HomeMy WebLinkAbout09-26-07
Estate of
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF (!L(/J1JSBU/9-AJ~ COUNTY, PENNSYLVANIA
File Number ,2J - ()l- 687 q
Helena L. ]),'e17.
also known as
, Deceased
Social Security Number I S"'j- .5 t! - 3 OS~
Petitioner(s), who is/are J 8 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
~ A. Prub:lte and Grant of Letters Testamentary and aver that Petitioner(s) is /-Me the /!!)(~n.i><
last Will of the Decedent dated htard, ~(). 2"0/ at;d tvd;,,;l(,) d,,!ed.
named in the
(Slale relevalll circl/IIlSlaIlCes, e.g.. relll/IICialioll, dealh of execl/lor, elC.)
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: JJ) II
.
o B. Grant uf Letters of Administration
(if applicable. elller: c.t.a,,' d.b.n.c.l.a.; pendellte lite,' durante absentia; dl/rante lIlillOrilale)
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) 'Ill\! heirs: (If
Admillislralioll, C.I.a. or d.b.n.c.l.a., ellieI' dale of Will in Section A above and complete list of heirs.) r
-: ,,,,..) -....
Name
Relationship
Residence,
;::
i.. '
(COMPLETE IN ALL CASES:) Allach additiollal sheets ifllecessalY.
"'~-;l
rincipaJ residence at ais wesle)'
17~S$
Decedent, then
8"2- years of age, died on SppI: /'1. 2Ml at ~a.ny h,lAte. L Dtter $1e:H ~
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
$ s;, G~", ,~
$
$
$
situated as follows:
Wherefore, Petitioner(s) respectfolly request(s) the probate of the last Will and Codicil(s) prcsented with this Petition and the grant or Letters in the appropriate form to
the undersigned:
/
.//,
~'u~
If-ms
/) /1
lL-~c..-z...
Typed or p1'1nted name and residence
17"/
FOI'II/ /I H"- OJ reI'. I 0. I J. U6
Page 1 of2
Oath of Personal Representative
corvIMONWEAL TH OF PENNSYLVANIA
5S
COUNTY OF C-u m88li-HAJi>
The Petitioner(s) above-named swear(s) or affim1(s) that the statements in the foregoing Petition are true and conect 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.
Swom to or affim1ed and subscribed
'It --\-L....
before me the 0.2 day of
C'
'~\k 0J.X'(~JL , /j,OOl
(~n(o.\A.1.\. \~ ~ G~ct:<!t
',J \ F or the Register IJ S(gna/ure aJ Personal Represelllative
I<l'1-dtr.
~.. -)
f-'-,',
.'I,. 07Q
File Number: d - 0 l - tJ f
Estate of J./elelJtl L. j);e/i
...'~)
, Deceas6d
'--'
w'
Social Security Number: /S'I- 3f- 30 S$"" Date of Death: 5tpt. /~ 2-/!JO)7
AND NOW, ~~~I{"'{\,'~,,-- 2.6 , 2(.J0/ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Mslhll.1t!A.fiU'V
are hereby granted to k'lLYY:YI Park~. I. Kit. I(,tr~.IJ C. AJ4~$
.
in the above estate
and that the instrument(s) dated /J1arc"h 30., 2/){) I
described in the Petition be admitted to probate and filed of record as the last Will
FEES , \:t~.
Letters ........ $ &J' CiO
Short Certificate(s) . . . . . . . . $ 1(0 C)\:)
Renunciation(s) .......... $
t ~. \ \ . . . $ IS-. GU
.jC-P ... $ IOcP
(\""\J..-::\ lNV'l"\ ~ \ G'f\. . . $ S--'00
l...1 ^- ~\).
Register oj Wills I,
~/~;:.~#
~rks E: S/'~'e/t:;& JiL
38SJ .3
6 ClouSe" Rd.
MecJ,Ul/~6t.(.-~~ fJA 17oS~
Ch.v.~
!Q~~~
Attorney Signature:
Attomey Name:
Supreme Court l.D. No.:
.. . $
... $
. . . $
.. . $
$
$
TOTAL .... . . . . . . . . $
Address:
Telephone:
7/7-7C.ti -()ZO'j
Fun" RW.O] rel' 10./3.06
Page 2 of2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
IN MINING. It is illegal to duplicate this copy by photostat or photograph.
