HomeMy WebLinkAbout09-26-06
....
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
James Reed Donithan ._. No. a \ ~ b\!)- Gtl\ j
Estate of
also known as
,Deceased Social Security No. 233-54-7115_
Roberta P. Gilley,
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 Testamentary and aver that Petitioner(s} is/are the execut _ named in the last Will of
the Decedent, dated
and codicil(s) dated
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 a victim of a killing and was never adjudicated incompetent:
f2l
B.
Grant of Letters of Administration
(d.b.n.c.l.a; pendente lite; durante absentia; durante minorilate
Petitioner(s) after a proper search haslhave ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
I Name Relationshio Residence I
Roberta P. Gilley DauQhter 767 Merritt Lewis Ln., Clarksville, TN 37
James R. Donithan, Jr. Son 408 Wren Court, Mechanicsburg, PA 17
042
050
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family
or principal residence at 408 Wren Court, Mechanicsburg, Hampden Township, Cumberland County, PA 17050
(list street, number and municipality)
Decedent, then 67_ years of age, died September 14 ,2006 I at Holy Spirit Hosp., E. Pennsboro Twp., Cumberland County
(location)
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 PAl Personal property in County
Value of real estate in Pennsylvania
$ 0.00
$ 0.00
$ .0.00
$ 0.00
situated as follows: nla
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 unde~:...:ign~d:
S ted name and resid nee
Form #RW-1 Page 1 of 2
Prepared by the Pennsylvania Bar Association 1991
..,.
Oath of Personal Representative
Cornmonwealth of Pennsylvania
County of Cumberland
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 Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this ~ I..n
~
.ld~~P1
No.
Estate of James Reed Donithan
Social Security No. 233-54-7115
And NOW,
Deceased
Date of Death: September 14, 2006
in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 0 Testamentary III Ot-Administration
(d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate
are hereby granted to Roberta P. Gilley
in the above estate and that the instrument(s) dated nla
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Lette rs ...............................
Short Certificate(s) ~..........
Renunciation .... ......... ........
Affidavits ( ) .....................
Extra Pages ( ) ...............
Codicil ........i".~JO.......
JCP Fee ...f-......................
Inventory.......................... .
Other................................ .
TOTAL .......................
$
$
$
$
$
$
$
$
$
$
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{). tj. o()
5' ' 00
111uvh:Jou /~JAdod2 eJd/
. Registeref Wills' '~a.<f
Craig A. Hatch, Esquire
76361
Gates, Halbruner & Hatch, P.C.
Attorney:
I. D. No:
Address:
1013 Mumma Road, Suite 100, Lemoyne, PA 17043
/5. oiJ
Telephone: 717-731-9600
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Form #RW-1 Page 2 of 2
Prepared by the Pennsylvania Bar Association 1991
05.~O' REV 1/(\'
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Regist:J:'ar. 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.
No.
-{~.. rflv,crJrl
Local gistrar
Fee for this certificate, $6.00
p
12835259
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TYPfNRlNT IN
PERMANENT
BLACk INk
1 Name 0' Decedent (FIst mIlkBe. IaSI)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
67
y,s
7 O.I.oll3l<1b _Ih. da .
4
OIher
o EAAlu lienl 0 DOA 0 Nwsn Homo
9 W.s Decedent 01 Hl$plnic ClJigin?
X' No 0 ~:~~P.:~.;~)
o Residence 0 OIne,.
10. Race Arne,.,." Indian,lIlack. _.IIC
(Speolll
White
James
; AQe Ilas' _YI
llt Counly ol 0..1/1
Cumberland East Pennsboro
11. Decedent's Usual Occ bon KIlld 01 work done dUrin mosl 01 worki ~'e, do not stale r.ti,ed 12
Kind Q1 WOI1i Kind 01 By,sinesSllndU5lry
Su erVlsor Steel
_ 16 Dec.denl's MaIlnO _ess (SIIe... ClIY.1Own S",Ie, Z!l code)
408 Wren Court
Mechanicsburg PA 17050
17. S"". . P A
17b County. .C !H!!b.~ r1 ~ !HI .
Did Decedent
liveina
Town~?
14 Ma,ial Slalus.Mamed. N.... mamed, 15. SuMvtrlil Spous.I" wife, giI. mardan name)
_WIll, DMlfcod 15I>ocdl1
Widowed
17c. If Yes. DecedOf1llwed in _ Ham p d ~.!1 Twp
17d 0 NO.Decedenllilledw1lhin
Actua' Linils ol
._._~ CIIY'BoIo
18. F.'h.... Name (F,sa. _. IaSf)
Luther Hall Donithan
19 Molh.r'. Name IF,st, _, maid.n .",name)
Doris Moore
lOa lnformant's Name (Type/print)
2Ob. Informan!'s Mailing Addre.s (Sk.e1, clyllown, sial., Z!l code)
Linda Dolan
897 Bucks Church Road Duncannon PA 17020
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21b. Dalo 01 0tsIx>s1lion (Monlh, day, yoar)
9-16-2006
21c. Place af OispDS'lOn (Name 01 cemetery. crema10ty Of other place)
Conolite Crematory
2td. lee.1ion (Clyilown. .tale. zip cod.'
