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HomeMy WebLinkAbout03-15-13 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 requests the grant of Letters in the appropriate form: Sheryll B. Heard Decedent's Information i Name: Michael Wendell Boyd File No: . 21-U a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 229-84-5663 Date of Death: 10/06/2012 Age at Death: 54 Decedent was domiciled at death in Cumberland County, PA (state) with his/her last principal residence at 225 North Bedford Street, Carlisle 17013 Carlisle Borough Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Highway 903, 23919 Bracey Mecklenburg VA 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 $ 52,000.00 If not domiciled in Pennsylvania Personal property in Pennsylvania $ If not domiciled in Pennsylvania Personal property in County $ Value of real estate in Pennsylvania $ TOTAL ESTIMATED VALUE $ 52,000.00 Real estate in Pennsylvania situated at (Attach additional sheets, if necessary.) 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) that 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 marry, was not divorced, was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 33238, and did not4Tave a chil(iborn or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. G c rt'1 M F1 NO EXCEPTIONS F1 EXCEPTIONS G-) O 44 ❑X B. Petition for Grant of Letters of Administration (If applicable) :U c. t. a., d. b. n., d. b. n. c. t. a., ped nn a 1t dUTInte bnntia. d}uant minoritate (12 ,a3 If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above and comolete list of heirs= G.N Except as follows: Decedent was not a party to pending divorce proceeding wherein the grounds for divorce haii been estat tt hedlS dQined in 23 Pa. C.S. § 3323 (g) and was neither the victim of a killing nor ever adudicated an incapacitated persona r ? © NO EXCEPTIONS F1 EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the {lowing spouseV an)Wf anleirs (attach additional sheets, if necessary): t Name Relationship Address Kathy Boyd Sister 273 Marengo Road LaCrosse VA 23950 Barbara Boyd Sister 14335 Long Green Drive Silver Spring, MD 20906 Carol Edwards Sister 916 Park Terrace Fort FortWashin ton MD 20744 Robert E. Boyd, Jr. Brother 2509 Grove Way Drive Valrico FL 33596 See continuation schedule attached Form RW-02 rev 10-1 1-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 PETITION FOR GRANT OF LETTERS (Continued) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Decedent: Michael Wendell Boyd File No: 21-12 a/k/a: Social Security Number: 229-84-5663 Date of Death: 10/06/2012 Age at Death: 54 Namg Relat[onshin Address Mary P. Boyd Mother 273 Marengo Road LaCrosse, VA 23950 Robert E. Boyd, Sr. Father 273 Marengo Road LaCrosse, VA 23950 Sheryl[ B. Heard Sister 3252 Twinflower Lane Virginia Beach, VA 23453 COMMONWEALTH OF VIRGINL4 CERTIFIED COPY OF DEATH RECORD COMMONWEALTH OF VIRGINIA - CERTIFICATE OF DEATH coPY A DEPARTMENT OF HEALTH - DIVISION OF VITAL-RECORDS - RICHMOND gEG1S7 T,ION CERTIFICATE RDWtiy1~N 2H 8A dJ BERo NUMBER MEDICAL EXAMINER'S NUM ER`E VITAL RECORDS r r CERTIFICATE D ULL- AME- (first) (middle) (last) 2. SEX male female OF D -C DENT /rye ~~{7 L013 MHR OF (110) ,(day) (year) 4 AGE IF UNDER 1 YEAR IF UNDER 1 DAY 5. DATE OF (mo.) (day) (year) 6. WAS DECEDENT❑ E r. months T days hours I minutes BIRTH EVER IN U.S. yes no p1 ❑ 1 0 (7 to 2- 6 Al years I I I ARMED FORCES? IOt PLACE OF 1 N l'OF HOSPITAL OR INSTITUTION OF DEATH (if none, so state) I Out Pat. 8. COUNTY OF EATH (if independent city, leave blank) DEA x H AA p i DOA Eme❑r Rot Inpatient TV R R ! ; i J lr.,r yes C U M B E R L .TY F} TOWN OF DEATH inside eisy or to n li riots? 10. STREET ADDRESS OR RT. NO.OF PLACE OF DEATH ~c( ` q o.5 USUAL 11. STATE (OR FOREIGN C NTRY) OF DECEDENT'S RESIDENCE 12. COU OF DECEDEN 'S RESIDENCE (if independent city, leave tilank) RESIDENCE OF DECEDENT pe n r%<4 an 0- C"Vkfy%lol..l Q f ^ vl 13. CITY OR TOWN S DENCE inside city or town limits? 