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Home My WebLink About04-08-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA Estate of DONALD F. BETZ also known as File Number 621- ~ 40) , Deceased Social Security Number 203-24-5091 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 Letters Testamentary and aver that Petitioner(s) is / are the EXECUTOR last Will of the Decedent dated APRIL 24, 1990 and codicil(s) dated N/A named in the .....Jq If\.e M., ~~ r~ . ~ c;QQ <y-'a. ilLc:f r (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: 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 / 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.) c Name Relationship Residence ~~ ~ ." 1~ ,:-0 -0 .-) (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ::.= ~ ~ :::0 .J 5[~ '.. L_ -,-,' ,q Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last princiPat;~8 at CX) ~", 2~1: 308 ERFORD ROAD, EAST PENNSBORO TOWNSHIP (CAMP HILL MAIL), P A 'OJ Q -ll ~ n (List street address. town/city, township. county. state, zip code) '. ):u :-':'.' (~ --l .s::- ". ,,-I at HOLY SPIRIT HOSPITAL, ~ENNSBOR<gWP., [ . ') '-::) -' 'I Decedent, then 75 years of age, died on MARCH 2, 2008 CUMBERLAND COUNTY, PA Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (Unot domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania $ $ $ $ I ~: () t)() , 170,000.00 situated as follows: 308 Erford Road, East Pennsboro Twp. Cumberland County, PA 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 ed or rinted name and residence DOUGLAS 1. BETZ, 1342 SCONSETT WAY, NEW CUMBERLAND, P A 17070 Form RW-02 rev. 10.13.06 Page 1 of2 ()~. LiO) Oath of Personal Representative D<::0/"\R' ncr, (\r:n....r ,-..,.. ! I ..J~}~t:...,L~,i \)1 rit..Jt t)r ~', COMMONWEALTH OF PENNSYLVANIA SS 2008 APR -8 PH 4: 07 COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true an~~ ia~he best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) ofthe Decedent, petitionn~~h~~~P~PA administer the estate according to law. Swom to or affirmed and subscribed iq%1 \~1- e of Personal Representative Signature of Personal Representative Signature of Personal Representative File Number: c21 - d200r 4();) Estate of DONALD F. BETZ 0::2t- tJ52.. , Deceased Social Security Number: 203-24-5091 AND NOW, O~I '( having been presented before me, IT IS DECREED that Letters are hereby granted to DOUGLAS J. BETZ Date of Death: MARCH 2, 2008 Q06~ , in consideration of the foregoing Petition, satisfactory proof TESTAMENTARY in the above estate and that the instrument( s) dated APRIL 24, 1990 desc:ribed in the Petition be admitted to probate and filed of record FEES $ao. oJ I;). OJ 15- ci) 10. L9-' -j.aJ ~ Letters Short Certificate(s) . . . . . . . . $ '~)'- $ Renuncl.....vn,,, . '0:il':: $ Jt:1:O: .. . $ .. . $ .. . $ .. . $ .. . $ .. . $ TOT AL . . . . . . . . . . . . . . $ Attomey Signature: Attomey Name: THOMAS E. FLOWER Supreme Court LD. No.: 83993 Address: SAlOIS, FLOWER & LINDSAY 2109 MARKET STREET CAMP HILL, PA 17011 Telephone: 717-737-3405 Ci2.. 0.00 ~ Form RW-02 rev. 10.13.06 Page 2 of2 HI05.W5 REV (()1107) LOCAL REGISTRAR'S CERTIFICATION OF DEATH 6~\-(/()d 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. thn, JJ;~. ~ --4- MAA 041008 Local Registrar Date Issued Fee for this certificate. $6.00 P 14122961 Certification Number 1'0.) = <:::) = ;:ca. -0 :::0 I CO o S:o ."J;g IO -l.".r- -,~ ~~g -:eU";>;; 'e'") ; .>-..0 .'\.J-n )C :::r.J ::u-i ::t> TJ (I', :-) ;~ 1-~'1 ::'--:J -u :x .t- O -.J COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) REV 1112006 PAINT IN !ANENT CK INK STATE FILE NUMBER 4. Dale 01 Death (Month. day, year) !YlA1U H d ;) D Qg 1. Name of Decedent (Rrst. middle, last, suffix) Donald F. Betz 5. Age ILast Birthday) 5091 Sa. Place of Death (Check only one) Hospital: Other: ~Iient 0 ER I Outpatient 0 DQA 0 Nursing Home 0 Residence DOther . Specify: 9. Was Decedent of Hispanic Origin? KINO 0 Yes 10. Race: American Indian, Black, White. etc. ~:;.;~:.~=; ote) (Specify) Whi te 6. Dale 01 Birth (Month, day, year) 7. Birthplace (City and stale or fo November 7, 1931 Honesdale, PA 75 Yrs ad. Facility Name (ll not institution, give street and number) Pennsboro Twp. ID~~ p,l/tL. 13. Dececlenfs Education (SpecIfy only highest grade completed) Elementary I Secondary (0-12) College (1-4 or 5+) 2 14. Marital Status: Married, Never Married, Widowed, Divorced (Specify) Widowed Decedent's Actual Residence 17a.Slale 17b. County . 