HomeMy WebLinkAbout12-03-07
REGISTER OF WILLS OF
PETITION FOR PROBATE AND GRANT OF LETTERS I'..:l
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COUNTY, PENNSYi~-ANIA ~
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also known as
, Deceased
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
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0"A. Probate and Grant of Letters Testamentary and aver that Petitioner~/ are the Mill< k PJ1EN'TI rF) EXECU 7Z'...;>named in the
last Will of the Decedent dated Nt' U. I tf) 200f.o and codicil(s) dated
(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 instmment(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
(lfapplicable. 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.)' 0 ~
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(CO/llPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
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Decedent was domiciled at death in C Ut11.6ERLAN D County, Pennsylvania with his / her last principa]~esidence at
2QU5 OIESrll/VT Sr:. CAmP HILL. Ct.J/JU3E~l/IlJ/J C~)UAJnj.J ,PilI nOli
(List street address, lawn/city, township'- counly, state, zip code;'
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Decedent, then 8: 2-
years of age, died on 11-25 - 2007 at
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SPIRIT fJ{)SPITflL
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If 110t domiciled in PAl Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
- Value ofreal est.ate in Pennsylvania
$ 57 50{J.Oo
/
$
$
$200, 000. 00
,
situated as follows:
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:
c:::: Signature
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Tvoed or orinted name and residence
IrJlJ;<1< fJ;.<ENTicc 2920 LI)JU)LA} ST. CAmP HILL ;JA nOlI
Form RW-02 rev. /0./3.06
Page 1 of2
Oath of Personal Representative
COMlv[ONWEALTH OF PEi'fNSYLVANIA
cou~nY or --.t\J..S\'~.....\0-1\d..
SS
Tht: PetitWI1Cn;i ahu\'>!U::1Cd ,''.C~H\') or <liTinn(s) that the statements in the foregoing Petition are true and con-ect to the best of
til,: 1-.;)0"-, kd,"c :lnd belief of Petitioller(S) ~\l,J that, as personal representative(s) of the Decedent, Petitioner(s) will wetl ane! truly
administer the estate according to law_
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Signature of Personal Representlltive
Sworn to or affirmed and subscribed
before me the
day of
SigJUlture q( t'ersonal Representalive
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Social Security Number:
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Sigfwture of Perso/lal Representative
File Number:
Estate of
, Deceased
Date of Death:
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AND NOW,
, in consideration of the foregoing Petition, satisfactory proof
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having been presented before me, IT IS DECREED that Letters
are hereby granted to fficu- '"' ~,(E'.1\\ ce
in the above estate
and that the instrument(s) dated ~O()~~('"' \ L\ ~bD~
desCribed in the PetitIOn be admitted to probate alld filed of record as the last Will (and COdlCil(s)) of Decedent.
L,tt,c;~Sl.;;:lt~ $ 310 v~m ~:;;,Jhtia<::?fJU rJtvder'
Short Certificate(s) _ .1 S_ .. $ ~O Attomey Signature:
Renunciation(s) _ _ _ _ _ . _ _ _ . $
-~$
---JLP $
Pv,-\-t) $
$
$
$
$
$
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TOTAL _ _.. _. _... _ _ _. $ 4-00
IS
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Attomey Name:
Supreme Court LD. No.:
Address:
Telephone:
FOnll R W-1!2 rev /U. J 3.06
Page2of2
HlOS.805 REV (01107)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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.
P 13989798
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Local Registrar "'"
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Date Issued
Certification Number
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
REV 1112006
I PRINT IN
\4ANENT
.CK INK
~ \ ()\. t)Cr,
STATE FILE NUMBER
5. Age (Last Bir1hday)
6. Dale 01 Birth (Month, day, year)
82
Yrs.
8b. County of Death
Cumberland East Pennsboro
11. Decedenrs Usual lion ,'Kind of worIt done du' most of life. Do nol state retir
Kind ot Work Kindot Business I IndustJy
Auditor lnt Assoc.mach.
- 16. DecedenYs Mailing Address (Street, city flown, slate, zip code)
14. Marital Status: Married, Never Married,
W_. DIvorced (SpecifY!
