The URL can be used to link to this page

Home My WebLink About03-12-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF e UIf1IJEfUA-N.b COUNTY, PENNSYLVANIA Estate of Et/Jt 8!. AI. AiJ,4/11 S File Number ;).,\ l'l, 6~? also known as . Deceased Social Security Number 7'r.-~f- S83b, Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) !Xl A. Probate and Grant of Letters Testamentary and aver that Petitione~is /- the EXt.l:lli.r last WiIl of the Decedent dated St:I't. /I. 111'1 and codicily.fdated 11-,"/' 'U. UDD named in the (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as foIlows, 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 kilIing 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) Name Relationship ...., R~i~, ,~: ',C,C--, , . '~';-, "- :~<--- c~ -" .-- .~.. - ~-. . -, ,----) ---=:...'~, (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. .: '? ... De~edent was domiciled at death in C.............'Aoncl County, Pe~s'y'lvania with his /-MP last principal residence:~7\ .tsaa Home I ~Dl 1tJ......""r Sf:. c.u..\~s\e (ii_tit /tI:Jdltl"H ~JP.);" (List street address, town/city, township, county, state, zip code) f'J CA w,;d. . ~ - Decedent, then Ii years of age, died on /'n4rvlr I ~ .51l:r/ e'l/ld, 1-1 &,~ It:,~ . Decedent at death owned property with estimated values as foIlows: (If domiciled in P A) AIl personal property (lfnot domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania $ .2oJ IJ{)(), ID $ $ $ 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 /7D~ Form RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF Cl.l.n\~N.P The Petitioner<}? 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 beliefofPetitioner~and that, as personal tepresentative~ of the Decedent, Petitioner0will well and truly administer the estate according to law. before me the I J day of ~d Sworn to or affirmed and subscribed 1'.4 170.s#} Signature of Personal Representative Signature of Personal Representative File Number: \)."\ - ~<~Io <:~ -;___0 ~.~~ .~ )-:'" 'c::'::'-:' S :::-~,~,a 0.-.\ :::0 - r..J Estate of E~S. II. /HJA-/HS Social Security Number: 7/' - (),- Sr3{, Date of Death: sJI/ZIJO" ; :: ..;, . '" ';c'::} r:-? AND NOW, (YJr-.{/I.U'1 /,;{ , ;;;, OZJ) , in consideration of the foregoing Petition, ~rifactory pr~ having been presented before me, IT IS DECREED that Letters ~~MSVTA1f!Y are hereby granted to /lJ;NAt-/> e - A1JAnl.5 ~ Ili)(EW7JIf - , Deceased<; --c _....,.". ','\ in the above estate and that the instrument(s) dated Sqlf. II. 1'17'1 #Ad Ap,./, '2,4, Z,D6D described in the Petition be admitted to probate and filed ofrec?:>tJsthe last Will (and FEES ~ 1.00.00 ~o,cb :oc- E: S#/t'UJS 1iJ Letters ............. '\ $ Short Certificate(s) . L ?:>/ . $ Renunciation(s) .......... $ 0\\\ ...$ \ 'l COO-\. c.. \ . . . $ -.Jet' .. . $ ~Jo ...$ .. . $ .. . $ .. . $ .. . $ .. . $ TOTAL .............. $ Attorney Signature: 1'5,00 (~,oO (0,00 S-.00 Attol1ley Name: Supreme Court LD. No.: Address: Telephone: 7/1- 7" -pzof {J. ':).06 Form RW-02 rev, /0,/3.06 Page 2 of2 H105.805 REV 1/05 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. No. (M~~~}J'n Local Registrar Fee for this certificate, $6.00 p 13378418 1t~~~ 't 0200 7 Date o =0 ..::; :~ ~) ,...:=:> => --.I -,.n.. :;:::21 :::0 N f.