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HomeMy WebLinkAbout08-01-13 PETITIQN FOR GRANT {�F LETTERS REGISTER OF WILLS OF ��u.�^�l!i�°�L�N� COUNTY,PENNSYLVANIA Petitioner(s) named below, who is/are 1$ years of age ar older, apply(ies) far Letters as specified below, and in support thereaf aver{s}the following and respectfully request(s}the grant of Letters in the appropriate form: Decedent's Informatian Name• ��� �, 5'fi�e�,�d,.� File No• ,�,�� �� �,���� a/k/a; (Assigned by Register} a/kla: aJk1a; Sacial 5ecurity No: 06'7-��—1�''�� Date of Death: �j 25",�t�t 3 Age at death: '7.j.. Decedent was domiciled at death in,,_,��crtt3��r-�,,.v� County, -�� (stnte}with hislher last principal residence at "3 c� R � C hNSCs R % �. n� Street address,Past C?ffice and Zip Code City,Townshig or Boraugh County Decedent died at `�2�l L1'�;�.►",� �t77 �.c�,+�r Kt�.� l'7vt l Gow,;�, �����/ ��,n/3���-.-Ar�r� f'� Street address,Post Office and Zip Code City,Tawnship or Borough County State Estimate of value of deqedent's property at death: If domiciled in Pennsylvania.. .......................... All personal property � �C>,00 U If nat domiciled in Pennsylvania. ..... . .... . ....... .. .. . Personal praperiy in Pennsytvania $ If not domiciled in Pennsylvania. .... . . . . .. . ............ Personal property in Caunty $ Yulue of reul estate in Pennsylvttnia................................................ ......... $ J(}CJ�,Qt9U, , TOTAL ESTIMATED VALUE. . . . $ lS',__OTD,U.O Real estate in Pennsylvan'ra situated at: 1��� �i4JG'.T"Ar�,����tC �R3�trg ���D ,,����'fA�,l.t'�S$Lt�°,� ,��ti`tB�RG.�}�t!!� (Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County � A. Petition fpr Probate and Grant of Letters Testamentary �; Petirioner(s)aver(s)he/she/they is/are the Executor(s)narned in the last Will of the Decedent,dated � �.� � �d Codicil(s} � thereto dated � � ��� C�'� ,�-`—�—CT State relevant circumstances{e.g.renunciation,deafh of executnr,e � � --� C'� D � �°i'q „r�°F Except as follows: after the execution of the insmarnent(s)offered for probate Decedent did not marry,wa�oQ�di��ced,was no��Y to a pending divarce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §�2�g��and ch,;;�ynot]�e-azchald born ar adppted;and I�ecedent was neither the victlm of a killing nor ever adjudicated an incapacitated person�-� c:.� •��:; � ��" �:."� �: :: c=�: �NO EXCEPTI{)NS (�EXCEPTIONS . :� � � " �� ^ia „�„ C,+"� z:) � B. Petitian for Grant af Letters of Administration (Ifappiicable) �' --� �' c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durc�nte absentia,durante�ninoritcate If Administration,c.t.a. vr d.b.n.c.