HomeMy WebLinkAbout03-05-07
Estate of .D;) r f) +l\ 1
also known as
PETITION F$~'_~B~.!~ AND GRANT OF LETTERS
REGISTER OF WILLS OF CJ /)JI) 1M rAA1cL COUNTY, PENNSYL V ANlA
CL c" ',f.' "".-
~"". ..' ;':fd\ :,),'
L-. 4d, .9tJlf"~rr:(-~i u~r~~.:
,
File Number
c2 (~ deDI. -13t
. Deceased
Social Security Number d () 7 - ;;:;J.. -I () C? 9
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
IZf' A. Probate aod Grant of Letters Testamentary and aver that Petitioner(s) is / are the
last Will of the Decedent dated I;) / d / ~tf and codicil(s) dated
( I
named in the
(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 instrument(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
(If applicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Administration. c.t.a. or d.b.n.c.l.a., enter date of Will in Section A above and complete list of heirs.)
Name
Relationship
Residence
Decedent, then
71
years of age, died on d / ) / / (J 7 at
I I
f Jltun fMyS IJuA €- I-!-& 51;hi
Q
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
$ J.OO()
,
$
$
~'5
$ .000
situated as follows: q EA'5f mAIl1 STEE7
/ofEwBj1,Lb PA
/
17;;1<>
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Lelters in the appropriate form to
the undersigned:
1/& /1 WJillrl~1e IZd
;e'/?S?dWA/
Form RW-OJ rev. 10./3.06
Page 1 of2
6~7 '-/ir
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA ')":' 7 1'1" , ,"
COUNTY OF C V 1K betJI1.(/d : 55 ''" 1lI11~ - ~ AllIl: 33
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing P.etitJri!JJ~ttu~/~d_correct to the best of
Ulir.'r';/'I ' '( I L'T
the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decc:@~#t;P'etiti~ner(S}'~fli 1~~1l and truly
, "
administer the estate according to law,
Sworn to or affirmed and subscribed
before me the ~ day of
~4F~itir;
.~~(Y~~
~,. ? iJ'~~
!Ii" '~P="'Re""~
Signature of Personal Representative
~il'NUmber~ {OJ 7 - r:;1t'
Estate Of~ J . .~~
Social Security Number: cVC>1 -';)9 / )o9A; Date of Death:
ANDNOW,_M(}((lh 5 , c){J)1in consideration of
- -
having been preSel1te~T IS DECREED that Letters ~
are hereby granted to , ( "Davis ') uu fl1
, %eased
ell// '7
f f
e foregoing Petition, satisfactory proof
in the above estate
FEES
$ /35: CJ)
tY C/. OD
Attorney Signature:
Letters
Short Certificate(s) . . . . . . . . $
R,nuncii P P 5
Ii... $
c:J ...$
.. . $
.. . $
.. . $
. .. $
.. . $
.. . $
.. . $
TOTAL ........... . . . $
15CP
IO,cO
5.CfU
Attorney Name:
Supreme Court J.D. No.:
Address:
Telephone:
J ~JfD
Form RW-O] rev. fO./3.06
Page 2 of2
}-~~t')~.~o~ REV :/05
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. 07- Iff
No.
~tf
-
Fee for this certificate, $6.00
p
13236320
jdj~~~7
Dae
;~2
!"-,,)
Hl05-143 REV 1112006
TYPE I PRINT IN
PERMANENT
BlACK 1M(
COMMONWEALTli OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructlons end exemples on reverse)
'-~-')
(..:~~~-'.)
"-J
-,
.......;.,.
;;;;:;
I
(.n
J:;"
--
-
-
STATE FILE NUMBER
(.v
W
7;
- IOQl1
5, Ago (lMIlIlllhday)
7.BiIthpIIct tndllateor
T-+
8'" County of Dealh
r (01\1\\:.\'''1 Chambersburg
11. Oecedent's LI8ual oIwortdont most 01 lIfe.DonotstBlel1li'ld
K>1d0l_ K>1d0l_'~
Machine Operator Beistle Company
18._.MIIlngAddoaaISlnlll.cily/-,_.zlpcoda)
9 East Main Street
Newburg, PA 17240
18, F..... NIme (F1IIl, _, Iul. 1IIffac)
Frank A. Thrush
12. WaI 0ecIdInt ever in the
U.s.__?
Dv.. OlINo
Dacadanra
__17.._
17b, CoirIy CUmber land
1lid~1
l.Mt~.
Townah~?
17e.D Yes, DecedenllMd in
17d.Kl No,___
Adualll* 01
Two.
