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HomeMy WebLinkAbout05-23-07PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF r G M $~ R L ~N ~ COUNTY, PENNSYLVANIA 1 ~. p '(Z ~.~.~ ~ Q ~' File Number ~ - ~ i ~ ©~~~ Estate of V ~ le /~ 1 also known as ~ "/ 6 - 1 ~ " 2. ~ ~~ Deceased Sociai Security Number Petitioner(s), who is/are 18 years of age or older, appiy(ies) for: (COMPLETE 'A' or 'B' BELOW:) ~\ ~[ `RC V '(' R ~ k named in the A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~, ~ ~ ~~ last Will of the Decedent dated l' 3 14 P >~ ~ -'s and codicil(s) dated ~ l (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 bom or adopted afte ~ xec~u_tion of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: 't,V( ^ B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; duraiite minoritate) _ , Petitioner(s) after a proper seazch has /have ascertained that Decedent left no Will and was survived by the following spous't3 (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.) _ ~ -~ ~, =-~--r (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in _.; C`• his /her last principal residence at ~ d t street address, town/city, township, county, state, zip code) a7 S' : r ~ L Decedent, then ~_ Yeazs of age, died on ~ °I lil ifY at ~ ~ L y `~ p ~ ~ l T ~"') Decedent at death owned property with estimated values as follows: $ 1 ~ t a ~ a. gu6 (If domiciled in PA) All personal property L " Personal property in Pennsylvania $ (If not domiciled in PA) $_ (If not domiciled in PA) Personal property in County $ S., D' (~ D ~ !moo Value of real estate in Pennsylvania ~u .~ .P ~ 1,4 z ~ ~ i4 J ~ X13 D ©~ ~u d d 1~ L. ~ to ~, ~ v ~ situated as follows: ~ Wherefore, Petitioner(s) respectfully request(s) the probate of [he last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to Page I of 2 Forst R.W-0? rev. !0.13.05 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF ~ U ~ ~ ~ L yf /1'~ 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. Sworn to or affirmed an¢ subscribed before me the ~~ day of ,~ For the Register Signature o e n 1 Representative ~ j ,--~ __ Signature of Personal Representative _ - „ Signature ojPersonal Representative --` .: .. ~,.. File Number: ~ ~ ~ 1 ~ s ~~ Estate of ~ ~d V~ ~Y ~ ,Deceased Social Security Number: I~l~ i ~ ~a11?g~ Date of Death: ~'~ AND NOW, ` ~ "'^~( ~J , ~~ , in consideration of the foregoing Petition, satisfactory proof having been presented befo me, IT IS DECRE~rED that Letters ~~TAMrc l~~`Q are hereby granted to ~-~ ~ `\ in the above estate and that the instrument(s) dated ~t.(t\~ 4 13 OS °L ~ ~~~ ~~i ~~ 01 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. say ,~ u_ o~ _~__ _~ ~,._ n__R,,.~ FEES Letters ............... $~~+~=, Short Certificate(s) ........ $ [~O Renunciation(s) .......... $ ... $IS .~ ~~~ _ ... $ i0-tom ...$ ... $ ... $ ... $ ... $ TOTAL .............. $ ~~c~~ Fort,: RW-0? rev. !0.13.OG Attorney Signature: " ~ ' Attorney Name: ~'~ ~ t ~ --~ ~ -~~ Supreme Court I.D. No.: ~ ~ z o ~ Address: '~ ~ ~ ~ ~ ~~ ~ ~ ~ S~ [~ ~~~.....4°22'7 Telephone: ! ~ ~ '- 7~ 7 - ~ ~ ~~ Page 2 of 2 105.805 REV 1/OS 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. Fee for this certificate, $6.00 ~.