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HomeMy WebLinkAbout04-04-08 PETITION FOR PROBATE AND GRANT OF LETTERS a 1 flIbtr1C\./1c! COUNTY, PENNSYLVANIA ,,-:DAft-} II frj/.ftT?{f/~..e S~, REGISTER OF WILLS OF Estate: of File Number 2-1 tJ ~ Gn~ also known as , Deceased Social Security Number / r'" ~ /:2 '/8' '7 s Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A I or 'B' BELOW:) o A. Probate and Grant of Letters Testa~ntary and aver that Petitioner(s) is / are the last Will oftbe Decedent dated I I / Y r rk" and codicil(s) dated I' I (State relevant circumstances, e.g., renunciation, death of executor, etc.) o B. Grant of Letters of Administration 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.) ,//1'*"" UYfl-Ut./~ (COMPLETE IN ALL CASES:) Attach additiollal sheets ifnecessary. /, Decedent, tben g'l years of age, died on /rlflL'/M';o,; .:)tKJt! (:~ls ~ /&fk'rl,q L .J 11M~L (~ Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PAl Personal property in Pennsylvania (I f not domiciled in P A) Personal property in County Value of real estate in Pennsylvania $ $ $ $ /~f/ ~OO ........~~~ ~ !O . , 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: c;. ('~/' ForIllRW-OJ rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~bP/ & 01 SS The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con-ect 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. /7 G;"4W>f ~.. ~U~ /' Ire of Personal Representative Signature of Personal Representative Signature of Personal Representative o c- ;;:;:0 '3;g ~iEP .,,"-2: r~rl (rj~ .~~~: ~ . :J:1 '0 -, ::J> Estate of eX I 0 ~ Q3&3' Jdhn fI. /1fPlau l/tI' J/ 18~ /2 ljjCIS' , 2iJbt , Deceased mO., ell 20 z.t:t6 File Number: Date of Death: Social Security Number: Apn I 4 having been presented before me, IT IS DECREED that Letters &mnle Jho/~(j '- JOJ\ I X /q ft{' '" t:::) t:::) co :hi. -0 ::::0 J .:c- _~ . r'r-; ~;-;;' ~~ ~:_~.'-:; ,~{ J ::~.:; ~;;Z -:,:::J ;~7 ('"5 rT, " ~ ~ I'\J c.n f- AND NOW, ~1 c~tion ~th,e foregoing Petition, satisfactory proof (tfS 1')' ILl / are bereby granted to and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Wil FEES Letters .., .11'1.J?C:{ $ Short Certificate(s) L ~ . . . . $ RenunciatiOn(r> .......... $ 1j' / .. . $ cP $ t-Jw fv $ $ $ $ $ $ $ TOTAL .............. $ ~loO d't )':; to [) Address: Telephone: (1/'1 ForI/,! R W-02 rev. 10.13.06 in the above estate Page 2 of2 iii)_"_,,05 R[\ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. 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. Fee for this certificate. S6.00 Certification Number ~. ~~&~~~ 2 2/2006 I.ocal Registrar Date Issued P 14384545 >2 ~?o ;;0 ,00 p) ~~ h=l _ '-C: ~D co 7'- ("-)0 ...r)-n '-)L_ -::0 -4 :B ~ = = c::o :P" -0 :;:0 , .&'" .'.,'->' ~-:3~ c:::) :0 C':::l -~--r1 C.J -0 :x ~ N U1 ~- .~... '~1 --rl (~ rl1 ,'0, e) -I" '\ t. I H105-143 REV 11/2006 TYPE I PRINT IN PERMANENT SLACK INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) 0% 03gi 1. Name of [)ec&dent (Firs!, mlddIe, last, suffix) ,John H. Keefauver, Sr. 5. Age (Lalil Birthday) 2008 Cumberland t. Rock, PA lXI,npalient DERIOlrlpa/jent DDOA DMJrsirtqHame DResJdenca Bel. Facility Name (If not institution, give skeet and nLmbef) 9. Was Oecedenl of HIspanic Origin? ag No 0 Yes (If yes, specify Cuban, ional Medical Center Mexican, Puer10 Rican, etc.) 13. Decedent's Education (Specify only highest grade completed) 14. MariI81 Slaws: Married, Never Married, C WKlowed. DNon:ed (SpeclfYJ Elementa<ygSecondary(()-'2) ollege ('4 ",S+) Widowed DO!her. Sped~, 10. Race: American Inclian, BIadt, 'MlilEl,etc. (White 84 y~. Bb. CotJ~ of Death 1'71).. County PA Cumberland D~DElCeclent live In a Township? f7C.