HomeMy WebLinkAbout02-02-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF bbiK~
Estateof .RoLl UJ. SC/-I;ce~rUiE-
also known as
COUNTY, PENNSYLVANIA
File Number
d\
Dl
() \6~
, Deceased
Social Security Number // ? 7'- c) ?,-"- /' y,29
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 r:? 0,/ (,d, SC:r/;C~ rrL4Ymed in the
last Will of the Decedent dated / .z -;2 B - f93 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 instl1lment(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
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="
f~ =~
7- 0 -:1
..;D rr1
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; duranl~ m1n([?1tate) c:v
J "C,;; f-::;~ I
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following sPot15;e;UJ;1my) Nheirs:
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) , '.~ ~.:
''';7f' ;
o B. Grant of Letters of Administration
(If
Name
Relationship
0'
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in C i..J M 1?tf:;:.t.AtIID County, ~n~y..!.vania with his / I' last princi al residence at /3'71
~, In St.;v'( r/t"/Zt< r..:!' _ /V'~4/ C!'~ ~L../9"A.L> '~ / ' 070
(List street address, town/city, township, county, state, zip code)
Decedent, then 8e:, years of age, died on 'Y' -;t <j-- 0"7 at
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
Value of real estate in Pennsylvania
$
$
$
$
'/6.Jt.'> 000
,.~
situated as follows:
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:
rinted name and residence
;7;
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
SS
,./(
COUNTY OF "___l)fJ1l3rU.l-AtClD
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.
Sworn to or affirmed and subscribed
dJr;;~ / ~2J
, Signature of Personal Representative
--..,
before me the
day of
Signature of Personal Representative
Signature of Personal Representative
File Number; ~ \ 0 lo 6 \ D~
Estate of ;Co r t!t/ c<;r:.''#~ r~~,AZ.- , Deceased
Social Security Number;/81- CY1- /9/9 Date of Death: C!J/- .,2<;;-- d 00 e.7
AND NOW, d, P e -.bl.-t\i'WL;J_, cJco! , in consi~ef,:tion~fthe;foregoing Petition, satisfactory proof
having been presented befo)e ~:' IT IS DECREEO that Letters If! ~ TllL!Jffid!1/L(
are hereby granted to ~J IfA f!( L lJ.1a elL J)--. -
in the above estate
and that the instrument(s) dated DO(1p IK.i:%2. y ;} ~ .I e::; U
described in the Petition be admitted to probate and filed ofrecor~ as the last WilJ
FEES
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
\..01.\\ ... $ \<=:;.00
~c....\>f_, ~'0 ... $ ('5.00
.. . $
.. . $
... $
.. . $
... $
... $
.. . $
TOTAL.. .. .. .. . .. .. . $~
$ 6), La ,(j::)
d-\ . co
Attorney Signature:
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Letters
Attomey Name:
',j... ....-.~
Supreme Court LD. No.:
~_ ';=2, ~~
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Address;
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Telephone:
Forlll RW-02 rev. /0./3.06
Page 2 of2
H 105.805 REV 1/0,
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 pennanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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';I"~"'N;,,'III
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Local Registrar
Fee for this certificate. $6.00
P 13105674
JAN 1 6 1007
Date
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REV. 0212006
/ PRINT IN
_ENT
CKINK
t Name of Decedent {Frst, middle, last, slJ'!ix)
I ,,/ 0 lOG
~"UL
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH
CERTIFICATE OF DEATH
=~
. VITAL RECORDS
N
C1'
5. Age (Last Bi1hdor)
6-7-1920 Harrisburg, FA
&I. Fldity N_IW oot iIs1iIutia1, Il"e _t and number)
3. SoO~SeculityN_
189 - 09 - 1929
Sa P!aceolDealtl Cl1eck one
Hospitli:
Otnpatient OER/OuIpa/ilInt OOOA :j[]NIMSingHllI118
9. w"DecedentolHispa'licOlilin? 19 No DYes
Gfyeo lI!'OCIfYCubM,
ealth South Rehabilitation MexIcan,PuertoRican,elc.)
12. W"Decedonl_tnthe 13. DecedontsEduC8llonISlJedfyon~hlghest9f'decompieted) 14. _SIaIull:Manted,N_MIlfI1ed,
U.S. Atmed Fortes? Elomentay I Second'"l'fO-l2) CoIege(l-4or5>1 _,DNor<:ed{Spoc/fy)
lives ONo 12 Widowed
Deosdent's Did 00cedenI
AcluoIRos__ 17a._ Pennsy 1 vania Livetna 17.0 Yeo,OocedenILived"
Township?
