HomeMy WebLinkAbout08-14-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of _ Thelma Nedra Burns
also known as Nedra Burris
Deceased
Petitioner(s), who is/aze 18 yeazs of age or older, apply(ies) for:
(COMPLiETE 'A' or 'B' BELOW.)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the executors
last Will of the Decedent dated May 7, 1991 and codicil(s) dated
named in the
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
Except as iFollows, 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
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; durante minoritate)
Petitioner(s) after a proper seazch has /have ascertained that Decedent left no Will and was survived by the following spouse (if nom) and heirs: (ff
Administration. c. t. a. or d.b.n.c.t.a.. enter date of Will in Section A above and complete list nfheirc.) ~"~ -
Decedent, then 72 years of age, died on February 19, 2008 at 89 autumn Lane, Enola, PA 17025
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 20,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 0.00
situated as follows:
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:
or printed name and residence
Iris L. Rouse, 6625 Wentzville Rd. Enola, PA 17025
COUNTY, PENNSYLVANIA
File Number ~ 1 d () ~ U~ (~
Social Security Number
Fnrm Rw-oz rev. 10.13.06 Page 1 of 2
(COMPL,ETE INALL CASES:) Attach additional sheets if necessary. _ _" :_~ ._ '
_~
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last princilfal residence ate
89 Autumn Lane, Enola, East Pennsboro Township, Cumberland County, PA 17025
(Gist street address, town/city, township, county, state, zip code)
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNT Y OF
SS
The Petitioner(s) above-named swears} 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 ~r affirmed and subscribed
before me the ~ day of
~oU~
For the Register
Signature of Personal
Signature of Personal Representative
Signature of Personal Representative
File Number: o~ , ~ ~ ~ ~ ~ ~
Estate of Thelma Nedra Bums
r'- ~ ~ _.
'1")
- ~" _
~--
_ ~ _r..,
,; -
~- --
_ _
`
- " ,-, ~ -
-.'
_ -~
.7
___ ~
Deceased
Social Secu ~ty Number: ~//®,Q' Date of Death:Febuarv 19, 2008
AND NOW, ` , ofKN , in consideration of the foregoing Petition, satisfactory proof
having, been presented befo me, IT IS DECREED that Letters Tetsamentary
are hereby granted to Iris L. Rouse µ.,,., _
in the above estate
and that the instrument(s) dated May 7, 1991
descrilbed in the Petition be admitted to probate and filed of recc~r~ as the Last Willd(and Codicil(s))pf Decedent.
FEES v
Letters . ~~fQ~~.....
$ Registe of ills
Short Certificate(s) .... ~... $ Attorney Signature:
Renunciation(s) ..........
' . f / ~
~ . • • $
$ ~ J -
Attorney Name: Wa e elnick
yn
n
J G /' ... $ ~ G Supreme Court I.D. No.: 53150
u ... $ ~
Address:
36 S. Hanover St.
... $
. , , $ Carlisle, PA 17013
... $
... $
••• $ Telephone: (717)249-0900
_ ... $
00 .,gip
TOTAL ...
Form. RW-02 rev. /0./3.06 Page 2 of 2
105.80? REV 101/07)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, X6.00
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
Reco~.rdy~s Office for permanent filing.
GG~n- ~ 'l ~ ~= FED 2 Z X008
Local Registrar Date Issued
r~
~:-:
c-~ -
=~
-- ~.~ :
• + /
- ,-:~„
;'-T
~~
~- ,, ~
-
_. ~
y-
-
,,
... _:
::a~
--'
_~
, , `
. lit
C,3
REV teI2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
NANIENTN CERTIFICATE OF DEATH i /^f~~ r'~,}~~Y (~
.CK INK (See Instructions and examples on reverse) STATE FILE NUMBER ~ 1 ~ (J v lJ ~ `~
1. Name d Demtlenl (Rrs6 midde, last, wHix) The 1 ma Nedra Burris 2. Ses 3. Social Securiy Number 4. Date of DeaM (Monts, day, year)
Female 192- 30- 1525 February 19, 2008
5. Age (Last Birthday) UMer 1 ear Under t day 8. Date of BirM (Monts, day, year) 7. BlMpteca (City orb slate a foreign country) Ba. Piece of DeaM (Check only one)
7 2 "r°'"h° Dan Hearn Mimes Hospital: oMar
3/16/35 Enola, PA
Vrs. ^ Inpatient ^ ER I Outpatient ^ DOA ^ Nursing Herne []Residence ^OMer -Sperry:
_
fib. County o/ Death &. City, Born, Twp. of Deets Bd. FedNly Name (K rid instltudan, give sheet and numbs) 9. Wes Decedent d Hispanic Origin? [~ No ^ Yes 10. Race: Americanylndian, Black, While, etc.
