HomeMy WebLinkAbout06-13-05
CuntJerland
Register of Wills of ~ County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
James A. Zeigler
No.
;)1-05 -5J<-j
also known as
, Deceased
Social Security No.
193- 52 -9264
I'c100"''',,(_L ,,",Dill"'" 18 YUfIO! All" ". olde" Ilpply(,el) to.
ICOMPLETE "A" OR "B" BELOW,)
Q
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut
Decedent, dated and cadicil{s) dated
named in the Last Will of the
Sta,,, .elev,"", "HCUITWI""""". e.g., renunci81inn. death nt e~eCU10!. "'"
Except as foilows. 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 incompetent:
~
B. Grant of Letters of Administration
le.t.._, d b.n.C.l,,,. pend..n'" '''~. ""'~"'e ~h""n"", ,j",,,,,,., "V''''''''''~'
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:
Name
Relationship
Residence
,
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C;)
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See Attached
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IN~ :;1' Attach additional sheets i necessary.
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Decedent w~ domici~ ~at death in
residence at?'~ 1395 Letchworth
10
L
Cumberland
Rd., Callll Hlll,
Decedent, then ~ years of age. died
May 17
County, Pennsylva~!~L with hisJher last family or Rrinclpal
Lower Allen Twp., CWlIver1and Co., PA 17011
,20 05, at 1325 Carlisle Rd., Canp Hill, PA
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Ills. S"""'. "l>mb@, ""d I....,,""~al"vl
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Decedent at death owned property with estimated values as follows:
Of domiciled in PAl All personal property . . . . . . . $
(If not domiciled in PAl Personal property in Pennsylvania. $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ............................ . . . . . . . $
Real Estate SitUatedT::a:OI;~;"~. "1395. i.e'tchwo:rt:hRcL ~. C~ .Hilt,FA. t1011. . . . . $
2,000.00
:S,uuu.uu
~ 000 00
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
o
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of ~ ClJlllber1and
The Petitioner(s) above-named swear(s) and affirm(sl 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(sl of the Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
before me this
13
day of
~E ",Q'i ~h! J4.3-;j/""
~lldl~(
DECREE OF REGISTER
Estate of
JaJIES A. Zei g1er
Deceased
No.
()/ - O~ -S,,)l/
also known as
Social Security No: 193-52-9264
Date of Death: May 17, 2005
AND NOW,
on the reverse side hereon, satisfactory roo
IT IS DECREED that Letters 0 Testamentary
20 OS in consideration of the Petition
having been presented before me,
1KK0f Administration
are hereby granted to
Tracy L. Zeigler
Ie,' ~" d.~" ,,' p~"dnn'" I,'~. d",""'" ~~."n".., d"",,,'" '''''''''''.>Icl
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........................... $
Regiliter at Wills
Short Certificate(s).......... $
Renunciation.................. $
Affidavit ( I................. $
Extra Pages ( )............ $
Codicil.......................... $
JCP Fee........................ $
Inventory & Tax Forms... $
Other............................ $
Attorney:
1.0. No:
Address: 600 N. Second St., 5th Floor
Harrisburg, PA 17101
Telephone: (717) 236-8000
DA TE FILED:
)f.,
llloI-7a
TOTAL.............,. .
$
HI05,g05 REV 1/05
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 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 1:1559427
No.
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f~i "-'__,,-" > ~l
h..>.#..... ""I
it *' ',., " ,~* $
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~ ;hp~~I7-
Local Registrar
Fee for this certificate, $6.00
MAY 2 3 2005
Date
144Aev.1f91
M
N
-(~-
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
......,""'"
...... .,."
.... ""'......
SEX SOClAI.SECURlTVNtMB:R
A Zeigler .. Male ..193-52-9264
UMDER1D1tt DATeOf'8lfmt ~jCilya.-.d I'VICEOFDEAJH(CtlllCkcny_ _itllIIrucIioroJOI'lot..-lIide)
Hold.......... (MonI1.~.'Itl8o') SIal.Dffor~CounIryj HQSPfTAl:
3an.16,1958 Harrisburg,P _0 ._...0 "",0
,.
_ CITY. DEAl'H F.-ClLlTYNAME~lnati~giwtlllr"8IId1lUl1'lb8r)
Lower Allen 1325 Carlisle Road
Wil.S DECEDENT EVER IN
U.S,ARt.EDFCJACl:S?
""IJI NoD
QECEDEflT'SEOUCRlON
--
1. 1 zo"l2l
DREOFDERH~Day,'IIIerl
. May 17, 2005
47 YI8.
Cumberland
RESU"""
(SelIinIIluclionll:
onlllll&'lIide)
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....
