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Home My WebLink About07-17-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CVll46ft<.A",t) 'FDlCfl€ST s. EatJ S T COUNTY, PENNSYL VANIA Estate of File Number ~ \ . ~ 0\ OlD l~' '~-07. '3.3S also known as . Deceased Social Security Number Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) 9'A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the ~ E'c. ()71t, J< last Will of the Decedent dated 2.~ "<'5 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 g\~.., '-(If applicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; duY.!f!!! 'noritate) t- C1} S) . ..' ;:] u c= ~, ) '::J Petiti.o~er(s) after a proper search has / have ascertai.ne~ that J?ecedent left no Will and":as survi~ed by the fOllowing;~~~any)r;;d heir~f~~ Admlfllstrallon. c.t.a. or d.b.n.c.t.a.,. enter date of Will In SectIOn A above and complete list of heirs.} ">.z.;::o -.J ::; I C.J "'cn^ ~~~ ~ '--i~~. _ _ ....-; 1_--) ,-, o B. Grant of Letters of Administration Name Relationship nty, Pennsylvania with his / her last principal residence at '2c.o "Z... ~- $-.d6, .1 j1 $ ;3s,ooc> 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 situated as follows: ' U%>L CDl...vWl6,A AVE. CAMP .., I u... PIr1 Wherefore, Petitioner(sj respectfully reguest(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: 31107 Form RW-OJ reI', 10. /3.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF C1M1tb{L:Ja Y1.d_ ' 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. File Number:' ~ \ 0\ 0 \on ",tate of . ~~~ 'i;. tx,,-& Social Security Number: \ C\S 0\ <1b%' Date of Death: AND NOW, ~J.U \'1 . ~, having been presented before m~, ~ DECREED that Lett~ are hereby granted to JiU L. 't){Y\~ . \ Sworn to or affirmed and subscribed FEES Letters ............. ^ $ Short Certificate(s) . . t;:? J. $ Renuncia~!~I(s) .......... $ t00JJ .. . $ ~ \\\ .. . $ ~ ~ ... $ -~ .. . $ .. . $ .. . $ .. . $ ... $ ... $ TOTAL .............. $ Form RW.02 rev 10./3.06 Y. I'--;) <:::) = - Signature of Personal Representative (") S=u 'Ti :0 n~(") )J 2 r- .~ . , , :cr5~ ... J' (')0 ()O--n ~~~ :0---1 :> N . .~, I'"'.. "1 '.r., I "I Pi.': '.J ~~;) .:,~~ !~~ l~1 rn ('11 ::;:01 CJ ,::.::; ,1 _ .' '..n .: C',') . I-'~rl <- c r- Signature of Personal Representative -...J > ::at: ,. . Deceased l\ ~ \01 , in oo;_onJ~fOregOing P,tition, '''"'''''tory p<oof 41<; )1 'l1'YlOA"l pAl I \~l.o<:" in the above estate ;AQ .O\) a:~ . dL \S OD \<;dJ $) dL 5=:aJ Attorney Signature: Attorney Name: Supreme Court J.D. No.: Address: Telephone: ~p$ Page 2 of2 J-J:().::q;o." r?F.\.' (()1I07) .. LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 13769902 Certification Number 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. ~../?l ~-, JUL 1132007 Local Registrar Date Issued 20 -.'-.'. -;g -,- con . ','!:co .::;'J:'::M; '1~' ':2;, ~ ':. GO /' ~'C") 0 _) Q-n -.') r ',-;:p . ~ -0 -;:7 N c:::;> ..:=. ce 1""""" '(1 :::oi>" r" -;:; (;") r..~ .-,~ :;:J , . <-'J ::.-~ .-c" I '-" '::d CJ o -1'. -rJ (-:>n r \,. ~...) (:":) (1 - ....1 ~ - - .0 N - Aevl1~ PRINT IN >>.HENT CKINK COMMONWEALTH OF PENNSYLVANIA-DEPARTMENT OF HEALTH. VITAL RECORbS CERTIFICATE OF DEATH (See Instructions and .xsmpleson rever..) STATE FILE NUMBER ~\ OlD ~.Soc:liJ5I!:uri\Y- 195 - 07 - 9335 ea. PIoco 01 Death (CIlOCk one HooplIIl: 0Ih0r: July 23.1917 H'8.rrisburg, PA OI,....OEAI~ OIlOAElHonlogHomo 0-... [Jou,.,.SpoclIy ed. FdtYNamo QIIlllIIOOlUl/l, gNe'-lIlld IUllboI\ D. Wu~oI~ OtIgInl Ii No. 0 Vu 10. Aooo:.~n _, Iliod<, While, ole. I~ yu,ipecIIly Cuilin, . 1.\'plr<iIJoj West Shore Health & Rehab Ctr. _.__...,) white 12. Wu _.,., ~ lIle 13. 