HomeMy WebLinkAbout07-11-13 PETITION FOR GRANT OF LETTERS
REGISTER OF WII.,LS 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 i 2 /�
Name: G Philip Sauer File No• �I � ��> — � ��F' �
a/k/a: Philip Sauer _ • (Assigned by Register)
a/k/a:
�a: Social Security No: 195563887
Date of Death: 10/28/2012 Age at death• 41
Decedent was domiciled at death in Cumberland County, Pennsylvania (State) with his/her last
principal residence at 965 Greenspring Road 17241 North Newton Township Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 965 Greenspriny Road 17241 North Newton Township Cumberland PA
Street address,Post O�ce and Zip Code City,Township or Borough County State
Estimate of value of decedent's pmperry at death:
Ijdomiciled in Pennsylvania................................All personal property $ 22,000.00
IJnot domiciled in Pennsylvania.............................Personal property in Pennsylvania $
Ijnot domiciled in Pennsylvania.............................Personal property in County $
Yalue ojrea[estate in Pennsylvania.............................................................. $
TOTAL ESTIMATED VALi3E.... $ 22.000.00
Real estate in Pennsylvania situated at: �O�e
(Attach odditional sheets,if necessary.J Street address,Post Office and Zip Code City,Township or Borough County
❑ A. Petition for Probate and Grant of Letters Testamentarv
Petitioner(s)aver(s)he/she/they is/aze the Executor(s)named in the last Will of the Decedent,dated and Codicil(s)
thereto dated
A ° �
State relevant circumstances(eg.renuncladon,death ojexecutor,etc) o �'"-' � �'
� � � � C'<
�3
Except as follows:after the execution of the instrument(s)offered for probate Decedent did not mazry,was n�i�c�was��ot a pa�c tqr�pending
divorce proceeding wherein the gounds for divorce had been established as defined in 23 Pa C.S.§3323(g�fln�'id�not haxe�child-lmrti-or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. � .�" rT? F-_..
❑ NO EXCEPTIONS ❑EXCEPTIONS � � '` �=' `°
� (`f _.� . •
� B. Petition for Grant of Letters of Administration(�fapplicable) =
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,:�urante ab.centia,durante{minoritate
If Administration,c.t.a. or d.b.n.c.�a.,enter date of Will in Section A above and complete list o�'.heirs: -wi
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(g)and was neither ttte victim of a killing nor ever adjudicated an incapacitated person.
� 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 neeessaryJ:
Name Relationship Address
965 Greenspring Road
Geor e Sauer father Newville PA 17241
965 Greenspring Road
Gilma Sauer mother Newville PA 17241
V
Form RW-02 rev.10/11/2011 Page 1 of 2
Oath of Personal Representative
Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petitioner(s)Printed Address
965 Greenspring Road
Geor e Sauer Newville � PA 17241
965 Greenspring Road
Gilma Sauer Newville PA 17241
The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are true and corcect to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of the Decedent, e Petitioner(s)will well an ly administer the estate according to law.
Sworn to or ffirmed and ubs ribed befo�r��� Da�e � ( i � ��
me da c�.v4--J ��2 ��, Date ��// — ;`_,�
By: v Date/��
For the Register Date
BOND Required: ❑ YES � NO To the Register oJ�lls:
FEES: Please enter my appearance by my signature below:
Letters....................... $ 60.00 Attorney Signature: �-
-- _.._.:
(2 )Short Certificates(s) ..... . 10.00 n - '.� '==
C ,� �,
Renunciation s C_�<����'.f`{,� l � �
� ) � ) . . ...... .. ;;�
( )Codicil(s) � - -'�� "`"
� � , �, z .r
� )Affidavit(s)............. �""' F---� ;
Printed Name: Suzanne M. rF�rit� r-� 4._., ,
Bond .......... . . . . ...... . . . . . Supreme Court � � ;,� �. :-
Commission ...... . . ...... .. . ... �"= ..
Other ... . . .... ID Number: 92747 `°=' c^� � -� �f`
� c -_�: --� .!
Inheritance Return .. . . ...., 15.00 � �"' F� .�
Inventory . . ....... 15.00 F'�nNa�"e: Zullinger-Dayis,�.C. _
�
Address: 14 North Mairas Sfi'eet �,T., :.�
""""' Suite200 "° �--� �''
��������� Chambersburg PA 17201
......... Phone: (717)264-6029
. . . ...... Fa7c: (717)264-1884
Automation Fee ......... . . . . .... 5.00 Email: strinh@zullinger-davis.com
7CS Fee . . . ............ . . . . . . .. 23.50
TOTAL ......... . ... .. . . . . . ..$ 128.50
DECREE OF THE REGISTER
Estate of G. Philip Sauer File No: �� —� �J ���L/' z
a/k/a:
AND NOW, ��� �-�� `��-d-�� , 2�'� ,in consideration ofthe foregoing Petition,
satisfactory proof having been presented efore me,IT IS DECREED that Letters
are hereby granted to �t�r�e ���i✓ �"�IUG �-�t �`Y1Cc Cc.L(C8�
in the above estate andl(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.
