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Home My WebLink About07-12-06 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Drew Michael Taylor also known as No. 21-06- '..\'.J ~ , Deceased Social Security No. 198-80-8610 Randall L. Taylor and Marcie E. Taylor Petitioner(s), who is/a"~ 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: (c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minoritate) 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: !RI B. Grant of Letters of Administration 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 402 Richwalter Street, Borough of Shippensburg , (list street, number, and municipality) Decedent, then 3 years of age, died 06/13/2006 at Children's Hospital of King's Daugs, Norfolk, VA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania Unknown: $ $ $ $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I Signature Typed or printed name and residence Randall L. Taylor 402 Richwalter Street 1!!a;~iL{ .1 ;2v Shippensburg, PA 17257 I Marcie E. Taylor 'YV~Ol,\t~.i 2.,cty,Lo--..; (j 402 Richwalter Street Shippensburg, PA 17257 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 Drew Michael Taylor also known as Name of Decedent: Date of Death: Name Marcie E. Taylor Randall L. Taylor Drew Michael Taylor 06/13/2006 Cumberland County, Pennsylvania ORPHANS' COURT DIVISION NO. 21-06- l:\~) , Deceased Social Security No. 198-80-8610 Petition for Grant of Letters (Continued) Relationship Mother Residence 402 Richwalter Street Shippensburg, PA 17257 Father 402 Richwalter Street Shippensburg, PA 17257 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 anc! truly administer the estate according to law. 1/7'- t:'''-...J-, "'z, C / ,i{!' I !)' ~(. L/ t. /" Forthef~ister ! //y; 1 fir liP /1/111 '~~I fJL~ No. ' ~ -06- '," ;l&twl4 cf /';r Randall L. Taylor "'Yl1oA (~{ 'f > .TC~-~ ( (J--Z. Marcie E. Taylor I 'J Sworn to or affirmed and subscribed ,AT) /cF' day of I J }\:~) Estate of Drew Michael Taylor , Deceased also known as Social Security No: 198-80-8610 Date of Death: 06/13/2006 AND NOW, , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters 0 Testamentary I!] of Administration (c.I.a.; d.b.n.c.l.a.; pendente lite; durante absentia; dui~nte minoritate) are hereby granted to Randall L. Taylor and Marcie E. Taylor, 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. l~ o,grr::',; flj Altom", CJktry A le, Esquire ' FEES Letters.......... .................. ........ ...... $ /:J(J .00 #8' cL' Short Certificate(S)........~........ $ Renunciation............................... $ Affidavits ( )...........................$ I.D. No; 01624 Weigle & Associates, P.C. 126 East King Street Extra Pages ( )......................$ Address: Codicil....................... .......... ......... $ Shippensburg, PA 17257 "; lu.fc JCP Fee. ....t... .1... ............... ......... $ J S- C C Telephone: 717/532-7388 Inventory......... ......................... .... $ E-Mail: Other............ .................. ........ ...... $ TOTAL............................ $ J-f3.0Q Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group. Inc. Form RW-1(1991) "- ". ~ FOR DIVISION OF VITAL RECORDS DECEDENT PLACE OF DEATH USUAL RESIDENCE OF DECEDENT ~ "'w ~ ~ :! 0. 5 .~ x~ 00. ~ ~ ~~ sf ~i 8.0 c-g "0 ~ o.E In .. ~ IE .2'.0 fi? ~.g 0-0 ~.E ~ II: 0. - L~a! ~.~ ~ 0111.- lE a..g "" - w ~.~ -g c ~ 2"2 :g 8 x " ~~ .0 " " c w ~ =: i I- 0. Z ~ ~ .!! II: w OJ:: 0.1- ~~ PERSONAL DATA OF DECEDENT CAUSE OF DEATH TO MEDICAL EXAMINER: Complele and sign medical certificatton ~ (~em 28) and give all ;:: 3 copies 10 funeral c( director as soon as ~ possible aftef inquiry. i= II: OJ o .... .. o is OJ :Ii NOTE: " "Pending" must be rdcaIed, noOify regos- Irar of final decision as soon as possible. FUNERAL DIRECTOR REGISTRAR '" ~ ;;j U) > RAISED SEAL REQUIRED REGISTRA liON AREA NUMBER COMMONWEALTH OF VIRGINIA - CERTIFICATE OF DEATH DEPARTMENT OF HEALTH. DIVISION OF VITAL RECORDS. RICHMOND MEDICAL EXAMINER'S CERTlFICA TE STATE FILE NUMBER 1 FULL NAME OF DECEDENT (middle) male female 1 Ga 0 5. DATE OF 6 WAS DECEDENT BIRTH EVER IN U S yes years ov 01 2002 ARMED FORCES? 0 fl I I I 8 fl Out Pat Emer Am lnpalian! B. COUNTY OF DEATH (if independent ciiy, leave blank) DOA o o inside city or town limits? , 0 STREET ADDRESS OR AT NO OF PLACE OF DEATH yes no 11. STATE (OR FOREIGN COUNTRY) OF DECEDENT'S RESIDENCE (if independent city, leave blank) 13. CITY OR TO N OF RESIDENCE Cumberland inside city or lown limits? 14. STREET ADDRESS OR RT. NO. OF RESIDENCE yes no ZIP CODE 17257 17. Marcie Ditzler 19. EDUCATION (Specify only highest grade completed) N/A If yes, specify Cuban, Mexican, Puerto Rican, etc ~ no Dyes Elementary/Secondary (0-12) College (1-4 or 5 +) 21 BIRTHPLACE (state or country) 22. NEVER MARRIED Ga MARRIED D DIVORCED o o 23. IF MARRIED OR WIDOWED. NAME OF SPOUSE (if divorced leave blank) 24. SOCIAL SECURITY NUMBER WIDOWED 26 KIND OF BUSINESS OR INDUSTRY 27. INFORMANT - OR SOURCE OF INFORMATION - RELATIONSHIP 25. USUAL OR L lor - Father INTERVAL BETWEEN ONSET ANDfEA TH ~;/} Sequentially list conditions, il any, leading 10 immediale cause. Enter UNDERLYING CAUSE (Disease or injury thaI initiated evenls resulting in deal h) LAST (B) DUE TO (OR AS A CONSEOUENCE OF) 28a. AUTOPSY? AUTHORIZED BY yes o ~ 28b 28<:. IF EXTERNAL CAUSE. IT WAS PRIMARY j-j(' or CONTRIBUTING 0 TO CAusclOF DEATH unknown 0 (mo,) l O~;..f fJt & (day) (year) 281. INJURY OCCURRED 1?7 (J& 29. 31 parklawns Memorial Gardens, Franklin CT.,Pennsylvar ~~~~~~6uNERALHollomon-Brown Ft\neral Hli>me 0502.C[oc3'f"5 ADDRESS 8464 Tidewater Drive, Norfolk, Va, Jr:JN~J -9- 2006~' TillS IS TO CERTIFY THAT TillS IS A TRUE AND CORRECT REPRODUCTION OJ!:..} . .', ; THE ORIGINAL RECORD Ffi.,ED WITH THE NORFOLK DEP ARTlVIENT OF PUBLIC ~TH~ NORFOLK, VIRGINIA. DO NOT ACCEPT UNLESS IMPRESSED SEAL OF NORFOLK HEALTH DE~~TMENTJS CLEARLY AFFIXED. "-, -". ~ !it/lo' /11 &:kJj--oYOI[rt ' DATE ISSUED DEP..REGISTRAR Section 32.1-272, Code of Virginia, as Amended.