HomeMy WebLinkAbout01-28-08
Estate of
PETITION FOR PROBATE AND GRANT OF I-JETTERS
REGISTER OF WILLS OF d~ berfC0K.(;{ COUNTY, PENNSYLVANIA
~o.+t, ke I" /~tr-J, 1+.f ct:/'llM\ File Number
, Deceased
d\-O~ 'b~
Social Security Number /75".- 0 3- f c,' b 9
tJ
also known as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
o A. Probate and Grant of L~tters Test~~n!ary and aver that Petitioner(s) is / are the
last Will of the Decedent dated 00u..j { ~ (q'":fC( and codicil(s) dated
e'f-. e acIo r,>
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 instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person;
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(If applicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante ilH!JiiiJiklte) c......
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Petit~o~er(s). after a proper search has / have ascertai.ne~ that I?ecedent left no Will and w.as survi:,ed by the following spous~~~~? and ~rs: (If
AdmullstratLOIl. c.t.a. or d.b.ll.c.t.a.. enter date ofWlll m SectLOn A above and complete Itst of heIrs.) '_,: ~ .&.-
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Residenci; ~ ,~,
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o B. Grant of Letters of Administration
I: .
Name
Relationship
t'
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sylvania with his f her last principal residence at &r.e ~::f- kl>t\
(List street address. to
Decedent, then
~ WVcLt C4). f ~-{r
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(lfnot domiciled in PA) Personal property in Pennsylvania
(lfnot domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$ '5(!) 0 (O() tJo
I
$
$
$
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:
Rcl.___
T"d-'51
ForI/! RW-02 rev. 10./3.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF 1/�U (1��f�Gf
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 Petitioners)and that,as personal representative(s)of the Decedent,Petitioner(s)will well and truly
administer the estate according to law.
Sworn to or affirmed and'subscribed
Signnlure of rsona[Represeatnfive tea
. . efore me tine day of C7
0
Signnlure of Personal Representative
` D N
.9'
For the Register Sigtmture ofPersam[Representative :7n" rJ
File\Number:
1 Q Q `I
Estate of ]�JQ. `22`�� \a �, �,\L(�('J� Deceased
Social Security Number: 1 eJ J`I Q 6)9 Date of Death:
AND NOW,_:. X00 &4 �2 CV ,in consideration of the foregoing Petition,satisfactory proof
having been presented before me,IT IS CREED that Letters�Q�-1-l.f' Q n -Wk tti
are hereby granted y
c� tin the above estate
and that the instrument(s)dated
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Deceed'nt(.
FEES /`' `3 :20M-U
Letters $ G .OU Register of Wi rya�.- /y - - -
Short Certificates) . . . . . . . . $ oZ •(3O Attorney Signature: _ { '
Renunciation(s) . . . . . . . . . . $ lb .0 O . r - . N -
W 1 I I . . $ 11m Attorney Name:
-c)CT $ I U' Ov Supreme Court I.D.No.:
$ Address:
$
$ Telephone:
TOTAL . . . . . .. . . . . . . . $ I
Farm RPV-01 rev. 10.13.0h
Page 2 of 2
111',,\11' RF\ 101//17,
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GrC{
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
;ee for this certificate, $6.00
Certification Number
This is to certify that the information here given i
correctly copied from an original Certificate of Deat
duly filed with me as L02al Registrar. The originr
certificate will be forwlrded to the State Vitr
Records Office for permanent filing.
P 13889315
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Local Registrar ~--- Oat; ~s~ed
f
\1
Cumb
11. OecedeIlfs US118/
Ki1d 01_
Housewife
. 16. Oec:edenl's Mailing Aoifress (Sree~ city 1-., state. zip code)
1 Ridge Lane
Newville, Pa 17241
18. F_s Name (first, middle, _ sulflx)
Bruce E. Bard
2Oa. In/ormant's Name (Type 1 PrinI)
Raymond R. Heckman, Jr.
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and eXamples on reverse)
STATE FILE NUMBER
Hl05-143 ReV 1112006
TYPE 1 PRINT IN
PfFlMANE/{I'
BlACK INK
5. Age (LaslflIrltoday)
9~rs.
Sb. County 01 Death
Carlisle Re ional Med.Cnt.
12. Was 0ecedenI ever in the 13. Oecedenfo Education (Spec#y only highest grade CllI1lpleted)
U.S. AImed Forces? Elementary / Secondary (0-12) College (1-4 or 5+)
oVes ()&o 12
10. Race: American Indian, Black. WhIte, etc.
wliUe
Widowed
Oecedent'o
AduoI ResJdenee 17e. Sole
17b. County
"'l1mh
P a 17e. 0 Yes. IJocedenll.iYed in
17d. 0 No, Deeedenll.iYed wilIlin
AduoI limits 01
W.
