HomeMy WebLinkAbout11-07-05
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Register of Wills of Cumberland County
Estate of Francis R. Cooper
a/so known as
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
No. ~ 1- Os- ()qRw
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. 1 60-20-9785
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, applied for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decedent was domiciled ,at death in~ lan~ounty, Pennsylvania, with h is last family or principal
residence at 113 May Dr~ve, Camp H~ll, PA 17011 .
(list street, number and municipality)
Decedent, then 74 years of age, died 10/19 2000
Hospi tal, CUmber land Cbunty, East Pennsborb Twp.
, at Holy Spirit
Decedent at death owned property with estimated values as follows:
([f domiciled in Pa.) All personal property
([fnot domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value ofreal estate in Pennsylvania
situated as follows: N/A
$ 1 00 ,000.00
$
$
$
-,~i
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the ~ppropriate tPr~
to the undersigned. ' . 1
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Residence(s) of Petitioner(s)
108 May Drive #1, Camp Hill, PA 170'11,
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
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SS:
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; ac or ing to law. ,
Sworn to or affirmed and subscribed {_,J 1 D.l C - W ~
Before me this 'l~ day of
\\lD\fem~A ,20 (',5
~~'~
~., _ Regisrer
N o.J 1- 05 oCj '?to
Estate of~o n .....r..1'\ R (' ()P'''' , Deceased
GRANT OF LETTERS OF ADMINISTRATION
intheestateof~.AQ""'~"^ Q, (rc,O.fA
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FEES
Probate, Letters, Etc. .............
Will .................................
$ OtIO .00
$
Renunciation....................... $
Short Certificates ( )............ $ d4 - CO
JCP.................................. $ It> . oc:>
$ 5. (;('J
$
$ ~4q ,00
2005
Attorney (Sup. Ct. J.D. No.)
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Address
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t'" a ,0 # , / I I' f?"1'I r? c.>'
Automation Fee...................
Bond.................................
Total
Filed ) I - l
Phone
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WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
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COMMONW' r. _! '" (> F.E.H,SY.',. 'I
DEPAi~1IV\ENT;; TA,:HVli.\lF: :: ;,
LOCAL REGISTHAF'S CErnlFeln 11 \ :H: 01:i:'1
CERT. I\JO, T 4 6 5 5 6 4 6
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Date ot issue at This CertifJ',':n)n;)
Narne 01 Decedeni
. L..~~<:::.E::L.._.__
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.../~ 0 - ~=z:Jl..eC_....______. Date at DeaHl
o - /' T -0 c)
Sex /4
So,~ial Secunty No.
Date o! f3Irt;, f ~d~ -d- c;: . Birtnplace ..C;;;..If:'::;{,:.[Qd.__,_.____ .___..___.___._ ______.~._
Place of Oeath h~ #~~d~.dd~_4,'J'~~~d-=i..,.-,--.E 4.~'^i{/f_;<;:;&~-...E(?i1n?Yi\!ania
Race&4r..c ()crIJpation~~4..J~.____ ..________.._ Armed Forces? (Yes or No). . .., _,__..__.
Mantal StatLls/Z-t/!~~C::{, ~~~~~e~~sdress .. <'~--,-~/--J?~~-,-. C~~-4f.<------.AL:?'o,;/
Informant ttJ+-r!",-!~cg; q~c7.A,.._.~__.~ Funeral Director ..Lij~~_J'~dJ.."'.!~-L.
Name an~(;('iress of r;' ~ h
Funeral Establishment .. U~~dd..:z:..r_-C'/i,.~~.~~..d;~~-~-~ uz::r4!___~.L.___ .___..
Interv,::\1 Between
Part I. Irnn1eulate Cau:;e Onset ~nd Death
.&-4d;. - ~./ L~"c;: ,-_.~-c.- .!-._.._.._.._.F.~.....~_.i~~
. ~u""" ------~--Z~.'~~_.__,____.________________.___._. __ ~ .. . ~~ _ .....
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Part II:
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Other slgniflcLcconditions. 6 . :'
uC~E--.~:?"&.~~~9L/kc~. ~-P~~~~_____~_._.____:"____
Describe how injury occurred:
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Manner 01 Dp3th
Natural
Accident
e
HCJlliIC!( Ic-;
Suicide
Pendinq Investigation
Could not be Determined
Name and Title ')f Certtler _ /___.~~&__,_. ________.___________ ._.____. __ __. ___________ ~_. __. _ _ .
A;/ . ~ ~ . ~ (M.D., DO" Coroner ril E )
Address ~f' .oL:./J~~~~~L__~~~~-------!Zd/.t:. __._. __. ..~__
ThiS IS to certify tilat the irlforrnation here given is correctly copied from an original certificate
of death duly fllecJ VVI!f1 me as Local Registr~~..~ ori,.9..'.'.,n. a...I....c,e...r...',.',.'c...a'.e will be.f.oIW.". r..de...d.'.O. '..he
S'a'e V"al Records Olfiec for permanent fili~'k~~n__ ,",?~YJ>:
/Cl ~/-OO /Y.&,(~~__. :Oq--"c;....?^"'-':"'~d._
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