HomeMy WebLinkAbout08-14-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA
Estate of William R. Carlisle. Sr.
also known as
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETEE 'A' OR 'B' BELOW.)
File Number ~ ~ ~ ~ ~ ~ ~~
,Deceased Social Security Number
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EXeCUtrlX named in the
last Will of the Decedent dated 2/3/1994 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: NONE
B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lice; durante absentia, durante miuoritate)
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. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Decedent, then 85 years of age, died on 7/18/2008 at Thornwald Home
442 Walnut Bottom Road Carlisle PA 17013
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:
$ 55.000.00
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:
C Signature ' ° ~, Typed or printed name and residence
Sandra K. Carlisle
751 Old Silver S rin Road Mechanicsbur PA 17055
Page 1 of 2
Form RW-O2 rev. 10.13.06
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. r'~ ~ ~.
Q
Decedent was domiciled at d erland County, Pennsylvania, with his /her last principal residenceat
442 Walnut Bottom Road Carlisle PA 17013 Carlisle Borough
(List street address, town/city, township, county, state, zip code)
Oath of Personal Representative
COMMO:vWEALTH 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) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
f-
be€~re me, the ~ ~ day of
~~
~1 For the Register
~gnature of Personal tRepresentative ~~ e
-; O ~,
i -~ _ ~
Signature of Personal Representative ~ n E• '
=t' i C7
~7 ~
`
.s ~
Signature of Personal Representative -; j r
~"
_
:
~
_
_~ ~
,-
File Number: ~ ~ ~ b~~B
Estate of William R. Carlisle. Sr. ,Deceased
Social Securit Date of Death: 7/18/2008
AND NOW, ~ ;~, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that LettersTestamentary
are hereby granted to Sandra K. Carlisle
in the above estate
and that t:he instrument(s) dated 2/3/1994
described in the Petition be admitted to probate and filed of record as the last Wilh (and CodicilO) of Decedent.
FEES
Letters ........~...E.4~.~...... $
Short Certificate(s) ••••~•••• $ ~~
Renunciation(s) •••••••••••••••• $
l,~ ~~ll .... $ ~`~
-~~ ' .... $ 10
.... $
.... $
.... $
.... $
.... $
.... $
TOTAL ............................. $ I ~`~
Register
Attorney Signature:
Attorney Name: David H. Stone. Esquire
Supreme Court I.D. No.: 39785
Address: 414 Bridge Street
New Cumberland
PA 17070
Telephone: 717-774-7435
Form RW-02 rev. l0. [3.06 Page 2 Of 2
105.905MS RE V. 6/0G
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act G6, P.L. 304, approved by the General Assembly, June 29, 1953.
Military
Status
H106-143 REV 11(2006
TYPE /PRINT IN
PERMANEM
BLACK INK
2~
~'
J
rc
WARNING: It is illegal to duplicate this copy by photostat or photograph.
.~
Calvin B. Johnson, M.D., M.P.H. Frank Yeropoli
Secretary of Health State Registrar
14 8 J 811 AUG 0 7 2D08
No.
Date
F DEATH
(See instructions and examples on reverse) ~r,.~ ~„ ~ ,,,,,,ono (`) \ nQ (~ d.2 Gk
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE O
1. Name of Decedent (FIrsI, middle, last, suRa)
Cam :. \
2. Sex
v.~
3. Social Security Number
o~ - c~3-b4`~ V
4. Date of Death (Month, tlay, year)
-~ - 8-
5. Age (Last Birthday) UMa 1 year Untler 1 tla 6. Date of Birth (Month, tlay, year) ]. Bldhplace (City and state or for eign country) fi e. Place of Death (Check only orle)
4 _
~' Months Days Haurz out J ')y1,
y
3 y (~~ (,~yya•~~/x `~ ~ Hospital: Olhel:
j/
Yrs. O(
`~ 3 r l,li1 1 IS Iles; ~_ ^ Inpatient ^ ER I Outpatient ^ DOA Nursing Home ^ Resitlen~ ^Olhar- Specify.
eb. County cl Death 8 ily, o, Twp. of Death 6d. Facility Name (If not institution, give shoal and number) 9. Was Decedem of Hispanic Origin? ~NO ^ Yes 10. Pace: American Indian, Black, White, etc.