Pennsboro
Twp.
City I Boro
19. MoIhe(o Neme {FIlsl, rnIdlIe, melden sumeme)
Nellie B. Fox
o
~
~
~
201>. Inlormanro MoOing Addl88l (Sreel, city 1-., olate. zip code)
550 Springfield Rd, Shippensburg, Pa 17257
21e. Piece 01 DIsposition (Heme of cemetery, CI9INlIOIy or other piece)
2008 St. Thomas Cemetery
22<:. Neme endAddress 01 FecfI1y
Egger Funeral Home Inc
231>. LIcense Number
Thomas, Pa.
ve
17241
230. Date Signed (Month, dey, yeer)
Items 24-26 .... be ~ by """""
who pnJnOlIlC88 -.
2~. T1me 01 Death
S : ~o
25. Dati PIOI1O<01C8d Deed (Month, dey
P M. I Z, C1 B"
26. W.. Coso Referrod to ~C8 ExamIner 1 Coroner lor e Reason Other then Cremation or Donelion?
o Ves Qo!fO
CAUSE OF DEATH (See Inslructlona and examples I
I1em 'lJ. Pert I: Enler.. ~ - dI8essea, ..,rIeI, or ~ -1hIt lirectly ceU88d tho _. DO NOT enter terminel events ouch .. ceniec al!8St,
I88IDfaY -. or venfri:uIer fibrillation wflhoul sholliIg!he etiology. list orty one ceuse on eacIllne.
=~m:=)~ a. Set f.-,'c- 5k.c.{....
b. Oueto(orr;~i::' CA C,' h'c;..
Due to (or os e consequence 01):
~leinfllMll:
Onset 10 Dea1h
Pe~ U; Enler other S_I corlliIIons emlrlbumo 10 doelll.
but not resulting in the unde!1yin9 ceuse given in Pe~ I.
? ~-.,~
G.:r. b {€fed...
28. Did Tobacco Use Cootrtlule to Death?
o Ves 0 ProbebIy
~o UnI<nown
29. " FemeIe;
o Not Il"llfI8IlIwiIhil pes! yeer
[j Pregnant eI tine ol_
D Not pregnenl, but pregnant wiIhin 42 <leys
ol_
D Not prognenl, but p<ognent 013 days to 1 rear
---
o Un_ W preg18nt wiIhilthe pes! rear
321;. PIece 01 Injury: Home, Form, Street, FlICloly,
0IItce BuJ~ 81c. (SpecIfy)
SequenIIsIy Jlol axdIIonI, I eny,
IeIlfna to tIvo... _...Ine e.
EnIsr h lINDERL'IlNG CAlISE
~~~~
Due to (or os e consequence 01):
~~ ve~ ().. O,..{..'c. <::.-f-t::.r1 o~ ,'S
~.,..h. re""",,( Pa: ( .....r<!
d.
32d. T.... 01 Injury
32g. l.ocetJon oIlnjuly (SIreet, city / town, slate)
30L Wos en AuIcpey
I'8rlonned?
oVes
3llb.WeroAulopsyRndhgs 3f~_oI
AVIIebIe Prior 10 CompIeIion
01 Cause 01 Dea1h? Iura! 0 Hcrnklide
o Acddenl 0 Pondng Invosligetlon
o SticIde 0 Coltt NaI be Datennined
o Yes (31QO
(
PJ
~
\I
~
321. n Transportation Injury {Specify}
DOrNer 1 0pe/aI0r 0 Put8I1g8r 0-
Other . SpecIfy:
338. CeI1IIIer (checIl orty one) 331>. S~ end 11IIe 01
, ~~~==:"~~~""":"'end~~:~~~_~~~~~"':~~_________________ 0 ~ D> .
. Pronounclng end CIIlIIyIng phyIicIen (PhysIc:ien boIh pronouncilg de8th end cer1lf)tlg 10 cause 01 death)
To the belt 01 my knowledge, deeIh 0CCUIIlld et the lime, dele, end piece, end due to the C8U18(S) end menner 88 StalId.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
. IIedIcoI EumIner / ear-
On the - 01_ end / or "'-tIgelIon, In my opinion, dnth occurnd 81 the lime, _. and pIoce, end due to the C8U18(1) end miMeI' 88 statacL 0
t,l.
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1:1.11 Id. I \ I 0 I
Disposltion Permit No.