(It yes. 9pecM/ Cuban, (~~ Wh l t e
Cumberland East Pennsboro 89 Autumn Ln. McXkan, Puerto Rican, etc.)
11. Decedent's Usual tbn Kind d work done d ~ roast of ~ I"de. Do not smte retir 12. Was Decedent ever in the 13. Decedents Education (Spedfy only highest grade comptelea) t4. Mantel Status: Martied, Never Marded, B B. Surviving Spouse (If wile, give maiden name)
Oivorcetl (Speciry)
Wklowed
Kits d Wak Kind d Business I Irdusay ,
U.S. Armed Forms?
Elementary / SecoMary (0.12) College lid or Sr)
Clerk Penn Dot ^Ye9 [~eo U NK Sin le
- is. Decedents Mooing Address (StraeL dy/town. stale, zip cede) Decedents Did Decedent
p,p,d,m Livetl in East Pennsboro Twp
PenriSylVanla Live ina t7c
®y„
89 Autumn Ln ,
,
qu,,,d fl89 176 Slate
Township?
Decedent Lived within
17d
^ No
Enola, PA 1 7025 .
,
tm. Ca~Da Cumberland
ACtud limns d Ciry /Bad
18. Faewr's Name (Fuel, mNdte, last, suffix)
Oliver W. Burris 19. Mortar's Name (RrsL midde, maitlen surname)
Dessie S. Eslinger
20a. Informant's Name (iygt / Pant)
Iris L. Rouse 2~. Inlamants MeiBrp Addess ISheal, dry /faun, stele. rip cotlel
6625 Wertzville Rd. Enola, PA 17025
21a. Method d Diaposiom ~ ®Crertladon ^ Daregon 21b. Date d Dispoellia (Marts, der, fear) 21a Place d DlsPosiBon (Name d cemetery, aemetay a odler place) 210. Laadon ICM / tarn, state, zip code)
^ Burial ^ RemovaliromStete ~w
2/21 /08 Evans Cremation Service Leola, PA
S°d®Y
^N
E
mM
es
a
x.
x
lbd
^ other - spedN: °'/
.- 22e. signature d wrierel fsarvica ' Sea (a.Qerson a9 alien ' 22b. License Number 22c. Name and Address d FadN'ty S u i va n F line r a Home
PA 17025
l
E
l
D
'~ /
no
r.
a,
FD014993 51 N. Eno
a
~
Complete Items ~~ti any when mrtirying 23a To Me best d my knowledge, deah occuned at Me lima, date art place stetetl. (SigmMe antl Bile) 23b. License Number
• 23c. Date Signed (Monts, day, year)
physidan is rid aOaBable at time of dots to
mrnly muse of tleaM.
Items 21-ZB must be canpleled DY person 24. Time d Deets AA!!
' 28. Date P
ced Dead (Monts, day, Year~)1
OUln
r~on
~
~ 26. Wes Case Relenetl to Mediml Examiner /Coroner to a Reason Oher than Cremenon or Donation?
^ Ye9 ^ No
- wMO laaauima tleaM. l.'l.) M.
J J ~
L
A
i 9. 01 dQ
r 1. CJ•~ll~/;
CAUSE OF DEATH (See inatructlons and examples) r Approxmiate Imerval:
Item 27. Pan I: Enter Me ghan d evams -diseases, injuries, a mmpRm6ons-Mal drectly mueed he tleaM. DO N0T erne termMel events such as mmiec arrest, ~ poser W DeaM Pan 11: Enter other w K I axrd'Aixu; coots akv+to tleaM,
Wt not resdang M Iha underiyag muse given M Pan I. 2e. Did Tobacco Use CaanbNe to DeaM?
^ Yes ^ Prooeay
~!
/
respirarory rarest. a ventMUter flbriBaaon wMM ahowi5 itro efioiogY. List ody one cause on e9cn ina. i ^ No
n
WMEDUiE CAUSE Rriel disease a
cmdBion resuning m r~h)
n't l7 O G
~~ ~
/
/I
Yr / 29. II Fen
nant
ithin
ast
ear
Nd
_~ a.
s
y~.
-
Ci preg
w
p
y
Due to (or as a mnsequavre of):
r
^ Pregnant at tlme of tleaM
hh r
dli
s
it an
l Itet
ti
m
,
mn
Sequen
a
y, b.