~~ ! n Local Registrar P 13354669 No. MAY 1 0 2007 Date O - -_. -Ace -- _, `- _ - ~, ~~ ~„'; REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS iAiiErTrr" CERTIFICATE OF DEATH ;N INK ~$@@ In@t-UCtl00$ BOCI @J(@D1PI@S 011 f@V@rS@1 STATE FILE NUMBER 1. Name d Deadanl (Flre4 middle, last, sulfa) 2. Sez 3, Sadel Security NaMer 4. Date d Death (MOnn, day, year) Vera P. Rhoads Female 796 - 14- 2684 11'1Q 9 X00 5. Age (last BirtlNay) Under 1 ear Under 1 6. Date d Bhn (Month, day, err) 7. &dhplea (City and side a ~ caunlry) Ba. Piece d Death (Check on one) klonme 0.n tan laawa Hospital: Other: PA I 6/11/1925 Harrisburg atied ^DOA ^Nurein Hone ^Resider,cp pother-S t ^ERIOut edry: ti , g p p npa en 81 vre • 80. County a Deep Bc. Glry, Bom, Twp. d Dean fid. Faddy Nana (If not irelautlcn, gwe sired and aanMg 6. Wee Decedent or Hepenk Oripin7 ®No ^ Yas ,o. Rea: pmericea Iriden, Brock, Wha, ek. Cumberland East Pennsboro Twp 1 (Ir yes, seedy Cuban, (SpsdM ,}--~~) S if Vi'i' ~us t {,..GL I Mezicen,PadoRicen,etcJ White 11. DeadanYs lMuel Uon Nkid d wank doe d ' moat d file. Do not slate rent 12. Was OeCedem ever in the 13. Decedent's Eduction (Speciy ony highest grade completed) 14. Merilel Slalue: Menbd, Never Mamed, 15. Surviving Spouse (II wife, give maiden name) "~ (~M NkM d Wont Nk,d d Business / Iridushy gistered Nurse O.R. Nurse U.S Armed Fyor-ce-,s? Elementary / $tlcondery (012) College4ll ~ or 5*) Wl ~ ^rea •LINa )[ • 16. Deadam's Maifing Addesa (Bred, dry /roan, stale, ziD code) Deceded'a PA Did Decedent ,ny, East Pennsboro Live in a 17c Decedent lived in Twp I Yes F 1083 1bgFnood Lar1e . . , ' Aduel Residence 17a. Stale Township? 17d. ^ No, Decedent LNed w11Mn miberlard O la PA 17025 , 17b c°'"ry Actual umire a ciy / Som 16. Fatlefs Name (First, midae, bd, sums) 19. Moner's Name (Rrsl, midde, rteian surname) Loretta Rose Hayes Pryor 20e. InlomianYe Name (Type / Print) 20b. Infament'a Meiling Address (SOeel, dry /town, srere, zip cads) Silk P.O. Box 367 209 4th St. St~erdale, PA 17093 - 21e. Menod d Dbpailian I ®Gemelbn ^ Donallon 210. bete d DisPosdlan (MOmh, day, year) 21 c. Plea d Depaition (Name d amdery, crematory a omer plea) 21d. Loa6on (City I town, arere, ziD code) p Re~n",d'mn'state i ~~r ~~ Amh°r~ed~ ^ ~, y ~/o /p ~ Hollinger Crmlatory Mt. Holly Springs, PA 17065 /~ ^ ~ ~ ~^~ ~ 22a SlgreNre d Furidd (a person adkq m such) - 22b. licwrea Number FD 012774-L 22c. Name and Address d FadNly Richardson Funeral Home Inc. 29 S. Enola Dr. E1TOla, PA 17025 ~ f. Hems 23ec oNy when aMynp 23a. To ne had IaloMedge, death accursed at ne tlma, dare cent plea stated. (SipneMre and ode) 236. Lkense Number 23c. Date Signed (March, day, Y~11 physidarl b not evakabre d dote d dean to wNy ace d dean. ~ nano 24-28 mud oe carplded b1' person 2d. Tme d Dean 25. Dare Praaukwd Dud l~n, ~Y• Year) 26. Was Case flderred Medical Ezemirer /Coroner for a Beeson One Mien Cremelan a Dablion? ~ ~ wM paauiaa aaan. 5 ~. ~ ~ q. M. m p oZ v U ^ Yes ( CAUSE OF DEATH (See InatnseUons and examples) r Approsknere idavd: Pan II: Enter otler 26. Did Tdeca Use Candbule ro Dean? Item Z7. Pvl I: F~ tl,e chain