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HomeMy WebLinkAbout08-15-07 PETITION FOR PROBATE AND GRANT OF LETTERS , REGISTER OF WILLS OF! l1-(1'1 b~ r ~ J.-- COUNTY, PENNSYLVANIA Estate of ~- , 7-1 t 7. (L-h c T ~ 2..' I)v.-\\ File Number ~/-()l' Oll/ also known as , Deceased Social Security Number I 1 Ie If o '7 5-C:; Petitioner(s), who is/are 13 years of age or older, apply(ies) for: (COMPLETE 'A'or 'B'BELOW:) !2}: A, Probate and Grallt of Le ten estamentary and aver that Petitioner(s) is / are the 2- ~ e (. i.A.tR. i "I- last Will of the Decedent dated 5 5 '1'6 ~ and codicil(s) dated named in the (State relevant cirC!lmstances, e.g" re11l1l1c:ation, 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 B. Grant of Letters of Administration (lfapplicable, enter: c./.a., d.b.n,c./.a.; pendente lite,' durante absentia; durante lIlinoritate) 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.bn,c.t.a., enter date of Will ill Sectwl1 A above and complete list of heirs.) Name Relationship Residence (COillPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled al-fleath in . (~_.j..l('l.-I C~.:_.... (List street (ddress, IOwn!city, township, county, state, zip code) GJ-, years of age, died on Del . , ,',- /) ~unty, Pennsylvania with h' / her last principal residence at ~ \.. .t. c:;' I 1 ., , Decedent, then ~. J.~~' ~~ .j\I. , at C (1 l'- I,,,:> /" i) : h~1 i .~;'1'~ O!t:',( CE.u~ 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 PAl Personal property in County Yalue of real estate in Pennsylvama ...Jf .', , :,;>(,) rr:-c., .--1) situated as follows: !.S- c .1. nl r c " ; ,,-- (1 C-<""'- .:.. 'i Cd/_Ii.>'':: $ $ $ $ ') -1 ''''' 4" rn:-C - fI1; , 7" J -'5 ( <. - Wherefore, Petitioner(sl 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: Signature Typed or rinted name and residence /YY'\ LLAL~ t h.-fr') (t. '- }ik~ M ,:t..o' ' be1/..) M (1.<:":- y_e 'I.~' D(:../'- ST C.'<.{ I is. Jt:' -; t- (:c /7l,?J F Oi'1}I R W-1J2 rev 10.13 O() RECORDFL) . " RI' "OH1C'[' :G1STFR ,-: C 2007 - 01" \\'II I S AVe 15'-- c' PM 3:31 -U:RJ..,: OF ORPH -\N ',. II Cl'MBF' - - S, COl'RT1\ "RL~'\'D CO " " P.~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tme and conect to the best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and tmly administer the estate according to law. Sworn to or affirmed and subscribed L... --+ 1-) before me the I 'J ~ -~'YY\ ~ tL .~ C_L-Iw-/ Signature of P~rsonal Representative day of 9- .AA~1 A ' doo 1 Signature of Personal Representative ~~l. C\C)..,lJ ~~ . ' -'V For the Register . 0 Signal!lre of Personal Representative RECORDIiD OFFICE OF REG ISTER OF \Xl1 LS 2007 AUG 15 PM 3:31 1 CLERK OF (.-, \l~ ORPK\.NS' COURT )' CU:\IBERL.\ND CO., P.\. File Number: c9-1-0"l - 011 l Estate of ~L? Q he..1,J- E UtA II ' Deceased Social Security Number: \(1l.o- \ ~ -()l S S5 Date of Death: I,). - 0>0 -0 In AND NOW, C.lu, o~u"t l-S- , ~1l) 1., il: consideration o.fthe foregoing Petition, satisfactory proof hav1l1g been presented befo e me: IT IS DECREED that Letters Tt' ':> T IA M~ ,,-i 0... V11 are hereby granted to '('<'0.:" \~-\.---"~ ('{\0-1' ~ -.J in the above estate and that the instrument(s) dated '2> descrIbed In the Petition be admitted to probate and filed of record as the last :"'111 (and Codicil(s)) ofDe~edent. ~- FEES ~ "-^J!a~-Cu.