~ Yes, DecedernLivedin 17d. 0 No, Decedenllived lIti!tIin AcluaIUmilsof South Middleton Twp. 1634 Walnut Botton Rd. Carlisle, PA 17015 18. Father's Name (FIrst, middle, last, suttb} Edward D. Keefauver, Sr. Oecedenl', AclualAesldence 17a.State Ci1yIBoro 19. Mother's Name LArs!, mkkle, maiden surname) Lucinda Mazy Sheely 33a C_lcheck "". one) ~~.:'...=:"':""'"::=:'~':t..~~~~_~~ _~~~~,:,.:s~_ _ _ _. _ __ _ _ n. _n _ D PTonounclng.... COlIIfylng ~ (Phys1cien boIh pI1ll1OOnCing_lIfIr1oe11ll)mg Iocauee 01_) !Z Tothe bnI ()f my 1a'IowIedge, death occurred at theflme, dIte, and pIM:e, and due to the ClUse(I) and manner u staIecL -.... -.... - -.................. @ = =::= and I or Investigltion, In my optnlon, death occurred at the time, date, and plaCe, and due to th6 cause(sJ and manner as statecL 0 ~ o ~ 201:1. lnformanh MaRing Address (Street, city / town, state, zip code) 1618 Walnut Botton Rd., Carlisle, 21c. Place 01 Di.spalmoo (Name 01 cemetery, cremaIOry or oIher place) er Maror' 17015 PA . ~ 22c. Name and Address of Facility Ewing Brothers Funeral Hate, Inc., Carlisle, PA 17013 23b. Ucense Number 23c. Dele Signed (Monlh, day, year) .dIPO?;7p 7 -L,. f/~/pP ~ 26. Was Case Referred to ~miner I Coroner for a Reason Other Ihan Cremation or Donation? Dyes ~ Approximate inteNaI: Onset 10 Death Parlfl:Enlerolf1ersiooi1'icBntcondltiansMntributlnatadealh 28.DId~Ob!ccoUst . 10 Death? but not resuIIng in Ihe undeI'Iytng cause !jvenin Part I. 0 Yes Dunlmown :::,. '::l 11 \.lJ ~ ~~~:::=~~ d. 3Cb.WtI1IAutopsyf"ncIngs 31.Mannei~ ,;=,::~~r;-:~ra1 0- Dyes ~ 0- Dp__1Ion D~ DCouIdNolbelletelmO>ld 29. II Female: o Notpnognen,......""",.., o Pregnant at tlme 01 death o ""'1"'9''''',,,"_-42days ol_ D Notl"W'8nt,,,"p_43dayslo',.., lie1o~_ o Unknown" -"'" _"" pas!,..r 32e'=:J=~}S1reet,Factoly, -:'l.. 1st -." eny, b. =~::rcAut'L =-,:.,'t.gV.":.~"" D'les 32tl'. Tll118ot/njury M. Disposition Permit No, I, JOHN H. KEEFAUVER, SR., of 1518 Walnut Bottom Road, Carlisle, 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 any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred in accord with my expressed wishes. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal 0 representative shall consider necessary and desirable fo~=~e purchase, erection and inscription of a suitable marker ~~~my grave .-.;;?:.= 0 _ ..<_..r- .~ ;:~ 9j FOURTH. Should my Wife not survive me, I make the '')''''''X -Qo following specific bequests: \J-n C ":rJ A) to my sons, John H. Keefauver, Jr., De9PTs Keefauver and William Keefauver, my 28 foot camper; B) to my sons named above, my guns, to be divided equally and kept in the family; C) to my sons named above, my gun cabinets, fishing equipment and hunting clothes, to be divided equally; D) to my son William, the boat and boat trailer. FIFTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my Wife, Mildred