HomeMy WebLinkAbout07-31-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of Barbara C Olmstead
also known as Barbara Clarkson Olmstead
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
COUNTY, PENNSYLVANIA
File Number t~/ ~ v ~ ~~~
Social Security Number 379-16-5794
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Co-Executors _ ,named in the
last Will of the Decedent dated 12/13/2004 and codicil(s) dated ~Z `~
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(State relevant circumstances, e.g., renunciation, death of executor, etc.) _. r r` ~ ~,,~
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the iu~trument(s) offered;---
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for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - ' ' ~. -
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B. Grant of Letters of Administration --
(/f applicable, en[er.• c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia; durance minoritaleJC~J
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: (/f
Adminisdration, c. t. a. or d. b. n. c.t.a., ender date of Will in Section A above and complete list of heirs.)
1 Name Relationship Residence I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
770 S Hanover St, Carlisle, Cumberland County, PA 17013
(Gist street address, town/city. township, county, state, zip code)
Decedent, then 85
years of age, died on 7/20/2008
at 770 S Hanover St., Carlisle, PA 17013
Decedent at death owned property with estimated values as follows:
(lf 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: 601 Yorkshire Dr, Carlisle, PA 17013
$ 365,000.00
375,000.00
Form RW-01 rev. /0.13.06 Page 1 of 2
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 1~~~ J~!L 3 i F~~ 3~ 43
CO[JNTY OF Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petitio~~a~~ab avtdiorrect to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the L)ecedent,`i~~~i~toner(s)~~~%~ilC~~el~~d truly
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administer the estate according to law.
Sworn to or affirmed and subscribed
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ore tae the ^^ day of
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For tMe Register
File Number: '- ~/
Estate of Barbara C Olmstead ,Deceased
Social Securi Num er:379-16-5794 [~ Date of Death: 7/20/2008
AND NOW, 1 _ - `" ~ , in consideration of the foregoing Petition, satisfactory proof
having been presente efore me, IT IS DECREED that Letters Testamentary
are hereby granted to Katherine B Clarkson and John C Oszustowicz
in the above estate
and that the instrument(s) dated 12/13/2004
described in the Petition be admitted to probate and filed of
FEES
Letters ............... $
Short Certificate(s) ... , .... $ ~
Renunciations `ry .~ ....:.. $ ~
.. $ 5. °
...$ ~-'
... $
... $
... $
... $
... $
... $
TOTAL .............. $ .&'88~
Will (ay~Codici~(s)
Wills
Attorney Signature:
Attorney Name: Tricia D
Supreme Court I.D. No.: 837ti0
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Address: ]04 S Hanover 5t
Carlisle, PA 17013
Telephone: 717-243-7437
Form RW-02 rev. 10.13.06 Page 2 of 2
If15.R05 Rf?V' IUIIO')
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LOCAL REGISTRAR S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 14649382
Certification Number
,,,,/rx~x~~~~~~~--.,, This is to certify that the information here given i<
1,~~a~ZN OF pfy~ __ correctly copied from an original Certificate of Death
~~ `fir', duly filed with me as Local Registrar. The original
~ _ ~ ~_ ~z certificate will be. forwarded to the State Vital
~ ,;y~~~' jn Records Office for permanent filing.
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Htosya3 Rev 11/200fi COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
PERLANENT" CERTIFICATE OF DEATH
BLACK INK See instructions and exam les on reverse
P ~ STATE FILE NUMBER
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1. Name of Decetlaa (Fast, mkae, last, sueix) 2. Sex 3. Social Becudry Number d. Dale a Death (Mt1Mh, day, year)
Barbara Clarkson Olmstead Female 379 - 16 - 5794 3uly 20, 2008
5. Age (last BinMay) Under I year Under 1 day 6. Date of Blrlh (Monet, day, year) 7. Birthplace (CHy and slate or brei n muary) 8e. Place of peam (Check only one)
Mmms bays Fkxn Minura Hospital: Other'.
August 18 1922 Buffalo NY ^
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Resldence
otner 5peciy
DOA ~Nursirg Home
Inpmient
ERl Outpatient
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Bb. County of Deam Be. City, Boro, Twp. of Death 6tl. Fac+Gry Name pl not inslituHOn, give street and number) 9. Was Decedent of Hispanic Origin? ®XJo ~ Yea 10. Race: Arnakan eMian, Black, Whne, etc.