00c0d0nI's EducatIon ( only hiQhooI plo compIoIed) 14. ~ ~~I~ MaITied, 15. SulVMng il!>ouoe I~ wllo, giYe _ nomoi U;S.AnMd"-? E-.yJSec<lndiiry(ll-12) ColIega(H Of 5<) n.........~ ........." Ovu[)lNo 12 Widowed =-~_ 171._ Pennsylvania r:.~ 17C.OYu,_u..d~ 17b.ColmIy Cumberland Townil1IPl l1d.~No,_LNod_ AduoI LmllI 01 1._oIDacodonl(RF1l,_,Iaol,tullIxj Forrest s. Ernst 5. Ago (luI_YI e.DalloIllIrIh and_or clI, 1. 89 YfI. 81>. County 01 DoaIh Cumberland Twp. Twp. Camp Hill CllyIBoro 200.1-' NomoCTypalPIWl Bonny S. 211._0I0itp0a1ll0n [3- 0-11"""'- o 0Ih0r.. : 221. lllF. (t( 19._'._(Flrs\_,maidtln~ Rebecca Hafer 20>.10_. MlIq_(Snol, cltyl_, tille, zipcorlll 9 Farmhouse Lane, Camp Hill. PA 17011 21~PlacaolOllpoallon(Namool_II'/._or_placal 21d.LocIlkln(CIlyI_,_,zIpcorlll Lower Allen Twp., PA 17011 _2"28_bl~by_ 24.TIn1oolDlll8\ """__ 0: M. CAUSl 0' OiATH(Siie ~."""......,...) 111m 21. Patti: e,.rlhl~-_, iljuriia.or~-IhaI<IraclIy_Iho_ OONOT___auchuCWocI. IIapiIaIOIyllllll,or_'_wlIhouI--.g"'~.l.IaIooiy_Cl""llll_lnI. =~~=)-=., C"."..J,.~c. h,4~~"" 1lulI1oj,....c:cinHqulnCloI): . ..... ...i .. (, . ... /. . b. A-a..frl' M-> IJ o~ -.r/;.-r>>;4n,... oulloloru."",--oI): /., / c. ~IH!l'lI"" J"c. t,..." A I A r.I""M'" ..h r4~ Due to. (01 .. a consequence ot): ,AppjIlldrnIIo_: I Of",,". ,*" , I : /~/IV I :~~;"'" i \l'}41 , , ~.._rlllfy, IiO CIUIIIMd (I'j h I. EnIor UNDERLYlNClCAU8l! =-~"&u,~ d. 3llL Wlls 10"'- lOb. Wort "'- Frdngs _ _Priorlocon.xllllon 01 Causa of DoaIh1 OVa ~ OVa ONo 31._0I1lo1\!1 [il.IIao.aI D- O Aa:Idont 0 PendIng IIwos1igtollon o SuIdde 0 CMI Not 1>1 DolenninId 32d. TIma of Injury 33a.Cet1I1Iar~or;yonel . CoItIfylngp/tyllcIlo(PIlyaiciIIl CIIIIlyino_of__anc*.orpl1ysic:iln hos """"",*,_Ind_ltom23) Tothoblatol"" ........,__lIICI cIlIolOlIla CIUII(.)and __ ul1lOld..__ _ _ _.. ___. _ _ __.. __ _... ...... _ _ __ _ 0 Pronouncing and cortIlyl"IJ phy_IPhy_ both ""'"""""" _ and CIIIIlyino 10 CI......_1 To the belt of my knowlIdgt, dIIth occurred .t thllhne, dllt, and pa.ce, and due to the ceuee(1) and """"" 1I.1IIed... .. _ .. .. .. .. .. .. _ .. .... _ .. .. .. _ _E,.-Iee.- Otlltta _ 01.._ and IOf m-tiglllon.ln ""...-. _ or:<",,,od litho tlmI, elIlO, and p/oCI, and cWa 10 lIle ClUll(I) Illcl_ H I1IOld.. 0 I~I DisposItIon Perm~ No. ,nFlmllo: o Not -"'" _jlIlI JOIf o Prognanllllimloldallh o NoIpragnonl.butpregnanl_42day1 ol_ D NoI-""" but p'"!PlII'..3 ""'0 1 _ -- O_'poognanl_lIleplll_ 32<:. PlIClI 01 Injury. HornI, F...., iIroIl, FIIClOl'{. OIlIcaBulklng,IIc.(Sj>>clfy) 32g. LocI1lon oIlrijury (SO...., oty '-,-1 ~y@ Western Surety Company . . . . " . ; ; ; , , . . . I , . , , . . . THAT WE, Barry L. Ernst , as Principal, . and WESTERN SURETY COMPANY, a corporation duly licensed to do business in the Commonwealth of Pennsylvania, are held and fIrmly bound unto the Commonwealth of Pennsylvania in the sum of Bond No. 70341164 Know all Persons by these Presents: Twenty-Five Thousand and 00/100 Dollars ($ 25,000.00 ), to be paid to the said Commonwealth, or its certain Attorney or Assigns, to which payment well and truly to be made, we bind ourselves jointly and severally, for and in the whole, our heirs, executors and administrators, fIrmly by these presents. Sealed With Our Seals - Dated the 16th day of July in the year of our Lord 2007 The Condition of This Obligation Is Such, That If The Above Bounden Principal, as Administrator of all and singular the Goods, Chattels, and Credits of Forrest S. Ernst deceased, does make or cause to be made, a true and perfect inventory of all and singular the Goods, Chattels and Credits of the said deceased, which have come or