HomeMy WebLinkAbout08-08-14 Aug, 8. 2014 4;05PM Weigle & Assoc. No. 3889 P. 1
PETITION FOR GRANT t7F LETI'ERS
REGISl`E�i�JF iMLLS OF CUMBERLANQ COUN7Y, PENNS1fLVANUI
Petiuoner(s)namea belaw�wnu isiare t e yearc of aga or Nader,ap�►h�'ies)rn►L�ters as specified bebu►,and;n support eheneM aver(s)tha
i�plqwing and raspedtuy uest( �o Leiters' fam: � /� '
M.1►an+er r_ i �V
o.��g��� �7, //_ D..D-,�l�-�_
lmme: Ltorreld N.Varner File[�o: 31-14- ' /�'I l!J ��
aA�la: (Msi9nad bS►R�B�Eer�
alkia:
aAc1a: Social Sawn�Na .
Dabe of DeWh: 071191�14 Age at Dp+atlr 7S
Decedent was danicaed at d�ath n Gumberf�nd �mY�
PA (�Ste1�Iti6lh1r last
prinapa�rasidenoe at 1900 Centar Rnad,NewWlis �i7241 I.Gw4r YMlla TownahQ �lmberlrnd
Cb. aM+tiiDarBaa� �h
Daoadent d�ed at H�n9 H�pi�)HSrrisbur9.PA 17101 Na Dauphin PA
8aea1 ad�kaFS„Pad 01�and z�C� G4;7aWnetrD a 9aou� Ca+�h �
Estinate of value af dea�s pr�r at dcsth:
IFdonricykdir�P'errrFS]rlYerrie...................... 1�A���P���N s _ 21�40d.18
If not tloimlcUed Jn Alnnsylvanla............... Peraonsl prapc��i in penn5yhiania S
if m�t donuciJed in Prrnsy/�nia.........�.. Petsonel property�CouMy S
Vekre ofMeof esbt+9/1t Aef!lrsy�hrrdefd-_--•_._..w--..........................r................�s
TDTAL EST11iATED VALUE s 21,498.fa
Ree+eMsus h rerr�synrerte e�e4ea at '
fA�chadtaiwie�latieeAs,�naaessa�cl
Shae�ed�ess,Po�sf OIFc4 a�d�P Gude CIry.7'uwu�el�a eanu� C�+�b'
�A. PwNtien f�Pro�and Geant aF Le#tera T�aene�arv
Pat�ianer(s)avss�(s)U�at helshe./tF+ey is►ere the Exe�xdor{a}named in tha last 1Nit of tltg Decedent,dated and Codidl(�}
the�e4o dated
Ste�a+alwa�cccunaar�ou(n.�.+e�e�dafops absll+d�exeo�r,eRx) _, �
iou
Except as folows:ai6e�the e�ution of ihe instrurt�ant(s}�fffertd fot pnobate.D�+t did naR m was nat d' was not A�:�y t0 ir�
divat�ce prooeedir�g�n the groue�for diVOrt:e hsd been e�rblishOd�i d�fnmd in 23 Pa.C.S�3323(A},and have a�d bo�n�!';,—.
a�dopmpd;and Decasdent was ne�her the v�m of a W7ing nor ev�adjudicaf�en inc9paa�ta�sd Derao^- p� � .. C� � —,"�
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ff/�ICI��Gf.a Of db.A.GLS.� ' ��-� � 1.J ;n
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i�t P a.�C 3.�§ : rd was not a party tn.pend i n Q divoroe pruceed i n g whe�sin the�dh+aoe had beso.�6shed as t!�'ined��(,�i
3 3 2 3(g)an d was t re i�h e r t h e v�d im��a 1 4 1 R n a e v e r a a�u d i W h d s n p e r s o n• � N
L'1
Q NO EXGEPTIONS❑ IXCEPTIONS
P�i6on�Ks��Fer a proper sr.ar�hasA�ave asce�tained thst Deoe.dent lett ra WIA and Mras survived by the iaBawinB�ou�e(tf any)and heins(a�tsr�
ad��unalsheet5 ifneoassar�:
Neme Ftslafionship Ad[9ress
Dona�d M. V'arner, ,7r. 31 Cherry Grorre Ra d Sh�ppensbu.rg, PA 17257
r.om,RN+�2 rw.�ar�,am� 000rridr{c)2ot1 tam�aryn�«ca�,r,e. P�+d2
Oath of Personal Representative °�pa'u�°"'y
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUMY OF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Donald M.Vamer,Jr. 31 Cherry Grove Road
Shippensburg,PA 17257
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 ent,Peti�t�i}n�s) 'll well and truly administer the estate accordin to aw.
