HomeMy WebLinkAbout07-06-06
PETITION FOR -GRANT OF LETTERS OF ADMINISTRATION
Estate of Philip S. Lego
also known as
No.
To:
;} lOb - () r () 3
Deceased.
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
Social Security No. 195-32-1389
The petition of the undersigned respectfully represents that:
Your petitioner(s), who2t5Y'are 18 years of age or older, applies
for letters of administration
on the estate of
(d.h.n.; pendente lite: durante absentia; durante rninoritare)
the above decedent.
Decedent was domiciled at death in
h is last family or principal residence at
Cumberland
County, Pennsylv.ania, with
3 Edgewood Drive, MechanlcsburgHoro
(list street. number, Twp. or Boro.)
Decedent, then 63 years of age, died June 28
at 3 Edgewood Drive, Mechanicsburg, PA 17055
2006
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 Pennsvlvania
situated as follows: 3 Edgewood Drive, Mechanicsburg, PA
$ 32-;BOO .
$
$
$ 1 z.5.,{}{JO
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Petitioner~_ after a proper search ha ve ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
Joseph J. Lego Son 1610 Orrs Bridge Road
Enola, PA 17025
David A. Lego Son 803 Highland Court
- Mechanicsburg. PA 17050
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration 10 the
appropriate form to the undersigned.
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1610 Orrs Bridge Road
Enola. PA 17025
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David A. Lego--" ~
803 Highland Court
Mechanicsburg, PA 17050
RECORDED OFFICE OF
REGISTER OF \'\lLLS
2006 JDL 6 PM 3:31
CLERK OF
ORPI L\:\S' COl'RT
Cl''\IBLRL.\:\D CO,. P\
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} 58
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 above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and
before ~e this & A
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No. .'J 1- ~ UVli S Ct3
Estate of
Phi lip s. T,prn
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
(-\~
AND NOW ZOCi , in consideration of the petition on
the reverse side hereof, satisfa ory proof having been presented before me,
lT IS DECREED that Joseph.T. T,ern ;mrl D::Jvi rl A T,PEn
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
Joseph J. Legn a~d DaVld A. Lego
are hereby granted to
in the estate of -Ph i 1 i r S T E' gn
FEES
Letters of Administration $
Short Certificates( ).......... $
Renunciation ................ $
$
TOTAL _ $
Filed ..................... A.D. 19_
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Lawrence J. Ne::Jry SlIprpmp r.nllrr I.D. 25827
ATTORNEY (Sup. Ct. J.D. No.)
108-112 Walnut St., Harrisburg, PA 17101-1609
ADDRESS
(717)238-4798
PHONE
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JUL 0 1 2006
RECORDJ]) (WHCE OJ,
REC;ISTER OJ, \,\'ILLS
2006 JDL 6 PM 3:31
CLERK OF
ORPH,\,\S COL'RT
CT.\IBERl ,\.\:D CO" P,\
v. 0212006
UNTIN
\lENT
INK 1/30-272
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH (CORONER)
lab tech
steel co.
12. Was Decedent ever in the
U.S. Armed Forces?
Dyes ~o
Decedent's
AclualResidence 1703. Slale
13 Decedent's EducaliOl1 (Specify only highest grade completed)
Elemenlary I Secondary (0-12) College (1-4 or 5+)
12
esidence 0 Other. Specify
10. Race: AmeriCan Indian, Slack, While, ele
(Specify)
white
1. Name of Decedent (First, middle,last, suffix)
Philip
5 Age IlBsl Birthday)
63
s
Lego
Yrs
6. Dale 01 Birth MonIt1, d , ear
7. Birth ace Ci
Feb. 27,
Harrisburg,PA
&I. Facility Name (If not inshMon, give street and number)
1943
Bb County of Death
Cumberland
3 Edgewood Drive
11 Decedent's Usual Occu ation Kind of woril done durin most 01 worki life Do not state retired
Kind of WQI'k Kind of Business I Industry
14. Marital Status: Married. Never Married
Widowed. Divorced (Specify)
16. Decedent's Mailing Address (Street. city Ilown, state, zip code)
3 Edgewood dr.
Mechanicsburg,PA17055
17b.County
P~nnRylvilniil
Cumberland
widowed
Did Decedent
Live in a
Township?
17c. D Yes. Decedent Lived in
17d a. No, Decedent Liv~rtin .
