HomeMy WebLinkAbout10-09-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF (! p~ L COUNTY, PENNSYLVANIA
Estate of ~ ~/lLh1.h J Ji. It! o-iJu
also kn~as . ~
~'+,/{~JJ (.j, A ~jo
, Deceased
FileNumberdl-O 1- ()q '-Ilo
Social Security Number /9 Cj - if: - 577 Y
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
o A. Probate and Grant of
last Will of the Decedent dated
Hers Testamentary and aver that Petitioner(s) is / are the
and codicil(s) dated
,) J}
! /J ( J 17//PI ?f -rr(~ Mm,d ;oth,
(State relevant circumstances. e.g.. renunciation, death oj e.tecutor, 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
(If applicable, enter: C.t.a.; d.b.n.c.t.a.; pendente lite; durallte absentia; durante lIIinoritate)
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
AdministratiolJ, c.t.a. or d.b./l.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name
Relationship
ReGi<!tnce
;('"")
"'-<)
')
:-..,
~
, .-,
....,.....
(COiIoIPLETE IN ALL CASES:) Attach a -c'"
Decedent was dom~cil~ death in
(List street address. town/city, township, county, state. zip con_ . #.. l /1111 J
O",doo",h," '"1 i Y'=Of,ge'd;'dOO~i. J~ 4pJ/I'f.; ~
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property $ '1 () 0
(If not domiciled in PAl Personal property in Pennsylvania $
(If not domiciled in P A) Personal property in County $
Value of real estate in Pennsylvania $ 75 I 60 6
,;,,,,,,ddollow, 3 0 d, .? Jr (! ~b ~ A.t4m 0-"",(11;;:,.,,='1 -a', I 70 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:
{J LJ;
I 80 J.,. {j} ~o (L f-{iJ- 11: 1) f1y E
I S I-J J Ii f ;11 /liS -r () t{) f1I pd. 1/ () / /
Form RW-02 rev. 10.13.06
Page 1 of 2
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 true and con-ect 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.
Sworn to or affirmed a\1d subscribed
before me the I q+U day of
x
t
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Social Security Number: \ C1ct \ t..t S 119 Date of Death: -.J Ld U
I
AND NOW, Q'\:::3~..A. ~~ , ~l , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, ITIS DECREED that Letters VC",-\oJ~I\.jnJ~
are hereby granted to '\'<'cl f\C>rI. ~ U~"-....J .
File Number:
1'.::'
Estate of
, Deceased
\ q<:1 ~
in the above estate
and that the instrument(s) dated '-)~ \ -t \ ~ ~
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
vkl~~~~~~.~
Register of Wills
FEES
Letters ............... $
Short Certificate(s) . . . ~. . . $
d\C)
8
Attorney Signature:
TOTAL
$
$ \s
$ \b
$ .s
$
$
$
$
$
$
$ .;)~ 'f:?O
Supreme Court I.D. No.:
Renunciation( s)
WI\\
~(~
~_\.\U
Attomey Name:
Address:
Telephone:
Forlll RW-O] rev. /0./3.06
Page 20f2
H105905 REV. 2.86
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: IUs Illegal to duplicate this copybVphot01'tatorphotograph.
No.
.~!/~
Charles Hardester
State Registrar
Fee for this(:~rtificate,$3.00
SEP 01 .
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DEC~OENT'S USIJAl. OCCUl'R1ON
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"..Public lUllations ....Telephone Co.
DeCEDENT'S MAUNO AOORESS.(SlUMIt. CilyflOwn. $late.l'1)COdel DECEOENT'S
}O2 w. Oourtland ave. ~~NCe
(See In!i'lJUCbOfl8
.1. slU.remanstown, pa 17011 """",...del
FRHEA'S NAME (first Middle. LasI)
11. F. Hennan Roth
lHFOAMANT'SNAME cr_
Marlon Roth
ME1'HOD OF ITION
_ Gil c....._ 0
1lonol1on0 Od>ot(Spoe'
2'
Ht05.143Aev.2187
TYPEJItRtNT
IN
PERMANENT
BLACK INK
NAME Of oeCEOENl (First. MiCkIe, l.1!a)
1. Frank H. Roth, Jr.
AGE (last8ifthday)
UNDER 1 YtiAR
......... Doyo
70 Vrs.
. COUNTY OF DERH
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lb.
Cl:unberland Co.
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WERE AUlOPSV FINDINGS
-....au PRIOR 10
COMPlETION OF CAUSE
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COMMONWEALTH OF PENNS~......-rMENT OF HEALTH' VITAL RECORDS
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sex
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$l'.QE FU NUMBER
SOCIAL SECURITY NUMBeR
3. 199 -14
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"INDOI' BUSlNESSIINlJUSTRV
SURVMNG SPOUSE
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citylboro.
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PMT n: 0Nt' tlQninc.w c::ondIIiOns contributlng 10 duItl. but
ltOt~fntheundeftytngc:alOe~ inPAAT I.
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DUE 10(00 AS A CQN&QUENCE OF),
MAHNEROF OERH
DATE OF IN,JURY
(Men". (Joy. _I
TIME OF INJURY
tNJURY 1J WORK?
OESCRtBE HOW INJURY OCCuRRED.
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o Pl.ACe OF mJURV . AI homa. farm. s"".tadofy.OffIce M.
buifdItIg..,c.(Spec!fy'l
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-CERTIFYINC PHYSICIAH (Physioancet'kfying cause of dlIa1h ~&r' anothef phYslcl8n has pronounced dealt! andcornoteled Item 23) ,
ToDMI.......""knowllldfe...thOClCuntCldWto....catae(.)and~r..ltated............... ................................
