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HomeMy WebLinkAbout06-17-08PETITION FOR PR/~YOBATE AND GRANT OF LETTERS REGISTER OF WILLS OF l.--l~.~l, ~`~l~i? Z1~1 V COUNTY, PENNSYLVANIA Estate of >~B I~-~~~~ ~ ~" V ~ ~~ also known as ___ Deceased Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or 'B' BELOW:) ~A. Probate and Grant of Letter, esta entar and aver that Petitioner(s) is /are the last \Nill of the Decedent dated 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 tom 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 Qjapplicable, enter.• c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia; durance 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. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) w r, Name 7.: r, z_ t..-r.1 _ - _ "„J ! ~~ (COMPLETE IN ALL CASES:) Attadi additional sheets if necessary. `~ _ f `t ~t / _ Decedent was o ciled at death in ~ `Zl~~~ County, P nnsyl is with his /her last prin ip~residenc t '- (List street address, town city, township, county, state, p od~e).y Y ~ Decedent, then ~~ years of age, died on ~J W~ ~~t ~ ~ ~ ~~~ ~ ~{ QQ ~~ J Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $_ ~ ~~+ ~~d- ~ G7 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: !~ /, Form R6V-0? ren. 10.13.06 Pate 1 Of 2 File Number ~ ~ ~ Social Security Number ~ 7 "X ~ ~~ ~~ ~ ~ © T X~ CG~~~ ~ ~ named in the 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: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF 'fhe 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. ~, n ~ . Sworn to or affirmed and subscribed before me the ~~ __. day of For the Register Signat ~ oj~ersonal Representative ~~z ~ ~. Signature ojPersona! Representative Si~natw~e ojPersonal Representative ~r~ c._ --~`"°. ~''~'} ~-_- ;~ •r! ,;-; ~.: ~- , ~ {~'. _t7 -._. File Number: °~ ~ ~ g 6 ~ S ~ Estate of ~OlC3.f\C~ ~~ ~`~~~~ ~ ,Deceased Social Security Number: ~ ~ ~ ~-~ ~ ~ ~~ Date of Death:_ ~~ ~,~ AND NOW, ~L.t-~ ~ ~ 7 , in c having been presented before me, IT IS DECREED that Letters ~B are hereby granted to ~C7h'r~~[~, ~- • ~~ e~,lAO-y_S ~ ' _i of the foregoing Petition, satisfactory proof S. in the above estate and that the instrument(s) dated described in the Petition be admitted to probate FEES Letters ...~~~ DOb , , $~~_ Short Certificate(s) .. ~ .... $ 1 ~ Renunciation(s) .......... $ _ ~ 1~ _ ... $ IS _ ... $ 10 ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ of Attorney Name: Supreme Court I.D. No.: Address: Telephone: FormR4V-OZ rev. IU.13.0( Page 2 oft Attorney Signature: ~__ iln,.Kn, xr.~ touo- LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. 56.00 ~ ~~~331~73 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 Record, Office for permanent filing_ ~~ ~~ ~-° u~ ~,~ zoo Local Registrar Date Issued n r.y ~ `:, ~ ~ _ ~~ r'- 1-1 J . =~ ~ -l - - :~~J 1ci i~ ~` y. - , I REV 11/2006 PRINT IN MANENT 1CK INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS '^' CERTIFICATE OF DEATH ^~'y /~ c /"`I _ (See instructions and examples on reverse) STATE FILE NUMBER ~-,( ~ 6 (~ (y~ (~\` 1. Name of Decedent (First, middle, last, sudlx) 2. Sex 3. Social Security Number 4. Date of Death (Month, tlay, year) Dorothy J. Woland female 174 - 20 - 7104 June 9, 2008 5. Age (Last Binhtlay) Under 1 year Under 1 day 6. Dale of Binh (Month, day, year) 7. Birthplace (City and slate or torsi n country) 6a. Place of Deam (Check only one) Moms bays ears Minma, Hospital. Other. 