d euanb - dheesu,'s(aba, a mnpfiatlone - neat tiredly ceuud tle dadh. DO NOT emer rernand evade such es ardec enes4 r Oreet ro Dean bd nd resdlkg in Ina uMedying ease gben H Pad I. ^ Yes ^ Pmbedy o eac h on e . o g p. l a ny are ~ ue ~ o ~ M rp 1M end M a respirdory arrest. a redricubr fibMelbn wiltaW ^ No ^ Unknown \ ~_ (~ U.l(/~11 C / ~ / 1 ~ J ~ w - 1 l y ~ n L aildllq' t reardlklg n deetlt)diswae a 1~, ~ V J ~ y ~ ~ '^'a 7 1 \4a' l V Y `~~ ~• "' ` r a ~ 29. H Femda: ^ -g• . ~ r ~(+~ , / ~a /~,, / Duerolaua ,p0r7 ~ Ve~~.~,.(,~~/1V"~ ~~'~'I4/ 1, !Y C. 4.C..~ ~ 11yy Pot condticoc, N arty, b Nd pregeM wnlw, pact year ^ Pregnml al ame d dean . Ing ne wee filed an fire a r RLY9M CAUSE Da to (or as a consequence ot): ^ Not pregred, but Dregrerd witllb 42 days i ~E~~~nkrrappnpeae UiNknD~~~Eay e ~~ c' d ~ edtlApul ~ bverle r ^ Nd pregnad, M pregnra 43 days N 1 year Oa ro (a as a coraequerla op: r belora dean d r w ^ Unkwim q pragted wlWn ne pad yar , 30e. Wu en ArAapey 3W. Ware AubpsY Flntirpa 31. Manner d Daen 32a Data d Injury (MOdh, day, year) 32b. Oeacrihe How Irgury Oaafnad 92c Pba d Hans. Farm, Bred, FMay, OMa etc. (SpecYM Padmnay7 AveMeble Prior re Conpbtiori d cause d Dean? .,-./~ ^ ~~ L7Ne ^ Aaident ^ Pendrp Invesligalbn 32d. Time d Injury 32e. Ivry at Woa7 321. n Trenspodation Injury (SDeaYy) 32g. Lacetlon d Injury (Bred. dry / Nan, tidal ^ Yes Q'NO ^ Vas ^ No ^ Sddde ^ Caad Nd Oe Dddmked ^ ~ ^ Yu ^ Odver /Operator ^ Passenger ^Pedesden M ~. 39a, Cereler (deck any one) 330. Slgnahaa end Title Ce • CertllYkr9 phyaklen (Physdan arNrying ease d demh wlen eriotlier pnyakbn Ms Domed deed, and comDrered nem 23) dMharxumeddwrom.we~(eland mulneruahted..-------------------------------- btowbd b dW T t my q, he a o • pranoundng and annyhp phyaklan (PAysidan bent pra,ounckig dean atl artlMnB to was d dean) To na beddmy lmowbdge,d.dhaawreddnetone. dsee, end pba,end daeron,e aaaee(s)end nemrera abkzL----------------- ^ 33c. Llanee Nurroer !II/_,_)~,o,s~~ z Z3 L 33d. Dale (Moon, qpy~ S (/~ / • Msdlw Faardtler I Coroner On tie Dub d auminatlon and I a MvssllgMNn, ro my opk,lon, sun aeeuned d tlr tlms, deb, and pba, and ere ro the cauea(s) ant manner u elated- ^ ~. Name and Address d Person IMO Completed Cause d Deers (deco Z7) Type /Print de ear) Date Fded (Madh 36 Kathryn Frantz 36. Reglstrer'e and Detrid r ~ - I a l ~ I ~ i l I ~ I , y, Y . jU ~ 890 Poplar Church Fd. Suit 508 Cep Hill, PA 17011 ~ Disposition Peenil No. ~ ~~ / v C / FAST WILL, 1~N~ T'EST'AI~EI®TT' ®~ V~RA P. ~-IO ADS _, I, VERA P. BROADS of the Township of East Pennsboro, Cumberland County, Pennsylvania, ;~~. declare this to be my Last Will and revoke any will or codicil previously made by me. ITEM 1: Upon my demise, I direct that my body be cremated with the service arraigned by Richardson Funeral Home, Inc. of Enola, PA and my ashes be buried in the lot with my late husband, - William Rhoads at St. John Cemetery, Trindle Road, Mechanicsburg, Pennsylvania. ITEM 2: Upon my demise, I direct that no viewing be held. ITEM 3: I direct that all my just debts and funeral expenses be paid as soon as practical ~~ O aQQ; ~~' as ~~ w after my death. ITEM 4: I