HomeMy WebLinkAbout06-23-08PETITION FOR PROBATE AN~ GRANT OF LETTERS
REGISTER OF WILLS OF ~~"~~~~~'` COUNTY, PENNSYLVANIA
Estate of t/7 ~~~ ~ ~ ~ ~ ~ O U~ ~~~ File Number ~, ~~ ~~~~
also known as ) C~ _
- ,Deceased Social Security Number -/ / ~ l ~~~ ~~ ~~
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(CO'rYIPLETE 'A' or 'B' BELOW:)
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LL7 A. Probate and Grant of Lette s Tes amentary and aver [hat Petitioner(s) is`1~ie the ~~'~'~'"~" -~ ~~~ ` ~ ~ named in the
last Will of the Decedent dated ~-G v~ QQ y
(State relevant circumstances, e.g., renunciation, death of executor, etc.J
Excerpt as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instnrment(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ ~ ^--
^ B. Grant of Letters of Administration
(lJapplicable, enter: c. t. a.; d. b. n. c.t.a.; pendente lire; durance absentia; durmtte neinoritate)
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Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spola~s (if any) ~ heirs- (~f
Administration, c. t. a. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) -' -`~' ~--- ~ '
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(CO>tilPLETE IN ALL CASES:) Attach ad/ditional sheets if nec ssary. C.lT
Decedent was domiciled at death in Cw'``'t ~`~ ~~-' ~ County, Pennsylvania with his !her last principal residence at
(List street address, town/city, township, county, state, zip code~)/~
Decedent, then _~3 years of age, died on ' . `~t~ ~l ~~
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) 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
situated as follows: t~.~ "`
(~ill~
~ ~
$ ('~
$ ~~
Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
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Form RYV-02 rec. ro.ls.oe Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
f SS
COUNTY OF C~~(~
The 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.
Sworn io or a;firrned and subscribed
before me the _ a~ da of
~ ~
For the Register
Signature of Persona! Representative
Signature of Personal Representative ~~
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Signature of Persona! Representative
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C~--^^yIy (4 j ...1~ -
File umber: -'~
ry- Y
Deceased
Estate of ~UY P /~ ~ ~~~~ ~
Social Security Number: ~ (o~ o~ T S a~5~ Date of Death: 7 ~Q~
AND NOW, l~ ~_ ~U~ , in consideratio of the fore ing Petition, satisfactory proof
having been presented be ore me, IT IS DECRIlEE'``D tha~etters ~~_°
are hereby granted to ~ .1~~. C.{_)' ~dZ 0(~
in the above estate
and that the instrument(s) dated _~,,
described iu the Petition be admitted to probate and filed of
,II FEES t'
Letters .... T~~3: ~S. $
Short Certificate(s) ... ~... $
Renunciation(s) .......... $
... $ is
_ ~} ... $
... $
... $
... $
... $
... $
... $
'TOTAL .............. $ ~~
as the Izst W
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Codicils
F~~~n aw-n? rep io.i3.or Page 2 of 2
m; xo; K>/c ~nun;i
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certiYicate, 56.00
I _3_"t~~`'f~J~~
Certification Number
phis is to certify that the information here given i ~on•ectly copied f;om an original Certificate of Deati
July filed with r(le as Local Registrar. The origins
certificate wit! be forwarded to the SCate Vita
Zecords O~f~fi~ce~f~o~r permanent filing.
R~ ~el-a+l~~' AI( 1 ~/ LWO
>/ocal Registrar ~ Date Issued
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~H106~143 REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE /PRIM/ IN
PERMANENT CERTIFICATE OF DEATH
BLACK INK /-~ (7r~
(See instructions and examples on reverse) STATE FILE NUMBER ~ ' T J ~) o a a
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1. Name d Decedent (FiM, middb, Imt, sNFx) 2. Sex 3. Social Scanty Number 4. Date d Deem (Month, tlay, year)
George M. Souders M 192 - 32 - 4525 March 7, 2008
5. Age (Last Blmgay) Urger 1 year Under 1 tlay 6. Dale of BiM Month, tlay, ar) 7. SMpbm (C' antl sbte or foreign auntry) Ba. Place of Deem (Check ono)
Minus oayc Han Mann Hospibl: Other.
