HomeMy WebLinkAbout04-20-06
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Jean L. McBride No. 21-- D(o - 034 ~
also known as
, Deceased
Social Security No. 186-28-4600
Randy L. McBride and Kim E. Dowell
Petitioner(s), who is/are 18 years of age or older, appl(ies) for:
(COMPLETE 'A' or 'B' BELOW)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
the Decedent, dated and codicils dated
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
00 B. Grant of Letters of Administration
(c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minontate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs:
I Name Relationship Residence I
See attached schedule
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family
or principal residence at 10 Regency Woods North, Carlisle l Middlesex Twp., PA
(list street, number, and municipality)
Decedent, then
69
years of age, died
04/11/2006
at 1 0 Regency Woods North, Carlisle, Middlesex Twp. Cumberland Co., PA
(Location)
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 Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
situated as follows: None
73,500.00
$
$
$
$
2206 Chaney Drive, Lot 490
Ruskin, FL 33570
Prepared by the Pennsylvania Bar Association
Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will
well and truly administer the estate according to law.
before me this
Jb-lh
day of
-?~ 4- ~C,~
~. L. Me. Bride
cr~QSZ
Kim E. Dowell
Sworn to or affirmed and subscribed
ct.pn I . .a. 00&
~ 1W/A ~0Afru/~
. J:)O).., t For the Register
/"" ~.
21~D8'1-r
No.
Estate of
Jean L. McBride
, Deceased
also known as
Social Security No: 186-28-4600
Date of Death:
04/11/2006
AND NOW,
CLftAU
iJ. ()+h
~tJOItJ
, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 0 Testamentary 00 of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Randy L. McBride and Kim E. Dowell, Co-Administrators
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
FEES
Letters.................................. ........ $
Short Certificate(S)..,{(o)......... $
)36, t>D
r11/-. DO
Renunciation............................... $
Attorney:
I.D. No: 19475
Bogar & Hipp Law Offices
Address: One West Main Street
Affidavits ( )........................... $
Extra Pages ( )...................... $
Codicil.......................................... $
JCP Fee.......................... ............. $
/0.00
Shiremanstown, PA 17011
Telephone: 717-737-8761
Inventory...................................... $
E-Mail:
autv
Other............................................ $
TOTAL............................ $
!5.0D
J74. ()O
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1(1991)
In the Court of Common Pleas of
IN RE:
Estate of
Jean L. McBride
also known as
Name of Decedent:
Date of Death:
Jean L. McBride
04/11/2006
Name
Kim E. Dowell
Randy L. McBride
Cumberland County, Pennsylvania
ORPHANS' COURT DIVISION
NO. 21-- Olp -0341
, Deceased
Social Security No. 186-28-4600
Petition for Grant of Letters
(Continued)
\r~~1.
Kim E. Dowell and ~8~_~ L. McBride do hereby promise and agree
that if Letters of Administration are granted to them as Co-
Administrators, that Randy L. McBride, who is a pennsylvania
resident, will retain all assets of the Estate of Jean L. McBride
in Pennsylvania during the course of the administration of the
Estate of Jean L. McBride.
NOTE:
Relationship
Daughter
Son
Residence
2206 Chaney Drive, Lot 490
Ruskin, FL 33570
81 Peach Orchard Road
Middleburg, PA 17842
/f? L.,lA. lI/2()!'/.(,
K.t D ~ jQOJ06
~~
~
\~
!III)'i.\(I~ RIV I!()~
This is to certify that the information here given is correctly copied from an original certificate of death ~;lly filed with me as
Lo~al 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.
