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Home My WebLink About02-23-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUM 13f.1U.1:rNf) COUNTY, PENNSYLVANIA Estate of RD"P>ctt:r /-I. Pt:"TCp's€,..} also known as File Number ~I -;100'1- I'll/- , Deceased Social Security Number I ~ 1 . 2. 0 . 3If 7 ~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ~ p~obate-and Grant of Letters Testamentary and aver that Petitioner(s) is / are the f(l.A(...<{ last Will of the Decedent dated 0 Z. - zp. 0'0 and codicil(s) dated L. {)U,"N named in the (State relevant circumstances. e.g., renunciation. death of executor. etc.) Exc:pt as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instlument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: o B. Grant of Letters of Administration Name Relationship -~~ I (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. l)M I iC (List street address. town/city. township. county. state, zip code) years of age, died on rt:r>"I1~'f_ ~O.., Decedent, then Slb Not.-"" Sfl (Lrr 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 PA) Personal property in County Value of real estate in Pennsylvania I../q, 100. co $ $ $ $ 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: T ed or rinted name and residence Q'A..,. AAL'-l L. DL.!':,cAJ joS Sc.-<1'Ll&ND~-l LAN/:: ENOL-/tf B. IlbZ5 Form RW-02 rev. 10.13.06 Page 1 of2 0" 1 (7 tl Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF 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) ofthe Decedent, Petitioner(s) will well and truly administer the estate according to law. ~ File Number: d I .- cJ(jC) 1 - 11 ~ ~ljt W-.'V~k(<;()n Social Security Number: 151 - d () - 3 415 AND NOW, re. bnJ Ilf~ d:3 ;;:t:;D ( having been presented before me, IT IS ECREED that Letters are hereby granted to~O-C~ L. 01561'\ Estate of -..:J r-:-~ C5 --J () ;:9 --. .J...,,: : -T"'" ,{(~, , : I ~ Signature of Personal Representative r'f1 CO r-" (..6 Signature of Personal Representative -..'-' _ ._~ ,., i" _n:.__ , '.~~~~ ~ ....-... ,'.-:; _.,~.J 5 .. o ..- 04- _ \) , Deceased ~/&/07 I I Date of Death: , ~~~~ forego;ng P,""on, "t;'''''to~ pwof in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will (and Codic' (s)) of Decedent. FEES Letters Short Certificate(s) . . . . . . . . $ Renunciati,C!n(s1/' . . . . . . . . . $ ()J ...$ '~ctJv TOTAL .. . $ .. . $ ... $ ... $ .. . $ .. . $ .. . $ .. . $ .............. $ Form RW-02 rev. 10.13.06 $ C;(J cJ) LID. (-; /5(P J (). tiJ /5: '- Attorney Signature: Attorney Name: Supreme Court J.D. No.: Address: Telephone: ICt(j. rD Page 2 of2 moo.goo REV ilO' 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. r I 011 - 1'1 '1 WARNING: It is illegal to duplicate this copy by photostat or photograph. No. 2}.;.~~=~ Fee for this certificate, $6.00 p 13310629 FEB 1 ~ LUU( Date f""",,' c::::::~ ~ --J .,.,., lTl co f"..) w J;t<, o o r I . COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and axampIBs on raverse) H105-143 REV 1112006 TYPE I PAM IN PERMANENT BlACK INK 5. Ago (Laol_,) 80 11.Oecedent'sUsual Khl~_ Milk In ctor . 16.___-_'*1'-......."'-1 105 Sgrignoli Lane Enola, PA 17025 18. FaIhIr'a NImI (Fisl, middIll,lut, Mflx) Peter Petersen 208. Wcwmant'. NM)t (Type I Print) Tracy L. Olson 21 a Method of DlIpoeIIIon 5l 0 Ji!,~D --- ~ ~ ~ llinH~ ~ . ~ ComploIo""23a~rrit-,*"""" JiIyIiclInilnolaVlllble81tlrneoldealhlo C8ftIy CIUIt of dedl. .......26..... be_by """'" who Jm'IClIlCII delltL 17b. County PA CllITlhP.rland DOlhe<-Spedfy; 10. Race:Amerlcan Indian, Black, WhIte,etc. (Spedt)1 White ,.. =~s;:;--. '5. S_ngSpouse (If""'. iIW -. name) Married Pearl E. Olson ~~ 17c.!XV",_""". Lower Allen T_' 17d.D ...._""".... _UnillI~ lOp. Bb. County 01 Ooolh COy/- 19. Motwr'. Namt (First, rridlII, mllIden SUfI'8/lWI Dagnar Lund 2Ob.1_'__~,'*I1__,"'_1 105 S i oli Lane, Enola, PA 17025 21c.Plsce~IllsposlIio1_~_._"'_pIsco) 2'dlocsllon(COy/_,_.Zi>_1 Cumberland Valle Mem. Grds. Carlisle, PA 17013 Hame, Inc., Carlisle, PA 17013 231>. Lice... N...... Z!c. 0s18 _(Mon~, dIy. yee~ 26. W. Cat Aefen'ed tl MIdcaI Exanlk1er I Coroner for a Reason Other thin Cremation or DonatIon? DYes [31Q'O' Part II: EnlerolherllimllarillllrdilnllODllit1uhlIod8d1 bUtnotresulingilthelllderlyingC8lll8giYenlnPartI. DYes DNo 31. Manner of D9Ith 12f'....... 0- 0-' 0__ 0..- DCouIdNotbeDsl8nnOled t ApproJimaIeinterYal: I Closet to Dea1h I I I I I I I I I I I . r . r r 28. OidTob8cco lJIll ContIitUeIo 0eIIh? . Dv" DProbsbIy DNo ~ 29." FeInaIe: o Nol__""yosr o ~"...~- o Nol_,"'''''''_'42''''' ~- o Nol_,,,,,,,,,,,,,,,,,101_ -. dss~ D_",...,._lhepsstyeer 32c'~=~~j-'Fsc1o<y, =e~=)~ . Sve.A1U\a-WOI.D /tf.molUHf\G~ ~(oras.~of): b., /'?)j)vRAt... I-tf,rnA10mA DusIo("".\:""'11iol): A ~."\ c. f\1)'{IA'L 1~l<.\UII110j\) 0(1.) rvilWMVLA1J VI'" d.~~~C1\V( J~1 ~R..~ =latccn:lianl,lfany, 10 ClUltllalldonha Enter UNDERLYllGCAUSE =-~"l:,\",~ OOa.WellanAljoply - ""._-- A__Io~ dCal.eeolOeattl? M. 321. IIT_Irlju!y(_) Do.Mo/Opslalot DP_r 0- 0IIw- _ :t1~JN.O 32g.locallonoflnjury(9:reet,city/town,slate) DYss ~No 32d._~I,*-", I o ! 