HomeMy WebLinkAbout06-10-15 �. �
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Petitioner(s) named below,who is/are 18 years of age or older, apply(ies)for Letters as specified below, and in support thereof aver(s)
the following and respectfully requests the grant of Letters in the appropriate form:
Shirley H. Radunz
Decedent's Information
Name: Catharine H.Feidt File No: 21 -15 ` �p��
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 08/06/2013 Age at Death: 73
Decedent was domiciled at death in Cumberland County, pA (State) with his/her last
principal residence at 1415 Harwich Court,New Cumberland 17070 LowerAllen Twp Cumberland
Street address,Post Offce and Zip Code City,Township or Borough County
Decedent died at Carolyn Croxton Slane Hospice Residence Susquehanna Twp Dauphin PA
Street address,Post Office and Zip Code City,Township or Borough County State
Estimate of value of decedenYs property at death:
If domiciled in Pennsylvania........................ All personal property $ 50,000.00
lf not domiciled in Pennsylvania................. Personal property in Pennsylvania $
lf not domiciled in Pennsylvania................. Personal property in County $
Value of real estate in Pennsylvania........... $
TOTAL ESTIMATED VALUE $ 50,000.00
Real estate in Pennsylvania situated at
(Attach additional sheets,if necessary.)
Street address,Post Office and Zip Code City,Township or Borough County
❑A. Petition for Probate and Grant of Letters Testamentarv
Petitioner(s)aver(s)that he/she/they is/are the Executor(s)named in the Last Will of the Decedent,dated and Codicil(s)
thereto dated
(State re/evant circumstances,e.g.,2nunciation,death of executor,etc.) �
Except as follows:after the execution of the instrument(s)offered for probate,Decedent did not mar ,was not divorced,was not a party to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.�g 3323(g),and did not have a child born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
� NO EXCEPTIONS❑ EXCEPTIONS
Q B. Petition for Grant of Letters of Administration (Ifapplicable)
c..a.; . .n.; . .n.c..a.;pe en e n e; uran e a sen�a; uran e mmon�a�e
If Administration,c.t.a or d.b.n.c.t.a.,enter date of Will in Section A above and comqlete list of heirs.
Except as follows:Decedent was not a party to pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person.
QX NO EXCEPTIONS Q EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that DeoedeM left no Will and was survived by the following spouse(if any)and heirs(attach
additional sheets,if necessary):
Name Relationship Address
See attached schedule ,._,
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PETITION FOR GRANT OF LETTERS
(Continued)
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
�eceaent: Catharine H. Feidt Fiie No: 21 - 15
a/k/a:
Social Security Number: 172-32-0929
Date of Death: 08/06/2013
Age at Death: 73.00
Name Relationship Address
Madaline R. Hughes Mother Died March 4, 2005
Marlet W. Hughes Father Died August 13, 2010
Melvin D. Feidt Spouse Died February 4, 2014
Julie K. Forst Daughter 4680 Oak Creek Street
Orlando, FL 32830
See Renunciation dated 4-20-15
Marilyn Y. Freeland Sister 15 Fisher's Run Road
Dillsburg, PA 17019
Shelva J. Hendricks Sister 4912 Earl Drive
Harrisburg, PA 17112
Shirley H. Radunz Sister 340 Herman Avenue
i ow,.,.,no PA �7AdZ
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Oath of Personal Representative Offcial Use Only
COMMONWEALTH OF PENNSYLVANIA }
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COUNTY OF Cumberland '� T�
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Petitioner(s)Printed Name Petitioner(s)Printed Address -- �;� �" - :^�
Shirley H.Radunz 340 Herman Avenue ��a R! �,
Lemoyne,PA 17043 �- ',;, f'"' ' 3
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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 Decedent, Petitioner(s)will wel and truly administer the estate according to law.
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Swom to r ffi1rm, ed and ci�hccribed before � �'a ' �' Date U—/�
me thi ttlay of n , 2Q/� Date
By: Date
F r th Reqi er Date
BOND Required? � Yes � No To the Register of Wills:
FEES Please enter my appearance by my signature below:
Letters............................................ $ Q' ��' Attorney Signature: .
(�)Short Certificate(s).......... .d 6 I�i a
� )Renunciation(s)............... � •O G `,,;�,'�,4 � �
( )Codicil(s).........................
___ .
( )Affidavit(s)....................... Printed Name: J an D Seibert
Bond.............................................. Supreme Court
Commission................................... ID Number: 41713
Other
Firm Name: Caldwell 8�Kearns P.C.