,
,;� � �
ti.
�Register of Wills ,�' � `� i��/��r��
Form RW-02 rev.10/Il/2011 Pa�Of 2
✓
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HI4S.805 REV(9lit)
LLICAL REGISTRAR'S CERTIFICATiON OF DEATH
WARNtNG: !t is iltegai to dupiicate this copy by photos#at or photograph.
�'ee far this certificate, $6.00 ��ir���'` : '°°� ��`"� �� y
�,,,,,�f���»�� ,. This is ta certif that the infarmatian here given is
�j n �^° -:-. � ° ? � �� �'��,P�S���pE,j%;f� carrectly copied from an original Certificate of Death
CY�U�sJ k _sy ! xj �j1
ta`'Q� -- f� duly filed with me as Local Regista•ar. The ariginai
, , , ;� �, ?�� =- �= certificate will be farwarded to the State Vital
<i!i� ���- �1 �i ' �� � ,° � , : �` Records Office for permanent filing.
��'' �. 9 �. � `_ � � � C L E�K G �°�'�9 E���'`�r � 4 2 01�
'f k '� � `��F q''}ry- /�[ tp'� a ��:�e.�. �'����De-�'+.a�tX" �E� /
� �
, �t(� Ii�i1J� VC.iUf1t ''�%T�`C�it�stJ�+p����
Certification Nnmber Locat Registrar I�ate Issued
�t�A1� GUMgERLA'�� �'(�.. �'�
TypslVNrat tn Ct7MMQNWEAiTtf OF PEN#SYIVftNfA�dEPA3iTME'KF Of FiEA1..7H�YtT'At�ECORpS '
oa,.,,a�e„t #33-3&$ CERTIFICATE OF DEATW $�y�eKlteNUrt�beY.
gr i.,k
1.1}mceAent's Lagal Name(Ffrst,M�ddlc,Laat SvHix) 2.S�x 3_Sucial Sec�a�ky N�mber a.pat�of D�ath�Mo/Oey/Vr��(Spell Mo�
G. Ph3tip Sausr Male _ _ Qctobssr 28,20'12
Sa..Aae-last 9lrthday{Yrs} 5h.Vntlar 1 Y<mt Sc.VnQer 1 O 6.6s2e at Btrth{MaJDaylYea�}jSpeti MOrstfi) Ta.Strthpiace Ctty and Stat�ar fore�lgm CavnXry)
/�7 Menths O.tys Hnun Mfnufez M
"��� � d.9 June 11 '1971 �b.BlRhplaca(GOUnty)
Hs.Rlfidenee STate or ForciR�CqUntry) &b.Residence(Stremt and Number-Inclutle Apt Np,) Sc.Qid Oecedane Live 1er a Tow�+xhipT
Penna 2van3 965 Gr�an �upring Rd �Jr�.a�r.rs.na�et., N rt ��-on ewc.
Sd.Res�a�nar Gounty}
� C um'�e r 1 a n d � e�.a�,�aG�«(ziP coae> 1 7 2 O No,ae�«+G�,e�wea wr�n�.,n.�.�o< <nvleK*ro.
9_8vc�In LS AYIT�d FqKlST 30.MYfiti�5lafv9 8Y Tm�O Death Me�f1�0C1 WldowC il.SurvWlnt Spause's Namer(If wtfe,�W!name prlor to flrnt marria�e
QYes �[Na []Unknown DOWarmd �NeverMaMeW �t]nkn4Wn
1�_Fatk�r's Nam�(Hrst,MFddi�,last,SuHixj 33_Mother's Mama tMior ta FlfxS Martisgt(Fl�st.M1tlHie,isst}
Georga M. Sauer Gi1ma S,eon
14b.Intormant's Name lAb.Relatiorvahip to t}wcedcnt 14c.t�brvnant's MYa111ng Address(Straut and Nufnbe�CtH.��� P otlej
� Geor e M. Sauer 965 Gr�enspring Rd Newv���.e. �i�3�4�
G '""....,... . a P aCb O aY . '.."..�..�...."""'"""»"'. ..�...�.�....�_»._.«...�..�..
"........"'_"'»...._"'...._...,.."""........... ......'_'_' """""""'..f.._......_":_�_...........�"'......,..»...°.^_Y...°T'q.....«"'..._.._..._._»..
