HomeMy WebLinkAbout04-16-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
C t..l hi GE7/.J..A.lJb
COUNTY, PENNSYLVANIA
Estate of ES1J{ffl 7: 13t/A!../J/TT
also known as
File Number ...J I . () t ; (J '133
, Deceased
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
D(l A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /_ the J::')(Uu-1vr
last Will of the Decedent dated Sept.', /99'1 and codicil(s) dated ~.pt ~ /'IiJ~
named in the
(State relevant circllmstances, c.g., rell!lllciatioll, 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 instl1lment(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: All tI ~
o ~ ..,1~-!
o lB. Grant of Letters of Administration ~j CJ ;g S~ ;,~~
(If applicable. enter: c.I.a.; d,b.n.c.t.a.; pendente lite; durante absell/ia; duran/eJI/,l!!!ffie) r-n ,"ll
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Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spo~?qflihy) and heirs: (If' '7
Administration, e.t.a. or d.b.n.e.t.a.. enter date a/Will in Section A above and complete list a/heirs)' --" 25 ~ ~ . :~;D
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Decedent, then
tJ>ti? years of age, died on 3/21/UoK at t.k/J4"-~ f//'jle1lft!, /JfecJutnics bu":j
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
SO, "D/). 00
#/04
...../A
AllIf
situated as follows:
Wherdore, Petilioner(s) respectfully requeSl{s) the probale of the lasl Will and CodiciJ(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
C Signature
)C
CHA-IUE.s.a ~IJITT
Forlll RW-OJ reI'. 10.13.06
Page 1 of2
Oath of Personal Representative
COlvIMONWEALTH OF PENNSYLVANIA
COUNTYOF CLtm8E1e.LAN.b
SS
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and conect to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirn1ed and subscribed
before me the J [pit, day of
~pa ~f1iJ\t0
For tF;- .
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Signature of Personal Representative
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Signllture of Personal Representative
Signllture of Personal Representative
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File Number:
/} I-O~' 04a33
Estate of /f".s7N~ 7: ~J(/2jJITT
, Deceased
Date of Death: 1ilA,.c.J, 26, J..oo8
Social Security Number: ~o a - 101. - 3;' Sh
,~ ,in consideration ofthe foregoing Petition, satisfactory proof
IS D CREED that Letters 7e.1 htll1e.11hz"_1(
'1J. S" tlfJ 17f
AND NOW,
having been presented before me,
are hereby granted to CII/ht!LE5
and that the instrument(s) dated Sept. iJ 1"'1
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of If:cedent.
FEES
Letters ............... $~
Short Certificate(s) . . . . . . . . $~
Renunciation(s) .......... $
... $_15.00
... $ j S,OO
.. . $ I O. 80
. $ C).(D
. .. $
.. . $
...$
...$
...$~
TOTAL.............. $Jlo'. -
Furm RW-02 rev. 10. 13.06
in the above estate
Attomey Signature:
Register of Wills
~g
Attomey Name:
eJ,,,.!es E: SA, eflU
33S/3
, elf) U ~ Rei.
lJtectlJUlie~"u" ~ pA
Supreme Court J.D. No.:
Address:
:or
/7() sS'
Telephone:
7/7- 7" -o~'1
Page 2 of2
1 i 05~O:'i Rl\' In I i(r' i
21-0g-0(3)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Certification Number
1'(~(W'otpl~---____
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This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
Fee for this certificate. 56.00
P 14328471
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REV 11f2006
PRINT IN
AANENT
CK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
C7\
STATE FILE NUMBER
11. Decedeot's Usual Occu tioo Kind of work done du most of life. Do no! state re .
Teache~O!W'" OC'::S't~~~~tit.
13, Decedenfs Education (Specify onfy highe" grade com~e!ed)
Elementary I Secondary (0..12) College (1-4 or 5+)
4
-3256
4. Dale of Death (Month, day, year)
March 28. 2008
,. Name of Decedent (Rrst, middlE', last. suffix)
Esther T. Burditt
5. Age (laS! Birthday)
86
YIS.
6. Date of Birth (Month, day, year) 7. Birthplace (City and state or for'
November 19. 1921 ansville, IN
CUllberland
Bethany Village
88. Place of Death (Check only one)
Hospital: Other:
D !npa!~nt D ER 'Ootpafien! D DCA ~ Nursing Home
9. Was Decedent of Hispanic Origin? XJ No
(If yes, specify Cuban,
Mexican, Puerto Rican, etc.)
