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Home My WebLink About01-30-08 PETITION FOR PROBATE AND GRANT OF LETTERS o REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVA~1\) Estate of Betty Adams File Number 21-08- l~ - i {i ::J also known as Betty 1<: Adams . _ ~~ r'- , Deceased Social Security 162-22-3658 ./ g ~'~"'''' ,""..---... G) C Petitioner(s) who is/are 18 years of age or older, apply(ies) for: [X] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the last Will of the Decedent dawd May 4, 2001 and codicil(s) dated N/A . ~,' l' :_ ~i '::j- ~~ ::D' .l-j ::"~1 CJ +" r '\ (state relevenat 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: l ] Bo Grant of letters of Administration (Ifapplicable enter: c.t.a.; d.b.noc.t.a.; endente 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, cot.a. or d.b.fl.c.t.a., enter date of Will in Section A above and complete list of heirs.) 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 343 "G" Street Carlisle PA 17013 Carlisle Borou h (List street address. town/city, towns ip. county. state, Zip co e 78 years of age died on 1/23/08 Carlisle Re~ional Medical Center Decedent then Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) (If not domiciled in Pa.) (If not domiciled in Pa.) Value of real estate in Pennsylvania situated as follows: 100,000.00 150,000.00 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 a ro riate form to the undersi ned: I nature -':~~ Page 1 of 2 d I . ;)06~ - /0'( OATH OF PERSONAL REPRESENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and corre _ 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 affirmed and subscribed before me this (j <Ik. 3~;f'~ Bonnie Roush 2 ~~o --~ -'7 , ,'~-:ll! (___) i'~0 1.....,- t..:""'_, C:t.:.'J '---'"-. ~t::... ~ -2'2] j..J --_. G.) a File Number: G2 / - c2608' () /07 :ro.. '-.,) Estate of Betty Adams , Deceased .J:"'" (-0 Social Security Number: ~ Date of Death 1-~3--0"g AND NOW ~ 'i( , 201lL)n consideration of the Petition, satisfactory proof having been presented before , IT IS DECREED that Letters Testamentary are hereby granted to Bonnie Roush in the above estate and that the instrument(s) dated May 4, 2001 described in thte Petition to be admitted to probate and filed of record as the las Will (and Codicil(s) of Decedent) FEES Signature Letters ~ (p{) .00 Short Certificates Jd. .()O Renunciation \^.J, LL lo-.oD -itlP LO (00 ~O~\()Y\ 5 -(YO Attorney Name Robert G. Frey Sup. Ct. LD. No 46397 Address: 5 South Hanover Street Carlisle, Pennsylvania 17013 Telephone: (717) 243-5838 TOTAL.. . 36OL. UU Page 2 of 2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ot. /0/7 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. Fec lor 1 hi~ certificate, $6.00 ~~~(f oc Re' strar P 1412084E Certification Number C) ~~n '1:ER ,.~ :./ ,; _' ,2 '-.--~ ::.'...; T'J -:t> . REV 1112006 ! PRINT IN MANE NT \CK INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE FILE NUMBER 1. Name or Decedenl (First, middle, last, suffix) Betty F. 5. Age (Last Birthday) Adams 162 - 22 3658 6. Date 01 8iM (Month, day, year) JA-WI 5 ~}JB Date Issued <...) C-") J.-"Jt,:. 'C CJ .[:.- ~ 23. 2008 July 28. 1929 Carlisle. PA Other: o Nursing Home 0 Residence OOthe! - Specify ~ No DYes 10. Race: American Indian, Black, While, ete (Specify) White 78 v" 8d. Facility Name (II not inslilulion, give slreet and number) Bb. County of Death 13, Decedent's Education (Specify only highest grade completed) Elementary liiondary (0-12) College (1-4 or 5+) 14. Marilal Status: Married, Never Married, Widowed, Divorced (Specify) idowed Cumberland South Middleton Twp Carlisle Regional Medical Center 11. Det.'9den\'s Usual Occu lion Kind of work done durin most otNOrkin life, Do nol state retired 12. Was Decedenl ever in the U.S. Armed Forces? DVes ~No Decedent's Aclual Residence 178. State 17c. 0 Yes, Decedent Lived In 17d. ~ No, Decedent lived within Actual Limlls of Kind o! Worl<. Housewife Kind 01 Business I Industry Did Decedent live ina Township? . 