Newburg
Cilyl8oro
. ~
19. Mother's Name (FiIIt, rrtiIe, nUten IUI'IUIIJ
Mary D. Reed
2Ob. _.MaIing-1SlnIIl. clIy/_, _,zlpcoda)
22058 Second Narrows Road,
21,. PlaceolDilpaallicn(NamaoloomallllY, _C)(olherplacel
Amberson, PA 17210
21~Loca1ion(Cily/_,_,zlpcoda)
Smithsburg, MD
21783
~
~
Funeral Home Inc., Shippensburg, PA 17257
23b. License Number I 23c. Date Signed (Month, day, yelr)
t>~-\l\-o7
11ams2+28 mull ba~ by pIIIOI1
. VItloprorll)OOCl8SdeIlh.
25. Dole """"""*I Dead (Monh, day, yaar)
s03 M. O~-\\-O
CAUSE OF OEATH (See ,_ .... oumpIH)
HemV.PIIlI: EIUllhtlllilD.Jl!.mlll-_,Irjuriaa,C)("""""'" lhtldiooctlyClllll8dlhe_.DONOTaolarteminal......_..canlacllllll,
_<<Y._C)(____oI-.glht~.LiBlaiy...._()(Iaachh.
IMMEDIATE CAUSE lFinaI_ C)( r \ .A A {') 1\ .. _ .J-
--.g~-) -.... '-.cI...VIUi~\ll\.\lIf.I.'" ".....~,
b. DUOIoI()(ll'~~ ..,....::i'
1>.le101()(8S'~~ '\t..l(oC..,ti--Q ~~e.
Due to (or as a con&equenc8 of): ~
Case ReferreclIO Medical Examiner I Coroner ior 8 Reason Other than Qemati)n or Ooretion?
VIS ~
, .
,"
32tIlT_""IOJI.'Y(SpecIIy)
DDriver/Dpatalc)( DPusanger O_rian
Olher._:
338. CelIfief (chect only one) Xtl. SI(J1aIlxe and TtUe 01 CertWier
~~~~~:.~~~~~~~-~-~~~~-----------------~ ~
PnInouncint... c:artlfyIng pIlyaicIan (Pt1ysicOan boIh pl()(IOlIlCing daalhlnlllOlWyi>g 10 _ 01 _I 330. Ucense _,
::.:..~:='-- ._.and dIlelo~cauaa(.)lnlmanner...Ialad..----------------- D M'b I.\'l.~~q..,
On the bui6 '" euminItIon and! at the time, dale, and place, and due to the cause(a) NIMM8f IS ,tIdICL 0
DYes DNo
~ural DHomiclde
0-- D PendIng~
D- DCouldNolba_
I Approximateinlerval:
I Onset to 0eIIh
I
I
I
I
,
I
I
I
I
I
I
I
I
I
I
I
Pan H: Enler other Ilianifanl oondiIionII c:onIrIdino 10 dMIh,
bu1notrest.6ngJlthemdertyilgc:ause~ninPartl.
28. Did Tob8oco lJH Contmute to Death?
OVIS OPI1lballIy
ONo ~
29. " FfIIl'I8le:
Iil Nol pragnanl wih~ pill yaa'
Dp_a11imaofdaalh
DNoIpragnanl,bulpragnanlwilhin<2days
ofdealh
D NoIpragnanl,bulpragnanl43dayslo1yaa'
beloredaalh
D _lpragnanI_lheplllyear
32c. br~= :ne~jSlreel, Fadory,
_lla1conr1lions,lIany,
leldinalohcause lisledon linea.
Enter tie ~DERLYWG CAUSE
=:a~u:.~~
301. Was an AUopsy
-
d.
3OIl. Wa<e AUopsy FkldInga
__IoCamplalion
01 Caulie of Deeth?
31. Mann8r of Death
D V.. (5Ho
32d. Tma 01 Injury
32g. Loca1ion 01 Injury (SIr"', cily Ilown, sIaI'l
M.
!
~
o
w
~
O:)..~ -0
34. Name Md MSress l!' ~rson Who CompIe1ed Cause 01 Dealh (Item 27~ Type I Print
~'S "",,.\....0 two.. ~~""'~ (1A "2,CI
Yn\C:> ~_ S~r *-.t).
(
-~
Disposilion Permil No.
\\Forrestmyers\SharedDocs\Word Processing\estate planning\client's work\wenger, dorothy I.LWftT.Nov04.doc
'.