. .. ...e
EY if Oeath Dcturcttl tn a HospStai: '(�InpatleM �f Oeath Octumad Somswhara 8tha�Thae�a tlaspttsl: Hospiee Factlity lMe�AenL'S Hamc
a £me n Room.dutpaclenC Wad pn Arrivsi � Nufsin Home/tpn6-Term l'ara Facillky O[har(5pediy)
�d 15b.Faciiity Name(If naC insUtutipn,glve sTYe<t and nUmber; 15c.Chy or Tbwn,State,pnA Zip Code i5d.county of oeach
� 965 Graens ri� Road Newvilia PA '1724� - u r d
�... lfis.hACH�oE Of pisposixlpif (a-8ur[ai '� - - ramwtlott i5b.O'aY!Ut tlESpnsfYicit 1 ' aCt o O S(.f6Sit3oA 'N;mt aT c@mEt@ry�CY6miFOry,b�ot3i�r pfaCt)
p n�..,o...�rro...sca:« L7 aa.,�cw., 1 2/1/2 Q I 2 H o 12 i n J e r C r c:m a t o r y
� aene�tsvet�rv� �
� i6 .1,owtton o/Dispostkian(City o�7own.SYe�te,and YIpJ 17a.Sig�atU�s GN F nerei rvlc�4cens�e o�ptnon in Chatse ofi Inte�ment i7ti 1,IC. ns!01uW4ssr5 L
M�_ Ho11y Spring�, PA 1706 �� ri� i.3o�
� IZC.iVam�a�rttl CamR�ete AddrosE of Punatat Fat�tftY
Hom2 Snc 25 Bi 8 ri Av� Newville,. PA 17241
18.Dattd�nt s caHOn-Check tha box that best dcscribh tMg 19.Decetlenf of Hispanlc Or1Yin.-Clieck che 20.DecaadeM's Rsca-Check ONE OR MORE raG4x to indiratp whaC
m highOB�t degren or level 04 school GOmplMed at[he itma 4f deaih. box that�best tlesCHbes wNether the dceedent the deGeden!cb�131d�Rd h1m5eNor h!'seif to 6e.
�$th g�ade or tesz ts SWnish/MSA���CJ�attno.Check th4"NO^ �WhIM �Kn�aan
(,�Na AlpMma,4th-12tfi 6Bde trmc if decedent ta rsot Spanish/Hizpanicltaiirm. 0$Iack or�AfiricYn Artftrftan []V3einim�s�
�High Rh4oi Hraduate ar GEO CompletCd Q Na,t�pt SRaNsfi/HizpanlcJtstino Q AmeNv�IndlM or A{sska NstNe 0 Ltthef Asian
Some callege�cretlit,but no de$ree Q Yes,Mezicary Merlon pm�NCSn,Chleano �Astcm�ndlan �Nativs Hawaiian
Assuciate d�gre�(w.�{_AA,A5) �Yea,Pu�rto Rlcan �CFY{rMSe 0 Guamsnbn or 4hamerro
[�Bachelot'a dearce(e.g.BA,AB,B5j �Yea,Cubart 0 Filipino Q Ssmoan
�(1 Mastar's dagree(9.g.MA,M5,MEng,MEd,MSW,M8A} " �YeS,Cth�r SpOnishfHtSpanit(LetFnG [�7ipantst �OtMpr Pac{RC tatand�r
- �ooccarate{�.g.aho,Eeo)a�arofes:mna�aea.ae {Spe6N3 C O Z OSCib�.Hn Q p{��{spEdfy)
_MO 005 dVM,lLB 1D
21.Oacedent's Single Race Seif-DtsignaHOn-Gheck ON6Y ONE tn Intliwte whaL ihe deCedent Corvsidered hlmself or herselt to be. 22a.CieceAMt'4 Usual Or.cupxbn-/ndicat<typ�o{wp�
�"Whlte j�lapan�se � Q Samoan dona duMn6I�most of woeleln{INe. b0 NOT USE RETlREP.
