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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 request(s)the grant of Letters in the appropriate form:
Decedent's Information
Name: Patrick B.Eberly File No: 021- o - "nn
1 t
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 167-64-6862
Date of Death: February 27,2015 Age at death: 31
Decedent was domiciled at death in Cumberland County,Pennsylvania (state) with his/her last
principal residence at 137 South 16th Street,Camp Hill,Pennsylvania 17011 --Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 137 South 16th Street,Camp Hill,Pennsylvania 17011 --Cumberland
Street address,Post Office and Zip Code City,Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania............................ All personal property $ 20,000.00
If not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
If not domiciled in Pennsylvania. ........... ............ Personal property in County $
Value of real estate in Pennsylvania... ...................................................... $
TOTAL ESTIMATED VALUE. ... $ 20.000.00
Real estate in Pennsylvania situated at:
(Attach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or Borough County
._J A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated rand Codicil(s)
thereto dated r-- v-r ::7
_:.. •� fel C7.
State relevant circumstances(e.g.renunciation,death of executor,etc) Cn
Except as follows: after the execution of the instrument(s)offered for probate Decedent did not many,was not div6—rce&was-"ot apr)ity to'apefMing
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. §3323(g)s and".did-not have a chHb"br�a or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
NO EXCEPTIONS 0 EXCEPTIONS - -_
C] r— M
B. Petition for Grant of Letters of Administration (If applicable) ;>
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia, ante mtnvritate
If Administration,c.t.a. or db.n.c.t.a.,enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedent was not a party to a 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.
®NO EXCEPTIONS ()EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse(if any)and heirs(attach
additional sheets,if necessary):
Name Relationship Address
Lakin E. Spuhler Daughter 445 Elder Trail,New Cumberland,PA 17070
Gle.s,4,, 4 35 V I hJ Vi0-40'D I PA I
pak-'iCk ef•Yc jgzt7 2ta �t;�,l,e�c,+�t�„ OA j-1 0;),a,
Form RW-02 rev.10111/2011 Page 1 of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
) SS: RECORDED OFFICE OF
COUNTY OF CUMBERLAND I R E G I S TF R nF v
Petitioner(s)Printed Name Petitioner(s)Printed MIA,j
Glenda M. White 435 Pleasant View Drive Etters PA 17319
_Et?N OF
Ad.J' lou", I
CU ? pn r
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,the Petitioner(s)will well and truly administer the estate according to law.
Swam to or affirmed and subscribed before )_)4mac- �M • Llh) Date e.al- l
me th' day of Date
By; Date
For the Register Date
BOND Required: 0 YES Q NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ Q0 Attorney Signature:
( 5)Short Certificate(s).. . . . .
( � )Renunciation(s).. . . . . . . . I (T C�\
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Pr 6,eme
Name: Johanna H.Rehkamp
Commission. . . . . . . . . . . . . . . . . . Su Court
Other . . . . . . . . IDber: 206589
. . . . . f5
m . . . . . . . . I115 Firm Name: Cunningham,Chernicoff&Warshawsky,P.C.
. . . . . . . . 1 Address: 2320 North Second Street
. . . . . . . . Harrishurg,PA 17110
. . . . . . Phone: 717-238-6570 X232
Automation Fee. .. . . . . . . . . . . . . Fax: 717-238-4809
JCS Fee. . . . . . . . . . . . . . . . . . . . . Email: jl r4r,, a=c rnm
TOTAL. . . . . . . . . . . . . . . . . . . . . $ 0
DECREE OF THE REGISTER (� t
Estate of Patrick B. Eberly File No: —L 1
a/k/a: n-
AND NOW, ��l CA7��'� o�t—( ,o�U1 , inconsideration of the foregoing Petition,
satisfactory proof having bee presented before me,IT IS DECREED that Letters Q-- Rdm I '
/33'JXO b C/V)
are hereby granted to Glenda M.White
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 last Will(and Codi6l(s))of Decedent.
Register of Wills
72 r ��n -
Form RW-02 rev.10/11/2011 _l.�X P, Page 2 Of 2
11los.845 REV(9111)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING; Itii��tI a this copy by photostat or photograph.
