HomeMy WebLinkAbout04-06-05
.
Register of Wills of Cumberland County
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of. DANA M. WINFREY No. -.:l '\ ' ~ S - ~ ~ \
also known as To:
, Deceased.
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
Social Security No. 175-64-6877
The petition ofthe undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl~ for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with h~ last family or principal
residence at 41 Oak Avenue, Hampden Township,
(list street, number and municipality)
Decedent, then 31 years of age, died August 31
College Township, Centre County, Pennsylvania
,20 04
, at
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ 5,000.00
$
$
$
Petitioner_ after a proper search ha~ ascertained that decedent left no will and was survived by the
following spouse (if any) and heirs:
N R I' h' R 'd
~\\
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i
ame e atlOns ID eSl ence
T aime A. Willey Daughter 41 Oak Avenue
Kylie M. Winfrey DauQhter 41 Oak Avenue
Damon M. Winfrey Son 41 Oak Avenue
Diann Willey Mother 41 Oak Avenue
THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the appropriate form
to the undersigned.
'X
Residence(s) ofPetitioner(s)
41 Oak Avenue, Camp Hill, PA 17011
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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SS:
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 ofpetitioner(s) and that as personal representative(s) of the above
decedent petitioner(s) will well and truly administer the estate ac~co ~ing to law. ,
Sworn to or ~ffirme1 ~nd subscribed {X ~ (~-1-CQL -Yf-
Before me thIS \D day of ---\J.-
~~Q.-'L. ,20 ~S
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Register ~\
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No. '). \ - ~S - ")~ \
Estate of DANA M. WINFREY
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ~~~'L \0 20~ in consideration of the petition on the reverse
side hereof, satisfactory proof having been presented before me,
IT IS DECREED that DIANN WILLEY
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to D1ANN WILLEY
in the estate of DANA M. WINFREY
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Register01'Wi s
FEES
Probate, Letters, Etc. .............
Will .................................
$
$
Renunciation....................... $
Short Certificates (l.) ............ $
JCP.................................. $
$
$
$
20~
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A orney (Sup. Ct. I.D.
01 MARKET STREET
CAMP HILL, PA 17011-4227
Address
Automation Fee...................
Bond. .. .. .. .. .. . .. .. .. . . . .. . .. .. . ....
Total
Filed \\~\ \ I....
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(717) 737-0464
Phone
to
Hl05.112 REV. 8/88
(FEE FOR THIS
CERTIFICATE $2.00)
WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
GERT. NO. T 57 2 0 161
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Name of Decedent
b~
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Middle
Sex :Jl j.,A"V , D-...J Social Security No.
Date of BirthG, t 8 . 101 ',91 J Birthplace
Place of Death
Facility Name
Race ~J...I.' -l:..) Occupation ~.JKJj. D--It-JtJ Armed Forces? (Yes or No)
f'\ , I Decedent's d'\_" A f't I ... / .
Marital Status .I:tJ-.I~1' Lo(....;Mailing Address 4/ (!~)u.... .J. l ~--f.J.....JJ.... ,j)
Number Street CIty r Town
~:~~~ ~:o~ t J ~~ l Ji,n~ra~Director 9-~~ Jai~d-f$
Funeral Establishment g~..;y 1., L .JJ'j AJ."'-4.' ~!i /'n.:J-~" .I LUt..1> il]. r(,g'.)-.3
I I I
Interval Between
I Onset and Death
:/
C~ II ..,.. L
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Part I:
Immediate Cause
(a)(' AJLJ....' ~A-< ~~~ LJLJ/ f ~-' ~ '/
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(b)C~ ~ /~ ~ j ~/'V\A. . ~j.. ... ) .A-t II ),~. ~ ;+,-.
(c)
(d)
Part II: Ot~:':::J:~;:t~Onditions J ~" .
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Manner of Death
Natural 0 Homicide 0
Accident t9"" Pending Investigation 0
Suicide 0 Could not be Determined 0
Name and Title of Certlier ~a. ~h:~ ~ ~
"'" ./ J "A J '" 1'\ (M.D., D.O., Coroner, ME)
Address ~ I' j LA.A.~ ... ~ k p...l ~ : J ...J. ; .... ! I fd 1. 1 · D jJ-,( h Jj ~, '" Y43
Describe how injury occurred:
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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 filin .
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'te ecelved y ~cat egistrar
local Regist of Vital Recoeds 1
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Street Address
District NO,
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