HomeMy WebLinkAbout09-26-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, appty(iea) for Letters as specified below, and in support thereof aver(s) the
following and roapetxfulty requests the grant of Letters in the appropriate form:
Decedent's IMormatlon
Name: Joseph M. Genera
allele: J~enh Wrfin t^snaro
aAda:
a/k/a:
Date of Daafh: 0 910 81201 2
Decedent was domkiled at death in Cumberland County, PA (State) with hisRter last
principal residence at 208 South 31st Street, Camp HIII 17011 Camp Hill Cumberland
Street atltlrses, Post Oftica sntl Zip Code City, TowrpNp or Bdggh Cwnty
Decedent died at Harrisburg Hospkal Harrisburg Dauphin PENNSYLVANUI
SIreN address, Post Olftce end Zip Code Cay, Tawnshq or addgh CourNy Stab
Estimate of value of (iecederd'a property at death
Ndomlciltrclln Pennsylvania ........................ All personal property $ 50,000.00
Nnot domlNNd !n Pennsylvania ................. Personal property in Pennsylvania $
Hnot domiciled In Pennsylvania ................. Personal property in County $
Vsltro o/rosl tttstate in PennsyNania........... $
TOTAL ESTIMATED VALUES
Real estate in Pemsylvenie sftWled al
(Atbch eddllbnal sheets, X rtecaaay.) .
Sheet address, Post Olace and aP Coda City. TownMip or aorotrph County
^ A. PeUUon for Probate and Grant of Letters Testamentary
Petlsoner(a) aver(s) tttat he/shelthey fa/are the Executor(s) named in the Last Will of the Decedent, dated
tMreto dated and Codidl(s)
(State MNWnt dreumetanaa, e.p., renunaeaio7r, death olexecuror, etc.J
Except as idwwa: alter the exetxfiort of the inatrument(a1 offered for probate, Decedent did not ma was not divorced, was not a pa irrg
divorce pro~a~rg vAtatain 1M grounds for tlivorce had been establbhetl es deflrtetl in 23 Pa
C
S
~~3323(g)
and did riot have a child N m
.
.
.
,
adop0ad; arM Deoedern was nsitlrer the victim of a killing rwr ever adjudi~ an incapacitated person. y
rTi
'~
^X NO EXCEPTX)N8 ^ EXCEPTIONS ~' ~ ~
~-' ~
^X B. _Pe~t Lion for Grarrt of Letters of Adminlstratlon (r ) ~ ~ - T7 ;~
c..a.; ..n.; ..n.c..a.; a;
M Adminbtratton, c.ta or d.6.n.c.ta., enter date of WIII In Section A above and complete list of heirs. ~ r~'~,
Except as fellows: Decedent was not a parry to pending divorce proceeding wherein the grounds for tlivorce had been established as
to 29 Pe. C.S. § 3323 (g) and was rtttitlter the victim of a killing nor ever edJudiceted an incapaelfated person. ~~
Q ~ j i'*i
^X NO EXCEPTIONS ^ EXCEPTIONS ~
Petitioner(s), after a proper cearoh haahtave ascertained that Deoadart left no Will and was aurvivetl by the fdlowing spouse (if arty) and heirs (attach
atidMbna/chests, Mne~essary):
Name Relationship Address
Sarah Carrara Wffe 3108 Chestnut St.
Camp HIII, PA 17011
Ava C. Genera -Age 5 years Daughter 3108 Chestnut St.
Camp Hill, PA 17011
Josephine 8. Canero -Age 8 mouths Daughter 3108 Chestnut St.
Camp HIII, PA 17011
Fam RW-02 nv. to•11-2077
CopyrpM (c) tot 1 form software only TM Lerlorar Group, Inc.
File No: 21 -12 - ~Qrj~
(Assigned by Regbte-)
Social Security No: 234-08-5782
Age a< Death: 43
Papa 7 Of 2 ^~
'\
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} ss:
couNTY of Cumberland }
mom/a~rpueeCony
?f ~llt1~L~ VI F~
REGiS;:.~ ~;;,;~ t~~ll~.S
Petitioner(s) Printed Name Petitioner(s) Printed Address
Sarah Canero 3105 Chestnut St
Camp HIII, PA 17011
(~A~BEALAND C0 , A4
1 he Petmoner(s) above-named swear(s) or aiflinn(s) the,statements in the foregoin Petition are true and correG to the best of the knowledge and
belief of Petitioner(s) and that, as Personal Representative(s) of the Decedent, Pet~i/oiner(s) will well and troy administer the estate according to law.
