HomeMy WebLinkAbout04-30-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~)."-. '\'\\~ f\(l~ COUNTY, PENNSYLVANIA
Estate of /)0..-. ~i K.. JA A. I Of! e
also known as /'::xn,.., ;, II) . IA....../ n I'L-L
File Number
~ \ (J1
tA:\3
, Deceased
Social Security Number
l7t-liJ-(p'2'l2
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
)Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I are the
last Will of the Decedent dated I (j II 0/2.00 I and codicil(s) dated
I .
E <L.eCv .{y\~.A.
.
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 tninori/ate)
Petitioner(s) after a proper search has I 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.t.a.. enter date of Will in Section A above and complete list of heirs.)
Name
Relationship
Residence
C)
-,::Q
.~~2-=,
~
c.)
C)
(COMPLETE IN ALL CASES:) Attach a
'\3:P
'..1
i"j
Decedent, then %5
years of age, died on
'+ /, '1/0'1 at
J I
/t{ aH-nY
r Ju1 L- ~JI,~ I~
(
w
U1
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$ (00. b~o. ..-
.
$
$
$ /~o oDD.
I ,
situated as follows:
q 10
9. 'l8~ Sr.
,
I
~f' I+\H
PA
lto l\
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:
f.
"7)1
T ed or rinted name and residence
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
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 ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
~~J~~
SS
day of
~-_?
Sworn to or affirmed and subscribed
before me the
Signature of Personal Representative
- :.-:~.!,
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Signature of Personal Representative
~~,
=:!~
co
..
File Number:
~ \ b\ bt\ \?:>
DO (0~~ \"'-.
\
\"\ D \ 1...0 Co :;;l3,d- Date of Death:
0)
Cl
\\\c~\LJhL
, Deceased
h\~DI
Estate of
Social Security Number:
AND NOW, , in consideration of the f~regoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters \ee::,. ~-\O-~
are hereby granted to \,,<\c, D. ~ 71 \e.n hro0~
\
in the above estate
Address:
a':ilI'~ ~
~~~ -
t I; ~ M ~J E("oT''''''
cC;~78' y
3901 ;tlwluJ sf
~ fAIl PA- /7o/l-lf).7. 7
FEES
Letters ............. ~ $
Short Certificate(s) . . (-'.~) . $
Renunciation(s) oo' (Woo. $
0\\\ ...$
0C? .oo $
~\0 oo' $
.. . $
.. . $
oo' $
oo . $
. oo $
. .. $
TOTAL .............. $
~l nb'():)
4().on
S-OO
\S.d)
\D.OO
;;.00
Attorney Signature:
Attol11ey Name:
Supreme Court J.D. No.:
Telephone:
?I 7 -- '7"3 'J-o 4 b Y
33S.00
Page 2 of2
Form RW-02 rev. /0./3.06
mOS.80S REV 1I0S
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.
~,t...- ~ ~~"at-);
Loca Registrar ,'/
Fee for this certificate, $6.00
p
13353284
APR 1 3 2007
Date
::0
( ~.)
C)
-[~
J,;~
C)
3 REV 1112006
01 PRIIlT IN
lMANENT
ACKINl<
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
85 VI$.
lb. County aI Deatl1
5-27-21
Harrisburg
\?
6. Date aI 81...
, or
7.IlIr1hpIace(C and_Of
moetal i1t. Donol_
Kindal_/1ndus1ry
T.R.W.
12. __OYer In It1e
u.s. AJmod FOIt8I?
DYes :UNo
13. ~s EducaI1Of1 (Spoclly only Nghest gnKIo completed)
EIementaIy/_I'f~I~ _ College (1-4 or 5+)
10. Race: American IncIan, Black, White, etc.
(Spoc/fjj
white
14. ~~~~' Married, 15. SurvIvIng Spouse (" wife, give maIdon name)
idowed
17c.[j V",_UWodIn Lower Allen
17d.O No, _UWod"",*,
Acil8l UmlIs aI
Twp.
Bd.FacII1IyNome{ltnol_,gIve_and........,
Manor Care
=~ 17.._ Ppnn;l .
17b.County Cumber land
19. ~s ""'" (FilI1, "*PO. IJIicjon sumome)
tsertna t'e~rer
1lId_
LNolna
TOWNhIp?
