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Home My WebLink About12-13-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mildred Elaine Wise Adams also known as File Number :91- 0 (- II Z::~ , Deceased Social Security Number 209-12-9066 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) lEI A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the Thomas W Adams named in the last Will of the Decedent dated June 9,2006 and codicil(s) dated N/A Robert A Adams (husband), Joann C. Eberle (daughter), and Barbara L Adams (daughter) renounce the right to administer the estate of the Decedent. (State relevant circumstances, e.g., renunciation, death oJ 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: o B. Grant of Letters of Administration (IJ applicable, enter: c.t.a.; d.b.n.cIa.; pendente lite; durante absentia; durante minorifate) 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.) Name Relationship Resi~.. ... ce o . ~ ,".'. '_1 l I fe', :" i " '" : " I I'~ . (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. :;po- > Decedent was domiciled at death in Cumberland 31 Greenfield Drive, Carlisle, P A 17013 (List street address, town/city, township, county, state, zip code) County, Pennsylvania with his I her last principal resi&~~ at :.-.--\ w zr \.0 Decedent, then 81 years of age, died on July 17, 2007 at her domicile at 31 Greenfield Drive in Carlisle PA 17013 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania 27,000.00 $ $ $ $ situated as follows: 308 shares of common stock in Chevron Corp (CVX) 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 d or rinted name and residence omas W Adams 1818 Pemberton Street Philadelphia, PA 19146 Form RW-02 reI'. 10.13.06 Page 1 of 2 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 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 affiImed and subscribed , ,..,.+ 0 before me the "-0 day of hQJL,(t. ~, , cJttl ~ Signature of Personal Representati\'e Signature of Personal Representative Signature of Personal Representative ~:?,~~ 'l: , -.) -:.""::.t-- ---r . ...!.-: e c::.:::J -...II CJ f'rj (.-oj - File Number: rJ I - 6i-lld.- S" w Estate of Mildred Elaine Wise Adams , Deceas~:, 'P'" ::it .~-,\ ~ r \J:J Social Security Number: 209-12-9066 Date of Death: July 17, 2007 ~)>'" AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Thomas W Adams in the above estate Short Certificate(s) . . . . . . . , Renunciation(s) .......... V...(ll J(v aU 111 n. J C{ il6 }, and that the instrument(s) dated June 9,2006 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) 9JDecedent. ~6l& 'tr01>kau~ 0):. r:-- FEES a 1IVl € ~ I .-1 (J :A ~: t/. ~~d~ C ~ _li? tR 27 l~/"] I Jetters . $~iO .00 $ ~ () D $ I () {)() ...$~ . . . $ ,tU U(J ...$ h.UU .. . $ .. . $ .. . $ $ $ . .. $ .............. $ 16G(.~ Attorney Name: Supreme Court LD. No.: Address: Telephone: 'J\} ...~ 4 ? --6'~~J-..;r TOTAL Form RW-02 re\'.10.13.06 Page 2 of 2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. (- L'rt i fi L'~ll! I 111 '\' II III hl'!' /"J,'I,,"I'm,,///~ This is to certify thai Ilw 1Il11l!'l11dlilHl 11l'll' f21\cn I' ;.(.f'~\.~\.\~VJ ?{,f';}~, correl'lly cnpicd from an \)I'!t:1IUI Certli'lc;ltc '.11 Lkatl; <i\~// "\'?~ duly filed with I11C a' Llllal RC~I~trm. Thl' ('n~IIl~,1 (f:~~~\~~ certificale \."ill he !<\l'\.