HomeMy WebLinkAbout02-17-06
PETITION ~OR GRANT OF LETTERS OF ADMINISTRATION
Estate of ~?~L~~ ~~Vil. /QLt,1s'
also known as ~71tc- t.r ~~~. ~Qi,~T
Deceased.
Social Security No. c7 2',~. •~ f~=GT~,I/~
No. 2.OI~fo - O 15 (o
To:
Register of Wills for the
County of ~...~../..w 1 in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your pedtionersyJ, who is/stra 18 years of age or older, appl /~F for.letters, pf administration
" `' on the estate of
(d.b.n.; pendente lift; durance absentia; durance minoritate)
the above decedent.
Decendent was domiciled at death in .~/ Count ;Pennsylvania, with
h s.y. ,last family or principal residence at + .+ .v ~.t
/~/~jyny ~jCa.my,~yfe~/~ P/rL ~ ~..3 Z,u (list street, number and mu icipality) ~
Decendent, then ~_ years of age, died I %~ ~i ,,~C~ipS~
at ice mar.... r'~oi...-~. /it i ~~ ~
(If not domtctled m Pa.) Personal property m Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Decendent at death owned property with estimated values as folllows: fj'
(If domiciled in Pa.) All personal property $ 7_ ~. Ova. OG'
Petitioner- after a proper search ham ascertained that decedent left no will and was sum+ived by
the following spouse (if any) and heirs:
_ Name ~ Relationship ~ Residence
zd,
s i~
THEREFORE, petitioner(s) respectfully request(s)
appropriate form to the undersigned.
C. ~.yl.,nA/
9
~~
ag
V
yyN a.
Y Q
Ci
_m
~' 3 ~- s ~•t~C~wO _...
the grant of letters of admta~tion itYthe -~~ ~.'_:
--, -_~ '
_ _ '~~
i_n •~./ t
r'l J _M1~
J ~ ` ~~
l 't t^~
t7rt. Ll~.yiYE~ ~?. /
.G~~tliyditS. ~} /~3 2~
_.. _... _.. -. _ ~.. 5
Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
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 of petitioner(s) and that as personal representattve(s) of the above
decedent petitioner(s) will well and truly administer the estate acc ing to law.
sw" 0" m to or affirmed and subscribed .,' {
Bef9l'fii'~thi~" nUl '<;!,d yof
\'. R4.tY.1tU:i ,20 U(9
V~/t('4,;j~~~) 5Jdic:::~eJL/sfJt,J
No. j
Estate of .::rU4/~ 1'!VN A'~, Deceased
o/~~ r.:tT/LJi!f "" ~f
GRANT OF LETTERS OF ADMINISTRATION
(/J
ciQ"
::l
C)
C
""1
A
~
. AND NO 'Y -idY'Ul ~ . i 7 / h 20~ in consideration of the peti tion on there"erse ~.~
Side hereof, satIsfactory proofh vmg been presented before me, .' '. =
IT IS DECREED that ~ ~ ~J!}KNS A I ~4?\//~~5' :::i
is/~ entitled to Letters of Administration, and in accord with such finding, Letters of Administration . .
are hereby granted to VU '-" ~ N"h"'~ ~, P"'1~/e-~
~~~.s; ~~~~tL/e ~, ~r
AUda. YaNU Mil). ruf~. il~'\../
Register ofWil1,~.,pPA. ~~ ~
?,~-?:., S; ~~"y/e~.~ #-~"??-SS-
Attorney (Sup. Ct. I.D. No.) ,
in the estate of v-~L./e- 4~
FEES
Probate, Letters, Etc. ............. $
Will ................................. $
Renunciation..~.~),............... $
Short Certificates (3) ............ $
JCP.................................. $
$
$
$
J-I 0 . () 0
i 6.00
IIJ,t'O
I A.. 00
10,00
.s ., cO
Automation Fee...................
Bond.............................. ...
Total
Filed
20_
c~~
,_c
ON'&;- w~~~~ s;.~ ~~.,2oS-
Address. ,/ L) /
49/Zu;tTy r~ / rc::v.3 <
:),/?- -,,;J-~J-' &:1 /
,
Phone
H \Ils.xns REV 11llS
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.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
'&- ~:o~~~~
Fee for this certificate, $6.00
p
12045148
NOV 2 9 2005
Date
-.J
c,,;
\..0-
H105.143 Rev. 2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
TYPE/PRINT
IN
PERMANENT
SLACK INK
BIRTHPlACE (City and
State or Foreign Counby)
J:.owell, Mass.
NAME OF DECEDENT (First, Middle, Last)
<AI .
!wp.
cltylboro.
~
~
1
1.