-f'-l ~ -6t.tiJ.^ bw i/ P-" bJ $ u c... . <J.) Register of Ills i rtl Letters .. ............ .- -.> I ShOlt Cel'lficate(s) . . $ 2, ():J Attomey Signature: Renunciation(s) $ l',.."\\ $IS-.OD ~CP $ID.DD C\jj.I()'fY'(L:-t I CY\ $ 5. uo $ $ $ $ $ $ TOTAL. .. . . . . . . . . . . . $ Attomey Name: Supreme Court LD. No.: Address: Telephone: Page 2 of2 III .RLi'-(l.? II},! _~. uu i i i ll~ I,' I. \ This IS !(l cerltl\ !hat the IIl!O\il1,II,,'!1 !ll'r,' ;11\ L~\l IS U)IT\.'Ltl '.""pied 1', ''Ill an (lli;2inal certificate of death duly filed with me as LOL'al Rcgistral. The ()1I~~IIl~I! l_?rii:'j,';.h \\dl he !"o\\\;mkd to ill" ~;utL 'iUt Recorus Office for permanent filing. WARNING: It is illegal to duplicate this '~opy by photostat or photograph. h'-l' illl lhh ;."l'!"l:llc'JI' "J" Oil e' ,.Ii'; "N//~-";~:',j--'..: .,' " .\\ ,1l.f.," ..'''', . ?'", '<. \' - I 'C.,''1'::'':.. <'" ~~... "'(.,~"0.:. ilJ?/. ~~. '. .~:{\ ,f~. " it;..: '.~~' !~ C;:), (1~' .;h~i :: t-> , ,j ~~." . . ,:. ~i ','" * ....'" ~ .?h'~_. '1' , __'.' \~'" li1o~. 'I' . y' ~,C;'" . ...~ ,,' .", <".0 . ';:,:,-'} 1,. .119' II . .,f".'r...... .'"c~c:,.l;!~;y( ':)\ \(>",'. <:~?~-:,~,.' ~!.!.' ;;;1/ . '2].-- ~.o~~~~ p J ?995589 DEe 2? 7C10S Date :-:,) RIiCORDED OFFICE OF REGISTER OF \\1LLS 2007 AUG 15 PM 3:31 CLERK OF . >S\ ORPIL\0.:S' COURT 1 CU;\IBERL-\~D co., P.\ H105143REV.02I2006 lYPE I PRINT tl PERMANENT 8LACKINK 1. NCI"Tle of Decedent (First, middle, last, suffix) COMMONWEALTH OF PENNSYLVANIA" DEPARTMENT OF HEALTH" VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER Cumberland I! """ " s.;~SeculityNum"" T,.O..ofDealhlMonh.day.yes) remale 196 -18 - 0758 December 20, 2006 !Sa. Piece of Death Check onl one I""''''''' 10"'" I~.. OER/Oulp""" ODOA 10Nu.....H""" 0- O""",.S""",, 9. WiIS Decedent of Hispanic: Origin? ~No Dyes 110. Ra:e:Americanlndien.Black,While,elc IIf yes, ""'" Cubao. (Spo<iIy) Wh i t Carlisle Regional Medical: Center M.Idcan.Pu""'RIcso1..~.) e 12, WMDecedenl:ewrlnlle 13. Oecedenfs Educallon {Speclly only hIghesl grade completed) 14. M!lffaIStabJs:MarrIed,NeverMarrIecI, 1"5. SwvMngSpou8e(lfwlle,glvemaldenneme) U.S -,""" r Elemenlely/S"""d",Il).1~ I CofIege(1~",5') 1 Wid_.Cl"""""(Sper:IM OVes lQNo 12 Widowed =:."'" 17aSIaI& PA :~n' 17',{] Ves,DealdenlLlvedh1 N. Middleton Cumberland. Township? 17d.0 No,DealdenlU"''''' 17b.Coonty AclualLimllsci Elizabeth E. Dull 5. Age (Last Bflhday} u""" I "'"~ I lll' UnderTrliv- 6, Dateo/aiM MonIl1, r 7. Birth ace C andslaleor D", I Haft I -.. I June 2, 1924 T Scalp T"evel, Be. City,Bcto,Twp.ofDealt1 ed. Facity Nane (llnolinslilulioo,gIve 9IreeI and number) PA 82 v~. Bb. County of Death .;' I S. Middleton Twp. 11. Decedenfs Usual Occupallon (KInd 01 wotK cbn8 dun mo&1 01 ~-Mfe, Do not stale retired. Kind of Work I Kind of Business I Industry Homemaker own home . 16 DecedenfsMaillngAddress{Slnlet,clty/IoWn,state,zipcode) 150 Imperial Court Carlisle, PA 17013 CIly/- Twp. 18 Father'sName(Firstmkklle,last,sulflX) 19. Mother's Ncme (Fifsl, middle, maiden surname) Elizabeth Stephen John Alex " ~ ~ 2Ob. Infa'na1fs MaIling Address (Street, dty floWn, state, zip code) Maribeth Macke 1131 Oak St., Carlisle, PA 17013 . 