33a. Ce!tiIIer(d1eckonlyont) . ~_(__ClIUSlI~__""""'_hss"""""""'_.""com_Itsm231 To.... belt of my knowItdgI, daIIh occuntcI gto Itlt ClUII(I) and mII'Ir1II' BItItIlL.. _................ _............................................. ~:='~~:"~Ind~~=",Io:=~~~_nnef.IIIted.._..__..____.............._ 0 ::: =:.n:= Indl OIlnYeltlgltlon, In my opinion, deldt1 0CCUf1'eCI1It the tImt. dItt, IInd place, and due to 111I ClUII(I) end manner..1IIted.. 0 M"D4~~3 ~ 33clal S;C;r;1-""~ j)N.r=:"ib:;Vr"""'~~AN) T.../Prim ,; 45b "TVlHJ D u:= (<..Q An I CAmP).j I L-L.) P A I::J-o tI y Disposition Parmi! No. lAST WILL AND TESTAMENT I, ROBERT H. PETERSEN, of Lower Allen Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby m'l,ke, "-- = (-) <=) publish and declare this to be my Last Will and Testament, hereby revokin!f::.~ Wills::xnd cc,'\ rr1 . . -1""' C"J co COdICIls heretofore made by me. .~-;; lT1 N W ONE. I direct my Executor or Executrix, as the case may be, top~(iill o~y ..~ '2 debts, funeral and administrative expenses as soon as convenient after my deceaseJfurtheIlllOJe, ~ I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Executor or Executrix of my estate. Further, to the extent that sufficient assets exist in my estate, any and all inheritance or other estate taxes, whether to non-charitable or charitable beneficiaries, shall be paid by my Executor or Executrix from the residuary of my estate. TWO. My Executor or Executrix may, at his or her discretion, compromise claims, borrow money, retain property for such length of time as he or she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he or she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My Executor or Executrix is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executor or Executrix. 01 -/'1<; ~ ~ THREE. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my spouse, PEARL E. PETERSEN. FOUR. If my spouse, PEARL K PETERSEN, does not survive me by a period of at least sixty (60) days, I then give, devise and bequeath the rest, residue and remainder of my estate as follows: A. Fifty percent (50%) to TRACY L. OLSON, Enola, Pennsylvania; ;f R'fJ B. Fifty percent (50%) to be divided in equal shares between the following charitable organizations for their general charitable purposes: HELEN KRAUSE ANIMAL FOUNDATION, Dillsburg, Pennsylvania, THE SALVATION ARMY, Carlisle, Pennsylvania and the DISABLED AMERICAN VETERANS, 3725 Alexandria Pike, Cold Springs, Kentucky to be used for disabled veterans from the Central Pennsylvania Region. C. In the event that any of these institutions named above cease to exist prior to the time of my decease and there is no successor entity with the same purpose, then in that event, its respective share shall be divided equally between the other residual beneficiaries of this Paragraph Four. FIVE. I hereby nominate and appoint TRACY L. OLSON, to be the Executrix of IP# P this my Last Will and Testament. In the event for whatever reason she is unable to serve as the Executrix of my estate, I hereby appoint JAMES D. HUGHES to be the substitute Executor of this my Last Will and Testament, whereby the said substitute personal representative shall have the same powers as are given to the original Executrix hereunder. 2 SIX. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. SEVEN. No Executrix or Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. EIGHT. No beneficiary may assign, anticipate or pledge its interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. NINE. If any person or institution entitled to share in any distribution under the terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest the probate of this Last Will and Testament, such person or institution shall forfeit his, her or its entire interest inherited hereunder and all provisions in favor of such person or institution shall be declared void and of no effect. The share of such person or institution so forfeited shall be distributed as part of the residue pursuant to Paragraph Four hereof except that if such person or institution is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary distributees. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~$ day of February, 2006. I( ~IJ ~(SEAL) ROBERT H. PETERSEN 3 Signed, sealed, published and declared by the above-named person as and for a Last Will and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. 4 (YW7 ACKNOWLEDGMENT AND AFFIDAVIT WE, ROBERT H. PETERSEN, JAMES D. HUGHES, and KAMELA S. CORNMAN, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYL VANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged bj~~re me by ROBERT H. PETERSEN, the testator herein, and subscribed and swoI1h~~ore me by JAMES D. HUGHES and KAMELA S. CORNMAN, witnesses, this.dJ2...!.. iiay f Feb ,20 COMMONWEALTH OF PENNSYLVANIA Notarial Seal JacquelineL ~=~ Carlisle BorO.lAlI1...-....- ~ My CornIT\iSSiOll Expires Aug. 14.200 . AsslJciaIionOfNolBrie& MembeI'.~