City/Bon>
2Ob.1nIoImanI's-.g-..s{-.cIIy/-....la,zlp-1
14 Woodcrest Drive Car1ise
21c PIaoo alllIepooIlion (Name aI cemoIaly,....-y Of - place)
Resurrection Cemetery
PA 17015
21d.].oc;pqo(~_,I\II!a,"'_...
lIt> b. uaK ljrove
Harrisbur Pa.
Rd.
221:. Name ar<1Ad<hs1 aI FacIIty
Neumyer Funeral
aI,lt1e~pIace_.{SIgna1uraar<1til1ol
?1 4P- ~n
"""" 24-26.... ba ~ by '*"'" 24. lima aI Oealh Dead (Monlh, , Y"!'l..
. M1opronclJOtldllth. O?'~() . /~. ~~t!J6'?"
CAUSE OF DEATH (_lnstructIona and . )
1Iom'ZT.PartI: EnlarIl1a~__,lrjurlaS,Ofcompllcallonl-lhaIcIrIc1IyClOlladIl1a_DONOTorlor__sucI1asCllldacanast,
18IPialOI'f'-' Of__wIlI1cl\f""""'uIt1e~. UaI onlyoneCOUlll on -....
=~=~ a. (v~-+: ~ ~t ~~ ~ (vve-
Dueto(orasa~
b.
Due to (or as a_ot):
Home Inc. Harrisburg, Pa. 17102
23b.li:Inso Nlll1'Iler 230. Date SIgned ~, day, year)
-f1l /~I'~~ /..:t 07 ~t:7 7'
26. _ Caae Re~ _ En_I Cotoner lor a Reasor Olher lhan Cremation or Donation?
o v.. [;2rNo
.\ppIlldmaIa _: Part It Entar __ ardIians _10 _ 26.1lId Tobacco Uoe ConIriIIuIa to Oaalh?
ClllsaIIoDeatl1 butnolllOUlllng 1n1t1e1nlellylng"""" given In Part I. 0 V.. P~
Unknown
3Oa._an_
Pa<Ionned7
d.
3lJl. Wele '"'- Rndlngs
Available Prior to CompIaIIon
aI CauIe of 0aalh1
Ov.. ONo
31._alDoalh
IKJNaIuIoI D-
O - 0 PandIng Investigation
OSuk:ida OColidNolba~
29. " Female:
o Nol-,_postyea!
OP_a1timaal_
o NolplOgllatll,but-'wilhin42days
aldaalh
o No! plOgIlatlt, but poaglOnl 43 days 10 1 yea!
o =-~__lhepostyea!
32c. PIaoo allrfJry: Home, Farm, -. FllCIoIy,
Oftice BuidIng. ate lSpeci/yj
_1aI...-..! any,
IeIlinatohClMtllledonlnea.
EnlIlr ... UIlIlERLYING CAUSE
=-~~~~
Due to (Of as aconsoquenca ot):
o V.. d{N.
32d.Tmeollrjul'f
M.
330. ~ (check only onal
. C<<tlIyIng~(Physiciancat1llylr<JCOUIlIaI__anoIhafpllysicianhasplOOClU'<ad_ar<1~IIom23) t'? . <:/
Tolt1eballalrny~ _ occunacl due to the cauoa(l) and mannor..__ - - - __ - __ - - __ - _u - __ - __ _n - - __ - n 1/
. PnlnounCIng and cortlfytng ~ (Physician boIh pronouncing _ ar<1 caltIIjIng 10 """" aI_) " 33d. Da~ ~ (Monlh, day, yaarl
. ::"=~=I,___atlt1e__and'-,andcluotothecauoa(a)andmannor...rt'd..._n---___-------- 0 lot IS' - L. If[ (JI() ..
On It1e _ aI._ and/ or 1..-getion,In my opinion, _ __ allt1e _ _, and.-, and due to It1e cauao(l) and mannor.. atatacL 0 34. Nama ar<1__ 01 PIl1Oll_ ~ CauIe aI Oaalh (1Iem 27) TY1l' / PlInt
35 RegiIIral's DIstrIct ., 36.DateFlad Monlh, ,yaar) CHI t..'1L (,0,,; .S'Tw I te.,
.. ~_ lo?l /1.::>11/1 1'1 '/3 ~~7 .~J.-;). .:5..p;t/.sf tf\l/'se.... PA /1013
DIIpoeiIIonParmitNo 0 J3la f) df ~
1
----
&
~
LAST WILL AND TESTAMENT
OF
DOROTHY K. MALONE
I, DOROTHY K. MALONE of Lower Allen Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and revoke any will or codicil previously made by
me.
