HomeMy WebLinkAbout06-04-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Kristin Noreen Burkhart
also known as Kristin J. Burkhart
,Deceased
COUNTY, PENNSYLVANIA
File Number 21--~~- ~0 ~I
Social Security Number 197-28-9424
J. Paul Burkhart II
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or `B' BELOW.•)
^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, dated 06/11/2004 and codicil(s) dated
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:
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 sp~s~'if any) an~ieirs: {Tf -j
Administratton, c.t.a, or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ,Y~:~ ~ -, ,
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(COMPLETE !N ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
311 South Orange Street, Borough of Carlisle, PA 17013
(List street address, town/city, township, county, state, zip code)
Decedent, then 7Q years of age, died on 04/27/2007
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
at 311 South Orange Street, Carlisle, PA 17013
All personal property $
Personal property in Pennsylvania $
Personal property in County $
situated as follows: All Pennsylvania assets jointly owned with spouse. An estate is being opened
solely for the purpose of conveying real estate located outside of the
Commonwealth of Pennsylvania.
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:
~ Signature Typed or printed name and residence ~
J. Paul Burkhart Il 311 South Orange Street
Carlisle, PA 17013
Rev. f0-13-2006
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 1 of 2
' ~ 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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) wilt well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed `j
.(~ Sigrtatu, iPersona/ Representative
before me this 1 ~ day of
Signature of Personal Representative
Fort Register Signature of Personal Representative v `
J. Paul Burkhart II
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File Number: 21--~~~~~ ~~
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Estate of Kristin Noreen Burkhart ~J
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Social Security Number: 197-28-9424 Date of Death: 04127/2007 ~: ? J ~~ ~ --!
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AND NOW, ' r 1 ~~~ , in consideration of the foregoing P~ition, satisfac~r proof
having been presented before m , IT IS EC EED that Letters Testamentary
are hereby granted to J. Paul Burkhart II
in the above estate
and that the instrument(s) dated 06/11/2004
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent.
FEES ~ ,q,~
Letters ............................................ $ '1 Vt~ -'
1 ~nj L
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Register or VYlls
Short Certificate(s) ........................ $
Renunciation(s) ............................. $ Attorney Signature:
~IV t ~ ~ $ ~ ~. yU Attorney Name: ,..- Jerry A. eigie Esquire
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~ $ ~~~ ~
Supreme Court I.D. No.:
-
~~~ $ ' ~ 01624
Weigle 8~ Associates, P.C.
$ Address: 126 East King Street
$
$ Shippensburg, PA 17257
$ Telephone: 7171532-7388
$
$
TOTAL .................................... $ ~~~ ~(J L~t1
Form RW-02 Rev. f0-13-2006 Copyright (cy 2006 Conn software only The Lackner Group, Inc. Page 2 of 2
his is to certify that the information here given is correctly copied from an original certificate of death ~lul~ filed ~~rt t me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanen_ fiiir(,.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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Local Registrar ~ ~"
APR 3 0 2007
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Hm6~t4a REV n/2o3s COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE/PRINT IN
PERMANENT CERTIFICATE OF DEATH
BLACK INK
(See instructions and examples on reverse) STATE FILE NUMBER
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1. Name d Decetlanl (Rrsl, mitlde, last, suaixl 2. Sex 3. Social Security Number 4. Date of Deam (Month, day, year)
Kristin Noreen Burkhart emote 197 - 28 -9424 April 27, 2007
5. Age (Last BlrtMay) Under 1 Bar Under 1 tlay 8. Date of Binh (Month, day, year) 7. Binhpace (City and stale or bre i n country) Ba. Place of Daalh (Check only one)
Iacn1M Days lbua Mxwtee Hospital: OIMl:
70 Yre. Sept. 21, 1936 DUBOIS, PA ^Inpatient ^ER/0utpafient ^DOA ^NUrsing Home Residence ^Olher-Specity.
6b. County of DeMh Sc. City, Boro, Twp. of Death 6d. Facility Name (If not iraleulion, gA'e street art number) 9. Was Decadent of Hispanic Origin? ~. No ^Ves 10. Race: American Intllan, BtaU, WNM, etc.
