HomeMy WebLinkAbout01-26-07
PETITION FOR PROBATE AND GRANT OF LETTERS
(~MtuvluVl(L.
REGISTER OF WILLS OF
COUNTY, PENNSYL VANIA
/' ,.....,
"""eof _'JO'~~ ~ ~I'T
also known as "2 :{ . _ '"Eii11Jlk1
, Deceased
r:21 -07 - DOg D
Social Security Number ;(1' ) - ~ ~ ~ c?,:J, '3 Cf-
File Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
, A. Probate and Grant of LeU rs Te
, "
last Will of the Decedent dated
amentary and aver that Petitioner(s) is / are the '~ f "{,..pC ~ ,(f-u(
C Sand codicil(s) dated-
named in the
(State relevant circumstances, e.g., renunciation, death of executor, etc)
f"-)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of.!I>e instrument~J.;offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: 'CO C) -.J
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(-)
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D B. Grant of Letters of Administration
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(Ifapplicable, enter: c.t.a.; d.b.n.c.t,a.; pendente lite; durante absentia; durantemill.6ritar,e) .
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Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spou5erii~riy) an~'heirs:
Admillistratioll, c.t.a, or d.b,n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~l : --
(If
Name
Relationship
Residence
a
(...J
(COMPLETE IN ALL CASES:) Attach additiOl~al sheets ifllecessary.
D
tg ;;"0
, Pen~lvania with his / her last principal residence at
T-Cl y- " UA , "{..< '0, :::>
(U" ",~, odd",.,. "w"/d~."w,,,"~. '''''ry.''O,". "p ,""e) .. . . ~
Decedent, then 7 )- years of age, died on ~ at &/1 <) ~ t
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
C;~e of real estate ~ennSYlVania
situated as follows: U. ~ \ I S ~ CL
:~
$
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 undersigned:
t I7tlli
Form RW02 rev /0./3.06
Page 1 of2
Oath of Personal Representative
COMMONWEAL TH OF PENNSYLVANIA
COUNTYOF ~mb_.utlL<Vll 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 Decedent, Petitioner(s) will well and truly
administer the estate according to law.
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. ffl" OJ P'~O," R =_ . .
Sworn to or affirmed and subscribed
Signature of Personal Representative
Signature of Personal Representative
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Social Security Number: I q I - 2- <6 ..- c9?.3;.z Date of Death: (- I q - 0 7 (:.,.)
AND NOW, ill tL ; , :Ji..07 , in consideration of the foregoing Petition, satisfactory proof
having been presented b~!ore me, T IS DECREE. that Letters (est an)"c.nh.l.j~
are hereby granted to DC b r Ct K.Ct ( () S I<' I, n 9 e-r
, ','I .""'0
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File Number:
Estate of
, Decease~
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed ofreco~d as the last Will (and Codicil(s)) of Decedent.
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FEES / ,II.J.A,l/( f''--
Letters
. . . . . . . . . . . . . . .
$ qooo
.8,1.00
Attorney Signature:
pel iff
ShOI1 Certificate( s) . . . . . . . . $
Renunciation(s) .......... $
W"I
"p
1i~~crha r/r'T\
. .. $
.. . $
. . . $
. . . $
" . $
... $
'" $
. .. $
. . . $
" . . . . .... . . .. $
15.00
10.00
5.00
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
TOTAL
15;l,C)0
Form RW-02 rev. /0/3.06
Page 2 of2
HI05.H05 REV 1105
'Th;s is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
L,cal Registral. rle origi;laJ certificate will be forwarded to the State Vital Records Office for permanent filling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fe~ for this certificate, $6.00
No.