(n yes, speclty Cuban, (SDeaM
Cumberland Carlisle Chapel Pointe At Carlisle Mezkan,PuedoRican,eta.) White
11, DecedenYS Usual iqn Kind of wok d are dutin most of woMln I'tle. Do rat sdk retired 12. Was Decedent ever in the 13. Decedent's Education (Spedty oMy hghest grade compl eted) td. Mantel Status: Married, Never Marled, 15. SurvMng Spo use (It wife, give maiden name)
Kira al WaM Kind d Busirmss I64ustry U.B. Amled Forces? Elementary! Becontlary (0-12) Collage (i -4 or 5t) W+dawed, Divorced (SpecilN
k r Own Home ^yaa ~'° Widowed
76. De edent's Mailing Address (Street, mY i lave, stale, zip code) DwetlenYa Dkt Oacedent
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Decedent Lived In Twp
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770 S. Hanover St. .
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Township? f7tl,~}Np,DecedentLivadwithin Carlisle
Carlisle PA 17013 t7h.camty Cumberland AdualLimllsol Gnyeaa
1B. Femer's Name (Rrsl, midde, lest, eunix) 19. MamePs Name (Firs(, Nidtlle, marten surname)
Irma Naumann
20a. InlortnanYS Name (Type 1 Pant) 20b. IMomtaM's Mailing Adtlress jSireel. ary I town, slate, Zip code)
1 Y6rkslix•xe Dr, Carlisle PA 17013
21 a. Method a Disposdion ,Cremation ^ Donation 2Ib. Dais of Disposition jMonm, day, year) 21c. Place of Disposition (Name o/cemetery, crematory a Omer place) 21tl. lxation jGiry! town, stale, zip wtle)
p Bad Ramov-enramsrete i
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2008
Jul Hoffman-Roth Funeral Home Carlisle PA 17013
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22n. of FunBrN Serves Lg~nsee acd sucn) 22b. Ucense Number 22c. Name art Atldress of Facility
Hoffman-Roth Funeral Home & Crematory
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Carp( Hems 23e<aNy when ceNh/irq 23a. Te dra hest a my k ,deem ocwrred ai dna, le end place slated. (Signature and title) o
•Llcertta Number
23 23t. Date Signed (Monet, day, year)
MY®rxan is rid aveiMde at time of dmm to 1 ~
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Items 2x26 rmul be completed by person 2<. Time of Deam )
26. ate P
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wuncetl Deed (Monet, day, year 26. Was Casa Refemetl to Medkal Examiner! Coroner for a Reason Other roan Cremation a Donation?
wta pronounces Beam. ~ 8 ! 3 V M. ~
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CAUSE OF DEATH (See InatruMlone and exemplea) , Approximate inierveY. Pan II: Enter artier 6jgnificant cmditiona rairioudne la death, 28. Did Toheao Use Cmtribute le Death?
Hem 27. Pen I: Enter ma mein a evatls -diseases, injuries, a cortglkeUona -that N+easY caused me deem. DO N07 enter terminal events such as erdlac arrest, Onset m Death Md not rasunag In me untlenying cause g'ven m Pan I. ^ Yes ^ Probaby
respireiay artesL a vemncular BbnllaHOn wdhoN showing me &klogY. Liar Drily one cause on each 11re.
Np ^ Unknown
IMMEDIATE CAUSE Rnal dLSease a
aanalkn rasanrng m ,beam) --~ Sc.,P S ~0 ~ (q
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2s. II^Female~
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Due to (or as a consequence ol): _
year
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kst cplMiaro, H any, t.
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^ Na pregnsm, but pregnam wnhm dz days
Enter the UNDERLYING CAUSE
(mdse a injury mat Inaatetl me p of death
i& reeullkg in deem) LAST pyre b (or as a consequence oN' ^ Na pregwrt, b.R pregnant 43 days to t year
before seam
d. ^ Unknown H Dregnanl wBhin me pest year
30e. Was an Auopsy 30b. Were Autopsy RrMirps 31. blamer of Deam 328. Dale 01 Injury (Month, day, year) 32b. Describe Haw Injury Ocanetl 32c. PMCe W Inryry: Home, Fertn, $Ireel, Factory,
Pedomietl'! Aveilede Praa to Complmkn
of Cause d Deem?