direct that all taxes and interest and penalties thereon that may be assessed in j 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. ITEM 5: I give, devise and bequeath all the rest, residue and remainder of my estate of I every nature and wheresoever situate, together with insurance thereon in equal shares to my children, namely, DANIEL BROADS of Saratoga, California, LORRAINE WAGNER of Enola, Pennsylvania, JEAN A. WENTZEL of Montana and NANCY SILK of Summerdale, Pennsylvania, or their respective ~ issue per stirpes. ITEM 6: Until distributed, no gift or beneficial interest shall be subject to anticipation or {voluntary or involuntary alienation. I ITEM 7: I appoint my daughter, NANCY SILK, of 209 Fourth Street, Summerdale, PA 17093, Executrix of this my Last Will. Should my daughter, NANCY SILK fail to qualify or cease to act for any reason as my Executrix, I appoint my grandson, WILLIAM P. SILK, of 209 Fourth Street, Summerdale, PA 17093, alternate Executor of this my Last Will ITEM 8: I direct that my personal representative or her successor shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ,~.~ day of , 2005. VERA P. BROADS 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. ^- residing at /ue-c/~. ~' ~S ~~+ ~~ ~ ~'/~ / ? a 3 ~- // t ,(~,y~w~/ residing at J0~' /1(.+~~ ~`u~ , {~~~"'^A ~it l ~ ~ I `~ 2 COMMONWEALTH OF PENNSYLVANIA ) ss: ~OUNTY OF CUMBERLAND ) We, VERA P. BROADS, CI $g ~"'9Lle Co~,c. and ~~nt.. ~b L~Oti ne,~. ,the Testatrix and the witnesses respectively, whose 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 lrnowledge, the Testatrix was at the time eighteen (18) years of older, of sound mind and under no constraint or undue influence. VERA P. BROADS Witness Subscribed, sworn and aclmowledged before me J, ~`-T ~ ~ »~ by VERA P. BROADS, the Testatrix, and subscribed and sworn to before me by L, ~ /' I q~-1 ~- ~ y~.~. and Y/n n-t M - d •,2 ~~" the witnesses, this i 3 * day of ~ P~ ~ C , 2005. Notary Public ( AL) NAIL ~ ~~~11 ~ COIIMgN1~ ONIAEi 3 f j~' ~ G ~ rr _ „_..t-' c~ 1 ~~ _ ~~ ~~_~ ,;,.. ~~ ~- ,' ~ ^~, Sri ~ _YL'7 ....v ~~ ~ -, ,~ J r ~_~° -~ -r..~ ~" '~ ~,",~ ~ ~ , ~ .,,~ .,1 ,.. L ~•~, s .:.. ..~ =,^_, A_ ;., ~,, ~. ,, "~, 4 {~-... OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS L U w1 ~~~ "9 ~ A COUNTY, PENNSYLVANIA Estate of V ~ ~ ~ ~. ~ ~'I~ O ~ ,Q ~ ,Deceased ~ ~ ~,l C 1~ ~' 1 G 1G and ~/U` t L Z r Aa(/l_ ~', S `1 L 1~ (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with ~ ~ ~' ~ ~' . ('~ j~ 0 I~ p --S' and am/are familiar with the handwriting and signature of the decedent, and that the signature of ~ ~ t2 ~4 ~, ~ ~ c7 t4 1~~, to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~ ~ ~ r4 'P _ ~ ~s ('~ l4 is in his/her own proper handwriting. (Signature) \ (Street Address) ~~,w.n_yc ~ ~ L ~ ~ 17 U ~~ (City, State, Zip) Executed in Register's Office Sworn to or affirme~~d22and~ubscribed before me this o~ K day of ~ , ~_. 'le t}= for egisrer of Wills x-'" r (Signs e) ZO l ~f~`-.'n S i . J5 COX ~6 ~' (Street Address) ~CJV~'~~^'ti~2~~LE,~ l~a'~i 3 ~ C{3~~ (City, State, Zip) C7 - .-~. - •. ~ -- ,. -=~ -- ~- ` ~ -, = =~ .. ;~., 4 ''~r Fn~m RW-04 reu, !N. /?.06