17bCounty Cumberland 17<1.00 ~~ofLivedwilhln Npw CllmhAT'l :::lnrl
7.8" ace
and state or
STATE FILE NUMBER
4. Date of Death (Month, day, ~
January 25, 2007
86
v~.
T'HJ>.
81>. CoImty of De"'"
Cumberland Lower Allen
11. Decedents Usus 01 worIr. done d most 01 life. Do not slaIe retired.
K>TdolWork K>TdoflluoineeallnduSlly
Mana ement State Gov't
. 16. 1lecodent.UailingAddnlll8 {_'lyf_,_, lil"xx'ej
1371 Simpson Ferry Road
New Cumberland, PA 17070
16. FaIlle", Nerne (F", .-e, lesI, su/lix)
City/Born
19. Molhef's Name {First. midcle, maiden SlJTIame}
Charles F. Schreffler Martha N. Snodd
200. tnbm...t's"'""" (Type/Prrlt) 2Ilb. iTformanf.UalllngMdmssISlreat,city/tlwn,sfeIe,",,_1
20 2 West Calle Morado
21a. _cf~ 21b. DateolDiepositicn{MonIh,day,yeer) 21'. Place of DIspoeition (Nemeof_. aemekJry or olher place)
OillJrIeI ORemovalIllmSlale
. ..
Corrii; _23&<ony_certifying
physDM.ool_atlinteof_1o
CIlItfy"""'cf_.
_24-26_be~l>ypelSOl1
who pronounces death.
C f'RIE ~'e'0 V ~C UL-'AR-.
f1- <: t. \ IX"""
<. \ 'l
: Approxknate I'lIerval:
: 0nseI1o Death
,
.
(')}' ~D
26. Wes Case Referred ~cal Exll1'li'ler I Coronerfor' a Reason Other than CremtItion (X DonaII:In?
o Yea {3"N,
pa1n:Enlercflersqlillcenl_ccnIribo""ll"..... 28. DidTcbea:oUse~loOeolll>?
buloot"""tingththelll1llerlyingceueoghenl1Pl1tI. 0 Yes Oprobebly
o No 0 U'*nown
29. W Female:
o Nolp'"!Jlenlwithinpastyeer
o Pregnenl8I Ume ol_
D :,:ent,bulPl89l18l1w1111n42days
o :'~buI_43dayslolyeer
OU"""","WI>l8ll"'"'t_nlhepastyear
320. Place of thjlJIy: Home. Form, _ F_~,
0lIIce BulkIng, etc. (Spedfyj
Due to (or as a oonsequence cf'J:
=~IsI_.hIlY'
lDcaJIIllld8donlnea.
EnIer UMlSlLYMlCAUSE
(_or i1jwy Ihot_the
_ts"""ting._)lAST,
b.
OuIltD(oraaalXll'lleqUllnC8 ot):
Duelo (or... oonsequenee of):
d.
o Vea j1No
301>. w...~FIndthg,
A_ Prlor 10 ComPetIon
of Cause of Deolh?
o Yea .c;r;::
31._ofOeeltt
~_ OHo-
0- 0 Pending IrNestIg8Ik>n 3211. Tine oIljury
o Suiclde 0 CouldNolbelJetemltned
3211. ~oflnjuy{_,cityf_._j
JOe. w. an Auilpsy
Perbmed?
32f.IIT""'portlIlionlljury(Specifyj
ODri>er/~ O-nger O_tnen
u. OOlher.SjIecly:
330. CeltIIIor (ch""'on~onel :. SlgnelulOlIld aeofCel1lIier /4 ])
=:.~:,,~==:-:.:""..::..:~::mnor~'=::~~~~~~_~~)______________m.jJ .. ,?/_ >z~r i,,,,, -'
. ~:'':=':==~=='~~I~::'~~_noreaotatad..mm _ mm m_ jJ 33c ~~ 0 6lt lc{ "1_ !-- 33d o"'9~j2'~'~7
. ~.:' ~= and I or lnvoItlgatlon, In my opinion, _ oce'UM at Ibotlml, deto, and place. and duo..... _I and.......... 8Iet!<L _ jJ
34. Nome IIld Add"" of Person Who Completed eeu.e 01 Death lI!m 27) Type / Print
pflT~ Ie i<.. rz. 'ttTv--J A-,.<1'rVV\.)' -;.
lOr L- G '-"'I l'!-(?\.c. -;: .,. c t:V'1\ -.:;, '1....n.!' r ~ I 7 0 it ,J
~
STONE, SAJER
Be STEWART
A ttorneys at Law
414 B ridge Street
New Cumberland, Pa.