Q (u yes, opacity Cuban (speciry)
(
i.D i1 C ~.
~-
V1~6-~t°J~ n,ex;ca-.?uetloRiwn,exl (.A=~\ \
11. Decedent's Usual Occu lion Kind of work done Burin most of workin tile. Do not stale retired 12. Was Decetlent ever in the 13. Decetlenl's Etlucation (Specity only hghesi grade completed) f4. Marital Status: Mauled, Never Mamietl, 15. Surviving Spouse (II wife, give maitlen name)
qIW of Work
Kind of Business / Intlustry ido
w
ed
.
DNOmed ($pecilyj
W
115. Armetl Faces? Elememary / Secontlary (P12) College (td or 6a)
rr''
1~ ~ K ~
/
_~
~~
/~
~
es
^NO WkIXO ~~
16. Decetlenl:'s Mailing AtlJpress r /t cRy I torn, state, zip cetle)
~SI DIQ ~i
~~S r) Decedent's
Did Decedent
Actual Resitlence 17a. Slate Live ins 17c.~Yes, Decetlent L'wetl in Z1 •~- /P~~~rrt~ Tory
/1/
~ /Yes' / Townshp? 17d
^ Ne
Decedent Lived wimin
[ yG - u D
r~/s .
,
1]b. county ( Aduel limits of CI /BOro
N
18. Fath 's IJame (Firsi midde, last, udix)
C,4~--I r ~ 19. Mdher§ Name (First, middle, maitlen sulpame) n ~~
r~el~ a
20a. Informs 's N me (Type / Print)
~ 20b. Informants Maaing Atldress (Street .city /town, stela, rip wtla)
'
rc~- r
~ :S
r r r> h Gf l~G ~ ICS u ~ 7ci~v
21 a. Mathotl of DisposNpn ~ ^ Cremation ^ Donaapn
~
--
~
r 27b. Dale 01 Disposition (Month, tlay, year) 21c. Place of Disposition Name mete amatory other pace) 21 d. Location (Chy /lows, stale, zip cpde)
Burial ^ Removal ham SYele 'Was Crartlellan or Donstlan Adhorizad
~
C
,j
^ QMer ~ S 11 by Metlleel Examiner / CoronaY! ^Ves ^ N°
' Z H ~~ ~ + ,,~ ' ^ ~ j
.J--I '~ 1 ~'s'M ~ ~ .Q ~JQ~T r ~p
/i( ~ V r (~ 2 ~ i766
22a. S' rf of F nerd Sernce Licans ~^
~ YID. License Number 22c. Name ant Addre of Facility
p
/ /
~
S~
~
~
~
L%
- ~ LZ 2 - wr~ 3~0;
-r
arr
;~/ ~n~~`s..
.,~rrrs
k
~
~c. l7r I
C to Items 23ec only canto ce ' rg To t my letlge, death occurred at the time, tlete artl pace statetl. (Signature and tale) 23b. License Nu bar 23t. Date Signatl (Month, day, year)
pnyvtian rs nM available al time of death Io _ n
sedgy ca se nl tleeth. / / V d
Items 24-26 must be canpletetl oY person .Time of DeaM 26. Date Pronauncetl etl (Month, tlay, year) 26. Was Case Refarretl b Medical Examiner /Coroner for a Reason omen than Cremation or Donation?
who pranourxes dMth. Z M ~ ^Ves No
` ~
CAUSE OF DEATH (Sea Inatruetlons end era lea) , Approximate interval: Pad II: Enter otllar 9gdfinnt mrWeions eodid~~aind to death 26. Did TobacW Use Caddbute m DeaUa
Item 2). Part I. Enter me chain of eeenle - dismses, in~udes, or cpmgicadpns -that directly caused Me death. DO NOT enmr terminal events such az araaz arrest. Oreet to Death but not resulting in me uMerlyllg Huse given In Pan I. ^Ves ^ Probady
respiremry anesl. w ventrkWar fEMpdon without showing the efabgy. List only one cause on each line.
