HomeMy WebLinkAbout07-06-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF c.\.t....-nb..e... \ A"'~
COUNTY, PENNSYLVANIA
Estateof \-\A~-eA C-_ YY"\ \.(\ \ ...c..l'\"'\.
also known as
File Number
(l J -01- O(o3Q
, Deceased
Social Security Number \ '1 ~ - J. 4: - (, '" 9?
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
1&1 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the1'Y\. A >r-\.' A.., \lcL-.L.t'\ e.r
last Will of the Decedent dated to,~"~ I "te1 and codicil(s) dated
named in the
o B. Grant of Letters of Administration
.-..
(State relevant circumstances, e.g., renunciation, death of executor, etc.) a g =:.:J
c: --' -en1
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of~~ent(S~ered ~S ~~
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:H ~ P r- c:3 0
'- ,m I [--, fT1
'c> -:: :0 ~ :'.'i"J C~J
..: c/") :A C') c")
~ l-n
:~~
,"- l-n
(Ife:;
(Ifapplicable, enter: c.t,a.; db.n.c.t.a.; pendente lite; durante absentia; durante mhJ-
'::> c-
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spou~~y) and~:
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs} )> 0
N
::Jt
Name
Relationship
Residence
Pennsylvania with his / her last principal residence at
. \7(14
Decedent, then
~9
years of age, died on
~ - ;}..l-o"7
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 PA) Personal property in County
Value of real estate in Pennsylvania
o
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:
Si nature
T d or rinted name and residence
:"""l'
\.~
('n
~.-
\')0')0
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF ~""^" \o.e.x- \~aQ.
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 beliefofPetitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Signature of Personal Representative
~..
~
Sworn to or affirmed and subscribed
(fftl
"n\.~
Signature of Personal Representative
(")
~O
~ ~ ::IJ
::g ~ (")
-1-,--
'-::~m
- :.n
..'-= (J) ^
.)00
.)011
.- C
'--) ::IJ
-4
~
......,
c::;)
<<=
....."
Co-
c:
r-
I
o.
File Number:
~ 1-(Yl-0Ji39
-0
:x
N
..
o
N
::0
::.0 rn
1,,0
C) ("..,)
- ,- ::0
(:.r~ CJ
f \ 1 f'Tl
.no
(-:-)0
'n."
::~5
:= rn
~,') ,.::J
r:.,
Signature of Personal Representative
Estate of
\\ A '"""2-.e..\ ~. \(Y\ : n \.. u V'Y"l
, Deceased
AND NOW,
having been presented before me,
are hereby granted to
\, ~ - ~Ll-(, ~ 9-7
:Jro7
Date of Death:
c - :.J..,-;).OO")
. in consideration of the foregoing Petition, satisfactory proof
in the above estate
and that the instrument( s) dated
described in the Petition be admitted to probate and filed ofrec rd as the last Will (and Codicil(s)) of De edent.
FEES
Letters ............... $ ~
Short Certificate(s) . . . . . . .. $~
Renunciation(s) .......... $
~"'$--'5.co
. . .. $-ED.1m..
. ... $ Cr:s.6D
... $
... $
'" $
... $
... $
... $
TOTAL.............. $ ~?>4Q
Attorney Signature:
Attorney Name:
Supreme Court J.D. No.:
Address:
Telephone:
Form RW-02 rev. /0.13.06
Page 2 of2
t.T11)).R05 ~SV rn'/f)71
~,I-07- 0(;39
LOCAL REGISTRAR'S CERTIFICATION OF ICIE,~~"H
WARNING: It is illegal to duplicate this copy by photostat or photl)'~raph.
Fee for this certificate, $6.00
P 13551194
Certification Number
REVIl_
I PRINT IN
_NT
.cKINK
This is to celtify that the infmmation here given is
correctly copi~d from an origi.la1 Certificate of Death
duly filed wilhme as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing. jUN 3 0 2007
am..~:?~1 L
Local RegistraI · Date Issued
("')
~O
." :0
:0-0
,flI("')
,~.J ~- r-
,- m
>,. :0
"'?w;:o:;:
, 00
JO."
'-,r-
,,-':0
::0-;
)>
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Inatrucllone -.d examplea on reve....)
STATE FilE NUMBER
'. Dolo 01 Doo1h (MonIh. d$y. yoa~
June 27, 2007
6._01 -.
7.
lIld_or
May 29, 1918 Tover City, PA
Ill. Fdlylillme IN noIlnoIlIuIion;gIYo_lIld-.,
Twp. Community General Osteopathic Hosp.
