~~
RENUNCIATION
~a~2 ~u~ ~~ at~ii~ as
~. ,.
REGISTER OF WILLS ~~~,`~ ~OUR~PA
uWl 6x-a-10.,f,,,~L COUNTY, PENNSYLVA A
Estate of ~..A~1Ce. ~11ow~F.r Kec IC/e.r ,Deceased
I,
in my capacity/relationship as
(Prim Name) r
,~~ye,~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
7J/~~ z
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this E day
of ~ ~
Deputy for Register of Wills
Form RW-06 rev. 10./3.06
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
purpos s stated within on this ~_ y
da
of.~ , 8D 1 Z
Notary Pu~Iic ~ ~
My Commission Expires: J ~l~(
(Siputun; and Seel of Notary or other official qualified to
administer oaths. Show date of expimdon of Notary's Commission.)
COMMONWEALTH OF PENN5YLVANIi~
Noladef Seel
Beverly K. Mogen, Notary PubNe
Upper ANen Twp., Cumbarteod Cant
My Commisaion Expko-s July T, 2019
Member. PenncylvaMe Aaeoclebon of Nofanea
~Qa~le~~:(~^ ~ /~~/ //
(City. Srate, ZipJ
I
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
__ P 17646047
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Re''connrds Office for permanent filing.
l~~cal Registrar Date Issued
n.?
4
[7 N
-lx
t5 ~ rn c~
V
i._. r c r
~~ t
~
.
BC _ f
'T'
_ ~
~~ ~
F ~~
C.)
X1W IM fIEV 11Rg6
1VPE/PRwTW
PERYIIIEM
@ALNM
a
6
COMMONWEALTH OF PENNSYLVANIA- DEPARTMENT OF HEALTH • VRAL RECORDS
CORONER'S CERTIFICATE OF DEATH
($pp I118ENN008 BOd B%a(IIPIl6 00 fWBf801 iaTF GII F xu1.6Efl
I.xmwaRmalMa. •uda bd Glfe z. sm tl.Rrlseo.p xwM I.aY9[INQFOUND
Lance T Keckler Male 198 - 62 -- 5367 November 8 2011
s.I.nelM xxxdml alMl UMI x.ordnwn r. altfbwl ad mom rPbwdo.m Crew awl
Rw Mm xmm[ ar..
r.w
June 24. 1982 C Hill PA ^tlwMl ^Pa louwMx CJcoc ^xmwq raw nrbxlw ^ow,~sMr
29 rre
.
acwhaomm x. ..naww n. Peary x...mealwml'I. a.mrwwwMl z.xr RUrwdxxo..m ognv ®xo w Ia M.IMwM rem. ae0. air. w.
Inyr. comas Cux.n (3 +A
Cumberland Shi enabur 101 North Prince Street rmm.PwbrM.l,ad White
• I1.OOM.IIW RadMevw - nrld wRnx eYY 12. Wr Ogrnrxn Ve IJ ROMP. Fe Wn!$~dlymx/dY.x Cxr ~xTl 11. 1YMM Mppl l3pthi MullW IS. axvMq S•nwtlwe. aw mean vlw)
KN dWaY xitldBUwnl4wwry II.S. MnW P°~1 Elelrnmryl5svdery10.12f Ctlxy 11~a5~1
^rM C71xo 12 Never Mauled
Isoma'. wMgbx.tlsiM.wylMen.wd,amwl R°0iY'° Pennsylvania u~m°n: xx" 1TC
^re5 ROrl wenb ro.
.
101 North Prince Street Apt.201 'dui Pdbwd
ROM11Aax can
na~xa
F
rte'
,
S
Li
Iro. w+r timberland
rdblmwd PPensb~rrr7
usrma
Shi f PA 17257
le. GweH xm.IPManw, mn Mrt le. ud.vexxrw lrsw, wM., n.x.l xalenwl
7hanas L Keckler. Karen J. Faust
2(a Hvmbll NvO1TW /PRN 3W.IMmIHe MWgKr.ISawl.tlNlbn. qt 41oa11
708 Hamilton Avenue Mechanics PA 17055
Els wmma Rwexa~ pclmMnm ^oo.tlm slx. RUaRwmm Aa+A W.sw IlF wwaRmweml~Mleawervv.o.~m}wdxrpwl Em.laullm lOryl b.n. mn.ywwl
(g awl O Mmwdnam wm w.e am.neen Rmnm.wmlMx
O
12 2011
N
b
Mechanics Cane Mechanicsburg, PA
p ax,m.,xPxary. : xyYMW Evnwrlawwwt ^w.
