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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C v-n 6.L.(! L.,.;frv/:;J COUNTY, PENNSYL V A1\L\
Estate of File Number :2.J - O~ -CO LPS
also known as
PEGGY
,7
u/E ( 1<6 <-
, Deceased
Social Security Number ~c;) C) - ~ 'I..... !? 9/ 0
Petitioner(s), \\ho is'are 18 years of age or older, apply(ies) for:
(COMPLETE '.j' OJ' 'B' BELOW:)
~. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I are the /JLL-C.(/ J-. uk! ~ ~amed in the
last Will of the Decedent dated o:.:z. - 1t?:3 - (/ ''/ and codicil(s) dated
,
(State relevant circumstances, e,g., renunciation, deatll 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:
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 I have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Adlllillistratioll, c.t.a. or d.b.l1.c.t,a., enter date of Will ill Sectioll A above alld complete list of heirs.)
Name
Relationship
Residence
(COl'dPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
Decedent was domiciled a14eath in
I? Cl6 C' A- "
(List street address, townlcity, townsllip, county, state, zip code)
i ~'7 -<. 1/)1 IE .s 7b/{,C:.
Decedent, then
? S-years of age, died on /7-;;" '"3_ 0 '7 at
,
41 J . ;:?-- 0
/? //1 .
$
$
$0
$ :=0
:,-;.~
T,Q
:>,-'1
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of LeJter~),] tMappro~e form to"
the undersigned: _ '. _
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(lfnot domiciled in PAl Personal property in Pennsylvania
(lfnot domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
.P""
~O,:) t::J. t::JO
situated as follows:
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C_
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Signature
Ty ed or rinted name and residence
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Form R W-OJ rev. 10.13. 06
Page 1 of2
Oath of Personal Representative
COMMONWEAL TH OF PENNSYL VANIA
SS
COUNTY OF
The Petitioner(s) above-named swear(s) or affiml(s) that the statements in the foregoing Petition are tme 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 truly
administer the estate according to law,
Sworn to or affir~1e&-tebscribed
before mt the I d day of
. %-1\-':'-"''''' ~ QlOO 'i?
'y! ". {' ~J O,~ JOp.ct;.
For the Register . J
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/;/j>i14-;
L.' 1/<-
Signature of Personal Representative
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Signature of Personal Representative
Signature of Personal Representative
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File Number: c9l-()~.-OV(j.5
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Social S curity Number: . Li-- " Date of Death:
C)
AND NOW,
having been presel e
are hereby granted to
, Deceas'ed
/d-k3/(J.4~
, ,
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o
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:J()()?, , in consideration of the foregoing Petition, satisfactory proof
before me, IS DE'lED that Letters " l-e STA H (l /J,A Ie y
a ] Q ~ 0 eLl! A )( e. 2
in the above estate
and that the instrument(s) dated d).- .~ - <::) Lj
descnbed ill the Petrtion be admitted to probate and filed of record as the last Will (and Codlcil(s)) of Decedent.
FEES ~Jdet'nclJl Va-~.//} Lr:;ftr-4N.p' ~ n .
f) Q (\ 0 Register of Wtlls .I)<2.AA. Fj
Letters ..,...........,. $ C7' . V'. 1\J..1J.:
Short Certlficate(s) . . . . . , . . $ 1-/ . t)l) Attomey Signature: , _. _
Renunclation(s) ........,. $ .
\ ^\ , \ \ , . ,$ IS, 00 Attomey Name:
Y. rJ . . . $ I (), u\) Supreme Court LD, No.:
G , I..+VVY\O.. t \ on $ S. 00
$
$
$
$
$
$
TOTAL ............,. $ 5'4 - 00
Address:
Telephone:
Forlll R W-IJ] rev, 10. /3.06
Page 20f2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 13991034
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.
Certification Number
17! :/J . .... .
,'~:r.vYL.. I/, /a~~,?2_v ~:r<
Local Registrar . .
DEe 17 ZO~
Date Issued
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
U)
REV 1112006
PRINT IN
AANENT
CK INK
STATE FILE NUMBER
8910
6. Dale of Birth (Month, day, year)
75
v"
st!. County of Death
Cumberland
11, Decedenrs Usual lion Kind 01 wOO< done durin mosl 01 wood life. Do nol stale rehred
KindofWOf1l Kind 01 Susiness Ilndl.lSlry
Maintenance Dress Factory
OVes ~No
14. Marilal Status: Married, Never Married,
Widowed, Divorced (Specify)
Married
Weikel
Decedent's
Actual Residence 17a. Stale
17b. County
P/\
Cumberland
17C.1XI Yes, Decedent Lived in
17d. 0 No, Decedenl Lived within
Actual Limilso!
Twp
19. Mother's Name (Rrsl, middle, maiden surname)
Mary Speck
20b. Inlormanrs Mailing Address (Street, city ftown, state, zip code)
129 Limestone Dr., Camp Hill, PA 17011
21c, Place of Disposition (Name 01 cemetery, crematory or other place) 21d. Location (City I town, stale, zip code)
City/Bore
Rollin Green Memorial Park
Myers-Harne: Funeral Home
L. Allen Twp.
23a. To the best 01 my knowledge, <l!ti!th occurred allhe time, dale and place staled. (S~nature and title)
~.'-"'-"~ /vJ.()
24. Time of Death
25. Date Pronounced Dead (Month, day, year)
12 2..;' ')-;
23c. Date Sigll9d (Month, day. yaar)
I 2. _ 2- .~. (! -7
26. Was Case Referred 10 Medical Examiner I Coroner for a Reason Other than Cremation or Donation?
OV" [31fc>'
=~~n~~~~~\dise~
CAUSE OF DEATH (See Inetructlons and examples)
Item 27. Part I: Enler the ~ - diseases, injuries, or complications -that directly caused the death. DO NOT enter lem1inal events such as cardiac arrest,
respiratory arrest, or ventricular fibrillation withoul showing the etiology. Us! only one cause on each Nne.