1926 Carlisle, PA ^ February 23 g2 ^ER ^D H ® ^ ^ yrs , Inpatienl IOutpatienl OA NUrsing Ome Residence Other Speciry eb. County of Death &. City, Boro, Twp. of Death 8d. Facility Name (If not InstilNion, give street antl number) 9. Was Decedent of Hispanic Origin? ®No ^Ves 10. Race American Intlian, Black. White, etc. Cumberland Ham den Tw P P • Lo altos of Creekview of yeaspeciryccoan. (spaeirY) )' Mexican. Puerto Rican, etc.) whit e 11. Decedent's Usual Occu lion Kintl of work tlone tlurin moss of world IAe Do not slate retired 12. Was Decedanl ever in the 13. Decedent's Education (Specity only highest grade completed) 14. Marital Status: Maned Never Married 75. Sumving Spouse (II wife. give maiden name) Kidd of WoM Kind of Business llnduslry LLS. Armed forces? Elementary I Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (SPeciM BookkeE: er A riculture ^Yes ®NO 12 Widowed • 16. Decedent's Mailing Address (Street city I town, state, zp coda) Decedent's Did Decedent Pennsylvania Live ins 17c Decedent Lived'm Hampden T ]Yes A l R itl 17 St l 1100 Crandon Way, Apt. 228 . , ctua es ence a. a e wp Township? Mechanicsburg, PA 17050 17b.Counry Cumberland nd.^ No,DecedemLivetlwanin ry ewo Actual Limits of Ci r 76. Father's Name (First, mkMle, last, sulhx) 19. Momer's Name (First, middle, maiden sumeme) Henry Wilson Ickes Elsie Susan Wenger 20a. Inlortnant's Name (Type I Print) 20b. Inlortnant's Marling Address (Slreel, cTy 1 town, slate, zp coda) Cheryl S. Stroud 2629 Butler Street, Harrisburg, PA 17103 21a. Method of Disposition ^ Cremation ^ Donaton 21b, Data of Disposition (Month. day, year) 21c. Place of Dlsposdlon (Name of cemetery, crematory or other place) 21 d. Laalion (City I town. stale, zip cotlei ^ Burial Removal)~omState i WasCremationorponatlonAumwlzed ^Ne • ®aner - spe~iry~n 1. ombme n t j by Medksl Examiner I Coroner? ^ vas June 12, 2008 Rollin Green Cemeter S Y Lower Allen Tw ,PA 17011 P 22a. SignaNre of Funeral Se L (or pe acting as such) 22b. License Number 22c. Name antl Atldress of Fadlity . ~ xa~, FS 012 849 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Cwnplete Items 23a-c Dory when c sidan is not evadable al ems of l0 h 23a. io lhe~gsl of my k edge, tleaM occurr al the lime, date and place slated. (Sgnature and t//i~~1~1e) 23b. Iceinse Number l 23c. Date Signed (Month, tlay, year) /"~ ' p y ,,_,,, ,,~ ~ ~ 1 l A 'C . ~ ~ 3 L~ ~ / ~'~ ~ CAL/ cenily cause of death. { .C j~ .! / • ~"~ ~.1 / V Nems 2b26 must be completed by person 24. Time of Death ~a 26. Da Praauncetl Dead (Monts day, year) 26. Was Case Relerced to Medical Examiner /Coroner for a Reason Other loan Crematbn or Donation? who Pronances death. ~}-M. D ^Yas [c}!fo CAUSE OF DEATN (See Instructions and examples) r Approximate interval: Pan IC Enter oNer significant conditions contnbunnq to death, 26. Did Tobacco Use Contribute to Dealh7 Item 27. Part I: Enter the ghij n of events -diseases, injuries, w compdcations -that dire Yty roused the death. DO NOT enter terminal events such as cardiac aresl, r Onset to Deatn but not resulting in the undertying cause given In Pan I. ^Yes ^ Probably respiratory artesL or venlncular librillatlon without showing the etiobgy. List Doty one cause on each line. r t t ^ No ^ Unknown IMMEDIATE CAUSE Final disease or ^^ ~ ,~ t canddion resulting in Ih) -~ a ~~~ry~ ~ ~ (~7"(~ ~ ~~ \,1/(~~7~ ~ 29. II Female. ^ Due to (or as a consequence oC: ~~j ,., ~• ~ Sequentialry dst contlitbns, d any, b. Q~ `~) ~}•(j~e7 / (Q ,~G„r.