HomeMy WebLinkAbout10-23-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYL VANIA
Estate of EVELYN G. BURKEY
also known as
FileNumber &\ - 07 -00.6/
, Deceased
Social Security Number 191-26-6443
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
121 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the EXECUTOR named in the
last Will of the Decedent dated MARCH 18,2005 and codicil(s) dated N/A
WILLIAM E. BURKEY RENOUNCED HIS RIGHT TO SERVE AS EXECUTOR AND SCOTT SHATTO WAS NAMED AS AL TERNA TE
EXECUTOR BY DECEDENT'S SAID WILL.
(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: N/ 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 minoritate)
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.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Relationship
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(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
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Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principalrllJiiWnce at
67 2nd STREET WEST FAIR VIEW EAST PENNSBORO TOWNSHIP P A 17025
(List street address, town!city, township, county, state, zip code)
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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
(lfnot domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
40,000.00
$
$
$
$
350,000.00
situated as follows: 67 2nd STREET, WEST FAIRVIEW (E. PENNSBORO TWP.), CUMBERLAND COUNTY
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 rinted name and residence
SCOTT SHATTO, 41\ FAIRVIEW AVE., WEST FAIRVIEW, PA 17025
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
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 ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) wiIl weIl and truly
administer the estate according to law.
before me the :J 3
day of
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Sworn to or affirmed and subscribed
Cc-\o~ Q r
fb.w Leo.
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For the )gister
Signature of Personal Representative
Signature of Personal Representative
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File Number: Q9- \- 6, - Oq 01
Estate of EVELYN G. BURKEY
, Deceased
Social Security Number: 191-26-6443
Date of Death: 10/16/2007
AND NOW,
having been presented before me, IT IS DECREED that Letters
are hereby granted to SCOTT SHATTO
, in consideration ofthe foregoing Petition, satisfactory proof
TESTAMENTARY
in the above estate
Letters............... $AL.Q{) .OC)
Short Certificate(s) . . . . . . . . $ CJ () .OG
Renunciation(s) .......... $ 15 00
\N'\ \ \ .. . $ Ib 00
jc.-\=) .. . $ 10. 0 ()
!1utoI"YlO. f10Y\ ... $ O.OU
.. . $
.. . $
.. . $
... $
. .. $
.. . $
Ll \-;:...., . ~-&.e&-
TOTAL . . . . . . . . . . . . . . $ -\ , J .
and that the instrument(s) dated MARCH 18,2005
described in the Petition be admitted to probate and filed of record as the last WiIl (and Codicil(s)) of Decedent.
~nd,\ ,1Ct()l,H ~aJ>ty1t ;)RrrhYJC1~
Register of Wills I U .
Attorney Signature: Vh4M~ ~
FEES
Attorney Name:
THOMAS E. FLOWER
Supreme Court J.D. No.: 83993
Address:
SAlOIS, FLOWER & LIND SA Y
2109 MARKET STREET
CAMP HILL, PA 17011
Telephone:
(717)737-3405
Form RW-02 rev. 10./3.06
Page 2 of2
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RENUNCIATION
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REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYL VANIA
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Estate of EVELYN G. BURKEY
, Deceased
I WILLIAM E. BURKEY
,
(Print Name)
SON AND EXECUTOR APPOINTED BY WILL
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
SCOTT SHATTO
10/17/2007
W~~~~
(Signature)
(Date)
220 2nd STREET
(Street Address)
WEST FAIRVIEW, PA 17025
(City. State. Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this day
of
Deputy for Register of Wills
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.)
Form RW-06 rev. 10.13.06
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WITNESS:~~~
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
On this, the IIfii day of (),~, 2007, before me, the undersigned
officer personally appeared Thomas E. Flower, Esquire, known to me (or satisfactorily
proven) to be a member of the bar of the highest court of said state, Supreme Court
attorney license no. 83993, and a subscribing witness to the within instrument, and
certified that he was personally present when WILLIAM E. BURKEY, whose name is
subscribed to the within RENUNCIATION, executed the same, and that the said person
has acknowledged that he executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set m
COMMoNWEALTH OF PENNSYLVANIA
Notarial Seal
Jo Am Seker. Notary Public
Camp HlIBoro. ClInbel1and County
My Commission Expires June 30. 2011
Member. Pennsylvania Association of Notaries
(SEAL)
'1111'\;.<11'\1,>1:\'1"'.."....