) 0
) UJ
<f>
"
~ <f>
- ~
.,
'^
'"
';:$
u ~
27. PART I: Enl... 11'1. dl......, I"J"rt.. or compllcatlona whIch cau..d tM d.ath. Do not en..r tna mod. ofdyl"il, ,,,cn.. c,ardlllc 01' r..plratory a.....,t, 'hock or h..rtf.nur.. : Approximate
U.. only one eIIU.. on ..ch IIn.. , Interval between
. : onset and death
l-u. ,p:.,....-c.-t---...:... 3:? ~
:::t
Sequentially Usl conditions { cb..
if any, leeding to Immediate
. cause. Enter UNDERLYING
CA.USE (Diseas& or Injury
. that initiated evenls
resullirlg on death) LAST d.
WAS AN AUTOPSY WERE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
DUE TO (OR AS A CONSEQUENCE OF):
DUE TO (OR AS A CONSEQUENCE Of);
MANNER OF DEATH
_"'t.
Natural
.liCI
D
D
DATE OF INJURY
(Monlh, OW!. V_.I)
TIME OF INJURY
INJURY AT WORK'? DESCRIBE HOW INJURY OCCURRED.
-.;
Vo. D Noti(!
Yo'D
NoD
Suiclde
HomIcide
Pending Invastigat1Qr.
Could nol be detennlned
D
D -D~D
D 30.. 30b. M. 30c.
PLACE OF INJURY. At home, farm, street, factory, office
lluildlng, etc. (Specify)
30..
~
Accident
~
W
o
W
()
W
o
u.
o
w
~
z
29.
'-MEDtCAL EXAMINER/COROHER
~~~:rb::~~~~~~~I.~~.~I~. ~~.~~~ ~~~~~~~.~~~~: .I~ .~~.~~I.~~~:.~~~.~ .~~~~~.~ .~~.~~.~.~I.~~:. ~_~~.',~.~~ .~~~:. ~~~.~~~. ~~.t.~, ~~~,~.t.~~ .~~., 0
318.
.ll /IOb}
REGISTRAR'S SIGNATURE AND N
t\. ~~~~"tN
~ l k3,1 ( 101
34.
,.
Repmerof~illsofCwmberlandCoun~
RENUNCIATION
Estateof VU ~/e /f,vA/ Ru.s:.~
Alsoknownas vt(LIE /1. ;4Z~S"r
No.
~
. deceased
To the Register of Wills of Cumberland County, Pennsylvania
The undersigned ___iApNe-r E. /<.US-..r / ~n9..4'Ph
(Name) (Relationship) , r (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters tS'~ .4-;!!>h7//V/r~nOt</
be issued to f Al'r It' ~.s're--/2.. i7'Z/'L./ /J.tiI'VNt:::- ~, Z>-'9N"/6'~
. J
r-7H
Witness my/our hand(s) this 1;:;, day of ;P~/ZH,~~ ,20 G'lC
~
tE
Affinn~ and subscribed before me this
/,<j~~day of ;:cgPud1vr 2-e\) 6
~~)~~S
7 2.... c-zt>e""V.> h1 ~ ~ c..:r .
?- ~7f!<.",~~q) /U.
B~e/<.~~~ L.t:?N~
.-
SG :3 ?- ">2:, ENCL;9....v- Z>
;'
(Signature)
~
f ,
0, HUDGELL YEATES GRANT SAw)
Affirmed d subs~i~TQNsROAD
_da of BI.A('J{IlIiATH l
- LONDON SE3 7EX
(Address)
(Signature)
Register of Wills
Deputy
(Address)
-_n!
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's conunission)
,",,~l
\..D
.,
Re~terof~illsofCwnberlandCoun~
RENUNCIATION
Estate of .:::J'-u 1../ G ;4f.NN
Also known as ::TZ.I/../4- A.
/P4' 5S
/I{ e( #s
No.
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
The undersigned ~41V~ ~ ~~S I ~H9/P,;-
(Name) (Relationship) , '. (ClIpacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters of ,.;p"pM/N~~77r?N
be issued to ~r $,,;r,,-.A... I ~/4N'.-ve- tl<, to.;fA//e~
day of ,r:-e~I'I}.A." ,200'
I.
Witness my/our hand(s) this
Affu:med and SUb~bed before me this
J In day of . h, ,
~ r
'o/t1ro'~+~.~ ~
Notary Pubh
I~
..,/ '9N~ · (Signature) ~ u.J" S'
r't' QLEYV'~/~ ~o~
h'IL rr::^'J c:r (Address) 0' 8'9 ?-
My Commission Expires:
VINCENT J. FA5ANO
NDTARY ~mJll..JC
MY COMMISSION EXPI 't31r.l\"31~:JOB
Or
(Signature)
(Address)
Affirmed and subscribed before me this
_ day of
:~:.;
-'
(Signature)
...-
,
Register of Wills
, \
Deputy
(Address)
''', I
c.)
....0
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission)
-~.