~Wl,S ~ ~0 ~- 7 ~ Nol pregnant within pass year ^ Pregnant al lime of death leading to tM cause lisletl on line a. Due to (or as a wnsequence of): ~ Not e ^ pr gnanl, but pregnam vnthin 42 days Enter the UNDERLYING CAiUSE (disease or inryry Nei initialed the c r .L ~~~~•~}/~.~•, of death events resullin n death) LAST. g ~ Due to (or as a consequence oU. ^ Nol pregnant, but pregnant a3 days to 7 year d. r before death ^ Unknown II pregnant wimin the past year 30a. Was an Autopsy 30b. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurtad 32c. Place of Injury. Home, Farm. Street Factory, Penormed? Available Prior to Completion of Cause of Death'+ NaNrel ^ Homidde OXice Building, etc. (Specify) Y N ^Ves No ^ ACgtlenl ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 32f. II T2nspwtetion Inryry (Spectify) 32g. Lacalion of Injury (Slree6 city / towq state) ^ es a ^ Suicide ^ Coultl Nat be Delerninetl ^Yes ^ No ^ Driver I Oparatw ^ Passem,/ser ^Pedeslnan M ^Omer ~ Specity: 33a. Certifier (check only one) 33b. Signal Title of Cenifler • CenUying physician (Pnysician cenityinq cause of death when anolner physician has Oronounced death and comDletetl Item 23) To the beat of my knowledge, death occurred due to the causes) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pronouncing and eMllying physician (Physician both pronouncing tlea!h and certilymq to cause of tleathl ^ r 33tl. Date Signetl (Month, day. year) To the best of my knowledge, death occurred at the time, doh, and place, and due to the cause(s) and manner as staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ C ~~ ~ _ `' - //~ Q~ • Medical Examiner) oroner On the basis of ecamination and I or investigation, in my opinion, demh occurred at the time, date, and place, end due to the cause(s) and mamur as slated_ ^ 34. Name antl Atloressfof~Per-so_n W`ho Canpleted Cause of D~S""t1h (I~teym -27)_ Type I Print N " ' rn '~ ~_ ~'~ ~ 35. Reg r Signature at r I ~I /I o'V i Ir I 36 Date ~F (Mont day, year) ~~~ ~ / ~ / ~ +^ s ~'•^"~=`r f+A',rtfirG~ ~' J~320 Y 1F'i1~x.c 1YL~ ~ / i , Dlsposilian Perms No. - d Lll~ 12.01 ~~o~Olo~ <~ ~~ ~ - LAST WILL AND TESTAMENT ~`-' ~ ~ `' OF ., _ _r\ ~ __ _,. DOROTHY J. WOLAND = ' -- ~ ~:: -~ --{ .. . , ~' __.. I, DOROTHY J. WOLAND, of Mechanicsburg, Cumberland CouM'y, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this, my Last Will and Testament, hereby revoking and making void all former Wills by me at anytime heretofore made. ITEM I. I order and direct all my legal debts, death taxes, funeral and administration expenses to be fully paid as soon as conveniently may be done after my death, costs of administration and other similar expenses from the principal of my residuary estate. ITEM II. I give and bequeath certain items of tangible personal property that are solely owned by me at the time of my death and that are identified in any separate writing which is dated and signed by me at the end thereof, to those persons designated in such separate writing who survive my death by thirty (30) days. If any item of tangible personal property is identified in more than one separate writing, I direct that, unless