HomeMy WebLinkAbout03-27-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
Estate of MaN E. Woltz
also known as
File Number
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, Deceased
Social Security Number 203-05-8475
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW:)
00 A. Probate and Grant of Letters Testamentary and aver that petitioner(~) is / are the Executrix
last Will of the Decedent dated 7/10/95 and codicil(s) dated!
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(State relevant circumstances, e.g., renunciation, death of executor, etc.) _ (--:':2 (::::; ~)_2,
Except as follows, Decedent did not marry, was not divorced, and did not have !l child born or adopted after execution oftli~-m.strumen~ offereij
for probate, was not the victim of a killing and was never adjudicated an incapaqitated person: '~~ --, ~
o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.tic.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has / have ascertained that Decedent left no \\IiIl and was survived by the following spouse (if any) and heirs: (If
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and cpmplete list of heirs.)
I
r Name Relationsh'D Residence I
51 Summerfield Drive
Jnann Woltz dauahter Carlisle PA 17015
alkla JO::lnn Woltz Minnir.h
(COMPLETE IN ALL CASES:) Anach additional sheets ifnecessary. I
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County, Pennsylvania, with his / her last principal residence at 700 Wlanut
PA 170~3
!
Decedent was domiciled at death in Cumberland
Bottom Road Carlisle
(List street address, town/city, township, county, state, zip code)
Decedent, then 86
Carlisle
years of age, died on 3/4/07
i at Forest Park Health Center
Cum~rland County
PA 17013
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal propelty in Pennsylvania
(lfnot domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
None
$
$
$
$
9.000.00
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: '
Typed or printed name and residence
Joann Woltz
51 Summerfield Driv
a/k1a Joann Woltz Minnich
PA 17015
Page 1 of2
Form RW-02 rev. 10.13.06
I
Oath of Personal Rfpresentative
I
COMMONWEALTH OF PENNSYLVANIA
: ss
COUNTY OF Cumberland
i
The Petitioner(s) above-named swear(s) or affrrm(s) that the statem~ts in the foregoing Petition are true and correct to the best of
i
the knowledge and belief ofPetitioner(s) and that, as personal represen ive(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
before me the
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day of
t'"-....."
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,=
Sworn to or affrrmed and subscribed
~A~r
File Number:
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Estate of Ma E. Woltz
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, De~sed
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Social Security Number: 203-05-8475
AND NOW, March d\ ,2007
having been presented before me, IT IS DECREED that Letters testam
are hereby granted to Joann Woltz taka Joann Woltz Minnich
Date of Death: 3/4/07
FEES
Letters ............................. $ Lt S ,00
Short Certificate(s) ............ $ <600
Renunciation( s) ................ $
L01 \\ $ \ Sou
~Cr $ lOoO
~.\U $ 500
$ Address:
$
$
$
$
$ Telephon :
TOTAL ............................. $ ~300
consideration of the foregoing Petition, satisfactory proof
nta
in the above estate
and that the instrument(s) dated Jul 10 1995
described in the Petition be admitted to probate and filed of record as th
H. Anthonv Adams
49 West Orange Street. Suite 3
ShiDDensbura
PA
17257
717-532-3270
Form RW-02 rev. 10.13.06
Page 2 of2
HIOS.80S REV 1105
This is to certify that the information here given is correctly copied rom an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the Sta Vital Records Office for permanent filing.
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Fee for this certificate, $6.00
!jJA~~ ~4P<;;r
;:).pate __ . '-',
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WARNING: It is illegal to duplicate this c py by photostat or photograph.
p
13236452
No.
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<-:?
H105.1"3 Rev. OfAl6
TVF'EJPRltn IN
PERMANENT
SLACK INK
,. Nlme 01 Otcedctnl (First. middle. IIsl)
COMMONWEALTH OF PENNSYLVANIA' DEPA TMEt>jT OF HEALTH' VITAL RECORDS
CERTIFICATE F DEATH STATE FILE NUMBER
3. SocioISecurily_
203 - 05
-
.....1
08..9S-
86
Sb. County of Dulh
7. Dille of Biflh Monlh, cia
1921
0ihI<:
o lienl 0 OOA tit Nurl' Home 0 Aesidence 0 OIlltr.
9. WI/oS Decedent 01 HispIr*; OrigWl? 10. Race: American Indian, Black. WhNe, tie.
. No 0 Ves (II yes. specify Cubln, ISpecif)o)
Mexicln. Pverla Rk:an,tlc.) White'
14. Ma,ilal StIlus: ....'rled. Never ,..."ied. 15. SUMmg SpoU!! QI wife, oiYt nlden name)
_._ced(~
Widowed
VII.