shall come to the hands, possession or knowledge of the Principal or into the hands or possession of any other person or persons, for the said deceased and the same so made, do exhibit, or cause to be exhibited, into the Register's OffIce in the County of Cumberland , within thirty days from the date hereof; and the same Goods, Chattels and Credits, and all other the Goods, Chattels and Credits of the said deceased, at the time of his/her death, which at any time shall come to the hands or possession of the Principal, or into the hands and possession of any other person or persons, for the said deceased do well and truly administer according to law, and further do make or cause to be made, a just and true account of said Administration, within six months from the date hereof, or when thereunto required by the Orphans' Court, and all the rest and residue of the said Goods, Chattels and Credits which shall be found remaining upon the said Administrator's account, the same being fIrst examined and allowed by the Orphans' Court of the county having jurisdiction, shall deliver and pay unto such person or persons at the said Orphans' Court, by their decree or sentence, pursuant to law, shall limit and appoint, and shall well and truly comply with the laws of this Commonwealth relating to collateral inheritances; and if it shall hereafter appear that any last will and testament was made by the deceased, and the same shall be proved according to law if the said Principal , being thereunto required, do surrender the said Letters Adminis 0 into e Register's Office : . aforesaid, then this obligation to be void, otherwise to rem in force : ~\\\\ Ul~~~~~ : J*"f... ihtI..~~~!ed in the presence of : ~~~., 0 ..q,~ , ~,-' ~1< ~ ^/It #".7'~ , ::::~/ ^.T '1:",\ ~ , ".....:."n:) . =:~: ()v ,;. ~ Vd iCJ:Jon . ~ : ~ ~ ~ E mn08 S,N\fHdtlO : :::: ~ : ;'('.-::: -'0 \JU3l:) I ~ ~\. ~ F: A" .l* I :J 110 : '\ ~ .... ....t\.~.f : ~~D'"~ · ~/" r~ : #4,,,,..,..,,'\' , . . .) , I , . . . Principal Principal !~lJ 1 ~".:C'ilH ,J_1_,;I......J.....: SURE TY COMPANY 6 I : II WV L I lor LOOl ':)"1 By Form 1149-A-12-2002 -li\/J ;r~ 0-"" i('.:,,-,; , :lJI.JJV JUCVvJU .. ~ . , Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint Paul T. Bruflat of Sioux Falls State of South Dakota , its regularly elected Senior Vice President as Attorney-in-Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, the following bond: One EXECUTOR FORREST S ERNEST bond with bond number 70341164 for BARRY L. ERNST as Principal in the penalty amount not to exceed: $ 25 . 000 . 00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force, to-wit Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Senior Vice President with the corporate seal affixed this 16th day of July 2007 ~ ~ ~rrt-/ . Nelson, Assistant Secretary By ATTEST STATE OF SOUTH DAKOTA} ss COUNTY OF MINNEHAHA 16th day of July 2007 , before me, a Notary Public, personally appeared Paul T. Bruflat and L. Nelson who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Senior Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. +.... ............................................ + ~ D. KRELL ~ I I ~~NOTARY PUBLIC@~ I~SOUTH DAKOTA I I I +..............................................+ My Commission Expires November 30, 2012 Form F1975-9-2006 On this ~dl Notary Public o 1Eagt IlItl! anb Qf~!ltttmtnt I, FORREST S. ERNST, of the Borough of Camp Hill, County of Cumberland and State of Pennsylvania, make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any tim.e here- tofore made. 1. I direct the payment of my just debts and funeral expenses as soon after my death as may be convenient to my Executrix hereinafter named. 