\;lrlkd III the Stdll Vil.i! I~~, f,"'. > i;;~1 R.ecords Oltll'C Inr pennalll'llt II! \\ *.. , ~ ", t'f/::r; . r-... \~~. ~~ ~~ \~~jMTN1~\~";~"'" (::\.. b.L~~_.JIJI,llH2002 ~"/'/FI/'JIII/.J!Jj~/ I I I 1.(1L'.11 Reg.islrar ),ilC \~ULU l'C jor thl"- ,,'ertlficak, S6.()() P 13744836 ~ c--~ ---.l c::J r'i'-~ c: w :P" :r: CR :;:- \.0 ~\6H105'143 REV 11/2006 TYPE I PRINT IN PERMANENT BLACK INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See instructIons and examples on reverse) STATE FILE NUMBER J ~ 5. Age (Last Birthday) 1. Name of Decedenl (First, middle, last, suffiX) Mildred W. Adams 3. Sociel Security Number 209 - 12 - 9066 4. Date of Death (Month, day, year) July 17, 2007 31 Greenf ield Dr. Othe, o Nursing Hama ~ Residance OOther' Specify: 9. Was Dacedent of Hispanic Origin? ~ No 0 Yes 10. Raca: Amarican Indian, Black, While, ele. (If yes, specify Cuban, (Specify) Mexican, Puarto Rican, ele.) White 14. Marilal Stalus: Married, Never Married, Widowed, Dlvorcad (Specify) Married 81 Bb. Counfy 01 Dealh 17b, Counly PA Cumberland 17c. eg Yes, Decedent Uved in 17d. 0 No, Decedenl Lived lII~nin Actual limits of Twp 12. Was Decadent ""er In Ine U,S. Armed Forces? DYes ~No . 16. Decedenrs Ma~lng Address (Slrae!. city II0000n, Slate, zip coda) 31 Greefield Dr. Car lisle PA 18. Fathllf's Name (First, middla, last, suffix) George Wise 208. Infonnant's Name (Type 1 Print) Robert A. Adams Decedent's Actuai Residence 17a, Stale City 1 8oro 19. Mother's Nama (First, middla, maidsn surname) Agnes Wagonner 21lb. Infornlllnt's Mailing Addrass (Slraet, eify I tOIlln, slale, zip code) 31 Greenfield Dr., Carlisle, PA 17015 21e. Place 01 Dispos~ion (Nama of oemataiy, eramatoiy or other plaoe) 21d. Location (City I tOlllfl, slala, zip coda) Westminster Manorial Gardens Carlisle, PA Home, Inc., Carlisle, PA 17013 'YY\.U) I ~.\\J noms 24.26 must be completed by person 25. ta Pronounced Dead (Month, day, year) IIIho pronounces death. f Of CAUSE OF DEATH (See Instructions and examplas) It am 27. Pan I: Entllf the ~ - di!easas, injuries, Of compflClltions - that directly caused the death. DO NOT anler terminal events suen as ear<liae arrasl, raspiratOiy arrest, or vantncular fibril. 'latiOn without shoWing the etiology. Us! onllon causa on "eIllln. a. IIIIIEIlIATE CAUSE (FIl18I disease or -I'- ' .J:!; .tt condition rasulting in death) ~ a. .J-;)ID.I'/I-''I1I11::.. UIiJl1~~Y / IdAP~' (" Dua to (or as a consequance o~: Approximate interval: Onsat to Death Part II: Enter other ~ianibnt tnY.Iltinn.lli contrihlltinn In death , ,~not rasulting in the undal1ying cause given in Part I. S Yli1is ?;;;w'/;jj77J/~ #4f.H 1.#J4~ l'iA.J'I1~.#,<.y' /ly.l'Mki 28, Did Tobacco Use Contribute to Death? o Yes 0 Probably o No 0 Unknown 29, If Famela: o Not pra!Jlant wfthin past year o Pregnant allime of death o Nol pregnant, but pregnant wfthin 42 days 01 death o Not p<egnant, but pregnant 43 days to 1 year befora death o Unlmown W pragnant wfthin the past year 32c, Plaoe 01 Injuiy: Home, Farm, Strae~ Factoiy, Offica Building, ate. (Sp6ciIy) ~~"%. ~'::~'~~: a. = UNDERLYING CAUSE ~n~~r~~~ b. Due to (or as a consequence 01): Due to (or as a consequence of): >- I i d. :lOa. Was an Autopsy Poriormed'? DYes ~ 3Qb. W... Aulopsy Findings 31. Mann7Death ~~:: :":'th~ompletion o;rt(.iural 0 Homme o Yas ~ 0 Accidonl 0 Pendil19 investigatiOn o Suicide 0 Could Not be Determined 32d. TifM of Injuiy 32g, Location ollnjuiy (Slree1, city I town, slata) M, 33a. Certtlter (check ooly one) Cerllfylng phyoicien (Physician oertifying causa of daalh IIIhan another pllysician has pronounced death and compIated lIem 23) To the _of my knowledge, _ occumd due 10 the cauoe(o) and manner eo stated.