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H1Q5-143 REV 1112006
TYPE / PRINT IN
PEAMANENT
BlACK INK
t Name of Decedefll (First, middle. las!, SUffix)
Sarah E. Fallon
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
Cumberland
6 Dale of Birth (Month. da , year) 8a. Place of Death (Check on! one)
Hospital Other
November 1 4 1934 Benton PA I}Q '"pa',,", 0 ER I o..lpa',,", 0 DOA 0 N"~~9 Home 0 R,"de"" l:::Jo..., _ _~
&1. Facility Name (Ii not instIlUlt\Jll, give slreet and number) 9. Was Decadeflf 01 Hispanic Origin? 5a No 0 Yes 10 Race: Anl80Cari Indian, Black, WhIle, etc
lit yes, specify Cuban, '(Specil)1
ional Medical Center "''''",_P..,"oR''''"_oI'l White
STATE FilE NUMBER
5 Age (last Birthday)
191
- 28
2232
19 2007
72 v"
8b. County 01 Dealh
11. ~l's UsualOccu 'lion Kind of worll done du' mostofworllin life. Do not stalerelirad
Km of Work Kind of Business Ilodustry
Laborer Warehouse
12. Was Decedent eVEll' In the
US. Armed Forces?
OV" @NO
Deced8nt's
Actual Residence 17a. State
13, D&eedenfs Education (Specify ooly highest grade comptel&d)
Elementary I Secondary (0-12) College (1-4 ()( 5+)
12
Pennsylvania
Cumberland
14, Marilal Stalus: Married, Nevel MaHlea',
Widowed, Divorced (Spec'1))
. 16. Oecedenl's Mailmg Address (SlIeet, cil)' ftown, state, lip code)
1820 Heishman Garden
Carlisle, PA 17013
17b.Counly
Divorced
DidDecedeol
Uve In a
Township?
17c. 29 Yes, Decedent lived in
17d. 0 No, Oecedenllived within
Actuallimitsot
North Middleton
Top
18 Falhef's Name (First. 1lUddIe,last, s.ulfixl
Har
Karns
19. Mother's Name (Firsl, midde. maiden sumame)
Geraldine Everitt
20b Ifllormanl's Maiiog Address (greet, city !town, stale, zip code)
201 Ewe Road
City/Bora
20a InlOffi'\anfs Name (Type I Print)
Q
W
00
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PA
23a. To the best of my knoMedge, dealh occurred al the lime, dale and place Slated (S'9f1ature and title)
zzi Funeral Home
23b. license Numbllf
23c. Dale Signed (Monltl, day, year)
'"T:YO
p...
h. day, yearl
2.DO"t-,
26. Was Case Referred to Medical Examiner I Coroner'Of a Reason Other IharlCremalion or Oonalion?
Ov" t'QNo
Items 24-26 must be completed llV person
whoprOOOUflCesdtldth '..
24. Tmeof Dealh
CAUSE OF DEATH (See Instructlona and examples)
lIem 27. Part I Enler the !itIiin.2!.b'ii1I:I.:i- llseases, IOJune:;, Of complicahoo5 - thai dirocUy caused lhtI death. DO NOr elltE'f Iermlll....1 t"t:rlls such as cafdia<: arrest,
respiraloryarrest, Of venlIiclJlar libriIahon Wlthoul showing thti ellology list only ooe cause on each flntl
SequenIiaDy ksl conditIonS, if any,
~=to J:oe~~~AU~1 a
(ciseaseOfIfl/UlY lhall/lllialed the
events fesulliilg In dealh) LAST.
YA'A.'L.
I Approximaleinlervat
: Onsel10 Oealh
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I~(/(t ~""'" I AW Rhol\lu
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CIM:J...k ~... t (l..,1...c.
28~obaccoUse Contribute 10 Death?
~ V" [Jp"'ba"y
DNa OUniloown
29.IIFemaki
J~Notpregnanlwilhlnpaslyeat
o Pregnant allime of death
o Not pt"egnarll, but preglallt Wl!hlll 42 days
oIdealh
o Notprllgnant,butjJregllillll43darslo1yeat
beloredealh
o Unlulown il pr~fll Wlthln the past rear
32c. Place oIlnju,y Home, Farm, Street, factory,
"""'""""",- '" (Spocdy)
~~~~~S:j~lliise~
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Due 10 (or as a consequence of):
PartII:Enl6folhef~~IIonSCOfltribllti~IO~,
bulnolresullmginlheunderl)'ingcausegiv80iflPartl
Doe to (or as a consequence at)
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o
j
11"
d.