'
^ No Unknown
IMMEDIATE PAUSE IFinal
tllsease or ~('~
coMltion revelling in death) _' ~ S 1~ J ~ V h~a1.
a.
29. b Female:
Due to (or as a consequence o0: ^ Not pregnant wNNn pssl year
Sequentially list cpnations, d any, b.
ketln9lo me cause 491e0 on Yoe e ^ Pregnant aI time d death
. pus to or az a mm
SE ( equence °~:
Enter the UNUEgLY1N0 C
A
U Not 1
^ pregnan ,but pregnant within 42 days
~
?
~
( e~ rasutllhg m Oele~thlew"Ae p d tleeth
Due to (or es a Wnsequence ot): ^ Not pregnant, bd pregnant 43 tlays to 1 year
d. betas tleam
^ Unklwvm if Dr¢gnanl within the Past year
30a. Waz an IWlopsy 30b. Were Adopsy Findings 31. Manner of Death ffie. Date of Injury (Month, day, year) 32b. Describe How Injury Occuned 32c. Place d Injury: Hone, Farm, STreel, Factory,
Performed? Available Prior to Comgetlan ~Nelurel ^ H
i
id Office Building, etc. (Specify)
M Cause d DeeN? om
c
e
^ Ves '~~Na ^ Yes ^ No ^ Acctitlenl ^ PeMing Investigation 32d. Time of Injury 32e. Injury at Work? 321. II Trenspodation Injury (Spe,aty) 32g. Leaflet of InNN (Street, cdy I town, slate)
^ Sulcitle ^ Coultl Nat M Detemline0 ^ Yes ^ No ^ Driver! Operator ^ Passenger ^Pedeslnan
M ^Olher -Specify:
33a. Cenifler ichecN only one) 33b. Slgnel
y~
antl Title of Ceref'
• Cedxying physician IPhysiaan caNfpng cause of tleeth when another physician has prorrouncetl tleeth ant comoleted Item 23! (
~
`yam ~ ~- Y
~ _
t
To the beat of mY kmwlstlge, rleath occurred clue to the eauee(e) acct manner as staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,
i
Prollouncin d cacti Ph siclen both
• g an tying physician ( y Dmnouncing tleeth end ceMty'mg to cause d tleeth)
To tlse Mal of my krlowkdge, death occurred at me time, Bete, and pace, and due to Me cause(s) and manner es staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
33c. License Number 33tl. Date Signed (Mundt, tla1~, y'ar)
1
``
a
• Metllul Exemlrrer/Coroner ~~
~ ~ ~ 1
J V `h ~ J ~O O
` l!
On the basis d examination antl / or Invesligati in my opinion, tleeth ocwrred et 1M time, date, end place, end tlue tome cauae(e) end manner as sWled_ ^ '
34. Name and Atldress d Person Who Gomq to Cause of Deatn (Item 2]) Type / P
~'~ ~
e~
~
Re
islrer'~
n
DI
S:
H N
36
D
l
Rl
tl
M
h
tl ~t o ~~ O ,
~
4
2h Scdur--
g
a
g
a a
S
u ~I~ I ~ I ~ I ~
k .
a
e
e
(
ont
,
ay, year)
~~-
A~
CZ~'+'J1
a
'
°
-
: ~t.
~ WZ~.h
.
5otilrr
A
Disposition Permit No. ~./~ ~G ~ ~'~^ DC./{„/
r-
c~ ~~
~~
T C-«-
//
I
-
} ~
~
~. ~ _ _ .
r
:
)
- ~
J
I
~~ ~
'
ma
,
y
r~
~~~~ i~~. ~~~x ~~~~~~~e~~
~____~
~:
-~
OF ~~ ~~~
<.~; ~, .