Widowed
Decedenfs
Actual Residence 17a. 98ls
Pa
Cumberland
17e. CJ Yes, Decedenl Uved in
17d. ~ No. Decedent Uved within
Actual Umits 01
926 ~I~tn~~ 170rrt
Twp
tTb. County
Camp Hill
CltylBoro
18. Father's Name (First. mlddle, last, suffix)
John Prentice
19. Mother's Name (First, middle, maiden surname)
Hazel Rainey
2Ob. Informant's Mailing Address (Street, city I town, state, zip code)
2920 Lincoln Street
208, Informant's Name (Type I Print)
Mark Prentice
Pa 17011
21d. Location (City I town, slate, zip code)
Gate of Heaven
22c. Name and Address of Facnity
Myers-Harner Funeral Home lnc 1903 Market
233. To the best of my knowledge, death oc:curred atll1e time, date and place stated. (Signature and title) 23b. License Number
Mechanicsbur Pa
Hill Pa 1701
26. Was Case Aef&rr9d 10 Medical Examiner I Coroner for a Reason Other than Cremation or Donation?
DVes DNo
I Approximate interval:
I Onset to Death
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Part II: Enter other siCIllficanl conditions contribullno 10 death, 28. Did Tobacco Use Contribute to Death?
but not resulting in the underlying cause given in Part I. 0 Yes 0 Probably
D No D Unknown
29. It Female:
D Not p!89IlaJ1l within past year
o Pregnant at time of death
D Not "'_,. but pregnent with<n (2 days
otdeath
D Not p!89IlaJ1l. but p'"lJI1anl43 days 10 1 yser
before death
o Unknown ~ pl'etI'\8nt within Il1e past year
32c. Place of Injury: Herne, Farm, Street. Factory,
Office Building, etc. (Specify)
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a.C{l;~<O - ?..; 1,,\A..l\V\ctJ2>.,t ~<<+
Due to (or as a consequeoce of): r
b. S67=.i<
Due to 10r as a consequence of}:
c. M~A 1'~'V\l\.unAA^
Due to (or as a coosequence on:
~islcondlions.llany.
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d.
:Ita. Was an Autopsy
Perfonned?
3Ob. Were Autopsy FIndngs
Available Prior to Completion
of Cause of Death?
31. Manner of Death
D Natural D Homicide
DAccidant DPendinglnveetigation
D SuicKle D Could Not be Determined
D Ves G?No
32g. Location of Injury (Street. city I town, state)
[J Ves D No
~.Registrar'SSi~Nu
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SAIDIS,
FLOWER &
LINDSAY
M"IDRNEYS.X!:olAV!:
2109 Market Street
Camp Hill, PA
LAST WILL AND TESTAMENT
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WILLIAM PRENTICE
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I, WILLIAM PRENTICE, of Camp Hill, Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament, hereby revoking any Will previously made by me.
I. I direct the payment of all my just debts and funeral expenses out of my estate
as soon as may be practical after my death.
II. I devise and bequeath all of my estate of whatever nature and wherever situate
unto my sons, MARK PRENTICE and WILLIAM PRENTICE, JR., in equal shares, the share
of a deceased son to be paid to his issue, per stirpes.
III. I appoint my son, MARK PRENTICE, as Executor of my estate. Should my
said son fail to qualify or cease to act as such, I appoint my son, WILLIAM PRENTICE, JR.,
as alternate Executor. Neither of my personal representatives shall be required post bond in
this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the
t!-
It/ . day of November, 2006.
A/~ ~;rD
WILLIAM PRENTICE
(SEAL)
Signed, sealed, published and declared by WILLIAM PRENTICE, the Testator herein named,
on this and one (1) other sheet of paper, as and for his Last Will and Testament, in our
presence, who, in his presence, at his request, and in the presence of each other, have hereunto
subscribed our names as attesting witnesses.
rA
tI ' Name
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~ Name
COMMON\VEAL TH OF PENNSYLVANIA
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Address
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Address
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COUNTY OF CUMBERLAND
WE, the undersigned, the Testator and the witnesses, respectively, whose names are
signed to the foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the instrument as his Last Will
and Testament and that he signed willingly (or willingly directed another to sign for him), and
that he executed it as his free will and voluntary act for the purposes therein expressed, and
that each of the witnesses, in the presence and hearing of the Testator signed the will as
witnesses and that to the best of their knowledge the Testator was at that time eighteen years
of age or older, of sound mind, and under no constraint or undue influence.
Subscribed, sworn to and acknowledged before me by the Testator, WtkLIAM
PRENTICE, and subscribed and sworn to before me by both witnesses, this /71 day of
Novillllber,2006. ~ kg: ,
~a Illf{j _
/ U I Notary Public
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SAlOIS,
FLC>WER &
LINDSAY
MIORNEYS.ATolAW
2109 Market Street
Camp Hill, PA
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Sara J. Ensinger, Notary Public
Carlisle Bora, Cumberland County
My Commission Expires Oct. 17, 2009
Member, Pennsylvania Association of Notaries