The URL can be used to link to this page

Home My WebLink About07-18-06 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Anna Elizabeth Moerschbacher also known as No. To: "\. . '. I '.' I 1 .)\ \ l. ~~ u..,L 1 J Deceased. Register of Wills for the County of C ~i ,1,1 B L -rZ-i/,IHV () in the Commonwealth of Pennsylvania Social Security No. 208-14-3046 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl lies for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 100 Mt. Allen Drive. Mechanicsbura (list street, number, Twp. or Boro.) Ii < ,,? 7 Decedent. then 83 years of age, died . - t"'; 1! .t. J 21- D ( ./ at Messiah Villaae. Upper Allen Township. Cumberland County Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (Ifnot 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: $ $ $ $ 5 000.00 Petitioner after a proper search ha S the following spouse (if any) and heirs: ascertained that decedent left no will and was survived by Name Relationship Residence 136 N. 26th Street Marv Elizabeth Hooner Dauahter Camo Hill PA 17011 3709 Falkstone Drive Joanne Edwards Dauahter Mechanicsburn PA 17055 332 Stetler Avenue Raloh C. Moerschbacher Son Selinsarove PA 17870 " ... .. .. , j c.. ,., THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the appropriate form to the undersigned. reoIJR,!!-~ "Ralph C. oerschbac er 332 Stetler Ave.. Selinsgrove, PA 17870 -- '" ~ <l) u = <l) ~~ <l) '" 0:::';::;' <l) -0= la .g ~.- ~~ <l)p., ....'- ~ 0 = OJ) Vi OATH OF PERSONAL REPRESENTATIVE cOMMONWE~THOF!PEr;rSYLVANIA } ss COUNTY OF (\, ty,b\)Cu-V The petitioner(s) above-named swear(s) or affmn(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 subscribed before me this. (~(. .'. . '. d. ay of \. ' : 1 . .),"". ....~ \ ,,/ L L/~ ~ ' '-~. 'd,lh 'In,~. \UJL. 1.(';.l 'Riiz' ? '<' <'fJ..'-r ~lster {~ f?C4i(1.t~/1lJl-;-- '-'.. '" "- ;:: 'e s::: .::!J CrJ No.) \ C (c Q k~j!-ll Estate of Anna Elizabeth Moerschbacher , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW , in consideration of the petition on. the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that :'::) ( .. is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to in the estate of Anna Elizabeth Moerschbacher l,l'iiLr0&:l -1{LJLt (,-,Jt'\:c llu it ~ Register of Wills " P'- (f" (t I Filed. . . . . . . $ $ $ $ TOTAL _ $ . . . . . .. A.D. ot3r) FEES Letters of Administration. . . Short Certificates ( Renunciation. . . ) . ADDRESS PHONE RENUNCIATION Estate of Anna Elizabeth Moerschbacher No. J\ \...J also known as , Deceased The undersigned, Mary Elizabeth Hooper, Dauqhter (Relationship) of (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters Administration be issued to Ralph C. Moerschbacher Witness her hand this I &/4, day of July >' 2006 U _/~(:.9~A(sf#, ~ Mary zabet Hooper 136 N. 26th Street, Camp Hill, PA 17011 (Address) (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed ,) ., '(r.'/7 before me this " " 'J day of ,. /7 ( { L. Cr NOTARIAl SEAL HEID~ M. NELSON, Notary Public Mechan/csburg Bora, Cumberfand Co My Commlssloi't ExpIres June 27, 2007 .' j ( ,'1_1 ,d--I{.~~, '(II ilk ,(;:.'/7 Notary Public My Commission Expires: ! ! r'~) C, (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 RENUNCIATION Estate of Anna Elizabeth Moerschbacher No. :A r,{, ,,-.