HomeMy WebLinkAbout09-11-07
REGISTER OF WILLS OF
PETITION FOR PROBATE AND GRANT OF LETTERS
c.v/l1 be.r{Q#1. L
~/Scrr,
COUNTY, PENNSYLVANIA
Estate of
also known as
Lv i / I/~ #VI fI-1
Bil, pa/5dh
File Number
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1&')... l,/ 0 - l( 'l'2l;'
, Deceased
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COiV;;-ETE 'A' or 'B' BELOW:)
~<\, Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I~ the
last Will of the Decedent dated and codicil(s) dated :j v~
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(State relevallt 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 instlllment(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
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(If applicable, enter: c.t.a.; d:b.n.c.t.a.; pendente lite; durante absentia; dura~ morilate) U') ',.'.' ...~:.)
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Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following ~(iH1ny) a~heirs:'(iJ :.'.J
Ad",",,,,",,",, "" "' d::'" """ dOl' 4 Will '" S,,"oo A ':::,:;::""P'''' Ii" 'J ','n) R~;~i ~ : '.. .'.~
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en
(COil'lPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
Decedent was domiciled at death in
County, Pennsylvania with his / her last principal residence at
,
(List street address, towl/lcity, townS/lip, COUllty, state, zip code)
Decedent, then 55 years of age, died on 't- '( - (')7
at 82- Lnt!.~
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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
/J.. /900._
$
$
$
$
o
situated as follows:
Where tore, 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:
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CCl ,..l.:.rl f.. S.f-
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170' ~
T ed or rinted name and residence
FoI'II' RW.Ol rev, 10.I3.06
Page 1 of2
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 hue and correct to the best of
the knowledge and belief of Petitioner(s) and that, as personal representati
administer the estate according to law.
ecedent, Petitioner(s) will well and truly
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Sworn to or affirmed and subscribed
before me the \ \ day of
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Signature of Personal Representative
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File Number:
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Estate of
W \\\\~ ("0, ?c-....\~C))
, Deceased
Social Security Number: I ~ \. l.t () '-\ ~ ti.. 4
AND NOW, ~~m~ ,\ , .;lObi
having been presented before me, IT IS DECREED that Letters
are hereby granted to _"'v... (' c b C ~a. \ So. c::. Y"")
Date of Death:
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, in consideration of the foregoing Petition, satisfactory proof
~~~rt"'Pf'.~~
in the above estate
and that the instrument(s) dated ~\..L)f"\~ ~) ';;;>D(:)~
described in the Petition be admitted to probate and filed of record as the last Will (and Codlcil(s)) of Decedent.
FE~S ._~.. Arob ~g~,~~;)JrofheIl"~I4t::> ~~
Letters.... \~"\qQ(;)... $ ""'~ ~
Short Certificate(s) . {\.~. $ 4C)oO
Renunciation(s) .......... $
1"':>11\ ...$
~C\> . . . $
~~ '" $
'" $
. " $
'" $
... $
. " $
... $
TOTAL .............. $
Attorney Signature:
I Sa?
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Attomey Name:
Supreme Court I.D. No.:
Address:
Telephone:
Form RW-02 rev. /0./3.06
Page 2 0[2
HI05.805 REV (01/07)
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 13822943
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.
W'Ji.: f2~q I~ It/'J
Local Registrar g Date I~d;ed
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See Instrucllone MCI ell8mptea on rever..)
H1~W}:;:NV~ ...
PE_NT
IlLACl<IIIK #31-086
1.Namo"_(F..._,Iasl.~
William
S./9I'Las18i11hday)
55
STATE FIlE NUMllER
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VII.
