The URL can be used to link to this page

Home My WebLink About07-09-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF {till hg,J;./cI COUNTY, PENNSYL VANIA Estate of (, ~L. A.. ~E'A~" ~ '1 also known as File Number 02/ - () '7 - b f{;? , Deceased Social Security Number ""1." ~'l- c::>4s~ .JcAAJ e:. 2i 'ZDDt Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ,..." L. ~...,"",c..- ~ed in the:) o -." # ~~ ~~ ~ (,'-~b , 1:C t. ) r 2,':; ~~ -~ r ~~ C? (S I ' .. d I if ) 2:::11" I' rn tate re evant circumstances, e.g" renunciatIOn, eat I 0 executor, etc,,' . r _ :D \.0 :::::) C.:J ..:~(f)?, C) ('~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution o~~~men~offere~.:~ :B for probate, was not the victim of a killing and was never adjudicated an incapacitated person: :"') c:: -;'-: ~ :...0 - .._ I -o~ .. ,') )> W -.I 0" A. Probate aod Graot OfL~T Te"meotary and aver that Petitioner(,) i, I are the~~c..c: last Will of the Decedent dated "Z" cp1 and codicil(s) dated 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 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 afheirs.) Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. D~cedent was domiciled at death in ~f!Ae:c ~.. "'0 County, Pennsylvania with his / her last principal residence at ~q \c1 ~6s~ ~. M.::-,.~....HL"'A~~. ~.~~ ",..w::. _~. PI.. \,~ (List street address. towlllcity, township, county, state, zip code) Decedent, then (-<- year, of age, died on ~ at I O'~A.A 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 property in Pennsylvania (If not domiciled in P A) Personal property in County Value of real estate in Pennsylvania $ '~f=\I'Z.Cl\ , $ $ $ situated as follows: ", q l 'S.bl c:.~"" A-n:> "'Cl~. "Z-bDO.I:I'D V........CA.$ 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: L . SttGl { FOl'mRW-02 rev./O./3.06 Page 1 of2 .~ Oath of Personal Representative COMMONWEALTH OF PENNSYL VANIA COUNTY OF G untii..YJJ 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) of the Decedent, Petitioner(s) will well and truly SS administer the estate according to law. ~i,~ Signature of Personal Representative Signature of Personal Representative FEES , Deceased Social Seeuri AND NOW, having been presented befor are hereby granted to in the above estate and that the instrument( s) dated described in the Petition be admitted to probate Letters $ ~.cb dO.OO Attorney Signature: Short Certificate( s) . . . . . . .. $ ~S) ...... .... :~ ~. :~ ... $ .. . $ .. . $ ... $ .. . $ ... $ TOTAL ..... .. . . . . . .. $ 1/ (J liJ Attorney Name: Supreme Court J.D. No.: Address: Telephone: Farm R W-O 2 rev fO.13. 06 Page 2 of2 '*Y (J7~ulf~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~e for this certificate, $6.00 P ___13670798 Certification Number This is to certify that the information here giver correctly copied from an original Certificate of De duly filed with me as Local Registrar. The Origil certificate will be forwarded to the State Vi Records Office for permanent filing. ocal Registrar 0' o Co ~:o :...J-O '.n:co D)>I ~...~~~ ::J C) 0 ;-) 2-n ,'--) :::0 --4 ~ ,....., c:;) c:::> ...... <- c:: .- I \D -0 :J: -r" f-n ~~ :r; t..:J C") 'if n C) rTi - .. eN ,...0 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and example. on reverse) STATE fILE NUMBER -;;,143 REV llf200ti ~PE : PRINT IN PERMANENT IllACK INI( 5 1qe {laslBorthdaYI 66 Vrs OOlher ' Spealy; 10. Race: Ameritalllnrloan, 1IIack, While, ole whTt'e Ill> County 01 Oealll 11. Oecaderots Usual Occ Kind al _ done ~er 34 West Keller st. 12. Was Ooc:edent eve' .. II1e U.S. Armed Forces? OVe. ggNo Oecedenl's Actual Reoidence 11.. Slate 11b. County PA CUmbr lam 17C 0 v"" 0ece0enI lived III 17d.1iI ~~r""'" Mechanicsburg Twp . lij Decedent's Maino -"'ISlreeI, cily 1 town, stale, ~ code) Qty IIlolo Smith 19. MoII1ol'. Name tRrsl, millie, maiden surname) Geraldine 2011. lnIOrmanl's ~ __ (SIr..., Uy llown, _, Zip tode) 34 W. Keller st., Mechanicsburg, PA 17055 21c. PIece 01 Disjlo$iIion (Name 01 cemeIeIy, ct""'*'Y Of lIlher pllAl 21d. localiOn ICily I town, _, Zip code) t. Holly sprin~~ Plaza Way Hollinger Crematory 8 Market Home, h n 2311. License Number lOa lnlom1anI's Name ITn'e 1 Pml) Nicole L. Snell 22a . ., IIems 24.26 must ~ compIele<I by peJSllll 24 Ttm8 al Dealh .r r 25 Dale plIlflOI01Cj!