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Home My WebLink About12-28-05 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Maryanna Senek Brandt, Deceased Social Security No. 178-56-2666 No. 21-05- //15 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner, who is 18 years of age or older applies for letters of administration on the estate of the above decedent. Decedent was domiciled at death in South Middleton Township, Cumberland County, Pennsylvania, with her last family or principal residence at 115 Shirley Lane, Boiling Springs, Pennsylvania 17007. Decedent, then 39 years of age, died November 10, 2005, at Harrisburg, Dauphin County, Pennsylvania. 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 PA (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: None other than as tenant by the entirety $30.000.00 $ $ $ 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 Spouse Residence Gary E. Brandt Jake N. Brandt Son 115 Shirley Lane Boiling Springs, P A 17007 115 Shirley Lane Boiling Springs, P A 17007 THEREFORE, petitioner respectfully requests the grant of letters of administrati~ in the:--~ appropriate form to the undersigned. ,:: r",.) Ct.; Signature and Residence of Petitioner ~4.~ Gary E. Brandt 115 Shirley Lane Boiling Springs, P A 17007 -=' -.I OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF CUMBERLAND ) The petitioner ablwe-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and beli!:fofpetitioner dn': that as per,onal representative of the above decedent petitioner will well and truly administer the estate according to law. :l!:i~ Sworn to or affirmed and subscribed before me this 2. 'if day of DLl:J~ ~ J l.LIC . h .1....0\ ~ . .~ ~ RM;dpr \.j)V V In 1.i1~~ No. 21-05- 1 I I B Estate of Maryanna Senek Brandt, Deceased GRANT OF LETTERS OF ADMINISTRATION ANDNOW DUE:::YV\ ~ 29 ,2006- , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Gary E. Brandt is mtitIed to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Gary E. Brandt in the estate of Maryann a Senek Brandt. FEES Letters of Administration. .$ QOJJV i. CO Wayne F. Shade, Esquire 15712 A TTORNEY (Sup. Ct. I.D. No.) 53 West Pomfret Street Carlisle, Pennsylvania 17013 ADDRESS 717-243-0220 PHONE ~ ~~ JicuttthAUA- 'AUctV . RegIster of WIlls ~ V rYl I Short Certificate(s) . ~. $ \J ~-V <1- Ar $ 15,' '\ \{_~D_ ~IIRgiatiOft-. . . . . . . . TOTAL Filed........... . f[!Il:\t-;O.'i RFV' j/()'; 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. Fee for this certi ficate, $6.00 WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ I-D5-11 /8 2:t:.... ~:o~~~~ No. 1\,\,,''(~(1irotpll---____ II~~ ~'4',,",,- II' =. V..t:"'- :1\\~_._..0"- I~~ "~ . 1-':;. I~~! . ' . \7 ~ :: Q' ~ _ _ l~~ ~(.,..)f /L.#--li::: ~ t . ,<j.iJ_ .' ~ (\*~'~.' .~.. ..,,*{ \<::2..... ~" \.~\. ..... ~"'l "'-1"~~ ~~"", "''''..f1MENT \\~ ~ ,."" """"'//IHH/lIIIIII" HOV 1 5 2005 p 12044916 Date . -) ., ~^..! -.:. ) - ~ \'.--' co:) -..l ,/ H105.143 Rev, 2187 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH 51 ATE FILE NUMBER TYPElPRJNT 'N PERMANENT SLACK INK ~! ~} .~ ~ ~ o?J, ~11rh MiririlQrnn \wp. citylboro. Pa 17404 Funeral Home M ek'?.{...,-c: (jtfMf'ct}1 CO)l\& I DUE TO (OR AS A CONSEQUENCE OF): . Approximate : interval betwe : onset and death : 3, F> Other significant conditions contributing to death, but not resulting in the underlying cause given in PART' S~entiany Usl conditions , if any, leading to immediate . cause, Enter UNDERLYING CAUSE (Disease or iriury . that Initiated events reslillng on death) LAST WAS AN AUTOPSY IJI.oERE AUTOPSY FINDINGS PERFORMED? AVAILABLE PRIOR TO COMPLETION OF CAUSE OF DEATH? E DUE TO (OR AS A CONSeqUENCE OF): DUE 0 (OR AS CONSEQLENCE OF): MANNER OF DEATH 30<1. LOCATION (Street, CityfTown, State) 30f. LE OF CERTIFIER ?11~?ll,rP1,t1. LICENSE N BER DATE SIGNED (Month, Day, Year) . lH 31e.lf; -ocrq!jtJtJ- L.. 31d. I f ~ tJ 5 NAME AND ADDRESS OF PERSON V\+iO COMPLETED CAUSE OF DEATH '~:!~:::ri~~~';~~~~~I~~I~~~tJg.~~.~:.f~,~,~"~~~~.~:.d~~t~.~e.~~.~.t.~~".~~:.~~,.~~~.p"e~,.~~~.d~~.t~.~~.~~~~~~1.~~~.. 0 ("';;~ T;.e :;.:;~? ~~t;:';7p<; ~;:;;~S Ji!7~ t1 ~ 31a. 32. " .::. . , REGISTRAR'S SIGNATURE AND NUMBER~.. _ C' . DATE FILED (Month, Da Year) 33. ~~. ~eu.~~'t.N ~I\ I~I \ 101 34. o o 301. 30b. M. o PLACE OF INJURY. At home, farin. street, factory, office buldng,BIc.{Specify) 28.. 28b. 29. 3Oe. CERTIFIER (Check only one) ~l~~~'lre:'tGJ~~~~e:~'it,s~~~ C:~i~J:t'i1 &e:r.~~(:r~~~~g.a~sh~~~~~,~.~~~~~~,~~~~.i~~~.~~).. Natural 1CI o o DATE OF INJURY (Month, OilY, YIIlIl") TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED Homicide Accident Pending Investigation Ye. 0 No IlSI Ye.O No It! Suicide Could not be determined SIGNATUR .....lEl 31b. .PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronOlX'lCing death and certifying to cause of death) To the best of my knowtedge, death occurred at the time, date. and place, and due to the cauHS(S) and manner as stated..