14. STREET ADDRESS OR RT. NO. OF RESIDENCE I ZIP CODE yes no I x rl ` ❑ ® 22 K01,4h ; I '10 -E ° PERSONAL 15. N OF DECEDENT'S FATHER Y t OF 16. MAIDEN NAME OF DECEDENT'S MOTHER DATA -O E DECEDENT 0 her ff. rt/' /t e-1 or 17. RACE OF DECEDENT If 8. OF HISPANIC O IGIN? If yes, specify Cuban, Mexican, 19. EDUCATION ( ify only highes rade completed) t ° Puerto Rican, etc. ~I ^ / IL~J no ❑ yes I n o N.V Elementary/Secondary (0-12) Collage (14 or 5 c 'o 20. CITIZEN OF WHAT COUNTRY 21. BIRTHPLACE (state or country) 22. NEVER MARRIED ❑ DIVORCED ❑ 23. IF MARRIED OR WIDOWED, NAME OF SPOUSE °a m (if divorced leave blank) i n MARRIED WIDOWED 54 24. SOCIAL SECURITY NUMBER 25. USUAL LAST OCCUPATION 26. KIND OF BUSINESS OR INDUSTRY 27. INFORMANT - OR SOURCE OF INFORMATION E, m T O LL 0 229 44.53 , t r~ v ~ I rw*,% heir eard - S, s ~~I'' m W 28. PART 1. Enter the diseases, injuries, or complications that caused the death. Do not enter the mode o ing, such as cardiac respiratory arrest, shock, or heart failure. INTERVAL BETWEEN > CAUSE OF DEATH List only one cause on each line. n j rQ ONSET AND DEATH m m 3 T IMMEDIATE CAUSE (Final disease or (q) 1 1 condition resulting in death) - ~ DUE TO (OR AS A CONSEQUENCE OF): z3 $ MO EDICAL t ^ . c y EXAMINER: V Elf CC V LA A, ~ R\E01C c o.. Sequentially list conditions, if any, leading (B) W to immediate cause. Enter UNDERLYING DUE TO (OR AS A CONSEQUENCE OF): g 2 CAUSE (Disease or injury that initiated m Complete and sign events resulting in death) LAST a E medical certification, C (C) n c (item 28) did give alf p: PART If. Other significant conditions contributing to death but not resulting in the underlying cause given in Part I. F211aAU TOPSY? Ma o tkg yes no THORIZED BY: m m 3 copies to funeral 28d E director as soon as LL `b C + I Q(~ " F C+~ El 29 n possible after inquiry. F m ¢ 28b. IF FEMALE, WAS THERE A PREGNANCY 28c. IF EXTERNAL CAUSE, IT WAS . DESCRIBE HOW INJURY RELATING TO DEATH OCCURRED V IN PAST 3 MONTHS? PRIMARY or CONTRIBUTING E] ,r. O;c J ❑ ❑ ❑ TO CAUSE OF DEATH 3T~~CK 0 R SCL-r' a iE Q yes no unknown r v E NOTE: If C 28e. TIME OF INJURY (mo.) (day) (year) 28f. INJURY OCCURRED 28g. PLACE OF INJURY (home, farm, 28h. (city or town) (county) (state) "Pending" must be f factory, street, office bldg., etc.) 1 indicates, while not while notify regis- r Z- I var of final decision at work at work t;L 01q th S ( Q E I p R A cc Y as soon as possible. 28i. I CERTIFY that I took charge of the remains described above, viewed the body, made inquiry and in my opinion death resulted at or about PM) from: NATURAL CAUSES ❑ _ ACCIDENT -SUICIDE _ HO ICIDE ❑ UNDETERMINED ❑ PENDING ❑ T ~r O . ACTUAL , DATE SIGNED: p SIGNATURE ,M t d " -1 j L- _ ________________I_ _ _ NAME OF MEDICAL EXAMINER (Type or Print) I ADDRESS OF MEDICAL EXAMINER V, .S. f4Gtd0L&Y 0`10 ; LscYo-nrv V (rIItzLFIV (3uKGr 1 FUNERAL 29. BURIAL REMOVAL CREMATION 30. PLACE (name of cemetery or crematory) (city or county) (state) DIRECTOR OF BURIAL, ❑ ❑ REMOVAL, ETC I(~IS IFDI~5cLN i k,/y~L A1 2_39I q 31. (Sig to of funeral direct r or person legally filing(tly~'Is certificat ••L~ NAME OF FUNERAL Irt5 . S ni (Q 1 E5 - 7 HOME AND 00. Cw~n Ii,~ A ` ADDRESS: f,` I TIC~Y~'rC REGISTRAR 32. 'nature of gist r) JVVV DD9 ~~~...lll , UCH DATE RECORD I FILED: _ a RESERVED FOR - REGISTRAR'S USE - to This is to certify that this is a true and correct reproduction of the original record filed with the Mecklenburg County Health Department, Boy Virginia. Date Issued -CL ~t At Registrar or Deputy ' (.SEAL} ANYREPRODUCTION OF THIS DOCUMENT IS PROHIBITED BYSTATUTE. DO NOT ACCEPT UNLESS IT BEARS THE IMPRESSED SEAL OF THE MECKLENBURG COUN2'Y DEPARTMENT OFNEAL TV CLEARLY AFFIXED. Section 32.1472, Code of Virginia, as amended. RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Michael Wendell Boyd Deceased Robert E. Boyd, Sr. in my capacity/relationship as nn Father of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sheryll B Heard Qdx v~ 013 (Da (Sign' re) Robert E. Boyd, Sr. LA- ° 273 Marengo Road Cj) _ (Street Address) LaCrosse, VA 23950 La._ :a._ CL. (City, State, Lp) C:71 01 U-) LLI rzi c- U-j t_ M Exe Rrd in` Registers gtfice Executed out of Register's Office Sworn to or a Wined and subscribed Before the undersigned personally appeared the party executing this renunciation and certified before me this day that he or she executed the ren ~7ciation for the of pur s stated within on thicS/ day 14/✓IrC ?yaw Deputy for Register of Wills Notary Public My Commission Expires: (Signature and seal of Notary or other offlcial qual~ecito administer oaths. Show date of expiration of Notary's commission.) ~ ~w a800~ Form RW-06 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, , %L UM RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Michael Wendell Boyd