HomeMy WebLinkAbout03-21-05
Register of Wills of cumbeeou'hty, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of A 1 b e r t J. Dei t c h
also known as
No. J..' J '\:) S - ~ "J...l.ofo
,Deceased Social Security No. 2 0 4 - 3 0 - 7 9 R 5
Petitioner(s) who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execute_named in the last Will of the
decedent, dated and codicil(s) dated
( State relevant circumstances, e.g. renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the
documents offered for probate; was not the victim of a killing and was never adjudicated incompetent:
@ B. Grant of Letters of Administration
(d.b.n.c.t.a.; pendente lite; durante absentia; durante mlnontate)
Petitioner(s) after a proper search haslhave ascertained that Decedent Jeft no Will and was survived by the following spouse
(if any) and heirs:
Name ReJationshi
Lenora Deitch
Barr J. Deitch
Daughter
Son
Cheryl L. Kuhn Daughter
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary
Decedent was domiciled at death in Cum b e r 1 and County, Pennsylvania, with hislher last family
or principal residence at 1 g c: r e en FI i 11 Rd. Me c h. Pal 7 0 5 5
(list street, number, and municipality)
. March 9 .J)5 f101y Spirit Hospital
years of age, died , 21)" _ , at
(Location)
Decedent, then 7 8
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County .
Value of Real Estate in Pennsylvania
See ~~~-f
.~ao-oD
$
$
$
$
J 7/P, /t&J0, ro
.
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant
of letters in the appropriate form to the undersigned:
\~
1 L. Kuhn
'70J5-17U
~
nc/3
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snaceMIIlIsPetGrantltJ200 1
Schedule of Real Estate
442 Fairground Avenue, Carlisle, PA
3286 Spring Road, Carlisle, P A
Newville Road, Cumberland County (Parcel ID 46-18-1400-027B)
Sandy Lane, Cumberland County (Parcel ID 22-33-0043-088)
').,-~s -~~~Ic
H105.805 REV 1/05 ~ \ - \:) 5 - '\::) ":l.\"~
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
thn-/J(~'
Fee for this certificate, $6.00
Local Registrar
p
11335700
MAR 1 7 2005
Date
I U05,143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
IT
CERTIFICATE OF DEATH
5. 78
COUNTY OF DEATH
v...
Albert J. Deitch
SEX
2. Male
STATE FILE NUMBER
SOCIAL SECURITY NUMBER
3. 204 30
H
I(
NAME OF DECEDENT (First, Middle. Last)
1.
AGE (L8sI _BY)
lb. Cumberland
DECEDENT'S USUAL OCCUPATION
(~..~"=~-='
11.. Farmer 11b.A riculture
DECEDENTS MAILING ADDRESS (_. CltyfTown. StatB. Zip Coda) DECEDENTS
39 Green Hill Road ~~~~NCE
Mechanicsburg. PA 17055 (Saelnstructioos
11. onolherslda)
FATHER'S NAME (Forst. Middle. Last)
11.
INFORMANTS NAME (TypeIPrlnt)
20..
METHOD OF DISPOSITION
Burial 0 Cremation !XRomovollrom State 0
Other (Spadfy)
FUNERAL SERVICE L1C
ac.East Pennsboro
KIND OF BUSINESS I INDUSTRY
BIRTHPLACE (Cily Bnd
~e::::::::;~).P :'1li
FACILITY NAME (II nollnsijtutlon. g;VB strOBt and numbar)
'5 pi.(;-\' \-\O'f:>~~'^-\
T
MARITAL STATUS - Mantad.
N_ Morried. WIdowod.
01_ (Spadfy)
14. Divorced
R_O :=.vI 0
RACE - American Indian. Block. WI1Ite. ,
(Spadfy)
White
SURVIVING SPOUSE
(If wife. give maiden ......)
2005
Old
docedent
=:.~"? 17d 0 No. _entllvod
~ ... . wlthIn octuolllmlts 01
MOTHER'S NAME (First. Middle. MoIdan Sumomo)
18. Martha Shearer
INFORMANTS MAILING ADDRESS (Street. CltyfTown. StaIB. Zip Coda)
20b.2890 Spring Road. Carlisle. PA 17013
PLACE OF DISPOSITION-Iloma 01 Comot'!')'. CnlITlBlori LOCATION - ClIyfTown. State. Zip Coda
orOthBrPIac(;remation Society of
21e. Pennsylvania Crematory 21d. Harrisburg. PA 17109
NAMEANDADDRESSOFFACILlTY uer Me\llor a pHAom~&lCI'emat on
22e.Services. Inc.. Harrisburg. 17 09
LICENSE NUMBER DATE SIGNED
(Month, Doy. Veor)
23b. 230.
WAS CASE REFERRED TO A MEDICAL EXAMINER !CORONER?
