HomeMy WebLinkAbout08-01-06
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
PETITION FOR GRANT OF LETTERS
Estate of CLARENCE W. TOOMEY, JR.
also known as CLARENCE W. TOOMEY
No. 21-06- "V/7'2)
, Deceased
Social Security No.
VIOLET ROSE MURRY
Petitioner(s). who is/are 18 years of age or older. apply(ies) for'
(COMPLETE "A" OR "B" BELOW:)
o
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut
Decedent, dated and codicil(s) dated
named in the Last Will of the
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 incapacitated:
GJ
B. Grant of Letters of Administration
(c.la., dbn.cla.: pendente lite, durante absentia: durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I Name Relationship Residence I
SALL Y J. TOOMEY SPOUSE 103 WAYNE AVE. E. PENNSBORO
DIANA TOOMEY DAUGHTER UNKNOWN
",
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. )
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or princip~L
residence at 103 WAYNE AVENUE, ENOLA, EAST PENNSBORO TWP., PENNSYLVANIA
(list street, number and municipality)
,2006 ,at Specialty Select Hospital, Carlisle, PA
(Location)
Decedent, then 55
years of age, died July 24
,."1
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 ............... ................... .................. $
Total.............................. .................... $
'OJ
. :"1
10,000.00
50,000.00
60,000.00
Real Estate situated as follows:
103 Wayne Avenue, Enola, PA 17025
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
I
v
l. / . /
/(i.j-.y/.. /J//U~d
/
Violet Rose Murry
608 Thrush Court, MechanicsburQ, PA 17055
''/..
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Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and 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 ay~OTding to la~. _
j. t /(I I- t- ~;:[.. ~ 4),
Sworn to and affirmed and subscribed / .... ......0 '- 1-<-,)/1
'Violet Rose M6rry
before me this 1 st day of
DECREE OF REGISTER
Estate of CLARENCE W. TOOMEY. JR.
also known as CLARENCE W. TOOMEY
Deceased
No. 21-06- () ([! '13
Social Security No: Date of Death:
AND NOW, \-\:\)(J~~sr \ , J-GC\.v , in consideration of the Petition
on the reverse side hereon, satisfac ry proof haVing been presented before me,
IT IS DECREED that Letters 0 Testamentary rn of Administration
1"\ ..,... (c.I.a., d.b.n.c.t; pendente lite; durante absentia; durante minoritate)
!. . \-,.(" .,. \
are hereby g ranted to \, \ \.. \ ~ '.' \ \. C ~ \ \ LU Y;'l,j
in the above estate and that the instrument(s), if any, dated ~\~\G~\l~\ \ ',fc,b[;
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
Letters ......
$
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\.JJtJ0a- aLl u: / c . I (i-..Ji;(CI,(,{
Register of Wills
r'C.'C.S
0'7
Short Certificate( s) ...........:?..
$
$
$
$
$
$
Inventory & Tax Forms............. $
.-GtIier ......A~::..{.~;................... $
Renunciation......................... .
12.-0[:
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Extra Pages (
) .......................
)........... ..
(7
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Affidavit (
t2.A.~..z 74/ ~
Attorney
Codicil .................................
JCP Fee .................................
I( CD
':;>- DD
Attorney: Gerald J. Brinser
1.0. No: 09655
Address: 6 E. Main Street, P.O. Box 323
Palmyra
Telephone: (717)838-6348
DATE FILED:
PA 17078
TOTAL............................ .$
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or
12626248
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JUL.
Rev,01h16
'AINT IN
ANENT
:K INK
1 Name of Decedenl (Firs!. middle, las,)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
Clarence w. Toomey Jr.
3 Social Security Number
194 42
July 24, 2006
55
Yes
7. Dale 01 Bir1h (Monih, da'.
12/7/50
<I Dale of Death ('.1coth. day. year)
5 Age (Laslbir1hday)
Cumberland
o ERlOut alien!
