HomeMy WebLinkAbout04-11-05
Estate of Danien M. Frev
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
()5 -~3'-!-
No.
also known as
. Deceased
Social Security No.
195-32-135
Petilioner(s), wI10 islare 18 yeans of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
n A. Probate and Grant of letters and aver that Petitioner is the executrix named in the last Will of the
Decedent, dated and codicil(s) dated
State relevant cin:umstances. e.g.. renunciation, death of executor, etc.
Exeept as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after exeeulion of the doeuments offered for probate;
was not the _ of a killing and was never adjudieated incompetent:
....................................- .
.........................................
[Xl
B. Grant of letters of Administration
(el.a., d.b.n.e.t.a.: pe_nte lite; durante absentia; durante minorilale)
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:
I Name Relationship Residence I
401 Front Street
John McConnell Son Wesl Feirview, Pennsylvania 17025
2316 Northeast Third Slrilet
Linda Schonemann Dauahter Boynton Beach, Aorida 33345
244 West Dauphin Street
Brenda Hess Dauahter Enola, Pennsylvania 17025
401 Front Street
Jay Max McConnell Son Wesl Fairview, Pennsylvania 17025
Tracy Hoffman 620 High Stieel
Daughter west Fairview, Pennsylvania 17025
..
(COMPLETE IN ALL CASES:) Attaeh additionals_ ff necessary.
Decedent was domiciled at death in Cumbertand County, Pennsylvania, with her last family or principal
residence at 401 Front Street West Fairview, Pennsvlvania 17025
(list strBet, number and municipali\y)
Decedent, then 63 years of age, died March 15. 20,QQ, at Harrisbura HOSDital. Harrisbura. PennsYlvania
(Location)
Decedent al death owned property with estimated values as follows:
(If domieilad in PAl All pel1lOnal property..................................................................................................................................$ 3,000.00
(If not domiciled in PAl Pensonal property in Pennsylvania
(If not domiciled in PAl Persona' property in County
Value of ~.:m~~.i"..~~~".i~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::;::~:::::::: 1~,::::
Real Estate sffualad as follows: 401 Front Street West Fairview. East Pennsboro TownshiD, PennsvlvBilia
Wherefore, PeIiIioner(s) respadful1y request(s) the probate of the last Will and Codicil(s) _led with this -. and the gra;;! of IeItai'. in the
appropriate fonn to the u_nsignad: . . . . c:'
T or name and residence
Tracy H an
620 High Street
West Fairview Pen ania 17025
Brenda Hess
244 West Dauphin Street
Enola Penns ania 17025
(,-;
f_-'1,,-,11112 to.......CouaIyj-Rev.W12
o S-~ 3311
.
Register ofWilIs of Cumberland County
RENUNCIATION
&tam of D~ ~~W
Also known as .I n V\Y2.
No.
(Y\cC.nnne ,(l
. deceased
To the Register of Wills ofCumbcrland County, Pennsylvania
Theundersigned ltn~ laM ScJt~n" (ck-u~h~ \
(NlIIlle) (Relationship) ( ity) -;/
of the above decedent, hereby renounce(.) die right to adminisler the cs\ale and respectfully requeat(s) that
Letters d- A4.m~~'
be issued to lro.L\. 0)..['\ / 13(2..,.-r)~-€- I~t:!;.s
J
Wltnessmylourhand(s)lhis ~1/J!!dayof /rJ~ ,20'~
uAtl,,-,~~ ~
(SigDltture)
"2-"01.(, IH. ?,(~~ ~~ (jA3"&1sy5
(Address)
Ci"
Affinn;l8l1d subsen'bed before me this
dayof m~ _ .
~ . ..
siMR~lDENSTEIN
N01Mt' c 000.(8324
. PUBUC , EXPIRES AUG 07 2005
rnxre OF &ONOED Tl<<OUOH
(Signature)
Or
(Address)
Affirmed and subscribed before me this
_ day of
(Signature)
Register ofWilIo
Deputy
(Addre..)
(Signature and oeal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary 's co1lllllission)
()5.35Y
~
.
Register of Wills of Cumberland County
RENUNCIATION
Estate of 1)~('\\Q.N ~
Also known as
S,\tv,
\
No.