~ t \.vi"~ \ also known as , Deceased The undersigned, Joanne Edwards, Daughter (Relationship) of (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters Administration be issued to Ralph C. Moerschbacher YhA v Witness her 2006 JJ ) ~o/ (Signature) anne Edwards 3709 Falkstone Drive, Mechanicsburg, PA 17055 (Address) (Signature) (Address) (Signature) , ~:- " ") (Address) Sworn to or affirmed and subscribed '\;-<<1 J ~ "J before me this day of r"(I, I / ,. / .rflr ~i " ,(/ / , , i ,.' ( Notary Public My Commission Expires: ,. ,',. / ./('('{j' , ..I '/II,Jld -/.,}.{. k;/( NOTARIAL SEAl. i HEIDI M. NElSON, Notary Public ,1 Mechanlcsburg Boro OJmbertlnd Co L~!.Commlsslon ExpIfes June 27, 2007 ;"~) C'I (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 ! L ~< ((.;.' I) 1241'" lO? .1.. 1. v..... ~ ,~~,' ,~".fJl"'~~---i/'!_: P I 900l I 0 A'v'W '\ 1 ) J ') i, ,,; Rev 01/06 'RINT IN ANENT ;K INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER (1\ 1 Name 01 Decedent (First. middle, la51) Moerschbacher I ~;:ale 13 SO"~S~C:NU~b: _ 3046 Under 1 day 7 Oat.:!ofBirth MOrllh,dav, ear 8 Birth lace {City and state or foreignr:ountrvl Sa PlacEofDealh Checkonlvone Hours I Minutes I I !HoSPital ~_Oth~J: AUQCust 8,1922 Reaovo. PA 0 '0"';'" 0 ERlOul all,,' 0 DOA 1~"coHome Be_ City, Soro. Twp or Death IBd FaCility Name ,ilf not ir1S,litlJ,tion, give sTreel an,d nurnber) 9 Was Decedenlol Hispan~ Origin,' 'l -)1 II?! f! No 0 Yes (I/yes. Specify Cuban, Cumberland Upper Allen Township '/l/--?:;J/Jiafi/ {~a~ M,,,cao, Puerto R<ac,'lq 11 Decedent's Usual Oc~lion Kind 01 work done durin most at workinl1 life; do no! slate relired 12 Was Decedenl ever in the US 13 Decedent's Educalion '$peci only hi hesl ri.lde correleted 14 Mar~al Slatus. Married, Never married, 15. Surviving 'Spouse (If wife, !:jive maiden name) Kind of Work I Kind of Busines$.~ndus\ry Armed Forces? I ElemenlarylSecondary (0-12) I College \1.40r 5+) Wkiowed. Oivorced (Specify') Homemaker Domestics 0 Yes Xl No 12 Widowed ; 16 Decedent's Mailing Address (Streel.city!lown, state, Zip code) ~~:~~n~:idence 17a State Pennsylvania .__ ~~e~:~edenl 17c. rx Y9S,OeLedentLivedin Upper Allen TownshiR.- Twp, l 100 Mt. Allen Drive Tow"sh~' 17d. 0 No, Decedent l~led within Mechanicsburg, PA 17055 17b, co""~ Cumberl:lnd - AclualUmrts01 Anna Elizabeth 14. Date of Death (Month, day,year) April 27, 2006 83 Yes 6 Under 1 vear I Months Days o Residence 0 Other. Soecilv 10, Raca: American Indiarl, Black. While. ale (Specify) White 5 Age (Last birthday) 8b CountyofDealh CitylBoro 18 Father's Name (First. middle,last) 19 Mother's Name (Fits!. middle, maiden surname) John Andrew Ropyak Elizabeth Litavic 20a, Informanl's Name (Typelprint) Ralph C. Moerschbacher 20b Informanl's Mailing Address (Street. city!lown, state, zip code) 332 Stetler Ave., Selinsgrove, PA 17870 ~ 21a. Method of Disposilion 21b. Dale 01 Disposition (Month, day. year) ~ ~ ~~~: _ spec~: Cremalion 0 Removal from Slale 0 Donation Ma vI, 2 006 ~ 22a, Sign~l?r~ 02:2:~ S~!:",ice Licensee (or person acting as such) 122b License Number i -Y'\"'<z.