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Home My WebLink About04-02-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA 0\ ()7)\ i ~\ Estate of JEAN E. LONG also known as File Number , Deceased Social Security Number 162-22-2230 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A'OR 'B' BELOW:) [g] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the EXECUTRIX last Will of the Decedent dated 10/18/2004 and codicil(s) dated 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 sp-<)use (if any) ~ heirs:(lf Administration, c.t.a. or d.b.n.c.t.a.. enter date of Will in Section A above and complete list of heirs.) c~ 0 ::::.:::; . -"--: ;~~J :~-. Name Relationshi U1 CO (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his / her last principal residence at 31615TH STREET NEW CUMBERLAN PA 17070 BOROUGH CUMBERLAND (List street address. townlcity, township. county, state. zip code) Decedent, then 80 503 NORTH 21 ST STREET years of age, died on 3/23/2007 at HOLY SPIRIT HOSPITAL CAMP HILL PA 17011 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 $ $ $ $ 575.000.00 0.00 0.00 75.000.00 1/2 INTEREST IN 316 15TH STREET, NEW CUMBERLAND, PA 17070 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: Signature Typed or printed name and residence JOYCE L. LONG 161 TH STREET NEW CUMBERLAND PA 17 70 Page 1 of2 Form RW-02 rev. /0.13.06 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND 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) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. before me the ~ day of (Jf\Cf( Sworn to or affirmed and subscribed Signature of Personal Representative Signature of Personal Representative File Number: Estate of JEAN E. LONG , Deceased Social Security Number: 162-22-2230 Date of Death: 3/23/2007 AND NOW, ~'(\\ ~ " ~ ,in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to JOYCE L. LONG in the above estate and that the instrument(s) dated OCTOBER 18. 2004 described in the Petition be admitted to probate and filed of rec TOTAL $ l>70!:t $ '-(k-- Attorney Signature: $ J .~ .tJ{) $ Attorney Name: DAVID H. STONE. ESQUIRE $ IO.iD Supreme Court I.D. No.: #39785 ,5vtD $ $ Address: 414 BRIDGE STREET $ NEW CUMBERLAND $ $ PA 17070 $ 717-774-7435 $ S~/vY Telephone: $ FEES ~~::~erti~~~~~~ ~.;.... ii.~) Renunciation(s) ................ Wtl! ~lv . Form RW-02 rev. JO.J3.06 Page 2 of2 H105.805 REV 1105 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. ~I'l~ Local Registrar Fee for this certificate, $6.00 p 13352477 MAR Z 6 7007 Date () SQ .--.j -::::~ r"; r -7 ~'_~ '"',,} r:;::::l = --.I ~ -0 -.-..,. ""-'- ./- -... I N -0 REV 1112006 , PRINT IN oIANENT CKINK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See Instructions snd exsmples on reverse) STATE FILE NUMBER (.11 , a \ O~ D'2>lre) 4. Dale ol Death (Month~V, yH~ n mGfO\ C:,i3 dCf:J Vrs. E. Lon 6. Dale ol_ Month, 7.81 (CilyaM""''' 3. Sor!&I Security Number 162 - 22 - 2230 61. Place ol Death (Check only one Hospital: OIhec patient 0 ER 1 0utpa1lent 0 DCA 0 Nursing Home 0 Residence 9. Wes Decedent ol Hi_ic Origin? 29 No 0 Ves (II yes, specify Cuben, Mexican, Puerto Rican. elc.) 001!ler.SpeciIy: 10. Race:.American Indian, Black, White, etc. ISpoci/l\ 1.Nameol~(Arst,_,Iasl,sufti'l 5. Age (Last 8lr1hdaV) 80 August 28, 1926 '7b. County Pennsvlvania Cumberland 14. Marital Status: Manied, Never Married, Widowed, -(Spocil)l Never Married Did lJecedent LiYeina Township? 17e.O Ves, ~ Uved" 17d.Qi:I~ee:'rwltiin white Cumberland E. Pennsboro Twp. 6d. FadlIIy Name III not_, r;.. ..... aM numberl ~C\~ S~r~ \ \-\05'\)\\0..\ moslof 11ft. 00 not s&ale Kind of BusInea I Industry Su ervisor Communications . 16. Decedent's MailingAddntss (Street. city I town, state, zip code) 316 Fifteenth Street New Cumberland, PA 17070 16. F_'s Name IFIrSt _, lest, suftIx) R. Dewey Long 2Oa. tntormant's Name (Type 1 Pr1nI) Joyce L. Long 2'.. Method of DIeposItIon 0 CramatIon 0 Donation gg BurIal 0 RerroYaIfromS1ala Wu~"__ o OIher.SpsciIy: byllodlcal_/ConlnIr'I o Ves ONic ~ 22a. . SeMce . (Of person acting as sum) 12. Was Decedent evef' in the U.S. Armad Forces? o Ves 1KI No 13. Dacedenrs Education ISpeciIy on~ t;ghesl grade completed) Elementary I Secondary (0-12) College 1'-4 or 5+) 12 Dec:edent'. Actual Residence 178. State Top. New Cumberland Ci~ I Bon> 19. MoIher's Name IArst,_, maiden........) Beatrice Walker 201>. _r. MaI1ng _1_, clIy 1_, slate, ~ axle) 316 Fifteenth