Actual Umits of prnrtnl l'RhllrJ
Twp
City/Bora
John Lego
19, Mother's Name (First. middle, maiden surname)
Margretta Funk
2Ob, Informant's Mailing Address (Street, city' 10Wl1, state, zip code)
lB, Father's Name (Firs!. middle, last, suffix)
20a Informant's Name (Type I Print)
Joseph Lego
, 0 Cremation 0 Donation
, Was Cremation or Donation Authorized
ify : by Medical Examiner I Coroner? 0 Yes 0 No
tu~e of Funeral ?Fice ;.,.ice;see (or ~rson acting as such) _ 22b, license Number
, ,/tv((},t,UW~cu/\---
23a. To the best of my knowledge, deattl occurred al the time. dafe and place staled, (Signature and tille)
21b, Date of Disposition (Month, day, year)
1610 Orr's Brid e Rd.,Enola,PA17025
21c. Place of Disposilion (Name of cemetery, crematory or other place) 21d, Location (City I town, stale, zip code)
Rolling Green Cern.
amp Hill,PA17011
22c Name and Address of Facility
Musselman FH&CS,324 HummelAve.,Lemoyne,PA17043
Complete Items 23a-c only when certifying
physician is oot available at time of death to
cel1ifycauseofdeath
23b. License Number
23c, Date Signed (Month, day, year)
CAUSE OF DEATH (See instructions and examples)
Item 27. PART I Enter the (,:,hai!l~ - diseases, injuries, or complications - Ihat directly caused the dealh, DO NOT enter terminal events sum as cardiac arrest,
respiratory arrest, Of ventricular fibrillation without showing the etiology, list only one cause on each line
: Approximate interval
: OnsetloDeath
26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation or Donation?
)d Yes 0 No
Parlll: Enter other sianificanlr.onditions contribubna to death
but not resulting in the underlying cause given in Part I
2B. Did Tobacco Use Contribute to Death?
DYes 0 Proba~y
o No 0 Unknown
29. If Female
o Nol pregnant within past year
o Pregnant al timeofdealh
o Nolpregnant.butpregnantwllhin42days
of death
ltems 24-26 musl be completed by person
who pronounces dealh
24 TimeolDeath
2:10
P.
25, Date Pronounced Dead (Month, day, year)
June 28, 2006
=d7t~t~;e~~tn~~; ~;~~ disea~
Gunshot to Chest
Due 10 (or as a consequence of)
Seq~entlally list conditions" if any.
~~~~~o ~NDE~t~NGn ~~t~E
(disease or inlury that initialed the
e'leots resulhng In deattl ) LAST,
Due 10 (or as a conseQuence of)
DYes DNa
31 MannerofQeath
o Natural 0 Homicide
o Accident o Pending Investigation
~suicide D Could Nol be Determined
gunshot - handgun
o Not pregnant, but oregnant 43 days 10 1 year
of death
o Unknown if pregnant WIthin the past year
32c Place of Injury Home. Farm. Street, Factory
Office Building, etc. (Specify)Home
Due to (or asa COfIsequence ofl
30a Was an Autopsy
Performed?
JOb, Were Autopsy Findings
Available Prior to Com~elion
of Cause of Death?
2:10 P'M
329. Location of Inlury (Street. city ItOWl1, state)
Edgewood Dr.,Mechanicsburg,Pa.
DYes ~o
32d, Time of Injury
33a. Certifier (check only one)
~:~~:I:~~~~a;n~;f~~~:~ :~i~~c~~: ~fu~e~~;:~~u~~~)e~~~y~~~~e~~sP;~~~~~ ~e~t: ~~ c~:p~e~d_lt~~ 2~)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _lJ Cor 0 ne r
~~Ot~:u::~~~:: ~~:~~:~J:~~~a~~~~~~~~ :~ht:~~~~i,n;n~e=::;da~~r1iZ:gl~OI~~u~;~:~~~d manner as statld_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _..D 33d Date S~ned (Month. day. year)
Medical Examiner I Coroner )Q1' June 30, 2006
On the basis of examination and I or investigation, in my opinion, death occurred al the lime, date, and place, and due 10 the cause(s) and manner as stal'!t!. _ ~ 34 .,N,aijle 3Qd Addre!is of-ferson 't/f'IO ComplfJted Cause....Qf Dealh (1Iem 27) Type I Print
, . M1Cnae~ L. NOrrlS, ~oroner
35 egis. 'JOatureaod"1'~.\\'~ u"'!it-'. . 36.o'teF'IedIMonl,/,y,yearl 6375 Basehore Road Suite 111
~ ~n"l ////t',,(~.atlc;, .,.C,. ~ II ...('1 / II "7// /',l t>tJ C Mechanicsburg, PA 17050
(See instructions and examples on reverse)
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