HomeMy WebLinkAbout09-21-06
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
d \ - () lo- ct$~'d
Estate of URSULA N. FAILOR
also known as
No.
To:
Deceased.
Register of Wills for the
County of CUMBERLAND in the
Commonwealth of Pennsylvania
Social Security No. 194287614
The petition of the undersigned respectfully represents that:
Yourpetitioner(s), who is/are 18 years of age or older, appl ie.
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 113 SOUTH ORANGE STREET. CARLISLE BOROUGH
(list street, number, Twp. or Born.)
Decedent, then 91 years of age, died 9/612006
at 160 HICKORY ROAD. CARLISLE. MIDDLESEX TWP.. PA 17015
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 Pennsylvania
situated as follows:
NONE
$
$
$
$
12.000.00
0.00
0.00
0.00
Petitioner after a proper search ha .
the following spouse (if any) and heirs:
ascertained that decedent left no will and was survived by
Name Relationship Residence
160 HICKORY ROAD
PATIENCE A. ECKMAN DAUGHTER CARLISLE PA 17015
700 SALEM ROAD
ROBERT F. FAILOR SON ETTERS PA 17319
RECORDED OFFICE OF
REGISTER OF WILLS
2006 SEPT 21 PM 4:00
CLERK OF
ORPHAN'S COURT
CUMBERLAND CO., PA
THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the
appropriate form to the undersigned.
~caA/
. ATIENCE A. ECKMAN
160 HICKORY ROAD
CARLISLE
PA 17015
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }
ss
COUNTY OF CUMBERLAND
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.
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{ . PATIENCE A. ECKMAN
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Sworn to or affIrmed fd subscribed
~. efor methis . <;l da.YOf.
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No.
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RECORDED OFFICE OF
REGISTER OF WILLS
2006 SEPT 21 PM 4:00
CLERK OF
ORPHAN'S COURT
CUMBERLAND CO., PA
Estate of URSULA N. FAILOR
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ,J I ~-PO.n..h<J.- 2c:t{p , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that PATIENCE A. ECKMAN
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to
PATIENCE A. ECKMAN
in the estate of URSULA N. FAILOR
FEES
Letters of Administration. . . .. $ (.o~ '(j:)
Short Certificates ( )...... $ "0, cD
R .. $ 5cf)
enuncIatIon. . . . . . . .'. . . . .
~$ \5 (j)
1 l TOTAL_ $ ~d)
Filed. .q ~.' W. . . . .. A.D.
/
54 EAST MAIN TREET
MECHANICSBURG PA 17055
ADDRESS
717-897-4850
PHONE
15.805 REV 1/05
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
p
12727203
No.
d\-D~-()~~d
Hl05.1'3 Rev. OMI6
TYPEJPRIIIT II
Pf_HT
BLACK ilK
1 Nome 01 Decedonl (First, middle.lasl)
~ t\. ~P\' l'\..-t:~_~
Local Registrar
SEP
8 2006
Date
RECORDED OFFICE OF
REGISTER OF WILLS
2006 SEPT 21 PM 4:00
CLERK OF
ORPHAN'S COURT
CUMBERLAND CO., PA
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE RLE NUMBER
N. Failor
Ursula
5 Age (Last bl1"w:1ay)
91
Vrs
\ .
11. Decedents Usual lion of 'M)rk done durin rmat 01 ife; do not stale retired
Man~g~ent ept~~~fare
16. Docedont's Moiing _ (Slr0ll, oCyiloWn. Slall,'" codl'
113 South Orange Street
Carlisle, PA 17013
13. oocodenl's EducaIiDn
Elomenlary/SOCoodoly (0-'2)
12
PA
17b.COUnly Cumberland
19. MoI""'si.1ii~'nillnsu'G}off
18. Fat""" Name (Firsl _.Ia,I)
Clinton
Neff
200. Ini>rment., Nlma (Typelprill)
e
III 1.. .......IStaIUs: ....nied. _ ..._. 15. SutvNilg Spouoo (II wile. givl maiden """")
CoIIogo (1" Of 5+) Wldowod. _ (SpodI)?
Widow d
Old 0_1
Live III 11.. 0 V... ~ lNod In Twp.
T~?
l1d. eX No. Oecedonl LiYod _ Car lis 1 e
Actual Li'nIIs of Clyllloro
Patience Eckman
~ ~nrmfrcllJyit[)a.~II. 'i> code)
Carlisle, PA 17013
21d. Loc:allonl~. """. zUodl) 17 241
NeWVille, pA
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C Rermvallrom Slate
o Oonallon
21.. _I ol DiIpcolIon (No... 0' comolol)'. cronatory Of _ pIoco)
Prospect Hill Cemetery
~~~al Home Inc 15 Big Spring Ave
Newville PA 17241
111::
. ""'" 24-21i.....1 be COfI'IIIotod by_
who pronounces death.
24. Tlma 01 Dealh
25. Dale PlOflOUncod o..d (Monlh. day. YII')
September 6, 2006
4:25
PM
CAUSE OF DEATH (See InstRICtIons end eXlmpIes)
Hem 27. Pal! J: Enle11h& ~ - disB85AS. ~ries. Of cofTl)lications -thai directly caused the death. DO NOT enter terminal events such as cardiac arrest.
respitllory anElSl.. or venm:ular ftbriIalion wlhout showi'lQ the etiology. DO NOT abbreviatB. Enler only one cause 00 a Iin..