WILLIAM R. CARLISLE, SR. ~-
I, WILLIAM R. CARLISLE, SR., of Dauphin County, Pennsy~'~ania
- c.~:
declare this to be my Last Will and Testament hereby revoking alr~
prior Wills and Codicils.
ITEM I . I direct that the expenses of my last i 1 lness and
funeral be paid from my estate as soon as practicable after my
death.
ITEM II. I give, devise and bequeath my residence at 6320
Blue Ridge Avenue, Harrisburg, Pennsylvania to my children, WILLIAM
R. CARLISLE, JR., SANDRA K. CARLISLE, JOHN W. CARLISLE, ROBERT A.
CARLISLE AND CONSTANCE S. NORTON, in equal shares.
ITEM III. I direct that my son, ROBERT A. CARLISLE be given
the option to purchase the residence at 6320 Blue Ridge Avenue,
Harrisburg, Pennsylvania. If he declines or fails to exercise said
option, I direct that said residence be sold at public or private
sale, with the proceeds therefrom distributed among my children in
equal shares.
ITEM IV. All the rest, residue and remainder of my estate of
whatever nature and wherever situate, I hereby give and bequeath to
my children WILLIAM R. CARLISLE, JR., SANDRA K. CARLISLE, JOHN W.
CARLISLE, ROBERT A. CARLISLE AND CONSTANCE S. NORTON in equal
shares.
ITEM V. Should none of my children survive me, I give,
devise and bequath all of my estate of whatever nature and wherever
situate to my surviving grand children, in equal shares.
ITEM VI. I nominate and appoint my daughter, SANDRA K.
CARLISLE, as Executrix of my estate. Should my daughter fail to
qualify or cease to act as Executrix, I nominate and appoint my
son, ROBERT A. CARLISLE, as Executor of my estate.
ITEM IX. I direct that my Executrix, heir successor shall not
be required to give bond for the faithful performance of their
duties in any jurisdiction.
ITEM X. I direct that all taxes due at my death or as a
consequence of my death shall be paid from my residuary
estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
~> ~ ~.
the ~ day o f --c t.~- ,.,,L ~ ti .., ~ 19 9 4 .
W I Lys, I A R. ~ARL~-,S L E, S R.
`--~W I TNE~'
/ ~/ ` ''t
WITNESS ,.-~`''
r~"`
._
.,~
_...
-.
,G~ ..
"1 ---''° ~ :-
r'`~ATTORNEY ~`~~~ ~~
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
,- ~
We G . ~,
c
~~~1C~n o~ ~ ~ _ c~c_.~r~:..,. t'e _ a ,tip--+ __~ C~(\c~cs.r'~~ ~ r ~-- t he
testatrix and witnesses, respectively, whose names are signed to
the forgoing instrument, being first duly sworn, do hereby declare
that the testatrix signed and executed the instrument as his Last
Will and that he had signed willingly, and that he executed it as
his 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 the
witnesses' knowledge, the testatrix was at the time eighteen years
of age or older, of sound mind and under no constraint or undue
influence.
WILLIAM R. CARLISLE, SR.
~ ~ ;. -~
,,~ ~ ,j.
L/
'Slq ,v. /'Y1Oc:~1FQ ,~ k~cL ~ l ,i
WITNESS WITNESS ~ _ `~
519 North Mountain Road
P.O. Box 6656.
Harrisburg, PA 1711
~~`~ ~-
On this, the ~ day of ~~ ~~-t.u~~ 19~~y
before a Notary Public, the undersigned officer, personally
appeared, Robert B. MacIntyre, Esquire, known. to me or
satisfactorily proven to be a member of the Bar of the Supreme
Court of Pennsylvania, and certified that he was personally present
when the foregoing acknowledgement and affidavit were signed by the
testatrix and witnesses.
IN WITNESS WHEREOF, I have hereunto set my hand and official
seal.