ITEM 1: I direct that upon my death, my body will not be subject to any viewing.
ITEM 2: I direct that my body be buried in the grave next to my late husband,
WILLIAM M. MALONE. The grave is located at the Resurrection Catholic Cemetery, 116b
South Oak Grove Road, Harrisburg, Dauphin County, Pennsylvania, (nl9:r:e part~larly being
-" __._.' 0<--
described as Section 5, Lot 88, Graves 6 and 7.
C,")
c:)
ITEM 3: I direct that all my just debts and funeral expenses be paid:as'soonlls practical
after my death.
c,.)
C)"l
ITEM 4: I give, devise, and bequeath to the Church of Our Lady of the Blessed
Sacrament, Harrisburg, Dauphin County, Pennsylvania Twenty percent (20%) of my residual
~ estate or Twenty Thousand Dollars ($20,000.00), whichever is a greater amount.
z
~ ITEM 5: I give, devise and bequeath the rest, residue and remainder of my estate of
::E:
~ every nature and wherever situate, together with all insurance thereon, in equal shares, to my
>t
~ sister, ALBERTA C. THOMPSON, 60 Palmer Drive, Etters, York County, Pennsylvania, and
o
0::
8 my niece, MARY ELLEN GROVE, of 14 Woodcrest Drive, Carlisle, Cumberland County,
Pennsylvania, or to the survivor of them.
1
ITEM 6: I appoint my sister, ALBERTA C. THOMPSON, and niece, MARY ELLEN
GROVE, Co-Executrices, of this my Last Will. If either of predeceases me, the survivor shall be
the Executrix.
ITEM 7: I direct that my personal representative or her successor shall not be required to
give bond for the faithful performance of her duties in any jurisdiction.
ITEM 8: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
a part of the expense of the administration of my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, this /0 tf; day of (J ~~ ,2001.
~kcm~
DOROTHY K. ONE
Signed, sealed, published and declared by the above-named Testatrix as and for her Last
Will and Testament in our presence, who, at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as attesting witnesses.
/1'It!'" v<< L If.tV~'" /2,1.
residing at AI~ I! '-_, N tv J //!- /70 ~ S-
~M~'
residing at
It) f1' ~ JI- I IJ~/'-( h- /7;17
2
COMMONWEALTH OF PENNSYLVANIA )
) ss:
COUNTY OF CUMBERLAND )
Malone, J,S,4 41J4-~/t=: (J1I/ H€ and
, the Testatrix and the witnesses respectively, whose
We, Dorothy
4"l7e ~ _ 2).,....--
K.
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and that she had signed willingly, and that she executed it as her free and voluntary act
for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of
the Testatrix, signed the will as witness and that to the best of his or her knowledge, the Testatrix
was at the time eighteen (18) years of older, of sound mind and under no constraint or undue
influence.
.~t:97t~~
;;}i:P-
~ J,;v0~
Witness
Subscribed, sworn
DIY-d) 1<. /J1...lolf G ,
/'$1.4 1?1~'C' Cvy,v,;
this ,o?: day of (!) c.1a A~
and acknowledged before me llen!'",~. ttyPIZ by
the Testatrix, and subscribed and sworn to before me by
and
~ t<-t~
,2001.
D...-r--
, the witnesses,
~
~-n:r,tU.!M."",",~i~"
NOTARlr..L SEAL
HENRY F. COYNE, Ntlrerj PubIc
~ Twp., ClJmbsrlaoo CountY
My COmIpII8ion expires June 7, 2004
3
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of DOROTHY K. MALONE
, Deceased
I ALBERTAC. THOMPSON
,
(print Name)
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
CO-EXECUTRIX
administer the Estate of the Decedent and respectfully request that Letters be issued to
MARY ELLEN GROVE
...~
-
D-
~c~
'1/0 /, ;z rtL .dL.
'1-.),3- 67
(Date) .:r
U'J
..
-
(Street Address)
C()
, ,
~
(~ We;, '71-. /701/
C)
o~-
-Ie
o
. <;::::,
Bxecuted'1iJ Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this ~ 3 day
of ~ ' ~7
Deputy for Register of Wills
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
COMMONWEALTH Of PENNSYlVANIA
NOTARIAL SEAL
LISA MARIE COYNE, NOTARY PUBliC
HAMPDEN TWP.. CUMBERLAND COUNTY
MY COMMISSION EXPIRES JUNE 10, 2008
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