HomeMy WebLinkAbout01-24-06
.
Register of Wills of Cumberland County
Estate of David M. Alexander
also known as
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
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No.
To;
Social Security No. 196-16-6398
, Deceased
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
(d.b,n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Your petitioner(s), who is/are 18 years of age or older, appl~ for letters of administration
on the estate of
Decedent was domiciled at death in Cumberland County, Pennsylvania, with h~ last family or principal
residence at CM Estates, Lot 157, Newville, Pennsylvania 17241
(list street, number and municipality)
Decedent, then 81 years of age, died December 31
HE?J\l...1'\\ Su"t\... ~ M\?L\'\f\Nlc:::.,~..:a<.~
2004
P,t\'
, at
Decedent at death owned property with estimated values as follows:
(If domiciled in Pal 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:
f'~ ?JC,
---
$
$
$
$
Petitioner_ after a proper search ha~ ascertained that decedent left no will and was survived by the
following spouse (if any) and heirs:
N R I' h' R 'd
ame e atlOns 10 eSl ence
I E::leanor Alexander Wife CM Estates, Lot 157, Newville, PA 17241
THEREFORE, petitioner(s) respectfully request(s) the grant ofletters ofadministration in the appropriate form
to the undersigned.
Signature(s) ofPetitioner(s) Residence(s) ofPetitioner(s)
~&4J (U~ J:h. a-1/a/~/~4:--/ CM Estates, Lot 157, Newville, Pa 17241
.
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.
Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYLVANIA
}
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 ofpetitioner(s) and that as personal representative(s) of the above
decedent petitioner(s) will well and truly administer the estate according to law.
!/;w? .e--r/ ?J? - Od/{a<7' ./~
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Sworn to or affIrmed an~ubscribed
Before me this ~\. * day of
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Estate of ~\'i.~\'0 ~\.~~~~~ Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW '::;- ~~~,~ ~\.X, 20~ in consideration ofthe petition on the reverse
side hereof, satisfactory proof having~n presented before me,
AIS DECREED that ~ ~\\\~~ '..1\. ~:~..~'x~ ~\)'\.:.\{
~e entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to I;;:I...~ \'::,'\\~\<.. ~, ~\...c:;,;x,\~~\),~
in the estate of
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FEES
Probate, Letters, Etc. .............
Will............................ .....
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. Register of Wills .~ "\ ~
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Attorney (Sup. Ct. J.D. No.)
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Automation Fee...................
Bond........................... ......
Total
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$
$
Renunciation....................... $
Short Certificates ( ') ............ $
JCP........ .......................... $
$
$
$
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Address
Filed
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Phone
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H105.905MS REV.(OIl03)
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This is to certifY that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
accordance
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~II~
Charles Hardester
State Registrar
0566242
fES 0 4 2005-:;
- .;...:~.)
Date
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H105.144 Rev. 1/91
CORRECTED ITEM (S) : 15 ,2~MMONWEALTH OF PENNSYLYANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
PER:FD DATE: 1-19-05 bas CERTIFICATE OF DEATH
(Coroner)
C..~i
TYPEIPRIHT
IN
_AllENT
......CKINK
# 29-411
1271'84
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ORE OF DEArH (Monltl, Day. ~r)
.. December, 31, 2004
Alexander
UNDER 1 OM ORE OF BIRTH
Hours MInutet (Monlt1, Day, Year)
BIRTHPlACE (City and
StateOfForetonCountry)
PI\.
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CITY, BORa
rtl
Q)
'M
p,
o
t>
DECEDENT'S USUAL OCCUMrION
(~~~~~~~r~or
,Supervisor 11.
DECEDENT'S MAlUNG ADDRESS (Street. CityfTOWf1, State, Zip Cats)
RACE. American Indian, BIIIck, While, etc.
l""1fh i te
10,
SURVIVING SPOUSE
(1I wife. give maiden name)
lI'l
DECEDENT'S
ACTUAl
RE!lIOENCE
(Seeinltructions
on other side)
Kolakowsk'i .
'7b.
COd
-
llvel",
townehlp? 11d.o ~~=of
MOTHER'S NAME (First, Middle, M8iderl Surname)
... Verna Solad.a
tNFOAMANT'S MAlUNG ADDRESS(Streec. City/bwn, State, Zip Code)
CM Estates Lot 157 Newville P~ 17241
PlACE OF OISPOSmON. Name ofCernetery, Cremetory l . CltyfTown, sw., Zip Code
"'Hc;'iiinger Crematory M .Bolly Sl;)rings,Pa
21c. 21d.
17C.rx_.~tlwedl"
twp
citylboro.
17065
..,
27. PART I: Enterttle......ln;urleeorcompllcationlwhich
Uel: only one cauee on each Ine.
Closed ~ead Trauma
DUE 10 (OA ~ A CONSEQUENCE OF):
Motor Vehicle Crash
DUE 10 COR lIS A CONSEQUENCE OF):
DUE 10 (OR A CONSEaUENCE Of)'
.
WERE AUTOPSY FIN~NQS
U1LABLE PRtOA 10
COMPLETION OF CAUSE
OF DeJJH?
MAN
OF DEArH
YolO
NoD
Naturj
I
-r
~
o
~
o
.....-
~ndtng InvestlgMlOn
Could not be dittermfnitd
DArE OF INJURY TIME OF INJURY
o (Mon1h. Doy, "..) APPX
o ,ov 23, 2004 2:15 P
o PlACE OF INJURY -At homo, fann, _, ~,_
~,..c.(Spec") Highway
S1GN~RE AND
o lb."
Coroner
INJURY 1JWORK?
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Z". JIb.
CElmFll!R (Check only one) I"
-CERTIFYING PHY8ICWt (Phyaician certifying cauee 01 death~ another physician has pronounced deatl1 and compIetect Item 23)
To..bettot...,.knowIIdge,cs.thOOCUlfMduetolhe~.).nd""""..eawd.................................................... .
-PRONOUNCING AND c::EInlfYINQ PHYSICIAN (Physician ~ pronouncing dee1h and oertiIying to cauae 01 de8ttl)
1b.......of...,.~I....OOGurNd......tIme.r.Md...Mddueto...~.)andmenMf.................................. .
i',
"llEDlCAL I!llAIIINERlCORONEA i
Oft......ofeumlnlttonMdlor~ton. tn opinion, dNth OCCU,................ ....Ind ptace.1nd due to the CMlM(.) end
............................................. ...................................................................
31..
REGISTRAR'S SIGNRlJAE AND NUMBER
~" b)..d 101
DATE SIGNED (MOnth. Qey. 'Mar)
o "c. 1. January 2. 2005
~~~~~~:tOFg~~aw~U:1~~oroner
~ 6375 Basehore Road, Suite #1
'f-' n. Mechanicsburg, Pa. 17050
:~EILED(Mon1h'DoY'''''~a..l\.3 ti.O()5"