(/ Dead (Mcnth, day, ye.r) who prOOOU<\Ces IleaIn /0 A M, ./ V' ---< ..J,,- J.r:>~ ,. CAUS~ OF DEATH (See In_Ilona and ..ample_, lIem 27 P.rt I. Entef Ihe l.'IwIn..Qt~ - _...., qune', Of CllIIlpIicalJoo -Ihal diredly ....sed IIle 0Ba1l1. 00 NOT enter lerminale,enls 5UCIl as cardiac arrest. respoal<l<y an..., or YBfllfiwla, fibrllatJOn willoul 5howing Ihe eUology. lis! ani\' one cauoe on """" ine . =I=~=""~ 26. Was ea.. Relerred to Medical Examiner I Cot""", lor . ANson 0lnel1l1en Ct8lna1ion or 000aIi0n? oVes ,BNo """""'im.... Wi.....,; Part U; Enter olIlllr sionillcaf1I candilions _10 _. 28. Did Tobolxo """ ContrWe to DealIl? 0""."0 Oeatll blA not ,esuIting III IIle l.IldeIlying ClWS8 1Ii- Wi Part I. 0 Ves 0 Proballly o No 0 Uol<nown SeQuenbaIy IosI condiOons, ~ any, IN<iI>o to ... ...... '"led IlfIIIlllI a. fIllEr tie UNDEIllYlIlG CAUSE (ll....se Of !"4U"/ Ihal irNIoaled ... .... 'esutrng III <Ie"", lASt Gr- ,....,..... e' ~. Due 10 (or as . consequence 01) b k- ~'q..-~/.'''. C'~~,~.,- Due 10 (or as a consequerw:e 01): C Q,-r1L J -"'c-..-....:., Due 10 lor as a consequence 01): .Jt::J '.........n" ~*~J 29 II Female; o Not PlOjJIlant ...tho, past year o P,egnant at .... 01 de"'" o Nol p.egnanl, bur preg>anl w_ 42 days ol_ D Not Plegnan!, blA pregnanl 43llays to 1 Y'" boforedealll o Unmown I preglifll wilhin Ihe pa.. year 12.. PIece oIlrljuty: Home, Farm, Skeel, FacIIlfy, 04lice &ilding, ate (Specify! ;r ...... J o Y., .31 No Ove. ONo 31 Manner 01 Dealll 18 Nalurill 0 Ham,,1de o AcCIdent 0 Pendrng IO'.5llgOlJO/l o S\JIClOO 0 Ceuld Not be Deler_ 12d. Tone allnjur; 32g. locaIioo 01 ~ (SIr"', c:iIy I town, sIaIe' :lOa Wa, an Aulopsy Perlo'IIIad? n. Were Aulopsy Findings ",_ Prior lo CompIeIrOn 01 Cause 01 Deall1? M 33a Cerol"" (cIIe<:t only one) Celfilyil\i pIIysltlon tPhy....... CO/WyIrlg cause 01 deall1 when anolll., pIly""..n lias pulnOUllCad <leall1 and campleled I1em 23) Tolllllleotol.... know......_ OCCUITeIIduelolho coUl4l(s)"'d mannet II stated.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 = -= ~=.:.~:: u:.~ ~~ .:'Z.101OU::'~:-: IIW1n,"s stalocl. _ _ _ _ _ _ _ _ __ _ _ __ _ __ j(J :::: ~~"':. ond 1 Of inves/igllioll, in my opinlOfl, dealh occur'ed alll1e lime, dale, ond place, .nd due 10 lhe CauseCI) ond ....._.. llated.. 0 ~ 3-4. Name arnlAddress ClI P,lSon WIlo Campleled eo.... 01 Ilea.. (1IerIl27j Type (Pml k/~> ./. ~,,;'. ."".-<. ~ /~..H. .""'. /____...",. ..,J'fII"""I,.c.c'" ""-c-.r_/,- S'c...- ,dA /.,Jo.", Olsposllion Permll No (J '7-, (p <I~ LAST WILL AND TESTAMENT (') ~o ~::o '-'::'-0 ~J~ () r.".-. r-- ,_ m :;:: CJ5~ r--:J .......... :-)8~ __)C :0 -u-l )5. ~ <<::::) c::;) ........ <- c: r- . \.0 -0 ::It r:-i' o \0 OF Carol Headley I, Carol Headley, a resident of the State of Pennsylvania, County of Cumberland; and City of Mechanicsburg; and being of sound and disposing mind, do hereby make, publish and declare this to be my Last Will and Testament, thereby revoking and ma1(ing null and void any and all other Last Wills and Testaments and I or Codicils to Last Wills and Testaments heretofore made by me. All references herein to this Will shall be construed as referring to this Last Will and testament only. FAMILY CLAUSE At the time of executing this Last Will and Testament, I am the widow of William H. Headley. The names of my children are listed below. If I do not leave any property to any of my children, my failure to do so is intentional. Craig A. Headley Nicole L. Snell RESIDENCY CLAUSE Having in mind the possibility that I may temporarily reside outside of, or simply be absent from the State of Pennsylvania, County of Cumberland, and City of Mechanicsburg, at the time of my death, I elect and hereby declare that this Will and each and every disposition and provision contained herein shall be construed and regulated by and in accordance with the laws of said State of Pennsylvania. It is my desire that this will be probated in the State of Pennsylvania, my place of domicile, and that the principal administration of my Estate be made in said State of Pennsylvania and that none of the assets of my Estate which may be