5225 Wilson Lane
KechanicsbuJ:g.Pennsylvania 17055
18. Falhef's Name (FIrSt, middle, last, suffIX)
Charles H. Tipping
=~ 17a.$lale Pennsylvania
17b. CountCUllber land
J:i:i~ NeP'%;'k'::' n~me)
17c. 0 Yes, Decedent Lived in
17d.1II No, Decedent Uved within
AcIualUmitsol
10. Race:American Indian, Black. While, ele
(5"6"'10 Vbi te
Bd. Facility Name (" not Institution, give street and number)
12. Was Decedent ever in the
U.S. Armed Forces?
Dyes !iNo
14. Marital Status: Married, Never Married,
Widowed. Divon:ed (Spec;fy)
Widowed
Twp,
City/Boro
2Qb. Informanfs Maitlng Address (Slreet, city I town, stale, zip code)
330 Fairmount Drive, Edgewater, Maryland 21037
21c. Place of D1sposKIon (Name 01 cemetery, crematory Of other place) 21d. location (CIty f town. stale, zip code)
Cremation Society of PA rrisburg. PA 17109
& Cremation Services. Inc.
/0: 3d
CAUSE OF DEATH (See Instructions and examples)
Item 27. Part I: Enter the MlJ;~ - diseases, injuries, or complications - that directly caused !he death. DO NOT enter terminal events such as cardiac arrest,
respirakKy aITesl, or ventricular IibrilIation wIthouI showing the etiology. Lisl only one cause 00 each line.
26. Was Case Referred 10 Medical Examiner / Coroner tor a Reason Other than Cremation or Donation?
D Yes No
Approximate intefvaI: Part It: Enter other sianillcanl COl'l!t1ions contrilUlIoo to death, 28. Did Tobacco Use Contribute to Death?
Onsello Deslh but not resutting in the underlying cause given in Part I. 0 Yes 0 Probably
D No D Unknown
Sequentially list COOIitions, if an)',
leading to the cause listed on linll a.
Enter !he UNDERLYlNG CAUSE
=~~m~a~L'A1t.e
a \N<CtV\\,C)('J
Due to (or as a conseque~ ~:
b. ~OV \...' ~Prt \)1) a...(,
Due 10 (Of as a consequence of):
C.HF
29. 11 Female:
o Not pregnant within past year
o Pregnant al time of death
o Not pregnant. but pregnant wrthin 42 days
of death
o Not pregnant, but pregnant 43 days to 1 year
before death
o Unkl'lOWl'l if pregnanl wilhin thepaslyear
32c. Place 01 Injury: Home, Farm, Street, Fadory,
Office Building, etc. (Specify)
=~~~~~ldi~~
TO
T\~Vq
Due to (or as a consequence of):
d,
30a Was an Autopsy
Periormed?
31. Manner of Death
~ D_icide
o Accident 0 Pending Investigation 32d. Tme of Injury 321. II Transportation InJUf'{ (Specify)
o Suicide 0 Could Not be Determined M. 0 Driver I OperaIOJ 0 Passenger DPedestrian
______ Of11er. Specify: ..
338. Certifier (check only one) :. ~~ur: a~ Tit~e or C\rtilier " ,
~~~~sr:r~~:::=n~::~:c~~: ~~:~~I~~I~e:I::~:~~::rh:: ~;~:.~_ ~a~h _a~ ~~~~ ~e~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 ,.. 'lJ\I~ rvrvvvv
Pronouncing and certifying physician (Physician both pronouncil1g death and certifying to cause 01 death) 33<:. License Number ~33d' Dale Signed (Month, day, year)
To the best of .my knowledge, de9l:h occurred at the time, date, and place, and due to the cause(s) and manner as stated... - - - - - - - - - - - - - - - - - 0 M. 0 A - ).... a -:1. 3 ""7 3\ .... v \ 0 Co
Medical Examiner/Coroner D &of"'" -" ...;) _ oL (,) _ b
On the basis of examination and I or investigation, in my opinion, death occurred (It the time. date, and place. and due to the C8Use(S) and manner as stated. 34. N~ a~~N \mleV ,a~se~ T\ ~ ~
:Re9~1 I dl /1 ~ /1 /1 '~p '3 ~ T/W')d.\e t<1'O~. CPMf ~
Dyes
Dyes DNo
n. Were Autopsy Ftndings
Available Prior 10 Complelion
cf Cause of Death?
32g. Location ollnjufY (SlreeI, city I town, Slate)
Pl'!-l.