Address: 3631 North Front Street
�n ak � n✓ �'�'�' Harrisburg,PA 17110
Phcne: 717/232-?E61
Automation Fee.............................
JCS Fee......................................... .5Q
Fax: 7171
TOTAL........................................... $ — E-mail:
DECREE OF THE REGISTER
Date of Death: 08/06/2013
Social Security No: 172-32-0929
Estate of Catharine H.Feidt File No: 21 -15 -� ,� (
a/k/a: •°
AND NOW, , ��l� ,in consideration of the foregoing Petition,
satisfactory proof havi g been presented before me,IT IS DECREED that Letters of Administration
are hereby granted to Shirley H.Radunz
in the above estate and(if applicable)that the instrument(s)dated
described in the Petition be admitted to probate and filed of record s t last Will(and Codicil(s)),,�f�Decedent.
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REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA ADMINISTRATION
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e�` No. 2015- 00648 PA No. 21- 15- 0648
J?� ���� ��
Estate Of: CATHARINEHFEIDT
O � (Fiist,Middle,Lastl
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� La te Of: LOWER ALLEN TOWNSHIP
`/� CUMBERLAND COUNTY
N Deceased
Social Securi ty No:
1750
WHEREAS, CA THARINE H FEID T
lFirst,Middle,Lastl
late of LOWER ALLEN TOWNSHIP CUMBERLAND COUNTY
died on the 6th day of August 2013 and,
WHEREAS, the grant of Letters of Administrat_ion
is required for the administration of the estate.
THEREFORE, I, LISA M. GRA YSON, ESQ. , Regi s ter of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day granted Letters of Administration to:
SHIRLEY H RADUNZ
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, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set m_y hand and affixed the seal
of my office on the 10th day of June 2015.
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L.O�AL �Et�l��'��►R'� ��RTI�IC�1`IGlrf'���;�u�dl'�E;� OF DEATH
WARNING: It "ss illega! to duplic�te th�s copY by p�=o �:�a,�ia�i or photograph.
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�-�ec :o; this �rrtifi�ate. $6.U(1� � �� ��. � ;� � ,�.� � Ili �is to ccifitti thit�the infoimatian here ��i��en i�
� �� � � � . 7� r �y �✓,,�;�y���+�-�����fy� � � �n ��ctiv �op�ed t�om �n o�i�inal C'c rtificate ot Death
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C'crtil!cat�c�n �iunibcr � ��-c_,,,,,,,,�,�,i" � � 1
� - � .c�� �� R ��istrar /�ate Issued
Typ�/Prini In COMMONWEALTH OF PENNSYLVANIA�DEPARTMENT OF HEALTH�VITAL RECORDS �'
P•�'�'"`"` CERTIFICATE OF �EATH
g��� ��k State Flls Number:
1.Oeced<nT's Letal Name(first,Mlddle,Last,SuHlx) 2.Sex 3.So<ial SaCurity Number 4.Date of Death(Mo/Day/Yr)(Spell Ma)
Catharine H. Fe�:d��:
Sa.A«-Lsst BiKhday(Yra) Sb.Under 1 Ya�r Sc.Vnd�r 1 Oa 6.Dat�of BIRh(Mo/Day/Ya�r)(Spell Month) Ja.Blrthplau(City and Staie or Fo�eltn Country)
� ,73 Monfhs Daya Moun Minut�s '
February 2 2� 1 9 4 O ]b.Birthplac��co��cy>
Ba.Residenca(Sbu or Fofei`n Country) 8b.Resldence(Streef and Number-Include Apt No.) 8e.Oid Decedent Llve In a Township7 �
'I 4"1 5 Harwich Ct� -- �.:,ae�va.�t n.,ga i„ r.o�,�er 7111e.n �P�
Btl.Resitlenca Co�nty)
e�.Resldence(Zip Cod�) O No,d�c�dent IiveA with{n Iimita of clty/boro.