found in my place of domicile, be remitted to any other jurisdiction for administration or distribution. DEBT CLAUSE I direct that the executor named pursuant to this Last Will and Testament review (as soon after my death as practical) all of my just debts and obligations, including funeral expenses and the expenses incident to my last illness; excepting those long term debts secured by real or personal property which may be assumed by the Heir of such property unless such assumption is prohibited by law or upon agreement by the Heir. The ::0 FgP~ GJ (:) ~.:s :t:) r=t ~:-:J :..] tE.!j ~:~~ ::::!J C) rn jW executor shall pay these just debts only after the creditor provides sufficient evidence to support their claim. My executor shall payout of my gross Estate, as if they were my delml, and without proration or appointment, all estate and inheritance taxes, by whatever name called; (including any interest due thereon) becoming payable because of my death in respect to all property comprising my gross Estate for death tax purposes, whether or not such property passes under this Last Will and Testament. I further direct that if any Heir or Heirs named in this Last Will and Testament should be indebted to me at the time of my death, and evidence of such indebtedness is provided or made available to the Executor of my Estate, then that share of my Estate which I give, devise and bequeath to any and each such Heir or Heirs, unless I have specifically provided in this Last Will and Testament for the forbearance of such debt, unless such Heir is the sole principal Heir. PRINCIPAL DISTRIBUTION CLAUSE I give, devise, and bequeath to my daughter Nicole Snell (my "Principal Heir"), 100% of my gross Estate after payment of all my just debts, expenses, taxes and as described hereafter; I give, devise, and bequeath to my son Craig Headley the sum of$lOfOOO.OO dollars of my gross Estate after payment of all my just debts, expenses and taxes. ALTERNATE PRINCIPAL HEIRS In the event that my daughter does not survive me, I give, devise and bequeath to the persons named below (my alternate Principal Heirs), ifhe or she whichever the case may be, shall survive me, all of my residue and remainder of my Gross Estate.after payment of all my just debts, expenses, taxes and alternate specific bequests, if any in the percentages set for the below. 1. Name: Timothy S. Snell Relation: Son-in-Law Percentage: 1000" In case such alternate principal heir does not survive me, I direct that the share of my Estate which would have been given to such alternate principal Heir shall he distributed to: Craig A. Headley. EXECUTOR APPOINTMENT CLAUSE (A) I nominate, constitute and appoint my daughter, Nicole L. Snell, to be the Executor of my Estate. (B) If, for any reason, my fust nominee Executor should fail to qualify of be unable or \U1willing to accept or to continue as the Executor of my Estate, I nominate, constitute and appoint my son..in-law, Timothy S. Snell, to be the Executor afmy Estate. (C) If, for any reason, all of the nominees designated above in Paragraph (A) and (B) should fail to qualify afhe unable or unwilling to accept or to continue as the Executor of my Estate, I nominate, constitute and appoint my son, Craig A. Headley, to be the Executor of my Estate. EXECUTOR POWER OF APPOINTMENT CLAUSE (A) All directives in this will that use by reference the word Executor mean and include any person named herein as my Executor (or Person representative, as may be defiDed under state law) and any person who may be acting in either capacity, at any time. Such person shall have broad and reasonable discretion under the directives of this my Last Will and Testament with respect to any property, real or personal, left by or held by me, or acquired by my Executor on behalf of my Estate. (B) I wish my Executor to have broad and reasonable discretion in the administration of my Estate, to have all of the powers pennitted to be exercised by an Executor under state law, and to be able to do everything he or she deems advisable for the best interest of my Estate and the Heirs thereof, all without the necessity of court approval or supervision.. I direct that my