E33 yrs. 1/28/1925 Harrisburg, PA ^,npaaent ^ER/Oulpaaem ^DOA [~NUning Marta ^Reskbnm ^omar. Speaty:
66. County of Death &. Clry, Boro, Twp. of Death ed. FaaFty Name (If not ineelulion, give street and number) e. Was Decedent al Hispanic Origin? {f]OJO ^ Vas 10. Race: American IrMan, Bbck, WNa, etc.
pf yes, specify cabers, (sPedM
~II[IbE:rland Carlisle Bom. Thoxwald Home Mexican, Puerto Riran, arc.) White
11. Decedent's Usual Oca Lion Kintl d wok tlay M' mint d waki Fla. Do not pate refiretl 12. Was Decedent ever in the /3. Decedent's Education (Specity Doty highest gmtle completed) 14. Mamal $latUS: Manietl, Never Marred, 16. Survwinq Spouse (If wife, gNe marten name)
KiM d W«k KiM of Busuleaa I IMmtry U.B. Annetl Forces? Ebmentary /Secondary (1112) Cotege (1 A or St) Wxbwed, Divorced (Spea!»
Un2Lble to work - ^rea C~No 6 Never Married
16.OecedenYs Mating Address (Street dN /lain. able, zip untle) DecadenYS pp Ditl DecetleM
442 Walnut Bohan Road AUUp Resitlence 17e. Slate LNe in a 17c. ^ Yes, Decedent Lived In Twp.
T mhro~
C
PA
li
l '7d.C~NO'oeceamL;radwitnn Carlisle
17e_~,gty (,lanberland
ar
s
e
17013 aaml umna of city / Boro
18. FenaYn Name (First, mFdde, bp, w6lx) 19. Homers Name (First, midrib, maiden wmeme)
Not available Not available
ZDa. Idamam's Name (Type / PnnQ 20b. Idormant's Meitng Atldresa (Beet, sty / rown, slab, zp cede)
Rlane W. Drozdowski 170 Rid Drive Carlisle PA 17015
21 e. Mphotl a Dlspmtlon ~] Cmmatlon ^ Ooratlon 21 b. Dale a Diapmiam (MOmh, day, year) 21 c. Place of Wpwllbn (Name a cemetery, crematory a o8te place) 21d. Lamaan (City I rown, stele, rip aria)
^ Buda ^ Removal hen Sate
^ omer~spedry: Wee Cramatlon a DonaUOn Autltorhetl
byttedbelExrrliner/CererlerT ®rea^No
3/11/2008
Ebans Crtanation Services, Inc.
Leola, PA
22a. sgnetum a Lkereee (« wch) 22b. Lkeme Number 22c. Name eM Address a Fadlity
- FD 012633 L Ekain Brothers E~ineral Hare, Inc., Carlisle, PA 17013
e roam zaa<aay wMn certtymg 2aa. To me heal a my knarladpe, ocmmed p me tine, ride aril pbm stated. (sgmmre a~a mbl tae. license Nwiber lac. Data sgnea (Halm, der. year)
phyeiden b not available p dine d Beam to
minty raanatleem.
s ~ ~ nti~~ ~~
4 $ SD'7 L
a,rc:GF ~ /Loo 8~
Item 2428 must b c«rgbtel by person 24. Time d Deem
26. Daa Pmrlauimd De
ad (Modh, day, year) 26. Was Case Refermtl to Medrop Examiner / Cacna for a Reason Omer man Camalron a Donation?
who prmwncee deem. 1
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r6 o6 M. l~(LL~.L. vl rl/ z00 s' ^Yaa ~o
CAUSE OF DEATH (See Instructions antl examples) r Appmxnma mbrvel: Pan II: Emer Diner ' 28.Oitl Tobacco Use CaaiONe ro Deem7
Item 27. Pad I: EMer me ffiBI6-I.eSdt -daeeem, irqudes. «rnlplicatiaa -oat directly named me deem. W NOT axe terminal evenle each m cardiac artep, r Omp b Deem ha not reaAtlrg M me undertykg cause given m Pan I. ^ Ym ^ Praeedy
respimlary anesl, a vertlimaar fiDrtbFon wthad ahortig me eaorog/.lip say as roues m each tin. r
r
~
^ Nc ~Unknam
IMMEDIATli CAUSE rlw daeme a
mldtan rewllnq ro ~eam) -~ a, 10.71w `-~• i ~ 11 h,~
29. n Femeb:
Duero (« as a consequenm o4:
t ^ Nd preyam vNmn past year
e
e
~mtl tp condiaom, tl arty. e
~6u
IS
~
^ Piegmnt p tine d deem
e
a
n
g
O CAl13E a Due b (a as a canaequena oQ: r
Fs1x to UNDER~LYM ^ Nd pregnant, but pmpmnl wimin 42 tlays
e~ ~ mat ~tla
a. atleam
Duero (a az a consequence op: ^ Na preyam, M pepnam 43 tleys rot year
d. betas deem
^ llnkmtm t pregnaa wAD'm tfa pep Year
30a. Was at Aaopsy 30b. Were Aubpay fMldrgs 31. Mannar a Deem 32e. Date a Irqury (Momh, day, Year) 32b. Describe How Inryry 0«urted 32c. Place a Injury: Hama. Farm, Steel, Fanory,
Perbrtnetl? Avateble Prbr ro Camplaim ~p NeWal ^ HaMClde Ofice BuiUklg, du (SpxaTyl
d cease a Deem? ~^4
^ Yee rb ,u
l
~C^' ^ Vas ^ No ^ Aaitlenl ^ Pentlinp Inveatlpatlon aYd. Tlma d Injury ffie. Injury at Work? 32f. n Tmnsporlatlon Injury (Spesi/yl 32g. Location d Injury (Brest, dy / rown, atste)