8<1- Facility Name (If nol instrtulion, give street and number) 9
Specialty Select Hospital
Cther
o DOA 0 NUfSin Home
Was Decedent 01 Hispanic Origin?
XI No 0 Yes (H yes. specify Cuban,
Mexican, Puerto Rican. elq
o Residence 0 Other. S cift'.-
Hl. Race: ,o..merican \nolan. Blade \Vl1i1e. e!c
(Specil)1
white
8b CountyofOealh
11 Decedent's Usual Clew atiorl Kind of work done durin most of workin life; do not state relired
A u to Kintsfa:or t s NI(A~ AineSsJIndustry
16 Deceden1's Mailing Address (Streel, cily/town, slate, zip code)
103 Wayne Ave.
Enola, PA 17025
13- Decedent's Educatiorl S eei on hi hesl rade co leled
Elementary/Secondary (o-12) College (1-4 or 5+)
U K
Pennsylvania
14. Mar;lal Slatus: Married. Never married.
Widowed, Divorced {Sped!}1
Married
15. Surviving Spouse (l:wiJe. give maiden name)
17a. Slate
Did Decedent
Liveina
Township?
17cJCI
Sally Harring ,
--1
Yes.O,,,,,,'L'ed'" East Perlnsbo!:o .. T"Jl I
No, Decedent lived within 1
AclualUmltsof __ ________ Crtv/Bom I
17b. Counly
Cumberland
17d.O
18 Fether'sName (Firsl. middle, lastl
Clarence W. Toomey Sr.
19. Molher's Name {First. middle, maiden surname)
Violet M. Lilley
Violet R. Murry
20b. Injormanl's Mailing Address (Street city/town, stale, zip code) 6 0 8 Th r u she t .
Mechanicsburg, PA 17050
202, Irlformanl's Name (fype/print)
o Removellrom Slate
o Donation
21b. Date of Disposition (Monlh. day. year)
7/29/06
2k Place 01 Disposition (Name 01 cemelef)', cremalory or other place) I 21d. Location (Cily.llown. slale. zip code)
Salem U.M. Church Cemetery I Etters, PA
22c N,m,,,'Ad',essolFacilily Sulli van Funeral Home
51 N. Enola Dr. Enola, PA 17025
23b Li"",, ""mh" 1230. 0", Si,oo, IMoolh."n""1
26. W-cs Case Referred to a Medical Examiner/Coroner?
o Yes ~o
(o pels~:~cting as S;5h) . rl/l' 22b_ ucense Number
...~J7:i;r;r~~ FD014993
23a To the besl 01 my krlowledge, death occurred at the lime, dale and place sialed. (Signalure and fme)
II ems 24-26 must be completed by person
who pronounces death
24 Time of Dealh
4: 36 P M
25 Date Pronounced Dead (Morllh. day, year)
July 24, 2006
CAUSE OF DEATH (~instructions and examples)
: :~~~~~::I~nteNal' I :~t n~t ~;~~;I~I;~~ ~~~n~~ae~:y~~~~~~~: ~~~~;~~:r11~. dealh,
28 Did Tobaq:o Us.;.,Contnbute!o Death?
o Ye3~rcbably
c; N::J 0 Unknown
Item 27. Par11 Enter lhe chain 01 events - diseases. injUries, or complications - thaI direclty caused Ihe dealh. 00 NOT enter lerminal events such as cardiac arrest
respiratory arrest, or ventricular fibrillation withoul sho,wirlg Ihe etiology. DO NOT abbreviale nler orl~cause on ~ ]:ne.
IMMEDIATE CAUSE (Final disease or l~ e. . ~ e... cP--b We 7\
condilion resulting in dea1h) ---7 a t:-.
0;;;;; (;as "0 , ~~ - '- ~. / .
Sequentially fiSlcondilions, ifany,
leading 10 the cause tisted Orl Line a
Enler the UNDEAL YING CAUSE
(disease or injury lhal inilialed the
events resuning in death) LAST
30a. Was an Autopsy
Performed?
