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Home My WebLink About03-30-06 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION (7(1~ Estate of RICHARD M. VARLETT No. 21-06- /A/)' also known as To: Register of Wills for the , deceased. County of Cumberland Social Security No. 168-24-4345 Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Vour Petitioner, who is 18 years of age or older applies for letters of administration on the estate of the above decedent. Renunciations for Kenneth E. Varlett and Sharon Kay Eichelberger are attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 38 Back Street. Plainfield. Pennsvlvania . Decedent, then ~ years of age, died Medical Center. Carlisle. Pennsvlvania . March 11 , 2006, at Carlisle Reaional Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property Value of real estate in Pennsylvania, situated as follows: 38 Back Street. Plainfield. West Pennsboro Township. Pennsvlvania $38.000.00 $79.000.00 Petitioner, Leslie Swartz, 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: Sharon Kay Eichelberger Kenneth E. Varlett Leslie Swartz Daughter Son Daughter 173 Hair Road, Newville, PA 17241 1518 McClures Gap Road, Carlisle, PA 17103 1189 Easy Road, Carlisle, PA 17013 WHEREFORE, Petitioner respectfully requests the grant of letters of administration in the appropriate form to the undersigned. ~L-==- ~ ./ ','" .......... ( s~::J~wartz ----.iL--:.)C'-}-<~ 1189 Easy Road Carlisle, PA 17013 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND The Petitioner above named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner and that as personal representative of the above decedent, petitioner will weli and truly administer the estate according to law. ~ . ~ r- 9_'~ ~ l. ,::..<;:~ (.' Leslie Sw~rtz Z\ Sworn to or affir~d p.nd subscribed before me this -....::>0 day of , M,arch, ~09~ . '\ i' . I 0.J l.i..hc!LfFl ~ilit\JtLI~ V Ltiltl.t I "'. l' ~st'r f 'fL i VI \ j[l{i '1l ,ir No. 21-06- 6 ~ ~~ Estate of RICHARD M. YARLETT , deceased. DECREE OF GRANT OF LETTERS OF ADMINISTRATION AND NOW, March 30. , 2006, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Leslie Swartz FEES Probate, Letters, Etc. . . . . . . . $260.00 Short Certificates( -3-) . . . . . . . $ 12.00 Renunciation(s) ........... $ 5.00 JCP . . . . . . . . . . . . . . . . . . . . $ 10.00 Automation Fee. . . . . . . . . . ..$ 5.00 Other . . . . . .. .... $ TOT AL: .... $292.00 Filed........................... . .----- 60 West Pomfret St.. Carlisle. PA 17013 ADDRESS 717 -249-2353 PHONE RENUNCIATION In regard to the Estate of Richard M. Yarlett , deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Kenneth E. Yarlett and Sharon Kay Eichelberger of the above decedent hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Leslie Swartz WITNESS our hands this day of March ,2006. !~fY\VJ. ~1 r;; ~/~ KENNETH E. YARr.$TT 1518 McClures Gap Rd. ADDRESS 173 Hair Road ADDRESS Newville, PA 17241 SWORN AND SUBSCRIBED BEFORE ME " THIS'~ DAY OF MARCH, 2006. " . I i / .i/ \ / . t /!. << Notary Public \ JJf il ii This is to cenifv that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrclr. 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. 0:0. ,II,"~'~G"'otPE;;---___ "'.':"Y'~'"'- ,,' ~~ "J',~"':. 'f ~ ~- !t~ .,,~~\ I'~' .'. \.7_ ~ c::t; ---:-~- !~~ ~ c.,..)\'i,j. /,)::. ~ \'*~... '. >;,*~ ~<::'~..__.~. I~,~ """'-~~ .. ./-$>,./ "''''-__~IMEN'f~~ 't.~",,'\ """""/#OOJIIJlI11" ~~. ~hs..~~~~ Local Registrar Fcc lor this ceni ficate, S6.00 P 12270'1Q1 ~ r::.. v .t MAR 1 4 2006 ,. [;late ,. . (-,) H105.143 Aev. 01AJ6 TYPElPRINT IN PERMANENT BtACK INK 1 NameorDecedenl(firSl.middle,IaSl) Richard M. Yarlett COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER I . Cumberland 3, Social Security Nurrber 4 Dale 01 Dealh (Monlh, day, year) 168 -_ 24 :- March 11, 2006 5 Age (Las!birtloday) 7. Dateol8inh Monlh,da eal 76 y" Bb. County 01 DeaUl o Residence 0 Other. ci 10. Race: American Indian, Black, White, elc. (Specifyl S.Middleton Twp. White 11. Decedent's Usual Occ alian Kind of wolk done