17070
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LAST WILL AND TESTAMENT
OF
ROY W. SCHREFFLER
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I, ROY W. SCHREFFLER, of the Borough of New Cumberland, ca1nty of
and revoke any will previously made by me.
Cumberland, and Commonwealth of Pennsylvania, declare this to be my last will
ITEM I: I devise and bequeath all of my estate of every
nature and wherever situate to my wife, ETHEL M. SCHREFFLER, if she survjves
me. Should my wife, ETHEL M. SCHREFFLER, fail to survive me, I devise
and bequeath all of my estate of every nature and wherever situate to my
step-son, WALLACE L. MACK, JR., if he survives me. Should both my said wife
and my said step-son fail to survive me, I devise and bequeath all of my estate
MACK, JR., per stirpes, who survive me.
of every nature and wherever situate to the issue of my step-son, WALLACE L.
ITEM II: I direct that all taxes that may be assessed in consequence
of my death, of whatever nature and by whatever jurisdiction imposed, shall
be paid from my residuary estate as a part of the expense of the
of my estate.
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I this my last will.
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ITEH III:
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I appoint my step-son, WALLACE L. MACK, JR., Executor of
Should my step-son, WALLACE L. ~~CK, JR., fail to qualify
Pennsylvania, Executor of this my last will.
or cease to act as Executor, I appoint CCNB BANK, N.A., New Cumberland,
Page I of 3 pages
STONE, SAJER
& STEWART
A ttorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
I
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ITEM IV: I direct that my Executor or his successor shall not
be required to give bond for the faithful performance of their duties in
any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
.. \'\"
.[~ \," day of December, 1983.
()
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/Wu~~ -r;'7if/~--""
Y W. SCHREFF
SIGNED, SEALED, PUBLISHED and DECLARED by ROY W. SCHREFFLER, the
Testator above named, as and for his Last Will and Testament, and in the
i
I presence of us, who at his request, in his presence and in the presence of
\ other, have subscribed our names as witnesses.
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! Witness
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Address
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Witness
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Address
Page 2 of 3 pages
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I, ROY W. SCHREFFLER, Testator whose name is signed to the attached I
or foregoing instrument, having been duly qualified according to law, do hereby I
acknowledge that I signed and executed this instrument as my last will; that I !
signed it willingly and that I signed it as my free and voluntary act for the 1
purposes therein contained. ~
--- I
'.~~.~ j
.r . - ROY W. SCo/EViLER .
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
'-.." ._l~'"
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'-\....'~ ''"-"Ca. LA.- ,t _ " J '\ / '... (i ~~- _ t C
Notary Publ{c
CONSTANCE L f(AR
N' C' U, Notary Public
ew umberfand, Cumberland C
My Commission Ex' A' 0., Pa.
pIres prd /3, )987
SCHREFFLE1
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Sworn to or affirmed to and acknowledged before me by ROY W.
the testator, this ,-~>.,-CYi day of December, 1983.
We, f( Ie L.,c. ~ (( I.-A.J ~';tnl;.t r' )- and ~ ~/IA-> ~I\1A..AAU
the witnesses whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, depo~e and say that we we.,re present and
saw testator sign and execute the instrument as his last will; that testator
signed willingly and that he executed it as his free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the
testator signed the will as witnesses; that to the best of our knowledge, the
testator was at the time eighteen years of age or more, of sound mind and
under no constraint or undue influence.
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Notary Public
CONST ANCE l I(>\RLI, Notary pubHe I
New Cumberland, Cumberland:"" Pa. I
My Commission Expires Apl'i, ,." 1987 !
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COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
'1) ~ C)~
t;;;",rA . ../Y\.... I' ~
Sworn or affirmed to and subscribed to before me by ~ i,-<.",
':.;\r",~~11 and ;':"'--:(.1, {(.I' /.I;~. 'h.>tl.C ./ , witnesses,
~ .J ,y t, \ day of I:,:" '_,( , 1983.
this
STONE, SAJER
& STEWART
Attorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
Page 3 of 3 pages