9.Ev�r in US Arm�d Forces? 30.MariCal SL�tus at Tlm�of Daalh Ma�ried WI owa 11.Surviving Spousa's Name(If wlf�,tiv�nama pMor to fttst rnarrlata)
OV�s �No DUnknow� � DNorced � NevarMarria �Unkno Meivin F''E1�t
12.Father's Name(First,MlOdle,Lasc,Sufflx) W 13.Mothar's Name Prbr to First MarrlaQe(Fint,Mldtlle,Last)
M 1
14a.Inlormant's Nama 14b.Relationsliip to Daeedent 14c.In o�mant s Mal Ing Address(Stre�i antl ar,Clty,State,21p Cotl�)� ,7 O,7 O
G 1 a n Lr ona
SIf D�ath Ocwrr�d In a Hoapli�l: ❑ Inpatl�nt �If Oe�th Occurred Somewhere Other Than a Hospital: ❑�oepice Facliity �DeceA�ni's Home
� O Emer enry Room/Oucp�tl�M O Dead on Arrlval � O Nursi� Mome/Lon -T�rm Gr�Faciilty O aher(Sp<elfy)
35b.Faeility Name(If not inftituilon,�Ive atroet and numbar) SSc.Clty or Town,State,snd Zip Cotl� SStl.County of Deaih
� 16a.MK od of Disposlllon �] Buri�l Cromation 16b.Da[e o spos on e.P aea of D�spos tion Name of cwmetery,cremaSory,or ot er place)
$ o a...,o,..ir�oR,se.s. o oo,,.cio.; gJ� 2 20'I 3 Wood�awri::.-,^-s�[�ao�# 1 Gardens
� O ah�r(Specify) � $
i16d.Locallon of Dlsposlilon(City or Town,Statw,and 2Ip) 17a.Slpnature of Funara erson In Charss ollnfermenS 17b.Lleense Number
� Harrisbur PA '1 7'I 7 O -D/ y0�l-L-
� 17c.Name antl Campl�Ce Adtlr�ss of Funa�al FSGIily
18.O�eedwnf's Etluutlon-Check ihe box Shst best Gescribes ihe 19.Deqdent o7 Hlapanlc ONgin-C ec t e 2 .Dece en's Race- hec OR E r c o cate what
r- hISMs�tl�ir��or I�v�l of a<hool completed at the Yime of tleath. box thai b�at tlesc�ib�s whethar the decedant the dacedenc considered himsaH or h�rselt to b�.
p asn s�aee or i<sa is Spanish/Hlfpanic/Latino. Ghack tM"No" Q[Whlta O Korean
� No tliploma,9ih-12th�rade box H deceGent is not Spanish/Hlspanic/UHno. � Black or African AmeNcan � VietnYmasa
� HI{h fchool Srad�at�or GED compl�ted No,not Spanish/Hlspani</Uiino �Am�rican InOlan or Al�ska Native 0 Oiher Aslan
Som�coll�Q�creGi<,bu!no Easrs� Y�s,M�xican,M�xican Americ�n,Chiuno �Asian InGian � Nativ�M�walian
� Asso<late dasroe(e.g.AA,AS) - �Yas,Puer[o R{<an � Chlnese
� Bachelor's d�sr�e(�.t.BA,AB,BS) 0 Vss,Cvban O Filipino 0 Ssmoan,��or Chamorro
0 M�ster's d�aree(e.s.MA,M5,MEns,MEtl,MSW,MBA) O Ves,oSlier Spanlsh/Hlspanic/LaSino �Japanese � Oiher Pacific lslantler
O Doctor�te(�.t.PhD,�EED)or irofesaional desrwe (SpecHy) � Oeher(Speci
fv1
� .MD DDS �VM LLB ID
21.Decedent's Sinsle Rrce S�If-D�slanation-Ghack ONIV ONE to Indicat�what the de<edene eonsld�r�d hlms�lf or hersel4 ta be. 22a.Deud�nt's Usual Occup�clon-Indluti typ�of work
Whtts O��P���s� O Samoan tlona tluring most of workin`Ilfa. DO NOT USE RETIRED.
Blaek or Atrlca�AmeNcan � Korean � Other Paeifle Islander
� �American Indian ar Alaska Native �Vietnam�sa � Don't Know/Not S�ra F'orm
0 Aaian Indlan �OthYr Aslan � R�(usad 22b.Kintl of Businiss/Industry•
� � Chlnase� 0 Nativ!Hawallan � OYhlr(Spa<Ify)
� Fmci.+o � Guamanl�norCh�morro PA Healtlz & Li uor Bd_
fTEMS L+a-2 MUST sE COMPLETCD 9�.D�te P�o�ouneed Deitl(Mo Oay � 23b.Sltnatur�o Pe�son P�onouncing Oe�t (Only when appl cabl� 23c.LI<ensa Num er
BY PERSON WMO PRONOUNGES OR
CERTIFIES DEATM � '�
23d.Oafe Sitnad(Mo�ay/Y�) 24.TI �a1 D th �
25.Wa�Madle�l Examin�r or Goroner Conbcted7 � Yes No
CAUSE OF DEATH ' ,y �,,,.i.