�u.,enter date of Will in Section A abave and camplete list of heirs. Except as fallows: I?ecedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323{g}and was neither the victim af a killing nor ever adjudicated an incapacitated gersan. �NO F.XCEPTIONS �EXCEPTIONS Petitianer{s},a$er a proper search haslhave ascertained that Decedent left no Witl and was survived by the following spouse(if any)and herrs{attach udditional sheets,if necessary): Name Relationshi Address 5`��g h) �J1"1tr�►r rv �t�n! �`� SK L`tN� D�v� iv �2n 1 � � � ��l, t ` v ��r�n��aa rev. �oi»�ao�� Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF �uMF3ER�A"N(J } . Petitioner(s)Printed Name Petitioner(s)Printed Address . 'fEPN �J /J�vn� �6�� Sk�(c.rNE SV� 1� A�N5�2o i� 1332 Ff 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 De edent, e Petitioner(s)will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before Date • � " me t s �'-. day of , -C/3 D�c�; $y'�� ' � r� � D� � f�1 For the Register C7 Dat��� � ....�_ rn � r� ,.� c, %'�7 Ts F" g�-� t"r'"! BOND Required:Q YES �10 To the Register of Wills: � � rn 1--� � � FEES: Please enter my appearance by�y�n�ure below:4 � r1 r� � � .~n Letters . . . . . . . . . . . . . . . . . . . . . . $ rG.�j'���� ,Attorney Signature: G'� +� -r� � --� � p C ..�.. C'y ( �`'� )Short Certificate(s). . .. . . �(?,�� � � pp r-- r.y't ( )Renunciation(s)... . . . . . . ' �—�/ �� Q--{ �"'" p � )Codicil(s). . . . . . . . . . . . . � �c=�t�c�""'_—� � '*i ( )Affidavit(s).. . . . . . . . . . . / Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: ��\N D`/ �� (J^���y�.>,A� Commission. . . . . . . . . . .. . . . . . . Supreme Court Other . . ID Number: �- � �e� �' T Fl +'i ► C .►2�:�l1rr� 1 S•�c� >C c t�� �, �-/ 1 ��'9 . . . . . . . . ���.(`� Firm Name: �Gz.�n� U�C��C,�. rs-t- 1""�,^��Q . . . . . . . . Address: Z2( S �r<s�- \�:`\� �c-��-� . . . . . . . . � . . . . . . . . � � 1�--( / Z . . . . . . Phone: � ( �'^' .� `'��' ��'�2.. .4utomation Fee. . . . . . . . . . . . . . . -�j,�v Fax: �- �- - ��-(� - � JCS Fee. . . . . . . . . . . . . . . . . . . . . ,(��, (,� EmaiL• �r^o,r\1G.+�� e!'12�c�� TOTAL. . . . . . . . . . . . . . . . . .. . . $ r��X.� DECREE OF THE REGISTER Es�atc: _�C�.YCa � �+Cl 11�f1 ._ Pile No: � �- �� -� %�3� a/k/a: AND NOW, , , in consideration of the foregoing Petition, satisfactory proof having been presented before me,IT IS llECREED that Letters are hereby granted to 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 Fo,�,,,nw-nz ,��v.toinizori Page 2 of 2 Oath of Personal Representative Official Usc Only COMMONWEALTH OF PENNSYLVAN[A } S S� COUNTY OF �uMNERLA'NfJ } � Petitioner(s)Printed Name Petitioner(s)Printed Address 'fePN �J N�on� �635 Sk`f�TNe_ RyV� 1�- Ns�i2o /V 14�2 � .. Thc Petitioner(s)above-named swear(s)or a�rm(s)the statements in the foregoing Petition are true and correct to the best ofthe knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the De edent, e Petitioner(s)wi0 weli and Wty administer the estate according ro law. Sworn to or affirmed and subscribed before Dace • gl,l� me t$;s �- day of S " ,�i ,�,3 Da�; 0 $y: ) n D�i � W ca FortheRe,qister r Q D'3L�--6�p rn z � � Q � y,. r mrn BONDRequired:QYES �O TotheRegisterofWilfs: � Z m �^' .