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Home My WebLink About10-05-05 - Register of Wills of Cumberland County Estate of Kenneth E. Wallace also known as N/A PETITION FOR GRANT OF LETTERS OF ADMINISTRATION ~~S N 21 - 05 - o. To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania , Deceased. Social Security No. 207-58-2926 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, applL- for letters of administratiop on the esta~Ofl r-) -.-:::1 Decedent was domiciled at death in Cumberland County, Pennsylvania, with h~ last family or principal residence at 2328 Ritner Highway, Carlisle, PA 17013 (Dickinson Township) (list street, number and municipality) (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. c Decedent, then 43 years of age, died July 28 , 20 05 U.S. Route 581, Hampden Township, Cumberland County, Pennsylvania , at r,~1 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 2328 Ritner Highway, Carlisle, PA 17013 $ Unestimated $ Unestimated $ Unestimated $ Unestimated Petitioner~ after a proper search ha~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Ralph W. Wallace Betty S. Wallace Relationshi Father Mother Residence P.O. Box 397, Shermansdale, PA 17090 P.O. Box 397, Shermansdale, PA 17090 THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate fonn to the undersigned. Silo\llature(s) ofPetitioner(s) fJo&db-Ci f) /J1-:,;..~ / Residence(s) ofPetitioner(s) Barbara J. Myers P.O. Box311, New Bloomfield, PA 17068 (717) 582-3469 4Yz~ Paul E. Stone 703 Bloserville, Road, Newville, PA 17241 (717) 776-7790 . ~ Register of wills of Cumberland County OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } S8: The petitioner(s) above-named swear(s) or affmn(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according~to ~w,/~~__. Sworn to or affinned and subscribed vvr Befo~ me th~s ~\:n day of { /Jq i C. ./1 w( tcJL-e I\.. ,20 ('f') ,~- jtj~I\A:C' ~(L~~L':'~~JL 9;C\ . Register I~ It, l ~I 19f'~ct'~ No. 21 - 05 - <' r.n QQ' 5 ii ~ Estate of Kenneth E. Wallace , Deceased GRANT OF LETTERS OF ADMINISTRA nON AND NOW 20~, in consideration of the petition on the reverse ,~.. side hereof, satisfactory proof having been presented before me, IT IS DECREED that Barbara J. Myers and Paul E. Stone is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Barbara J. Myers and Paul E. Stone rv in the estate of Kenneth E. Wallace FEES Probate, Letters, Etc. ............. Will................................. Renunciation.... ..,.,. . ..... . . .... . Short Certificates ('\>0) ..........,. JCP.................................. Automation Fee................... Bond................................. Total Filed ,~ - <.., 20~ $ i~, $ $ ,~ $ '\~. $ '\~ $ S. $ $ ,,'3 .~~ ~~'\;,~'~~~ ~~;n, q.,<; ,'~="'~ /lr!;;ltAl9c. Attorney (Sup. Ct. LD. No.) Robert R. Black, Esquire (06267) 36 South Hanover Street, Carlisle, PA 17013 Address (717) 243-3727 Phone ~\ .,,~ . ~:,%S. Thi., IS 10 certify that the information here given is correctly copied from an original cntificak or death d II: filcd with me as J ,m,d Registrar. The original certificate will be forwarded to the State Vital Records Office ror 1)L'lll1anellt tiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. '::. [" " "'1, J~:: ?'i ' ~~.~~~~ Local Rc~istra[ Fee for thi, certificate. S6.00 No. OCT 3 2005 Date '-.0 " -) HI05'~17A.JAL TYPE/PAINT"'" , ~ 'N PERMANENT BLACK INK " z w o ~ o ~ o ~ COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) r0 E '" 2'. Male STATE FILE NUMBER SOCIAL SECURITY NUMBER ,. 207-58-2926 OIUE OF DEATH lMO/lth, Day. Year) July 28, 2005 UNIJEA 1 YEAR Months Days UNDER 1 DAY HOLlrs BIRTHPLACE (City and PLACE OF DEATH (Check only one SSli! 'OSllUCHorlll on oIhyr siOliI St"l"-,nr For.,;gn CotJrLtry) HOSPITAL Carlisle,PP... InpalienlO 7. Ia. FACILITY NAME (II nolln~ti!ulinn, OM> ..1...." i1nd n"mber) Other g (SpOOl)t)Y!Io. RACE - American Indian. Black. White. me (Specify) White MARITAL STPJUS. Married SURVIVING SPOUSF. NeVill Married, Widowed, 01 wile. give maiden name) D/vorcedlSpeci/yJ Qivorced II. rCJ'lflSaere '" cttylbOrO PA 17241 ,,.. TIME OF OE.uH O.uE PRONOUNCED DEAD (Month, Day, Year) ,.. 