~. 9(kJd^J;}Orj
Local Registrar
Fee for this certificate, $6.00
p
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j b. /)1) c~
(
Date
t110~ 144flov 01106
TYPf,?RlffT 1/4
P:1RAMt:"I~~T Ii 3 0 - 2 1 5
l-N';;;;" of D;;;;denl (Fuslrr;;ddle.las~'----
Jean
L
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH (CORONER)
~~;:ale 3 ;;1~ecur:Nu;e~ _ 460.0. 4 Da:;t;:~MO~h2da:.r~~06
8 Birth lace ICily and stale or breigrl counlry) Sa Place 01 Dealh (Check onl',> one)
Hosprtat. 1 OMr
Me..c.hani.-C...s.DJ!r_g_ U_. 0 In alieni 0 fRlOu alienI 0 DOA 0 NursllgHome Residence 0 Oher ~'L--._.____
Bd. Facility Name (It not InsldullOn, gl\le street and nuntler) 9. rSN~ec~.n~~~ ~:S::snic~t~uban 10 (~~~ICan tndllln, Black. Whde. etc
10 Regency Woods North Mexocan, Puerto Rcan, elCj W hi te
STATE FILE NUMBER
McBride
Yrs
8il"'C;;;;;;jyofoe.ih--.- ..-
69
ear _ und;r-:-.l da,-'-=l1 Dale 01 BlrUl Monlh'da ,
Oars ~ MlI1ules J.F e b. 2 3 ~ 1 937
.-.- &-('1,. t:lo~De.llh
5 Age ILasl bllltld_rJ
Cumberland
Middlesex
l100c'edent's usuaiOcc.;;;at.lIln (Kind 0/' work ~nost-~te~'OOlSlale rehred-
. KInd 01 Walk KInd 01 [iusUleSSilndjjSlry
Cashler Retail
16 Decedent's MaNIOo Mdrass (Slreel. cftyllown, state, lip code)
10. Regency Woods North
Carlisle PA 170.13
12 Was Docedenl ever wllhe US
Armed Forces?
o Yes No
Decedent's
A.:lual Residence 17a. Stale
h, h"SI rade con leled
Conege (1--4 or 5+)
14 Mantal Stalus' Marned. Ne;91 mimed, 15 Survl\'lOg Spouse (11 wile. giote maiden roa"",;
Widowoo. Divorced (Specify)
Widowed
f?A
Old Decedenl
LIVe III a
Townsh~?
17c. ~ Yes, Decedenl LIVed in _.M i d dJ ese..x____ Twp
17b Counly._~ ~~ ~~ t"J.~!lg
17d 0 No, Decadenl Ll\led wllhll
Actual LimIls of ClI} 'Boro
18 Father's Name (Fwsl. middle, last)
Charles
H .
Baker
19. MOlher's Name (Fwsl, middle. maiden surname)
Isabell Mildred Wilt
~tniOr;nanl S Name (T rpe/pnnl)
20b Inlormant's Malkng Address (SIr eel, cilyllown, stale, lip ~)
o
w
U)
:::>
U)
<C
~
L. McBride
81 Peach o.rchard Road Middleburg PA 17842
21c Piace at DlSposrtlOn (Name 01 cemelery, crematory or other place)
21d. Location (Cllyllown, slale, lip code)
Schaefferstown PA 170.8
FD-012662-L
Conolite Crematory
22cNariieani Addrll<>S of faclllty
MYERS FUNERAL Ho.ME MECHANICSBURG PA 170.55
0Il1'~ e herns 2 C.r1lfylllg
phrslCloln IS noI available ar lone 0' d84lh 10
certdy cause 01 duath
. hems ~Sl be coiilii8iedbY person - 24
who pronounces dealh
23b. License Number
23<: Daiii Sl\IIled (MOnIh, day, YUI)
Time 01 Dealh
6:00
25. Dale Pronounced Dead (M"nll!, day. year)
April 13~ 2006
CAUSE OF DEATH lSee tnslrutCllons and .umplesl
hem27 Part I Enler Ihe ~ - diseases, intunes, ur con1llocallOns 'lhal dlleclly caused lhe death DO NOT enter (ermlllal evenls such as cardlilc anesl,
resptlatory arrest. 01 ventricolar fibrNlalion wrthoul showlIlg Ihe ellOlogy DO NOT abbreviate Enler only one cause on a hlle
=~~~;e~~~~~J:::dlSea~r a ghI()J:!!~__ Q~~~ !"~.~~!Y~_.X~!moJ:!~~Y_P ise~~~
Due 10 (Of as a consequence oQ
: ApproxlOliIle interval
: onset 10 death
26 Was Case RefeRed 10 a Medical EJcaminer/COloner?
)CesONo
Part II: EnlSf other sianifICanl condlllOns conlllbullllo 10 dealh.