�7 C7 FEES: Please enter my appearance by,g�,y�i(�,n�ure below:Q q r1�" ,e�-�, C'� p � -tl Letters . . . . . . . . . . . . . . . . . . . . .. $;nL�t���, �,V��" AttorneySignature: G� C 'n � h ( I('� )Short Certificate(s).. . . . . '"�L�� V V � :x1 m �'"' � ( ) Renunciation(s)... . . . . . . r 'D� � 'a�f ( )Codicil(s). . . . . . . . . . . . . ��' r ( )A�davit(s).. . . . . . . . . . . / Bond.. . . . . . . . . . . . . . . . . . . . . . . PrintedName: Q`�'\ND`/ �. (^.ZJ�4-�.A� Commission. . . . . . . . . . . . . . . . . . Supreme Court Oiher ID Number: � r5 �� �' T h r( � }2�1tiU'n I�.O[� 'rf t�, � C� � a 7 . . . . . . . . ��j.(� FirmName: �cui..> CJ�-C� t, d� 1_"��`��"`.`�." . . . . . . . . Address: J?.+, T £�,y-<S�- 1�:��c �r�v-� :i--. s . . . . . . . , otic�i S}nwr � �'�-( l Z . . . . . . . . �--._---7-�. . . . . . . . . Phoue: � ��" S '"�p- ��'�-(Z Aummacion Fee. . . . . . . . . . . . . .. rj.f� Fax: `>' �' � ��'lo - & JCSFee. . . . . . . . . . . . .. . . . . . . . KJ,7,.SL7 Ema�e e�o.�1c..-� e%,z�- TOTAL. . . . . . . . . . . . . . . . . . . . . $ �iG+X. �9 DECREE OF THE REGISTER Ec'aYe . _�(�YQ � ���n-i��� __ rue No: �.I— 13 -(��30 a/kla: AND NOW, ��� I'"�I.l�.�� _ _,��,in w sid ration of the regoing Petition, satisfactory proof having been pr nted befate me,IT IS $C��I—""REED,t�ha;�,€t,ters�n� Y11 �(] �Yl are hereby granted to � �fT���f�I'1 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. � egister of Wills Fo„�,nw-oz ,�v. minrznu � Page 2 of 2 . E_ �.,...�.��, �.� ��_ �.,�..�..�,,. . H105.805REV(9/11) . . _ .._ .. .. ..._ ... ._ .. .... . ...... . LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNiNG: It is illegal to duplicate this copy by photostat or photograph. Fee far this certificate, $6.00 �������� ������ ,�������� --. This is to certify that the information here given is �'' lZH QF p"''�. ����J��� �� �'� '1 - EN'f',��; aU y��iea w h me asaLocal�RegC�ificThe�o ginal �o ?��� ��(j � � � = - .ia certificate will be forwarded to the State Vital y � a� Recards Office for permanent filing. P 1972 � 37 � ?* = *�` �, � /� C L E R K Q =��•o,�l�j DE�`�'P~�,,,1, � .