~~~ '-- ':;;.J "--j ""0 ---~.. Hl05-143 REV 1112006 TYPE I PRINT IN PERMANENT 8lAC1< INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) N W STATE FilE NUMBER ~\ 6t ()~O'(), &d. FaciiIy Name (N noI ~_, give str... and........1 .. Dale of OealII(MonlII, day, ~ 716 - 09 - 5886 March 1, 2007 Sa. Place of Daatl(Ched< one) Hosl>ifaI: 0Iher: o Inpalient 0 ER I Culpa_ OOOA Nuosing Home 0 R,_nee 9.__of_O<9n'DlNo DYes (N yes, spedly CubaIl, Church of God Nursing Home ...."""', PuefIoRican, etc.) 12. Was 0ec8de0I ever iflltle 13. 0ecedenI'. Education (Specify only highest grade ~ 1.4. Marital SIaIus: MaIried, NtN Married. U.SArmed ForalS' EIemeoIaIy I SecondaJy (0.'2) College (1-4 or 5+) -, I);voo:ed(SpoaI)? Dyes [jb<o 12 Widowed '=""'~ "'.Slale PA ~~ "c~ Yes,OecedenIliYod. North Middleton ".c"""" Cumberland T_' 17d.ONo,_liYod_ AcIuallinilsol (COy and _ or 1. Name 01 0eceden1 (Fils!. midde, !asl, sulix) Elmer N. Adams 5 AfIO (las'BiIttldaYI 1Jode<' da - 6. Dale of Binh (Month, day, 88 Mar 29, 1918 OOlhel . Spec,~. 10. Race: American Indian, BIadl., WhIe, ale. (~ite 8b Coun~ of Daalh 801 Hanover street Carlisle PA 17013 T... COyI- Irwin Adams 19. MoIhef's Name (FISt. midde. maidenSllff'llln) Eva Biddle 2Ob. Informanrs Maing Address (Slteet, city I klWfl, sIldlI, ~ code) 18. Father's N8me (FiISl, midde. last, suffix) 2Oa. Wormant', Name (Type I Print) : FUNERAL HOME 37 E MAIN STREET 'S' KrJ 231>. Ucenoe _ 23c. Dale Slgnod (_, day, year) RN J ~ 3 5 7 3 L- nt 0.. 't~.h I, ?-N 7 26. Was Cil58 Referred to Medical Examinef I Corooer tor a Reason 0Iher 1tlan Credlalion Of 0anaIi0n? Dyes ~No Part u: Etief other sDlikanI. oonditions contmuIina m.dlilll, 28. Did Tobacco Use ConIItMAe to 0eaIh? btilnotresullingintheundel1yingcallS8~inPartI. 0 Yes Probably 0- ;;)Cv7 Appfoximateintelval: CJf\selIoDeaIh ~lstoordlions,jf8flY, leadingklhcauielistedoolioea. Enlef lie l.NJERlYING CAUSE ~~IIl~TJtr ('V---(jP~.J>~ ~t ~: (v,,€..- Duekl(OfaSa~oI): b. Due 10 (Of as '8 consequence 01): ~J~=)dise::. Dyes ONo 31. Manner of Death stNab"" D- O- OP"",",g'"'esligalion o ~ 0 Could No' be DeI,,"'n.d 29.. f8lfllBe: o Nor ",_-past yea< o Prognanl"'" of..... o Norpl8gllOlll....pI8gIlOIIl_.2day. ol- D Nor_buI"egnarI43day.1o'yea< ......- O-'"egnarI-"'pastye" 32c. Place 01 k1jury: Home, fann, SIreet, faaory, Qlice~,eIc{_) Due 10 (or as a coosequence of): Di. Was an AWlpsy PeI1omled? d. 3Qb. Were Autopsy findings Available Prior 10 CompIeIiOrl olCauseofDealh? OYes~ 32<1. Tmeofkljury 32g.Localionolkljury(SlreeI,OIyI_,_1 M 33a Ce<1k (check only 0001 CertWyIng ptlytician (Physician certifying cause of dealh when aoolhar physician has pronounced deaIh and completed Item 23) Totht besloI my knowIIdgt, dealhoc:cuntlddue SO Iht CMaSe(s) and manner.. atated........... _ _ _ _ _ _ _... ...... -... -... - - - -............ - - - - - -... :=:':~=~~:::'~:C~:':~lokl:c:~~a:maMef..ttated...... _ _...... _ _...... __ _...... _ _ _ 0 = ~~J,= and I 01 inve~ in my op&nion, death occurred at the lime, dale, and place, and due to the ""uta) and mantlllf as silled..- 0 (). 0 - \; ~ ~ o ! Disoosilion Permit No LAST WILL AND TESTAMENT OF ELMER N. ADAMS I, ELMER N. ADAMS, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and ~ereso~r the ~=: () ---l same may be situate, to my wife, Katherine M. Adams, her~;~!:,rs ~d assigns, absolutely and unconditionally. 