;`
rz~...~
NOTARY PUBLIC
AiOTAf;,~t! S~r,L
IANA L. DAV;S i'dotary°;;~~~~'~
Harrisburg, Daap;,E~~ ~:~_;>y
My Commission ExpireJarj. 5,~:;~a
OATH OF SUBSCRIBING WITNESSES}
C7
=- C.~
REGISTER OF WILLS r' ~ ~-~
CUMBERLAND COUNTY, PENNSYLVANIA `"' i;++:~
';
`~-~
~, '=+
Estate of WILLIAM R. CARLISLE, SR. ,Deceased
MARION E. MacINTYRE and ROBERT B. MacINTYRE , (each} a subscribing witness to
(Print Name/s)
the ~ Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, deposes} and
say(s) that they were present and saw the above Testator sign the same
and that they signed the same and that they signed as a witness at the request of
the Testator in his presence and in the presence of each other,,
(Signature)
(StrYpi Addrer~J
IC'i1c, .Sutlr. lip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
~,
~_
E i ~r
;,
.~
r
Y
..
($rgnatureJ
i~~`5(c0 C'c~rn~l~ Kcs~~~
(Street Addrea~J
~v,,-~~°s~o~r~ , ~~ t-1 lta
jCiq~, Stale, Zip)
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this ~ day
of _;~ ,
COMMONWEALTH OF P.ENNSYLV/1t
Notarial Seal
Shelby A. Nelson, Notary PubNc
Lower Albn Twp., Cumberland County
My Commission Expiroa Auy. 20, 200Y
Member, Pennsylvania Association of No!'
(Signature and Seal oC Notary or other otliciaf yualified to
administer oaths. Show date of expiration oC Notary's ('ommis.~inn.l
~,
`'' ~,~~,
Notary Publ c
My Commission Expires:
NC17E. 'rn ~ taken tty Ofl"leer authorised to administer oaths. Please have present the original or copy of instrument{s} at rime oS notarization.
IirrnrR{f'-0~ rer 10.(3116
c
C~ "~:
-~
~~. ~., _-
1~E~1ST~R OP WILLS
GIJMI~ERLANI~ ~9LJNTY, P~NNSYLV,r~NlA ,~-,
_ - ~ c~
estate of W1LLlAM ~. ~aARL1SLP, SIZ. _ _ ____-_ _ - ,Accessed
M~-RI4N ~. Mac1~iTY~ and ~(~>~EI~T ~. MacINTYR~ , (each) a subscribing witness to
(prirol Nlrrnu/s)
the ®Wilt ^ ~odici!(s) prellented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that they were pxesent and saw the above Testator sign the same
and that th®y signed thv same and that they signed as a witness at the request of
the Testator in his presence and in the presence of each other.
(S1RnrorurYl
l,S'IrPel Addre.+,r)
Rx~cut~d !n Rtgister's Q~tce
Sworn to or afiirmod and subscribed
before me this day
of ,
peputy for Register of Wills
(.Si~roalroreJ p
l~rrfftr AddrraaJ
(~'ip~, ~+alv, zip)
Rx~+cut~d opt of Rt,~~ster's O,/Jrtce
Sworn to or affirmed and subscribed
before me this ! 5~'" day
,., ~ n ~. n
Notary Public
My commission expires: Rpr~ ~ (~ rZba~
(si~aturt anA stet of Nots+~ or other a(tlcial qustitleQ t<+
aciminittor osthe, show Arta of tzpiratian of Notary's Cammietifln.)
NC?TF=: To bt taktn by !)tllcbr wuthorixed u+ adminir~ter t>mthF. Pltart Mave prtwnt Iht arisituti or copy of (nRlrumont(e) at time of nottrixutinn.
Fnrni Rli'~rN re+. ((J.13.(1h
NWEALT'H OF PENNSYLY
Notarial Seal
tl0foheNe S.1N~otspl, Notary Publicity
Mir Commbsion Ex~w~BC 200
Member Pennsylvania Association of Notaries