16. Decedenfs Mailing Address (Street city I town, stale, zip code) 308 Erford Rd. Camp Hill, PA 17011 PA Cumberland 17c. Qg Yes, Decedent lived in 17d. 0 No, Decedent Lived within Actual limits of Twp. City/Born 19. Mother's Name (Rrsl, midcle, maiden surname) Gertrude Erk 2Ob. Informants MaUing Address (Street. city f town, stale, zip code) 1342 Sconsett Wa New Cumberland PA 17070 41.c. pnoJ Disposition (N~ 01 cemeterytrematOlY or other.,place) HO lnger runera Home & Cremator 22c.NameandAddressotFadl!y Myers-Harner Funera Home Market St. Hill PA 17011 18. Father's Name (Rrst, middle, last, suffix) Frederick M. Betz s PA 26. Was Case Rele~to Medical Examiner I Coroner for a Reason Other than DYes IiZlNo Part II: Enter other sionifk:anl conditions conlributinolo death, but no! resulting in the underlying cause given in Part I. I Approximate interval: I Onset to Death I I I I I I I I I I I I I I I I 28. Did Tobacco Use Contribute to Death? o Yes .BI Probab. o No 0 Unknown 29.lfFemale: o Not pregnant within past year o Pregoanl al time of death o Not pregnant. but pregnant within 42 days otdeelh o Not pregnant, but pregnant 43 days to 1 year before death o Unknown il pregnant within the past year 32c. Place ollnjury: Home, Farm, Street. Factory, Office BuUding, elc. (Specify) ~:'ATe;;~Si~~I)dise~ a. ~~~~Hs==';;~i~a. Enl~ UNDERLYING CAUSE (tisease or ir.ljury that initiated the events resulliilg In death) LAST. b. Due to (or as a consequence of): d. 31)). Were Autopsy FIndings Available Prior to Completion of Cause of Death? 31. Manner of Death ~turaJ D- O Accdent 0 Pending Investigation o Su""o 0 CoUd Net be Determined 308. Was an Autopsy PorIonned? 32g. Location of Injufy (Street, city I town, Slate) 32d.l1meot Injuly Dyes 'ii1 Nc DYes ~Nc M. 33a. Certifier (check only 000) Certifying phyttclan (Physician cerlilyir'lg cause 01 death when another physician has pronounced death and completed Item 23) To the best of my knowledge, death occurm due to !he ClUse(S) and manner as stated...... -.... - -.. -.. -.. - - - - - - - - - - - - - -.... - - -.. fiJ ~==~~ a: ~:WKyi~~J:~~~a~~::::~ :hti~~;n~~':c~~~~:~ol~=~~~~~ manner as stated_.. .... .... .... _.. _ _ _.. .... _..' 0 ~~ =sm~~~~;~~o;: and 1 or Investigation, in my opinion, death OCCUlTed al the time, date, and place, and due 10 the cause(s) and manner as stated.. D A\7'-f~o).3~ 34. Name and Address of Person Who Completed Cause 01 Death (Item 27 Type I nl .J.-(~~ c,....:1....'Y ~ '5a~ )oJ .~1 s-\ <;t, . ',\ 35. Aegistrar'~ture and Dis ~ ~.... 3Sjato F;V%?;~r 0195667 1..2\ 1\ <>Z I / ( DispoSition Permit No. ~, ~~ ~H !~~ -- 0 ~ - ',.5- Yo LAST WILL C) ~5~ ""il. C) J~:-" ( '. ,?:rn . u) ::0 X (:"'20 ;::.i .. 1 ::D -0 --I :r.> r-v <::;::) <::;::) = :%:J" -0 ;::0 , CO OF DONALD F. BETZ -0 :x ..c:- ( } (~,.) . ""T1 -:!J (-) IT) ) ~~~~~~ <::) I, DONALD F. BETZ, of the Township of East Pennsboro~ Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. Item 1: I devise and bequeath all of my estate of every nature and wheresoever situate, together with insurance thereon, to my wife, JANE M. BETZ, providing she shall survive me by thirty (30) days. Item 2: Should my wife, JANE M. BETZ, predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath all of my estate of every nature and wheresoever situate, together with insurance thereon, to my sons, DAVID D. BETZ and DOUGLAS J. BETZ, share and share alike. I direct that distribution be a per stirpes basis and not a per capita basis. Item 3: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. Item 4: I appoint my wife, JANE M. BETZ, Executrix of this my Last Will. Should my wife, JANE M. BETZ, fail to qualify or cease to act as Executrix, I appoint my son, DOUGLAS J. BETZ, Executor of this my Last Will. In the event my wife, JANE M. BETZ, and my son, DOUGLAS J. BETZ, both fail to qualify or cease to act as Executors, I appoint my son, DAVID D. BETZ, as Executor. Item 5: I direct that my personal representative or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. Item 6: I direct that all my just debts and funeral expenses shall be paid from my residuary estate as a part of the expense of the administration of my estate. IN WITNESS WHEREOF, I have hereunto set my hand this ~ ;; Jt'-; J ;./ I , 19 fa . day of The preceding instrument consisting of this and one (1) other typewritten page, each identified by the signature of the Testator, DONALD F. BETZ, was on the day and date thereof signed, published and declared by DONALD F. BETZ, the Testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. /)I;~.-a~ Z~4 / res iding at 3'1'DI~~~ ~ W.dJ) ~J7a) 3 p~, ~J:?- ~ ~~ ./?o~ ~"- residing at COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND We, DONALD F. E; le-e nJ /3. BETZ, 14-;11../ I'l-,Y r ~YAV6- and ~ r,AlG , the T:stator and /the witnesses / respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~~~ Witness Subscribed, sworn to and acknowledged before me, J\ ~L \? N {'f\, G' \-'\ rf ;T~ ' subscribed and sworn to before me by by DONALD F. BETZ, the Testator and /T'eN,tl7 F (! ~Y/l/'e- , the witnesses, this ~ and E//e~;v /!;. eoy/V6 / day of A~'r'~ L ' 19~. ~\L11\ ,Q~ Notary Public AL) f~0TARrAL SEAL HELEll M, GRFFrTH, NOTARY PUBLIC CAMflI'lILL ~ORO. CUMBERLAND COUllTY I ~ C~jSSI0~ EX'IRES APRIL 18, lt92 l