3. -1:) r'0 !'.) C__) r0 In the event that my wife, Katherine M. Adams, should predecease me, or should she die at about the same time as I do, such as in an accident common to both of us, then in such event, I give and bequeath my entire estate, of whatsoever nature and wheresoever situate, to my three children, to wit, Nancy Ann Oxley, David B. Adams and Ronald E. Adams, share and share alike. Should my wife predecease me or should she die at about the same time as I do, such as in a common disaster, then in such event, for the purpose of facilitating the settlement and distribution of my estate, I authorize and empower my Executrix, hereinafter named, to sell any and all real estate which I may own at the time of my decease, at either public or private sale or sales. LASTLY, I nominate, constitute and appoint my wife, Katherine M. Adams, Executrix of this my Last Will and Testament, and in the event -1- that my said wife should predecease me, or should she be unable or unwilling to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint my daughter, Nancy Ann Oxley, Executrix of this my Last Will and Testament, in her place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of September, A. D., 1974. ~~~ Jt W~~~ftIJ~/7(~~) , Elmer N. Adams Signed, sealed, published and declared by the above named, Elmer N. Adams, as and for his Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testator, in his presence and in the presence of each other. KJ.,~f~ J5~JJRA~ R~ e R~ -2- CQDICIL I, ELMER N. ADAMS, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this a Codicil to my Last Will and Testament dated September 11, 1974. 1. I hereby revoke the appointment of my daughter, NANCY ANN OXLEY, as contingent Executrix of my Last Will and Testament, in the event that my wife, KATHERINE M. ADAMS, should predecease me, or should she be unable to serve as Executrix of my Estate for any reason, and I do hereby nominate, constitute and appoint my son, RONALD E. ADAMS, Executor of my Last Will and Testament, in the event that my wife, KATHERINE M. ADAMS, should predecease me, or should she be unable or unwilling to serve as Executrix of my \."--,"1 Last Will and Testament for any reason, and in all events, I direct that ~ said ~'"""";;'O ~-".\..J ~ -'("1 personal representatives be excused from posting bond or other security .~ ~e :;;(J .' -0 N ") ".' ........--.... faithful performance of their duties in any jurisdiction. 2 -:1 r'-) (j) r-.) - 1 - 2. I hereby ratify and confirm my Last Will and Testament dated September 11, 1974, in all other respects and to all intents and purposes not inconsistent herewith. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .!lo day of April, A. D. 2000. ~k~ Elmer N. Adams Signed, sealed, published and declared by the above-named, ELMER N. ADAMS, as and for a Codicil to his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. xL~~ d. 'Jt)~ - 2- ~ \ () I Cld,6 d-. OATH OF NON-SUBSCRIBING WITNESSfES} REGISTER OF WILLS C ttlH~LHN..b COUNTY, PENNSYLVANIA Estate of ElJItE1< H. ~A-/11S , Deceased /0 ;O;AlAtJ) E. ~.5 and ...{Mch}-being duly qualified according to law, depose(s) and say(s) that -eM / he /~ was /-were- well- acquainted with EZAt~,IV, h/1-lJt.