16, Decedent's Mailing Address (Street. city ftown, slate, zip code'l 343 "G" Street Carlisel. PA 17013 Pennsylvania Cumberland 17b, County 18 Falher"sName(First,middle,lasl,suffix) William K. Strine 19, Mother's Name (First, middle, maiden surname) Grace A. Fishel 20a, Informant's Name (Type I Print) Bonnie L. Roush 20b. Informant's Mailing Address (Street, city I town, stale, zip code) 447 Oak Flat Road. Newville. PA 17241 21d, Location (City ItoWrI. state. zip code) 21 b. Dale of Disposition (Month, day, year) 21 c, Place of Disposition (Name of cemetery, crematory or other place) Twp. Carlisle Cityi Bora . ~ Cremation Society of PA rrisburg. PA 17109 22c.NameandAddressoIFacHit>Auer Memorial Home and Cremation Servcies. Inc. 4100 Jonestown Road. Rarrisburg. PA 17109 23b/r;J)umbeCr?5~7-2 'E 23c.DaisiQ 23nlh"68"1 Pari II: Enter other sionificant conditions contributino to death, 28, Did Tobacco Use Contribute to Death? but nol resulting in ltIe underlying cause given in Part I. g Yes 0 Probably o No 0 Unknown 29. If Female ~Notpre9nantwithinpastyeal D Pregnant at time of death o No! pregnant, but pregnant within 42 days of death D Not pregnant, 001 pregnanl 43 days to 1 year balore death D Unknownifpregnantwilhinthepaslyear 32c. Place of Inj~ry: Home, Farm, $lreet, Factory. OffICe BUildIng, etc_ (Specify) lIems 24-26 must be completed by person . who pronounces death CAUSE OF DEATH (See Instructions and e amples) I!em 27, Part I: Enter the ~ - diseases, injuries, or complIcations - that directly caused the death. DO NOT 8l1ter terminal events such as cardiac arrest, resDiral.Ory arresl, or ventricula.r fibritla:~:on . haul ShOW~ngtl1e etiology. Lisl only one ~us,on each ~n~,>... _ IMM~DIATECAUSE{F"al"seaae" C .1A -~~.. /~/, /t__:-r - ",~~A_ I)n..~ condillOO resulting In death) --.. a "-',//.1'1",- U~/J- -..---f1...-....i- ,.---.-" -"'~J ~j,-'~r.1A- Due to (or as a cc,nsequence on I Approximate inteNal Onset to Death ~ Sequentially list conditions, if any, leading to the cause fisted on line a Enter I'ne UNDERLYING CAUSE (disease or ir)jury that initiated the events resultlll9 In death) LAST. Due to (or as a cClnsequence 01): Due 10 (or as a wnsequence 00 d. 3Oa, Was an Autopsy Performed? 3Ob. Were Autopsy Findings Available Prior 10 Completion at Cause of Death? 31, Manner of Death IM:'Natural 0 Homicide D Accident 0 Pending Investigation [J Suicide D Could No! be Determined M. 32d, Time 01 Injury 32g. Location of In[ury (Street, city I town, slatel Dvas~o D Vas D No 33a Certifier (check only one) ~:~:.g.r~~~~~=i:nc:~~:~~~: ~:"~~t~h:C~U:~~~:~~~S:n~~;:: :;:..~~ d~a~h:~d ~:"~I~~ ~e~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 ... ~~~;:~~~:,a: ::=~hJ:.i~a~~;::i:~ ::hH:::::n;n~e;::c:~a~:rt;te1ot~h~~:~~~~~ manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ MedICIII Examiner I Coroner On the basfs of examination and I or investigation, in my opinion, death occurred at the time, date, and place, and due 10 the cause(s) and manner as stated_ 0 ,~, Ilo.?, / 1/ I Disposi{ioo Pe,mi{ No 0093984 LAST WILL AND TESTAMENT OF BETTY ADAMS I, BETTY ADAMS, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, hereby declare this instrument to be my Last Will and Testament, revoking any and all Wills by me heretofore made. ITEM ONE: I direct my hereinafter named Executors to pay all my just debts, funeral expenses and administration expenses, including inheritance taxes, as soon as may be convenient after my decease. ITEM TWO: SPECIFIC BEQUESTS. A. I give unto my son, RICHARD ADAMS, of Carlisle, any and all interest I may have in the property I own at 250 F. Street, Carlisle, Cumberland County, Pa. 17013, and direct