Deceased Mary P. Boyd in my capacity/relationship as o-nnt e Mother of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sheryll B. Heard (Date) (signal r) Mary P. Boyd C CZ) CI <C 273 Marengo Road t (Street Address) LaCrosse, VA 23950 Cj (City, State, Zip) Lr) UJ 3.e..) LA I C v~ ® g c-~7 ~ Exea"din Rejister's Offke Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this da party executing this renunciation and certified day that he or she executed the renuSc tion for the of purpo es stated within on ay of ~ a2p/3 o~ Deputy for Register of Wills Notary Public My Commission Expires: (731/~~,(~/Cj (Signature and seal of Notary or other official qualified to administer oaths. Show dale of expiration of Notary's commission.) Form RW--06 Rev. 10-13-2006 Copyright (c) 2006 farm software only The Lackner G RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Michael Wendell Boyd , Deceased Robert E. Boyd, Jr. in my capacity/relationship as Brother of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be Issued to Sheryli B. Heard (00te) m9r*'61 Robert E. Boyd, J f. 2509 Grove Way Drive x-..t (Sbvet Addrwo Valrico FL 33596 MY, iu < ( Y Staff 1JP) to C Uj Q- cr= m CJ GJ Cz Q= UJ 4 Executed in Rei-ister's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this - da party executing this renunciation and certified . y that he or she executed the fe )ation for the of purposes stated within on day ZU 1 g of Deputy for Register of Wils tary Public y Commission Expires: S S *aft stw~w"afaa or odw cf smmmluM) MMitx ERIC T. WATKINS NOTARY PUBLIC STATE OF FLORIDA Comm# EEOWIS Expires 5/1/2015 Form RW-06 Rev. io-m2m copyrigm (o) zoos form so tmm orgy Mw Utdo r Group, Mo. RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Michael Wendell Boyd Deceased ( Carol Edwards in my capacity/relationship as u-nni ame S t sy' of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sheryl[ B. Heard -Z 13 (Dare) (Signature) Carol Edwards LL- C) Lau :.:i t- 916 Hawk Terrace Fort (StreetAddress) c Fort Washington, MD 20744 qyr' tt~ (city, state, zip) ti Lo - Q E.z.,9 U-1 LAJ J _.1 _ C= U Uj t ' M Executed in register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the party executing this renunciation and certified befPra mo that he or she executed the re ni,~tion fQ(tR' "1~~~~~~~~r~"''~ in on m ay ~J`~i A of- purposes stated with On rOOM ' `r' OTAR , Cl rZ Deputy for Register of Wills Notary 15ub ( = 2 A ` My Commis ion Expires: F •.~it r 24 Zo.O • (Signature and seal of Notary or other official qualified to ,0 administer oaths. Show date of expiration of Notarys commission.) ~iC460 E, S Ci ''t'~'g4u ut+s, i Form R W-06 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Michael Wendell Boyd , Deceased Barbara Boyd in my capacity/relationship as nn am Sister of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sheryll B. Heard (Date) (Signature) Barbara Boyd (0 C, * L .'w1 , o^ 14335 Lonq Green Drive C J 4 r-t =D C> (Street Address) u._ t C c: C-D a~ Silver Spring, MD 20906 (City, State, Zip) E Cr tea ( W C3= l_ C--) - C ca UJ ~ c j tX v Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this da party executing this renunciation and certified y that he or she executed the ren Rciation for the purposes stated within on this day of of EL 2013 ~n 1' rrnnn/eq Deputy for Register of Wills NotaryP blic ♦♦♦.•~`c~dD .10, , My Commission Expires: .°a~~• ~y (Signature and seal of Notary or other official qualified to Q ~/£Ey administer oaths. Show date of expiration of Notary's con missioi) S/SS~a/d n, zqq n 4,95 0"'0"1141111 W000 Form R W-06 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Michael Wendell Boyd , Deceased Kathy Boyd in my capacity/relationship as Sister of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Sheryll B. Heard te) (Signature) Kath BO d Y v c.) d,; 273 Marengo Road f C°::Y (StrestAddress) LaCrosse, VA 23950 1.:? L.f'~ L U (City, State, Zip) i,a..^ 5.t.I r-A ~ I Q S C9 C> Lit.! ~ Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the party executing this renunciation and certified before me this day that he or she executed the rend tion for the of pu 7es stated within on tku day o f / 2~ ~L A, Deputy for Register of Wills Notary Public My Commission Expires:.62-?, ~~~G (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notarys commission.) Form RW-O6 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group,