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ . ~::':n~a:: =:,~mn~ ::I~n~~::c.~~~~~~:,~,:.~ manner ao olalad- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 _leal exomlner I Coroner On the basi, of IxamlMtIon and I or Investigation, In my o~nion, death occurred at the time, date, and place, and due to the cause(l) and manner as stated_ D 33d. Date S~nad (Month, day, year) '7;'; 8"')0 Jl- 34. Name and Address of Person Who Complaled Cause 01 Death (lIam 27) Type I Print .1 Eo--v .t~.c:6f--, /?1pJ /J _ /../ /} 8".s;.-t.;,? W4//Jvb L3o~ /V'J, L4-rt.....rIG /Z; / '?0,<3 '. LAST WILL AND TESTAMENT OF MILDRED W. ADAMS \. ' ~ ...;:'r (i:J t= I, MILDRED W. ADAMS, of 308 Glendale Street, Carlisle, :5. CUJ'1'Iberland County, Pennsylvania, being of sound and disposing mind, memory n, - . :-;'~anctutiderstanding, do make, publish and declare this as and for my Last Will and .- \ (-'. ,-- --' ,~) '~,testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I give, devise and bequeath all of the rest, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, to my husband, ROBERT A. ADAMS, provided he survive me by thirty days. THIRD: I have made an advance of the sum of Fifty Thousand ($50,000.00) Dollars to my daughter, BARBARA L. ADAMS. In the event that my husband, ROBERT A. ADAMS, fails to survive me by thirty (30) days, I give my daughter, JOANN C. EBERLE, and my son, THOMAS W. ADAMS, each the sum of Fifty Thousand ($50,000.00) Dollars to equal the advancement made to my daughter, BARBARA L. ADAMS. If my husband survives me by thirty (30) days, this gift shall be deferred until his death. FOURTH: In the event that my husband fails to survive me by thirty days, I hereby give, devise and bequeath my residuary estate to my children, in equal shares, THOMAS W. ADAMS, of Philadelphia, Pennsylvania, JOANN C. EBERLE, of Charlotte, North Carolina, and BARBARA L. ADAMS, of Carlisle, Pennsylvania. FIFTH: If my daughter, JOANN C. EBERLE, predeceases me, I leave the share of my estate which she would have received to her husband, JAY EBERLE. If my son, THOMAS W. ADAMS, predeceases me, I leave the share of my estate which he would have received, one half to my daughter, JOANN C. EBERLE and one-half to my daughter, BARBARA L. ADAMS. If my daughter, BARBARA L. ADAMS, predeceases me, I leave the share of my estate which she would have received ,one-half to my daughter, JOANN C. EBERLE and one-half to my son, THOMAS W. ADAMS. LASTLY: I nominate, constitute and appoint my husband, ROBERT A. ADAMS, to be the Executor of this my Last Will and Testament. In the event that my said husband, ROBERT A. ADAMS, shall be unable to serve as Executrix for any reason, I appoint my children, THOMAS W. ADAMS, JOANN C. EBERLE and BARBARA L. ADAMS, as Co-Executors. No Executor shall be required to file bond in this or any other jurisdiction. 2 IN WITNESS WHEREOF, I have hereunto set my hand and seal this /"\ ''1Lh /i '-1'"C1 \ day of . C ~/Lc.