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HomeMy WebLinkAbout10-26-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF c: (.b;f{(3 EJ!- t-fi-N J) COUNTY, PENNSYLVANIA Estate of Nf ~ It I e l. /-(11'1 G--5 fJ () e 6 iJLG- H f(f}!!. T J V- also known as ~1l5, P A- U.L fJU I f1 A f<. It N File Number J-l --b l - Ct 14 , Deceased Social Security Number 16 t. ~ ;3;), ~ 0 b .2. :L Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A 'or 'B' BELOW:) ~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the last Will of the Decedent dated and codicil(s) dated named in the (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 instll.lment(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; 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.l1.c.t.a., enter date of Will ill Section A above and complete list of heirs.) Name Relationship Residence rr) o . (COMPLJiiK IN ALIt~ASES:) Attach additional sheets ifllecessary. Deceden.Lwas dbin~i!ed at death in C l.L 11 5 I County, Pennsylvania with his / her last principal residence at 301 N. H}JNDVe...R. ST, ~4f<L(:>LE:.. C./.>.,ftf3, PI/I 176{~ (List street l;dd!'ess. tQwn!cily. township, county. stdte. zip code) I I ,'-..J ',.. Deced~~ then ~~; ~ & ....,., , f'-- C) c' i:~ Deced~hr:pt death owneo'property with estimated values as follows: (If domiciled in P A) All personal property (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 years of age, died on /t>~/q-61 at]' W, tLIODL-C:5E...t DR., ( CfU!.L/:?<..E PA. /7D13 $ '-I J"'j &661 So $ $ $ I fo t;'J 6DO I DIJ situated as follows: .301 Ni ffA/1/0uEL 57, crt R-L 1:5 L-E. Pfl r7()13 , 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: Ty ed or rinted name and residence YIIONN (IJ f?. L-ISL f. Form RW-02 rev. 10./3.06 Page 1 of2 Oath of Personal Representative COMMONWEAL TH OF PENNSYL VANIA ss COUNTY OF The Petitioner(s) above-named swear(s) or affim1(s) that the statements in the foregoing Petition are tl1le 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 tl1lly administer the estate according to law. Sworn to or affirmed and subscribed Signature of Personal Representative Signature of Personal Representative Q l,-oi -<114 f(\11\ pI \\';16 ~ IYYv ~ f} , Doc""d Social Security Number: d. biD ~ ~OLD Date of Death: \0 \ \~ \<:'-1 AND NOW, I ) 1~()'1 , in con ideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to l \ \}Ol\(v? r{\'L:tA..\J\~O Y) 1 File Number: Estate of in the above estate Letters .............. . $---3-\ () Short Certificate(s) . . . . i. . $ /10 Attomey Signature: Renunciation( s) ......... . $ W ll\ $ lS"" Attomey Name: -.JCAP $ , 0 Supreme Court J.D. No.: tJvlo $ :5 $ Address: ;) $ :~.:.:" $ , -.1 $ $ Telephone: $ TOTAL " ,............. $ oS lo Form RW.OJ rev. 10.13.06 Page 2 of2 H]()."S{):'i kE\' IO!,'071 01- cl1~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Certification Number 111"t'~\.1\rOrpl;;---___ ,,\'~\..~'r4t- l~ ..... ~~ t~_~..u~. . ~\ ~ ~I ~.. ... . \';2!:~ ~c:::::;) --- -~-. I_~ ~ c,...)\,.zr_"" '. Jh~ ~ '_ '-hj~ !!Ii: >'*\~'-"'."-.""* \~ '"'.' ~l ...