HomeMy WebLinkAbout08-21-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C aM el3i?tJl.lJ:b COUNTY, PENNSYLVANIA
Estate of AI () r m 1"'/
also known as
If:.
t: It at} It.
v
File Number
~\ O't 6l~
, Deceased
Social Security Number
1'0-,:/' - 9Q'2
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
~ A. Probate and Grant of Letters Testamentary and aver that Petitioner~ is I-e!te the EX~c.ltt,.iK
last Will of the Decedent dated A'1u sf" 2eoS" ~.d c~di,il(J) dllted
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: Ai/A
o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante mitIOri/ate) r--.:>
o g
Petiti.o~er(s). after a proper search has / have ascertai.ne? that I?ecedent left no Will and w.as survi:ed by the following s~~if any) ~eirs: ,tIf
AdmullstratlOll, c.t.a. or d.b.ll.c.t.a.. enter date of Will In SectIOn A above and complete list of heirs.)' "~, "T:J C'
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Name
Relationshi
Residenc;~~ Q:l
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(COMPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
,Decedent was domiciled at death in (! Ul'I1bG
IDS 's "
(List street address, towl/lcity, township, COUllty, state, zip code)
Decedent, then 7 ~ years of age, died on ~.I3. 2{)tJ7 at '59B C&rl,'~/e AKt:, /J1edJ4A./~.s"Jtll
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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: '59B C?4r/islt A'Kt.
$ I, IJDD. liD
$
$
$ / ~... be" . ,/II
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:
T ed or printed name and residence
F orlll R W-02 rev. /0,/3. 06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
: SS
COUNTY OF C u.rn I3liYUA IJ))
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.
Swam to or affirnled and subscribed
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Signature of Personal Representative
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Signature of Personal Representative
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File Number: ~ \ Dl.. () 1 <6.3
Estate of NPIlIJI,f-N E FLeA~ t.!;
, Deceased
Sod,\ soo"'rfumbor. /91J - .:1{,- '11/ 9 ~ Dote ofD"th: ~"$ f: / ~.. 2bD?
AND NOW, ~~~1.ril rQl , aCbl , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, T IS DECREED that Letters Tesfrlme.J1fttNI
are hereby granted to IV tJItJJIlJ. JE~ I?~~ ..J
in the above estate
and that the instrumen*'1"dated 4ufusJ ~ iltJOS
described in the Petition be admitted to probate and filed ofrecor~ as the last WiB (and Codicil
FEES
Letters ..... a~iQW. . . $
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
1.v .\\ ... $_'~tb
<JA~\v :::; '~~D
.. . $
.. . $
.. . $
.. . $
.. . $
...$ (jl
TOTAL.. .. .. .. .. . .. . $ \\~
\\lC).66
l~ ,CD
Attorney Signature:
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m~ehan;cs 6t.(,~ ,r//J
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Attomey Name:
Supreme Court J.D. No.:
Address:
f7osS'
Telephone:
7/7- 7~11- tJ3.~f
Form RW-02 rep, 10.13.06
Page 2 of2
H105.805 REV ((I1/07J
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
(
P 13671196
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
6~~Bli'f/~?
ocal Registrar Date Issued
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See In.tructJon. and eXlII1lple. on rever..)
RUJ6.144 REV 1112006 ~
TYPE f PRINT iN
PE_NT
IllACK IN!<
#31-072
1 .....1i_lFilsl._....._1
Norman
S.A9'(last_1
E
Fleagle
'.DoIoliM1 _, ,
72
12. Was Deceder'f IMr in....
U.S. ....... Foroes'
~ ONe>
-.r.
AduaI ResidencI 17a. Sate
,,,. County
PA
Cumberland
T.
c ......or
y".
June 23. 1935
Somenlet, Penn.ylvanl.
'"' County Ii lloa1I1
8d. FodiIy..... 1''''-, gOo -...._
6598 Carlisle Pike
Cumberland
11. OecedInI'slJsual cAwodl.done
Sup:~sor
mosI of Iitt. Do noI'"
'li1dsl-,_
U~ uovernment
,ll.-.r.Maii1g_1-.cily/kMn, -...,-1
6598 Carlisle Pike
Mechanicsburg, PA 17050
STATe FILE NUMBER
() '1 <6"3
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10. Roco'_.....,_ _.IIe.
(SpooIlj White
Oid_
Uwlna
T_'
Silver Spring
T.,.
17CjiLv86. DectdIri lived in
1?d.ONe>._Uwd_
A<u/UdIIi
Cilyl-
'I- F_'.Namo lFirst, _,...._,
Blain Fleagle
19. ,***'$ Name (FiniI. midcIe, NidIn U'fIlIfM)
Clara Liberty
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...............I.taiIilgAddr...I5>....cily/_._...,_1
P.O.Box 447 Shermans Dale, PA 17090
2'.. Plaatd llisploiIioo (Name d...-y, ....-yor_ pIatol
Conollte Crematory
20a ........... Homo (Typo I P"'I
21d.Lor:aIIorI(CiIyI__...._1
Schaefferstown, Pa. 17088
. ~
22c. Namo...._d FodiIy
Myers Funeral Home, Inc. 37 East Main Street Mechanlcaburg, PA 17055
231>. Llcenta _ 230,DoIo Slpd 1_, day, ~
..... 24-26 """ bo_1lf '*"'" 24. T_KIIIIK 25. IJalo - Dead 1-, day. yo.,)
who","""""",_ 7:20 P. M. August 13, 2007
CAUSE OF DEATH c___e"""",*)
1llm27. Plitt: Etiir"'~-Ii&eaMs, injuries, OIcomp1ic1tion1-....clr8dlycausedlhedlail. DO NOT enl8JterminaI events suctl as c:aniac arrtsl:,
fespillklly..... or venIric:uIIl' IibrIIUon wiIlOUt &howilg thl8IioIogy. List only 0f'lI cause 00 ~ line.