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
The undersigned Me:,. 1. '""" ':, (c.) f' \!.. ~ ':"':'
( ame) (Relationship) (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) 1!hat
Letters os.. ""'-C)~""",,..,\~ 1>0\ \0"'-
beissuedtoq"~,,,~~ "'e.::>':) \~<;>..'-'\ \-\<::)c;;.~r?""'::"
\
;i
('-j')
Witness mylour hand(s) this 5 day of ~,-,,\
,20~
Affirmed and subscribed before me this
. <; day of Ari.>~\ \
'2.cb..5
C~~llh'G).W~
Notary Public
-:S=CJ~~
'1.:>\ ~,,,,(0. 'S\ ~')'; ~,<:,-;(.'-l f....
(Address) \/O~S
My Commission Expires:
(Signature)
~ .- \ -1-~c>~
Or
(Address)
Affirmed and subscribed before me this
_ day of
(Signature)
Register of Wills
(Address)
Deputy
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary' s commission)
:rH
NOTARIAL IlEAL
COUFmE'I A. W"., ,!lRWK, NllllIY Pdc
e.t Plllllllloro 'fi1Ip.. CIIItlei'IIInd Cau/lIy
CClmmIIIlon MInt! 1, 2008
C'5.J3Y
Register of Wills of Cumberland County
RENUNCIATION
Estateof tH~,\\'C,,-\ ~ ~ey
Also known as
No.
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
!~J/lk?// gON
(Nam (Relationship) (Capacity)
of the above deced nt, hereby renounce(s) the right to administer the estate and respectfully request(s) th~t
Letters ~~ (>-c)~"~t~r ~ .ft
be issued to f:JP':::-.AlJ;; -it /-.b -m~;J
Witness my/our hand(s) this ~ day of Je.I
Affirmed and subscribed before me this
,C; day of Arp r; \
2:00.'0
Ct-\= Q . \U~~
Notary Publi
C;",
-
,20~.
~
. (Sign~ture ~
t:/O/ /%.~i Sf Wc;:r-l ~1/eA/
(Address)
My Commission Expires:
~- \ - 2..06 '3
(Signature)
Or
(Address)
Affirmed and subscribed before me this
_ day of
(Signature)
Register of Wills
(Address)
Deputy
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiratio~ 9fNotary's commission)
JHOF
~iARlAL IlEAl.
.COlJm'NEYA WESTBROOI<. NalIIy NlIII
EatI f'IJi'I1IIlojO Jti!p.. CW*~Sill1 CouIIl1
My ClIliltnlsI~ 1ii~.lCto :.!~
n~.~r',~ 1.'1:\
This is to certify that the information here given is correctly copied ti'om 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.
{)5 -33'-1
y.
'G:
-,::
\
~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
fee for this certificate, $6.00
1111f/l1"""~~~~III",,,
","''i..\>.\.'" OF p[f.----,
'i'#~" "t.~\.
,.~_. ~,
g:el o. . ~~
~ ~I .{Ii.: i;~
'*~"" '.' '*f
'ta ".. .......\\
':.~" ~.~.;\\
'\.~ . ~l
-'---J'l"'fNT ~\ ~\"",
#"....,.,.,.,.,"""11111111'1
p 1 4 ~. ~. (j '') ('"
'. ,.. ,.,.~,
I .L v U ."j \) j
No.
H1Q5u3R.,.. 2187
~~~IL
L,kal Registrar
3/PJ/~S-
Dale
Darlien M.
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
'TATt'Ill~
TYPEiPRJ/olT
,.
PEIUilA.NE/olT
av.CKI/olK
W,ME OF OECEOENT (Fnt. MidclI.. LIlli)
rey
SEX emae
,
,
AGE (LIIlEIO'1hdIy)
81RTHPl..ACE(CUyWId
llln-~lll1il'!l:'l"K"
63
~
-0
7. ...
FA.CIUTYNA.ME(lInollo~JIYI.n,I...-.rt~
, HamsDurg HOspItal
...
'"
..
COUNTY OF OEA TH
Dauphin
...
...
DECEDENT'SUSUALOCCUPATION
,..~
Fa be 'lee
1(1NO{)FIlUSlNESS/INOUSTRV
C 00
SDECEDENTEVf:RIN
U,S, ARMED FORCES?
v..O NoE
"
HI.SIIII
OECEOEKT'S EDUCATION
.
111-'21
llb.
!)I t;IWtl.la1l1,lJp
""
-
hein.
~-,
MOTHER'SNAME(Fnt,MIlXI..M~S~ith M. Speelman
".
:~.....r~l'lI~fI'~M'JiM'I'ai'M~;4"A 17025
PlACEOFOISPOSlTlOH-N_afCanwllrry.CtwmalorJ LOCATION Ci!)llTO*n.S~II.Zipeoo.
Ol'OIhw~ming Green Memorial Park Camp Hill, PA 17011
Z1<:. Z1d.