$ and a~ familiar with the handwriting and signature of the decedent, and that the signature of I?t.JHMlt IV. ~ to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~Atii'fl AI. IftNIT/JS is in hi~ own proper handwriting. (Signature) (Street Address) /7IJS' (City. State. Zip) Executed in Register's Office Sworn to or affirmed and subscribed ,,", ''':: 0 --0 ::::-) .........,.~ ~- ~-;'::>" :::0 before me this \ ~ of f('\o-.rL.h day .10:> "\ N -cJ ---- -,,:" Of\~~ Deputy for Register of ills ~ c....) - Form RW-04 rev. 10./3.06 'a \ D"\ D?-3J.. OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS C &of 1M SRUA-NJ> COUNTY, PENNSYLVANIA Estate of E:t..Mtm. N. /f1JA-fJ1J , Deceased ~ 8El2.T F: fJENl>~ ,~) a subscribing witness to (Print Name/s) the'M Will 0 Codicil(s) presented herewith, ~being duly qualified according to law, depose(s) and the Testator I Tei:t1tm was ~ present and saw the above Testator.,t....Te,~ta11ix sign the same signed the same and that ~I he I~ signed as a witness at the request of ill ~his presence and in the presence of each other.,__, say(s) that ~he~ and that ..I he l-tftey ,,'T?~ X, ~.dA,./ (Signature) ~8trR T 1='. esvDIF'R. .32 F.'c.ldc,rest 1>,.,'ve (Street Address) C) ~:: 1_;; , , :';'J 1'.,) (Signature) ~ (Street Address) t..,.___ ::'-:\ r::' 0) M~",b..,,~, fJA 17o~ (City. State. Zip) (City. State. Zip) \ Execute~ Regist r's Office Sworn to or' ffi ed and subscribed )6 Executed out of Register's Office Sworn to or affirmed and subscribed of day before me this of t}Ht ~ t6du t~1r day Uor 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. Pleas.t:.hav.e D=entth~[o.tiginJlI or copy pfinstrument(s) at time of notarization. ~OMMUNWEA. I fl UF PENNSYLVANIA Notarial Seal Olarles E. Shields III. Notary Public Monroe T"'1l.. Cumberland Cotrty My Commission Expires June 20, 2008 Member. Pennsylvania Association Of Notaries Form RW-03 rev. 10./3.06 ~ \ 0 l o?--~:l OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS eUM~~ COUNTY,PENNSYLVANIA Estate of e- t.AI Erl IV. ~A-IfJ5 , Deceased .x /lI;BseT STAUFFe:. ,.~ae:h1 a subscribing witness to (Print Name/s) the 0 Will ~ Codicil~ presented herewith,~) being duly qualified according to law, depose(s) and say(s) that -Me / he /~ was /~ present and saw the above Testator t Testatrix sign the same and that .sae./ he /~ signed the same and that -afte. / he / ~ signed as a witness at the request of the Testator I- TesttNRox in .fter+his presence and in the presence of each other. (Signature) r"-) C:: ,~ ~:;5~ _:~~ .~~ "<- -:, .\ ~ --' .:;0 N .,-:;.. (Street Address) - .' i' ..:., _.- .. (Street Address) -0 -:r: /J!F&/ANles/Jul!.(;, fJlf /I/)S~ (City. State. Zip) (City. State. Zip) ,; -":::-\:l .-. '" (..) ~ecuted in Register's Om l? Sw~o or affirmed subscribed before me day of x Executed out of Register's Office Sworn to or affirmed and subscribed before me this of /I/~ 9~ day , ;UtJ1-. ~!!~p 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 presenOOMMl:iltIWm9llb'~ ~ItIIh\I\IffAotarization. Notarial Seal Charles E. Shields III, Notary PttlIic FormRW-03 rev. 10.13.06 Monroe Twp., Clmber1and Coulty My Commission Expires June 20, 2008 Member, Pennsylvania Association Of Notaries