~jlaNrel ^ Homicide OHme BuiOirq, etc. 75pealyl
^ ~°~N ^ PeraHng InvestigaHm 32d. lime al Injury 32e. Injury al WoM? 321. H Transporlalkn Inlury (SpeciNl 32g. Location of lnjurY (Street, city! town, state(
^ Yes ICI No
"'l ^ Vas ^ No ^ SuCMe ^ Could Nat ba Delemllned M ^ Yes ^ No ^ Driver /Operator ^ Paeaenger ^Pedeslnen
Deter ~ speay:
33a. Cerhkar (check Doty one) end lisle cf CenHler
33b. Signstp
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• Ce"ityMtg pkryskdan (Physkdan cenitying cause of deem when anaher physkian has prawunced death and completed Item 23) ~
To tIM beat of mY knowledge, da•m atoned due to me ease(s) and manner ea etete~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ \
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• Pronouncing and arNyirtg physlcUn (Pnyskdan both pronour,pnq deem and ce"dying to cause of tleath)
^ 33c. Licerxte Number
• 33tl. le Signetl (Monet, daY, yee0
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Ta ins fleet of mY kMwlatlge, dMlh xaurtM at tM time, dale, and plea, end due b tM ceueajd) art manner es ataled_ _ _ _ _ _ _ _ _ _ _ _
• Medkal EZeminer/Coroner _ TM~ ~ v ` ~ ~ U I (d
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On tM laxsu of naminNion one! or Invastigatlon, In my oplnkn, deem occurtetl at the rime, date, and place, ens due to the cause(s) and nrenrrer ea Metetl_ ^ 3p Name erxi Address of Person Who Completed s0 a aih (deem 2]) Type ! Prml 1
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LAST WILL AND TESTAMENT ~ ~ ~~
OF
BARBARA C. OLMSTEAD ~~~~ ~~~~ ~ ~ ~~ ~' 44
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I, BARBARA C. OLMSTEAD, a legal resident of Cumberland~~ri~ty', ~_`~~~~~~,
Pennsylvania, being of sound and disposing mind, memory, and u~'erstandir~g, do ;
hereby make, publish, and declare this as and for my Last Will and Testament, hereby
revoking all other wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my grave
marker, shall be paid from the assets of my estate as soon as practicable after my
decease.
SECOND: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my
residuary estate as a part of the expense of the administration of my estate.
THIRD: I devise and bequeath the residue of my estate, of every nature and
wherever situate, to my son WILLIAM CLARKSON and my daughter CATHERINE
CLARKSON in equal shares, provided they shat{ survive me. If either of my children
predeceases me then his share shall lapse and my surviving child shall receive that
share.
FOURTH: I nominate, constitute and appoint, JOHN C. OSZUSTOWICZ, ESQ.,
and CATHERINE CLARKSON as Co-Executors of this, my Last Will and Testament. In
the event of the renunciation, death, resignation, or inability to act for any reason
whatsoever of either of them, I nominate, constitute, and appoint ,the other of them to
serve as sole executor of this my Last Will and Testament. I hereby relieve my Executor
or his successor from the necessity of posting security in connection with their duties as
such in any jurisdiction in which they may be called upon to act, insofar as I am able by
law so to do.
^IN~WITNESS WHEREOF, l have hereunto set my hand and seal this ~~day of
U G C~ n, ~.. L.3~ , 2004.
V~ ' r
BARBARA C. OLMSTEAD
... +~
Signed, sealed, published, acknowledged and declared by the above-
named Testatrix, BARBARA C. OLMSTEAD, as and for her Last Wifl and Testament, in
the presence of us, who, at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses thereto.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
I, BARBARA C. OLMSTEAD, Testatrix, who signed the foregoing instrument,
having been duly qualified according to law, acknowledge that I signed and executed the
instrument as my free and voluntary act for the purposes therein contained.
BARBARA C. OLMSTEAD
Sworn to or affirmed and
Acknowledged before me by
BARBARA C. OLMSTEAD, the
e~statrlx, this ~' day
~f 6.e.. / ~-., .2004.
4---~~0 ~ N~^'-~ Notarial Seal
ry Public Tricia D. Naylor, Notary Public
Cazlisle Boro, Cumberland County
My Commission Expires Oct. 2, 2006
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
We, the undersigned witnesses who signed the foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw Testatrix sign
and execute the instrument as her Last Will and Testament; that she signed and
executed it willingly as her free and voluntary act for the purpose therein expressed; that
each of us in her sight and hearing signed the Will as witnesses; that Testatrix is known
to each of us; and that to the best of our knowledge and observation the Testatrix was at
the time of sound mind and under no constraint or undue influence.
`~ ~ l~ fir. =~.~
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Sworn to or affirmed and subscribed
to before me by~tb;. 1Nt. ~.k..,~ t
C.~~i !t i C . Sh,e. f witnesses,
t i _~- day of'~c~, r .2004.
Notarial Seal
Tricia D. Naylor, No[azy Public
Carlisle Boro, Cumberland County
My Commission Expires Oct. 2, 2006