Schaefferstown PA 170 8
22b. Li:efl68 Hulmer
FD-012662-L
22c. Name and Addrass 01 Facillr't'
MYERS FUNERAL HOME E MAIN ST MECHANICSBURG PA 1705
23b. License NUrrMI
23c Dale Srgned (_, day. yearl
25. Dalo Pronounced Td (_, y, Yeal)
q I 1-00 (.
CAuse Of DEATH (See lnslrucllonl and .....)
lam 27. Pan I: Entellhe ~ - dlsea$es, i1J,Jne5, or C~IlOns - that dileclly caused lhe dealh. 00 NOT enl8r Ienniflalevents such as cardiac 811851,
lesprak:lly &frest. Of ventri:uIar M>nllatlOn wfhout showilg the ehology. 00 NOT abbrevaale. Enlef only one cause on a line
=~o=t'::~~ a ._~--~...'dlQn___________ ..___.~~______.___
DUlIaI"....COIlSIqII<<lC.o~: ~L '
=~o~=~~~a ---- ~~l.2 ~ I'CilhcfLo,..
_ Enter tl8 UHDERl V"G CAUSE Oue 10 (or as a onsequ8OCe oQ
_ (disease 01 -..rr thai "lilted lhe
, evenli fBSUU\g in dealh) LAST
2ti Wu Cue A.lenad 10 a Medical Exarnn..JCoroner'?
I o. ~ ()
j/fYISONo
.6WrOlinale inllwal
onsello doalh
Pan n: Enl8f oIhar Aianifir..anl condlions NVlltbulM 10 death,
but nol resullnQ in Ihe underlying caus. gillen in Pan I
28 0.. Tobacco Use ConInIlult 100ea1h?
)liI..Yes 0 Plllbably
o No 0 IJnirtown
o Yes II1..No
d
:JOb W... AuIopsy Findrngs
AvaiAable Pfiollo Corq>lelion
of Cause 01 OeaU1?
DYes 0 No
31. Mal1l1OfolDaaIh
~lUral 0 Homicide
o Accidenl 0 Pending Iflveshgalion
o SUicide 0 Could Not Be Oeteullloud
32a. Da,. ollnJUI'/ (Monlh. day, year)
321> Oescribe how InJUry Oocuned
29 NFomale.
o Mol p,egnant wiIlin past yeaI
o Pr..,.,.. allrma 01 deelh
o Not p'egnant, but pregnant WlIhin 42 day>
oldeelh
o Nal pregnant. but pt'egnanl 43 days 10 t yea'
btlor.deelh
o Unllnown it pregna" wlhin lhe past year
32<;. Place 0I1njUfy: Home, Farm. Sllte1. Fac1r>Iy, 0Iic.
1lu*ling,IIC (SpeciI)j
oUe-to-(oi- ~s ~ -coo~;;eoce oQ
JOa WasanAutopsy
Per1olmed?
32d Time ollnjUf)'
32a.lnjufy al WOrk?
DYes 0 No
321
32~ location (Slroal. cllY.1Own, Slale)
3 rwt.~ ~ In-
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330 C_iet (ctWlC. only one)
Certifying ph~sici.an (PtIYSIl:L.llfl (ertitylfl~ cause olljettth when another ph~slCian has pronounced dflalll and cofl~leled Item 23)
. ;~::::-:':fa: :::-.;.:::7:::::7hl;:::~,::': :~h::;:~:~:c~~~:;~~:~;;m...m"7"7/"""""';<lk!(""";'....~...~u
To the best of my know""'ge, de.Jlh occurred Oil' the lime, d.ale. and pl.1ce. and due to lhe cause(s) and ma~~L.h.(,L,...~...............'!w!.fjd
. Medinl eummerJcoroner
On lhe ~Sls 01 eumiNlion and/or investtQiltion, in my opinKm, deillh occurred i1t lhe lime. date, and plilce, and due 10 the causetsJ and manne, as staled .........0
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(See instructions anit examples on reverse)
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34 N.meandMJ12:J:~S~~jYbTYP~M
3~"'~b{I.~ lJ#-
33<1 0.,. Signed 1"""'1/1. day. yearl
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.
Register of Wills of Cumberland County
Estate of James Reed Donithan
Also known as
RENUNCIATION
No. ~ \ - D \0 - O~l..\CS-
, deceased
To the Register of Wills of Cumberland County, Pennsylvania
The undersigned James R. Donithan, Jr. Son
(Name) (Relationship) (Capacity)
of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters of Administration
be issued to Roberta P. Gilley
Witness my/our hand(s) this
day of September
,20~.
Affirmed and subscribed before me this
day of
Notary Public
My Commission Expires:
Or
Affirmed and subscribed
~ day of
doou
,Xdo ~\J!i}--~
bt~o~ .
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission)
8 Wren Court
echanicsburg, PA 17050
(Address)
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(Signature)
(Address)
(Signature)
(Address)
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