~n.14<-<>---_ FD 012 848 L ~ Complete lter$-23a-c onry when certifying 23a To the besl 01 my knowledge. death occurred althe time, dale and place slated. (Signalure and lille) ~ ~:~~;~;:en~; ;;:;~ble at lime 01 death \0 Gate of Heaven Cemetery I 22c. Name and Address 01 Facility Parthemore FH Ipo Box 431, New Cumberland, 23b. License NurrtJer I ~:~:I:(C:::~':'Z::. PA & CS, Inc. PA 17070-0431 23c Oaie Signed (Month,day, year) 17055 21c. Place of Disposition (Name of cemelery, cremalory or other p~ce) ~ Items 24.26 musl be compleled by person . whopronouncesdealh " T;me 0' 0:; Lo 30M, 125 oa/J:;:'~'~;~ daY;1 0 cCa CAUSE OF DEATH (See Instructions and exampkfs) / Ilem 27, Part I: Enter the chain of events - diseases, inluries, or complicalions -that direcl~ caused the death. DO NOT enter terminai events such as cardiac arrest. respiratory arrest, or ventrK::ular fibrillation without Showing the etiology. 00 NOT abbreviate. Enter only one cause on a line. 26 Was Case Referred \0 a Medk:al Examiner/Coroner" o Yes ~ No : Approximate inlerval Partlf: Enter other sianiflcanl conditions contributina to dealh, 28 Did Tobacco Use Contribute 10 Death? 'onsellodeath but nol resulting in lhe undertying cause given in Part I 0 Yes 0 Probably g....-Mo 0 UnKnown IMMEDtATE CAUSE (Final disease or condition resulling in death) ----7 a yobaJo1c: /YJeL{ mOIL1 i c:t.- Dueto or as a consequenceoD' -=l{vvetiLl {on(lesh\~ t1LUrl- 29 ~l:~egnanlwrthinpastyear J .-f-C,( ,. 6 J--e, 0 Pregna'1t at time of dealh C./7vV n "COli~iLch ~ 0 ~Io~~~~~nant. but pregnant withll'l42 days _ '}1 f...i /rJ--1 0/1/.:( ri..4 rJ,Se..t: J.<..o Not pregnarll, but pregr.<lnI48 days to 1 year II. _,~ beloredealh ~ A I / h 5 "..( <{h C4 -c; YlLA.j' 0 Unkn:Jwn 11 rre\jnanl wrthin the past year 32c Place of Injury: Home, Farm. Street. Factory, Office Building, etc. (Specify') Sequentially list conditions. ilany, Ii leading 10 the cause listed on Line a 5 Enter the UNDERLYING CAUSE n ~~~~~ss~e~~~~~~nt~~t~~h~i~~~~e 2 Due 10 (or as a consequence oQ Due to (or as a consequence 00 DYes ~ d 30b. W~re Aulopsy Findings Available Prior to COfT'(llelior. of Cause of DeatlJ,Y DYes Mo 31. Man~Death 19"Nalural 0 Homicide o Accident 0 Pending Invesligation o Suicide 0 Could Not Be Determined 323. Date o! Injury (Month, day, year) I 32b, oescrib, how loj'ey 0<000';' 30a. Was an Au!opsy Perlormed? M 132e Injury at Work? DYes 0 No 321 If Transportation Injury (Sped!;? o Driver/Operator 0 Passenger o Pedestrian 0 Other - Specify: )~a~'2?~;:;j, ~~ 33c License Nurmer ,....... - I'YI() LjJ ~- L/ 75 32g. Localioll (Slreel,cityl1own, slale) 32d. Time ol Injury 33a. Certlfjet{check only one) Certifying physician (Physician cer1ifying cause or death when anolher physician has prorlounced death and completed Nem 23) To the best 01 my knowledge, death occurred due 10 the cause(s) and manner as stated.... Pronouncing and certifying physician (Physician both pronouncing dealh and certifying 10 cause of death) To the besl 01 my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner as stated..... ... ..........................................0 ",umq/' 33d, Date Signed (Monlh.day. year) iN - ;;('7- ;;( () 0 4> Medical examiner/cotoner On lhe basis or examination andlor investigation, in my opinion, death occurred at the time, date. and place, and due to the cause(s) and manner as stated ........0 ~~""SS;9:;D.i21 I ~ I eoll / I~ 1/ I / I I 36;/;/"'h;;;C tT (See instructions and examples on reverse) 34 Name and Address or Person Who Completed Cause or Dealh (Item 27) TypelPrinl .;:541:'-1'1 H NO D ~ e4H S H /Yl C> 100 m r /h-l-€ tV px. I ve: fh6CHI"'rIVIC5/S0",-6- 1""/-1 / 70 S-<;:'