HomeMy WebLinkAbout11-28-05
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Register of Wills of Cumberland County
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estateof Anita L. Diven No.~I- 05- IO;=)'2>
also known as To:.
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. 2 0 6 - 3 2 - 4 9 0 5
The petition of the undersigned respectfully represents that:
Your petitioner(l(), who is/are 18 years of age or older, appl i e s for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
)
. . . Cumberland PI' . hh rI "'1 -..\'. I
Decedent was domICIled at death In County, ennsy vama, WIt ~ ast laml y or pI" nclpa
residence at 27 S. Earl Street, Burouqh of Shippensburg .....
(list street, number and municipality)
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Decedent, then 62 years of age, died February 5 ,2005 , at Chambersb-urg =-"
Hospital, Chambersburg, Franklin County. PA -
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(Ifnot 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:
r0
5,000.00
$
$
$
$
none
Petitioner_ after a proper search ha~ ascertained that decedent left no will and was survived by the
following spouse (if any) and heirs:
Name
't
Dlven
Patrick L. Diven
Thomas L. Diven
Tonia L. Fasnacht
hter
THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the appropriate form
to the undersigned.
Signature(s) of Petitioner(s)
Residence(s) ofPetitioner(s)
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Tonia L. Fasnacht
105 Hollar Avenue, Shippensburg, PA 17257
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PA 17257
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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SS:
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 ofpetitioner(s) and that as personal representative(s) of the above
decedent petitioner(s) will well and truly administer the estate ~cCOrding to~Iaw. '. I J
Sworn to or affirmed and. subscribed {~CN\Av i ~1Mo..Lif
Before me this "\ S .Ie"'. day of
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Register
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Estate of Anita L. Di V~eceased
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GRANT OF LETTERS OF ADMINISTRATION
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AND NOW N.Cl'fe.m h..r r rQ.B 2009 in consideration of the petition on the reverse
side hereof, satisfactory proofhavjng been presented before me,
IT IS DECREED that Ton~a L. Fasnacht
is/are entitled to Letters of Adminjstration, and in accord with such finding, Letters of Administration
are hereby granted to Ton~a L. Fasnacht
in the estate of
Anita L. Diven
FEES
Probate, Letters, Etc. .............
Will............................. ....
Attorney (Sup. Ct. LD. No.) 3..i.('s -4 ~
J.-l q- ~W\ ";"~ C-\ Q..."-~
Address ~-:::.
2:.)\\~~E.N~~\JR~, p~ p:tS ,.-"'2..\ ~
$ "qO. CJ..."j
$ ;>t
Renunciation....................... $ It') . t 1~}
Short Certificates ( ) ............ $ L-l; .(r')
JCP.................................. $ lG' CD
$ SeD
$
$
20 OS
Automation Fee.. ...... ...... .....
Bond. . . .. . . .. . . . . . . . . . . . . .. . .. . .. ....
Total
Filed II -;) 'I
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Phone
Register of Wills of Cumberland County
Estate of
Anita L. Diven
Also known as
RENUNCIATION
No.d t- 0 S--I 033
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
Michele R. Fritz - daughter
The undersigned Michael R. Diven - son
(Name) (Relationship) (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(~[:that
Letters of Administration(~
be issued to Tonia L. Fasnacht 1
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Or
N of:o.r$4 W (fJ ; dJaeJ I? DVer7 trJ/l;
Affirmel1' and subscribed before me L~MM . ,
d '5 <leY of n . , ONWtJ-\LTH OF PENNSYLVANIA
~~ NO~
D~BORAH WARREN, N)'~;nl Public
ShIPpensb~rg. Twp.. Cumbl!rlai'U County
My CommisSion Expires NOli B, 2009
Witness my/our hand(s) this
day of
!\JDtonJ fur i'n,d--e/{., K. Fnlz
(\\ffirmed and subs'ilri~ed before me this Jf)/vj
r ~day of JJLilli . ,
+~~ GJ,;tf<j,,o{6
Notary, ENNSYLVANlA
NOTARIAL SEAL
My C Ax~LSKI, Notary PubIc
Shlppenabufg Twp., Cumberland County
My CommI8sIon Expires Feb. 9; 2008
Register of Wills
Deputy
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission)
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/ie-Jl00 J<d S'~W<2V'5hc:;;
(Address)
(Signature)
(Address)
Register of Wills of Cumberland County
RENUNCIATION
E~~e~ Anita L. Diven
No.c210 ~ - / 03 3
Also known as
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
Patrick L. Diven - son
The undersigned Thomas L. Diven - son
(Name) (Relationship) (Capacity),
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters of Administration
be issued to
Tonia L. Fasnacht
Witness my/our hand(s) this
day of
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f~ CP~
p~rick L. Di~~Pfture)
() /3 (,v C/ '3 \' 51 /J;; 4, ,
, ( Address) I
I0ok~ tuJ" ~tr;ti L ~'~~\Jr.1
Affirmed and subs,{ibed before me this ~.