Duete(~~;~~\- H ~~
Approximate interval:
Onselto Death
Part II: Enter other sianilicant CCII'1CitioM conlributinn to death,
but net resuning in the underlying cause given in Part I.
28. Did Tobacco Use Contribule 10 Death?
o Yes 0 Probably
o No 0 Unknown
29. tfFemale:
D Not pregnant within past year
o Pregnant al Ume of death
o Not pregnant. but pregnanl within 42 days
of death
o Not pregnant, but pregnant 43 days 10 1 year
before dealh
o Unknown if pregnant wiltlin the past year
32c. Place of Injury: Home, Farm, Street, Factory,
Office Building, elc. (Specify)
~~~da~~'~~i~a.
Enter'\: UNDERLYING CAUSE
(disease or injury that initiated the
events resulting In death) LAST.
Due to (orasa consec:ruenceon:
Due to (or as a consequence on:
o Yes [j\Ne
DVes ONe
31. Manner 01 Death
~ Natural 0 Homicide
o Accident 0 Pending Invesligahon
o Suicide 0 Coukl Not be Determined
32d. Time of Injury
308. Was an Autopsy
Performed?
3Ob. Were Autopsy Findings
Available Prior 10 Completion
of Cause of Death?
M.
321. If Transporlation InitnY (Specify)
o DriVef { Operator 0 Passenger OPedestrian
DOt"", - Specify,
33b. Signature and Ti
32g. Location of Injury (Street, c/Iy Ilown, slale)
338. Certifier (check only one)
Certifying physician (Physician certifying cause 01 dealh when another physician has pronoonced death and completed nem 23)
To thebnt of my knowledge, de8t:h occurred due to the cause(s) and ITIInner 85 stated...... _ _. _ _ _....... _ _ _ _ _.. __.... _ _ _ _. _.........
~::U:~~f a~~ ~e:v~~J:~~a~~uh~::~ t~~I:~:~n:n~;::C:~:rf~f~10t~hr::;~~~~~~ manner as stated. _ ... _ . ... ... ... ... ... _ ... . ... _ . ... _ 0
~~:~:~~~:~;~:t~:~ and I or investlgallon, in my opinion, death occurred at the Ume, date, and place, and due to the cause(s) and manner as stated. 0
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Disposilion Permit No.
0093757
'.
,
WILL
OF
PEGGY J. WEIKEL
I, PEGGY J. WEIKEL, currently of Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils
made by me.
I. I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate and inheritance taxes that may be assessed in consequence of
my death, shall be paid out of the principal of my general estate to the same effect as if said
taxes were expenses of administration and all property includable in my taxable estate
whether or not passing under this Will shall be free and clear thereof.
III. I bequeath unto my husband, Allen L. Weikel, all tangible personal property which
I own at my death.
IV. All the rest, residue and remainder of my estate, of whatever nature and wherever
situate, including property over which I hold a power of appointment, I devise and bequeath
unto my husband, Allen.
V. In the event that my husband, Allen, does not survive me, I devise and bequeath my
entire estate that would have otherwise passed under Paragraphs III and IV above as follows:
A. I bequeath all my tangible personal property unto my daughter,
Peggy A. Floyd.
B. The residue of my estate shall be divided as follows:
(1) One-half (~) unto my daughter, Peggy, or her
issue per stirpes.
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(2) One-half (lh) to be divided equally between my two (2)
grandchildren, Justin and Jennifer, or the survivor of them.
VI. I appoint my husband, Allen L. Weikel, Executor of this my Will. In the event that
he fails to qualify or ceases to act as Executor, I appoint my daughter, Peggy A. Floyd,
Executrix in his place.
VII. I direct that no bond be required of my fiduciary for the faithful performance of her
duties in any jurisdiction.
IN WITNESS WHEREOF, I, PEGGY J. WEIKEL, herewith set my hand to this my
Last Will, typewritten on two (2) sheets of paper including the attestation clause and
signatures of witnesses, this 1/"-{ day of February, 2004.
cf' ~) ydt.; (SEAL)
PE J .,yWEIKEL
Signed by PEGGY J. WEIKEL, by her declared to be her Will in our presence, who
have hereunto subscribed our names as witnesses in her presence and at her request, this
J r.J day of February, 2004.
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COMMONWEAL TH OF PENNSYL VANIA
COUNTY OF
WE, PEGGY J. WEIKEL, GERALD J. BRINSER and /lUG-M L. 4/~KE-t.
the testatrix and the witnesses, respectively, whose names are signed to the attached or
foregoing instrument, being first duly affirmed, do hereby declare to the undersigned
authority that the testatrix signed and executed the instrument as her Last Will and that she
signed willingly (or willingly directed another to sign for her), and that she executed it as
her free and voluntary act for the purposes therein expressed, and that each ofthe witnesses,
in the presence and hearing of the testatrix, signed the Will as witnesses and that to the best
of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
tP~~, fr~
PE J. EIKEL
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WITNESS /
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WITNESS
.
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Subscribed, sworn or affirmed and acknowledged before me by PEGGY J. WEIKEL,
the testatrix, GERALD J. BRINSER and /1{,L~N' '-. W':;-IK€ '" , witnesses, this
~~ day of February, 2004.
NOTARIAl. SEAl.
tIAItt'ftIll PEIffEI. NOT_....
PALMYRA 8OIlO.. LE8ANOII COUI1Y
MY COMMISSION bPiiEi OCt,. _
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otary bhc
(SEAL)
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