Swom to ffxmed an sub 'be before ~ r~ /~`d o~• 9 ~2 6 ~
me thi da , o r~ ~•
Date
~• Dete
BOND Requirsd9 ~ Yss ~ No To the Register of ltitlls:
FEES
Letters ............................................ a _ ~10~
( 10 > Short Certficate(s)..........
( ) Renunaation(s) ...............
( )Codicil(s) .........................
( )Affidavit(s) .......................
Bond ..............................................
Commission ...................................
Other
Automation Fee .............................
JCS Fee ......................................... ~,
TOTAL ........................................... S T~~~ r ~ "
Please errtsr my appearance by my signature below:
Attorney Signatu
~
` _
Printed Name: Richard E Connell Esq
Supreme Court
ID Number: 21542
Firm Name: Ball, Murren 3 Connell
Address: 2303 Market Stroet
Camp HIII, PA 17011
Phone: 717/232-6731
Fax: 7171232-2142
E-mail: eonnell~bmc-law.net
DECREE OF THE REGISTER
Date of Death: 09i0N2012
Social Security No: 234.08-5782
Estate of Joseph M. Gnero File No: 21 -12..
aAc/a: Joseph Martin Cansro
AND NOW, Q , in consideration of the foregoing Petition,
satisfactory proof having been presented. before me, IT IS DECREED that Letters of Administration
are hereby grerded to Sarah Cansro
in the above estate and (N applicabb) that the instrument(s) dated
described in the Petition be admitted to probate and flied of record as
Fam RW-02 rev. rar t-zor t Copyright (c) tot t roan sortware a,y me lxknx G/roua~ inc. ~"vI.LO 7f~` JF'fC" Peaeka z
LOCAL R 'S CERTIFICATION OF DEATH f ~~/~~~
WARNING: ~e this copy. by photostat or photograph.
/ n
Fee iix this certificate, $6.00
P 18800501
2012 SEP 26 PM !: I~iH OFpf`-=.-, This is to certify that the information here given is
yy cocrecdy copred from an original Certificate of Death
py' rfr' duly filed with me as Local Registrar. The original
_ ,~ ~.
<vLLit ~ _' o _ ' .,. _, z3 certifcate will be forwarded to the State Vital
,S * - ~- * ~ Records Office for penn~uient filing.
a`
9r F~<v,,l
n.k MfNT 0 dl
,,,,, ,,,,JJJ,,,,
Local_ Registrar _ _ _ Date Issued
____.__-
COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH .VITAL RECORDS
CERTIFICATE OF ~EATN _____ _ _ _ _ _
Certification Number
Typ//riot In
P•rma,Nnt
RI.n41n4
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W
1. DecWntY laNl Name (First. Mldd M, LaR, sufflK) 2. Sax 3. Sotlal S•curhY Number ~ 4.•Dab of Death (MO/DeY/Yrl (Spell Mol
Male 234-06-5762 September 6, 2012
S. Ap.la Birthday (Vn) Y • c U r 1 w 6. Date of Birth [MO/DEV/Yerr) (SPell MontR) Tr. 61rthPbu (qty a,M 3t~tP qr0 r•Itn Country)
MenMf wys Nouns MlnutN 3tOW11 L~11
F~brua 19 1969 Tb. Birthplace (County)
M. RNldenw IStetr w Foroltn eeurdrv) tb, Resklrnee 1$trrrt end NYmber- Intlude Apt No';) 0<. Did lt•eeden<Llw In a Township?
P' a QY4F. drerdrm IIWd In twp.
td. RNldeno (COVnH
r. 1Ykkhnu Is•P Cede) ~q'
tare, hcatl•M Ilyed whhin Kmits of dH/bere.
B. lyer In U
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..yAyr
ed Forasi 30. Madfal StatN at 11m• o Wet rcletl ow 11. Survhrlnt Speuse•s Nam• (I} wire, tiya name Pdor <o flirt merdapl
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QYN e„w,.o QUnknOWn QDNOrpd QN•Wf Mrrrletl QUnknow
12. Nt • Name (First. Mlddlr, Lest SufflK) 13. MotMr'f Nam• Prbr to First Marclate (Pint, Mltldl•. last)
Martin Canero He ins
Ls. InloDne • Namr 14b. ftrladonshiP m DNetlerK Ik Informan<L Mallint A dies (StrrN and Number, qH. 5iaq, Dp Cedel
240 Millbrook Vill a Dr. 2
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.... .. ..• .... ................................. . ~~! , •t...'..«., n one .............. ...........
ty ....... ....... ....
