HomeMy WebLinkAbout08-01-06
Register of Wills of Cumberland County
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of James P. Miller
also known as
No.
To:
\\
.:-...;~ '\
C l.
(Ii
"/'"",,
1\,.-;
, Deceased.
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
Social Security No. 169-44-6304
The petition ofthe undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl ies
for litigation purposes only
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
for letters of administration
on the estate of
,-,-~
Decedent was domiciled at death in Cumberland County, Pennsylvania, with h~ last family or principal
residence at 81 Linda Drive, Mechanicsburg, PA 17050
(list street, number and municipality)
Decedent, then 48 years of age, died August 20
81 Linda Drive, Mechanicsburg, PA 17050
,20 OC
, at
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
(Ifnot domiciled in I'a.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ -0-
$
$
$ -0-
Pctitioncr_ after a proper search ha~ ascertained that decedent left no wiU and was survived by the
following spouse (if any) and heirs:
Name e atlOns 10 eSH ence
Phyllis Susan Miller Widow 81 Linda Drive, Mechanicsburg, PA 17050
Devon Marie Miller Daughter 81 Linda Drive, Mechanicsburg, PA 17050
Cory Brent Miller Son 3549 Green St., Camp Hill, PA 17011
Kalin Renee Miller Daughter 81 Linda Drive, Mechanics-burg, PA 17050
R I
hi
R . i
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form
to the undersigned.
Signature(s) ofl'etitiQner(s) Residence(s) ofPetitioner(s)
~~~'l'''''~~~'- 81 Linda Drive, Mechanicsburg, PA 17050
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
County of Cumberland
SS
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 ofpetitioner(s) and that as personal representative(s) of the said decedent petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affmned and sub-
,- ('
~4~~~"L~~~~,
'--
scribed before me this day of
",\ i-\l)(( ~ -\ , 20 06 ,
l. '-\1 C I \{ (U -~ J; IlL \ Jt k'....b0t ~\.., ;t' I
For the Reg' er f ytJ'G./
Estate of
No. ~ \ ' ('XC': ' Cle'! t)
James P. Miller
, deceased
.(
AND NOW
hereof
GRANT OF LETTERS OF ADMINISTRATION
j f-fL \~J ( ld 20 06 , in consideration of fb.e petition on the rev~ side
satisfactory proof having been presented before me.
IT IS DECREED that
Phyllis Susan Miller
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to
Ph Y llis Susan Miller
in the estate of
James P. Miller
and bond, ifrequired, fixed in the sum of $
is approved and filed.
Documents Attached:
Bonds $
[]
\', \
t i"l ! '1\ I' .
~'J\'"
Rcnunciation( s)
--', "7\
....J..C (: l'
kl.O
.J -v
\,'
')\ \\1 t
. \(: \'/
\ t
t-, : (
i L' V{)
, If./
)
(0
'1-~)
717-238-2000
Phone
I"
UC~!l I\,,_'~l \
C..; rii'iL'atc' \VIJ
rUl ...:Crr!fll";Ui
,k
." -.
\_-'\.C ! t
'\ h 1(-, \. ..ruh rh~lf the infurlllanOl! lh::Tl'
I'C'I
1\ t'";ll
WARNING: It is illegal to duplicate this copy by photostat or P,'lotograph.
q
:I, ,
t-,\.,
" ) ,\
ill.' .:;i; I ~;~'" r'~' ~;-- ;:.::,,__
",\\\1.\' .-"'ft,:-."
/~.~/ ~.' '<)~';.\
~.~. .... ;~;~'. . " ~~'
~_ * (' .:, ;?t- '...""'"',j'. ..;~
'~ . ".~"
\...~.. ~~\'.\>,/
", ~;".. .:\,.~~,.,\
"':;!;Y~~I \\\ t\ ."
<'2: ::::!; ~,:!,( ~,-,~:. :~: ~!>I_,
.~
-f: j/ ;) 7~ '~"
't/f~.Ll'-:GIf:.z.:..::...~i 1.':'.r:;~ -._? -V-~..~
, ;' ..r / //
l> V
")
r
C--7 r. ;:; rJ II 1
otb4(t-\.....
>"("
4/~
'-.j
??3, dd~1a_
(.
'J:)
Hl05 144 Rell 1/9\
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
TYPE/PRINl
IN
PERMANENT
BLACK INK
~
<(
z
SlATE Fll E NUMBER
SEX
SOCIAL SECURITY NUMBER
p
Miller
2.
Male
3.
169-.44-6304
DAlE OF OEAfH iMu.,tI D,,>y ""..'I
August 20, 2000
UNDER 1 YEAR
Days
UNDER 1 DAY
Hours
CITY, BOA
PLACE OF DEATH (Check only olle see II,SlruU'or'~ r)Il<)II,e( ..;,lle)
HOSPITAL
Inpallllnt [J
..