�"l�I-�• / � Z Certification Number ��'��A�� ��U -•,ENT���,,,,n��'' C!l M B E R LA t�D C 0., �A Local Registrar Date Issued �/irint In COMMONWFAITN Of>ENNS�'IV�NIA•DEV�IITMENT OF MEAITH•VITRL NE[OPM #2013-07-350 CERTIFICATE OF DEATH 'ck InM, Stala FIIe NumWr: I.Oe�eAent's lqal Namv(flr�t,MltlLle,Lasl,SW14j ].Se� !,Soclal5etwlty Number �.Oate of Death�MO/pay/Vr1lSpell Mo� Sara E Stenton female Olp'7- �p July 25,2013 . Sa./�e�Uf�BMfhdry(Vn� Sb.Under l Year Sc Under 1 6.O�te of BMF(MO/OW/�'ur��Sp�N Mon�h� '!a,9YtA bce(Clry md StNe w Fwe4n Coun[ry) � . � � � �� Month� Wy� Nwn Minutes �� �'. ��. . � � � �. � � � � � 74 Ma 31,1942� � �e.eMnpuce�cw�h� y > . . . . &.IIeWeMe�3faUerimeM��ountry) lb.11esldence�Slrttta�MNUm4er-IrxIW�eAO��.I ��lc0id0eced�nttMelnaTawnMlp7 �� � �� � � � . �Say �..15b�.wh �. �,e�e.��u.Mm l.�ei.iry fll�rv, nw . � . ee.rtesk n�e I�ounrvl � . . . � le.Ile�Wexe�zbCOEeI \ ❑xo,oeceeenllivedwlln�nliml�ol <tty/bora � 9.EVer In 115 ArmeA Forcn7 I0.M riUlStatus at Tlme ol Dealli ❑Mar�M ❑WlOowed Il.SuMNry Spwse's N�me pl wik,�roe name 0/�a 10 flnt marrlatc� . pr.. �H, ❑ww�� �a�d ONeverMaMed Ou�w�ow� � Il.ialAer'�Name�rlrsl,MWdlq l�rt,SWlix 13.MMhnY Name Vrlw ro Rnl MaMa�e(Fl�St,MWEb,laft) �. Z f1e.Inlormam's Name 196.11el�tlon�hlp y Decedenl 16c.Inlammt'�M�iHy Addms(SM<el�uk Number,Ory,Sble,Zlp Cotlel . .. . . �. 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Shi LnSb PA l'1�57 p��• O tl �„ vc Name.�ecomWe�e�aem`orF�M.at.nuM � � l Os e 18. 4nY�Eduulion�[hecY e�ot Mat bert defaibes Ihe 19.Decedent M NI+qM�Orl6��- �� f0,OeredenYs act�Uie�k ONE�MORE rtces karc wh�t � �itAest Eryrte a kvN af scheel completM ri tM tlnle of death. 6a�Ihat 6e#descrihef whNher Me Eecedenl Me denl mn9de�M hNnsell or heMl�a be. ❑Ithlrodearleu h5panl�h/NltOank/laHrro.Chedthe^NO' �e ❑Korean ❑NOtllploma,9lh.�=1h`nde bo�ilde[edmthnolSp�MSh/Nispank/Cillro, �BlxMerRhklnRmeAnn ❑VkiMmeu ❑NI�uhod NaEUate w 6E0�ompleted �NO,irot SpaNSh/Hispanlc/I�llna �AmMnn IndNn nAlaska NatM �Othe��sNn 0 Som�mlkp neEk,Out ro dHree ❑Yes.Me inn.M�tkan Amerkan.Chkinp �ptixi IiMHn �NotWe Hawail�n ❑f�+��te Ee{ne(e.�.M,�SI ❑Yes.PueNa Rbn ❑CMnef� ❑fiwmanian w Chamttra Q�Ba[helW�depM(e.{.B0.FB.BSI ❑Yef.Cub�n ❑RXW�ro ❑S�moan ❑MaAer's dfene��.y.MA,MS,MEnG MEd.MSW,MBR) ❑Yes,mher SO��b�MbW��4��ina ❑Ipuwfs ❑Othet Petlfk Islantler ODecrorHe(a4PhD,ftl�lorOrol���lomlEqne ISpetlryl ❑OtherlSpedhl e..MO 003 DVM,LLl,10 21 Ment's Sln{k Nm klGOefynatbn�CMCY ONIY ONF ro Indlnle wh�t the tlecMm��omWend him�d!m hersell ta be.31a.Decetlmt'�Uswl Oavpatbn�iiMkate rype el work White ❑lapmex ❑Lmaan Eonedurin�moctefwarklnSlNe.00NOTU5ENF11PfP. ❑BIx4nAMunAmen�an ❑ROr<�n ❑phervaclflclsl�nder �! � ������ /� � ❑NnerkM IMNn of�IasMa Natirv! ❑Vietnamese ❑Den'1 kMw/NIX Sure jri}pY vvKOIOV� ')/ly�L'U'S ❑,�wo mm.� ❑om«iw,o ❑R�mxd 216.Kind ol Buslr�ns/bWUrtry ❑cni�. ❑ea�we H,w.n,n ❑ome�IsoecNr�---. \' ],� . ❑FiMp1IW ❑Gu�m�nfanorCMmdro (�C�Y �1111C 1 -T . � �� RFMf �=)dMUfTlFCOMPLEtEO i3a.0alaVronounu OeW�IMDry r 33b.51�nnwtoPerwn9ronouncln��eaU�OlNywhenaOWk+bh� 2l�.tkenvNUmbei �� �� . .. lYPLI60NWHOVa0N0UNCE50R � . � � . � � �. . � � � CERIIFFSOFATX � . . . � . . � .. . � . � 23E.Dati Sl�xi.