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Hl0S14j REV 11:~lIU6
l'rPE PHI NT IN
f'lH.''INtNI
Bl AU' INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
Bb C0unly 01 D(:iilh
Cumberland
&I. FaciJltyNarne(lInotlflstllulloo,giveslreetaoonumbel)
Bethany Village
STAfE fiLE NUMBER
1 Ndmt! of Deff:df:rlt (Flr~l rlll<idlt! last. suthil
Helena L. Dietz
3 Social Sewrity Number
159 - 38
4 Date 01 Death (Monlh, day, yealf
September 14,2007
y"
6. Dale of Birth (Monlh, clay. year)
5 A9" (ldSt Birthday)
82
March 2, 1925
Rio de Janeiro, Brazil
if NUlslng Uorne 0 Heslo.;nce llOthl;/ Specify
9 Was Decedenl of HispanIC Origm? g No 0 Ves 10 Race: American Indian, Black, White, etc
~:x~~:~~~:~, etc.l (Spec,~ White
- 16 D...'Cedenl's M<lllll1\j Address (Strool, cil)! ,'Iown, stale, liP Code)
325 Wesley Drive
Mechanicsburg, PA 17055
17b Counly
PA
Cumberland
Did Decedenl
uveina
Townstlip?
17c J;(1 Ye:;;, DeceJant Lived m
17d 0 NO,De(;e<!l;lntLlved...11hm
AduilllHTlil:.ol
lw>
11 DeceJc1l1\ Usual Occu :>Iion Kmd of wOO dor,e durin mO,1 of ....orkm hle Du fl{)t state relil€d
Ho~e;naker 'tj~8nS'~~muery
12. WtlS Decedenl evel in the
US Armed FOfl;es?
LJ,,, ~c
Decedent's
Ac1ual ResldtlrlCe 17a State
13, Decedent's Educahoo (SpeCify only highest grade completed)
Elementary 1 sicondary (0-12) Colleg41-4 or 5+)
14. Marital Stalus: Married,NeverMarned,
Wioowed, Divorced (SpociM
Widowed
(Atyltluru
18 FdUJlJ(S Ndme (Flr:'ll1llddlt! Id~t, Strttr~)
Ozorio Leite
19 Mother's Name (Fil1il, mtddkl, maiden surname)
Albertina
20a Intornlilllf:. Nilme (l ype / PUllt)
Karen Parks
200 InloHrldnl's Mailing Addless (Street, city I tawn, stale, lie code)
22 Maple Avenue Camp Hill, PA 17011
~
:t
n Crt!OIdtlOlI [J Oon<lUOII
21c. Place of Disposillon (Namtl at cemelery, cremalory Of (IIher lJIace)
Chestnut Hill Cemetery
21d. LocatlOO (CIty I to...n, :.\ale, lrpeode)
Mechanicsburg, Pa. 17055
23b Llef/nse Number
A.N ~500 Cf4-L-
11"'1Il~ 2426 ll'iu~llJt< lornplet<:d by ptlr:;()(1
whuIJ1(x)ourlce::;iJe"th '.
.1 () 0'1-
26. WdS Case Relerred to Meulcal Examiner I Corone' 1m a Rea$oo Guier th<ln Crem<ltlOfl 0( DOOillton?
[J y" }<lI<o
Approxlmdle KllelVal Pan II. Eulel 0111(11 ~!WlIll!;iilll \;Q[ll1llLQrn; J;Q(tlLl1l1d1ng lQ ~i&l l6 Did Tooacco U$€ Coolnbule 10 Death?
