HomeMy WebLinkAbout01-08-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
Estate of Clyde E. Russell
also known as
File Number
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, Deceased
Social Security Number 184-12-2695
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Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE ~'or 'B' BELOW:)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the Co-Executors
last Will of the Decedent dated October 7,2002 and codicil(s) dated
I
CO named in the
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(State relevant circumstances, e.g., renunciation, death of executor, etc.)
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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
(Ifapplicable, enter: c.t.a.; db.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. ar d.b.n.c.t.a., enter date afWill in Section A abave and complete list afheirs.)
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his / her last principal residence at
Claremont Nursing Home, Middlesex T ownshio, Carlisle, PAl 70 13
(List street address, town/city, township, county, state, zip code)
Decedent, then 86
PA 17013
years of age, died on January 1, 2008
at Claremont Nursing Home, Middlesex Township, Carlisle,
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(Ifnot domiciled in PAl Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
50,000.00
$
$
$
$
100,000.00
situated as follows: 411 South York Street, Mechanicsburg, P A 17055
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 fonn to
the undersigned:
Gary Russell
J85 Gameland Road, Newville, PA 17241
Mary Cree
119 Regency Wood North, Carlisle, P A 17013
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEAL TH 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) will well and truly
administer the estate according to law.
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C]}7(M~ O. \(~(7 J2
Signature o.f Perso. I Repres tatrve
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Sworn to or affirmed and subscribed
Signature o.f Personal Representative
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File Number:
?A l 05 DD"d..<
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Estate of Clyde E. Russell
, Deceased
Social Security Number: 184-12-2695 Date of Death: January 1,2008
AND NOW. ~ ~D '6 . ;Ja:Ji? . in C<lll,idpration ofllleforegoing Petition, satisfactory pmof
having been presented fG me, IT IS ECREED that Letj:ers 7-c..s~-h-y
are hereby granted to a 'Y eu rs:P J I Q...jlO( 1Yb..'V Cr.f'f!
and that the instrument(s) dated Dc -.pbz r 7 ::lOb;;;;'"
described in the Petition be admitted to probate and filed of record as the last Will
in the above estate
IS
10
S-
Attorney Signature:
FEES
Letters .... (g)/?p::) . $
Short Certificate(s) . . '1. . .. $
Renunciation(s) .......... $
WIt{ .. . $
,,)eP ...$
~-fu .. . $
. .. $
...$
...$
...$
. .. $
... $
TOTAL. . . . . . . . . .. . . . $
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Attorney Name:
Supreme Court I.D. No.: 6351
Address:
Market Square Building
Mechanicsburg, PA 17055
Telephone:
717-766-3172
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Form RW-02 rev. 10.13.06
Page 2 of2
0).805 REV (OI/Ol)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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,
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Local Registrar
/
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~ee for this certificate, $6.00
P 14124890
Date Issued
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Hl()5.143 REV tt/2lXl6
TYPE i PRINT IN
PERMANENT
SlACK lNf<
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
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mostol Iifu.Donots;laters"
Km of &lsin6ss I kdlstry
12. Was Decedem &Y&f WI the
U.S. Armed FO<<l8lO?
oY.. 'tit..
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Al:.1uo>> Resideoce 17a. Sale
1._ICilyand_or
STATE FILE NUMBER
4. Oat. of Death (MonIh, day, year)
January 1, 2008
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I. Name at Dectdem IFim. rMKIe, last, suIIix)
5. AIJ& (lasl Birthdayj
. Dale 01 Bi<1IIt\lonlh, day. ~
86
Bb. County 01 Death
October 14,1921 Newville, Pennsylvania
&1, FaciIiIy Name III nQ inStiIuIion, give skeet and 1kJlTlbef)
0"""" . Spedly:
10. Race:Amefic.anhtian.BIac:k. WhII,etc
lSj>ecj~ White
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lib. Coun~
PA
Cumberland
19. Mothe(s Name (FrsI, midlIe, maiden surname)
Did_
LMliina
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17c.O Yes,DeaidtltNliV8di'l
11d8Na._lMld_
AcsuaILinilsol
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411 South York Street
Mechanicsburg
Clyl8oc'o
18 Faltler's Name (Fll'St, midcle,
Pearl Mixell
2{l). Intormanrs MaiIi1g Address (Street, city I kIwn, lltal8, ~ code)
119 Regency Woods North Carlisle, PA 17015
2IcPlaceol(J;sposrooo(.....oI........"._.."""pIace) 2Id.localion(Ci1y/_._.l~_1
4, 2008 Newville Cemetery Newville, Pennsylvania 17241
220. ..... and AddI... 01 faOlily
M ers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
2:lc. Dale 5qJod J_ day, _)
:K>a. wasanAWlpSy
Per1ormed?
JOb. Were AlAOpsy Finlings
A'JailabIe Prior 10 Completion
8fCauseolOealh?