pprox
26.P�r�i_ Enqr Ylie chain n1�v�nts--tllsaases,InJu�les,o�complicationa--MK dir�ttly ea�s�tl tha tlaath. OO NOT entrr[�rminal even�s s�ch as G�diac a���at, � Interval:
r�spi�atary arrast,or ventAeuiar fibrillaii wlthoui fhowins th��tiolo{y. DO NOT ABBREVIATE. Enter only one cau n a Ilne. Atld dd�ition�l Ilnes if nec�ssary. 1 Onset So Death
s�o ��.y
IMMEDIATE CAUSE ------------> a.�IL�Q��I� � ' �V`{; 1
.(Final Ala��s�or conditlon Dua to(or as a cons�q��nc�of �
rssulein`In d�a<hJ � '
b. �
S�qu�nelally�ISC ccntlKlons, � �ue io(o •s a cons�q�enc�o�: �
If any,leadin`to the pus� �
Ilsted on Iln�a. Ent�r th� � �
1
UNDERLYIN�GUSE Du�to(or as a cons�Quenea of): � 1
� (d�se�s�orinJ�rythat ' �
� Initiat�d the avents resulHn[ d� as a con '
�� �n a..cn>awsr. ou.so(o. seq.,ance or): �
� 26.P�'t 11. Entar ochar but not�esultins In the unde�lyln`u�se{ivan in Part I. 27.Was an autopay perf d7
� � Yes No
� 2B.W�re�ucopsy flndints awllabls
m So complet�th�Cauaay�.tleachi
� . n.r O Ves Q�No
29.If ier�le: 30.Did Tobaceo Us�ConiHb�ta to D�aihi 31.M� ot D�sch
� m�NOt p��snan[wlihln past y�a� , ' O Yes � �P bably 0'�Nai�ral 0 HomlciEe
p Presnant at sime o!death � No �Unknown - Q Aceltltnt 0 Pending InvefTlpilon
�' p Not pre{nant,but praQnint w{thln 42 d�ys of tleath � Sul<Ida 0 Coultl na[be Gaiermined
� Noi pro{nant,but pr�`nant 43 days to 1 year befor!dpih 32.Date of InJury(Mo/Day/Vr)(Spall Mon<h)
Q Unknown if praQnan!wlthin tha pas!Vpr 33.Tlme of InJury
34.Place of InJury(e.t.home;constructlon site;farm;school) 35.Loutlon of InJury(SCreet and Number,Qty,County,5late,21p COCw)
36.Inj�ry at Work 37.NTransportatlon Injury,Speclfy: 38.Dascriba How InJury Occurred:
O ves O orweNoperrtor O P�destriaa
O No O Pa�s�npr � Ofher(Speeify)
39a.CSRIfie�-phyflcian,caKifled nune p�aetkion�r,m�tllul�xamine�/coron�r(Gh�ck only one):
�i.etl'ESfylns only-To tt�e best o1 my knowled`e,d�aeh occurr�tl dw to the cause(s)and manner st�t�d.
� Pro�ounclns 8 Grtilyln{-To the b�st o1 my kn4wlad`a,de�ih oeeurred at th�Hme,tlate,antl pl�c�,and dus to the cauae(aj and manner sSsteG.
O Mwdical Examinar/Cor �r-On ihe basis nailon a d/or InwsNpclon,In my opinion,d�ath ocy`.r�tl aY che Nma,dais,and place,snd dw to ihe cause(s)a d manner sSatad�.
5�anatur�of<e�tifler. 7ix1�of carcifiar. �M�1 r ,.,�.,,..N„mb.�: MD 6l cSz�� (.�
� b.N�m Atldrus and ip Code of n Compl�tins Cause of O�aih(Ii�m 26) 39e.Dace SI{n�tl(Mo/�ay/Vr)
r• i-: . '// �r�r-�oii o � aoi3
�.. _., 40.R�i�scr�r s�Istrict Numbar 41. Istrar'a 51`nahr� C 42.Ra 1 Date Mo Dry r
� a3.nmandme,nts .
