HomeMy WebLinkAbout02-27-13
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 n p
Name: RAYMOND L. SEILER File No: 0? r 0 - 02
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 203-52-0427
Date of Death: 2/10/2013 Age at death: 54
Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (State) with his/her last
principal residence at 704 SOUTH BROAD STREET 17055 MECHANICSBURG CUMBERLAND
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 704 SOUTH BROAD STREET 17055 MECHANICSBURG 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 $ 13,500.00
If not domiciled in Pennsylvania .............................Personal property in Pennsylvania $
If not domiciled in Pennsylvania .............................Personal property in County $
Value of real estate in Pennsylvania $ 157.000.00
TOTAL ESTIMATED VALUE.... $ 170.500.00
Real estate in Pennsylvania situated at: 704 BROAD STREET 17055 MECHANICSBURG CUMBERLAND
(Attach additional sheets, ifnecessary) Street address, Post Office and Zip Code City, Township or Borough County
❑ 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 and Codicil(s)
thereto dated
State relevant circumstances (e.g. renunciation, death of executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was noQvorced, was t W par sending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g),iid (M not havG* jhild 9
03 ~ r-n - ~
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
M C-)
0D C/) ❑ NO EXCEPTIONS ❑ EXCEPTIONS M r c» r
r- M
® B. Petition for Grant of Letters of Administration (if applicable)
c. t. a., d.b.n., d.b.n.c.t.a., pendente lCtc7 d rG t abse~ , dur ntte4gT'inoritate
If Administration, c. t. a. or td b. n.c.t. a., enter date of Will in Section A above and coi4m2 list of heirsr
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorceud been established as &MnE~
in 23 Pa. C. S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. 0)
EI 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
7624 TANEY PLACE
BARBARA J. COOKE SISTER MERRILLVILLE IN 46410
704 S. BROAD STREET
LESTER K SEILER l BROTHER MECHANICSBURG PA 17055
Form RW-02 rev. 10/11/2011 Page I Of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s) Printed Name Petitioner(s) Printed Address
7624 TANEY PLACE
BARBARA J. COOKE MERRILLVILLE IN 46410
54 E. MAIN STREET
MURREL R. WALTERS MECHANICSBURG PA 17055
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 belie
591, of P titioner(s and that,\a Personal epresntativ s of the Decg~dd~~t, the Pell 'oner(s) ill well a truly a minister tt~ date a or n to law. ~ ,
C% \ v-1, t ,,Lw11 C c~-n a (y I Vet l CAL-CS , 11
Sworn to or -affirmed and subscribed before Date
me day o IQDate
f1ju ) Date w M
BY
For the Register ;17 Date
Ia f " rv p'l Tz1
rn v d
BOND Required: ❑ YES ® NO To the Register of Wills: CKn
FEES: Please enter my appearance by my signatarC-J)e~gv:
c:7
Letters Attomey Signature: , r v
( Short Certificates(s)
( ) Renunciation(s)
( ) Codicil(s)
( ) Affidavit(s)
Bond Printed Name: DAV D R. GALLOWAY
Commission Supreme Court
Other ID Number: 87326
Firm Name: DAVID R. GALLOWAY
Address: ATTORNEY AT LAW
54 E. MAIN STREET
• • . ' • • • • • MECHANICSBURG PA 17055
Phone: 717-697-4650
• • • • • • • • Fax: 717-697-9395
Automation Fee op Email: david(cDwaltersgalloway.com
JCS Fee
TOTAL $
DECREE OF THE REGISTER
Estate of RAYMOND L. SEILER File No:
a/k/a:
AND NOW, , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters of ADMINISTRATION
are hereby granted to BARBARA J. COOKE and MURREL R. WALTERS
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 the last Will (and Codicil(s)) of Decedent.
Register of Wills
Form RW-01 rev. 10111/1011
Page 2 of 2
1110; 6o5 REV l9/1 l l
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00 RECORDED OFFICE OF This is to certify that the information here ~~i~en is
corectlt, copied from an original Certificate of Death
REGISTER OF V ILLS
duly filed with me a,, Local Registrar. The original
s c cltificate will he forwarded to the State Vital
!613 FEB 2 t iln 9 21 Records Office for permanent filing.
P 19179985 CLERK OF - ORPHANS' COURT ~MfNTfi~~'1
Certification Number mac- ac's
vo./vrml In Load Registrar Date Issued
t/~AA
CUMBERLAND
COMWPEALTH OF PENNSYLVANIA• DEPARTMENT OF HEALTH• VITAL RECONDS
PBlaacck inlet #2013-02-082 CERTIFICATE OF DEATH
Stele File Number.