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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.
~RZ,~B!!I"!ed
P 13859844
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REV 1112006
, PRINT IN
"ANENT
CK INK
1. Name 01 Decedent (Firs1, middle, last. suffix)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
5. Age (Last BirttKlay)
7. Birthplace (Cttyand state or
STATE FilE NUMBER
94 y".
6. Date of Birth (Month, day, at)
3. Social Security Number
191 - 26 - 6443
.4. Date of Death (Month, day, year)
10/16/07
Evelyn G. Burkey
5/6/1913
Harrisburg,
Sa. Place 01 Death (ChecIc only one)
Hospital: Olher:
o lnpalienl 0 ER 1000patient 0 DCA XJ NUlSing Home 0 Residence 0 Other _ Specily:
9. Was Decedent of Hispanic Origin? Gi No 0 Ves 10. Race: American Indsn, Black, White, atc
(If yes. sped~ Cuban. (Spacffy)
Mexican, Pu..o Rican, .tc.) Wh i te
14. Marital Stalus: Married, Never Married, 15. Surviving Spouse (II wite, give maiden name)
Widowed, Divorced (SpecifY!
80. County 01 Death
ad, Facillly Name (If not Inslitullon, give streel and number)
Cumberland
Golden Living Center
11. Decedenrs Usual 11oo Kind of work done du
Kind of Work
Clerk
. 16. Decedent's MaiHng Address (Street, clly! lown, slale. zip code)
67 2nd street
West Fairview, Pa 17025
'8.F.~er"Name(FI"t,middle,l.sl,su!llx' Harry Brinton
12. Was Decedent ever In !he
U.S. Armed Forces?
Oy., i1lNo
Decedent's
Actual Residence 17a. Stale
1lb. Coun~
Pennsylvania
Cumberland
17c. 5i: Ves. Decedenl lived in
!7d. 0 No, Oecedentlived wrthin
ActuarUmJlsol
F,;:,,::t Ppnn,::hnrn
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19. Mother's Name (RlSt, midde, maidan surname)
Irene Deardorf
C'Y I Boro
scott M. Shatto
2Ob. Informanrs Mailing Addresa (Street, city I town, state, zip code)
411 Fairview Ave., West Fairview, Pa 17025
21b. Date of DisposIlion (Month, day, year) 21c. Place 01 Disposition (Name of C9metery, aemalory or other place) 21d. Localion (City flown, slate, Zip code,
238. To the besl of my knowledge, death occurred at the lime, dale and place staled, (Signature and title)
v'(Y\~ .-:J ~ k- Rt--J
24. Time of Death 25. Dale Pronounced Dead (Month, day, yearl
CY ~~o6- \. \ Lv 8- 001
CAUSE OF DEATH (See InstructJon. end exemp"')
tlern 27. Part t: Enter !he ~ - diseases, in~nes, or complications -thai cIr8ctIy caused the death. DO NOT enter terminal events such as cardiac arrest,
respiratory arreS!, or ventricular fibrillation witl10ut showing the 8li%g'j. Us! only one cause on each line
Rolling Green Memorial Park Camp Hill, Pa
22cNameend~SSolFacil'Y Sullivan Funeral Home
51 N. Enola Dr. Enola Pa 17025
23b. license Number
j2"N ~o~n() L
26. Was Case Referred to Medical Examiner I Coroner lor a Reason Other than Cremation or Donation?
o Yes !Xl No
23c. Date Signed (Month, day, year)
C) QSk0.J.('.'~ \ 1.0 I ;lDa' I
ApproximaleinlelVBr:
Dnsetlo Deeth
Part t1: Enter other siCJnilicantl:OnlttiooK conttibutiM to death,
buinol resulting in the unclerlying cause given in Part I.
28. Did Tobacca Use Contribute to Death?
o '!Os .JaProbe~
[31io 0 Unknown
29.IIF
CO.~t <' /-tv.c.
Due 10 (or as a conJAque":.ff~: 1_0.
b. ff~/'ru:_
Due to (Of as a consequence of):
~/r- hill.p',
("'"re/lo s- If
t pregnant within pasl year
o Pregnant at bme of death
o Not pregnant, oot pregnant wllhin 42 days
of death
o Not pregnant, but pregnanl 43 liays to 1 year
belore death
o Unknown it pregnant within the past year
32c. Place 01 Inju/)': Hoole, Farm, Street, Factor,<.