26. Was Case ReIttTed to Mecical Eumr.r f CoIorwIor . Reason 0IhIf IIiIfI Cf.-nalion 01 0clnIIi0n?
~y.. ONe>
Appfoma&t io1eMi: Part I: Etier c;Cher ~ awitions ~ ID dAaIb 28. Did ToMcco UllI CcdrilIAe to DeIIl?
Qnsal..lleaI\ buI'" '""'*'9 In'" UI1dol1iInll-g;,an.. ParI , 0 Yes Ol'lollolllr
ONe> 0-
~-==~ a, Occlusive COrOnary Arterv Disease
Due to (or. . consequIoc:e 01):
aliltcondlionl,ifq,
to ClUllIiltldOO....
t_ UlClEaYIIGCAUSI
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Due 10 {Of II a c:onuquenct 01):
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. ==~=:::=:::vand~-:".=a....~=_.------------------- 0
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32g.Lor:aIIorIdlrjuly(_cilyl__)
Coroner
33<1. IJalo S9*' ~ day.lWl
A~gust 14. 2007
"m-~mdt':" f'orrm c:-(!garJ;'i~ Typo I PlinI
6375 Basehore Road! Suite #1
~echanicsburg. PA 7050
LAST WILL AND TESTAMENT OF NORMAN E. FLEAGLE
I, NORMAN E. FLEAGLE, single man, currently of 6598 Carlisle Pike, Mechanicsburg, Silver Spring
Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all
prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can
conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, is to be distributed to my daughter, NORMA JEAN ROWE, currently of Shermans
Dale, Perry County, Pennsylvania. In the event that she predeceases me, then to her issue, oer stiroes.
2 a.
For purposes of clarification: my son, NORMAN E. FLEAGLE, JR., has been omitted from my
will purposefully and by design. He is not, nor is his bloodline, to inherit through my will or from my estate
directly or indirectly by representation, partial intestacy, per stiroitallv. or in any other way or manner
whatsoever, nor is my said son to serve as an administrator of my estate under any circumstances.
3.
I nominate, constitute and appoint my daughter, NORMA JEAN ROWE, to be the Executrix of this
my Last Will and Testament. In the event that she is unable or unwilling to act as Executrix, I appoint my
granddaughter, JENILEE MIEDZWICKI, to be the Executrix in her place and stead. I further direct that
they shall not be required to file bond or other security in the Office of the Register of Wills f~r) the purpo~
of administering my Estate. c"::~ ~ ;:::
J-'CJ C
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e'/I. day or: ,~5 ~~:
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~C~S~:)
NORMAN E. FLEAGLE
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
;4-<lr~4"'
, A.D. 2005.
~
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Signed, sealed, published and declared by the above-named NORMAN E. FLEAGLE, as and for
his Last Will and Testament, in the presence of us, who at him request and in his presence, and in the
presence of each other, have hereunto subscribed our names as witnesses.
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OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
e (,( m (;E"IUAAJ/) COUNTY PENNSYL V ANlA
,
Estate of Ifpl'tAlAAI E: I=lll,4 (; L E
, Deceased
/JI/ellE l..iE":r. .:rl( Il/(J,k
, (eaeh) a subscribing witness to
(Print Name/s)
the ~ Will ~((Ld:v:l(~) presented herewith, ~ being duly qualified according to law, depose(s) and
say(s) that she Lhe / they was J..W0f&.. present and saw the above Testator .t..Testatrix.. sign the same
and that she ,(..he, " till.)
signed the same and that she t 1:.18/ they signed as a witness at the request of
in -MMi his presence and in the presence of each other.
the Testator t Te8t~
(Signature)
o
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(Signature) .1&1 leH t!LL IF J: Jp~tt5;J
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(Street Address)
(Street Address)
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(Cily, State. Zip)
mechan ;csbu~, PI1
(City, State, Zip) \
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
day
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
17Ht day
, ;?.1Jf) 1- .
~f4d-
~t~r-
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
of
of
Deputy for Register of Wills
NOTE:
To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument{s) at time of notarization.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Charles E. Shields Ill, NolaI)' Public
Monroe Tv.p., Cumberland Colny
My Commission Expires June 20, 2008
Member, Pennsylvania Association Of Notaries
Form RW-03 rev. 10.13.06
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OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBFRLAUJ) COUNTY,PENNSYLVANlA
Estate of N~I?/I1l-tI
E.
,cL EAr; L. E
, Deceased
CII~ e
Sf! / ez..Ds 7lf
,~) a subscribing witness to
(Print Name/s)
the Dll Will ..0 Ceaieil~ presented herewith, Eetteh1 being duly qualified according to law, depose(s) and
say(s) that ~/ he /~
and that ~ he ~
was~
present and saw the above
Testator / Testatrix
sign the same
signed the same and that ~I he~ signed as a witness at the request of
f"..:l
the Testator t T._ ~presence and in the presence of each othergo ~
~~~ f ~~sP~~~-- ~i~=~}']~~ ~
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~ vUtlSEA!. /lIJ.j~
(Street Address) (Street Address) ),;.
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Mcel{AA/I(!'S~tlK6.~ f7~ /7~S"S
(City, State, Zip)
0"'
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
of ~l~\
d\ day
,~\.
before me this
day
of
Notary Public
My Commission Expires:
(Signature and Seal ofNotsry or other official Qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of inslrument(s) at time of notarization.
Form RW-03 reI'. 10./3.06