HomeMy WebLinkAbout08-16-05
(I) Register of Wills of Cumberland County
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PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estateof0~/leer\ M. Ni~o\~ No. :t \ - <:::lS - '\ ~ ~
,
also known as To:
Register of Wills for the () ">
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, Deceased. County of Cumberland in the'::: 0 <::,;> CD
Social Security No. '31<1- - In - -:>'6"'l K' en
Commonwealth ofPennsylvanji!D :c:... rn
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The petition of the undersigned respectfully represents that: ;i1 - CJ
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Your petitioner(s), who is/are 18 years of age or older, appl ; e..> for letters ofadministratiii!c) " .::::;.
on the e~~ofl ."
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(d.b.n.; pendente lite; durante absentia; durante minoritate) ::::i:J (,.'" C)
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the above decedent. J-' - " ::-:>
Decedent was domiciled at death in f!.v,J,.,I,.,J County, Pennsy vania, with h (I' last family or principal - .,
residence at Q ~ r) A-
(list street, number and municipality
Decedent,then 475 years of age, died Avc,ust- s- 5>-
,200 ,at
YIrY't:- -Spr'l~'" ) pPr I J'Sl"2-
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ \0, OX>.ClD
(If not domiciled in Pa.) Personal property in Pennsy lvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania e.J.. $ \ C:I::J I C:J:J:) .00
situatedasfollows:~' S~ ) ,\.,.,.~C,f""f\".<:,..pA-
Petitioner_ after a proper search ha~ ascertained that decedent left no will and was survived by the
following spouse (if any) and heirs:
Name Relationshi Residence
r.
THEREFORE, petitioner(s) respectfully request(s) the grant ofIetters of administration in the appropriate form
to the undersigned.
~ Residence(s) ofPetitioner{s)
m S. \!Ve::A \)4" ~t- .C ~ 1?&n~\3
(I) Register of Wills of Cumberland County
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENN5YLV ANIA }
55:
COUNTY OF CUMBERLAND
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. -
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Estate of ~<&.. ~ \\"'~\~"\J, Deceased
GRANT OF LETIERS OF ADMINI5TRA nON
AND NOW ~'" ~ ,,'<> 20~:; , in consideration of the petition on the reverse
side hereof, satisfactory pr f having been presented before me,
ITIS DECREED that ~"''lo.'"'''''''' c. "'N<< ~ ,"-""""\.S~~
is/are entitled to Letters of Administration, and in accord with such finding, Lerters of Administration
are hereby granted to ~"''lo."",,\>. -:s ......" ~ \"""'I\l.!-."~
in the estate of ~,,'-'-""''\) '" . ~\"-""':\I..S<:>~
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FEES Register of Wills ~. ~~\ ' '\,~
Probate, Letters, Etc. ............. $ ~\~. -::S:O>-.M A All ~w' I. q '-\ \oS-
Will................................. $ Attorney (Sup. Ct. I.D. No.)
Renunciation.................. ..... $ s. \Q,-\ . S . ~-\t\- <:...+-. W~'e. PA-
Short Certificates (S) ............ $ "'d,.'\).
JCP.................................. $ \<:1. Address I
Automation Fee................... $ S.
Bond................................. $ )...'-l~ -<;s'bo [(
Total - $ ~~.~~
Filed ~ - ,\, 20~ l'-.:I
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(I) Register of Wills of Cumberland County
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RENUNCIATION
Estateof~'t~~" ~, \\.\\<:.1\0 Y:,(M No. J..\-'\:JS.'\l~
Also known as
, deceased.
To the Register of Wills of Cumberland County, Pennsylvania
Theundersigned_ ~~<:,<;.tA... \.\.~\L\-.n\~ I ~iliJ<;'~ "'\-. ~~
. (Name) (Relationship) (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters
be issued to ~ M.~ -:s-- \0,~ \ <;'ov-.
Witness my/our hand(s) this day of ,20_
\
A~ and SU(jribed before me this ~r~~~
(SIgnature)
day of j I ~.Jr- ~\~-thfll\ l;hr~\lfYjsl?dJ/6/~
~
(Address \
Notary Public
My Commission Expires:
(Signature)
Or (Address)
Affi~d and S~ribed ~fore me this
~ayOf ~' (Signature)
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(Signature and seal of Notary or other official 'Tl - ~-n
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qualified to administer oaths. Show date of ./-- C')
expiration of Notary's commission) 0 -n "
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H105_XOj REV ltoj ~, .<;J S -'1:l..,\
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.