M
Palson
B.OlItl>oIl!i11h(_, ,
Dec. 6. 1951
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6b.CcluflIyol_
Cumberland
Bel F__II"'_g;.._"'1UlIboll
82 Linda Drive
11.Dec:eci8nl'sUsull
Kildol_
Administrator
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computer
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AduII ReIidence 17a. Staae
PA
Cumberland
. 16, Oec:edBnI'IMaingAddnlss{&reet, cily/kMn. stall, tipc:ode)
82 Linda Drive
Mechanicsburg, PA 17050
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1I.__.Namo(Firs1,___1
Barbara Allee Holman
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Albert William Palson
2lIl._.-.g_'_cily/__,JiplXldol
302 S. Carlisle Street New Bloomfield, PA 17068
2.f.L-.(ClIr/__,;plXldol
Schaene,.town. Pa. 17088
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September 4. 2007
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Sliver Spring
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Conollte Crematory
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Myers Funeral Home, Inc:. 37 Eat Main St....t MechanlC8burg, PA 17055
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K1cnael L. ~orr1S. ~oroner
"'!.~ 1 1 '1 1 1"'1 0-. !-.dor..1II'l !.... 6375 Basehore Roadl Suite HI
ue,: I~I I~I . 0'. ~~ uc Mechanicsburg. PA 7050
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who ptOl'lOlR:U de.
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M. September 4. 2007
CAUSEOFDEATH(____.~I
1&erR27. Part t; Enlerfle ~ - diseues,.Wljuries, Of comp/ic8&illos-thaldnldly r;IlLI8fKt....deaIt. 00 NOT IIlI8rtemWIII events such ascardac: armt,
respiraIofy arrest, or ventricuIIr IibriIIaIion wihJuI showing: ht eeioIoIW. list only In ca.ton uch IinI
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I, WILLIAM M. PALSON, of the Township of Silver Spring, County ofC~~d ~
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and State of Pennsylvania, being of sound and disposing mind, memory and understariding, do ~
OF
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WILLIAM M. P ALSON
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make, publish and declare this my Last Will and Testament, hereby revoking and making void
any and all former 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.
I direct that there shall be paid out of my residuary estate all estate, inheritance and like
taxes together with any interest or penalty thereon imposed by the Government of the United
States, or any state or territory thereof, or by any foreign government or political subdivision
thereof, in respect to all property required to be included in my gross estate for estate, inheritance
or like tax purposes by any of such governments, whether the property passes under this will or
otherwise.
3.
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my son, JACOB CALEB PALSON, absolutely and in fee
simple.
4.
I nominate, constitute and appoint JACOB CALEB PALSON, to be the Executor of this
my Last Will and Testament. I further direct that no bond or other security be required of my
personal representative to guarantee faithful performance of his duties.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
of ~ .2003.
&/l
day
It! J~)4 J tfi~
WILLIAM M. P ALSON
(SEAL)
Signed, sealed, published and declared by the above-named WILLIAM M. P ALSON as
and for his Last Will and Testament, in the presence of us who have subscribed our names hereto
as witnesses, at his request, in his presence and in the presence of each other.
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OATH OF SUBSCRIBING WITNESS(ES~
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Cumberland
REGISTER OF WILLS
COUNTY,PENNSYLV~A
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Estate of William M. Palson
. Deceased
John M. Eakin and Heidi M. Nelson , (each) a subscribing witness to
(print Namels)
the IZIWill 0 Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he / they was / were present and saw the above Testator / Testatrix sign the same
and that she / he / they signed the same and that she / he / they signed as a witness at the request of
the Testator / Testatrix m her / his presence and in the presence of each other.
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(Signature)
~m.G:L
(Signature) .
Market Square Building
(Street Address)
Market Square Building
(Street Address)
Mechanicsburg, P A 17055
(City, State, Zip)
Mechanicsburg, P A 17055
(City, State, Zip)
before me this
day
Executed out of Register's Offree
Sworn to or affinned and subscribed
before me this ~ day
of ~pI--k 111 ~ , ~tJ"1
Executed in Register's Offree
Sworn to or affirmed and subscribed
of
Deputy for Register of Wills
tary Public
y Commission Expires: 7- /J-;?C) /0
ignature and Seal of Notary 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.
Form RW-03 rev. 10.13.06