Cumberland Carlisle
11. Decedtnl"UIUIIOcc lion i1dofworkdonecM' mos.lofwor iIe'donol'lIllltliled
KInG 01 Work Ki'M:l of EluHIIssnndUllfy
Waitress Restaurant
- 167 &"o'"1i:~~"'rc;tro,;,' ~'ti~M''''
Carlisle, PA 17013
12.
h' I
CoQege(Hor5+)
Did Decedent
livt in I
Townsh\>?
T"p
17c. 0 Y!5, Decedenl Lived in
(.,1
17d. ~ No, OecMtant lived wlIhin
klual llmill 01
Carlisle
ITb. Cooo~ Cumbe land
Cityl9oro
18. FalMr's Hame (Frst, mildIlI,lull
19. Mother's Name (First, niddIe,lT8iden SUlnarM)
Jose h L. Donohue
201. Inlofmenl's Ha.,.. (Typelprili)
Catherine McHale
2l:MJ. InkKrnanI's Mallno Address (Strlll. clly/lt:n1ln,slat., zip code)
51 Summerfield Drive
Carlisle PA 17015
21t. PIllt. 01 OiIpodlon (Name ol temellry, CI.nwkJry Of oIhlN plat.)
21d.l..oallon(Ciy~,s"II,~code\
o
w
on
=>
~
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Approlfimaleinl.rval:
ollHl10 dulh
28. Did Tabac:co Ur.eConlmule to Death?
o Ya 0 Plobably
~o 0 Unknown
Smithsburg Crematory Smithsburg, MD 21783
22c. NlmI and AddIess 01 F.ciMy P.o. Box 3
Fogelsanger-Bricker Funeral Home Inc. Shippensburg,
23b. Uc,nHNurmer 23c. OallSigned (Mon,h.day, yur)
PA
-?AJJ~(c, 73& J- cJ3-Ci1-,JN7
26. Was Case Referred to a Medical Examiner/Cofone(1
fV\1.~
)If V" 1/. No
Perl I!: Enter o(herdOniflC:ln1 condilimls ~butino 10 <lealh,
bul not rnulino in the undl"t!ng tauu QiYen In PIIrll.
o ?je 4"
CAUSE OF DEATH (SH Inslructlons and lxamptes)
lIem 27. Parll: Enler the ~ _ diseesas, in~s, or cotTlllcalions - lhal dhcdy caused Itl. dulh. 00 NOT tottl' Ieminllavents suc:h as Clrdl8c arl
lespiralofy IIf'st, Of venllbNr lbilotion wllhoulshowino the ,lioIogy. DO NOT ab!"eNle. Enter only one cause on a In,.
IMIlEDlATE CAUSE (Ful disease or
eondiIionllStllilglndulh) ~ a.
~~ ~ ,c~
29. II Femele:
E!t"1'IbIpregnaf\!wi!hinpestye.r
o Pragnlnlllltil1leoldealh
o Nol pregnanl.bul pregnanl within 42 days
01 death
o NoI JMIgnBnl. but pl'egnanl 43 davs 10 1 yesl
belofedealh
o Unknown ~ pll'gnantlritm tha pasl year
32c. PIece otlnjory: Home, Farm, Slree!. Factory, OffICe
Building, elt. (Sped/;)
Sequantialylislcon:lMions,ilany,
UdIng ID lhe cause Isled on Une 8.
.. Ell18llhe UNDERl YJHG CAUSE
.. (olSl.seorinjuryIhMlniialedlh.
events lesuling In death) LAST.
Due 10 ~s. consequence o~:
Due to (or 1.1 tonslquene8 01):
b.
Due 10 (01 IS a consequence o~:
301. WIs.nNJtopsy
Performed?
d.
3(l). Wertl Aulopsy FIld'1IlVS
AvallablePrIorloCoft1Jlelion
olCauseotDaalti?
DYes o.-1io
32d. Time ollnjuiy
321. llTr.nsportalionlnjury(SpedI)1
o Driver1Operelor 0 Pe!Hf1Q8r
o Pedestrian OOlhllf-Spedfy:
33b. S~IUfe end UIe of Cerihf
,;'
/~
32g. locallon (Slree!, clIv^own, slale)
321. OIte ollnju1y (Monlh,day, 181)
32b, DeSC1ibe how m;uiy OCCUl'Ied:
31. Manner 01 Dealh
JYl<a1ur.1 0 H_
o Accldenl 0 Pending Inveslioellon
o Suicide 0 Could No! Be Oelermined
>-
Z
W
o
W
o
w
o
"-
o
w
::;;
<(
z
/72 Yf.
o Yes O"No
M.