Ov" ~
DYell~
31. Manoer 01 Death
~atural 0 Homicide
o Accident DPenoolQlnvesllgalioo
[J SwclI:le 0 Could Not be Determined
32d. TllTleollnjUlY
32g localion 01 InjuiY (Sl:reet. city I lown,siale)
30&. Was an Autopsy
Perlormed?
3Otl. Wt!leAutopsr Flndings
Availdble Prior to CompIalioo
01 CilUse01 0ea1h?
!Z
i
15
~
321. II Transportation IflfUlY (Specify)
DDllver/OJ.>erator DPa55efl!Jflf Dp"a.;stnan
Othef. SI'eClfy
33a Cer1ilillr (checII only 0061 J3b Slgrlalllfe anJ Tit
Certityb\v phrskian (PhrSlCian certilylllg Ci!use ol death when another phrsician has pronounced death and completed Item ;!~) ...
Tathe beal 01 my knowledge,l1eath occ;orred doe to the Cluse(sl and manner.. staled.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
. Pronouncing and certifying physician (Physician both prollouncing death and certifying to cause 01 death) 'tvf 33c license Number
To thebe.. 01 my knoMedge, delth occurred" the time, date, Ind pl.ce, and due 10 the c.auae(s) and manner.I stallild_ - - - - - - - _ _ _ _ _ _ _ _ _ _ YJI 4t:.
. Medical e.aminer I COfOfMlr -J
On \he buil 01 elimination and / Of Icwfitigation, In my opinion, death occurred at the lime, date, and ptae;:. ilnd due to the eaulie(s) and manner as alated- [J 34. Na"~ress 01 p~ ~ Completed Cill1se.,R! Death (I/em 27) T~pe I Punt
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DispoSition Pelfl1lt No () \ J 5 7 S {
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LAST WIU AND TESTAMENT
OF
SHAB B. ..aT.LOII
I, SARAH E. 1'ALLON, of the County of Cumberland and
Commonwealth of Pennsylvania, being of sound mind, memory and
understanding, do make and publish this, my Last Will and
Testament, hereby revoking and making void all former Wills by me
at any time heretofore made.
FIRST:
I direct my hereinafter named Executrix to pay all
my legally enforceable debts, funeral expenses, administration
expenses, and inheritance, estate, succession or excise taxes,
which I owe or may become due on account of my death, as soon as
may be convenient after my decease.
SBCOND:
I give, devise and bequeath all of my property, be
it real, personal and mixed, whatsoever and wheresoever the same
may be situate at the time of my death, to my daughter, DBBRA EARNS
KLINGER, if she survives me.
THIRD:
In the event my daughter, DBBRA EARNS KLINGBR,
predeceases me or fails to survive me, I give, devise andcbequea~
c:.,: 0 -'
all of my property, be it real, personal or mixed, whats~~~ a~
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wheresoever the same may be situate at the time of my d~~ ~
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equal shares as follows:
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A)
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One third (1/3) of my estate is to pass to my grandson,
JASON NEDROW, if he
survives me.
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Sar . Pallo
Page 1 of 3 Pages
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B) One third (1/3) of my estate is to pass to my
granddaughter, DANYBLLB NEDROW, providing she has
attained the age of twenty-one (21) year. at the time of
my death. In the event DANYBLLB NEDROW is under the age
of twenty-one (21) years at the time of my death, I
direct that her share of my estate shall pass In Trust as
set forth below.
C) One third (1/3) of my estate is to pass to my grandson,
PATRXCK KLXNGBR, providing he has attained the age of
twenty-one (21) years at the time of my death. In the
event PATRXCK KLXNGBR is under the age of twenty-one (21)
years at the time of my death, I direct that his share of
my estate shall pass In Trust as set forth below.
In the event either or both my granddaughter, DANYBLLB NEDROW,
or my grandson, PATRXCK KLXNGBR, are under the age of twenty-one
(21) years at the time of my death, I direct that said
granddaughter's and/or grandson's share of my estate shall pass In
Trust, and I nominate, constitute and appoint GLBNN P. KLXNGBR, as
Trustee of each of the aforesaid Trusts.
I direct that as Trustee, GLBNN P. KLXHGBR is authorized and
empowered to expend so much from the principal and/or income of the
Trust for my aforesaid granddaughter and/or grandson, as may be
necessary in the sole discretion of the Trustee for the support,
education and welfare of said granddaughter and/or grandson without
the necessity of posting bond or securing Court approval for said
expenditures.
