HomeMy WebLinkAbout08-04-05
Register of Wills of Cumberland County, Pennsylvania
Estate of Grace Krol
also known as
PETITION FOR GRANT OF LETTERS
No. a 1-05- LPq to
, Deceased
Social Security No. 091-38-0547
Petitloner(s), who is/are 18 years of age or older, apply(ies) for
(COMPLETE "A" OR "B" BELOW:)
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A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut
Decedent, dated and codicil(s) dated
named in the Last Will of the
State relevant circumstances, e.g,. renunciation. death of executor. etc
Except as follows. Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate: was not the victim of a killing and was never adjudicated incapacitated:
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B. Grant of Letters of Administration
(c.ta.. d.bnc.ta. pendente lite. durante absentia. durante minoritate) ~
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived b0~ followi~~pouse
(if any) and heirs: '~i ~
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I . . Reside;;;be I .-) ,'r
Name Relationship .r:- " :::':,
Annie A. Krol-Kniaht Dauahter 71 Sherwood Circle='-c ' "
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Enola, PA 17025 -. . ...~ ,;.~
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at 71 Sherwood Circle, Enola, PA 17025
Decedent, then 87
years of age, died May 11
(list street. number and municipality)
,2004 ,at Holy Spirit Hospital
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PAl All personal property.
(if not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County,.. ,
Total... .
$
$
$
$
$
0.00
0.00
0.00
0.00
0.00
Value of real estate in Pennsylvania
Real Estate situated as follows:
N/A
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Typed or printed name and residence
Annie A. Krol-Kni ht
71 Sherwood Circle
Enola, PA 17025
RW.7
--
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and 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 Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
L\ --\.~
day of
before me this
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DECREE OF REGISTER
Estate of Grace Krol
also known as
Deceased
No. ~\ - a 0::::: ... OU::Ci (0
Social Security No: 091-38-0547 Date of Death: 5/11/2005
AND NOW, ~, ---t{ ,~<') ,in consideration of the Petition
on the reverse side hereon, satlSf tory proof havmg been presented before me,
IT IS DECREED that Letters 0 Testamentary (8) of Administration
are hereby granted to Annie A Krol-Knight
(eta., d.bnct, pendente lite. durante absentia; durante minoritate)
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters .......... .......................... $
20.00
Short Certificate( s) ............... $
Renunciation .......................... $
Affidavit ( ) ....................... $
Extra Pages ( ).............. $
Codicil................................ $
JCP Fee ................................. $
Inventory & Tax Forms............. $
Other. f.\.y.to.r:n.a.tip.n. .F.~~........... $
12.00
10.00
5.00
TOTAL ...........................$
47.00
RW-7A
G~h ~LUY\~' '},T;\~4k /~ ~
Register of Wills \
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Attorney: Douglas L. Cassel, Esq.
1.0. No: 92895
Address: 3631 North Front Street
Harrisburg
PA 17110
Telephone: (717) 232-7661
DATE FILED: <? if /u)
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-~I1' i:. 10 certify that the information here given is correctly copied fro~ an original ce::ificate of death dult filed with me as
L'H 11 Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fIlmg.
WARNING: It is illegal to duplicate this copy by photostat or photograph. ~..~
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No.
Fee for this certificate, $2.00
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Date
'--n05 143 Rev 2/87
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TYPE/PRINT
IN
PIERMANENT
BLACK IN",
CERTIFICATE OF DEATH
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
,.
AGE (LaS! Bu1hday)
STATE FILE NUMBER
SOCIAL SECURffY NUMBER
3. 091 38-
87 Vrs
BIRTHPLACE {City and
Slats or FOf8lQ(I Country)
Netherlands
mst b
5.
COUNTY OF DEATH
. Cumber land
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OECEDENT'S USU^l ocC\JP~ TION
1~=:~~4;:'~':i'
foOd service
whi te
MARITAL Sf A TUS . Mamed
Never Manied, Wdowed.
Divorced ($p8Clty)
14. widow
SURVIVING SPOUSE
(1'''''e,~Im&ldenn.mel
twp
13492
17b. COUnIv
Oneida
Whitesboro
Cllylboro
....
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FATHER'S NAME (First, Middle. Last)
1.. Jouke J. Krol
INFORMANT'S NAME {TrpeJPrinl)
20.. Annie A. Krol-Knight
METHOD OF DISPOSITION
Don...", 0 1M.. f8 Cr_ o."",oval'om Slata~
21.. 0_ (SpaClfy)
SIGNAT E S
17025
'l;
To the best of my kl'lO\'rledge, death occured at the lime, dale and place slaled
(S.gnah...., and TiUe)
231.
TIME OF DEATH
2.. ;}. f C (./'M 25.
27. PART I: em. 1M ......., Intune. Of complUtion...t.ktl c..tMd tIut 4..... 00 Mt w. 1M ~ 04 .""", ~
Liat only one~.. on Udlllne.
NAME AND ADDRESS OF FACILITY
2~etrick Fun. Home
LICENSE NUMBER
Inc.
Kirkland, NY
3125 Walnut
DATE SIGNEO
(Mcmth, 0":1. '(ear)
St. Hb .
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<g
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ii
o
21d.
:...
2'.
'ApptOXllTla1e
: interval betw
: onset and d.eam
ooe
OF)
(S
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a.
Sequ.,UHy iat condIbons b
I' any. leading 10 immediale
. cauM. Enter UNDERl. YlNG
CAUSE (DiMU. Of lr'4UIY t e
. thai initiated I'Vnf
resulting on deaUl ) LAST d.
wAS AN AUTOPSY Y\ERE AUTOPSY FINCMNGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
Of DEA lH?
( "SACON Q NCEOfI:
OUE 0 (OR AS A CONS UENC
'-.
v.. 0 No
V.. 0
"ANNER OF QEATH
~
D
D
Natural
Homicide
Pending Inveltig.cion
Could not be Oe\efTl'ined
DATE OF INJURY
(Monti. a.,. v....)
o
o -D~D
O 300. 300. M 3De.
PLACE OF INJURY. At nome, 'arm, street, factory. office
buiklIng..r.c.(Sp.a1yj
300.
TIME OF lNJURY
INJURY AT IAORK? DESCRIBE HOW INJURY OCCURRED
:)
l
Accident
"MEDICAL EXAMlNERlCORONER
~:nn~ b::,o:.:~~~.~~.~ ~~ .~~~~atlon, In my opinion. d..alh occurred It tn. dme, d.ate. .and pJlct, and due to the c..uaes(a) Md 0
31a.
REGISTRAR'S SIGNATURE AND NUMBER
NoD
Suicide
2.... 21b.
CERTIFIER (Check only one)
~l:~~~ J::~~~~~,="th~~~J:toJ8.e:~ha=(m~r~=a~r:~.~~~.~~.~~~~~.i~~.~~.)...
20.
-PRONOUNCING AND CERTIFYING PHYStClAH (Physician bOth pronouncing death and certifying 10 cause of death)
To the b.... of my knaw4~. ,"6th "t;UI"ted I' Ule Um', date, .and pl.ee, and due to the c.uaU4s. Ind manner.. at.ated...
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