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HomeMy WebLinkAbout11-13-06 Register of Wtlls, Cumberland County PETITION FOR GRANT OF LETTERS Estate of Camren M. Raaer No. (21- OLP - qq1 also known as , Deceased Social Security No. 201-78-5492 Tammy Ann Raaer Petitioner(s), who islare 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, ete Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: [i] B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: 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 Tammv Ann Racer Mother 195 Beaale Club Road Carlisle PA 17013 Randv Euaene Racer Father 194 Beaale Club Road Carlisle PA 17013 (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 195 Beaale Club Road, South Middleton Township, Carlisle, PA 17013 (list street, number and municipality) Decedent, then 6 years of age, died July 30 I 2006 I at 195 Beaale Club Road. Carlisle, PA 17013 (Location) 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.. ....... ..... ....... .... .... ....... ..... ........ ....... ....... ....... ....... ........ ... ......... ........ ....... ..... $ 500.00 500.00 Real Estate situated as follows: "" Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and ~.m.ant of letM in the appropriate form to the undersigned: ~ ~ Z Signature Typed or printed name an!~~ rn e ,~ (I) ~. -I A :~) 0 11 ;' ::::r.J -I )> ._- ,Tl .s::- RW-7 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 according to law. Sworn to and affirmed and subscribed before me this~ day of t--\aY~m~ .JOJ ~M~M'\ -~~1f- ~L}~ I --1"' tWvvvINlJj? ~.ed DECREE OF REGISTER Estate of Camren M. RaQer also known as Deceased No. Social Security No: 201-78-5492 Date of Death: 7/30/2006 AND NOW, ~l)\[. \ 4- 2006 , in consideration of the Petition,...., on the reverse side hereon, satisfactory proof having been presented before me, ("') g :~) C:O O"'T I ~:D :z ~;;~~ (c.t.a.. d.b.n.c.t.; pendente lite; durante ab~~~ m te mi _ te) i-~~ fc~~ :i~~ ~ ;~ _-I ca, ,~."-, :8 ~ ',c-: \D IT IS DECREED that Letters 0 Testamentary fXI of Administration are hereby granted to Tannv Ann Rager in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the last Will of' Decedent. FEES Letters ...... ............... ............... Short Certificate( s) ............... Renunciation .......................... Affidavit ( ) ....................... Extra Pages ( ).............. Codicil ................................. JCP Fee ................................. Inventory & Tax Forms............. Other ..~.~.~.;\:'!?....~......... $ ZO. CD $ ~ I t>D $ 5.00 $ $ $ $ \D. 00 $ $ 5 . db Attorney: David W. Rea~er I.D.No: 20868 Address: 2331 Market Street Camp Hill Telephone: 111-71,3-13%3 DATE FILED: ~ OLP PA 17011 TOTAL .............................$ CJ~, 00 RW-7A --I 105.805 REV 1105 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. No. ~~~~~ Local Registrar Fee for this certificate, $6.00 p 12726582 AUG Date 2 2006 20 g::o m-oo -.:0 $,\ t,;: :z; 93 >= en 7' i::J ('") C) C) O-n (~c ~ :0 :0-1 )> ~ <<:::) c:;:) c:T' Z o <: .." :x ca .r:- \.D (..a) . \ COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (CORONER) " 1- 0' - qq STAlE FILE NUMBER ~ UI - 4. OIIoclOolll~.cIo"/,1Ul Rager . July 30, 2006 Hl05.144 REV. 02t2006 lYI'E 1 PRINT IN PEIlIIANENT IlACKINK #30-299 1. Nnocl~(fIIsI._,""'1UIx} Camren s..(l,aIt1lihlll!l 6 M 6.OIIocl lib. CoIIIIy cI Doolto White _cI ...OOnal....._. I<i1d ai_' InduIry 11b. CaJnIy PA CUmberland 17e.(] v_,o...,ILMdin 17d. 0 ~~cllMd- Middlesex Twp. Cllylllanl ~ 19. _.Nno(Rlll,-.--1 Tanmy Ann Orosz 201>. _Mllnu_IShet,dty _._,zlpaldol 195 Bea Ie Club Rd., Carlisle, 21b. OIIoal~{IoblIl.cIo"/."'''' 21e. _cl~(NnoalOlllllllly...........,ar__) CUmberland Valley Memorial 5, 2006 Gardens 22c NnoIlld_clFodIty Hoffman-Roth Funeral Home N. Hanover St. Carlisle Pa 17013 2311, UCOnII Numbor Pa 17013 21d. LocaIIon (CIIy ,_, _, zip aldol Iil ~ ~ Carlisle, Pa 17013 ~_23KanIy_cd!ing ~ilnaI_"""'cI_1o l8Ily....cI_. _:M-26_bo~by_ ....--. 23c. lloIo SIgnod (Monfl, dllY, ,..) ~ M ~ r 25. DIfot_~I\IoIII1,dIy,,..) 11:27 P M. July 30. 2006 CAuse OF tlEATK 1- ....__ and aumplHl .... 27. PART ten.... cIllIIILlUIIIdL--...... arllllll1plicllla- ....dIIIcIy...... .._. 00 NOT __ _ oudl.ClIdiac_, lII!IiaIorY_ar_~_oI1owi1g"'eIIoIogy.UllanlyOf1l_on-"line. ===--+ Smoke Inhalation 0.. to (or... c:onMqUenOt 01)' House Fire au. tD (or. . conHqUel'tClt of) 24. Tineal DooI1 26. w. ClIo _10 _Exminor leon... lor a ~ Ollar"'" CIomallon ar_7 Va DNo AjlpIoldmIfa -: Onoot 10 DooI1 Pert n: EntIr ot......... awIIkm twIMIdIM W. rIUII but noI.-.g in Iho undoltyrg _ gNon in Port I. =...IXllIdIIIonI,...." 1o__onInoL en.. UIIlell Y1NO CAUSE l_ar~IhII_1I1o -1IIIllIiV,,_)lAST. au.tD(or_lI~ot) 3lIa. w...""""", JIll. _",-,F~ 31. M_alDaoIl _ A_PriarIoCoqjolan aI Couu aI DooI1? o VII ~ o V- 0 No 35. . I tkl I I A..I , I 0 I Register of Wills, Cumberland County RENUNCIATION Estate of Camren M. Rager No. also known as , Deceased The undersigned, Randy Eugene Rager, Father (Relationship) of (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters Administration be issued to Tammy Ann Rager Witness 4- hand this a I;S f- day of October . 2006 {J> Rc~fj z. -e~~ (Sl ature) 195 Beagle Club Road. Carlisle (Address) PA 17013 0'\ ..:r t ~ c::::. c<""; LU C) q: C5 @El C)\- 2S C,j c.':> ~T:~ =- <::) :z ...0 <::::) c:> '" cf l- ce : :::::>C: LL C) (:' QUei EE ~ ~~: w~_." -l c-: U ^ - t.!_2.' ~ a::.: 0:::::2: o=:> o (Signature) M x: a.. (Address) M (Signature) (Address) bOOl -.oi-:~nw-sa~xiuo~SfWWOO Aft ~unoo PUllJlquJnO 'OJog litH dweo :J!lqnd '<J"ON '~3H3030 .W 3NNVZnS lY3S 1YIWlON Y^lASNN3d .:10 H MNOWWOO ,~.. , (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3