7:00 M. ". July 28, 2005 27. PART I: Enter the dlM_, ifIjurles or complications which caulled the death. Do not enter the mode 01 a,;ng, $Ilchas cardiac or raspiratory arrest, 3hoc~ or IlMrI tllilul'1l List onlyOl'J8 C8USEI On each 11m. 23b. 23<:, WASCA$E REFERRED 10 MEDICAL EXAMINERICORONER? Yo'~e<# NoD Blunt Force and Thermal Trauma DUE10 (OR AS A CONSEQUENCE OF)' Motor Vehicle Crash with Fire DUE 10 (OR AS A CONSEQUENCE: OF) 20. IA(:>pro~imale :lnteMllbelwlien !0I'l9EIt and de8th , , PARTU: Othll1"slgniflcanlcondltiollScontributlngtoclealh,but not .........ting in UllI underlylngcauM given In PART I. c.___ DUE 10 (OR P<5 A CONSfaUENCE OF) ,. WERE AUTOPSY FINDINGS AVAILABLE PRIOR 10 COMPLETION OF CAUSE OfDEI'YH? NAlural D ;& D Homicide Hill, PA MANNER OF Of'ATH DATE OF INJURY (Month. Day, Year) DESCRIBE HOW INJURY OCCURRED Operator tractor-trailer struck by auto wjfire VIIS ~ NoD 28a. 28b CERTIFIER (Check only one) .CEFlTIFYlNG PHYSIOAN (Physic;an cer~lyill!l cause 0; death WIlen anolhe< ptlysiclan has pronounced death and complllled lIem 23) To the be.t 01 my knowledge, dealh occumtd due tQlhe ellUlle{S) and mlUlneraa alated. . . v..fI'l. No D Accident Pendi"lllnllastigation Suicldu ". Couldr.olDedetermlned Coroner 'MEDICAL EXAMINER/CORONER On the bu.1. of eumlnatton andJor Investlgatlon, In my opinion, death occurrvd at the time, date, and plllCe. and due to the ceuee(s) and mannerslltated., ..".".,....... ..............,... :na. REGISTRAR'S SIGN.uURF AND NUMBER "-' ~[\b<i\[()1 DATE SIGNED (Month. Da'G, Year) o 31c 31d. October 3, 2005 NAME AND ADDRESS OF PERSON WHO COMPLFTFO CAUSE OF DEATH (I1em 27) Type Of Prinl Michael L. Norris, Coroner 1'Wl' 6375 Basehore Road, Suite 1/1 Y'\ J:/.. Mechanicsburg, Pa. 17050 DATE FtlED (Month, Day, YeIlr) Q.c.",\ , <\- '$,C)o,s- ,.. 'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician bolh proocur-.;inbl rJ....th and ~arlilying tll ~"usa oj death) To the balIt 01 my knowledge, d.a1hoccu<ntdatlhellm.......I..,..nd plec.., !lnd du.. 10 the c au_(s)"ndm"nnefssstated.. - Register of Wills of Cumberland County RENUNCIATION &tate of I!5t tfC1 H Also known ~ 1;r e-- vi .4t~AtC€ Z/-O~--- %~ No. , deceased To the Register of Wills of Cumberland County, Pennsylvania The undersignedhL- fl/-l- W. W ftL-L--rrc.~ F MH IZ Ie. (Name) (Relationship) (Capacity) ::::above ~1en~);;;;;;:;:;;Jht to administer the estate and respectfully request(s) that be issued to fJlt:f? r%'fH<~;f II1lf~#!C; fr1\l 0 fin<-L t;t: S'1O/'I~ 1Jt Witness my/our hand(s) this (p day of ~~;%t<: ,206 My Commission Expires: ~~.A avv 0Vt/ ~~2...~ (Signature) ~wJ?o~~~ fA !ioCf?) slfE Pr'./M-N OS P4t-E I . A6;'($d and subscribed before me this '1i day of ~.J:'fP-M~ ~J;1&~JL, Notary Public (Signature) lariaJ Seal ~ ~lacJc. NolaJy Public Or M r-,-,- . Cumberland County y -__n Expires Sept. 10. 2005 Affirmed and subscribed before me this _ day of (Address) (Signature) Register of Wills Deputy (Address) (Signature and seal of Notary or other official qualified to administer oaths_ Show date of expiration of Notary's commission) r',.) Register of Wills of Cumberland County RENUNCIATION Estate of Also known as-NfA KeN tJf1 rt ~ W,th--vl4c.f No. ~/--(}5- ~~ , deceased To the Register of Wills of Cumberland County, Pennsylvania 0et1l( s: Wift"Wr~ !vf011l~ R (Name) (Relationshipj (Capacity) of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Len,,, 1)( ~ I ~" ~ItfIO,.J 71; be issued to 12 y1; I'< / l' 111lf~te 5 /f1J 0 f1 tit- e. S:; t; It ~ 18 Witness my/our hand(s) this ~ day of ~tjU f?J'~202.5 The undersigned Affirmed and subscribed before me this 4>'1Jtdayof sepf~~ Jt$fW ~t Notary Public V/94 ~tIM)~~ft-- , (Signature) o ~K. 3tfr S'j / JI') (A~2fcss) nE.,<<..14f Hj(.5 Pit t.E. I '1OCfO . I My Commis . Notarial Seal Robert R. Black, Notary Public . . . ' umberland COUnly My CommIssIon Expires Sept. 10. 2005 (Signature) Or (Address) Affirmed and subscribed before me this __ day of (Signature) Register of Wills Deputy (Address) (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission) r~.)