OtI~o11o Oe<Jth btJl nol ru:;;ultU1Q In lilt! underlymg cause given III Pan I [1 Yes lJ PrOOiltJIy
[] No [] Unknuwn
CAUSE OF DEATH (See Inslructlona and 8umples)
Iklll 2.1 P,u11 Enlel ti.1: ~LIl!!! Ii.! 1.:{\iI~ dl$lJ~'-'~ IIIJellltl$ or l,.vrlllJlKollIOns It.al directly c<llJ.wd tilt! dl;l"lh DO NOT enltH lillIIlllldl ~~elll::; sucll a$ eardidC alle::;1
re~pJlalolY <lIre:.!. or v~nlfl<:uku hbJlII"hon ....ltl,OlJt ~huwrny lire ",hulo':lY List only one CiWSO un eaeh line
IMMEO+ATE CAUSE Ihi....1 (1I~"'b~ elr
coodltronrtlsullw.gindealh] -..
. ACv\..1 FA-\wt...( lQ r)tl2..lve
Due folor as a consequenc:e(>f)
b f'<;O\lC"'li"l U::~ 0 l('A. Wl\ PI
Due 10 (or C1~ <I consequence of)
C-Dlf(.' WU1\~
c.oPO - Od. DW(N()~
HTN
29 If Female
[] NoIprtlgnanl wlltllopd:.l ~tlal
[] Preynill1lattlweoldealh
o NoIpregnillllbulplegnanlwI1Il1ll420i1ys
01 Clealh
f] N0Ipregl\dfll,llulple!1laIll43day~101 yeal
bel(J(edealh
o Un~nowfl II prfgnilllt wrlt,lfl the pd~1 Yfilr
32c Place 01 If\lury: Home. Falffi, Sired, Filctory
OnlCeBuildlng, elc (Sp.::clfy)
Sb.jU~lIt!...lI~ 1\:>1 (uI,tJillufI" II Jli)'
~r~I~;a,~o JNOEAt;I~~~IU~~e d
!dr~(,d~" i,r ~'I'JJ'i 11,,11 rlullill",(j !h"
I:'lel,l5. rf~ultlr'9 III ..1",,11,) LAST.
Que ll, (OIdS iiconsr.quI:nce of)
J'"' [:yc
)(e,
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[] Acull,"l.t
[]Pt;I,Lllllyhl',,,,Sllg<l1101l
32..1 Time 01 fnlury
)0" Wd:><In Auhlf;S)!
Pfltu'll,tJ7
30/) WeflJAIII(JpsyFrrujmgs
A"'dlldbl",PrroftoCornpldl,-,l,
01 Cdu:>e 01 Oe"II,?
31 Manner of Dedth
[~I"I L'Jt101IJl(;lde
L}SUIUJe
r J Cl.>Ulu N(JllJt~ O"lellllllled
M
321 II TransporldliOl1Irljury (Specdy)
[J DII.for I Opel alar D P<:ls~en!ler OPede;,lrldll
JOllier. Specify
l3b.sVW::~
32g Localran ul Infury (S1reel, city I lowo slale)
J.ld Cdt,ht!r!ct.eckunlyor,c)
Certifying phy~ician If-'1l,~IU'''11 t;erlllilflY WI,~" ul Jl)dU, ",1,..:10 d110U,1:1 fJ1'y"IC,...n Ila~ prurloum;ed d~dlh dnd cOlllple1ed ltem23j
TQ lhe best 01 my knOWledge, deillh occurred due to the cause(s) and milnner as slated.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
:~~:u~c~~~li~~ ~~:~r::hI:~~~i1~(:~~r~~r~rt~ t~~r:l~~', 1'~~I'::I~YI1~~~t~c'~:~~~f~f~~"iol~~~~::(~~~~ manner as slaled.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D
Medlul Examiner I COloner
On lhe basis 01 uamination ilfld I Of inves1i9~tion, ill my opinion, death occurred al the lime, dille, ilnd place, and due 10 Ihe cause(li) and manner as slated_ [J
33c L~mlseNumbllr
M 0 4 ~q
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llh,dily,yeal)
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DI~pO~lljQn Pelllll( N(J 0 o'~ ~ q ::A.o
3;Q;ie an;LZ.!p~~edcalJse of Death tUem 27) Typei Punt
sp,to '~~~';T~ k 34-51. Tl\Ano>vLL R.oM/CAmP
ItllA
I~l\
LAST WILL AND TESTAMENT OF HELENA L. DIETZ
I, HELENA L. DIETZ, currently of Bethany Village, Lower Allen Township,
Mechamcsburg, 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, shall be distributed into four (4) equal shares, one of which shall be given to
my son, RICHARD C. DIETZ; one of which shall be given to my daughter, SANDRA E.
