HomeMy WebLinkAbout10-02-06
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Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
Estate ot Donald W. Bartoo
also known as n/a
, Deceased
No. 21-06-0800
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Register of Wills for the c~ 55
County of Cumberland in the =2 C~
Commonwealth of Pennsylvania; hi
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Your petitioner(s), who is/are 18 years of age or older, and the execut_ named in the lastwm ofth~..,)
above decedent, dated , 20 .u -i ..
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and codicil( s) dated .-- ( n
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Social Security No. 175-48-4390
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The petition of the undersigned respectfully represents that:
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(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Mechanicsburg, Cumberland
Pennsylvania, with h~ last family or principal residence at
240 West Simpson Street, Mechanicsburg Borough, Cumberland County, Pennsylvania
(list street, number and municipality)
County ,
Decedent, then ~ years of age, died January 5 , 20~, at East Pennsboro Township, PA
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after
execution of the will offered for probate; was not the victim ofa killing and was never adjudicated incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(lfnot 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: 240 West Simoson Street Mechanicsbura Borouah
$ 1,300.00
$
$
$ 24,000.00
Cumberland Countv Pennsylvania
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and the grant oflettersof administration
thereon.
Signature( s) of Petitioner( s)
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R~ster 'Of 1 I ,tJ;A t<} ~~ P" - 0/' )
q 0 0-. Mark W. Allshouse, Esquire
Attorney (Sup. Ct. LD. No.)
78014
4833 Spring Road, Shermans Dale, PA 17090
Address
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
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COMMONWEALTH OF PENNSYLVANIA
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The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petitio1}-.~irue and I..
correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) Mthe above ~
decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or ~ffirmed and s ~ {'~~ X~
Beforeme IS day of ___
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(IV J No. 21-06-0800
COUNTY OF CUMBERLAND
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Estate of Donald W. Bartoo
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
10 'J.
AND NOW
hereof, satisfactory proof havin
20~, in consideration of the petition on the reverse side
been presented before me, IT IS DECREED that the instrument(s), dated
, described therein be admitted to probate filed of record as the last will of
; and Letters are hereby granted to
Cathy L. Bartoo
FEES
Probate, Letters, Etc. ............. $
Will ................................. $
Renunciation....................... $
Short Certificates ( ). .. .. . .. .. .. $
JCP.................................. $
Automation Fee................... $
Bond................................. $
Total $
Filed /d /L / tJ --:-- 20
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(717) 582-4006
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The origina ccrtJ '1\.:atc wi ' ,
WARNING: It is illegal to duplicate this copy by photostat or photograph.
l'cc r.)r t h:, l'crt i ficalc, $h. 00
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
STATE FilE NUMIlER
TYPElPRlHT
IN
PERMANENT
BlACK INK
SEX
2, Ma 1 e
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AGE (List BirthdIYI
BIRTHPlACE (City and
Slate Of FOfelgn Country) HOSPITAl'
~ock Haven PA ::....[)
FACILITY NAME (If not illllilution, give slreeland number)
5, 5 0 Yrs.
COUNTY OF DEATH
Ib, Cumberl and
DECEDENrs USUAl OCCUPATION
(~~of~~u=:r
lb. I nvestment Brook 11b, Bank in
DECEDENrs MAILING ADDRESS (Sll8et, CllyfTown, Slate, Zip Code)
240 West Simpson Street
l~echanicsburg PA 11055
Bartoo
AS DECEDENT EVER IN
U.S. ARMED FORCES?
YesO Noij]
12.
HI, Slate
PA
SOCIAL SECURITY NUMBEIij
3,115 48-
DATE OF DEATH (MonIh. Day, Vllr)
,January 5. 2006
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RACE . American Indian, 1IIacI<, White,
(~qryl
10, >Wh i te
SURVlWlG SPOUSE
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lTc, 0 Yel, decedent lived in
Hb. COIJnlv
Old
-"nl
Iv. in I
Cumb e r la n d Iownohip? Hd.lXl ~~nt::of Me c ha n ; c sb u rg
MOTHER'S NAU.E (Fpt, MId'Maide~S~l B
II, lSe't'ty 1'. ;,ml1;n a rtoo
citylboro
Iwp
21c. Con 0 1 i tee rem a tor
NAME AND AOORESS OF FACILITY
22c,M YE R S FUN ERA L
LICENSE NUMBER
2
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DATE PRONOUNCED OEAD (Mooth, Oey, Year)
/-~- Z~<:"b
Sequenllaay ~S\ Conditionl
. Iny, leadlng to immediate
. cause. Enler UNOERL YIHG
CAUSE (Disee... Of injury
. thac initialed 8venls
resutOOg on dt;tattl ) LAST
E
U7.:I-
.$p(.l (Un?
WERE AUTOPSY FINDINGS
AVAilABlE PRIOR TO
COMPlETION OF CAUSE
OF DEATH?
DATE OF INJURY
(Mon&h. O_y. Yu')
23b, 23c.
WAS CASE REFERRED TO A MEDICAL EXAMINER /CORONER?
21, Yes ~ ;"f~ No 0
: Approximate PART.: 0Iher lignificant c:ondilions contributing to death, bul
. intervBI be not resulting in the L1ndertying cause given in PART t
: onset and death V iV', r
: i)A ~ ,,:/14-t-
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:OltyJ. GfrtJ CAhD
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED
Accident
Pencjing lnvesligahon
Could nol be determined
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o PLACE OF INJURY - AI home. lann, street, factory, oIIice
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301,
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3Oc.
Homicide
Ye$ 0 No
Yes 0
NoD
Suicide
211, 2tb.
CERTIFIER (Checl< ooly one)
.~~I}J:=:'~for:::'~~~~~~C:C~~a~~S: g a:~.~:~(:r~3(.g~=~.h:.~a~~~~.~.~~~~..~~.~.~~~.~.i.t~.~~.~>,
211.
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'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and cerlifying 10 cause of dealh)
To the belt 01 my knowledg., d..th o~eurr.d ..the tl..... date,...d place. and due to UK cau..at.} and manner.a .tat.d....................
'MEDICAL EXAMIHERlCORONER
On 1he b.~. 01 ..~tn.t:on and/or Inv.,tlgatlon, In my opinion. death occurred ,)t the Uma. date. and place, and due to the ciluH.(a) and
mann.r .llliIIl.d............. .......... ......................... ...................................................
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