_01 ".001101_ 12.Wos__~1he 13.0eced0nl'.~{SpocIfyonlyhigheolgraclollCllllpiOlld)
Kildol_l--, U.S. Armod F.....? ElomonIIHyf_ry(().l2j CoIIogo(l-<1or5+)
oVto ClINo 12
_r.
_--.. 17a.SIB..
Pennsylvania
Cumberland
l1b. C<ulty
OllIe<:
ro..)
c::;;:)
c::;;:)
--'
c....
c
r-
I
0"\
.."
:x
~
o
N
:0
'0 '''/1
{'nO
00
()5 :::0
"...., C::J
rnrn
:no
C.>O
.- n 'T1
.- ..,.,
~8
,--,) '. )
{'-l
oOlller" Spodly:
to. Race:.AmiIritan 1ncIM,-BIat:k, White, ,Ic.
ISptcIfy)
Lemoyne
white
14. ~~~Maniod, 15, SurvMng Spouoe (Itwlla. give m.1den name)
Widowed
Pitt II: _~ dhIr~ mdIImI mtrtluha Il:IdIIlIh
butnoi-.g ~ Ihe uncIOIlyIng cauoe ~...In Part t
Top,
CMy/Iloro
19. MaIhen Nome IRIaI.-.__1
BessieTholll son
allb. -. MaIIng_(8rooI.dIy/......-.,.,-1
107 Bunker Hill Road, New Cumberland, PA 17070
21~ Placool~ {Nameolcomolory. ....-y"-pIacol 21d. Location ICl!yI-. ..... Zip-I
July 2, 2007 Greenwood Cemetery Tower City, PA 17980
22c,_IIld_oIFdIy
FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
23b. Ucanae No.onbor 23c. Dele Slgnod (Mon1h. da~ yoarl
3llo._..~
-
d.
3011. w... ~ 'ondngI
_ Prior" Completion
01 Cauao of 001'11'
0.... oNo
3211. 11mo 01 '*""t
1"""24-26_bo~ by_
"""-_.
24. l1mo 01 Doo1h
25._P~Doad(Monlll.dly.lOI'l
: ':P .A. M. ..:rune 2.1 2.C:D'7
CAUSE OF DEATH (See InolruolIona _ ......,....)
110m 27. Part I: EnIorIhe~--.Ir;a1oo."~-1haIdIOIdIy_""_DONOTonlar_I__aaoanlocal1Oli,
1IOpiIatory-'''--~'''oIIaIc>Qy.lJaIonly""_",,,,,,,,,,
=~~=-:;. (r-/r~ne/_e_Ml~ 4n'l~..1
. . OuIlto(lYu,~~: /'
~...-,Iany. b.
=~=c::::a. Due 10 loraa a_oI):
=-~~~ C.
Oueto(Ol'UICXlI'lMQOtllC8of):
~-
0nIat " 0aaIl
st. _ 01 DooI1
I8l NalulOl D-
o -. 0 PIIdng "-ligaIlon
0- oCouldNolbo_
o Yaa !if No
OIdDoaodanl
Uve1na
ToomahIII?
17C.0 Vto, -. LNod In
17d. gg No. -. LMd_
AduoI ~ 01
26. Waa CaN _10 _EJoomInot I Coroner for a _ 0Iher1hen CI8ma1ion or Oonallonl
OYaa [j'INo
26. OIdTobocco Uao ClintJIJU... DoafIl?
0.... OPlObably
oNo 0-
29.N_:
o NotpregnanlWllhlnpaal,...,
o Pragnant a'limo 01_
o NoI pregnanI. but pragnant _ 42 days
ofdlalh
o Not prepnt, but pregnenl43 days to 1 year
boloro_
o _"_'_lhepaalyoa,
32<. Placo 01 '*""t: _. Farm. SO..... F~,
OIIIcolluildlAg. ole. (SpecHy)
/?'?~hvl- J.i -h;.-
7:>...~ ., .t~_' .
M.
32f.NT~~(~}
ollriwor/~ OP_ OP-
0Ih0r.~
33>. SignoUa Il1d llIo 01
33a.Ca<!iIiorI_onlyonel
. ~::::r.7::'=-==:'~~"':.~IIld~':~_~_~~~~____..__.._______ 0 ~
=~=~..=::~~.::::.':.~=_.___________________ 0
. ==~and/or~.",myoplnlon.__a111lo1tmo,....and_.andcluololhecauaa('land_aaalatocl.. 0
33c. lJcanaaN_
35. Rt9strat't .
~
I~ II~I/I(
Disposition Permit No.