- ^ SuicMe ^ Could Nd ba Delemnrred ^ Yea ^ No ^ Oliver I Opaata ^ Pa55angar ^Pedmtnen
M OIMr- Spedly:
33a. D~tiax (p,.ak agy ate) 33h. $igm Tltlo d Cartltle
• GMHying pltypcbrl (Ptrypcien mrtlrymg mine d tleam then another pfryskden fas pmnaxxed tleam antl mmpleled Hein 23)
- toy ~ (~AAq 1•w Y~`
O 3
To tla hptamy roawbage, tfeem oaarrtM duoroma auae(sl arW msnner es aMbd..________________________________
• Pltatourldrg art mmyug physklen (Phypcrsn ban prorwming seam end cengyxg ro Hasa d deeml
d d
m
d
at
d
^
t sac. License Nanaar sad. Da sipad IMonm, say. rid
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Tama hope my roawl.ag.,eam aaurtMnms tlaa,tLM, enO wa.a, an
a eaaae(., en
m.mar.. a
e
ue
o
• MsdkN Exemhrr/Caomr r`.f,~ o l ~ z4•(~ C t~ar~3. 1~ , 7.10 V
2J
Om me Dash a examlrallan end l a brves8gsllsn, m mY aphtlon, dntlt occurred p ma Unn, deb, and pba, and due to the cause(s) art manmr as sbtxL ^
~. Nam end Atlaen a Person W/h~o Caiglea~dfCaux d Death (Item 27) type / Pdnl ~~ll11
m
36. Rays eNre and ' Date Rbp (Manor. day. Year) '.a
~` ~, ~ ~ \- . ~ r fv~ ~ ~ J fn'1 J ~
- I,~ I f ~ I I I OI ~ 5o w•t~.n.FLO ~tl'ork.~ 0."D Cz~l.( e~ ~t
l Dispmitbn Pennd No. 0 ( ` 3 T~
WILL OF
GEORGE M. SOUDERS
I, George M. Souders, of Carlisle, Cumberland County,
Pennsylvania, declare this to be my last Will and hereby revoke all
prior Wills and Codicils.
I direct that all my just debts, funeral expenses,
gravemarker and administrative expenses shall be paid
from my residuary estate as soon as practicable after my
death.
2. I direct that all inheritance, estate, transfer, succession
and death taxes of any kind whatsoever which may be
payable by reason of my death shall be paid out of my
residuary estate.
3. I direct that my entire estate be distributed as follows:
A. I leave everything to Duane W. Drozdowski.
4. I appoint Duane W. Drozdowski as Executor of this my
last Will.
5. The Executor of this Will shall have the power to
distribute my estate in kind or in cash, or partly in either.
6. I direct that no Executor acting under this Will shall be
required to enter bond in any jurisdiction.
LAW OFF:fCES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE: 101
CARLISLE, PA 17013
IN WITN , I have hereunto set my hand this ~~~ day
of .~ , 2004.
~~~
George M. Souders
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The preceding instrument consisting of this and one other page
vras on the day and date hereof signed, published and declared by
George M. Souders, 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.
WITNESS WIT S
LAW OFFICHS OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE; 101
CARLISLE, PA 17013
ACKNOWLEDGMENT
~~
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Notary f~uf5iic/Attorney ,
State of Pennsylvania
County of Cumberland
ss
I, George M. Souders, the testator, whose name is signed to the
attached or 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 as my free and
voluntary act for the purposes therein expressed.
l ~ ~ gorge M. Souders
Sworn to or affirmed an c~g for
M. Souders, the testator, this ~~day of
2004.
State of Pennsylvania
County of Cumberland
AFFIDAVIT
ss
Ge:®rae
We, ~FLI~- B~fi?ER~~~and~~,~~,_/I~//11~'.~14/r?the
witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testator sign and execute the
instrument as his last Will; that the testator signed willingly and
executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testator signed the Will as a witness; and that to the best of our
knowledge the testator was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
~~.~xm :e..~sh-~--~--.
orn to or
this day of _
~bs ,i~d to before me by witnesses,
-~~~~ .2004.
LAW OFFICES OF ~
STEPHEPT J. HOGG N ary Public/A~
19 S. HANOVER STREET
SUITIE 101
CARLISLE, PA 17013