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~ PENNSYLVANIA
/ ~ID~R~LS~l
<. f'QWERS, Notary Public
. v . :~~rsOOrg, Franklin Count,
CommfSSlO!l._'?Pires Oct 5, 2006
My Commission Expires: Iv ",-6(.;,'-'~'-'-
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Thomas L. Di v~~nature)
Or s-'6 ,5. lIol/aV' Or/f/'e
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Affirmed' and subscribed before me this U ;
'OMMONWEALTH OF PENNSYLVANIA
NOTARI EAl (Signature)
. BOR~H WARREN, Notary Public
ShlPpensDurg Twp., Cumberland County
Register of Wi \Is My CommIssIon Expires Nov, 8
T' "'.-''''~'' " _.., .......~.'.._
(Address)
Deputy
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission)
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Thi, is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
l.ocil 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.
11333409
No.
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Fee for this certificate, $6.00
Local Registrar
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FEB 0 8 Z005
Date
ITEM # ,r'
SHOULD READ AS FOLLO\r~):
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j Rev 2187
21- 05-/033
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
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Franklin
DECEDENT'S USUAL OCCUPMION
(~t:Of~~:O~~;~~
Ie.
Chambersburg w.Chambersburg Hospital
KINO OF BUSINESS/INDUSTRY ,^"S DECEDENT EVER IN
U.S. AAt.tEOFORCES?
"'. D No (;'(
SEX
NAME OF DECEDENT {FIrst Middle. LolSil)
1. Anita Louise Diven
AGE (last Birthday) UNOER , YEAR
Montha O..ys
S.
COUNTY (y DEATH
62
VIS
UNOER 1 DAY
Hours ! .......
B!ATHPLACE IC,tw' and
Stale Of rcr8lgr'l CounlrY)
MAfUTAl STATUS. Merried
N...,... Manie<l. Widow<<f,
DiYotced (Speedy)
White
SURVIVING SPOuSE
(It ...,... ~ maiOen name)
. .... Cook llb. Hub
DECEDENT'S MAlUNG ~OOReSS (Street. C.tylTown. SIal.. ZIp Codel
27 South Earl Street
Shippensburg.PA 17257
DECEDENT'S
ACTUAL
RESIDENCE
lSee InsuuCl1Oi'\I
on OCher Side)
17.. Stale
P.^.
... Widowed
17C.O .....__..
lWp.
...
17...
(l;d
-.....
Min.
Cumberland townOhiO? 17..0 :;.:-'::01
MOTHER'S NAME iFitst. Middle. Malden Surname)
Shippensburg
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11ME OF DEATH DATE PRONOUNceo OEAO{MQf1th. Day, Year)
... 1:\ :35' 1>. M. 25. ;z. - (1':>- - ,,~-
27. PART I: Ent.' lhe di......, injuries Of compliCatIOns which caused lhe death 00 not enter the mode of dying, such as cardiac or respiratory arrest. shock or heat1lailur.
Uat onty one cause on each ItM
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'MS CASE REFERRED 10 MEDICAl EXAMINEAICORONER?
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I ApplOllUnala
I ln1erva1 bMWeen
: onMI and death
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PART I':
OIh",~CO_~IO_.'"
I'lOl fMUItIng in the undeftVing c:aUH given in PART I.
SEOUENCE Of),
DUE TO lOR AS A CONSEQUENCE Of),
Wt.S AN AUTOPSY
PERFORMED?
WERE AUlOPSY FINDINGS
A\!lUlA8LE PRIOR 10
COMPLEllON OF CAUSE
OF DEMH?
MANNER Of DEATH
DATE OF INJURV
(MQf1Ih. Dav. '$..,.)
liME OF INJURY
INJURY ,;,r WORK? DESCRIBE HON' INJURY OCCURRED.
....0
Nof1J
V.. 0
...0
Suicidlt
~
o
o
Homieide
o
D
o PLACE OF INJURY. At hom., larm,O:;..t. t.ctory, off.ca
buildin~ etC. \Specil\l\
300.
.... 0 NoD
Natural
Accident
Pending Inwll1g.Uon
Could noI ~ delermined
~
~
2". 21b.
CERTIFIER IChedl only onel
.CERTIFYINQ PHYSICIAN (PhySICian certifYing cause 04 death wt\erI al'\O\her phVSIC''''' has ptooounced deall'1 ana compleled lIem 23)
Tottte.....o'm'knOwtedge. deathocc:utredduetoth.uuM{.'.ndm.nn.f...tated.................................
...
.PRONOUNCING AND CERTIFYING PHYSICIAN (PhvSIClan bOlh p.onOUllClng dealh and certifying 10 cause 01 dealtl)
To lhe best of my knowledge, death QCcurr.d.1 the Um., d.I., .and plac".nd dualo th. c.use(...net m.nn.r.. .I,ted.. .
o
.UEDICAL EXAUINER/CORONER
On the baal.of .K.m~n"'on andJOf investigation, In my opinion. death occulT.d.t the 11m.. dat.. and place, and du.lo the caus'(I) and
manner II It.ted.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31..
REGISTRAR'S SI
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