OOijr~1
'j": Ill] 1 .'! ~ "/ ')::;
l_lJ\J\ ",~f-~.~l L...J
Pf"i 12: 07
OATH OF SUBSCRIBING WITNESS(ES)I [[co[{
\_!L.,,"p~. ~l \
ORDf.--t.,: ~,
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I RFpISTER OF WILLS CUi../'-
~jJffihr/~ COUNTY,PENNSYLVANIA
9 \ - 0 0 - 00 ?s L-f
Estate of ~, UoJh kif} AA tk~
, Deceased
, (each) a subscribing witness to
(Print Namels)
the 0 Will 0 Codicil(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.
,.
/'()!11/J~.N'lAt'A ~
(Signature) . "
(Signature)
9tJJ/ f-~,./n~ /l/H~J
(Street Address
(Street Address)
(l~~ ..J.A l7ZJ/3
(City, State. Zip) "
(City, State. Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
cfk/Ilt. day
, __ ,u.70~.
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
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 ofinstrument(s) at time of notarization.
Form RW-03 rev. /0./3.06
OATH OF SUBSCRIBING WITNESS(ES)
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Estate of
REGISTER OF WILLS
COUNTY, PENNSYL VANIA
J I ., O~ - OOEY
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o
co
, Deceased
, (each) a subscribing witness to
(Print Name/s)
the ~ Will 0 Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that @/ he / they~ were present and saw the above Testator~ sign the same
and tha~~ he I they signed the same and that ~ he I they signed as a witness at the request of
the testato~ in ~ his presence and in the presence of each other.
~eA pok-ne~6JJ<-
I~re)
~,~i#r'Jl~~
(Va~ I AJ'-i~ L/Jfi- 1'7010
(City, State, Zip) ./
(Signature)
(Street Address)
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
'L
beteme thiS. . ~ &y
OfOl~ll2S ~C01(
I\~~~~,-'~ ~
~~ty tor RegIster of Wills
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
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
RENUNCIA TION
" \ ~ ~ISTER OF WILLS
~ I COUNTY, PENNSYLVANIA
--
J\ -O~ -UO~\--)
Estate of
~ .~~~. ~~~
I. ~D~~~ *" ~~A-?5_L
~rinl Nom,) . \
~~ of the above Decedent, hereby renounce the right to
, Deceased
, in my capacity/relationship as
~5::::>
~~ ,<-f\
(City, State, Zip) \
\l~
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 ..Jf;"t:h day
Of~(~ _.
Notary Public . .
My Commission Expires:
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
(Signature and Seal of Notary or other official qualifie~ to
administer oaths. Show date of expiration of Notary's Commis~ioJl.)
COMMONW!AI. f~ Of. ~I!NN8VL VANIA
Notarial Seal
Sherry A. Chapman, Notary Public
Derry Twp., Dauphin County
My Commission Expires Mar. 30, 2010
Member, Pennsylvania Association of Notaries
LAST WILL AND TESTAMENT
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I~ KATHLEEN B. HECKMAN, of the Borough of Newvijle,
o
Cumberland County~ Pennsylvania, being of sound and disposing mind,
memory and understanding, do hereby 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 order and direct my Executor hereinafter named,
to pay all of 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 resid-
uary estate.
SECOND: All the rest, residue and remainder of my estate,
be it real, personal or mixed, of whatsoever kind and wheresoever
situate, I hereby give, devise and bequeath to my husband, Raymond
R. Heckman, Sr.
THIRD: In the event that my said husband should pre-
decease me, I hereby give, devise and bequeath my residuary estate
to my children, Raymond R. Heckman, Jr., Deborah A. Reitzel, and
Pamela K. Collins, in equal shares, share and share alike, per stirpes.
LASTLY: I hereby nominate, constitute and appoint my
husband, Raymond R. Heckman, Sr. to be the Executor of this, my
Last Will and Testament, he to serve without bond in the Common-
wealth of Pennsylvania, or in any other jurisdiction. In the event
that my said husband shall be unable to serve as Executor or com-
plete the administration of my estate for any reason whatsoever, I
hereby nominate my son-in-law, Robert K. Reitzel, to be the
Executor hereof, he likewise to serve without Bond.
~/1~
!
.
... ..
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this /5'l::i day of August, 1979.
IfK:d~ If, ~k(4M-(SEAL)
Kathleen B. Heckman
SIGNED, SEALED, PUBLISHED and DECLARED
by KATHLEEN B. HECKMAN, the above named
Testatrix, as and for her Last Will and
Testament, in our presence, who, at her
request, and in the presence of each
other, have hereunto set our hands as
subscribing witnesses.
L-tJ.dl/7~~
<yfiu% ~ YYl 0Jr. hv.rlra
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