FACILITY NAME (It 1101 ",stLlul,un <d,',a S118CI ol1U nun1tJel)
~~~P~A~:f~I;'I(g'~~;;~)
Cumberland
White
_DECEDENT'S USUAL OCCUPATION
((";",'e ",lOd 01 work de'le dUllng [(lust
ot wOIking hfe, 00 not U5e I"tlfeci)
". Sa 1 esman ""Reta i 1
DECEDENT'S MAILING ADDAESS (Slrf:let CII'I/Tow(I, State Zip Code)
Linda Drive
,. Me c h ani c s bur Pal 7 0 5 5
FATHER'S NAME IF",;!, Mllldle Last)
Miller
SURVIVING SPOUSE
.1I",Lt"" 'J"";!!",mle"lldrn"l
Food
DECEDENT'S
ACTUAL
RESIDENCE
(See,rlslrucIIO(lS
UIlO!!I!;!15,ddj
14 15 Phillis Flea le
17c.!i(] Yes,decedenllrvedin_~J~.l:__~[:!r_L!lL____._. _____twp
17b.Count
Cumberland
17d.O ~i(:h~e~~I~~~:/::j~~ot
(,ty/bolo
~
=>
'"
"
~
17088
LICENSE NUMBER
22b 012662-L
PA
23a.
TIME OF DEATH Aprx.
2.. 1:00 A. M 25 August 20, 2000
27, PART I: Ente/the disease!>. injuries or complications which cau5l;ld the death Do not enler the mode at dying, such as cardiac or respiratory arrest, shock or heart failure
LiSI only one cause on each line
DATE PRONOUNCED DEAD jMollltl. Day, Year)
23b. 23c.
WAS CASE REFERRED TO MED,5Al EXAMINER/CORONER? . _ '
YasJ&J. . Nur
26.
: Appwxll-nal8
ilnterval between
,~':.' 0""""" de..:
,..1i.eY~1:.e.. Thre~-V~ss~l.J;Qrona!,Y,Artery Disease ,_ .
DUE TO (OR AS ACONSEOUENCE Of)
b'-DUEro(ORASACON0E()U[NE;oT)-~----"._----~-~----~---t~--
d -'DUETOIOR'A'SACO",iCllJiiiCiOici ..----, ~-. -----.------l~----
WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY
AVAILABLE PRIOR TO {M,~,,,n, U"y y"",)
COMPI ElION Of CAUSE
OF DEATH"?
PART JI:
Olher sJgilllicant condit,ons contrlbut,ng to death, but
nol resultIng In the underlYing cause gIven In PART 1
Ye" ~ No rl
yo, }X
No [I
A(,;ciotlnt
Penulfl\:jln"..stlgatlon
Ii
! 1 3Q!c.__ ..~__ n' ____~___ 30b.._______.
PLACE 6F lNJtmV. At home, larm. strl:ll:ll, lac/ory, ol/io;;o
l_ J btJIIJing,l:lIC (0",,,uly)
30.
INJURY AT WORK?
DESCRIBE HOW INJURY OCCUHREO
Natural
~
r-I
U
HomlCloe
Ye, LJ Nol J
28'1. 28b
CERTIFIER (CtltKk (,1,1', one)
'CERTlFYING PHYSICIAN l~'tlySLt:I<\" U;lll,tyulg c:....'''Ai ul utJdltl ""r'ell d,,,,II',,,,1 ~,I''y~'':I,,,\ I'd" fiIU'luu"",,,j d'c.;II,...., ,I,
To the best of my 61nowledge, dellth occuf"f"ed due fa fhe coltuee(s) and mBnne, BS slBled, ,
SUICide
2'
COU!Oilot btlO"t",lilllfled
'MEDICAL EXAMINER/CORONER
On the basi. of examination and/or Investigation, tn my opinion, death occurred at the time, date, and place, and due to the cause(s) and
m.nn~r as .tBr~d..
31'1.
AEGIST
~421
U " Coroner
L,',CcENSEN BER ~'-S~~;~~'~'[J'2~-:,;l) 200~~~.'.
LJ NAME ANo'ADORESSOFPEASON WHOCOMPl Ef.1i'(;AUSE~OFDEA"t------- '-.-
(Ilern 27) T)'peorPrint Michael L. Norris, Coroner
\A 6375 Basehore Road, Suite #1
~_ Mechanicsburg, Pa. 17055
DATE FILED (Muntll DdY Yeal)
'PRONOUNCING ANDCERnF'fING PHYSICIAN WiltSI,'ldrL ["Jlt, P'()Il""IICUly <.k"lr, eu"j "ell,I,''''') 10 Cd';~,c <)1 ,t",,1111
To the best 01 my knowledge, death occurred at the lime, date, and place, and due to the cause(a) and manner as slated
34.
11)5 r ..i i ,l 0 (J n
/