KINDNESS; one of which shall be given to my daughter, KAREN C. ADAMS; and one of
which shall be divided between my two grandchildren, JACOB MICHAEL NESS and MARY
ELLEN NESS, the children of my deceased daughter, Linda S. Ness.
3.
I nominate, constitute and appoint my daughter, KAREN C. ADAMS, to be the Executrix
of this my Last Will and Testament. In the event that she should predecease me or for any reason
be unwilling or unable to act as such Executrix, I nominate, constitute and appoint my son-in-law,
RONALD E. ADAMS, to be Executor in her place and stead. In the event that he should
predecease me or for any reason be unwilling or unable to act as such Executor, I nominate,
constitute and appoint my grandson, DA VID C. DIETZ, to be Executor in his 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 for the purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~JL day of
J1;~ _,AD.2001.
diW~DwIJ } (SEAL)
Signed, sealed, published and declared by the above-named HELENA L. DIETZ as and
. Wr her Last Will and Testament, in the presence of us, who at her request and in her presence, and
<in.' the presence of each other, have he~UbSCribed OUf. n. apes as witnesses.
(':', . ~ ;:/t2kdP- -
. ~/l~
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
C Lt >>t 13I=""7€L.If-NJ) COUNTY, PENNSYLVANIA
Z\-lYl- ollt\
Estate of
fI~/M4 L. ]);efz.
, Deceased
Ka. re n ~.f?t t' ks
"
~
~ being duly qualified according to law, depose(s) and say(s) that ~She~ was ~ well-
acquainted with He/ena L. ];>;e-r2- and a~ familiar
with the handwriting and signature of the decedent, and that the signature of Helena. L. D,'e7Z
to the foregoing instrument purporting to be the Last Will and Testamenttcedieil of He/8f1A. L. D/eIZ
is in~her own proper handwriting.
7 // '
~ ,) /',// /,
)( UA_/'~ L i c......."tt..~
(Signul re) .... C {)I t~~
,no..:t'en . t'a..rl;o
2Z /J11tp/e .live.
(Street Address)
(Signature)
(Street Address)
ea~ ~/~ /,4. r7ell
(Cily. State. Zip)
(Cily. State. Zip)
'.-',
\. /
".''1
+ C")
i ;
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this 2lotL. day
of S ~\~,r-, ~cl .
!'
t:; .
IC)
a
0-'
Form II 11'-04 reI', 10. /3.06
OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CLunl3~ COUNTY, PENNSYLVANIA
2\ -Ol - O'8lC'
Estate of
II e /el1ll 1. j)/~
, Deceased
Cft~~.s E. ~/e/d5
r;;I
-
, Eetrehra subscribing witness to
(Prillt Name/s)
the li! Will-O Codieil(s} presented herewith, (gach)1:>eing duly qualified according to law, depose(s) and
say(s) that -efie./ he /~ was;" 'vv en, present and saw the above 'ft;;::,tttt5~ Testatrix sign the same
and that -&fie+ he /..#try signed the same and that ~/ he ,.4hey signed as a witness at the request of
the -+0statClf J Testatrix m her /~ presence and in the presence of each other.
x {!kW p.~~
(SigllallJre) {!INVk E. c5lu'el~ ~
~ C/tJIIser #d,
(Sigllature)
(Street Addres,j
(Street Address)
/JleeAtlJ1;~SbU1' ;1,4
(City, Slale, Zip)
17o~S"
(City, State, Zip)
Executed in Register's Office
Swom to or affirmed and subscribed
before me this 2 i 2 -I-L day
o -k .
of <:::?Kp\J!.J'A b...e"-. , 2 DC> I .
Executed out of Register's Office
Swom to or affirmed and subscribed
before me this
day
of
(1.0f.) ~
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.)
NOTE: To be laken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW03 rev. 10.13.06