Page 2 of 3 Pages
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Sarah B. Pa11CSn
(SEAL)
I further direct that as my granddaughter, DANYBLLB NBDROW, or
my grandson, PATRXCE ELXNGER, attains the age of twenty-one (21)
years, the Trust established herein for said granddaughter or
grandson, as the case may be, shall terminate and all principal and
any accumulated income of that Trust shall be paid to said
granddaughter or grandson outright.
PQURTH :
I nominate, constitute and appoint my daughter,
DEBRA J:ARNS ELXNGBR, as Executrix of this, my Last will and
Testament, authorizing and empowering her to sell and convey any
and all real estate of which I may die seized and possessed. In
the event my daughter, DEBRA EARNS ELXNGBR, is unwilling or unable
to act as Executrix, I nominate, constitute and appoint MELLON
BANE, N.A., as Executor of this my Last Will and Testament.
I further direct that my Executrix or personal representative
shall not be required to post bond to act in said capacity.
IN WITNESS WHEREOF, I, SARAH E. PALLON, have hereunto set my
hand and seal, to this my Last Will and Testament, this ~~ day
of '" -4t:;fi,.
, 1995.
SIGNED, SEALED~ PUBLISHED
and DECLARED by the above-
named Testatrix, SARAH B.
PALLON, as and for her
Last Will and Testament, in
the presence of us, who at
her request and in the
presence of each other, have
hereunto set our names as
ttnesses:
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Residing at: 0 :
.:3 S-C-J=V(.6 W po.. 'f DI(_~su u;.- r A. !1c}1,'1:
~~c ~~EALI
SARAH . PALLON
c:\pak\will\fallon.sef
OATH OF SUBSCRIBING WITNESS(ES)
C REGISTER OF WILLS
M \'Vl ~\ \ (j I/lrL COUNTY, PENNSYLVANIA
r2J -07- OOgD
Estate of
S(c<h
t,
~[I{JY\
, Deceased
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th ,k:W'l'll 0 COdl'CI"I(s) presente ( 'nt Namels)
~ w rewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he / they was / were present and saw the above Testator / Testatrix sign the same
and that she / he / they signed the same and that she / he / they signed as a witness at the request of
, (each) a subscribing witness to
the Testator / Testatrix III her / his presence and in the presence of each otheh
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(Street Address)
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(Signature)
(Street Address)
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(City, State, Zip)
1\ " c..::> \, \.? (
~\+ \7055
(=,
LA)
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(City, State, Zip)
Executed in Register's Office
before me this
Sworn to or affirmed and subscribed
/ :.foIl
Executed out of Register's Office
Sworn to or affirmed and subscribed
day
, c-~Y)I
before me this
day
of
\..
Deputy for Register of I
~I
)
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form R W-03 rev. Ii) .'3.06
OATH OF SUBSCRIBING WITNESS(ES)
~ W REjSTER OF WILLS
A~ t1A if Vlf COUNTY, PENNSYLVANIA
Estate of ~u(ah f. Fa llUVl
, Deceased
~. \ \tJ}I\ )1\1\ Ul/1Ko ' (each) a subscribing witness to
(Print Name/s)
the Will 0 COdICll(S) presented herewIth, (each) bemg duly qualIfied accordmg to law, depose(s) and
say(s) that she / he / they was I were present and saw the above Testator I Testatrix sign the same
and that she I he I they signed the same and that she I he I they signed as a witl!ess at the ~uest of
c) 0
the Testator / Testatrix m her I his presence and in the presence of each other.'~~~; ~
(Signature)
.~ ~I2X-- ~l~
(Signature)
7 3 S-TA~<: vJ r>..y
(Street Address)
(Street Address)
C)
W
{D lLL<;.e:>0e G
(City, State, Zip)
fA
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(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
Executed out of Register's Office
of
Xi (I.
;;-F day
H:L:o 1
before me this
day
before me this
of
~w,,-J;{ 4LLO
Deputy for Register of Wills
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy ofinstrument(s) at time of notarization.
Form RW-03 rev. 10.13.06