1.Oecetlenl's Lgal Name (FInL Middle, asL Sumxl I. Sex 3. Setae Serer Numb 1F. Oarc o/ DeNh (MO/Dx/Yrl (Spell Mo)
Raymond L Seiler er
Male - bruary 1), 2013
Sa. Age aN glrthem, rrm) 5b. Under 1 Year sc. Under 1 D 6.Oaa of girth IMo rw/Year) (Spell Mo Uq ]a B x. fGry a d Sate er 17o"
)
Maras Day Mours Minutes
November 5, 1958 m. elrthplan kwmry)
ft. Me (Sale w Furelgn Country) gb. pesbe a (Sheet >Ib Number. IncludI Apt No.) k. Did O c of Uee Ina T-Ihlp?
, O Y V , derade.1 ll dIn hem.
Retbr reIEW
aal
Ba. thund n 12b [oriel brine, dxedent lived w W (iamb of enY/laon.
9. Ever m ti ~~ppnmi F.- 10. MvWI Sabs at Time of Death 0 Mamkd Widowed Il. SurYMng Spouse's..me (If wife, She name Drip to OM mart
10*
N
CIZ pNo 0u.- Olvhwted ®'ifolo Marred DunitE:
12 Fathers Name I M rile, Last, S.Mj 13, =Lftamni prior to flnt rage IFkst Mddle, -0
. I cat's Name 108 atb sMp a Deatlenl 1 . Inl 'f/NalNrig Adtl s (51 el Numb_e ry, tie, D
AI
Fy .............._.......................................'W ............~......x.. o,fret vvww qw1o
2 Il Death Ottrxr.dMaHmpIW: ylnpatlent........--.. .....-........~Il OeaaD[cuned SOmewherecOthv iMna HOSpItN-~yHVSpke FaNNry -~tDxetlent's HOme-Emery. Room/Qnpatlent Dead on A N l I3 Nursing Home/tioWTwm one Facility Olho (SWRY
15b. FadlRy Name (t,bt instltutbn, [he and number; I Sc. Oryor Town. Slate, and Zip Code 15tl. [aunty of Death
704 South Broad Street Mechanicsbu PA 17055 Cumberl n
IBa. Method of Dlspostbn udal 0 Cremation 16b. Daa of Dlapwluon 15c, wan of ObpwNbn IName of cemetery, vem spry, w whir pacaj
p 0 R.moval from Stale OWMWn
d Ott.,(specify ) 3 U,
Z 1 , lontbn of WpoNlbn IcRr wT ,Sate, and apj lJa. Sit Funv 5ervke Lkenue Peron In Chary. of Intetnenl 1]b.lkense Number
J N d made IPM ,T
18. retlent's Educatlpn - cF the boa That best desvbes the 19. Decedent w Hb nk Oridn - Check me 20. is Raze Check OHE ORE rxes to Nblcate what
high red degree w IevN of school completed at thetlme et death. boa 1ha1 best d_rlbes whether ae decadent the .dent conddared hMSelf or hmsell le be.
get grade or less Is Spanish/Hlspanic/L.: Check 1M "NO" ~ta ❑ Kwon
o diploma, 9th 12th gnde byy1f decedent Is not S eamh/Hllpankt.o., 0 gad w African American 0 ulor.mese
Hlgh=olgradue or GEDComplelul t+Sno. not Sp.Msh/111spank/tAirm D Amercan lMan w Masks Natty OOther Asian
❑ Seoe college cletlll, but no degree 0 Yet. Mind-, Malian Amerkan, Chi- 0 Alan Indian 0 NaWe H -lian
0 Aapdne degree ftFg. Auk, AS) 0 Yet, Puene Rican D chorea. D Guaoadan er Chamome
❑ Bachelors degree (e .g. BA, All, 55) D Yet. Ulan 0 Flllplno D Samoan
0 Matter's degree (lig. MA, MS, MEnL MEd, MSW, MBA) 0 Yes, other Spankh/HNpank/ailno 131- ete 0 Other Pacific Islander
0 Doctorate (e.g. PhD, Edo) w Prof.sdonl degree (Spvtry) D other (salcim
e.. MO DDS DVM, LLg, ID
21. Oeydent's Single pace seNOesl[natlon-Check ONLY ONF to Indkate what the tlxedr!nl comlderad hlmsel! or hersell to be. 22a. Decedent's Usual Occupatbn IMkate type of wok
Re 0 jot emal, ❑ Bamd+^ during most oT perking Ite. DO NOT USE RETIRED.
