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Home My WebLink About04-14-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA Estate of EDW AID F. SHUEY also known as File Number 2-. \ 0 '?) oL\' L\ , Deceased Social Security Number 186-07-8713 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) I2J A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the EXECUTOR last Will of the Decedent dated SEPTEMBER 23,2003 and codicil(s) dated 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: o B. Grant of Letters of Administration I"-.) = = (If applicable. enter: c.t.a.; d.b.n.c.t.a.: pendente lite; durante absentia;'iflj.. e minorit : :;-' . ...:~ , "0 -0 ".-. >) Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the followinS~ (ifaiitJ and h1itsiWf Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ," ::-~ S9 :&:= . ~:-Ti ~~ ~ 'c;~ I ~ .. ;:~~=- _ .f~. o Name Relationship (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in CUMBERLAND BETHANY VILLAGE NURSING FACILITY (List street address. town/city, township. county. state, zip code) County, Pennsylvania with his / her last principal residence at Decedent, then 87 years of age, died on MARCH 21, 2008 at BETHANY VILLAGE NURSING FACILITY Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania 195,000.00 $ $ $ $ 0.00 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: a,,? ~/h" ,/ -/W'- T ed or rinted name and residence ~',;?' ~/Y7 1/7 .s'hc- 'e - :J.ObO Count L/~;'e RJ. ~6KJ'lSpR1NifJ fA 1737J Foml RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND 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 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 affirmed and subscribed ~a~~~~ before me the Ji-l z:J!f Signature of Personal Representative 2\ o~ 011Lf o (::0 .,: --r'l ;--~ ::::;:.< '1.:<::2 . ':~=q; '--(J)~ :5 ~ '" :-g r-) = = CP ,.,.. -0 :;0 Signature of Personal Representative v -i-) "~!~~~~~ :,< ,'c) f:~~~ ;i~ C) ~n _ --r-l o f'rt File Number: )> :x o N -a F-) ~~~ Estate of EDWARD F. SHUEY , Deceased Social Security Number: 186-07-8713 AND NOW, Apn/ If..{ having been presented before me, IT IS DECRE are hereby granted to (/ 11a; and that the instrument( s) dated 0(; pI;.JYJi;P /' 23 21Jli3 described in the Petition be admitted to probate and filed of record as the last Will <. Date of Death: MARCH 21,2008 , JJJb2f in the above estate FEES Letters .....I~~/;i?~.. $ Short Certificate(s) . . . .:i. . . $ Renunciatir(S) .......... $ l0ll ...$ \~- ... $ _~tD . .. $ . .. $ .. . $ .. . $ . .. $ .. . $ .. . $ TOTAL . . . . . . . . . . . . ., $ .2.~() 2..0 Attorney Signature: Ie; \(!f 6 Attorney Name: PAUL BRADFORD ORR, ESQUIRE Supreme Court 1.D. No.: 71786 Address: 50 E. HIGH STREET CARLISLE, P A 17013 Telephone: (717) 258-8558 J10~O~ Form RW-02 rev. 10.13.06 Page 2 of2 HIOj.805 REV (01/071 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Certification Number 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 /7 ReCO';O~fiIMnAR Z 5 Z008 ~ --- (j / / Local Registrar Date Issued Fee for this certificate, $6.00 P 14124032 C) C;o 'J ;:g ~IO :~~~~ , ;:;3~ 00 - , l:) ..., c= :J:J --i :g ,...., <:::::> <:= co ):loo -0 :::0 .r:- ~EV 11/2006 PRINT IN >ANENT ;KINK //31-242 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See instructions and examples on reverse) > ::c: c;t N ...., C) -r\ " R f'1:1 /) C~~: , I at. County of Death ad. Facility Name (It not institution, give street and number) Bethany Village o"'b (J'-\/L 1. Name of Decedent (RrsI, miOdle, last, suffix) Edward F Shuey 6. Date of Birth (Month, day, year) 8713 5. Age (Last Birthday) 87 March 13, 1921 Hurrmlestown, PA Ba. Place of Death (Check only one) Hospital: Other: o Inpatient 0 ER I OU1pabent 0 DCA Nursing Home 0 Res~ence DOt"',. Speti~: R Was Decedei1t ot Hispanic Origin? ex No 0 Yes 10. Race: A{nerican Indian, Black, White, elc. (II YO'. 