~. /' ; U /\/1 ~\\xd.W~ Fldio-yY)~ , Mildred W. Adams ,2006. SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: ~-{ \) ~ .....' /) . ~~5 ! >7. I~. / . " - ~I .t- 7/ -". 1;;~17/{ - . {;//kf/U 3 COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I, MILDRED W. ADAMS, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirrned,J"o and acknowledge before me, by MILDRED W ADAMS, the Testatrix, this ~ tit day of ,2006. il,{.JLcLvt2rJ- UJ. /~~Y11/::V Mildred W. Adams, Testatrix '~ tIJWIAL lEAL IIERtBtE j. MARHEVKA. rI)1MV PUBUC CARUSlE CUllERlAM) COUNTY. PA MY COMMISSION EXPIRES JUNE 8, 2010 4 . . COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND . and vlt1unt of J.t17Ail.~, the witne es whose names are sig d to the attached or foregoing instrument, being dul qualified according to law, ao depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me b~/YU.; I ~-L ( ~_. and {bL~ cR. 4-frV,J_R.J\. this qti'-- day of gu...u ,2006. -/-4 .I -// ~,!f(";;/~z/ Witness 5 RENUNCIA TION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mildred Elaine Wise Adams , Deceased 1, Robert A Adams (Print Name) , in my capacity/relationship as of the above Decedent, hereby renounce the right to Executor/Husband administer the Estate of the Decedent and respectfully request that Letters be issued to Thomas W Adams l-~ -C~ ) / . . / ' /)//" C ;''.? (("y-u_</ (Date) (Signature) 31 Greenfield Drive (Street Address) Carlisle PA 17013 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of '-0 o 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 purpo'es stated within on this 4~ day of ,~? . . ..::J.-- r. "'"'- <::L. , ' . Deputy lQr Reg~ter of Wills . . 1I \ i /__0 '0 cc. l:-_~_} (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) ('...~ NOTARIAL SEAL MERlENE J. MARHEVKA, NOTARY PUBLIC CARLtSLE, CUMBERLAND COUNTY. PA MY COMMISSION EXPIRES JUNE 8,2010 Form RW-06 re\'o 10.13.06 RENUNCIA TION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mildred Elaine Wise Adams , Deceased I, Barbara L Adams (Print Name) Co-executor/Daughter , 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 Thomas W Adams /- Lj- 0 B .,>7 / ~ It' ~~?-6 ,;.- . '/I~-' (Date) (Signature) 239 Skyline Drive (Street Address) Carlisle PA 17013 (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 purpo' s stated within on this N~ day of 6lDoP D~puty ~ Register 9f Wills .. ( ..:::r Nota Public My Commission Expires: c., fd J ~o I 0 C: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTARIAL SEAL MERLENE J. MARHEVKA, NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTY, PA MY COMMISSION EXPIRES JUNE 8, 2010 _ Form RW.~; re\', 1O,1.fi!f6~,. \'~.../ ".I RENUNCIA TION REGISTER OF WILLS CUMBERLAND COUNTY, PENNS YL VANIA Estate of Mildred Elaine Wise Adams , Deceased I, Joann C Eberle (Print Name) Co-executor/Daughter , 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 Thomas W Adams /'ljj-l/tJ1 (Date) I ~~ Boiling Springs P A 17007 (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 IA/..J..I.- day of.n~~l::u.A , -.1.007 ~ Deputy for Register of Wills C4.( i 1_0 10 '...D a (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) G- '-'" NOTARIAL SEAL MERlENE J. MARHEVKA NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTY. PA MY COMMISSION EXPIRES JUNE 8, 2010 FOr", R'W..a6 rer:IO.}3.06 -~- ...~r ... ~:. -'j C.:::> C' C"'--J