OBlack orAfrican American Dgprean DOther Padfcblander I Amin- Indian or Italia Pill. 0Vklnameu 0Don't gnaw/Not Sure
0 Aem, Indian 0 Other ANan 0 Refused 221. Kind of ./Industy
❑
rnlnae 0 NNhnH or n other IspxlNl
❑ Chi G I[.. ar
n D Yl _ _ _ 1
pam ETamprnp IL-.YUIV fY VL7s-~A+11
-S 23a- 23d MUST BF COMPLETED 23a. Dab Pronounced Dead Mo/Day/Yrj 236. Signature Person PronouncInr Death (Onry when app kaMN 23c.llcenFe Number
BY PERSON WHO MONdINCES OR
CERTIFIES DEATH
23d. Dme Signed (MO/Day/Yr) 21. Tkne of No,
Unknown A. M. zs. was MedkN Exammo or mronr conlacaeJ r.F ❑ No
CAUSE OF DEATH I Apio nin
26.Pa L EnlxtM¢lalnofenana.-dlseases, injurix,ornmpllc d otbeldlreaNa,sed the death. DONOTodertommileventssuchasnrdletarrest I Interval:
resplntory uresL wvenlrkulx Rbrllatipn without showing the etblpgY. Oo NOTABBREVMTE. Enter only en cause en a line, Add addithml llrucs N rwcesary i 0. to Death
IMMEDIATE CAUSE Pending Investlgation i
(Final race. or terWiden Ouw a (or>s a consequence M: I
nsumng In death)
b.
Sequentially tilt codill m. Weto(w o. comeauNNe pre;
Harry, le.mng to the u,,..
N3led pre line a. Enter the t
UNDERVING GIBE We to for as a comoftence on:
5 (diseau or Injury tiut
inkload the event: reoultIn[ d. I
In death) use. We to far..... Fam, rln o0:
26 Part 11. Enter other significant conditb contributing to de but not resulting in the und.tvlng cause then in Part l 27. Was an autopry pekormedJ
a
i m net 13 No
2e. wen>aegwy nnel,ha: antabk
to camplea the cave of death?
vy l7 Yes m Me
P 29.11 Female: 30. DM Tabec[o USe Centdbute to Oeath7 11. Ni-nerol Death,
ii 0 Nw pregnant within pan year 13 Yes 0 P..M, 0 Natural Hooked.
0 Inerrant at three of death 0 No 0 Unknown 0
E3 Nolp ium but peg^anl within 42 d., .1 death 0Actident 0P Idedann
0 SUkb! _ 0 Could b rot be dNermlruM
o NN pregnant but Pregnant 43 day to 1 year b death 32. Date of Injury (Mo/DaY/Yrj (Spell Month)
0 Unknown N pregnant wnhln the past am 33. Time of Injury
31. Plate .1 Injury (a 1. hoo.; connrvclion site; (arm; uhooll 35. Location .1 Injury (street and Number, 0". Stale. cep Cod.)
36. Injury It Work 1 371
N Tri n en-l , Injury, SpecilY: 38. Describe How Injury Otcwr,el
13 Yet t7 Driver/Operator C) Faroe, to
0 No 0 Pimiento ❑ Other ISPecify)
39.. Coti lolCherk only one):
0 Certifying Phykiln - To the best of my knowledge, death occurred our in the cause(s) and manner stated
0 Preneunclng L Ce tiMn h,ewci T tlhe best of my knowl.dre, drib aaurmd at the tlme, date, and place, ant due to eM nuulsj and manner Hated
0 Matual Eaamix/ - On th Is of eM Ua\[\` q,,nd/or Imo tier, in my opin-, death occurred at the time, doe, and place, orb due to the..nNs) and manner hated
Sknlw. N nrtlnx: 741-freolfo: Coroner
license Number:
39b. Name, Atldreu and Dp Cade of Peron Completing Cauu of Death Illem 261 3k. Date 51[nM IMO/Oay/Yr)
Charge E. Halt Comm 8375 Bwehorei Road, Suite 1, Mechanlml urg, PA 17050 Feruary 15, 2013
40. Ba[Mrar i Diane N r 11, pegNt y ores 42 tree fl Date Day r)
1j 1~,1i R ~h1q `i
13. Amabmmb
Dhposlden PI-ft HOW(-l s~.~s~`~ HI S-143
REV 07/2012