HomeMy WebLinkAbout04-19-05
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PETITION FOR GRANT OF LETIERS OF ADMINISTRATION
Estate of \)o,()~'.\ [\"""e~. ""nA,-,\
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also known as no,,"r)~ ~ ~,,"oI"4\c-r\.,-,
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~........_n... ~~.r mr-...-ll \ Deceased.
Social Security No. ,..,.....--. ~ ~'\ -C\ (),-:>..,
No.
To:
al-05 -35LP
Register of ~ills for the ""'"
County of (,u.."",,'ce.\ in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older. appl, e "'-
for letters of administration
on the estate of
(d.b.n.; pendente lite; durarue absentia; durarlte minoritate)
the above decedent.
County, Pennsylvania, with
.\: ~ (J PI \\ \ .
(II t street, number and mumcipality)
Decendent. then \ q years of age, died '(',V'd C'.v--. \u
at c::;r.o....-~'n A \~A.r\. N'\f"...""""",(~c,\ \-\,.,fY\..D 'DDl0_~..~~.(n"h.......\e
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,t!D::;l.OO"S ,
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Decendent at death owned property with estimated values as folllows:
(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:
$ 7,c:;.) ='00
$
$
$
Petitioner_ after a proper search h~ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name
Relationship
d
Residence
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THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
} 58
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 of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affi~fl...,and subscribed J Jr:.~'--._ '// A:___ ~/
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No.dJ-05<~-l')to
EState of
Dorothy Anne Dermody
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ~ J- \ q ~/)()S 't9_. in consideration of the petition on
the reverse side hereof. sl\tiflfact9ry proof hav' been presented before me.
lT IS DECREED that K~ -
is/are entitled to Letters of Administration, and in accord with s finding. Letters of Administration
are hereby granted to k 0 AJ.--V.-.., \ 10 --rJ 0 "--y-y....~
\)
in the estate ofJ)~.~ ~~DJL~no., 5'
\.J-\ h,,~~Q^ r~^ (~~(A h hr."1L
~:<<~Wilh~~ _~
,. ""'~U> ~
FEES n.
Letters of Administration ..... $ '-1U ,00
Short Certificates(1~ . . . . . . . . .. $ 4-0 .60
ReI 'nllu~.~$ 6'()~
\\If> $ I ,Dl
TOTAL _ $ \'-1-5. uD
Filed ..:1 ~.I~.: P.'?.. . .... A.D. 19_
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ATTORNE up. Ct. l. No.)
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ADDRESS
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PHONE
Ifli6~il' FIe\' ';il~
Thi, i, to certify that the information here given is correclly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the Stale Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Fee for thi, certificate. $6.00
P 11330644
w.,RU2005
Dale
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
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TYPE/PRINT
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PERMANENT
ILACKINK
91.orE'''E''UMlIEA
NAME Of OECEOEt(flf.......""... L"l
~,
SOCI...LSECUAITYNUMBEA
OA1EOFOEJlI'H,MoM'I.0a..._J
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.. Cumberland
Ie. Carlisle Boro.
;Female
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077 - 24
- 9073
t. March 16, 2005
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AGEllaslaOlMoyj
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A. Demody
UNOER 1 DAlr'
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OECfOENl'SUSUAlOCCUPRION IIINOOFBUSINli'$$/It+OUS1P.Y
(Gi..""",oI__dut"'ll"- D' k'
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DECeDlEt(f'SM1dl.INGAOOAESS(Sl''''''.CiIylbon.SIaIo,~CooIl DECEDENT'S
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flESlOENCE
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IolOTHER.S_lF....M.,...,..._SU'"omel
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JNFOF1MANT.S~ADOAESS(Slr_~,SloIe.Z"Coo>>I
55 Cher Lane: Carlisle, PA 17013
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1.. Married u. John M. Derrrody
17c.~ ......__.. Middlesex
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55 Cherry Lane
,.. Carlisle PA 17013
FRHEIl.SNAMEIF....._.l.o"'l
William H. Brandes, Jr.
17b.Cou
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2IIL Kevin W. De
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DEPARTMENT OF VETERANS AFFAIRS
Medical Center
1700 South Lincolu Avenue
Lebanon, P A 17042
April 12, 2005
In Reply Refer to: 595/520
John H. Broujos, Attorney
4 North Hanover Street
Carlisle, PA 17013
Fax 717-243-8227
SUBJ: John M. Dermody
Mr. Dermody's wife, Dorothy Anne Dermody, died on March 16, 2005 without a will. I
understand that in such a case, the spouse is typically appointed to serve as administrator of the
estate.
Mr. Dermody is currently a patient at the Lebanon V A Medical Center. As Mr. Dermody's
attending physician, it is my opinion that due to the severity of the cognitive deficits related to
his diagnosis of Dementia NOS, he is incapable of performing the tasks required of an
administrator of her estate. I am therefore submitting this letter at the request of Mr. Dermody's
son and attorney recommending that the role of estate administrator not be granted to Mr. John
Dermody.
Sincerely,
'7p^ >>qD I'
JAMES D. ST AUFf'ER, MD
Attending Physician, Extended Care
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DEPARTMENT OF VETERANS AFFAIRS
Medical Center
1700 Soutb Lincoln Avenue
Lebanon,PA 17042
April 12. 2005
In Reply Refer to: 595/520
Jolm H. Broujos, Attorney
4 North Hanover Street
Carlisle, PA 17013
Fax 717-243-8227
SUBJ: Jolm M. Dermody
Mr. Dermody's wife, Dorothy Anne Demlody, died onMarch 16, 2005 without a will. I
understand that in such a case, the spouse is typically appointed to serve as administrator of the
estate,
Mr. Dermody is currently a patient at the Lebanon VA Medical Center. As Mr. Dermody's
attending physician, it is my opinion that due to the severity of the cognitive deficits related to
his diagnosis of Dementia NOS, he is incapable of performing the tasks required of an
administrator of her estate. I am therefore submitting this letter at the request of Mr. Dermody's
son and attorney recommending that the role of estate administrator not be granted to Mr. Jolm
Delmody.
Sincerely,
1~ ~I'
JAMES D. STAUFP'B'R; MD
Attending Physician, Extended Care
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