W,MEANOAOOflESS OF F-'ClLIn'
Z2c. Michael J. Shalonis Funeral Home 206 Maple Avenue Marysvitle, PA 1
UCENSENU/II8ER OA ESIGNEe
(Month,e.y,v..,
Z:NI.O .,()tJ r;'51 r L nc.r, .....-,- J. II, 1",-, j
WAS CASE REFERRED TO A MEDICAL EXAMINER ICORONER~
K. V.. 0 Ne
'~IIII' PAlnu:'OIf'Ml:igniI\c:anIccndilion.COIlllill<.Cir9tcOUlh,l>.,ol
:......... 11DI..~In""~I""Cll""gN..inPARTI
:Ol'IMClI'ICldull'l
:'1.-..........,,,
~........::t4
Cumberland
~
"
,
"
<
,
"
FATHER'S N,.tJ.lE (FtrI~ MIcldl.. L'Il)
".
INFQRMANr N,.tJ.lE (Ty~)
201.
METHOO OF OISPOSlTI N
00naIi<>r'l0 Bunalr8Ier.n.IicnOt..."....,"","SIllll'O
.Z11. OtlII(SpIciIy)
SIGNATURE FUN S E
.,...
~i.....23H:anIyw
phy.........ncl....IIiI_IIb
c:wtityeau..cfcMt'"
IlMlt24.211/IIUl1lMc:r;ImpI'~by
PWIOl'l'oOt1o~.""1h
1Tb.CCU"Ilv
Delbert Ray Ensor
Tracy A. Hoffman
c.o..TE OF OISPOSITION
l-.Oor.T~ar 18. 2005
ZiD.
E OR PERSON ACTlNQ AS SI..CH
. r
K ~J
V.PAR7l: _...__......_.........-._....M<l..._. O'__..._"'_""'._.._.....,.......,_~oioooro..._,.......
u.._.._......___
L., v-."_
A-. ~ ";'.4 J -lA r ~ j
,
!:
~- //
I MACH
'< ,-;
Lv'~
L.A..-_c:,qr
<'
S_bllily.l1ccrldili",'"
illtI'j,-.gleitrwMOlIW
.,.",.. Enl...UNOERLYlHG
CAUSE10i.....crilluty
1h....b.I~.wet'Ill
"Wl"'Q<>r'l"'.Ih)LAST
WAS AN AUTOPSY ~RE AUTOPSY FINDINGS
PERFORMED' AVAILABLE PRIOR TO
COMPlETION OF CAUSE
QFOEATH?
Homic>a.
PMCi....I"..1IIQ1IliOn
COUIOnollM~
o
o
D~EOFINJURY
......,....ISpoaIr)
_.
_. .
AI........,'..m..lrM!.'IClOr'/,cIr.:.
y"O NoD
,...
"
MANNER OF OEA,TH
OATEQFINJURV
11lI_.CIo.,....)
~
o
o
N.turll
-."
".
ve'DNe~
V..D
~o
.....
~
8
~
o
~
.
.
<
<
Z". ZIb.
CERTIFIER (CNdlOl'lly.....)
.l~~~F~~lGJ::.~,..~~J.~='::io~.':8:':~I=m~.f.'X~.r:~~,~.~.~.~~.i.~,~~l
".
."I'IONOUNCI~G AND CERTIFYING PHYSICIAN (Pnyo<ci... tlCl/'l prortIlU/IarIQ ".1IlI1...a cen~ to.:.uN aI dNVl)
To tho b..l 01 my k'.......o.;... 0..111 occ......o II "..lim.. O.t..ln<! pl".. onO O..e te tI.. CI...n(.) InO m.n.....lI.lMH... .lQ
'MEDICAl EXAMINERlCORONER
On_ DIIII "'ulmln.li"" ondle, In_gIU"". Inmy opinion. O..lIo cc:cu...O ot lIo.tl..... dlt..lnd plllCl....O 0...10 tnl co"""o) InO
311~.nn.'''Olll.0 D
"G
SOC~TYNU.R 130
,. 3::1.. -/30G
lI~'b ~)O
RACE.AmlOicMlndi....BlIrC:ll.WliI.,.1
(SpIcily) White
...
IIlARITAl.STA,TUS-MIIlWd.
N~~
,.
i7C.2:JY",_iY~in
SURVlVlNGSFOlJSE
11._.....___1
('''..')
~,
17d.O:;:OIti-on~oI'
""-
53
TIt.lE QF INJURY
INJURY AT ';\QRK? DESCRIBE I-IOW INJURY OCCURRED
..........0