Fee for this certificate, $6.00 .."H"""""..,..,...... llu- ~:'~~::i~~
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P 11851073 ,,* ' "_C-,,'_ ~i
"'~ . -- ~l 8 2005
" 1Pt, ~'" .,' AUG
~... ........ MENl \\\' /..t.,III
No. .....""",,,"111/ Date
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, COMMONWEALTH OF PENNSYLVANIA." DEPARTMENT OF HEALTH. VITAL RECORDS '5:] W ~cn
Hl06.144ReY.1191 ~~ ~-i
CERTIFICATE OF DEATH 'lt~
.......~ - ',1
w (Coroner) -
.- SW'EFlLfHUMBE:1l
ouoa<w. = SOClAlseCl,lAITYNUtII6EJl tw"'OFDEAI'Ii(MonItl,OsI\~
M Nicholson I. Female 374 .. 70 .. 3598 ~ August 5. 2005
..... , """ UNDEll1011'1" ""'~- BlRTHPLACE(CIty..-.J PlACEOFOE.liI)lp-..:k<;W"lyono _inoIn.cliono",,,,,-__
~- - - tII_ (M"""',o.,.~ ~OIF<>roigllCounlry) ~ ~
July 27.2005 Ft.Benning, GA. 1........0 _0 ="'lIO ="0
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""'" Fl\CtLrTYNAtllEplntII........iOr1.~_.nd.......ber) AACE-An-.-...-. -"eIC..
Cumberland South Middleton 91 Smith Road .-,
k. ~. ". White
DECEDENrS ""- ~"" K1NDOF8USI ''''"''' 1olARm\l.S1lVlJ8-_ SlIfMIIlf<<)SPOUSE
~~':~~="""'1 Farmers Market _tlllnled,~ plwjJe,,,,,,,,__)
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, Waitress staurant 1 (HOI~+) 14. Divorced .,
DEcetleNrS .....IUNO IIDORf;:SS (SIrMI. 0rI'fb0n, SIll... Zip CotIol DECEDENT'S PA l1c.DJ v..............liqd.. South Middleton
91 Smith Rd. """~ 1711.s.- '" ....
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York Springs, PA 17372 (Seo-...:tiono ....
",,,,",,,-> Olrnberland - 17"'0~""="=
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f'mlER'=:GtIol"'~~cNaroara tII01liEf'I'S_(~Midl:III,~
'L 11. Ann .. Donohoe
INFOIlMAHT'SfWoIErrypef'rinl) lNFORr,W(T"SYMJNGADDAESS(SIr.....C~.S_ZipCoclo)
Amanda J. Nicholson 154BW. Penn St. Carlisle, PA 17013
~ Pl..ACEOf'DISPOSfTIDN'_ol~.C-..lory , -Clly(li>wn.St.loI.ZlpCodo
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c ~s Eagle Crffil8tion Srvcs Leola, PA
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~ .""", LICeNSE NUMBER N/l,MEAND~OFFll.ClUTY
.... FD 012633 L in Brothers Funeral Hane, Inc., Carlisle, PA
,~.. IItllle~IM,_.....pIo<:e_ ~. tw"ESIGNED
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TIMEOFDER"H prx. DAY PFIONOUNCEDDEAD(to1on1r., ~" WllSCASERE ,.,~
M. 11:00 A. . & August 5', 2005 .. ~O
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'~PHYflClAH{Phof1il:iIInC8l1trng<:alll801doB11__~yoic:....llppJOrlOOOl;<ld,*,,,8/d~lIM\'l3l Ollb. Coroner
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.PflOHOUNCIIlGANDCMTIF'I'INGPHYJ;ICIAN~nboll>"'lIo'\OUnOilg_III>dOlllliying"'''''_oI_h) 0110. 11l August 8, 2005
W ToIlle_"'''''~___.IhoI......_,_~__.....--..(1I\__.__... ................".
~ NAMEAND ADDRESS OF PEIlOON WHOCOtIIPLETEDCAUSE OF DERH
"MEDICALEXAIIINERICORONER (llem27)TI'I,earPrlnt Michael L. Norris, Coroner
~ Onu.......CII..-'rlaaonMdforIlWMllpllon, In tR'fDplnlon.dHIl'locc:urrMlltlh.n_,dIII_, ..,1'1_...,......10_......'... 6375 Ba8eho~e Road, Suite #1
! --..........,.....,........""...........................................................,.............. n Mechanicsburg. Pa. 11050
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z RlEGISll'Wl'S NR\IFlEANDNUMBEIl t:\. ~~&l ~['ddIOI DREFH.J:'D(Monlh.o.,."-l
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