21. V.. IX] JL No 0
: Approximole PART.: 0Ih0r s1g_ c:ondItIono contributing to _. but
. inloMll be_ not rosuItIng in tho undortylng cou.. given in PART I.
: onset end death
.
.
17e. IKI V.., docodontllvod in
Silver SDrinl!:s
Iw
17b. County
Cumberland
clty-
Samuel Deitch
Lenora Deitch
o.
Soquenlloly IIsI conditions ! b.
. BnY,Ieoding to invnodlale
. couse. Enlor UNDERLYING
CAUSE (Dleoue or Injury e.
. liioi initlotod ovents
rosultlng on _ ) LAST d.
WAS AN AUTOPSV WERE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
MANNER OF DEATH
DATE OF INJURY
(Month. O.y, Year)
TIME OF INJURV
INJURV AT WORK? DESCRIBE HOW INJURV OCCURRED.
o
o -0 NoD
Could nol be dBtennined 0 300. 3Ob. M. 3Oe.
PLACE OF INJURV . AI homo, fonn. street, foctory. office
buikting, etc. (SplIdfy)
21.. 28b. 28. 300.
CERTIFIER (Chodt only ons) SIGNATU
'~~':i.~tGof~~~':J."'='~od~gll:'~~:~(:r~r,g"~~~sh~~~~.~.~~~.~~.~~~.~~.~~~................. 0 31b.
LICENSE
'P:..o':>~"'~~Gm~~~I:::::.I:== lr'~..:'.~r.=~~~.~: dO:: ::::~~~:(~~~~d,::~~or 00 .tat.d...................... 0 31e. 0 \ L 31d.
NAME AND ADDRESS OF PERSON WHO COMP4'TED CAUSE OF DEATH
'MEDICAL EXAMINERlCORONER (Itom 27) Type or Print l?> a ~ a." l 0 d ~ r"\
~.:..:rb:=:~:~I.~~~.~~~~~~~~~~~~~:.I~.~~.~~~:.~~~.~.~~~~.~.~~.~~~~:.~~~:.~~.~~~~~..~~~.~.~~.~~.t.~.~~~~.~~.(.~~.~~.. 0 8' q f'OP 10 tl C h 1Attt.l-> KcI
31.. 32. (VI P H .I, I P (\- /1 0 1/
REGISTRAR'S SIGNA DATE FILED (Month. Doy. Ve.,)
Id /~I/I/I
Noturol
DlI
o
o
Homicide
AccIdont
Pending Investigation
(Month. Doy. VO.,)
Ves 0 No 1]1
V.sO
No 19
SuicidB
34
c:Y1t1.
Oath of Personal Representative
Commonwealth of Pennsylvania
County of York
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief or Petitioner(s) and that, as personal representative(s) of the
Decedent, Petition(s) will well and truly administer the estatefSG.~ordin~ to. law.
1..fl ";\. --r-. A
Sworn to or affirmed and subscribed ~ v/f-vl7tTl/l( ~
before me this <>;).. \ ~~ day of D f. f'.1J-f
""~~\;.~ 20<:::15 +- tU.OJUlJ ~. ~~
~~ ~ CS~1 ()" I
~ q" ~~ I For the Register ., a1..Vu.t) /f(~
~...\) ~ ~
AND NOW,
"'~Q..~~
No. )... \ - ~ 5 - ~).. \0 ~
~'C '"'"" \-\
- '?>~ - ""\~ ~S Date of Death:
~\
Deceased
Estate of ~L~<C..~, ~
Social Security No.: -;)... ~ '4
~~-~~ -""l..~~S
,20 ~5
. in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 0 Testamentary ~ Of Administration
Q..b.l).c~~; pendente lit . durante absentia; durante minoritate
are hereby granted to L~~'(~ '.)'-\~~ ~~:~'( ~. ~'Q.."~,,", "
~~~~~ ~. '<-\).~ Y\.
in the above estate and that the instrument(s) dated ~ \ ~
described in the Petition be admitted tD probate and filed of record as the last Will of Decedent.
FEES
Letters . . . . . . . . . . . . $
Short Certificate(s)~.$
")..\o~ .~~
'1.~ .\J ~
~~ ~~ ~~
Register of Wills \
~~. ~~\ ~~t) ~~
AttDrney: And r e w H. S haw
Renunciation . . . . . . . $
Affidavits ( )....... $
Extra Pages ( ).....$
Codicil. . . . , . . . . . . . $
I.D.No:
87371
Address:
61 West Louther St.
JCP Fee. . . . : . . . . . .$
,~ .~~
Telephone:
Carlisle, Pa 17013
717-249-1177
Inventory. . . . . . . . . . .$
AutomatiDn Fee. . . . . $
s.~~
Other. . . . . . . . . . . . . .$
TOTAL. . . . . . . . $
':)..~5 .~~
snacellllllllsPetGrantlV2001