'pedfy Cuben. (Sped/YI Mexiea1\ Puerto Rican. ele.) Whi t e 12. Was Decedent ever in the U.S. Armed Forces? nes ONO 13. _', Educatkln (~on~ h;gllesl grade completed) Elementary I Secondary (0-12) Cottege (1.04. or 5+) 12 14. Marital Status: Married, Never Married, WIdowod. DWo<oed 1Specffj/} Married Elfreth 16. Decedenfs Mailing Address (street, city flown, stale, zip code) 325 Wesley Dr. Mechanicsburg, PA 17055 Decedenfs Aclual Aesi<Ienoe 17.. Slate P A 17b. County Cumber land ~~ ~t 17e. ~ Yes, Deoedent LMld in 7ownship? 17d. 0 No, IJeoedeoI Lived within Actual Umits of Twp. City/Born 18. Father's Name (First, middle, last, suffix) William M. Shue Sr. 2Oa. Intoonanrs Name (Type I Print) William M. Shuey,III 19. Mother's Heme (Rrst. middle, maiden surname) Mildred G. Ehley 2Qb. InfOfmanfs Mallng Address (Street. city f!oWn, stale, zip code) 2060 Count Line Rd. York S rin s PA .17372 21c. Place of Disposition (Name 01 cemetery, cl'8matory or other place) 21d. Location (City flown, stale, zip code) Hollinger Funeral Home & Cremato y Mt. Holly Springs, PA Myers-Harner Funeral Home i I 011 23c. Date Signed \MonU'1, day, year) Items 24-26 musl be compleled by person who pronounces death. 24. TIme 01 Death 4:40 P. 25. Date Pronounced Dead (Month. day. year) M. March 21, 2008 26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation Of Donation? Yes 0 No CAUSE OF DEATH (See Instructions and examples) Item 27. Part I: Enter !he ~ - diseases. injuries, or complications -that directly caus&d the deattl. 00 NOT enter terminal events such as cardiac 8rffisf, resplratofy arrest, Of ventricular fibrillation without showing the etiology. Ust only one cause on each line. o Yes 0 No 31. Manner of Death o NahJraJ 0 Honlidde ~ A_' 0 Pendingln""'iQalion o Suidde 0 Could Not be Determined 1 Approximale interval: : Onset to Death I I I I I , I I , I I I I I I Part II: Enter other skmilicant conditions contributino 10 d8a1h but not resultilg in the underlying cause ~ in Part I. 28. Did Tobacco Use Contribute to Death? o Yes OProb.~ o No 0 Unkn""" =~~~~~~\d~~ 301. Was an Autopsy Pertormed1 d. 3Qb. Were Autopsy Findings Availab4e Prior to Compfetion of Cause of Death? e passenger struc ran red light 29. If Female: o Not pregnant within pasl year o Pregnant al time of death o Not pregnant, but pregnant within 42 days 01 death o Not pregnant, but pregnant 43 days 10 1 year before death o Unknown if pregnant within the pas! year 32c. Place of InjoTy: Home, Farm, Street, Factory, OtficeBUitdIng,MC(~treet ~_Hstcondition',II"'y, . lCIto the cause listed on line a. Ente< Ut<DERlYING CAUSE ~=n~~e b. Pulmonary Comprimise Due to (or as a consequence of): Multiple Traumatic Injuries Due to (or as a COOseqUflnce on: Motor Vehicle Crash Due to (Ot as a consequence on: 8:53 A.M 32f.IITran_tionlnju'Y(~) o Oliver f Operator ~Passenger OPedestrian Other . Specify: 33b. Signature and li 33<1. Date Sigl1ed (Month, day, year) March 22, 2008 o Yes ~ No 32d. Time 01 Injury 338. Certifier (check onty CII1e) =:rJ:I=.n~~=::ue~theW:u~:::~~_~~:~~~~~~~_________________ 0 .,. ~~o,:u~m:,a~~=:::=~~=;~=~::~=~~:~= manner as silted.. _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ 0 = =~~= and I or Investigation. In my opinion, death occurred at the time, date. and place, and due to the cause(s, and manner as stated... ~ 35. Registrar's 8' ~ ,;2,1' I ?