w er
ovan
zM mwww.Ma. mml YAMMw a.mm m.Mxwwwe..aPeary 8 Market. Plaza Way
- - FD - 014889 Mal zzi Funeral Hone Mechanics PA 17055
vy Gan fY. TO Ve Maury hnwlYr rw omme xud611e, rb.d Ww wma 459wnvptltlel mE.luwwrar t]u Oex SlV+a psTm, my. s..rl
bM 6M nlNb
Mryaoaren.
xmmnmuaFOUND x. Rb Pm[u'M CMIMVm. wY MN 3flW. CO PwmImMGIaIEOibM~l rglpMlml e(Mem~ Ctlw lbnCmwwIX WOlw}
Iy.lyynlMwmlµb]b/palm ~°i ~x0
• "'°IX°°""iOiYi 7:40 A. "'- November 8 2011
CwVBE Of OFATN IS.e lnwuetlene eM aempW) ~ kMaYmW YM+eI:
N
Y
' Mon EfMW
wR
mw dmlFMPI
M
a
NM' ze.mTSm WGnaNem Rebl
^rM QPmled/
mu~
, ~ O
W mCUN
Iwn31. PYII: FitrmefllEtlHLY-d.u.. rllw.aOlpwane-MaxNytvm Nea>,T. CO HJi MgwwwalmlN&Trw eg
.
nm
i
W
K
nir.xynHmwmmMbxeYO wMeeIwT9 Ve exlkp/.Lwml~wxOwnsxxw. ~Xp ^LXUexI
CMRE b0ea
w~w°"'E~rwezM~l
Inanition
a N.IIFSmM
^ xd
sMmw,w
m
.
y
awmlw.emwwd al'. w p
w
^ Pna•n xmbdawn
Mental Illness
MmmwG.x xry. e
ss
~~
~~
.
!gg~~!!
Pr°rt:'ux.nxue°.rtirnwr~eun~Pe` a.blIXwa<««owllw tiff:
1
a ^weel~waw+tlGa.llzrw
ppp1Fab0itl
~
' ~aa wvm+u Mtmlrem
^
•
RSmlwrxmawwm dl
.
e. ~
^ uM
a
wxPmawwrMw
v. wa mMmT.s 3R.wm Mhv/Fwp sl wMaown as pMaxrslxdw. M.v.n sm oemr xw llfs oamr r~
a
w`'on'ueasaartf~a9M.PbMy.
feMnMT nremMMwnculpeaall
d w.a dn? ~'1 XmM ^Hmlrw
^~aml ^Pmagl~l.xrmn se.rmdbilw sa.llsvva wore Yd.nrlvxpdban xfn f9Mar1 ~T nmm~dtlrylw.n wvlmen Frl
pw ~w ^r. ^w
^SUMw ^CM NxwRbmkb
^YN OW ^omlla.am ^Pwvdm^
n OYw 5f11P,
9M RMGIaYaMml m /~•
• Rxtlv+xlordMlPlryvM nlasvgrwedewn eabn enw. aMrMe Pmmwxw MnmdomgmesM V!
arna+I.eeu.loa.nugFlMmmrr..wLL________________________________ ^
iGnwxewam
bmwr} - ~ ~~ p' - Coroner
P
.
• PwlMemxlfmwwxMtlro alrlMlxI IPIIwIMMwdmedgabm xgwelbpnwwaMnl
^ a. wa. aerrr tie. Re a>xPPlwm, M.vrA
mm.Malw amwew.PrnaMmx rxl.a.,aw, me Wwwrawmx.wWgwq nlmlw. rbea__________________
• wa.lMmrl./Rww 2011
On NeYwaovwwlmwlaMMgmen,Mgopnbq amN eswMrlwaO,Cpe,Wpb.WawbuM nwyOWllwxlMrxlelrl~
~`` m. Mb dFwIMIw LOIIaMm RU.eO.M1IM!] Trya/PIM
n
n
5~
M ow ReelBaRn hr. VeeA
x ba (
Id l ~ l a~ l l l 3,I rbtiae^~ r (i7C+l eehore
Rda~u Suite
Ykl
637
- ~
olwa.eall Pemm r. 0693509