E OF
Q�Vr REGISTER Qr WILLS
Fee for this certificate, p .aa }N}rrrrr 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
C( E R K a �z certificate will be forwarded to the State Vital
Records Office for permanent filing.
oR Artfs �' *;
P 21714445 CUMBER�.�(,{r., LU I v�
Certification Number ---rrNT,,,,f}rj''1'�(
Local Ifegistrar Date Issued
Ppar�thanMM COMMONWEALTH OF PENNSYLVANIA.•DEPARTMENT OF NEALTN-VITAL RECORDS
BI.ok Ink Case plumber:J-2015-02-0102 CERTIFICATE OF DEATH
F atzep• •m , .YL u rty o .Y Pa o
k B, Eberly thele 16
February 27,2015
a. 9 •.t •y » •r ata o +r .. oe d t a. tat•er 1mry
31Monthln Data FbUraet MInM•a Harris PAn
September 12.1983 7b.emhptaea(CMntY).
!•.ReaM.nCe(Stat.Or For•I9n DOVnery) db.R•.band($Neat antl NumMr-InCNtle Apt NoJ BC.Dad Daeed•ne Uv.In a T-hip, -
Penns lvania 137 South 16th Street Ya•.de-dent lNaab
�y11f,,.�y l $a.Reabantb(ZIP Code) 17 011 NO.decedeht I-whhin 11,hha of ca • Hill -ya, .
9.Ev.r In US Armetl FOrce•T 10.Marital 01-dStatue et Tlm•�/O�t,D..th M•Med V Vidowad 11.SuNWlnp 8Pou••'%Name(I1�e.pNa nems Odor b rat mam.pa)
M Ya. Q Ne Q Un knovm ffi '.-ad Q unkn- N A
12.Fatn.YY Neme(Fi»L Migd+•,4s.L Sufn%) 13.MWDer•Name Preprte Pint M-,.(Flan,Mbdie.Leat) -
Pat;ick B_ Eben Glenda M. Lentz
l a..I.I."Peln.Name tap.Retatbn-P 1.-.ant c In Mm•nY•11111n0 Atltl»ea(Street and Number,City,Stab.V. Otla) -
g Glenda M. White Mother 435 Pleasant View Drive, Ette=S, PA 17319:
- t a.P1 a D•m n ery oho .
tt Death OcarrteC M A No3Pjtai: Q InpatMnt I1 Death OC'atted Som.when OtherTDah•N4•obe4 bap ny e
C3 Hmer9wnry Reo.hroutpeu«m 1� ae-oh Armor Q Nati-Nem•.A-90-Tam.Care Peon" O other tsP•biry)
isb.Facility N•me(11 n.t Inautudon,9Ne abort and number) $a.11,Or Town Stata,•n'ZIP 0*-
-"
OM FEE.
of Death
137 S.16th St. Com Hill hA 17011 Cumberiantl
t - tee.MetnM e}DI•poehlOn 0l Bunal Q C-i- Ia...-al D13pONVOn lac.Place of D.p..-.(Nem.of eemagry,txamatory,of othar pl•C.)
E3Pia-N"non,a.. Q De^atop Ma C1t17,2b15 Woodlawn Memorial Gardens
Ci 4n a aPoa ry or own. P u»O un r a'O/.-.n Pa. um ar
Harrisburg, PA 17 09 ,e �(,JQ,(� FD-1 38702-L
- 1re.Nameant+cemPtae Atld»aa or FUne»+FeGfetty - .
T"refz & Bowser Funeral Herne Tnc_ 114 West Main Street HumttelstC>vM PA 17036
10.DecMent's EdUoetlon-Check the box that beet de•cnblra the 19,De dent Ot NI.Oa Io Onppin-Check th b0% 'O C eG�mteoRa a»E hCk ONE OR MORE»Cas t0 Mtliwta what
mpMDt
4e9»e w I•wl pf aenool ComDl•tetl at 1M um.01 death. at t»tldeaUbaa vm•tMr M e dent la de« n•Id Irrls b or Mne.tq be.