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_PRONQUtfCtNG ANOCl!RTIFYINQ PHYStClAH (Physic18n boCt1 p'onounong death and cef1ifytng 10 cause of dt!alhl
TO....bHtofmyknotiltMlge. dUChocCUfNd..lMthM........pta<<*........totMc.UMC...ndmanMr..SUlled... .......................
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1EClst Mill Clttb illestamettt
OF
FRANK H. RO'lH
I, FRANK H. ROTH, of Shiremans town, ClUIiber land Colmty , Pennsylvania,
make, publish and declare this as and for my Last Will and Testan:ent, hereby re-
voking all other Wills and Codicils heretofore made by rre.
FIRST: I direct the payrrent of all my just debts and ftmeral expenses,
including my grave marker and all expenses of my last illness, shall be paid from
my residuary estate as soon as practical after my decease as a part of the ex-
penses of the administration of my estate.
SECOND: I devise and bequeath all the rest, residue and remainder of my
estate of whatever nature and Wherever situate, together with any insurance
policies thereon, tmto my wife, MARION W. ROIH, provided she survives TIe by sixty
(60) days.
THIRD: Should my wife, Marion W. Roth, predecease rre or die on or be-
fore the sixty-first (61st) day following my death, I devise and bequeath all the
rest, residue and remainder of my estate of whatever nature and Wherever situate,
together with any insurance policies thereon, tmto my children, srorr F. ROTI-l
and KURT E. ROTH, in equal shares.
FDURl'H: Should either of my children predecease rre, I direct that their
separate share or shares tmder this, my Last Will and Testan:ent, pass to their
respective issue, share and share alike. In default of issue living at the time
of my death, I direct that the share or shares of any child predeceasing me pass
to my surviving child.
FIFTH: In addition to all powers granted to them by law and by other pr -
visions of this Will, I give the fiduciaries acting heretmder the following powers,
applicable to all property, exercisable without court approval andce~~ecti~~til
actual distribution of all property: ,) n
,",-,
(A) To sell at public or private sale, or to lease, for any~peri6a of
-- ,~--.
,.
time, any real or personal property and to give options for sales, exc:banges:.nr
...) __-0
leases, for such prices and upon such terms or conditions as are de€ired pro~.
(B) To partition, subdivide, or improve real estate and to enter into
agreeJrents conceming the partition, subdivision, improverrent, zoning or managemen
of real estate and to impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to abandon any property
which is of little or no value.
(D) To invest in all fonns of property, including stocks, carmon trust
funds and IlDrtgage investment funds, without restriction to invest:rIEnts authorized
for Pennsylvania fiduciaries, as are deened proper, without regard to any principl
of diversification, risk or productivity.
(E) To exercise any option, right or privilege granted in insurance
policies or in other invesbnents.
(F) To exercise any election or privilege given by the Federal and
other tax laws, including, but not necessarily being linri..ted to, personal income,
gift and estate or inheritance tax laws.
(G) To make distributions to my herein naned beneficiaries in cash or .
kind or partly in each.
SIX'IH: I direct that all inheritance, estate, transfer, succession
and death taxes, of any kind whatsoever, which may be payable by reason of my
death, whether or not with respect to property passing under this Will, shall be
paid out of the principal of my residuary estate.
SEVEN'IH: All interests hereunder, whether principal or incane, while
1ID.distributed and in the possession of the fiduciaries acting hereunder, even
though vested or distributable, shall not be subject to attaclment, execution or
sequestration for any debt, contract, obligation or liability of any beneficiary,
and furthernore, shall not be subject to pledge, assignrrent, conveyance or anti-
cipation.
EIGlITH: I nominate and appoint my wife, MARION W. RO'IH, Executrix of
this, my Last Will and Testammt. In the event of the death, resignation or in-
ability to serve for any reason whatsoever of the said Marion W. Roth, I nominate
and appoint senTI F. ROTH and KURT E. Rom, or the survivor thereof, Co-Executors
of this, my Las t Will and Tes tarrent. I hereby relieve my Executrix from the
necessity of posting security in connection with her duties as such in any juris-
diction in which she may be called upon to act insofar as I am able by law to do
so.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my
Last Will and Testammt, this
I} day of , run Q , 1985.
i'
r ' ~J
' ~J ;/ 0<:P~
Frank H. Roth
(SEAL)
-2-
Signed, sealed, published and declared by the above named Testator as
and for his Last Will and Testam2.nt in our presence, who, at his request, in his
presence and in the presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
Address
-3-
~\ at ()~~Lo
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CQ<<I.~'\.~I'- ~ COUNTY, PENNSYLVANIA
Estate of <;, ~ ~ \.2.... \-\. Rc:i~-~
l Deceased
,
~U~-\- ~. 'R~\-~
and
(each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well-
acquainted with ~u ~ \-\ .\<--.0 ~ andGliDiare familiar
with the handwriting and signature of the decedent, and that the signature of ~~"'--~ \-\. '\<-1::>\\.......
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of~..I....-. \.-\. R~
is in his/her own proper handwriting.
{Sil1.~ c!' ~".:;tL
\ d- 5 '\'-a~ ~ <<- c\~ \ <<-
(Street AddresJ) ~
C:~,\\s \ Q.... .~ A ,-=to, 3
(City, Slate, Zip) I
(Signature)
(Street Address)
(City, State, Zip)
~
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this ~ day
of ~b" ,c::::bo,.
._~_. ;
V:J
:J::~,
1",.)
FormRW-04 rev. /0./3.06