IIIIIEDIATE CAUSE (F...I _se Of - 1"(' AC ' . r-'-
_r~ind..lh) -7 a. ,(- v
DIle'" (or es I aqUoncIOQ:
r...-....l"
Due to (or as 8 consequence o~.
: .wwinllllln_t
: onset to death
Saq-ttlist _Ions. ~ Iny.
IeBding to the cause listed on Un. I
. Entor "'" UNDERLYING CAUSE
. (disoast Of inJlIV Ihat mlocl fhe
_MSUIIingindo8ll1)l.AST.
~"'~
b.
Due 10 (or as a consequence o~:
.311II. _ an AaAopsy
_mod?
o VIS }f No
d.
3lI> W... Aulopsy FIndings
_blo Prior to COn1>leIion
of CAuse 01 DedI?
OVISONo
32d. TInlt 01 Injury
31. ManntJofOealh
g,. Nolurll 0 Homc:ila
o _, 0 ~1....lIgalion
[J Suioill 0 Couil Net eo Doll_eel
321. Doll 01 Injury (Month. day. y....l
M
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Z
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331. CotII1Iet (chod< only 0001
CotIItyIng PhYIIc:Ian (Physician clr1i1ying cause 01 dealh when InctIIer physician has pronounced doelh ond c:o"1>lllod hem 23)
To the beSt at my knowledge, duth occUtTld due 10 the cause(st Inti manner ""ated .._..._........................__.......____
Pronouncing Ind certllylng physician (PhysiDian beth pronouncing doalh and e8llilyino 10 cause .1 d8a1ll)
To the....t of my knowledge. doeth <><<:UII'Od at the tlmo. _. aM plI<e. md duo to Iho ""wo(o) md ...n....... SIOIOd....._....__..__..._._.__........_....._C1
MedIc.1I UlImlnetll;..-
On tho basis 01 lo_n Ind/or in_ligation. fn my opinion. doelh occurred at .he lime. d......., pQce. Ind dw 10 lhe '"use(S) and 1lII1UW.. _--CI
36. oall FlIlId (Monlh. day. YII~
''6
.. ....................-_.__._...__tI
35. R
(See instructions and examples on reverse)
I.Q.II 1&1 \ It) 1
23b. LiD_ N_
230. 01110 Signed (Monlh, day. Y"'"
26. W.. ColI FIalorrod 101 ModIcaI eu_lComntlf?
~V.. C No
ParI n: Enter obr !liIJnhnll!MdilkJn!l emlrbttiM to dMlh,
but ncI losuling in lha undarfying cause givM In Pert I.
2ll. Oil Toboo<o U.. Conkllu" to 0"1h?
o VIS 0 PlobabIy
CI No 0 UnkllOWll
29. II F....Ia:
o No! pregnanlllill1ln pasl yoe'
o Prognanlollinll 01 d8a1ll
C No!p<OgMnI.buIp1OO1l1nl_~d1ys
ofdUlh
o Not pregnant, but pregl'lllnl43 days 10 1 year
_I dealh
o Unknown ~ pragnanl wilhln 1Il1 put y....
321:. Ploca ollnjury: Ho.... Film, Slroel. FIClory. 0Ifice
Uling.alc.(~
32b. Ooocrilo '-Injury Qa:""od:
32;. Locdon ($-. oCy^""". slale)
Wittfam J. Phelan, MD:
2 T~1cr Court
Carlisle. PA 17015
3311. 0111 ~Monlh, day, year1 I
(.1' -1..3 (;
34. Nlme and Addr... of Person Who ~od eo... ol Dealh (110m 27) TypoIPrinl
,vt,;>o4 Z $" B r;
WiUlam J. Phelan, MoO;
Carlisle. PA 17015
d \- Dl9-0BQ
RENUNCIATION
In Re Estate of URSULA N. FAILOR, deceased.
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned, Robert F. Failor, son of the decent, hereby renounces the
right to administer the estate and respectfully asks that Letters of Administration
be issued to Patience A. Eckman.
WITNESS my hand this 20th day of September, 2006.
~;ZI~ .7 7~
RECORDED OFFICE OF
REGISTER OF WILLS
2006 SEPT 21 PM 4:00
CLERK OF
ORPHAN'S COURT
CUMBERLAND CO., PA
Robert F. Failor /'
700 Salem Road L' I 6'
Etters, P A 17319
COMMONWEALTH OF PENNSYLVANIA:
ss:
COUNTY OF CUMBERLAND
AND NOW, thisp1{)~ day of ~~"- , 200~ before me, the
undersigned officer, personally appeared Robert F. Failor, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the
instrument, and acknowledged that he executed same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seaL
I/Y;oJ ~ ~
Notary Public
..l. ...! j-, I
, NOTARlAL SEAL P blic
DEBORAH L. F\'f AN. NO~(cu~ber'and
Mechanicsburg Boro.. C.ountv 11 2010
My commission expires June ·