him to satisfy any liens or encumbrances against the property within 6 months of my death. B. I give unto my daughter, BONNIE ROUSH, of Newville, any and all interest in my savings account with Members First Bank, Account No. 43810 - AD. C. I desire to be cremated; therefore, I give my cemetary plot, and all rights appurtaining to such plot, to the first family member that may pass away after my demise. ITEM THREE: I give all the rest, residue and remainder of my Estate, real, personal, or mixed, of whatsoever nature and wheresoever situate, in equal shares unto my children, BONNIE ROUSH, of Newville, DAVID ADAMS, ofMt. Holly Springs, THOMAS ADAMS, of Newville, and RICHARD ADAMS, of Carlisle, or their issue per stirpes. ITEM FOUR: I hereby nominate, constitute, and appoint my daughter, BONNIE ROUSH of Newville, as Executrix of this, my Last Will and Testament. If BONNIE ROUSH is unwilling or lmable to serve, then I appoint THOMAS ADAMS, of Newville, as my Executor of this, my Last Will and Testament. ITEM FIVE: I direct that my Executor or Co-Executrices, shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. (i:; ~ ',-;) ".".:.: (.::2 -.".e. ""'c..: "- "'.- fT} (..-' c. ( : ~.u Cj .;:;- IN WITNESS WHEREOF, I have hereunto set my hand and seal this this, my Last Will and Testatment, consisting of -L typewritten page(s), bearing my signature, this day of A.D. 2001. ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BOROUGH OF CARLISLE I, BETTY ADAMS, the 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 and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. /( , On this, the Y day of J.-/a.. t,.. ,2001, bet; re me, a Notary Public, the undersigned officer, personally appeared F. own or proven to me to be the person whose name is subscribed to within Last Will and Testament, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~AME.a~ (jOTARY PUBLIC [==!~1~ , AFFIDA VIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BOROUGH OF CARLISLE The foregoing will, consisting of _ typewritten page(s), was, on the day of , 2001, signed, sealed, published and declared by the said testator as and for his/her Last Will and Testament, and it is hereby acknowledged that said testatrix appeared to be of lawful age and sound mind and memory and there was no evidence of undue influence. We, at her request and in her presence, have hereunto subscribed our names as attesting witnesses: of Witness Address On this, the day of ,2001, before me, a Notary Public, the undersigned officer, personally appeared , known or proven to me to be the person whose name is subscribed to the within Last Will and Testament, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NOTARY PUBLIC (SEAL) of Witness Address On this, the day of ,2001, before me, a Notary Public, the undersigned officer, personally appeared , known or proven to me to be the person whose name is subscribed to the within Last Will and Testament, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NOTARY PUBLIC (SEAL) o ~- 10'7 OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Betty Adams , Deceased Bonnie L. Roush and (each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were we acquainted with Betty Adams and am/are familiar with the handwriting and signature of the decedent, and that the signature of Betty Adams to the foregoing instrument purporting to be the Last Will and Tesatment of Betty Adams is in his/her own proper handwriting. (Signature) 3~L~~ (Signature) (Street Address) 447 Oak Flat Road (Street Address) (City, State, Zip) Newville, PA 17241 (City, State, Zip) Executed in Register's Office Sworn to or affirmed a.>>d;?bscribed before me this \.fOe day of January, 2008. Q <-:I~ -.0 I~TC) '?{:[~ ~ ~i :~)~' ;~~ .- ; S~? -.'i< '-- -r~J ::p~~ .,.;...;,. ~~; :,:: Jv{;~1t~ ,M ~eputy 1st of~ills <.0 a ~~ :,{~ B .;:- <...)