Cumberland ~1 1~O~~::
YOTHER'S NAME (F"nl, MidlIe. M8id8nSunwneJ
MAflfTIl.LSlllruS....-rtIMl
---
--
ivorced
111;.W....'*'-"*IMd.Lowar
_SPOUSE
lW.......~.............
CECEDeNr8USUALClCCtJAIlIlON Kl OF8USINE~DUSTAY
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1 ruck driver nnsy
DECtDENT'SMALlNG~(SII_~SlI't.lipCOOel
PA
Allen
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III
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ra
.w.lNGADDRESS\Sh8l. Sl8.ZipCod8l
o Walnut St.Lemo ne PA 17043
~~OOlf'OSfTl()H.~oI~~ -~.....
lfpn
haefferstown,PA
Inc.324 Hu~mel Ave.
ORE
p,Ianh.Olrt.'*-l
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MSCASEAEfERREDlOME~~
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I~ PARTII: OII.-.......~COIllIIIuInOIO..........
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OFDERlt P x. OOEPFIDHOU EODEAD(MonIh.Oey,'Ib8I1
u. 3:00 P. May 17, 2005
%7.l'NIJl: e-lIlec:ll8MM8.lnjuriM;DI'~IIIhIclI___lIl8dNlh.Oonol_lh8m0d8l11d>ilng.IUCh"~or~-.""",*DI'huIt~
UIt~__(II'I-=,,"',
Gunshot to Head
DUElO-tCIIASACOtlSECl\JENC'i::Cf):
DUElO(OFtASACONSEQUENCE OF):
Dl)ElO(ORJ>SACQHSEOUENCEO'):
DREOfINJUAY TIME Of' IftJUAY
(MI.lnIl.Dev.'IWl Aprx.
_ 0 - 0 May 17,2005 3'00
Accld8nl 0 PencIng~ 0 .. P....
NcllS! ...... 0 No 0 PLACEOflNJURY-A!hOt'ncI,,.,,......r.t:IDIy.-
.... r nb. ~ Cl;ajdld'08~\n8d 0 ~'*-~chool Parking Lot
~~tPI,ysiciatlctlJ1llying~dde&lh.......~phy$iCi8r1llu~onouncl,lddeelh.rIdcom~lIem23l SJllH,IJ\Iflf::
lIo......otJIIJlPlDwlHg..,dHIh__..ID...-.e(tI}......-_........ ..... ... ...,. ... ..... ... .... .... .............. ... 0 II1b.
,
WEReAUlOPSYFlNDlNGS
Jt.N..ABLEPRIORlO
COMPlETION Of' CAUSE
DEJiI"H'I
MANNER OF DEATH
"""'" "...-.
...... 0 No)(
~HONKlURY
Self-inflicted
handgun
gunshot.
~....u:.=~ln.lll'a u n,InMY.,..,......lhoccun'ed ...tInw.dal..andplK4.......totMc.uu(-l.....
__.....,...............................'u........ ..................... ..... ..............u...... .......
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1...7 /..z,h' I
Coroner
DRE8lOHED~0lrt. -"0"
o ... Ma20,i!201l5
NAME ANDADDRES8 OF PERSON WHOClOW'LETED CAI.I':E OFDERH" ., ._~','
(Mem27)1'YP"orPrlnt Michael L. Norris. Corone-r,:
6375 llasehore Road, Suite/II
Mechanicsburg, Pa. 17050.;.
-,
Hill, PA
...AQ'IQlICIIIIlAHDCERTIFYINIIIPHftlCIAN~boIlproro..onclogd88lhandeerliyinglocalMoId88Ih)
lb......oI..,........,....___.._......._plMe."'O..IiO...~....s----..... ',... ..... ..... ......
...
HEIRS OF JAMES A. ZEIGLER:
Name Relationship Address
Jesse A. Zeigler Son (minor) 6309 Stanford Court
Mechanicsburg, P A 17050
Jennifer A. Zeigler Daughter (20 years old) 1362-A Mount Vernon Ave.
Williamsburg, VA 23185
Darryl K. Finney Brother 340 Walnut Street
Lemoyne, P A 17043
David Zeigler Brother 6100 Ann Street
Harrisburg, P A 17111
John Zeigler Brother 1200 Walnut Street
Harrisburg, P A 171 03
Kenneth Zeigler Brother 2001 Red Bank Road, Lot #124
Dover, PA 17315
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