Mae1M1 Occurri~n ~ I(oapttiY••••••••••••t~•rrry ~tlwd H Oreth O«urcitl Se awhrra QMr Then • H PM I:. •t~HOSpic~ ~acNIH •.•••t~~Deaadeht's Nbme •..
Emr RO Ou atNn< Deed en Arclval NYrfi MOm bn -TrrmUre FaeN Other 5 M
1S . Fetlllty Nemrp net InstituNpn, tN• street a ntnn rl 15e. GN or Town, Sgtr, Intl ZIP Code 19d. GaunH oT DNeh
Harriebu Hospital Harrisburg,. PA 17101 Dauphin.
,6 3 dwesltbn weal Onm.ewn 1¢b. we. O.Rlen S6c. Pro a Dispn. Ion (N.m. a .amee.rv, er•m•eerY. er oaer P).ul
Q Rrmewl from SLN ° Donation
Other Se -telQliHr 15 Gate of Heaven McCYtanictsbur Pa 17055
3 . LPCaibn bpNhbn GH or Town, Stale, and Dp) W FY or Prnon in ergr of Infercnlnt SJ . Uunse NYmber
MecYlanicsbt2r Pa 011654-1
1>e. Name emf Complete Address of Funeral Fatllhy
~ L. tlrnt'f Edue - Cheek eM beK rhea at descN of n< a pan c n _ • < e p en f ee - etlt ONE OR MORE ncN to Indlota what
hYhest tl•trN or level of Scheel complNed at the time o1 Wath. bN tMi brf[ tleseribef whe<hN Ma tleotl•m tM d•otl•nx unsiderrtl hlmseR er henah m tM.
Q hh OetlexbN Is Spanbh/NlsWnkJlatlno. Check Mf 'NO^ Q Whha Q Konen
Q No diploma, fM - 12th eratlr bar If tlaatlent b not SPanlsh/Hispanlc/Lstlnp. Q Black or Afrk:an Amerk:en Q N•mam•se
Q Nith school tratluete or OED tom Pbt•d Q[IVO, no<5penbhMlswnle/lanne ~ Amerlon IMlan or Alefke NatlVe Q OtMr Nlen
Q Same <uNr
r ortlh
but
tl
Y
,
na
yrN Q
t
N, Mexlon, Mexk:an Amerlon, Chlune Q Aflen Intlbn Q Natlw Hawaiian
Q Assocbte dNroe (e.t. M, AS/ Q Yes, Puar[o Rlon Q Chinese Q Guamanbn er Ghamorro
'
Betlfeler
a tletrN le.t. BA, AB, BS) Q Yrs. Cuban Ig FlePlno Q Srmoen
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as
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rRre le.t• MA, M5, MEnt. MEtl, MSW, M6A) QYN, oMer Spanish/NhPanir/Latino Q Japanefe Q O[her Padflc IslandN
O DoetOfete (e.t• PhD. EGD) Or ProfambnN detror (SpeeMy) O Other (SOrctNl
VM J
Z1. DewdenYs SIntN Rep 5eR-DNk(netlon -Cheek ONIY ONE m Intllot• whet the decedent considered himself or herfeR m be. 22e. wotl•nt's Usual O«uPatbn - Indkate type of wont
0 Whlta ~ JepeneN Q Samoan done tlurint most Of Yrorklnt IRe. DD NOT USE RETRED.
Q Bbek Pr AM1lon Amerleen ~ KerNn Q OM•r Patlflc lalantler
Q Amerlon Indian or Alaska NetW Q VNmameN Q Deno Know/NOt Sur• ter Pro rat[iLr
Q Aelan Intllan Q Other ASlan Q Refusetl 22b. Kind of Busln NS/Induatry
q ChlnNr Q Netlw H•w•Ilan Q Orh•r (Specify)
IIpM O6uamanbnorcn.merco Delta Airlines
^ - D eb ronouno wa Mo sy Yr 23 : 9ltneture a Prrmn Pronoun<In DNtn w ens
ar PERSON woo ewaNOUN~s OR September B, 2012 t ( ^ pPROb •. c Llnnse NYm r
23tl. Date 31tM Mo V Yr) 14. nme Of oeeth 1 1 :07 PM
Z9. Was.M•dlol Examiner or Cmroner CPntrccedT ® YN Ne
CAUSE OF DEATH
APProxknx•
36. tirt 1. EndrtM ehaln of aw•~<s~tliNeas, b)udN, or ompl4atbns-that tllrrctly uYfrtl the tleaM. DD NOT enter Lrmbel •ynH such N urtllaeercast
Inbml:
.