OfficeBuiJdlng,e1C, (Specify)
c.
Due 10 (or as a consequence of)'
d.
DYes
No
3Ob. Were ALIlopsy Findings
Available PriOf to Compl9tiQn
of Cause of Death?
DVes ~
31. Ua~oI Death
~lu(a1 0 Homicide
o Accident 0 Pendil'lQ Investigation
o Suicide 0 Could Not be Determined
32d. 11ma 01 Injury
32g. localion of Injury (Stree~ city flown, stale)
M.
331. Certifief (checlc: only one)
Certifying physician (Physician cerlltying cause of death when another phys;ctan has Pronounced death and compteted lIem 23)
To the be,tof my knowledge, cMllfl occurred due 10 thecause(s) and manner as stalecL.........................................................................
;~~:u~~~,.~ ::~"::.=a~~=:~ ::~'~:~n~:'~~~~:~~enfof~:~~~~ manner as stated-.. .. _....... ...... ... ..... ...... .... 0
","leal Examiner f Caronit'
On the balls of exemlnatlon and I or Investigation, In my opinion, death occurred al the time, dale, and place, and due 10 the cause{s) and manner 86 slated- 0
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Disposition Permil No.
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SAlOIS
SHUFF, FLOWER
& LINDSAY
AITORNEYS.AT.LA W
2109 Market Street
Camp Hill. PA
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LAST WILL AND TEST AMENT
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EVELYN G. BURKEY
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I, Evelyn G. Burkey, of West Fairview, Cumberland County, Pennsylvania, being
of sound and disposing mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST
I direct the payment of my just debts and expenses of my last illness and funeral
from my estate as soon after my death as conveniently may be done. If there be no
cemetery lot available for my interment owned by me at the time of my death, I authorize
my personal representative to purchase such cemetery lot with a contract for perpetual
care, using therefor funds from my estate in such amount as he shall consider necessary
and desirable, and I authorize my personal representative to cause title to or ownership of
such lot so purchased to be vested in such person as my personal representative shall
designate.
Further, I authorize my personal representative to expend funds from my estate, in
such amount as my personal representative shall consider necessary and desirable for the
purchase, erection and inscription of a suitable marker for my grave.
SECOND
To my son, William E. Burkey and his wife, Malinda Burkey, I give an devise a
joint life estate in my real properties at 216 State Street and 301 Second Street, both in
West Fairview, remainder to my grandson, David Shatto, per stirpes. In addition, I give
,
.
SAlOIS
SHUFF, FLOWER
& LINDSAY
ATTORNEYS'AT'LAW
2109 Market Street
Camp Hill, PA
my son, William, the right to use the garage at my property at 201 State Street, West
Fairview, to store his automobiles during his lifetime.
THIRD
To my son-in-law, John Shatto, I give and devise a life estate in my real properties
at 67 Second Street and 201 State Street, in West Fairview, remainder to my grandson,
Scott Shatto, per stirpes, subject as aforesaid to William Burkey's right to store his
automobiles in the garage at 201 State Street during his lifetime.
FOURTH
I gIve and devise to my grandson, Scott Shatto, the following parcels of
undeveloped real estate:
(a.) my Adams County mountain land;
(b.) my properties in Cumberland County at Enola Road, Wildwood Road,
Belmont Avenue and Penn Township; and
(c.) my properties at Belle Vista Drive, Enola, and at Front Street and E. Locust
Street (Lot 44), in West Fairview.
FIFTH
I gIve and devise to my grandson, David Shatto, the following parcels of
undeveloped real estate:
(a.) my properties in Cumberland County at Pennsylvania Avenue (Lot 27), at
137 Third Street, West Fairview, at Forestry Road, and my mountain land at Baltimore
Road;
(b.) my York County property on Oak Drive in Newberry Township;
(c.) my property off Mountain Road next to the Belle Vista Drive lot, which I
have given, above, to my grandson, Scott; and
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SAlOIS
SHUFF, FLOWER
& LINDSAY
AlTORNEYS'AT'LAW
21 09 Market Street
Camp Hill, PA
(d.) My property at Fulton Street and my second property at Front Street, both
in Enola (the other Front Street lot having been given, above, to my grandson, Scott).