C. Keefauver, provided she survives me by thirty (30) days. In the event she fails to survive me by thirty (30) days, I give, devise and bequeath all said tangible personal property not specifically devised in paragraph Fourth unto my four children, Bonnie Keefauver Sholly, John Keefauver, Jr., Dennis Keefauver and William Keefauver, in equal shares, per stirpes. SIXTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my wife Mildred C. Keefauver, provided she survives me by thirty days. In the event she fails to survive me by thirty (30) days, I give, devise and bequeatn all said real estate unto my four children, Bonnie Keefauver Sholly, John Keefauver, Jr., Dennis Keefauver and William Keefauver, in equal shares, per stirpes. "-> = = co :Do- -0 AJ , .:;:- fl"i (-) '-::) ~-~J \.:::J '" ,=1 C,J ., =n - -') ;'n -0 :x ~ N c.n ....J provided she survives me by thirty (30) days. In the event she fails to survive me by thirty (30) days, I give, devise and bequeath all the rest, residue and remainder of my estate unto my four children, Bonnie Keefauver Sholly, John Keefauver, Jr., Dennis Keefauver and William Keefauver, in equal shares, per stirpes. EIGHTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. NINTH. I hereby nominate, constitute and appoint my wife, Mildred C. Keefauver as Executrix of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of Mildred, I nominate, constitute and appoint my daughter, Bonnie Keefauver Sholley as Executrix of this my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting security in connection with her duties, as such, in any jurisdiction in which she may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. this, pages IN WITNESS WHEREOF, I have hereunto set my Last Will and Testament, consisting this 1 g-tl, day of ~tt-YU-~~r_ ' j my hand and seal to of two typewritten 1988. / .,.... '/ ~ /./ . ; . " ".0" J . .'{tvlr../8 " .1; /41..'1/~U JOHN H. KEE~AUJEf;//SR. L.' / ,yl/, Signed, sealed published and declared by the above named Testator JOHN H. KEEFAUVER, SR. as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. YI7 --<-4h-'-Ct C k ~4'H/vU ~v C Q1/1 " COMMONWEALTH OF PENNSYLVANIA: ss. COUNTY OF CUMBERLAND I, JOHN H. KEEFAUVER, SR., Testator 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'RTT)free and voluntary act for the purposes therein expressed ......~f;,(j.l;!, j:;: (/',~ " JOHN H. K'EEFAJ\AER, "'SR. 0/ i~. Sworn or affirmed to and acknowledged before me, by.. JOHN H. KEEFAUVER, SR. this ff~ay o f ~C~""'I.A-~CJ"'-(f- , 1 9 8 8 . i~! ~ ~1~~b'~C . -~f~L) My commission Expires:/~/dY/9a COMMONWEALTH OF PENNSYLVANIA: ss. COUNTY OF CUMBERLAND We, If\',l tlft"& 0. Ket::"f(l.u...,;e.. and Ww-. A.""l:>v..\.,-( 0. ~, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw JOHN H. KEEFAUVER, SR. sign and execute the instrument as his Last Will; that JOHN H. KEEFAUVER, SR. signed willingly and that JOHN H. KEEFAUVER, SR. executed as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge, the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by In; Itlfed C. tc",€FA.,-,--ve~ and Wrn. A :l '^ ",cC\....... , witnesses, this ~ \ 'fa;:...... day of ~t~"'Y f OA_J~P$ ~*ry pu6ifc' ( SEAL) . . ~ /.",J.&~ ~ l .(~ C' i<f /1 . /!y) , II f.rte'< . -" '..L ,,,PItH..o/-. \.~(,'Vl C Ct..t.~ 1988.