Q em p»d•Or Nee NPNIOI M IIanoiSpintI�W1Che
�nMin,e n-bolt 11 22 SIN Q KON.n
Q N4 tlipbm.,9th-12th 9»db Q Btapk or Afrk;.an A dcan Q Vhnnemeea
QNt9h seneol p»tlu.ta m OHD compteled M N.,-Soo.hi-ispanecn.Adr o Q Amartean IMtM or Ale:ka Naitra E3 Otl»r ANsn
Q Spm•coM9e credit.DM n0 a".. Q Ya•,-Ind-n,Me%lan Amaqun,Chi.... Q A.I.n Indian Q NaUW NawNlan
IN AII.L.t...p�.e(..g.AA,AS) Q Yaa,Pu•n0 RICen Q Clunes. Q Guamanian Or Chamorro
Q Bachelors degree(e.9.BA.AB.BS) Q Y. Cuban Q Filipino Q Samoan
Q Matta/a d(e(pC»C•..p.MA.MS.MEnp.MEtl.MSW.M$A) Q Y.s.other Sp.nlahMi.p.nlMatlne Q Japans. Q DUH,P..ft IslaM.r
Q (Daep iAptIDO$'.DhvOn3ELlD�.JO} aeabn•I dap»• (soe4'Y) Q Othar(Soo ty)
.1..-ad.. 61npN R•Ce Seth-Da•lpnapon-Ch.bk ONLY ON! Io kMitate wn.t In.tl-0-conaberatl hlmaeo or h-a"to be, 22a.Decedent's UWaI OecUP.don-Indicate 1vp rk ,
gl White Q Ja P.ne•. Q Semean do-during-.1 of wondn91lta.DO NOT USE RETIRED.
Q Blocker Anloan Am- Q Kp»•n Q Other Peelle lataM.r Federal Filler
Q Ame.canjnd1--AhaUAN.Itva Q Vj•Mamaea Q a It-$u»
Q A.1-I" . Q Oth.,Asian Q R.N.P. 221P.Kin..1.U.i-ntluaby
Q ChMes. Q Nettie Newail.n Q other(ave-fir) Dairy
Q Find- Q Ou.m.nian or Ch...-
23a.O.te Pronounced Dead(Mo/Oeyrvrj 231.619-1-W P. Pron.-o.,Oeam(Only wtr•n eppllubte) c. can•O um.r --
SY PERSON WHO patoNOUNCea OR '
ERTIFI s OEATH
23d.Dote 91pne.(Mo/O.Y/Yh 2a.Tlmp Pt Oeath
23.We*M.-I B%•meMr or er con»etadT v.• Nb
CAUSE OF DEATH ..AP.pncnd .
mt.-I..
2.. Fort L En»r 4hNn of w tt-dhia i-1.).....Or-MPPoa'-e-that -C"T-a-tM death.DD NOT anter termtn.i rwnu dUCn••c•eCf•C.nest, On•.t.Death
»fpi»tory-1.or venuicuiar rtDrlitatbn--hawing In..tloloW.DO NOT ABBREVIATE.Enter only on.Cause on a line.Add additional fMet it necessary
}MMHOIATE CAUSE •, Acute Morphine Toxicity
(dal.�1)diaeaea or cbntlillOn»auMnp In w.,or ea.con•e0uance or);
b,.
Seouantlally nal eOMttbn•,I1 Ue to .e•conaequenee or): -
w.iloe:nleni:eq ou:•n.tae
UNDERLYING CAUSE c. `
(pleated or Mjury*hwt ue m •s a conaeau•ncs
IniWtatl tM•van.rcsvitinp � -
{ir M death) LAST. r
e.
26.Port 11,Enter Other bM not reaulUnO M the unMMinp cause pNen In Pen I 2T.Waa.n awopaY P•Mp.metlT
(•y7J Ye. YQ Ne
wacWWnOMNth-hoioPGnm+ �
ZD.b Female: . 30.DidTobeec0 U..Cenbibuta to.,•InT 31.Manner 01 path
Q Not P»gn.m w11111n peat rear Q Yea Q Pmbabty Q NahlrN Q....Cid.
Q Prepwarvt aYpme of death ®No Q Unknown Aeeltlant' Q Pending lnvaYp9adon
Q Nor P,o,nent,bM p»gnant. 1 a2 day.of death Q sMeba Q COM.nee be Mter -
M. Q Not pragnenl.but Pre In.3.•Y.b 1 year baht»death 32.DataroXnJury(Mo/D•Y/1"r)(Spelt Month) ,Yima br in
Q Unknown N pragnanf within th.Past Year APP lury
FebruB 27,2015 Unknown a.m.