~ . ~I\ ""--~-~!MENl \\\ ~\III\\\ -""'''''###111111'''''' This is to certify that the iriformation here given is correctly copied from an original Certificate of Death duly filed with me as Local Regimar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. Fee for this certificate, $6.00 P 13746144 ~. ~~~OCj 24/2007 Local Registrar Date IsslIed M o ';;'-1 \_-~ (J 1..- r", C_~) L'. ' G... C) H105-143 REV 11f2006 TYPE / PRINT IN PERMANENT BLACK INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See instructlons and examples on reverse) 98 12, 1909 7.Bi~ andstafeor Carlisle, PA .. Dale of llooI> (Month. day. .-J OCtober 19, 2007 h" 12.Wu:0ec:eden18\!el'in!tle u.s. Anned Fan::es? 0.... Elllo 13._'_ISpecffyoriyhig1es1gl3deCll<llploflld) _lmy I Sec<>nda<y lo-l2} CoIIoge I'" '" S.l 10th OOttlec.SpedIy. 10. Race: American tndiaA, Black, Mile, ate. I~ White ". ~ ~~Manlod. 15. SurvMngSpouoeI..... gMl maiden name) Widowed 8b. Coonty of o.a.. I. Cuntlerland 11. Decedenl'sUu most 01 IiIe.Dol'dlllate Kind of Work Kntot EMnss/ lNfusIry Homemaker Own Home . 16._,__ISbeof.dlyl_._",_l 301 N. Hanover St. Carlisle, PA 17013 8d. FedliIy Hemal' not_ g;.e_end numbe~ 31 W. Middlesex Dr. 17b.ColJoIy P",nn"'ylv",ni", ("111T1hArl.::lnn 19. Mother"s Name (Fiml, miIdIe, maiden surname) Bertha Bolen 2lIb.'_,__(Slreel.dlyl_._",_1 31 W. Middlesex Dr. Carlisle, Did Decedent Uveln. T_ 17C.O Ves.Decedenl.l.iIIedin 17d.KJ ~~oflJved- Carlisle Boro T"". _. ActuaIResidence 11a.Stat& ClOyI.... 18. F_',Nems (FOS\ _..........1 2Oa. Infomlant's Name (Type / Print) Yvonne Davidson PA 17013 21aMeIhodof.DisposiIion 21c.Pleceof"-(Nameof_._",-plece) 21d.l<>cetionIClOyI__..,,_) Carlisle, PA 17013 Funeral Home & Crematory 219 N. I:Janover St. 28. DIf Tclbaeco Use Conmbute to 0edl7 0....0- 0110 0- 29. If Female: o Notpregneol_""",... o _.....of_ o Not_butpregneol_<2deys of_ o ...-.but_43..,,101,,,, -- O-'pregneot"""'''''''''''''' 32l:.PIecoof.;.y.-........Sbeof._. .-a."ng,eIc. 1_ AppltIllimete- 0nseI1D 0ea0l -...-...... IealingtotheC*ll(llsl8donlinea.. Enterfhe UNDERLYItG CAUSE =-.=':...~ c. Oueto(or8Sa~oI):. d. OVa 'Jla 110 3lIl.__1'1nlfngo AveiIabIlIPrIorlOc:orr.-aon otCause ofDealh? OVa 0110 31. MImIr of DedI. .t!d.- 0- 0-0-'''''''''''''''' 0- 0 Coodd Not be Oefom;ned 32d. Tme or I~ury 32g. Localionollnfury(StJ8el,cfty/lDwn,state) 3Oa.WlIsanAulopsy - M. 33aCertlfie<ldleckonlyooel ~pI1y__ce<1Iyi1g""'~_when"""'_hes""",,"__end_ltem23) To the bnt of my knowIedgt, death l)CICUQd duelothecatlSl(a)and mllIIrIIt.. stIIeCL -.............................. - - -........ - - -............ =~":t:=ge~~~ti~ancI~'::1oto=~=mannerasstated..________..________ D =:== and I or Invntigrion, in my oplNon, deldh occurred at the time, date, and place, and due to the caust(s) and manner as ItltecL 0 I~ I \ 10..1 \ 10 I Cis_Penn'No 00 '114-/0-. 34. Name and Address of Person Who Compleled Cause of Dealh (Item 27) Type I Print Patricia Gomez 850 Walnut Bottom Rd. Carlisle, PA 17013 ,) ( 01-(17'1 I, Muriel K. Martin, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound disposing mind and memory, do make, publish and declare this to be my last will and testament, and hereby revoke all former wills and codicils by me made. 1. I direct that my Executor, herein named, pay all of my just debts, funeral and testamentary expenses. 