331. Certifier (check ont,' OM)
Caftltylng physician (Physlelan C8r\lIyIng cause 01 dlalh when .noth. phyIlcilIIn has pronounced dellh Ind colflllllled Rem 23) ./
To thl besl of my knowledge, dark occul'1'ad due to lhe e.usa(s) and mamMlr as stal8d '-'~____M'_'_'MM__.__'''M_'M''''MM'''__'M .'.M'...._.._.._......_m""
Pronouncing and certifying physician IPhysk:lan both pronouncing dulh and certifying 10 caus. of d.elh)
To lhe best of my'knowledge, death oceurred lllhe time, dale, and place, Ind due to lhe c.use(s) and manner as stated'__''''''-''MM''_'''M ...M'..".."'''''.....""....D
Medical Rummerlcol'tlMf
On the ba$Js 01 eumll'lltlon'ndIo
33<1. Dale Signed (Monlh, day. yeal)
5 - /Jk..... (})
OS/JO)//Ok
34. Name end Addt8!>S 01 Pelson Who ~ Cause of {}P..alh (hem 27) TypelP!inl
J ;)/c,,-,
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IV{ I/V U It. t ,.:
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#ritt,,;t#- 01753
LAST WILL AND 1BSTAKBHT
I, MARY E. WOLTZ, being 4f sound mind, memory and
understanding, do make, publish and declare this my Last will and
Testament, hereby revoking all prior wills and codicils made at any
time before by me.
FIRST: I direct that all my f neral expenses and just debts
SECOND:
I give, devise and b queath my personal property,
be paid as soon as practical after
tangible or intangible, to James B. oltz, Michelle E. Woltz, Joann
Woltz Minnich, and Michael E. Woltz in equal shares, per capita,
with the further provision e children may share in the
property in kind, and remove s which they desir~accor~ng
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to value.') ~.:'
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THIRD: I hereby grant to the a ove named children t:.li!;i~ opMon:
,<. ,J C":") -J
to purchase that certain residence hich I may own at th~ o:tim~: of.
.,:::~ 0,)
my death for the value as set by a independent appra~sal of -the
-..l
said property.
The amount of the money shall be paid into the
estate.
FOURTH: I hereby give, devise and bequeath to James B. Woltz,
Michelle E. Woltz, Joann Woltz Min1ich and Michael E. Woltz, all
that real property which I may own t the time of my death, or the
proceeds from the sale of that sai real property, from either a
public or private sale or from e pursuant to paragraph Three
FIFTH:
I nominate, constit
appoint, Joann Woltz
hereof, share and share alike, per apita.
Minnich, to be the Executrix of thi my Last will and Testament.
IN WITNESS WHEREOF, I,
Mary E. !lwol tz, to this my Last Will and
..~ ~~~
seal, t1is /U. day of kp~' , 1995.
Testament, set my hand and
&,(0
ltz
(SEAL)
Sworn to and subscribed, declared nd
published by Mary E. Woltz, as
her Last Will and Testament, and so
done in the presence of we the
witnesses, who sign at her request,
and in her presence, and in the
presence of each other.
~~
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
I, Mary E. Woltz, whose nam is signed to the foregoing
instrument, having been duly qualif'ed according to law, do hereby
acknowledge that I signed and exec ted the instrument as my Last
will and Testament; and that I si ned it willingly; and that I
signed it as my free and voluntar act for the purpose therein
expressed.
Sworn to and acknowledged, before
by MaryE. Woltz, t~~statrix,
's (~ day of , 1995.
NOTARIAL SEA
DAWN MARIE SHOOP, Not ry Public
Shippen8burg, Cumberland unty, PA
My Commission Expires Feb 5, 1996
COMMONWEALTH OF PENNSYLVANIA:
:ss
COUNTY OF CUMBERLAND
We, H. Anthony Adams and Sharo Coleman Adams, the witnesses
whose names are signed to the for going instrument, being duly
qualified according to law, do de ose and say that we saw the
Testatrix sign and execute the ins rument as her Last Will and
Testament; that she signed willingl and that she executed it as
her free and voluntary act for the p rposes therein expressed; that
each of us in the hearing and sigh of the Testatrix signed the
will as witnesses, and that to t e best of our knowledge the
Testatrix was at the time at least ighteen (18) or more years of
age and of sound mind and under no onstraint or undue influence.
Sworn to and subscribed before me b
H. Anthony Adams and Sharon Coleman
the witnesses, this 1f5Lt'\ day of .
~t 7Yrwl~-p
Notary Public
~tl~
NOTARIAL SEAL
DAWN MARIE SHOOP, Notary Public
Shippensburg, Cumberland County, PA
My Commission Expires Feb. 5, 1996