pt vas, apedry wean, (spearyy
Cumberland Carlisle 311 Orange Street Mexican,PUenoRican,eta) White
11. Decedent's Usual Occu tlon Kind d wort tl one tlud most of world tile. Do rid stale rented 12. Wes Oecedanl ever in the 13. Decetlenl's Etlucalien (Specify Doty highasl gretla comp leted) t4. Marital Status: Menlad, Never Married, 15. Surviving Spo use (ll wife, give maiden name)
KiM of Work Kintl of Buskrsss / IMUStry U.S. Armed FomesT Elementary /Secondary j0-121 Cdlage (1-4 or St) W~~' aVOr~d ('~~
^ye,
o Jacob Paul Burkhart II
16. Decedent's Milling Atltlress (Street, oily /sown, slate, zip mile) Dltl Decetlenl
Decedent's
311 S . Orange Street AduM Resitlerxx+ 17a. SIa19 P~ Uve In a /TC. ^ Yes, Decedent Lived In Twp.
TownsnpT
, 7d r,o Decedent DYad whhin
,7b. ca,nty Cumberland ~
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Carlisle PA 17013 Adud umi1901
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18. Father's Name (FAsI, midda, last, suffix) 19. Homer's Name (First, mMde, marten sumamel
R ce Olive J boson Evel Mild ed Anderson
20e. Inlarmanl'e Name (Type / Pnm) 20b. Inlartnent's Meierg Atldress (Street, ciy / form, ateta, zip code)
Jacob Paul Burkhart II 311 S. Oran a Street, Carlisle, PA 17013
21 p. Method d Dieposhkn ^ Cremelbn ^ Danetlan 21 b. Data of Dispositlon (MOMh, day, year) 21 c. Platte of Dislwsabn (Name d cemetery, aemdory or dher place) 21d, Location ICiry /loom, elate, ap coda)
^R~moval trio slate !
Bu
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dO1 Amnamed
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~ May 2, 2007 Mt. Zion Cemetery Allen, PA
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22a. Signature d Funer ri rsan ailing u such)
"~ 22h. license NumMr 22c. Name aril Address d Facility
Hoffman-Roth Etianeral Home & Crematory
138425
Complete Items 23ac oMy when ceroryirg 23a. To eeM d my krwxledge, M occurred at are lure, date and place staled. jSignature and tole) 2 .License Number 23c. Dale Signed (Monet, tlay, year)
pny ~ en is not avaneble al lkna of deem to ~~
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sere ~evae d Beam. .. g
ttems 2426 neat be canpeled by person 24. Time of Oe$th
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y / 25. Date Pronouoeq .Dead (, tlay, year)
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n 26. WO Case Refenetl to Metlical Examiner /Coroner for a Reason Other then Cremation w Donatan4
wM lxonouMes death, ?~ M_
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CAUSE OF DEATH (Ses Inasructlons end axemplea) r Approxirreta mterral: Pad II; EnNf other ' 2B. Did Tobacco lha Contribute ro Oeem7
nem 27. Pen I: Enter ple chain of evatb - dle9asss, irqunes, a mmpAkenwa-dint dkectFy caused me deem. DO NOT enter IermmM events such as caNim angst, Onset to Death
' hu(nd resuttirq n me uMeryirg ®use gNen in Pan I. . ^Ves ^ Probahy
respiratory Hest, a veMnNtar fibdlab
an wdMUl showing the eliobgy, list only one telae on each line.
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N1MEpATE CAUSE (FkW dseese a
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e to (or as a consequence ol):
SequantlaXy Msl conSnore, II arty, b.
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h Nd pregant WAhin pest year
^ Pregnant et lime d tleam
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e cause
sted on
ne e. Due to (or as a Caaequence oQ:
Einar 9re UNDERLYING CAUSE ^ Nd preyleM, bN pregnant wflNn 42 tlay&
(66ea~ njury met IrNie~~aadd the
ry in death) LAST
c d deem
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Due to (or as a consequence oN: ^ Nd pregnant, but pregnant 13 tleys to 1 year
d' before deem
^ Unknown it pregneM wAMn the pest year
:ba. Was an Aaapsy 30b. Were Autopsy Findinrg 31. Manner d Death 32a. Date of Injury (Monet, tlay, year) 32b. Describe How Injury OCpprlBtl 32c. Pleca of Irrjury: Hpma, Famy, Slred, Fadory,
Pedamed7 AvaNebb Prior to Cantplelian
Netural ^ Fbmkde OR a Balding, etc. (Spaciry)
of Cause of Deelh7 ~
^ Yes ~'lo ^ Vee ^ Nc ^ Acdtlerll ^ Pantling Invesllgation 32tl. Time of Injury 32e. Inryry at WanT 321. II Trensponatlon Inury (SpealyJ 329. Locafkn of Injury (51rea1, mY /town, stale)
^ Suictae ^ Coed Nat M Oelemuned ^Ves ^ No ^ Driver (Operabr ^ Passenger ^Petlesttlan
M ^DIMf- Specify
33s. Certll'ar Ichedc ony one) Tdle d
• CerlUylrp pbyelebn jPhy&dan caAilpng cause of death whin andher physician Ms pmwuncetl deem aril completed Item 23)
To tM bM d my knowledge, deem occumed dus to iM auae(a) arM rrwxrer se etaled_ _ _ _ _ _ _ _ .. _ _ _ _ _ _ _ _ _ _ _ _ _ _,. _ _ _ _ _ _ _ _ _ •
