HomeMy WebLinkAbout04-15-05
Register of Wills of Cumberland County
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of L)fW\.~ _ {Je (\ ne( / J(:
also known as
No. 011- 05- ?'Sd-
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No..;z 0 '-( - :2 to - L> 3;;;,- b
,
The petition of the 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
residence at Cl 0
(list street, number and municipality)
lounty, Pennsylvania, with h& last family or principal:::':
fl/ w..
I
years of age, died MCLt-<::-h .'3 ,
C1...
, 20 0 S ,at loJ c> I r
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 , h
situated as follows: st. I' --r- 1-. 7 '" [A/ t1/ P oJ .w l +
/r;,~066. CK)
'-\'
WI R.
$
$
$
$
Petitioner_ after a proper search ha_ ascertained that decedent left no will and was survived by the
following spouse (if any) and heirs:
Name
o
-Oal
THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the appropriate form
to the undersigned.
Signature(s) ofPetitioner(s) Residence(s) ofPetitioner(s)
J-r~'MJ<.'h1. LJeMMoQQ 3oS"<::<,,,y~. c..,:~+f(lc;f-4. 1;:>0 I(
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
}
SS:
COUNTY OF CUMBERLAND
,>
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petitioh are true'and
correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the a:pgve
decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and s~ribed
Befor~ I ::)*
J. .20
day of
05
{
IS d-~VV\' tr-. 10M 'Y'oO 0
----
en
<ii'
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2
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\ ~.iIle\~ 'iO...JLr\ DA \....)t}\ll/)~\.--,
~ C~_ ~-r;;egister
~ No.:JJ-OS-03S~
Estate 01\ kllll,!l m \:ll k lonnPli c;ro~ceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW Q p~J J ~ 20Q5 in consideration of the petition on the reverse
side hereof, satisfactory proof having bee_n presented before me,
IT IS DECREED that ~o ph, '" 0 YY'\ \ ^-~ 1\ no J 51
is/are entitled to Letters of A lnlstratlOn, and In accord With such finding, Lett r of Administration
are hereby granted to . \('(\
in the estate of
vki
Attorney (Sup. Ct. I.D. No.)
FEES
Probate, Letters, Etc. . ...........
Will...............................
$
$
$
$
$
$
$
$
20 l2.5
c9 (PO ' 0-0
i:
Renunciation..
Short Certificates ( )...........
JCP..................................
Automation Fee...................
Bood................................
Total
Filed "-\ - I ~
;;)O.m)
10.0<:>
500
~
..:.JCt5. 0'1:>
Address
Phone
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Tl1i, is 10 certify that the information here given is correctly copied from an original certificate of death duly filed with me as
l.ocal 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.
P 11330832
No.
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Local Registrar
Fec for this certificate, $6.00
APR 4 2005
Date
Hl06.144A8V.1191
TYPE/l"AINT
"
PI!....AHe:NT
BLACKrNK
William
UNDEA1 YEAA
"Io0l~' Do""
OECEOENT'SUSUALOCCUMION
~~.:l~d=':':~~~
30 Sussex Rd
Camp Hill, PA
c2/-05-35~
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
p
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2, Male
SWEFIl.ENUMBEA
socrALSECURITYNUMBER
DATE OF 0ElITH1Month. O.y,Ve,")
4. March 31. 2005
Wennell
,. 204-26-8356
UNOER1DI<<
H"".. Mln,n.,
DI\TEOFBIR1H BIRTHPLACEICitvOnd PLACEOFOEI\TH(C~lOkonJyono _,n6l,uoti""'onolhor.i"")
(Monlh,Do,. ''''~ SI.I.O' FO''';<jI1Comi"" foIOSPI",,~
York Co. ,PA Inl"'llonlO E'RIOIJ"'atl8nl~
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oeIVH FACrUll' NAME Illnot;"Ol~ulion.~"" s1'....ond number)
RACE.I\ml<iOllnrnd~n,BI&Ck,Wn~.,..c
(SpocifJIl
White
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East Pennsboro
Holy Spirit Hospital
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MAAITAlSWUS-Ma,,1tt<l
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OI"""'IId~y)
14. Married
SURVrVII<IGSPOUSE
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(Hm~+)
17011
DECEDENT'S
ACTUAL
REsrDENCE
(Seeinstroc1iOns
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MOTHER'SNAME.(Fi,".Middle,M_Su'nam.)
10. Rudy Treva
rNFORMANT'SNJArLIN(lADDRESS{Sl,....CitylTown,SI.t..Z;pCocloJ
Cltylb'uC
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INFORMANT'S NAME [Ty....Prinl)
Jose ine Wennell
IolETHODOfDrsposrnON
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PLACEOfDISPQSITION.Nam.o1C.rMtlK'/. ,.motory LOCl\TrON.Cltylbwn, Stot., Zip Co""
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2~~rland Valley Mem. Gds. 2'd~rlislef PA
NAME AND ADDRESS OF FACilITY Hoffman Ro1;:h Funeral Horne
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UCENSENUMBER DIlTESrClNE:DlMonrn,lloy.Yeo,)
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NAIoll;ANDADDRESSOFPERSONWHOCOMPLETEDCAU8EOFOE.IUH
(~"",27JTl'PItOd>'lnt Michael L. Norris. Coroner
~ 6375 Basehore Road. Suite #1
pi" 32. Mechanicsburg. Pa. 17050
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