--I 1 II 34 '1lIT~1'n oI't":'" "1fMr~tl1r!8Wlt T""IPrint 6375 Basehore Road! Suite #1 Mechanicsburg, PA 7050 Olsoosltion PefTTlit No SAlOIS SHUFF, FLOWER & LINDSAY ATIORNEYS'AT'LAW 2109 Market Street Camp Hill, PA LAST WILL AND TEST AMENT OF EDWARD F. SHUEY I, EDWARD F. SHUEY of the Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I. I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II. I direct that any Ned Smith, Betty Snow or Doug Phillips prints and paintings which I still own at the time of my death shall be sold and the proceeds added to the residue of my estate. III. I bequeath certain items of my tangible personal property, not including cash and securities, in accordance with a written list made by me during my lifetime. In the absence of such a list or designation on said list, I direct that my executor hereinafter named distribute my household goods and personal effects among my children, with due regard for their preferences and in as nearly equal shares as possible, and that the remainder be sold and added to the residue of my estate. IV. To my wife, Marcella A. Shuey, if she survives me by thirty (30) days, I give and bequeath one-third (113) of the value of such household effects as may be distributed to my sons under article III, above, plus one-third (113) of the residue of my estate, in recognition of the fact that sh~lvo~l~ ,Qthef\V~sy, ~e required to elect to take against this will in d.__ ",,, ,j ,:) order to preserve her eligibilit;9bl9~~A~l.id~istance benefits, on which she relies for the ...l'J );cHrJ costs of her care. L Z :01 WV +J I ~dV enOl '",' ~~('; :1~"')'~~! )(\'IJ.,'.'-"!,,.J~Y"l~,JH ~.v ...'\0 ~-1_....J ~_""'''\,'''\''''''.JU SAlOIS SHUFF, FLOWER & LINDSAY AlTORNEYS'AT'LAW 2109 Market Street Camp Hill, PA V. I give, devise and bequeath the balance of the residue and remainder of my estate, of whatever nature and wherever situate, unto my sons, Robert W. Shuey, David E. Shuey and William M. Shuey. Should my son, David E. Shuey, be deceased, his interest shall be divided in equal shares among his wife, Donna Shuey, and his four children, in which event I nominate Donna Shuey to serve without bond as guardian of the children's shares during their minority. Should my son, William M. Shuey, be deceased, his interest shall pass to his wife, Gail Shuey. Should my son, Robert W. Shuey, be deceased, his share of my estate shall be distributed to his companion, Anna Church, provided that they were still cohabiting at the time of his death. V. I appoint my son, William M. Shuey, Executor of this, my Last Will and Testament. Should my son, William M. Shuey fail to qualify or cease to act as such, then I appoint my sons, Robert W. Shuey and David E. Shuey to act jointly as co-executors. None of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the )~~ daYOf~,2003. q~rrAL) Signed, sealed, published and declared by the above-named Testator, Edward F. Shuey, as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our names at his request as witnesses thereto, in the presence of said Testator and of each other. ~c;p~ ~~~ WITNESS ADDRESS ?-~<;{ ~Ikt <;(:- ADDRESS ';) l cct $t-. VV\. ... r k..., T- L ,,~ tA... ? PA \ ~I (I SAlOIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LA W 2] 09 Market Street Camp Hill. PA COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND WE, Edward F. Shuey, TH-ot-1~ E, f 1..{)/-l./CR.. and (:""~eV11"\ \.c..'l:...~V\~ , the Testator, and witnesses, respectively, whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the under- signed authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly, and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. q~~~ Edward . Shuey, Testator U ~~ Witness 4~ Witness ~~ Subscribed, sworn to and acknowledged before me by Edward F. Shuey, the Testator, and ~bscribed to and sworn or affirmed to before me by 7IJdbJl.29 E ,q~ r and f9i1e/Jf1 /lJep]6 , wilnesses, thi~day Of~~~ ~SEAL) ~ary Public Notarial Seal Sallie Allshouse, Notary PubIlc Carlisle Boro. Cumberlarid ColI1tY My Commission Expires Mar. 29. 2004