2. I give, devise and bequeath all of my property, real, personal or mixed and wheresoever situate at the time of my death, to my wife, JEAN C. ERNST, provided she survives me by at least thirty (30) days. 3. Should my wife fail to survive m.e by at least thirty (30) days, I give, devise and bequeath all the rest, residue and remainder of my estate to my then living issue, per stirpes. 4. Should my wife, Jean C. Ernst, predecease me, I appoint BARRY L. ERNST to be guardian of the person of my minor children. 5. Should any of my children take under the terms of this Will while minors, I appoint BARRY L. ERNST to be guardian of the estate of such minor with discretionary powers to make such payments out of principal as well as interest .. he deems fit and proper, to provide for the care, support, medical and other expenses and to provide the funds for a college education for such minor child. 6. I name, constitute and appoint my wife, JEAN C. ERNST, to be the Executrix of this my Last Will and Testament. Ie ~ said w~~;r~~~~ to survive me or is unable or unwilling I Z : 1/ t.Jtj L I tnr Lnaz , J" +,,;;~I H~l?~P?~ JL.;\j UCh,"';V' i' ilJ ~ ,-<-; V::XJ Page 1 of 2 pages to act in this capacity, I nominate and appoint BARRY L. ERNST to be Executor of this my last Will and Testament. IN WITNESS WHEREOF, I hereunto set my hand and seal this , j...~ ..4 day of January, 1965. ~~4~- ( S EA L) Signed, sealed, published and declared by the above named Testator as and for his Last Will and Testament, in the presence of us, who at his request, in his presence, and the presence of each other have hereunto set our hands as subscribing wi tness es. w~ r\ \ . !<-'? ,.f fj J P . ~~ Page 2 of 2 pages d-\\ Or owlS OATH OF NON-SUBSCRIBING WITNESS(ES) "' REGISTER OF WILLS CUWlI}l?~L..A"'l> COUNTY, PENNSYLVANIA Estate of ..f; (2Jl.EST S. C fA. rJ ~r , Deceased C-a>~ fO~T Blf(~T and GJ1RY L, F,..sl-l Ge (each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well- acquainted with FO~E'!;q S. EIO/~r and am/are familiar with the handwriting and signature ofthe decedent, and that the signature of fufZ.U"Yr $. ER-NSr to the foregoing instrument purporting to be the Last Will and Testament/Codicil of fU e.llbS, S. E/l.}J~T is in his/her own proper handwriting. ~~TU 1700 I/l-LhAH/ LA-J..;c (Street Address) .mec.HA-N/c~I)Rt J /?4 /70SS (City. State. Zip) , ~ignatufAr7 ~ ~~ L700 Wl-lt IJJEY lJIi'-il/E (Street Address) / Yo f!.X fA (City. State. Zip) 17'1D 2.. Executed in Register's Office Sworn to or affirmed and subscribed be~ 1&11. day of , ()rfJ7 . ("") c -..~o :0, ::0 3.?-u ji];P ',._>m ,,; ;S ::0 r:-"':'" ^ jC)O ,>.)Q'l ,,,) '--- - ::0 TJ-I > '" ~ <:::::l -.., '- c::: r- -.....J ;:t:loo :x ~8 ':'0 'fl r:Tl C') L~) ':'J c-',,:.,:' :JJ i::r:i ~::J :nc5 C) "'q --,-, C) rn - - .. N Form RW-04 rev. 10.13.06 .1 ... BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF FORREST S. ERNST, DECEASED NO 21-2007-0673 DECREE OF THE REGISTER OF WILLS AND NOW, this 17th day of July, 2007, upon consideration of the Petition for Granted of Letters filed by Barry L. Ernst, dated and filed on July 17, 2007, for the estate of Forrest S. Ernst, IT IS HEREBY DECREED that the Petitioners shall post surety bond in the amount of $25~900. IT IS, ALSO DECREED that upon filing the Bond of Personal Representative, Letters of Testamentary shall be granted to Barry L. Ernst. C) ~o ...... ;I:) ':':-tj :IX J:L'>.P ..<[n ..; C/3 5? .'C) - . )C) C) C)'-..: " . ::::.0 :12-; ~ c:::::> ~ ~ r--" f0/ ,.3i ,~. " ) (~~S!~'y? !;.f f9 c:) ~~i ~ - '-J ~ c:.." .. c:.." c:.." ~