31. Manner 01 Death
~Jfal 0 Homicide
o Accident 0 Pending lnvestigalion
o Suicide 0 Could No! Be Detennined
32b. Descnbe how Injury Occurred:
29 HFerr.a!e
o Not pregnar.\....1.hlil past year
o Pregnanl at time of dealh
o Not pregnant. bui plegnant ',vnhin 42 days
ofdealh
o Not pregnar.L but pregnant ~3 days to 1 year
before dealh
o UnJmown if pregnant within the past yeal
32c_ Flace ollniury: Home, Farm. SIJeel. Factory, Office I
Building, €Ie. (Specifj1
Due 10 (or as a consequence 00'
Due 10 (oras a consequence 00
DYes "'NO
,
30b. Were Autopsy Findings
Available Prior 10 Completion
of Cause of Oealh?
DYes 0 No
313. Dale 01 Injury (Month. day, year)
321
32Q. Loc;:,tiCH} (SlreeL cityilown. slate)
33a Certifier (check oniy orle)
Certifying physician (Physician certitying cause of dealh when another physician has pronounced death and completed l1em 23)
To the best of my knowledge, death occurred due to the cause(s) and manner as stated
Pronouncing and certifying physician (Physician bolh pronouncing dealh and certifying 10 cause 01 death)
To lhe best of my knowledge, death occurred al the lime, date, and place, and due to the cause(s) and m;nner as stated_._..m
....~
\{2- L
33d. Dale Sigrled (Month. day. year)
7 2-) 0(,
I 32d. Time 01 Injury
M
...._..__...0
Medical examiner/coroner
On the basis of examination and/or investigation, in my opinion, death occurred at the time., date, and place., and due to the cause(s) and manner as stated ........D
35 RegZZst~ ignature and Dyicl Numb,..L...-
/;7-1 (/1 ,
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1,;21 lid I / I /'1
34 Name and Address of PersoJf'flho Compleled,pause QI P~V1 (lIem 27) TypeIPri.nl
't(. CO tt't: C'-'{ vI-{ "'::' r',,' C
L-1-7, '1 r ~ ~," /V 'x t" ::~O
,/~e ~ ~. (, . /7'0,) \,;)
(See instructions and examples on reverse)
j,:~.l.c; Fi:.Jb ~:4t:~'M
:j'.~)d.., WAGi\:k ,~ z:vWcRMAN
2" 7
REGiSTER OF WILLS
CuMBERLA.ND COUNTY, PENNSYLVANIA
RENUNCIATION
Estate of ~LARENCE W TOOMEY, JR.
also known as CLARENCE W. TOOMEY
~Jo. 21
06
c \J:, '7:) _
I Deceased
The undersigned, SALLY J. TOOMEY, SFOUSE .' .
(P.~IIl,'o~ship)
. of
(C!\p~(litYl
the above Decedent, hereby renounce(s) th~ right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION be issued to~OLET R9$E MURRY, SISTER OF DECEDENT.
Witness MY hand this '~'I J.;f- day of \.) u{y . 20QL.
via "'1 9- \ .1~37tU~
~ '9J\~ture)
103 WAYNE AVENUE
ENOLA PA_ 17025
(M1re5~)
(SlgnllturG)
(AOClr€:35)
(Sign;\lut8)
(Adcr~~s)-'
Sworn to or affirmed and subscribed
-U-
before me this .~ { day of
., ']..0.0 Iv
NOTARIAL SEAL ~.
JEAN BURSON, NOTARY PUBLIC
CITY OF ENOLA, CUMBERLAND COUNTY
MY COMMISSION EXPIRES JAN. 16,2007
N~l ry Public
CommilSSiorl Expires: f II L, /-:2-uO/
(S!9,,~tl.Jrl! and seal \)1 Nolary or other
official quallf:ee to administer oathS Show
da~ or e,)([.liratlon or Notary's commi~~Gn.)
NOTE: Renunel"fOi:S eX<lcuted outside t11a Office 01 Re;g'ster 01 Wills a"O
required if' some cOlmol,lo to be notarized.
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