21, ....D':.~~;""'"OoooR"""."""slal& : W'~Doe..,:.::_ 21~';;~~I"200"6""J ~;;lr~~t.hof~ti!"H~~""h l21d """""'ICIly/.............-J O""",.Spedff : by_' EnmedComnoc? .li:IVesONo Crematory I Carlisle, PA 17013 '" 220. S~""'~~I",,,,,,,,n"""'ll"suchJ 22b lken.,Nu_ 1220. None"'dAdd....of'...., Hoffman-Roth Funeral Home & Crematory, Inc. . ~ ~~;;;? 138425 . 219 N. Hanover St., Carlisle, PA 17013 Coollleleltems23a-conJywhencertifying .pa. TOthe!le8lr:lmy~edge'-7J)~..rtlne'dat8andpllr::est:aIed.(8l!rlatureandlltle) 23b. Lk:enseNttnber 23c. OateSV18d~;;IM~. ,yeti') ~iI1i8notavallC>IBatlimeofdeallto I n A \ t """'""",of""". _ If. PI ~ Pi';:; -D'f'5~1 L... /2... 2." <9(. . hems24--26mus1:beoompletBdbyperson 24. TimeolOeatll ~r25. DatePronouncedOead{Month!!r'f.~ 26. Was Case Referred to Medical Exanlnerl Con:lnetfot a Reason otIerttlan CrematiCI'l or Oonalioo? " who""",,,nces"'~ 10.'1ff{ jl M /2../U/tH. OVes ~ CAUSE OF DEATH (Sell Instructions and examples) Approximate llterval: Part II: EIier other !li:JrMlir:Mt mndiMn!l ~ kl deaIh l\em'll. PART I: Enlerthe~.diseases,njuries,oroomplicallon:i_thatdirecllycaJSedthedealtl.DONOTenlertarminalllveotssud1ascadiac;rresl QnseIIoOealt1 butnolresullilgntheundElffyilgcausegiwlnlnPlltI. respi'aloryanest.Ol'Y8IltriculS'fibrillOO7('on .thout8how1ngthee1iology.Ustonlyone~onea:tlline. IMMEDIATECAUSElFm"_"'~. <I ,/1 _ _ n I J coMitionr&9llltinglndealh) ~ a. ----=----~ ~ Du&\o~I!ISI!1 QU8nceo1): .... \) , !":'l~elylsl"""-.,eny. ,. ~AA--'~ ~,;t;1:=a:~':~~ Due 10 (or as a consequenOllof)' (diseaseorin~lt1atinitialedthe c events r8SU1~ng In dealt1) LAST. 2aa, InlormanrsName (Type/Prlnl) . j " A ~ '" 'i ;--l \.J.l ~ ~ \5 ~ 28. DldTobeccoUgeContrlbumklDe8th? o Yes 0_ Q.No 0 U"_ 29. W'""", ~""",..._pestjOer O~lmtlmeof_ o Not"""'""~but""","wII1ln'2deys 0'_ ONot""""'"'~but,,","",,43"""',.", oIdeelh o UnkrlOwn npregn8l1twlhinthe pest year 32a DatecflrVi'{Morrth,day,year) 132b. DescrileHowlnjlryOccurred: 32c. Plar:ect~:Home,FIITTl,Street.Facklr1, I omcellt.b'o.""-r_ 32d. Trneoll~lfY 1'26. InjuryatWork? li32[ IfTlWlsportallon.lnjUfY(Specify) {329. Locatiooofln;.y(S--.cIly/loWn,!ltat8) o V" 0 No Oon..r/Operator OP"- 0-'" M OOf1er-SpecIy 33a, C8r11fler{ct1eckOl1tyone) 33b. SignabJre"':G:''''''''' J . Certlfytng phytlclan (PhysidlYl oriying cause of d8lllh when anolher physician 1189 pmnouooed death and completed Item 23) M' ~ / I Y7 Tot......."mykeaw10dg0.....h_rndd...tolh."'..e(.I.ndrronno...ItaloJI_______________nu_____________-~ ~ - yl--~'7.;!.'11 . /'-"~ /,'j..<.) . ;::u=~::;::=~,h:~~~=:~:~n=~a~:=:uo~:r:~dmanr.ern.tlttcL ...D 33c. UrenseNilmber 133c1. D.Sgned{~,day,year)O I' . _,,,'Ex""'OI,c.""OI _____n__n_n_n U $' 6 () ) ( ! D if I :A {f'~ '" On lne blsls €A examll\8tlon .nd I or InvestigaUon, in my opinion, dHth occurred at the Urne, d.te, and place, and due to the cauae{s} and INInner IS stat!<L _..D 34. Name ln1 Address C!i Pefson ~ CompIsted c~ DeeII1 (It8m 27) ~.! Print 35. ~nabJreandDislr'dN~ ~ateFlecl(Month,day,year) . ~.J C) '. iL... (7J /<1 f - ~v ~ ' '"'"' ~ ~~. '"'~u c.'kt;~u I ~ I \ 1Cl..1 j 10 I 1J'let- d.d,.