Swom to ffirmed ubscribed fore ��'v o�e �
me th' y o ��e
oaee
�-
� Date
BOND Required? � YES � NO To the Register of Vl�ills:
FEES• r n'� P�ease enter my appearance by my signature bel
• VtJ
Letters.......................................... $ Attomey ' ature:
( v�)snort cert;ficate(s).-.-.---- � U J
( )Renunciation(s).............. ,i'
( )Codicil(s)........................
( )Affidavit(s)...........••••••••••• Printed Name: Jerry A.Weigle Esquire
Bond.............................•••••••••••••... Supreme Court
Commission........................... .. ID Number: 01624
Other � �
�L�sl�l�— Firm Name: Weigle 8�Associates,r�s.� , �?
Address: 126 East King Street ���,.: � �'-� �: ;
�� ' 4"') C ., .-�,,
`..
Shippensburg,PA 17 � ' G� � __-
C' ..,� `._ :.: ,.:;
L'a C.:: ;-,
�.,
Phone: 717/532-7388 �=— °''`� '-
Automation Fee............................ U�
-a��G..i �- r,�,
. Fax: 717/532-5289 �y ��O
JCSFee....................................... •
TOTAL................... E-mail: " 'r �
...................... $
DECREE OF THE REGISTER
Date of Death: 07119/2014
Social Security No:
Estate of Donald M.Vamer File No: 21-14 — L �f� —
�
a/k/a:
AND NOW, , ,in consideration of the foregoing Petition,
satisfadory proof having been p ented before me,IT IS DECREED that Letters of Administration
are hereby granted to Donald M.Vamer,Jr.
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 Iast Will nd Codicil(s))of Decedent.
Regis of Is ,/ � �/'
Copyright(c)2011 tortn soflrrare ony The Laclaier Group,I ( /�<=/,( • age 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: il�nga9 #abu� I te this copy by photostat or photograph.
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Fee for this certificate, $6.00 ,,,������° This is to certify that the information here given is
. � ���� �$ ��� �: ,��p�TH OF pE�;��_ correctly copied from an original Certificate of Death
?;�I;; � ,
`��,�o __ ___ L` duly filed with me as Local Registrar. The original
`o `� -; z; certificate will be forwarded to the State Vital
_ d�Office far ermanent filing.
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UM�'���d 'v' `vl� )����O - " ����'�� >
P 2 0 �? �. � 7.. � �' CUMBERLANC C�., �°q �, �
�' Q,~`� � _
"" '�qIMENT OF� , � ��
,,,
Certification Number . ""�"""'"����'1/ cal Registrar ate Issued
Type/P�IM In COMMONWEALTH OF PENNSVLVANIA�DEPARTMENT OF HEALTH�VITAL ftECORDS
°ernianent CERTIFICATE OF DEATH
Black Ink Sfafe FII¢Number:
1.Decedent's Legal Name(First,Middle,Last,Suffix) 2.Sex 3.Social Security Number 4.Date of Daafh(MO/Day/Vr)(Spell Mo)
Dona�d M. Vwcne�c S�c. �e �`�g-�'�-172 -�
Sa.Age-Last Birthday(Yrs) Sb.Unde�1 Year Sc.Under 1 Da 6.Date of Birth(MO/Day/Year)(Spell Monih) 7a.Birthplace(City and Siate o�Forel ouniry)
nno�cn: oav� �o��� nn,.,.,ies O[tftv-�.Q.Q.¢ PA
. 75 Janccwc 77 1939 7b.Birtliplacecco.,��y� Um n
8a.Residence(State or Foreign Couniry) Sb.Residence(Stree[antl Number-Include Ap[No.) 8c.DIA Decedeni Live in a TownShipT
Penne -e.vccn.�a 1300 Cen�eh. Road A3ve�,de�ede�=u.,ee�„ Lowe�c M.i,�S�S.�i.n =wP.
Sd.Resitlence(COUnty)
Cumbe�and 8e.Resitlence(Zip Code) "L �No,decetlent Ilved within Iimiis of city/boro.