• Prayouneing art arlgylrp phyeklen (PhysAien hdh psaaundng tleatll and ceMrrn9 to wusa d deem)
To tM beat d my Imassledge, death occurred a<tM Ilme, dale, eM pleee, and tlue to me ceuega) end manner ae eteted _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Q' tense Number 83tl.~DJale S'ggnn'ed IM?omh, deY, Year)
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• Nedieel Examiner/Coroner e ~ J G /
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On me Mek d axemirletbn antl! or investigation, in my opfMon, deem occurred et tM time, data, end pMCe, end due to IM cause(s) end manner ae ateled_ ^ ~ Name end Atldress d Parson Wra CanpMMd Cause of Deam (item 27) Type 1 Print
Re r Sipnalure
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Dlaposillgn Pertnil Na. \ l I r~L~I ~b'
LAST WALL AND TESTAMENT"
I, KRISTIN J. BURKHART, presently residing at 311 South Orange Street, Carlisle,
Cumberland County, Pennsylvania 17013, being of sound mind, memory and disposition, do
hereby make, publish and declare this my Last Will and Testament, hereby revoking and making
void all wills by me at any time heretofore made.
FIRST. I order and direct the payment of all my legally enforceable debts and
funeral expenses as soon as may be convenient after my decease.
SECOND. I give, devise and bequeath all my estate, real, personal and mixed,
whatsoever and wheresoever situate, including any property over which I shall have any power of
appointment, to the Co-Trustees of a certain revocable inter vivos trust known as the Burkhart
Revocable Trust created on or about June 5, 2003, to be added to and thereafter treated as a part of
that Trust Estate to have and to hold, IN TRUST, for the uses and purposes and subject to the
terms and provisions thereof, including any alterations or amendments thereto.
THIRD. I nominate, constitute and appoint my husband, J. PAUL BURKHART,
II, to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of
Executor, I then nominate, constitute and appoint my children, namely, KARI B. SOFFEL,
KARIN B. MILLER, J. PAUL BURKHART, III and JOHN M. BURKHART, or the survivor
thereof, to be the Co-Executors of this my Last Will and Testament.
FOURTH. I direct that my personal representative(s) shall not be required to give bond
for the faithful performance of their duties in any jurisdiction.
FIFTH. I direct my Executor to retain the services of JERRY A. WEIGLE,
ESQUIRE, with offices located at 126 East King Street, Shippensburg, Pennsylvania 17257, with
respect to the settlement of my estate due to his familiarity with my affairs.
IN WITNESS WHEREOF, I, Kristin J. Burkhart, have hereunto set m hand and seal to
this my Last Will and Testament, written on one (1) page, this ~ day of ~~ o , 2!?04.
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W E{GLE & ASSOCIATES. P.C. -- ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1997
This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to
be her Last Will and Testament, in our presence, who at her request and in the presence of each
other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed
our names as witnesses.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
I, Kristin J. Burkhart, the person whose name is signed to the 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 my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before
me by KRISTIN J. BURKHART, the Testatrix,
this 11'~ `1 day of ~"u,~y , 20p4.
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1 TOIy~
~e0~otlGH cotnvey
isston'Exptrea J~
II WEIGLE & ASSOCIATES, RC. - ATTORNEYS AT LAW - 1Z6 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND :
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and
the witnesses whose names are signed to the foregoing instrument, being duly qualified according
to law, do depose and say that we were present and saw Kristin J. Burkhart, the Testatrix, sign and
execute the instrument as her Last Will; that she signed willingly and that she executed it as her
free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight
of the Testatrix, signed the will as witnesses; and that to the best of our knowledge the Testatrix
was at the time eighteen (18) or more years of age and of sound mind and under no constraint or
undue influence.
Sworn or affirmed to and subscribed before me
.---
and ~~_~ ~~~,-~
witnesses, this ~ ~Y'` day of ~~~r~,> , 2004.
No~aw, sFx
MnHCN ~ toME
~eoAOUptau~oca,nm
My canmYpon Exp+r..Kx> >. Y000
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W EIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EA5T KING STREET - SHIPPENSBURG, PA 77257-1397