2. I give, devise and bequeath all of my estate, real, personal and mixed, unto my daughter, Yvonne Martin Davidson, absolutely. 3. I hereby appoint my daughter, Yvonne Martin Davidson, to be the Executor of this my last will and testament. 4. In the event that my daughter, Yvonne Martin Davidson, should fail to survive me, then I give, devise and bequeath all of my estate, real, personal and mixed, equally to my two grand-sons, Kevin Martin Davidson and Sean Robert Davidson. In the event that my daughter should not survive me, I appoint my son-in-law, Robert Lackey Davidson, as the Executor of this, my last will and testament. In the event that neither my daughter, Yvonne Martin Davidson, nor my son-in-law, Robert L. Davidson, should survive me, I appoint my grand-son, Kevin Martin Davidson, as Executor of this, my last will and testament. In witness whereof I have hereunto set my hand and seal to this my last will and testament this 27th day of February, 2000. /~ ~.L2:j (SEAL) Signed, sealed, and published and declared by the above named testatrix, Muriel K. Martin, as and for her last will and testament, in the presence of us, who, at her request and in hmpresence and in the presence of each other, have hereunto set our hands as witness. a ('...I C,,: /J17-~ '?l7r ~ ~ (). .:;e;;dzwJ t--- :.--..-, OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS tvlt~i--IH+ f) COUNTY, PENNSYLVANIA Estate of /J (/ tL. ( tZ. c.... Ie. /'1 fl-iL,. f 1-/ , Deceased !lo r.?,~ ? D/7-vll)/\J,-J and (each) being duly qualified according to law, depose(s) and say(s) that she@ they eJwere well- acquainted with /1 i/~ I:.-~ /14-"-1/1" and ~are familiar with the handwriting and signature of the decedent, and that the signature of /1 v t1,...( C ~ 11 ~J to the foregoing instrument purporting to be the Last Will and Testament/Codicil of //_rt- (~ '- , ri ./f7L-TII/ is in his/her own proper handwriting. . (Signature) ,(jjvd~~~ J? (Signature) ;!/ t{Jc ~/~~ (Street Address) ~lJ;f 170J5 (City, State, Zip) ~ (Street Address) (City, State. Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this d. ~ day of M~ ,Q:bJ. Form RW-04 rev. 10.13.06 OATH OF NON-SUBSCRIBING WITNESS(ES) , REGISTER OF WILLS ('v"'~y~j) COUNTY, PENNSYLVANIA Estate of 11 u 12-' ci: L- ~ \ NftfufN , Deceased @/ he / they (jjjj;i were well- and~re familiar with the handwriting and signature of the decedent, and that the signature of j1 ~Il. {fL<-. rltf"'-rr-/I /(,q,lLfl f/. D~v,p.$'D.i/ and (~) being duly qualified according to law, depose(s) and say(s) that acquainted with H v ILJ l:..L. J< Mill\.. TrH . to the foregoing instrument purporting to be the Last Will and Testament/Codicil of If v (1..1 hA- 1<. H tT (L.:n f/ is in hi~wn proper handwriting. (: ig ature) ~r {lQCbl V\.. Yh (Street Addresj) (C~J0 fA l1V\3 (Signature) (Street Address) (City. State. Zip) l-__-"-:- Executed in Register's Office Sworn to or affirmed and subscribed ~LP day ,~J ..... ..., l '~.J 0"' ~ of ---..~ ---1 co Form RW-04 rev. 10.13.06