(MO/Day,�Yr� 24.Tlma olOeaM � � � � . . . A rox.2:15 P.M. zs.w,.ruawi�„mm«ac«oM,comx«e��� m r., p No � � . . . � � CAUSE OFbEATH�� ��� �� ' aowm�mxe � . � . ]6.Yv1 L Emer lhe cHin o!eveMS-�disea�es,InW�s,m�omdkrtbr�s��that dkectN uvsed d�e death.DO N0T mtn ImnMal wems suN as cndlx uren � Inlerval: respintary anM,orvmlricular Ilbrlllalan wkhout showMy the eNOlory.00 NOTABBqEVI�TE.Enler mly one uufe an�Ilne.Add additbnal Ilnes H riecnsary�Onset lo DsNh IMMEDIATE UUSE -----�-o a HanpinA I Irciw muaeamna�wn ouemloru.conua�enc<on: . . Inry in aeaml � b. Sea�MmM nsi mmmiom. oue m Ivr a a eom.a�ce o�: . i �.. � � � NiM�k�tllry�oMea�te � . � . . �� � . � � . . . . Ilstedm�Met Enterlhe �� i . . � � . . . UNO[nq'�NCUUSF Due�alarua<omea�+�M6 . . � . � . . .. � � laisnuormpnexa� � . .� � � . . . . . F InitiNediheeyenUreOUIIIry d. � � .. � � . . � In Ee�th�lAST, pue�o(er��a comeyuenn o�: � ifi.Mel6Enterather' 111 dlbn Mbutl� t deaMLutrKKrervNI�InMeundrrlyln��us�6wen�nVattl t1.W�sanautopsyperinmrcdi. � . rti No . . 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E � �:r.. �0 Ho . � � � ]9.Iffem�k: . . 30.ddTaGCCaUxCoMrlbute[aDeathi 31.MamerofDeath . � - � � � ��DnBnantwMhlnpasl�eae Q Yes �DroWbly �NaturN Q Homklde � p�e�ne,�[�aau p eo m uowow� ❑�cnaem �Omtlin`Imnti�aHon ❑ nrov�,m+nemm�zaovswdea�t m swcae p cWw��eea.umnnw 0 Not prc{nsnt W[p�qnant�3 Aays l01 year belare tleatl 33.Dxe of InWry�MWDay/Vrl(Sp�ll MoM�) munk�uo�n�,�ewnnmenewsiru� Jul 25,2013 33.nmeonni�n Y Approx.2:15 P.M. 3C.vNCe of�n�ury�r.{.�ome;tons[ruNan sMe;faim;u�ool) 35.Lotation of In��ry�Stnet aM Number,Clty,Stafe.Pp Cade) Home 824 Lisbum Road,Camp Hill,PA 17011 36.inJury rt WoM1 3).I!lnnsport�tbn In�ury,5pecih'� 38.Oe�cr116e Hw N�ury Occuned: �rn ❑omedopenm� p vedesm�� Intentionel Henging m Na p ouxn�e� ❑oin«IsoMNI �sa.[wne.�cn«k onH o,�l: ❑c.rtnyiry uny��i.n�ro�ne e..i or my kmwka��,a..en o�a�.ed aue w ine n�.el+l,�a m H.�.rce ❑vronwn4M i CNIlyM�plry�kbn�Ta the bM of my knewkd`e,death occuneJ n the tlm�,dah,�M O�Me,end tlue ro the uuu�s�aM mannn�Irted m MrElsal E��mimr/C�/W�r(�l(.��Dn,�M1/,y,aiy W}yV i�tp\ �a(/�o./M)vnep�uo�,i�my oNnion.eertn onmrea a�ene nme,d.re,one pa�e,a�a due�o ene<.�u�s�ark mann.r��aee SIt�+�unolc�niR<�: �".VIJ�'i��C,r `1^C.LY x miemamn���Coroner Ll�enfeNUmbrr 39b.Name,Atllnss anU ilp Code ol Verfon CompktlM Cause a10�+1h(Item 36� . . 39c.Oate SynM�MO/psyM�l . � Chedes E.H811,Coroner 8375 Basehore RoaQ�,SW�e 1,Mechanlcaburg,PA 17050 � July 28,2013 � � �� � � ��� . d0.11e[iNnr� NtrlctNUmbe. I.Rellsnrs �natw� � � �1.0.rylsbarfl dte Day/Vr � � �1-:�rh i,� �- "]�9 <3.Ammdmmts . . . . � . � �� �'j yh1 N 0 5 �ta5.�<, Dlfposifbn VNmtt No. MFV 0)/3011