"
~
----
"
..
LAST WILL AND TESTAMENT
OF
HAZEL C. MINIUM
I, HAZEL C. MINIUM, presently residing and domiciled at
2712 Lisburn Road, Lower Allen Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and hereby revoke
all Wills which I have previously made.
ITEM I:
I appoint my daughter, MARIAN
KEENER, as Executrix of my estate. If she is unable to serve
in this capacity, or having been appointed is unable to
complete the administration of my estate, I appoint my grand-
daughter (if she is qualified to serve by virtue of her age)
JENNIFER KEENER, as Executrix of my estate. If Jennifer is
unable to serve in this capacity, I then appoint my son-in-law,
DENNIS KEENER, as Executor of my estate.
ITEM II:
I give all of my jewelry to my
granddaughter, Jennifer.
ITEM III:
I give the residue of all of my
tangible personal property, including any automobile that I may
own, to my daughter, Marian.
ITEM IV:
,,,..,,,
of ~ THOt!SAND::o ~
:'=. :n c.... l"n c-)
cc -u c:: GJ <:::>
Len,n~ ,r- (is ::0
E~~ I i~;:: i-r~
;: CI5 ~ 0'\ :D C..J
r~J 00 -0 ~..~ ~;)
(--lO-n __ ",1
- -)C -- :D
:- ~ ~ ?~
12
I give the sum
DOLLARS ($1,000) to Trinity Lutheran Church of
Pennsylvania.
C)
N
II
I'
ITEM V:
I give the residue of my estate,
of whatever nature and wherever situate, to my daughter,
Marian. If Marian should predecease me, I give the residue of
my estate to my granddaughter, Jennifer. If Jennifer should
also predecease me, I give the residue of my estate to my son-
in-law, Dennis Keener.
ITEM VI:
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 cost of administration of my
estate.
IN WITNESS WHEREOF, I have hereunto set my hand this /~ ~
day of
r
, 1989.
~c,~
Haz C. Minium
The preceding instrument, consisting of this and one other
typewritten page, each identified by the signature of the
Testatrix, was on the date hereof signed, published and
declared by HAZEL C. MINIUM, the Testatrix therein named, as
and for her Last Will, in the presence of us, who, at her
request, in her presence and in the presence of each other,
have subscribed our names as witnesses hereto.
f,
LfJ<<n ~~
c.~U ~~1C
/y~ tV. ~~ ~I p~
Residing at
~~l -R.
Residing at
/J...
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
~.Q.JlAttrJ( COUNTY, PENNSYLVANIA
-
fif -bl~lJ3q
Estate of
\\ tt-v.e.\ c- _ rn ~ (\ l u.. vn
Y'r\. A- v- ,,' ~ '"
lL -e..-4!. V'\ .e.r-
\) .e.<0 v'l' So ~.\J..4-4-\f'...cu-
and
(each) being duly qualified according to law, depose(s) and say(s) that
acquainted with ~ fl L-e..\ e. _ '(Y'\ ~ r), \.(.. VY\..
was / were
she / he / they
, Deceased
well-
and am/are familiar
\\ .pc "V ~\ C. VY'\; (\ \ wW'\"\...
with the handwriting and signature of the decedent, and that the signature of
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
\~ ~ ~ t e., p'-: n \ u..""'- is in his/her own proper handwriting.
~~~ G~ f. ~
(Signature) (Signature)
lo ') ~~ \\.'\\ ~ ~D7 6l.r,uk E:-Y' tlllt ~d
(Street Address) treet Address)
'<\.€A.J ~l A' f'-1 PA l'lo"") 0 ..1) ~ ') C')l "^^-loJ .r \ ~ NCi #AJ \'A}tO
(City. State. Zip) (City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
U Ht day
, 2D61.
e:>
~O
'..0;-. :0
;;~-o
'Ie:>
~'~d ):>r-
>~~
'~ Cf) ^
-00
")0.,
'::.) C
:0
::o-i
::r>
~,
Form R W-04 rev. 10./3.06
r--.)
c=
c=
-..I
C-
c::
r-
I
0'\
.."
X
N
..
o
N
.::0
.::.D r "I
rneJ
G'J C")
cj", =0
'~\.~J
nfrn
:T) CJ
("-)
.'h~
-n
C'j
r- fT1
c../) C-)
r"t