stated to the contrary, the separate writing bearing the last date shall govern the disposition of such item. 1 ~~ ~ ~ ITEM III. BENEFICIARIES. A. I give $1,000.00 to each of the following persons: DORIS (SOLLENBERGER) BARTHOLOMEW; DIANE (SOLLENBERGER) McCLEARY; DEBRA (SOLLENBERGER) ]OHNSON; MARY CATHERINE (McCULLOUGH) STECKEL; JOANN (McCULLOUGH) KITKO; ROBERT McCULLOUGH; BARRY ICKES; CATHY ICKES; MICHAEL ZAKIS; ]AMES WOLAND; DENNIS BUTLER; and RICHARD BUTLER, as are living on the thirty-first (31~) day after my death. If a named person does not survive me by thirty (30) days, then his or her share shall lapse and be divided equally among the persons named in ITEM III(C). B. I give $5,000.00 to each of the following persons: DONNA LEE SOLLENBERGER and EDWARD L. ICKES, as are living on the thirty-first (31~) day after my death. If a named person does not survive me by thirty (30) days, then his or her share shall lapse and be divided equally among the persons named in TTEM III(C). C. The rest, residue and remainder of my estate, I give said property equally to, BETTY (ZAKIS) MILLER; CHERYL (MILLER) STROUD; MARGARET (ICKES) CECERE; CONNIE (ICKES) FLAUAUS; WALTER PARMER, ]R.; ED VALLISH; CONNIE VALLISH; PAT ELLIS; and ROBERT ELLIS, as are living on the thirty-first (31~) day after my death. If a named person does not survive me by thirty (30) days, then his or her share shall lapse and be divided equally among the surviving named persons in ITEM III(C). 2 d~' s' ~~~D~ ITEMr ~'. I appoint, CONNIE (ICKES) FLAUAUS and CHERYL (MILLER) STROUD, or the survivor thereof, as my Executor under this my Last Will and Testament. My Executor, shall have the authority, in their sole discretion, to appoint another individual or bank as an additional or successor Executor, or to renounce appointment in favor of another individual or a bank. ~-~~10~ ITEM I direct that no Executor created in this Will be required to enter bond for the faithful performance of duty in any jurisdiction. ITEM ~I. No beneficial interest under this Will, whether in income or principal, shall be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall such interest be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, consisting of three (3) typewritten pages, this 1~ day of May 2008. r DOROTHYI, WOL4ND 3~~~' We, the undersigned hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, DOROTHY J. WOLAND, 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 set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. Residing at o~y3~ ~ee~ sf- ~/a ~ ~ %f ~b9 P~J ~ ~ i ~o 7/7- (os 7~- ~9~'9 ,~C l~~d~~~~a0 Residing at ~ v~ ~~~ ~ ~ ~ e~K ~- l ~ ~Co.3 ~I~- g~~3- ~~~ ~ 4 G~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS We the Testatrix, DOROTHY J. WOLAND, and ~0 ~ ~ ~ ~~T~ t,~,~ and G~~~~ A• l4~fS ,the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. WITNESS: C>,~Yv_- ~~~ ~ ~ ~ ~ ~ l a rn D~ z~~ DOROTHYI, WOL4ND ~ U'U ~ ~ - N-2 ~S Subscribed, sworn to and acknowledged before me by the Testatrix, DOROTHY J. WOLAND, and subscribed and sworn to before me by ~41~~ Xz. I71TZ~~~ and GJ~l~~L ~, 1~'~Ss' ,witnesses, this 1~ day of May, 2008. BARRY K. TREXLER, J.D. 551 wESTDRNE Notary Publi NOTARIALSEAI FWRRISBURG, PA 17111 BARRY K. Tt2EXlfR 717-566-1732 NOTARY PI~UC-NOTARY Ip 1210355 SWATARATOWNSFAP, DAUPhdN CQ, P/1, USA MY COMMISSION EXPIRES OCT.'f, Z0 5 ~~; ~'