1\
DiSposilkx1 Penni! No, 0195 8', ~
LAST WILL AND TEST AMENT OF ESTIffiR T. BURDITT
I, ESTHER T. BURDITT, of the Borough of Mechanicsburg, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish
and declare this my Last Will and Testament, hereby revoking and making void any and all prior
Wills by me at any time heretofore made.
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I direct the payment of all my just debts and funeral expenses as soon after n!~~eas~s
(./) ^
the same can conveniently be done.)8~ ~
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All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, I give, devise and bequeath in equal shares to my beloved children, m
stiI:Pes; GORDON LEE BURDITT, GWEN ELLEN BURDITT PURCELL, and CHARLES B.
BURDITT to thier own use and benefit absolutely.
3.
I nominate, constitute and appoint my son, CHARLES B. BURDITT, to be the Executor
of this my Last Will and Testament. In the event that he should predecease me or for any reason be
unwilling or unable to act as such Executor, I nominate, constitute and appoint my daughter,
GWEN ELLEN BURDITT PURCELL, to be Executrix in his place and stead. I further direct that
they shall not be required to fIle bond or other security in the Office of the Register of Wills for the
purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1.d.- day of
t/~~ , A.D. 1994.
~~ ~ iJ~~
ESTIffiR T. BURDITT
(SEAL)
Signed, sealed, published and declared by the above-named ESTIffiR T. BURDITT as and
for her Last Will and Testament, in the presence of us, who at her request and in her presence, and
in the presence of each other, have hereunto subscribed our names as witnesses.
~4~E~21L
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C.OD/CIL
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;:to ~ #uti ~ ~I G-~tePt/N LEE Bl.(tej)lr~ ~ ~ Is/- ~ ~
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fk f' ! C!.II/fIZ-L#S/ Go/U)J~ ~ 6-4'EN. c;-?--f'l
/l~~u.l'h' ~ !I!,/L/J-::IJr ~~~~ ~sff!..v, ,: ~cI.dL
REGISTER OF WILLS
e.,,, 1Jf~@tLlMlj) COUNTY, PENNSYLVANIA
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OATH OF SUBSCRIBING WITNESS(ES)
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Estate of L:::S 7J.IE71 ?: I3ttK./Jrrr
, Deceased
, fettdt) a subscribing witness to
(Prillt Name/s)
the T.S Will S Codicil("" presented herewith, ~) being duly qualified according to law, depose(s) and
say(s) that ../ he ~y was /~ present and saw the above Tmttltof / Testatrix sign the same
and that ~ he ~ signed the same and that ~ he ~ signed as a witness at the request of
the -~\",,,tatur/ Testatrix 111 her ~ presence and in the presence of each other.
~g,.,"~ {~.ff#~ ~ig'"W")
{, Cl"t{jI," /rd.
(Street Address)
(Street Address)
(f!:,~~;t:S/llt' I fll! 110$5"
(City, State, Zip)
Executed in Register's Office
Swom to or affirmed and subscribed
Executed out of Register's Office
Swom to or affirmed and subscribed
before me this
OfJ1p('\ \
1..1
j (j ~ day
,~cog .
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.
ForIllRW.03 rev. /0./3.06
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
~ll h1t3~./) COUNTY, PENNSYLVANIA
d-\ - O~"" Olf ~.~
Estate of .c37h'~ 7: ~J{IUJITT
(!H/l;t!L1:S &. iB,,~/rr
and
, Deceased
~) being duly qualified accordi~.to law, depose(s) and say(s) that ~ he~ was / 'l:er@ well-
acquainted with ~wc;r ~ ,(J1//dJlrT and arnLaf&. familiar
with the handwriting and signature of the decedent, and that the signature of €S 77Yl7< -r:- ~llI(Uh rr:
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ES7;if~ T
~,w17r
is in Mher own proper handwriting.
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(Signature) f!.N/I-/U.j;:5 is. ,8 J{/2JJ I Ii
(StL~~s) SAUfA4~z- 1fJ#.
fa r/,'s/t, 1'''' /71)1.3
(City. Slale, Zip)
(Signalure)
(Street Address)
(City, Stale, ZIp)
Executed ill Register's Office
Sworn to or affirmed and subscribed
before me this J(lllh day
of ~'O r't \ ,21X2Z-.
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CillJ,bWlt 4-QElIft:IlYU
Deputy for Register of ills
Form RW.04 rev. 10./3.06
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