9.Eve�In US Armed Fo�cesT 10.Mariial Status ai Time of Deafh Married $7 W�dowed 11.Surviving Spouse's Name(If wife,give name prior fo first mar�i�ge)
�Yes �No 0 Unknown � Divorced � Never Marrled �Unknaw �
12.Fa[her's Name(Firsi,Mitldle,Last,Suffix) 13.Mother's Name Prior to First Marrlage(Firsf,Mlddle,Last)
Ro F. Vwcne�c �.e�f�.e�c �. Z-i nn
14a.Infor ant's Name � 14b.Relafionship to Oecedent 14c.Informant's Mailing Address(Street antl Numbe�,City,State,Zip Code)
o 'Dona�d M. Va�cneh Jn.. Son 31 Cheh�c G�cove Rd S b
G - - - - ---- - - --- - - - -i a.ria�e o - - -�o.,y.00e - - - - - - - - - - - - - - -
If Death Occurred in a Hospifal: �InPaHeni �If Ueaih Occ rreO SomewM1ere Othe Than a Hospital: d Hospice facilify b Dec¢dent's Home
a O Emergency Room/OUtpatlent � ❑ead on Ar�ival � Nursing Home/Long-Term Care faciliiy O Other(Specify) _
s15b.Facility Nams(It not instlxution,give stree[and number) 1+SC.City ur Town,Staie,and Zlp Code 15d.County of Death
"' Ha�,i,a bwc Hoe :iX cLC Ha�-a bu�c PA 7 71 0 7 '�QU h-Ln
�� � 16a.Meihcd of Disposition � Burial � Cremafion 16b.Daie of Oisposiilon 16c.Place of Dlsposition(Name of cemetery,cremaiory,o�ofher pla<e)
� � Removal fram Stata �Oonatlon sCe
0 ome�csPe��r.,� 7-24-2014 f-(a. a Gh.ove Cem�te�c
4 2 16tl.Locafion of Dlsposiilon(City or Town,5[a[e,and 21p) �7a.51 f Funeral Service Li e or Vers�n in Char�e of Interment 37b.Llcense Number
� Newv,i�ee PA 1724T - 014831-L
E 17c.Name antl CompleYe Atldress of Funeral Fadllty
8 �a eX,ean eJC-Bn.�chelc �.fi. Znc. 71 W. K.in "
� � 18.Decedent's Education-Check the box ShaC besi tlescribes the 19.Decetlenf of Hispapic Origin-Check ihe 20.Deced�nt's Race-Check ONE OR MORE races io Indicate what
highesf tlegree or level of school completetl aT the time of death. boz that besf tlescribes whether ihe decedent t�ecedent consideretl himself or herself to be.
� Bth grada or less i Spanish/Mispanic/Latino. Check the"NO" Whlte � Korean
� o diploma,9fh-12in grade bo3I�decetlenf is not Spanish/Hispanic/Latino. � Black or African American O Vleinamese
�igh school gratluafe or GED completetl �No,not Spanish/Hispanic/Latino �American Intlian or Alaska Nailve O Ofhe�ASian
� Some college c�etli[,but no tlegree �Ves,Mexican,Mexican American,Ctilcano �Asian Intllan � O Native Hawalian
0 Assoclate tlegree(e.p.AA,AS) O Yes,Puerto Rican �Chinese O Guamanlan or Chamorro
� Ba<helor's tlegree(e.g.BA,AB,BS) O Yes,Cuban O Filipi�o O Samoan
� MasTer's tlegree(e.g.MA,M5,MEng,MEd,MSW,MBA) O Ves,other Spanish/Hispa�ic/Latino O�apanese O Other Pacific Islander
� Doctorate(e.g.PhO,EtlD)or Professional degree (Specify) 0 Oiher(Speclfy)
.MD �DS �vM LLB,J❑
21.D edent's Single Race Self-Designatinn-Check ONLY ONE to Intlicate what the Aecedent considered himself or herself to be. 22a.DccedenYs Usual Occupatlon-Intlicate type of work
�White �Japanese - � Samoan tlone du�ing most of wo�king life. OO NOT USE RETIRE�.
� Black or African American � Korean � Other Pacific Islantler
� �American Intlian or Alaska NaTive �Vietnamese O �on't Know/NOi Sure RQ Q�C�[maK
�Aslan Intlian �Other Asian 0 Refusetl 22b.Kind of Business/Intlustry
.�i� � Chinese � Native Hawallan � Oiher(Specify)
� � Filipino �Guamanian or Chamo�ro � �
ITEMS 23a-23d MUST 6E COMPLETED 23a.�afe Pronounced DeaA(MO/�ay r) 23b.Signaiure of Person Pronouncing Death(Only when appltcabla) 23c.License Number
BV PERSON WHO PNONOUNCES OR
CENTIFIES DEATH
23d.Oate Signed(MO/Day/Vr) 24.Time of�oacli
25.Was Medical Examiner or Coroner Coniactetl? O Yes No
CAUSE OF UEATH � Appraximate
26.PaR 1. Enter The cha'n of events--diseases,injuries,or complicaTionS--ihaf directly caused the dea[h. DO NOT enier ferminal events such as cardlac arresf, � ,Interval:
respiratory a�resf,o�ventricula�fibrillation wiihout showing the tiology. DO NOT ABBREVIATt. Ente�oniy one cause on a Ilne. Adtl adtlifional lires If necessary. 1 Onset io Death
e
°��-��� '
IMMEDIATE CAUSE -------------> a. � ��1~�
(Final tliseasa or condition � e co(or as a sequence oF): . _ �
resulNng In tlBaYh) �
b. 1.(- �
Sequentially Iist condlilons, Du t (or as a consequence of): �
if any,leadlnQ to the cauze , �
listed on line a. Enter ihe
UNDERLYING CAUSE � Due to(or as a consequence of): �
1
(disease or injury that � � .