hol not resohlOg in Ihe underlying cause given in Part I
28 Old Tobacco Use Conllibule 10 Death?
o Yes 0 Probably
o No 0 Unknown
o Yes ~No
d
'jji--We.. Au101lly findiiiOe
Available PrIOr 10 CO"1llehon
01 Cause of DeaU,?
o Yes 0 No
31' Manner of D.elh
)It Natur.1 0 Homoclde
o Accident 0 Pending Inveshll'lllOn
o SUICide 0 CoukJ Nul Be Delermined
32, Do" of -,"'". '" ,q" ~l:"";"'" ",., 0..00",
32d. TIme of Injury 32e Injury al Work? 321 If TransportallOn InJury (Speci/)oj
o Yes 0 No 0 DII\/9//Qleralor 0 Passenlier
o Pedestrllln 0 h Sp8cIfy:
29 If Female
o Nol pregnant wilhlll past rear
o Pregnant allJme ot death
o NaI pregnant, bul pregnant Will 42 days
01 dealh
o No! pregnanl, but pregnanl 43 lIdys 10 I year
beklfe death
o UnknoWll ~ pregnant wChlllllle pasl your
32<:. Place 01 Injury: HorN, Farm. SI'"I, Flctory. ~-;'"
8ui1ing, ele (Sp8cIfyJ
SequenhaUy IIsI rondalOns, d anr,
Ieadlllg 10 the cause ksleJ on L Ule a
- [nlerthe UNDERl YaNG CAUSE
. (dISease Of .'IUIV Ihal inilialed the
events resullng in dealh) LAST
D~e io("OI as a consequenCe oil,
---".-----------.... - - - ... ,-" -
Due 10 (or as a consequence oQ:
JOi' - Wal-.n~op;y--
Perbmed?
32g localion (Slresl, CilyIloWll. stale)
M
f.-
Z
W
@
U
w
Cl
u.
o
w
:E
~
z
33a Cartirl8f (clleck only one)
Certilying physicgn (PhrsICian cenlfylng cause 01 dealh when anolher physICliIn has prOflOUnced dealh and ro"1lleled lI~m 23)
To Ihe Ilal 01 my kno..ledge, dulh occurred due 10 lIIe cause(s) and lllinner as sllted ....__...______............__.... .__... .... ____.______....___.................
. Pronouncing and certllylng phYSician (PhysICliIn balh prorlOOl1C'ng dealh and certifying 10 cause ot death)
To Ihe besl 01 my knowledge, dealh occurred allhe lime. dale, and place, and due 10 lhecause(s) and manner as sl.1led..
Medical euminerkorone,
On lhe basis 01 euminallon arldJo, investigation, In my opl~lon, death occurred ~~ lime, dale, and place, and due to lhe cause(s) and lllinnel as sllled ..~_
3S Re r's Slgnalure and DlSlrlCl NUIT~r 36 Dale Filed (Monlh. day, year)
I~' I I k.?? LLJ.dJ 1/. :;J.~ 0 t.
(See instructions and examples on reverse)
33b. Signal
Coroner
___...........u
33c license Nurmer
33d. Dale Signed (Month, dar. year)
April 15~ 2006
............___......................0
34 Name and Address 01 Person Who Con1lleled Cause olDealh (hem 27) T ype!Plinl
Michael L. Norris, Coroner
6375 Basehore Road~ Suite #1
Mechanicsbur ~ PA 17050