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DlsposltiOn P�rmlt No.O��OpL SO NEV 07/2012
"'**"7 fP,A"�'II"�i17'' °
RENUNCIATION
REGISTER OF WILLS
��/�h �.h���tc� COUNTY, PENNSYLVANIA �-, �; ==� �
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Estate of t,!Ei, ���F-�h� �= r� �d � ,�� .
' _�, Dec.e��,ed
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I' '� ��" ��� �` 1��'��h�G���' , in my capacity/relationship as
(Pr:nt Name)
- ��$���' of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
�/i�� �r /� ���.�vn �
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(Date) • �__���_I�4�,(c*f.�dt�
(S��E�
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S� �J� 4�'G;�- .t,��.�,-
(Street Address)
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(Ciry,State.Zipi
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
before me this day party executing this renunciation and certified
of , that he or she executed the renunciation for the
purposes stated within on this s* day
, _20��'
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Deputy for Register of Wills ota Pu licC..�_'
My '�sion Expires: ��� ` ,Z�i�
(Signature and Szal of Notary or other official qualified to
administer oaths Show date ofexpiration ofNotary's Commission.)
. COMMOPJII'E���6;TH OF PENNSYLVANIA
NO'1',�,RIAL SEAL
Carrie Jeam.`i�n$er,Notary Public
Form RW-06 rev. 10.1j.06 �Wex pa�ton Twp,Dauphin County
M cutr�rni�+i�:u�d'x.ire�Sa t�mbcr 07,2018
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RENUNCIATION � `'-. � � '
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REG STER OF WILLS �==3 ��
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. COUNTY, PENNSYL,VANIA �,-� �'�, �. 5..,
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Estate of � ..� c` ._,;Q , _.�� , Deceased
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� � � � �``" `��� �� ` � �� �.� 4��� , in my capacity/relationship as
� (Print Na )
, s ;���1z_� of the above Decedent, hereby renounce the ri ht to
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administer the Estate of the Decedent and respectfully reGuest that Letters be issued to
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(Date) �`_'��.d ,�,
(Signature�
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;, ;�^ i a �u/,Yf�'E�v�.�� (Street Addressj
` 4:� )�.i� � / � � 1
(City,State.Zip„i
Executed in Register's Office Executed out nf Register's Office
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
before me this day party executiri€r this renunciation and certified
of , that he or she executed the renunciation for the
purposes stated �vithin on this �� day
of �%'%� 'i' �O /.�"
,
G�it/�,.''�r''�c':�c.J
Deputy for Register of Wills Notary Public
My Commission Expires: l�-/v �//-�
(Signature and S:al of tiotary or other official qualified to
administer oaths Sho�rv date ofexpiration ofNotary's Commission.)
COMMOtVWEALTH OF PENP�SYLVANIA
�!._ NWarlal Seal
Form RW-06 rev. 10.13.06 F'3Ui�te Sheff21',Notary PuWie
Luwer�191en Twp.,C�rrnberland County
My�;.��imission Expires Dec.6,2015
MEM�E:R,f'EMIN:;YLVANIA A.riSfJCYATION OF NOTARIES
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RENUNCIA.TTON
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REGISTER OF WILLS ��'.�. � � �` �
CUMBERLAND COUNTY, PENNSYLVAN�, x; �,� � � ';
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Estate of Catherine H. Feidt ' �Deceased
I, Julie K. Forst , in my capacity/relationship as
{Print Name)
daughter of the above Decedent,hereby renounce�he right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Shirley H. Radunz, sister of Catherine H. Feidt
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(DateJ (Sfgnature) �,,�'
4680 Oak Creek Street
(srreer Address)
Orlando, FL 32830
(Ci1y,Srate,Zip)
Executed in.Register's Office Executed auf ofRegister's Of�ce
Sworn to or affirmed and subscribed Befare the undexsigned personally appeared the
before me this day party executing t:his renunciation.ax�d certified
of , that he or she executed the renunciatior#for the
purposes stat d within on this - D�'`�'' day
of � ' � , ��`� .
�� ,
Deputy for Register of Wills N tary ublie �) E� �P��'`��
y Commission Expires: )1 I aL � �°��
(Signature and Seal ofNotary or other o�cial qualifced to
administer oaths. Show date ofexpuation ofNotary's Commission.)
,�'pr n��i.
;�r �,�,; JABEEN NOOPNARINE
. . Notary Public-St�te of FbriGt
Form RW-06 rev.l0.13.Ob RW-O6 ;�, "P�My Comm.Expins Nov 26,2017
%,;E������"� Commiasion�FF 07358�
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