dUlin mosl ot workil'l ~le: do nol slale retired Kirld 01 Work Kind of Businessllnduslry h'hest radeco Ieled College (1-4 or 5+) 14 Marital Stalus: Married, Never married. WidoWed, Divorced (Specify) 15. Survivirfg SpellSe (lfwife, give maiden name) 16. ec en sMalling dress ( tfeel. cityl1own, slate, zip code) 17b. County PA Cumberland Did Decedanl Uveina 17c. ex YIJS,DacedentUvedin WjQl~t- PAnn~hnt"n Towl'lsh~? Twp 38 Back Street Plainfield, Pa 17081 17d.D No, Oecedenl Lived Wilhin ktualUm~sol CilyiBofO 18. Falhef'sName(FirSl,middle,lasl} Herman I. Yarlett 19. Molher's Name (First, middle, maidel'l surname) Minta E. Woods lOa. Informant's Name (Typelprinl) 2Ob. Informant's Mailing Address (Street, cHyllown, slate, z~ code) Kenneth E. Yarlett 1518 McClures Gap Rd., Carlisle, Pa 17013 o w <J) ::> <J) <( ~ o RelTlJvalfromState 21c. Place 01 Disposition (Name or cemetery, crematory Of other place) 21d. LocaliontCityllown,state,z~code) o Donation March 15, 2006 22b. License Nuntler Westminster Memorial Gardens Carlisle Pa 17013 "0. N.""."" "",,,...IF"'''' Hoffman-Roth Funeral Home 219 North Hanover St., Carlisle, Pa 17013 23b. License Number 23c. Dale Signed (Month, day, year) . Ilerns24-26muslbecorrvletedbypersoo whopronouncesdealh. 24 Time or Dealh 25. Date Prol'lOul'lCed Dead (Month, day, year) CAUSE OF DEATH (See Instructions and examples) llem27. Part I: Enleflhe~-djseases,il'ljuries,orco~licalions-lhald:recllycausedlhedealh. DO NOT enter terrrNtlal evenls such as cardiac arresl, respiratory arrest or ventricular fiJrillalion withoul showing Ihe etiology. DO NOT abbreviate, Enl91 only one cause on a liI1e, IMM~~IATEC~USE(finaidiseaseor C.......... ~\C r_ rP -I. - _.~ M"~ J.- conditvnresuhmgmclealh) ~ a, ~&.- V-~ Sequentially IistcondiUons, if any, Due 10 (or as a col'lsequenceoQ: Q~ leadil'lg to Ihe cause listed on Linea Due to (01 as a consequence oQ: . _' _8 c-.'" ,..... - E~le(theUN~EAlYINGCAUSE t1)\J. ~'.jo...~ ~c..........~ . ~~::~~~~Ug1nt~I~~~~i~e Due 10 (or as a consequence oQ:--r- d. Approximaleinterval: ol'lsel 10 death 25. Wes Case Referl.?-a MedK:al ExaninerlCoroner? aYes ~ Part II: Enterolhersiol'lilicanlconditionsconlrtJutinolodeath, but not resuning in the undertyingcause given in Pan I. 28_ Did Tobacco Use Conlribule 10 Death? DYes 0 Probably ~ No 0 Unkl'lOwn 29. If Female. o Not pregnanl within past year o Pl9gnanlallimeotdealh o NOlpragnanl.bulptagnarrtwilhil'l42days 01 death o Nolpregnanl,bulpregnant43dayslo1year beforedealh o Unknowl'l if pregnanl w~hin the past year 32c. Place 01 Iniury: Home, Farm, Stree!, Factory, DffK:e Building, etc. (Specify) 8:25 am March 11, 2006 o Yes tJ(. No 3Ob. Were Autopsy findil'lg5 AvailablePriorloCo~letion o/Cause ot Death? DYes 0 No 31. Manner of Dealh ~alufal o Homicide o AccKlenl 0 Pendinllll'lvesligalion o Suicide 0 Could Not Be Determined 32b. Describe how Injury Occuned: 3Oa. Was an Aulopsy Perlorrned? .... Z W @ U w o u. o w ::; <( Z 33a. Certifier {chect: only oneJ Certifying physician (Physicial'l certifyil'lg cause 01 dealh whel'l anolher pnysician has pronounced death and COITllleted 11em 23) To the best 01 my knowledge, death occurred due to the cause(s) and manner as slated... Pronouncing and certifying physician (Physicial'l both pronouncing death and certifying 10 cause of dealh) To the best 01 my knowledge, dealh occurred althe time, date, and place, and due 10 the cause(s) alO manner as stated ..................... .............. Medical examinerleoroner On the basis 01 examination and/or Inve.stigation, in my opinion, death occurred at the llme, date, and place, and due to the cause(s) and manner as stated. 35 g' arlSigna\ur~o.~~:e~ t\~ \ '"' '\, ~~ IQ:{ I \ I ~ I \ I 0 I ...........0 CJ .~ 32e.lnjuryaIWolk? DYes 0 No 321 32g. Localion(Street,cityll.owl'l,Slate) 4-{cS ri k.L 33d_ DateSigl'led(Mol'lth,day,year) 1\ 12. oc,,~ '1 ......0 34. Name arn:l Address 1 Person Who Co~leled Cause or Dealh (lIem 27) ypeIPril'lt Alexander Spasic MO, CRMC, 45 Sprint Drive Carlisle, PA 17013 (See instructions and examples on reverse)