�j 8fack o�Afirfcan AmaRcan [�tCorean Q 42tur s�actt7c isiander r, iT ey 61r 1
q ['�AmeriCan lndian oY Atsska Nathre Q Yietnamasa Q Oon'L Knaw/Noi Sura
:X 0/isn Intlian []Other Aslsn Q Rafused 22b.KI'W o1 Busiraess/Industry
[�Chinesa []Native MnWalle't �Oth�r(5plcify)
� [�"]Fltlpin4 �Gua afliaY�or CNiYAlprro ��
iT6M5 23a- MifST Y ONCAi. Q 23m.Bate Pronovn ad(Ma aY r 23b,Siyr�aturc a Person PrOrtauncing peath(Oniy when app ip e 23t.Licwnzc Nuen r
SY VERSOIi WHi3 ARONOUlMCFS QN
GERTIifES DEATH
23tl.Oate 5{gned(MO/bay/Vr). 24,Tim�of��ath
A rox.3-00 P.M. zs.was rv��a�ca�ews..,��e�or coroner concacrea7 � r�: p No
� CAUS£OF OEATH aop�am+ea
26.Pa�!i.£e�tn itra chair�oF events--tlfzeaxas,fe�Jurles,or complMaHans-2hat direckly csused ki�e deatfi. 00 N4T'<nter teYminat evrtrKa such as Gardbc ar/est ; tnMrvst:
rospi'stary arreltt,or van[ricular flbrilldilon wFCMnut showing the etlo�ogy. Oq NOT AOBREVIATE.Enter oniy one uusp cn a 1(ne,Add addiHOnal Nnes H necesaary [ Onset W DeMh
IMnneo�nl'�rause -------> , COmpIiCHtions Of MusCUlar Dy9tropM1Y �
{flnaf dis<AS!or condltlon ba�G ta{or ty a consequt�cz of}: �
.,e�s�w.,a:.,a<e:nt €
i'' 3
Saq�aenHally Iiaf condttlona, bue to(or as e Consequenee o�; �
fI11f1y�IGitlit'�g tO�tfiG C845f
ttated an linm a.Encer tha
V NOERiYiN6 GUSE Due So{ar aS#cansequenx afy:
�' �idicoasa a�InJury that .
� In{Heted shc evenb resultinp d� , ss n con �
ln deatn)IA:iT.. qu!to(or sequence on:
� 26.�Vaet#i.He�ter otM1er �ntiic dtf ntr t h 6ut af4t rosulH»;irt the urt ertWnE�usa givan in Part t 27.Was an eutopsy peefofmcd7
� Ycs �No
2H.WePe autepay RrMings mvsilsbla
{n , ta r.:qmPle[e N�e cause W deafh? .
� V�s No
� 29.11 Famsfe: 30.�Yd Tbbaceo V s CoMrtbuYC to Dest ? 31.Msrner af beath
�Hot pre$nant'within past ya.ar �Yes 0 RrabaWy (g Netvra! ��Homicids
�Pre`erant at tima of tfeath No Unkr�qwn Accitlent
r�' Not pregnant,but pregnant with7n A2 de � ^� � [3 prntltn`tAVtrti�ation
ys of dsath 0 Su�c�ae p cou�a.,ec be a�c�enm+nea
Not prEgnsn[.bUC ptegnprlt A3 tlaV�td 1 year 4ofor�de.atF 32.DMe 4f Injury Mo/Day wJ[Spell M6�[h)
Q Unknown if pregnant withfn the past yea� 33.1im!of!n}ui}e
34.Place af Inju+y t�`-g-hOme;canstrfetiioei siLe;farm;scfiboi) 35.Lac&tirin-of Inj�ry;5*rcei emt Ff�mber,Cli�+,Siate,Zip fbtlr} _
36.In)�ry at WaYk 3T.If TraeispoKation InJUry,Sp4Gl/y: . 38.Desa^b�How Inj�ry Occurred:
Q Ycs (=Oriv�rJbpe�atar (�Pedes;rise�
[�No Q Gaax�ger �Ott�er{Spttify}
39Y.Cettifier CNeck oniy one):
�C�ttify�ne,physlctYn-to thc bcat vf my knowledRe,deaih occurred due to the wux�fc)end manner ska[ed �
�Monounctng a CertlfylnE Phy'wn-Ta tFe best of mY k ledae,dtath occvr�cv3�t the tlm�,d�t<.�nd pfaNtr,arfd dvb to Cfie causaT(s)asrd mtlrtn��Sts�CRd
(�Medicat 8awm#narfGOranar- n t 6�cxami tl{cr lnvesiigatton,In my opinio�,dzath occurretf at thc tFme,data,and ptxa,arni du�ta tAp tause{ay erM manner aLattO
51glYiiu20fC<Ktf{��:��� ._.r�T TNeoic�rtitisr:CFIi@f O@PU�/C.OrClflBr u�e�amn'�r.�een
39b.Name,Adtlress and tlp Cotl�bf Penon Gnmpbtlng Gause of CiCath(Item 26) . 39c.OattStgned(MO �y/Yr)
� Ma#lhew S.Stoner Chtaf D� ut Coroner 6375 Baaehors Road,Sufta 1,Mechanlcaburg,PA 17050 �F�brvary 1,2013
d0_RegFZtrar s atr}�y Numbee 41_ egi5{��s 5 tUre � 42.Regt1M� a 6ata Mo ey
� 43.�,m�.,dme.,� ��a` 4
�
'� � �-" �
_ � . _ . _ �v'
t7laposition PermSY Na. C��f���`� H10Sll43
. . REV OJf2011