HomeMy WebLinkAbout11-22-05
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
05 -IOZlP
Estate of
also known as
Sara J. Zeigler
No.
To:
168-24-2765
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
ocwl Secunty No.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, applies for letters of administration
the above decedent.
on the estate of
Decedent, then
at
90
years of age, died
November 17,2005
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: 20 Dewalt Drive
$
$
$
$
Silver Spring Township, Cumberland County, Pennsylvama
400,000.00
150,000.00
Petitioner after a proper search has ascertained that decedent left no will and was survived by the following spouse (if any)
and heirs:
Name Relationship Residence
Nancy J. Dellin2er Dau2hter 10 Meade Drive. Carlisle. Pennsylvania 17013
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i:lWHERERi.E, peti~~er(s) respectfully request(s) the grant of letters of administration in the appropriate form
to the underiiined. c:5
C'<:l
thereon.
-n Sign~~(S)
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Nancy J. Dellinger
Residence(s) of Petitioner(s)
10 Meade Drive, Carlisle, Pennsylvania 17013
OATH OF PERSONAL REPRSENTATIVE
l;OMMONW~ATLH O.'l'~NNSYLVANIA
l;OUNTY 0.' l;UMBERLAND
Sworn to or affirmed and subscribed
before me this 2. 2. day of
November, 2005 ~ L..u'l
't D 1 j1 clI.J..Fil ~ t4. u.J.l
'-P4Vm~
No.
The petitioner(s) above-named swear(s) or affirrn(s) that the statements in the foregoing peition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
~~~~~
Nancy . el ger
Reglster
~ 1- 05 -lOlu
.Estate of Sara J. Zeigler
Deceased
GRANT O.F L.ETT.ERS O}' ADMINISTRATION
AND NOW November -.J\!O U I ~ 3 , 2005, in consideration of the petition on the reverse side
hereof, satisfactory proof having been presented before me, IT IS DECREED that
Nancy J. Dellinger
Is/are entItled to Letters ot AdmInIstratIOn, and In accord wIth such fmdIng, Letters ot AdmInIstratIOn
are hereby granted to
in the estate of Sara J. Zeigler
Nancy J. Dellmger
Probate, Letters, Etc.
Will
Renunciation
Short Certificates (j )
JCP
Automation Fee
Hond
~~~8
FEES
$ 4 LoO. Do
$
$
$
$
$
$
Total 4 $ 3 a r/, ()()
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Filed 11.22-
(717) 243-5~3~
PHUNE
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H105.805 REV 1105
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Regis~rar. The original certificate will be forwarded to the State Vital Records Office for permanent. filing.
WARNING: ft is illegal to duplicate this copy by photostat or Photo~r~05 _{ 0 ~ it?
~:<~UJ~N
Local egistrar
Fee for this certificate, $6.00
p
12065131
No.
Ht05144 Rev. 1191
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COMMONWEALTH OF PENNSYLVANIA 0 DEPARTMENT OF HEALTH 0 VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
TYPE/PAINT
IN
PERMANENT
BlACK INK
J
SEX
2. Female
Zeigler
DATE OF BIRTH
(Monlh,D4r,Year)
UNDER' DAY
Hour. MinuI..
BtRTHPLACE (City and
Slale or Foreign COUfltry}
CITY,
DE"'"
East Pennsboro
Ie.
DECEDENT'S USUAl OCCUPMION
(~~~oI~~~u~f~~
. 11. Homemaker 11. Own
DECEDENT'S MAJUNG ADDRESS (Street, CilvlTown. State, Zip Code)
20 Dewalt Drive
,..Mechanicsburg PA 17050
FATHER'S NAME (Fl(st, MJddIe. last)
Alvin M.
Home
DECEDENT'S
ACTUAL
RESIDENCE
(See inWuctbns
onolherside)
17.. Stal.
Cumberland
no.
o
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DATE PRONOUNCED DEAO (Mooth, Day, Year)
24. 8: 20 P. M D. November 17, 2005
27. MAT I: Em., the diseues,lnjurkts or complications which caused Ihe death. 00 not enter lhe mode 01 dying, such as CClIdiac or respiratory arrest, shock Of heart failure.
list onty one cauM on uch tine.
b.
DUE 10 (OR f:..S ACONSEQUENCE Of):
d.
WERE AUlOPSV FINOtNQS
AVAIlABLE PAJOR TO
COMPlETtON OF CAUSE
OF DEATH?
MANNEA OF DEATH
SWE FILE NUWBER
SOCIAl SECURITY NUMBER
168-24-2785
DATE OF DEATH (MonItJ, Day. Yew)
4. November 17, 2005
~O
Old
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Min.
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MARiTAl SWUS. Marlilld
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1 i dowed ,.
17C.[jYoa.-........ Silver
RACE. AmeriCan 1ndiM. BIadt, W..... tIk:
-)
Wh He
SUAVlVING SPOUSE
(It 'lIIIiIe, giwt maiden name)
....
D.
IApprOJdm..e
: intervat between
! 00I8I and dNah
i
NoD
PART U:
OC....1Iignific:ant c:ondItklM COf'ltrtbullng kI __, but
noI~in.IM~c--.g;wr.nInMRTI
Yos 0
Aco....
Pending Investigation
OATE OF INJURV
(Moolh, Day, Year)
o Nov. 3,2005
o . ~
O PLACE OF INJURY. Al home, farm, 8hel, laclDly. oIfice
::::-;ng. otc. (Specdy) Highway
SIGNATURE AN
o
Jl!I.
o
Natural
Homicide
No 0
Suidde
zo.
Could not be ~Iermined
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w
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III
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Ha. 2ft.
CERTIfIER (Ch8ck cny 0fl6)
"CERTIFYING PHYSlClAH (phySICian ctJI\llying cause or dedlh when another phySICian has pronounced deillh and corllpleled 116m 23)
To thebnt of my lmo..... ..th occWNd due to 1M CIIU....) end JneAnef.. staW. . . . . . . . . . . . . . . . . . . . . . .
.PfIONOUNQNQ AND CERTiFYING PHYStclAN (Physiclall bolh p-onouncing dealh and ceflitying Ia cause or daalh)
To Ibe beet of my k~, c1Mtb occurled.t the Uma, de.., end", and due to Ihe CItUM(s)end rnannet".s stel".. .
,"MEDICAl. EXAMINER/CORONER
On the...... of ...mlnatlon and/or In".saltatlon, In my opinion. de.th occulred al the lime, date..nd place, and du.lo Ih. cau..(.) and
m.nnef..Itatad................................................................................................. .
31e.
REGIST
~,f,~ 11,21
INJURY AT WORK? DESCRIBE HOW W.lURY OCCUAREO.
Unbelted passenger,
Yoa 0 ""Pl impacted 3 vehicles
R
o 31b. Coroner
LICENSE NUMllER O"'E ~~:be c:v. nl , 2005
o 31c. 31.
=2~f~:IOF\m~fl.l~E~~~~~oroner
~ 6375 Basehore Road, Suite #1
'^ 32, Mechanicsburg, Pa. 17050
DATE. F)ED (Monah, Day. Year)
...No <2.m ee 1'1 doo -