SIXTH
In the event that I own any real estate not disposed of by the foregoing provisions
of this Will, I direct my executor to apportion the same between my grandsons, Scott and
David Shatto, in such manner as to equalize, as well as may be, their respective portions of
my estate.
SEVENTH
I leave to my Executor's sole discretion the disposition and distribution of my
tangible personal property and household effects, and I authorize him to distribute such
items among my heirs in kind, or, as he may deem appropriate, to sell the same and add the
proceeds thereof to the residue of my estate.
EIGHTH
All the rest, residue and remainder of my estate, including but not limited to cash,
bank accounts, intangible personal property of any kind and insurance payable to my
estate, shall be devoted first to the payment of the costs of the administration of my estate,
second to pay my just debts and funeral expenses, and third to pay all inheritance, estate,
and transfer taxes imposed upon my estate passing under this Will. In the event that the
residue of my estate should prove insufficient to defray the aforementioned expenses, debts
and taxes, I direct that the excess be charged equally to the shares of my grandsons,
hereunder. In the event that the residue of my estate should prove more than sufficient to
pay all such expenses, debts and taxes, then any balance remaining shall be paid to my son,
William, if he survives me, or to his wife, Malinda Burkey.
3
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SAlOIS
SHUFF, FLOWER
& LINDSAY
ATfORNEYSoAToLAW
2109 Market Street
Camp Hill, PA
NINTH
In addition to the powers conferred by law, I authorize any personal representative
acting under this instrument, in his absolute discretion:
A. To retain in the form received, or to sell either at public or private sale
any real or personal property;
B. To exercise any options to subscribe for stocks, bonds, or other
investments;
C. To JOIn In any plan of lease, mortgage, consolidation, exchange,
reorganization or foreclosure of any corporation in which my estate or any trust
may hold stocks, bonds or other securities;
D. To sell, transfer, convey, mortgage, pledge, lease or exchange any
property, real or personal, which at any time may form part of my estate, for the
payment of debts or taxes, or for any purpose of administration or distribution, for
such prices and upon such terms as my personal representative, in his sole
discretion, may deem wise, and to execute and deliver deeds of conveyance or
transfer thereof;
E. To make settlements and compromises on such terms as my personal
representative in his sole discretion may deem wise without the necessity of
obtaining any court approval thereof;
F. To make distribution hereunder either in cash or kind, as my personal
representative in his discretion may deem wise.
TENTH
I do hereby nominate, constitute and appoint my son, William E. Burkey, to act as
Executor of this my Last Will and Testament. Provided, however, that ifhe is unwilling or
4
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SAlOIS
SHUFF, FLOWER
& LINDSAY
AlTORNEYSoAToLAW
2109 Market Street
Camp Hill, PA
unable to act as Executor, I direct the duties of Executor to be performed by my grandson,
Scott Shatto.
ELEVENTH
I direct that no personal representative, guardian, trustee or other fiduciary
appointed under this instrument shall be required to give bond for the faithful performance
of his duties in any jurisdiction.
IN WITNESS WHEREOF, I, Evelyn G. Burkey, have hereunto set my hand and
seal to this my Last Will and Testament, consisting of five (5) typewritten pages, the first
~
four (4) of which bear my signature in the margin for identification, this I V -day of
~ c.-R- ,2005.
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Evelyn . Burkey
Signed, sealed, published and declared by the above-named Evelyn G. Burkey,
Testatrix, 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 said Testatrix
and of each other.
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ADDRESS
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SAlOIS
SHUFF, FLOWER
& LINDSAY
ATIORNEYSoAToLA W
2109 Market Street
Camp Hill, PA
COMMONWEAL TH OF PENNSYL VANIA
SSo
COUNTY OF CUMBERLAND
We, Evelyn G. Burkey, 'T H.MA~ E . fi..owf-IL and f..J4fH '([ /l;eJit/t, the
Testatrix and witnesses, respectively whose names are signed to the foregoing or attached
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her Last Will and Testament and that she
signed willingly and that executed as her free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and hearing of the Testatrix
signed the Will as witnesses and that to the best of their knowledge the Testatrix was at the
time eighteen (18) or more years of age, of sound mind and under no constraint or undue
influence.
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Evelyn . Burkey
~~
Witness
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Subscribed, sworn to and acknowledged before me by velyn G. Burkey, ~e
Testat$UbSCribed to and sworn or affirmed to before me by the witnesses, this ~
day of 1- ,2005.
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