W Ini<lafed xhe evenis resulting d.
� In tleath)LAST. - �ue io(or as a consequence of):
� 26.Part 11. Enter other t di I i Ib I i d th but not resulfing in the underlying cause given in Part 1. 27.Was an auiopsy performedi
O Ves No
g _ za.ware euxopzy f��tlin¢s available
to complete the cause of tleaih7
- O Yes No
� 29.If Female: 30.Ditl Tobacco Use Contribufe to Dea[fiT 31.Manner of Deaih
� � Nacural � Homicide
E O Not pregnant wlthin pasi year � Ves 0 Probably
s p Pregnanc at time of deaih 0 No �Unknown � Accident � Pentling Investigatlon
$' � Noi pregnanf,bui pregnant within 42 days of death O Sulcide O Could not be determined
� Not pregnanS,but preQnant 43 days to 1 yea�before death 32.Date of Injury(MO/Day/Yr)(Spell Monih)
� Unknown it pregnant wiThin ihe past year - ' 33.Time of Injury
34.Place of I�jury(e.g.home;construction sife;farm;school) - 35.Location of Injury(Street and Number,City,Couniy,State,iip Cotle) --
S' 36.Injury at Work 37.If Transportatlon Injury,Specify:_ � 3H.Describe How Injury Occurred:
� O Yes 0 D�iver/Operetor O Pedestrlan �
No �Passenger � Oiher(Specify)
39aaaa....tttCertlfler-physiclan,certifled nurse acililoner,medical ezaminer/coroner(Check only one): -
�Certifying only-To tF�e besi af m wledge,d t occ retl duec o the cause(s)and manner stated. anner
Pronouncing 8.CertIN��6-T best f my k '''l///ed���ge u aih oc red at the Gime,data,and place,antl due to the cause(s)and m statetl.
O Medlcal Exami Coroner-O the of e�' d/or invesrigafion,In my opinion,death occurr A at ihe time,date,antl place,antl due to the c �sqJ(s)and taxetl.
Signature of c rtiffer: 1 n Title of certifi� �5���J License Numbg(:�"� ����,� �
' 39 ame,Addre Code n Completing Cause of Death(Item 26) -' ' 39c.Date Signed(MO/Day/Vr)
- � _ ' �.. s � �- ,-, � �. �a a
� 40.Registrar s Distri ber 43.Rcgistra' nature J 42.Ragistr � le Dafe Mo Day r)
� G�l ''� FS� Z 2� /
,� 43.Amendments
�
H105-143
Disposiiion Permi[No.����2�� kEV O7/2012
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA ADMINISTRATION
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R�
No. 2014- 00746 PA No. 21- 14- 0746
Es ta te Of: DONALD M VARNER
(FirsL Middle,LasU
Late Of: LOWER MIFFLIN TOWNSHIP
CUMBERLAND COUNTY
Deceased ..,
Soci al Securi ty No: � �.=��
� �.: _�_,:`�-•-�°
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�-TJ (�„'Y r'�^ -'-�
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!—.S.-, � i i ;
WHEREAS, DONALD M VARNER �� ;'- � ' ' , , '=�
(fi�st,Middle,LasU �J�:-.� . r� � -
l l L r�" `� ... Y t��
late of LOWER MIFFLIN TOWNSHIP CUMBERLAND COUNTY ��_ �=« ��
died on the 19th day of July 2014 and, D ^' �'� ;��,�
.�` _�1
WHEREAS, the grant of Letters of Administration '�
is required for the administration of the estate.
THEREFORE, I, L/SA M. GRAYSON, ESQ. , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day granted Letters of Administration to:
DONALD M VARNER JR
who has duly qualified as ADMINISTRATOR (RIX) of the estate
of the above named decedent and has agreed to administer the estate
according to law, all of which fully appears of record in my office at
CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the Sth day of August 20�4.
,
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)