** LAST WILL AND TESTAMENT **
07 -19<6
I, DOROTHY l WENGER, of Newburg, Cumberland County, Pennsylvania, revoke my
prior wills and declare this to be my Last Will:
FIRST: PAYMENT OF EXPENSES -I direct that the expense of my last illness and funeral be
paid from my estate as soon as may conveniently be done,
SECOND: BEQUEST - I give, devise and bequeath my estate, real or personal, tangible or
intangible, together with all insurance policies thereon unto my children in as nearly equal
shares as possible, per stirpes,
THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and remainder
of my estate unto my children in as nearly equal shares as possible, per stirpes.
FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual
payment to a beneficiary, no interest in income or principal shall be (i) assignable to a ;;5
beneficiary or (ii) available to anyone having a claim against a beneficiary. !,~o ~
23 ?~
-,- (') j:J
FIFTH: DEATH TAXES - All federal, estate and other death taxes payable on the p~ty ~ I
forming my gross estate, whether or not it passes under this will, shall be paid ourQf)ij:(e U1
principal of my probate estate just as if they were my debts, and none of those tax~stlall b!;:::
charged against any beneficiary. This provision shall not apply to any property ov~[which E
have a general power of appointment of federal estate tax purposes. \j'':::'; ;~,
0)
.-" j
SIXTH: MANAGEMENT PROVISIONS -I authorize my Executors, as follows:
A. Retain/Invest: To retain and to invest in all forms of real estate and personal
property, including common trust funds, mutual funds and money market deposit
accounts and certificates of deposit, regardless of any limitations imposed by law on
investments by executors or any principle of law concerning investment diversification;
B. rompromise: To compromise claims and to abandon any property which, in my
Executors' opinion, is of little or no value;
C. Borrow: To borrow from and to sell property to others, and to pledge property as
security for repayment of any funds borrowed;
D. Sell/Lease: To sell at public or private sale, to exchange or to lease for any period of
time, any real or personal property and to give options for sales of leases;
E, Capital Changes: To join in any merger, reorganization, voting-trust plan or other
concerted action of security holders, and to delegate discretionary duties with respect
thereto;
\\Forrestmyers\SharedDocs\Word Processing\estate planning\client's work\wenger, dorothy I.LW&T.Nov04.doc
"
F. Distribute: To distribute in kind and to allocate specific assets among the
beneficiaries {including any custodian hereunder} in such proportions as my Trustee
may think best, so long as the total market value of any beneficiary's share is not
affected by such allocation.
These authorities shall extend to all property at any time held by my Executors or my
Trustee and shall continue in full force until the actual distribution of all such property.
All powers, authorities and discretion granted by this Will shall be in addition to those
granted by law and shall be exercisable without court authorization.
SEVENTH: EXECUTOR - I appoint my daughter, Betty L Davis and my son, Larry L Wenger,
Executors of my Will. Neither my Executor, nor any successor shall be required to give bond.
IN WITNESS WHEREOf, i have hereunto set my hand and seal this 2c:L day of December,
2004.
(SEAL)
estatrix
In our presence, the above-named Testatrix signed this and declared it to be her will, and now,
at her request and in her presence and in the presence of each other, we sign as witnesses:
2
\\Forrestmyers\SharedDocs\Word Processing\estate planning\client's work\wenger, dorothy l.LW&T.Nov04.doc
., -.
STATE OF PENNSYLVANIA
SS
COUNTY OF ~~L~
I, DOROTHY L WENGER, having been duly qualified according to law, acknowledge that
I signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for
the purposes therein expressed.
We, DOROTHY L WENGER, the Testatrix in and the undersigned witnesses to the Will,
the attached or foregoing instrument, who have signed the instrument, having been qualified
according to law do depose and say:
(a) that I, the Testatrix, do hereby acknowledge that I signed the instrument as my Will, that
I signed it willingly and as my free and voluntary act for the purposes therein expressed;
and
(b) that we, the witnesses, were present and saw the Testatrix sign and execute the
instrument as her Will, that she signed it willingly and executed it as her free and voluntary
act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the Will as witnesses and that to the best of our knowledge, the Testatrix
was at that time eighteen or more years of age, of sound mind and under no constraint or
undue influence.
Subscribed, sworn to or affirmed,
and acknowledged before me by the
above-named Testatrix and by the
witnesses whose names appear on
this 2.c:l day of DECEMBER, 2004.
p +-~ ~
Notary lic
NOTARIAL SEAL
FOREST N..MYERS. NOTARY PUBUC
SHIPPENSBURG BOROUGH, COUNTY OF FRANKLIN
MY COMMISSION EXPIRES DECEMBER 17,2005
3
......