~
kadng ro tlra muse Bated on One a. ^ Nd pregnant, bM pregnant wi1Nn 12 days
Due to (or as a consequence op:
Enter Me UNDERLYMG CAUSE
~
(disease or iqury Mal ini8aud Me of tleaM
o,
eveMS resulkng in tleaM) LAST. ^ Not pregnant, out pregnant a3 mys to t year
Due to (or as a consequence op: ~
r oeWa death
^ Unknown 11 pegnam within Me pest year
d
30a. Was an Aulopay 31b. Were Avbpsy Findngs 31. Ma eM 32a. Date d Inryry (Math, day, Yeart 32b. Describe How kqury Ocwned 32c. Plain d Injury: Hasa, Farm, Street, Faaory,
Ogwe Buikeng, ek. (Speciy)
Penamed? Available Prier Ic Corrldetla NaW~ ^ Horriidtle
d Cause d DeaM?
^ Acpdant ^ Pendng ImesBgetan
32d. Tme d Injury
32e. Injury at Wak?
321. M Trenspartetbn Injrry (Specify)
32g. Location al Inryry (Street, oily 1 town, state)
^ Ves No ^ Yes ^ No ^ Suiade ^ CouU Nd be Delemkned ^ Yes ^ Na ^ Driver I Operela ^ Passenger ^PedesMan
M. goer - Spery:
330. Sigmture art Title of CerBBer
33a. CerBfia (mark Dory aye)
d It
m 23)
d
l
t
tl
M ~/
~ ~~ F~
7
.
mrrip
e
e
e
ea
an
• Cerdrl'M9 phyakien (physidan cediMn9 muse d tleaM when aratller phyakian nes Waaaed
_ _ _ _ _.
nner a ahtea
d
h L
~
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
e mrtse(s) an
nw
To Me heat d rml grossledga, rleatll awned due to t
• PraauaMg oral undying physklen (Physidan bath prarorsidng tleaM and cenllying to muee d tleaM)
^ Nanber
33c. Um
ns
e 33d. Date Signed (Month. ,Year
To the Wst d m',f knonled94 desM atoned a/ tlis tlme, dNa, arts pteu, arts due to Uw uuea(s) and memsr n stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ /' , yy. l 2' ~ ~/
p
~
y
7
Y" ~"~ Z /
• Medesl ExemiMa/COraer
On the hole d nxaminatfon and I or Invas6getlon, in mY oplrNa, death occuned N the Bme, date, and place, end duo to Me cause(s) and manner as stataL ^ 3y. Name as Addre>~ N~ ~~~ Cause9yj bath (Item 27) Typa I Pnn~ ,v ~ ~`l~
11'
~'7°/Jy /f
J o
~.~Z /G
36 b r' igna - i I .~(~~ ~ l~ i / ~ ` ~ 38. Date (Mal y~~earr)p~
~ ~W 0 ~/
/J
/
."-( /~.ri 6i/"IJ uJ
r,,..~a,~~ a.~a Mn O C7 7 y D `f ~
burris.wl
5/7/91(jaz)
WILL
I, THELMA NEDRA BURRIS, also known as NEDRA BURRIS, of Enola,
Cumberland County, Pennsylvania, revoke my prior wills and declare
this to be my last will:
ITEi+I I. I direct my executor hereinafter named to pay all
inheritance taxes, funeral expenses, and just debts as soon as
convenient . c-> t. ,
__
r~ ~: ;
,:~
,_, .__._
~_, ~.__
_;..._ ,,
ITEM II. I give to LISA C. ROUSE all my bonds in assafe=~
deposit box at the Dauphin Deposit Bank and Trust Comp~7~`al~~the
_a.
sums in my Checking Account at the Dauphin Deposit Bar33~ and 7?~ust "
cj.J
Company, and all the sums in all savings accounts that I may have
at the Pennsylvania State Employes Credit Union, less net of
inheritance tax due as a result of my death, together with my "old
doll" received from my natural mother.
ITEM III. I give to my nieces, LOVEEN H. HARGLEROAD, HEATHER L.
HARGLEROAD, SHANNON L. HARGLEROAD, my crafts and yarn, to divide
among themselves as they decide.
ITEM IV. I give to my nieces, TWILA HAWBAKER and CHERI
HAWBAKER, my ceramic dog collection, to divide amongst them as
they may decide.
Page 1 of 5 Pages.
burris.wl
5/7/91(jaz)
ITEM V. I give to my niece, SARA HARTMAN, my diamond pierced
stud earrings and my stuffed plush animal collection.
ITEM VI. I give to HELEN McCABE, a/k/a KAY McCABE, my black
onyx ring and my black onyx pin which she had given to me as a gift.
ITEM VII. I give the residue of my estate, real and personal,
in equal shares to MARTIN ROUSE and MARK HAWBAKER to divide among
them as they may agree, or in the absence of agreement, as my
executor may think appropriate. However, articles which my executor
considers unsuitable for MARTIN ROUSE or MARK HAWBAKER may be
sold. The share of any beneficiary under this residuary clause
who predeceases me or dies on or before the thirtieth day following
my death shall be distributed to his or her issue per stirpes
living on the thirty-first day following my death and in default
of any such then-living issue such shares shall be added to the
share of the other beneficiary under this residuary clause. My
executor may, without further responsibility, distribute property
passing to a minor under this article to the minor or to any person
to hold for the minor.