Executor perfonn all acts, take all such proceedings and exercise all such rights and privileges. Although not specifically mentioned in this Will, with relation to any such property, as if the absolute owner thereof: and in connection therewi~ to make, execute and deliver any instruments, and to enter into any covenants or agreements binding my Estate or any portion thereof. (C) No such person named in, or appointed in connecti()n with this Wtll in a fiduciary capacity shall be required to file any bond or other security for the faithful perfonnance of his or her duties as fiduciary in any jurisdiction; and if, despite this directive, a bond should be required, I request that it be accepted without sureties and in a nominal amount. NON...UABILITY OF FIDUCIARIES Any fiduciary, including my Executor and any trustee, who in good faith endeavor to carry out the provisions of this Last Will and Testament, shall not be liable to me, my Estate, or my heirs, for any damages or claims arising because of their actions or , . inactions based on this Last Will and Testament. My Estate shall indemnify and hold them harmless. SAVING CLAUSE If a court of competent jurisdiction shall at any time invalidate or find unenforceable any provision of this Will, such invalidation shall not be construed as invalidating the whole of this Will. All of the remaining provisions shall be undisturbed as to their legal force and effect. If a court finds that an invalidated or unenforceable provision would be become valid if it is limited, then such provision shall be deemed to be written, deemed, construed and enforced as so limited. IN WITNESS WHEREOF, I, the undersigned Testator, declare that I sign and execute this instrument on the date written below as my Last Will and Testament and further declare that I sign it willingly, that I execute it as my free and voluntary act for the purposes expressed in this document and that I am eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ (Signature of Carol Headley) SSN: Date: 6/J,'J /07 7 I ~ .. ,. . ATIESTATION CLAUSE This Last Will and Testament, which has been signed by Carol Headley, the Testator, was signed, executed and declared by the above named Testator as his or her Last Will and Testament in the presence of each of us. We, in the presence of tile Testator and each other, under penalty of perjury, hereby subscribe our names as witnesses to the declaration and execution of the Last Will and testament by the Testator, and we declare that, to the best of our knowledge, said Testator is eighteen years of age or older, of sound mind and under no constraint or undue influence. '-' :~ ..- 1. fN>> ~ (Signature of witness) L ~A A'-, "'e"l (Print Name) , Date: i--J7- 07 iy U ~vn ^j cAM (Address) e: (0\".. fA lIOd-\ (City~ State, ZIP) 2. ~ C'-" (Signature of witness) to-1. ~ ~ SJ I/.t:- (Print Name) Date: -b..2. 7-t/7 s- S06 J~ ~"..c. (Address) r $.~(..S 11~ (?A- (-e,) cs (City, State, ZIP) Estate of LA~ A, \-\ CEADiJ" -'-1 -.LISA -,). AI "*"1 , 6~ ~I~I~-- (each) a (Print Namels) - / subscribing witness to the lirWill 0 Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that: Testator / Testatrix was unable to sign his / her name thereto; Testator's OATH OF WITNESS(ES) TO WILL EXECUTED BY MARK REGISTER OF WILLS ~I:ud COUNTY, PENNSYLVANIA c/ / - ~(X)rr,. ~ ~;; , Deceased ~ / Testatrix' name was subscribed thereto in Testator's / Testatrix' presence; Testator / Testatrix made his / her mark thereon; Testator / Testatrix and deponent(s) were present when Testator's / Testatrix' name was subscribed and when Testator / Testatrix made his / her mark; and Testator / Testatrix was present when the undersigned signed the ririll 0 Codicil as witness( es). ,,~ ~. CL..% (Signature) ..]10 sterUf\;j loyt- (Street Address) E#1D (~ PF\ II~ (City, State. Zip) ~C'- (. ature) S' 806 ~j 0u;.s.1..4""~ (Street Address) Jki~{C.j1,-,/'t ~rt- (City, State. Zip) Sworn to or affirmed and subscribed before me this QU\ day ;~~J'~-2aY7 . beputy B Register of Wills (") ~O '0::0 ;i~;go C"~ ~ hi ::~ ~ 5? c:Jo '---"00 >__-' _ "'T1 <),,- :0 =0-1 )> Form RWc05 rev. 10.13.06 17056 ,...." c:::::;, c::::J ......... <- c:: r- I \0 .." :x ~ N ~