3a.PI•M Of Injury(•.9.MrrM:COnattucdon sit.:Iamt;.chOOp 35.L.oGtbn OI n)Ury(SneN antl Num Der,1-1,Cdunry,$uta,Zi. had)
Residence 137 S 16th Street,Camp HSI),Cumberland.PA,17011
30.Inlury at wore 3t'.IrY»u•Pertaupn np,ry�spec rt': 19.OeacnW Mow Injury Oeuun+.
Q Ya. Ddy.roP.mbr P.d.+Mah Intentlonel misuse Df Illicit drugs
0 NO B Pa».neer 8 Dlhar(Speedy)
39..Canter(Chock only bn.):
Q Ce01ty4n9 Phy,"On-To the beat of my knohfadge.death-Mad dve to an.Cauaa(a)and manner stated
Q Proneuncen9.C•rd%nng"y-W.-To the D.•tW my knowfae9e,death Occur»d 1-1 time,date,."pta<e,end due b Me cau•e(e)end manner atatatl
Medial E%•mIrNNCorq\���/1�'�,^(/y�'►h�e brei(pf-_e%-. Ina I d/ Ilnva.11oT.T ion O Inion.tlaath oCCunaO al the lime,data,all dace,and due b the-...(.).Ad rr»nner.-ad
W m Ipnatu»W canip.r: �-•"'BMs'^-r`� `r Y y mY P Ttda W e.rUfi.r.COfOR@( tJo,...Number;
A.d+eas.M Zip Cbde or Pe»pn Comlltetihp Cauae W Death(item 26) 39c Data Sipnetl{MO+D•yKrj
C"...H$11,Coroner 6376 aesehor.Rood Suit.#I,M.Chenicaburp,PA 17050 March 30,2015
4g.RaplYt»r Ot•MCt Number at.Rplap.r•81pn.b» 12.Repl.h.r Plta O (Mama r)
r 17
a3.Areantlmenta
Stele Use Only
DIaPOaI.Ory PermH No.
1171773 REV Oi�=2
ry
RENUNCIATION .
co 6--, a
Cn
REGISTER OF WILLS �' �- �' �' --- QD
rn
CUMBERLAND ? M '
COUNTY,PENNSYLVANIA �.�
CD P Crl
r X11 Cn O�
F—'
Estate of PATRICK B. EBERLY , Deceased
I, PATRICK B. EBERLY , in my capacity/relationship as
(Print Name)
Father of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Glenda M. White
/Ala q 0,
(Date) (Signature)
5420 Ridge Road
(Street Address)
Elizabethtown, PA 17022
(City,State,Zip)
Execu in Register's Office Executed out of Register's Office
Sworn to affirmed and s cribed Before the undersigned personally appeared the
before me t ' day party executing this renunciation and certified
of that he or she executed the renunciation for the
purposes stated within on this /.3*h day
ofyG/JST 020/S
Deput or Register o\ No r Public
My ommission Expires: 02`d2
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission.)
GeMM15NWIALTU R efeN�N
NOTARIAL SEAL
JAN HOFFMAN,Notary PublIC
Form RW-06 rev.10.13.06 Denylwp.,Dauphin County
My Commission Expires February 26,2016
RENUNCIATION
u' -U
:m
o r, C_
�
REGISTER OF WILLS cn 70,---j c7
CUMBERLAND COUNTY, PENNSYLVANIA ; • m Frv'
co 7
_. CD o
t�7 , CJ -n 1
o -Tj y -�
C:) r- M
(J•T
Cl) o
Estate of PATRICK B. EBERLY , Deceased
I, STEPHANIE C. SPUHLER , in my capacity/relationship as
(Print Name)
Natural Mother to Minor Child,Lakin E. Spuhler of the above Decedent,hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Glenda M. White
T� Z01� 114y"11
(Date) ( gnarure)
445 Elder Trail
(Street Address)
ta UJ---
New Cumberland,PA 17070
(City,State,Zip)
Execut \thi
ister's Office Executed out of Register's Office
Sworn tomed and subsc ' ed Before the undersigned personally appeared the
before mday parry executing this renunciation and certified
of that he or she executed the renunciatian for the
purposes stated within on this U'�' day
of �f
Depu or Register of WT Notary is
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
Barbra J.Wright,Notary PubBo
Form RW-06 rev. 10.13.06 Fahvin Tvrp.,York Courtly
my Commisskn Expires Aug.2,2018
■E■ E ,PENNSYLVANIA ASSOCIATION OF NOTARIES