DYes~
31. Ma.nner of !Jea'tr-.-
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DAccidefl' oP"""gln"stogaOOn
o Suicide OCOIJidNol:beDetellTlined
~inleNat PartU:EfiafolhefsiMilir..anlconditionsccnlribulinalOdBaltL 2tl.0id1ObacooLIM~IO~?
Onsetk>OeaIh butnotresul\flglnlhelMel1yingcaUS8~...Pattl 0 Vea Dprobll.:lty
DNa 0"'"""""
29. tf Female:
o Not",......_....,..,
o "'......M....oI.....
o Nol. pregnanl, but Pl~ wiUlin ofZ days
01.....
o Not",.........."'......"'....",,..,
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32<:. PIac& rJ Irf.wy: Home, Fllml, S1reet. FlIdClIy,
0lIaI1luiding. ole ISpoaIyI
Jtems2-4-26 ITIOStbe completed by person
who plonouoces dealh. t.
24. TmeofOeafh
~'. \o~ AM.
CAUSE OF DEATH (See Inalluctlon. and .umpIre.)
Item 27. Pan I: EntW \he ~ - di5eases. injunes. cw complications Ihal cirectiy caused /he d&a#I. 00 NOT Iflt8f leJJJJinal events such as eanlIac arrest,
respilalOry arrest. 01 ventricular llbriIatiorl wiftrout showing !he etiology. L.isI only ooe cause on each n.
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Enter lie UNDERLYING ClUSE
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b. O""lD(orasa~F ~
lJuelD(or..-1icon_oI): t
Due to <Of as a cons.equence 01):
32d.Twneoflnjufy
II.
330 (;o"''''(''*'''''''' """I
Certifying physician tPhysiaan certifying cause 01 death Wh6fl iUlOthet phy.sidan has pl"0I'l0tJ1lC6d death and completed Item 23)
Tolhe bhf atmyknowJectQle.dNlhOl:l:untddutlolhe cauNt') andn\aMef "statecL _ _ __.. ___... _ _ _ _.. _ _...... _... _... _ _ _... _... _.. _..
~::=t~~=-1an=:::u:::'~~~~~::'101o:~'::maMft..stated_ ...____..... __ _ _ ___.. __ 0
::: =n:'~C: and 1 Of Klvutiption, in m~ opiniofl, dNth CN:tur1ed at the tinw, date, and p*-, tmd duft to the eauM(s) and mBI\I'I$f .. .tated... 0
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CLYDE E. RUSSELL
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I, CLYDE E. RUSSELL, of the Borough of Mechanicsburg, County of
Cumberland and State of Pennsylvani~ 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 be conveniently done.
2.
I give, devise and bequeath all the rest, residue and remainder of my estate, real,
personal and mixed, whatsoever and wheresoever the same may be situate, in equal
shares to my children, GARY, VIRGINIA, and BARBARA and my step children
MARY CREE and BETTY DAVIS.
I nominate, constitute and appoint my son GARY RUSSELL and my
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OATH OF NON-SUBSCRIBING WITNESS(ES)
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Cumberland
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
Estate of Clyde E. Russell
Betty J. Davis
and
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, Deceased
(each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well-
acquainted with Clyde E. Russell and amlare familiar
with the handwriting and signature of the decedent, and that the signature of Clyde E. Russell
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
Clyde E. Russell
is in his/her own proper handwriting.
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(Signature) Vi / i' t:'
764 Highland Street
(Street Address)
(Signature)
(Street Address)
Steelton, P A 17113
(City, State, Zip)
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
~.
of
FormRW-04 rev.lO.I3.06
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OATH OF SUBSCRIBING WITNESS(ES)
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Cumberland
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
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Estate of Clyde E. Russell
en , Deceased
John M. Eakin
, (each) a subscribing witness to
(Print Name/s)
the IZIWill DCodicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he / they was / were present and saw the above Testator / Testatrix sign the same
and that she / he / they signed the same and that she / he / they signed as a witness at the request of
the Testator / Testatrix III her / his presence and in the presence of each other.
(Signature)
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(Signatur
(Street Address)
Market Square Building
(Street Address)
(City, State, Zip)
Mechanicsburg, P A 17055
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this g
Of~
\
Executed out of Register's Office
Sworn to or affirmed and subscribed
.!"
, cXbo .
before me this
of
day
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 taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW-03 rev. 10.13.06
stepdaughter MARY CREE to be the executors of this, my Last Will and Testament, and
in the event, for any reason, either is unable or unwilling to serve as executor the other
shall be the sole executor. I direct that no bond be required of my executors to guarantee
faithful performance of their duties.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7!1i day
of October, A. D., 2002.
~t:'~
, Clyde E. Russell
(SEAL)
Signed, sealed, published and declared by the above named, CL YDE E.
RUSSELL, as and for his Last Will and Testament, in the presence of us, who have
subscribed our names hereto as witnesses, at the request of said Testator, in his presence
and the presence of each other.
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