~ {"',,:; . If {' c> '/ ~17({, ()j i/ (.:-v Ii A</ r? ~ -'(I ~ See instructions and examples on reverse) Due to (or as 8 con&el(luence of): d. 31. MamerofDeath JOb. WnAWpeyFlOdirlgs AVlIIIat*Prb'laCcmpletion ofCauseofDeattl? /' Dyes ~ 308. W8SlI"lAut>pBy Po_? ~I OHo- 0A<:ddenl 0Pen<lng1_"'" 0....... 0 Could Not'" Oele"n".d OVes~ .... Be it remembered that I, ELIZABETH E. DULL, Widow, of Juniata Township, Bedford County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all wills and testaments or writings in the nature thereof by me at any time heretofore made. I order and direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, be the same real, personal or mixed, I give, devise and bequeath to my daughter, MARIBETH MACKE, and my niece, PATRICIA RICHARDSON, share and share alike, or the survivor of them. Attached to this Will is a letter to my Executrix in connection with my 10.4 acres of unimproved real estate in Juniata Township, Bedford County, Pennsylvania. I name, constitute and appoint my daughter, MARIBETH MACKE, to be Executrix of this, my Will. In the event that the said MARIRETH MACKE should, for any reason, fail to qualify as Executrix, I then name, constitute and appoint my niece, PATRICIA RICHARDSON to be Executrix of this, my Will. I further direct that neither of the above-named fiduciaries shall be required to post bond. IN WITNESS WHEREOF, I, ELIZABETH E. DULL, the Testatrix, have to this, / ' , , my Will, written on one sheet of paper, set my hand and seal this day of , , Ii \ 1986. / / (SEAL) Testatrix RECORDED OFFICE OF REGISTER OF \'\lLLS 2007 AUG 15 PM 3:31 I CLERK OF ,-,\'i\ ORPI L\:--:S' COURT \ CU~IBERL\ND CO., P. \ I Signed, sealed and published and declared by the above-named ELIZABETH E. DULL as and for her Last Will and Testament in the presence of us who have hereunto subscribed our names at her request as witnesses thereto, in the presence of the said Testator and of each other. '\ \ c~~~ (/.'f ~ j! \, (u (( 'f) { nJ {( (( l Witnesses Commonwealth of Pennsylvania: ss: County of Bedford : I, Elizabeth E. Dull testat rix ,whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. . Sworn or affirmed to and acknowledged before me, J;>y Elizabeth E. Dull . y, .- I . the testat~ , this.~ day of " . : / ,19~. / / / /f Testat ~ RHEI\ V. \'J'jc;::5!:R, r:,')Tt.p.y PUEUC BEDFORD, BEDFORD GO" Pi', My Commission expil}0t COMMI~~ION FXPIRES MAY 16, '988 "/ '/:X-t< J . / I L- L .,,- ',,'j---- ' Notary Public Commonwealth of Pennsylvania; , ss' County of Bedford : . We, Barrv R, Scatton and Dana M. Miller the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified accorciir~g to law, do depose and say that we were present and saw testat rix sign and execute the instrument as ~ free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testat ~ signed the Will as witnesses; and that to the best of our knowledge the testatr~ was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by and Dana M. Miller ,19~. Barry R. Scatton , witnesses. this 'J' day of : "./ ) \, . ,.:::..- ~~<" Witness / ) / " ;/ ./ ::- ,c t::.., \ ~. ( ~. My Commission expires I ""'" r '~I"'l"'''' R\' ~'II'4ni / RIlE,., V. WUl:t\"E~, >:::. ';.,- I ~- "I'" _< (, Bf"Or.ORO BEOFOC\0 Gu..; : . ,iy COM~1ISS!ON EXrIHES I'I::\Y 16, 1988 IDcv/'~ 'iii 'meleC'Ll \tltness ..