rNPlramrY errosy er yrn[rlrvlar flbdlletbn without shewint the •tbbry. [KJ NOT AB6RCVIATE. Enter on1V one oufe en a Iine. Mtl adtlkional lines If n•wawry Onset [o waM
IMMEDV.TE CAUSE -------> a. Gunshot Wound To Head
(Final dlNase or contlhlon w• m for N • cona•gwnu oT):
rosul<Int In tl•aM)
b.
Squentblly Ibt opnditle..s, Due m (er .: a conoquance. ot): E
If enY. Netllnt tP Me reuse
Ibvtl on Ilm a. Erlt•r Mr c.
YNOERLy1NO OUSE pus m (er ea • con»quenpof):
(tlYNfe or MJYry Met
r
InMabd ehr ewnb rsuklnt d.
In deethl LAST. Due m for N e «roequ•ncv Ofl: t
2Q pert R. Ender oM•r but nctrrauhin6ln Me untladVlnt ous• then In Pert I 27. Was en eumpry p•rbrmedT
N
} e
ZE. Wars evtppry flndlnp awllebb
m cpmPletr.Me uON of tlaaMT
Y s No
29. M Female: 3D. Dltl Tebe«e Use Centribub to wafhT 31. Manner of Death
Net PNitMm whhM pert year QYN Q ProbeblY Q Natural Q Nomldtl•
ai Q Prop,•n<et tkev of deeM ~ NO Q unknown Q AceWent Q P•ntlinf lnyastlp<len
Q Not Prrtnem, but Pretnant wIMM 42 days eT death ® Sultlda Q CpOld net br tlKermbetl
Q Not pr•tnarrt. but Pretnent 4H deyf t0 1 year b•fOrr ONtr 32. De<e O/ INYrY (M Day/Yr) 9p• MenM)
Q Unknown M praEnant wlMln Ma past yea, September S
2012 3S' rTe of iNurY
,
qpx 10.25 P
34. Pbo of In/uN le.t. hems; cpnx[roCdon ah•; r , u I) 35. LPOibn o1 Inlurv (Sira•f antl Number, CRY. 9teo, ZIP Code)
Reeldanca 3512 Clovemeld Road, Harrisburg, Pa 17109
%. INury N Work 37. If Tnnsportetlen inlYry. SPe<ify: 3t. wacribe Now Inlury occurred:
Q Yaa p dh,•./op.r.tor O Ped«tnen Gunshot Wound To Head
® NO Q PNfenNr Q Other (Sp•cMy)
3Pa. 4rtlRrr (CMCk only enr):
Q brtllylnt physlcbn - To Me beat pi my knewNMe, tlNM occurred tlw to Me ouse(al and manner stated
~ PronountlnE a UrtlfylnE phYfleien -Te Ma fYft Of my knoWl•dte, d•aM occurred at the time, tlaa, antl pleee, end tlua m M• ouN(s) and manner staietl
® Matliul Examiner/COro t f atbn, and/er InvrfNEatlen, In my Pplnion, death occumd a<the time, date, antl Place, and dw to M• ous.la) .nd manner rtaead
Sltna<u raMOrtNI• one of oerofler: Chief DeDUty uonse Number:
HHb. Name, AtltlroN antl ZIP d• Person Com Ple<Mt Caws wNh (hem 26) 39e. wq tM1W ( D•Y/Yr
l,lsa A. POtteiper, 1271 South 2Sth Street, Hamsburp, PA 1711.1 September ?, 2012
40. Pet t f Dh et Num r 41. R•tbtra s ! 42:R nr 1 • Date y.. r)
1 ~ - a ~~ - i
a. s O
49. Am•nem.nt.
Dlspotlibn Permit Nol/ ~ V fI ~a~ NIAS-149
REV 07/2011