Street, New Cumberland, PA 17070 21e. PIaca oIDisposIIion (Nameolcame\ery,aamatory"-placel 2,d. Location ICily 1_, -,~-) . ~ CompIela Only when CII1IfyIng pI1ysicIInlsnot_a1limool_lo corlIfy causa 01_. ~ 24-26"'" be completad by pellIOfl . who pronou'IC8I dHIh. Mt. Olivet Cemetery 220. Name aM_ 01 FadliIy arthemore FH & CS, Inc., P.O. Box 23b. LIcenea Number Fairview Twp., PA 17070 431, New Cumberland, PA 17070 230. Dale Signed IMonth, day, yH~ 24. Trne of Death 25 ~ma:;r,;J:!;j2 t!7l 26. Was Case Referred to Medical Examiner I Coroner for . Reason Other than Cremation or Donatkln? OVes ~ /() CAUSE OF DEATH 1_ fn_ - eurnplM) I Approximata_: ItemV.Pertl: EnlarIhe~__,IIjurIIs,,,~-lhaIdradlyCllJSOdIhe__IlONOTontarlerninal......_..ce_anaet, I OneeIloDeath l8IIplratOryarraal,,,~l\blt1a1ion_~lheatlology.UsIon1yonecausaon_ine. : L1 '( ..J:' I ~~=-::. .. ~c(nL P....Jt- AL...//iJ h~ ."j~ /~aT:~.40 G.l8to(oras,~: " (/ I ~ b. ~~-h ,1)'.t;<~A:~ I Co ('1-i It? ~~ ir-r' : "ad Duo 10 I" e 01): V I Part II: ErHr olher lIiDnIIicanI mdtioos cmtrilutino to dRath bulnot resUlIng Inlhe urdor1ylngcausa given;n Pert I. 26. Did Tcllac:cc Use ContrtlUIa \0 Death? OVes O~ ~ Ne 0 unknown 29. H Fomale: o NoIpragnanlwltiinpestyear o Prognant at limo ol_ D No! pragnanI, but pragnanI wilhn 42 days ol_ D No!pI9gIl8It. butpragnanl43days\o 1 year belora_ OlJni<ncMnUpragnanlwilhinlhepeslyear 32e b\::= ::-~jSlrael, F~, _......-.., Uany. 118i1na101he...lIstedonlnea EroIIr Iho UMIlIIILVlNG CAUSE =:e~":.tt.~ d. OV. ~Ne DYes ONe 31. Mamer aI DeaIh SNalural D- 0-- 0 PencIng InvesligaIIon OSuicide OCWdNo!be~ 32d. Trme of Ir;.y 3Oa. Was an AW>pay I'ar1or1rod? 301>. w.ra ~ RncIngs A_ P!Ior \0 Comple1ion aI c....e aI DeaIh? M. 32t.IIT~lnjury(SpecIfy) ODriverI~Op_D- Other . SpecIfy: 33b.SlgneIuraaMTlIleofCe<llllel, ~ 32g.LoceIlonollnjuryl_cltyl_,_) 33a.~(c:Ilackonlyone) CarlIlyfng pIryIIctIn (Physician certifying causa of _ when........ pI1ysicIIn has prorlCUIc&d _ am completad Item 23) ro....bastof"" knowIodge, _ _dut......cauoo(.)and _es__ _ _ _ _ __ _ __ _ _ _ _ _ _ _ _ _ _ -- - - - - - - - - - __..l!a Pronouncing and cor1IlyIng pIryIIctIn (Physician baIl1 p"""""",,, _ BOd certifying \0 causa ol _I . To"" bast of ""knowIodge, __ ......time, _ and ,*" and due.. Ihe cauoo(.) .nd _.-.t.._ __ _ _ __ __ _ _ _ - - - - - 0 =="=and/..~.inmyOfllnlorl,__atlhe_._.andplaco.onddut,,""cauaa(')and_.-- 0 35. ~ I~I /!o?I/Y n;onn<mnn ..,mil Nn ()I'3i. 1 CrOJ II ep\wills\LONGjean LAST WILL AND TESTAMENT OF JEAN E. LONG I, JEAN E. LONG, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, to my sister, JOYCE L. LONG, if she survives me. Should my sister, JOYCE L. LONG, predecease me, I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, to TRINITY UNITED METHODIST CHURCH, New Cumberland, Pennsylvania. ITEM III: I appoint my sister, JOYCE L. LONG, Executrix of this my last will. Should my sister, JOYCE L. LONG, fail to qualify or cease to act as Executrix, I appoint CARL F. PETERSON, Executor of this my last will. ITEM IV: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of h~~jher duties j:.1O in any jurisdiction. Page 1 of 4 ",....\ I !.A 2- ():J. ,'-- J 1\ IN WITNESS WHEREOF, I, JEAN E. LONG, have hereunto set my hand and seal this \ 'i~ day of ~C\~,,- , 2004. ?~f~~ JEAN E. LONG - SIGNED, SEALED, PUBLISHED and DECLARED by JEAN E. LONG, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the have subscribed our names as witnesses. ;t~t<r ~.l Address \J ~ CV-U W ""-~ R Address Page 2 of 4 II COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND I, JEAN E. LONG, the Testatrix whose name is signed to the at- tached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. )~ ~.,ck: JEAN E. LO;;:-t Sworn to or affirmed to and acknowledged before me by JEAN E. LONG, the Testatrix, this \\~ day of ~~ir- , 2004. ~~" ~4- Notary Public Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND We, D.t~ I\~ \--\ .G~ and iCt~h \.e e lIJ ~tl~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she 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; 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. Sworn to or affirmed to and acknowledged before me by \>0~'t1J.oeVl \\t(~. ~ )..\ J1\"'-t witnesses, this \ '\~ day and of ~c1:~ , 2004. ~..QJ). ,~f\~, Notary Public JH OF PENNSYlVANlA iJ'ARIAl SEAl CAROL L. TROXELL, Notary Public New Cumber1and Bora. Cumberland Co My Commission Expires Dec. 27,2005 Page 4 of 4