ITEM VIII. No interest in income or principal shall be
assignable by, or available to anyone having a claim against, a
beneficiary before actual payment to the beneficiary.
Page 2 of 5 Pages.
burris.wl
5/7/91(jaz)
ITEM IX. All federal, state, and other death taxes payable
on the property forming my gross estate for tax purposes, whether
or not it passes under this will, shall be paid out of the principal
sums of my checking account at the Dauphin Deposit Bank and Trust
Company and/or the sums in my savings accounts at the Pennsylvania
State Employes Credit Union.
ITEM X. I authorize my executor:
A. To retain and to invest in all forms of real and
personal property, regardless of (i) any limitations imposed by law
on investments by executors or trustees, (ii) any principle of law
concerning delegation of investment responsibility by executors or
trustees, or (iii) any principle of law concerning investment
diversification.
B. To compromise claims and to abandon any property
which, in my executor's opinion, is of little or no value;
C. To borrow from and to sell property to others,
including my beneficiaries hereunder, and to pledge property as
security for repayment of any funds borrowed;
D. To sell at public or private sale, to exchange or
to lease for any period of time, any real or personal property,
and to give options for sales or leases;
E. To join in any merger, reorganization, voting-trust
Page 3 of 5 Pages.
burris.wl
5/7/91(jaz)
plan or other concerted action of security holders, and to delegate
discretionary duties with respect thereto;
F. To use administrative or other expenses of my estate
as income tax or estate tax deductions and to value my estate for
tax purposes by any optional method permitted by the law in force
when I die, without requiring adjustments between income and
principal for any resulting effect on income or estate taxes; and
G. To distribute IN KIND and to allocate specific
assets among the beneficiaries in such proportions as my executor
may think best, so long as the total market value of any
beneficiary's share is not affected by such allocation.
These authorities shall extend to all real and personal
property at any time held by my executor or my trustee and shall
continue in full force until the actual distribution of all such
property.
All powers, authorities, and discretion granted by this will
shall be in addition to those granted by law and shall be exercisable
without leave of court.
ITEM XI. I appoint IRIS ROUSE executor of this will. Should
IRIS ROUSE fail to qualify or cease to act as executor, I appoint
MARTIN ROUSE executor under this will. No personal representative
appointed hereunder shall be required to give bond or furnish
sureties in any jurisdiction.
Page 4 of 5 Pages.
burris.wl
5/7/91(jaz)
ITEM XII. The term "executor" and "trustee" or any pronoun
used to indicate the executor, trustee, any other fiduciary or any
beneficiary shall be deemed to apply to one or more than one person
or corporation and to the masculine, feminine or neuter gender as
the case may be.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my last will, this ~ day of MAY, 1991.
/~~
tf1.~Ut'vL.c~v ' (SEAL)
THELMA NEDRA~ BURRIS, a/k/a
~7 ~ .~ w ~~ , h"I / ! Iii ~. ~ ' ( SEAL)
NEDRA BURRI
SIGNED, SEALED, PUBLISHED, and DECLARED by the above testatrix,
as and for her last will, in the presence of us, who thereupon at
her request, in her presence and in the presence of each other, have
hereunto subscribed our names as witnesses.
~~~
x~ J ~ c~,, ~~_
Page 5 of 5 Pages.
burris.wl
5/7/91(jaz)
STATE OF PENNSYLVANIA
COUNTY OF DAUPHIN
ss:
We, THELMA NEDRA BURRIS, a/k/a NEDRA BURRIS,
XfI ~ ~/~ • ~L:_ we o m f ~. , and ~ /~ N G v C. A ~ L ~ % i fi , the testatrix
and wi nesses, respectively, whose names are signed to the attached
or 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 our knowledge, the testatrix was at that
time eighteen years of age or older, of sound mind and under no
constraint or undue influence.
THELMA NEDRA BURRIS, a/k/a
NE RA URRIS
Witnes
/C
~~.-weal ~ ~ ~~ u~a
Witne
SUBSCRIBED, sworn to or affirmed, and acknowledged before me
by the above-named testatrix and by the witnesses whose names appear
above on ~'~c~ , 1991.
I
o ry P lic
NoG=iial Seal
Pauline 'aiti 'i hcm:~s, Notary PubNc
~(ar1lSbUrg, ~atcpilln COUnty
My Commission Expires April 15,1995
Member, Pennsylvaraa Associ2~ori of Notaries