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HomeMy WebLinkAbout08-20-08PETITION FOR PROBATE AND1GRANT OF LETTERS REGISTER OF WILLS OF ~V >'» 6~1ctn G~' COUNTY, PENNSYLVANIA Estate of (~~ ~ ! ! / ~' H'- (J/~ re. ~ X14 Sr' File Number ~! - t/ U ~ D b also known as ' Deceased Social Security Number 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 TestaTentary and aver that Petitioner(l) is /are-the ~ X'eG'G{ ~~ named in the last Will of the Decedent dated. /a~d5 L 7a and codicil(sl dated I _. ~ _ y~ ~ 0 ~~, -f'h,L Lrts t fA.? t'I l fh eM r-ct wt p ~.~t ^(-I o n ~ Q g ~ ~ ~ti fo (' _ - (State relevant circumstances, e.g., renunciation, death of executor, etc.J 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: h,` !>: Q C.Y ^ B. Grant of Letters of Administration ~`j -~ 2~. (lJapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendenre lire; durance absentia; Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following sp Administration, c. t. a. ord. b. n. c. r. a., enter date of Will in Section A above and complete list of heirs.) Name ik~o~itate) ~) r_.._ r`n ` ` ', ,:~~any)~y~i d heirk~_(If~_i C.~' t _> _,..r ~ (COMPLETE INALL CASES:) Attac/t~~attdditiotta[ sheets if necessary. D cedent was domiciled death in ~Gt m ~ Q.t-'Q~n County Pen s lv with his /her last pr'n ' al residence at f o Nom- ~ are,., I- sle h-i t w (Listsh•eet nddress, towidcity, township, county, s ate, zip code) /~~Syy VQn t a- rt / ~J r l Q J Decedent, then ~_ years of age, died on a` at ~ ~~ `'t ~ ~O ~ `Q~~ ~~ 1'~.. ~ ~ Q-'r! l~^j 6 e-1 ~ Decedent at death owned property with estimated values as follows: rn~ // (If domiciled in PA) All personal property $ pL Cp t ~ a~ (If not domiciled in PA) Persona] property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows:. ~a~~ Sa~t'~4S t2Cemuv.T C.~~ Mo~e~ ~'rlttt'~e~~Cd~n~~ C~\2en1S D~k Form RW-0? rer~. lo.t3.o6 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 COMIviONWEALTH OF PENNSYLVANIA // / SS COUNTY OF ~ Jh2 D ~` R'~~ 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 before me the (J~ ~ day of For egister Signature ojPersonal Representative Signature of Personal Representative Signature ojPersonal Representative ~~ ~ .. ~1~/ IV File Number: ~ ~ Estate of ~ 1,~ ~ ~ ~~ ~~ fie- ~~ `1 S` ' ,Deceased Social Security Number: ~,=. Date of Death: J V ~ ~g.~ ~d© AND NOW, '" having been presented befor m I IS are hereby granted to and that the instrument(s) dated described in the Petition be admitted to that - r.; C7 -z~ m "'~ '~~ ~ G`~ t..;~ ._ _z=~ Pd O lJ J ~~ -] ,-., ~~ -O >C -T' ~_. ,; _ F- r- - consideration of the foregoing Petition, satisfactory proof in the above estate ~_-' -_ and filed of recor as the last Will (an~ Codicil(s)) of D cedent. FEES p~ W Register of Wills 7 Letters ............... $ Short Certificate(s) ........ $ ~ Ren nciation(s) .......... $__~ ... $ ... $ ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ Attorney Signature: Attorney Name: Supreme Court LD. No.: Address: Telephone: Form RW-OZ rev. 10.13.Oh Page 2 of 2 IOs cos Rr_v roun;~ ~ LOCAL REGISTRAR'S CERTIFICATION OF DEA•TM WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 1454179 Certification Number This is to certify that the information here given is correctly copied from an on ginal Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwa~•ded to the State Vital Records Office for permanent filing. :~ Local Registrar Date Issued ~~ ~" : O ~~ _ ~~ a~- - :, --t =U r-_ G> >., ~ - - ~~ ~ . ~ ~'j ~~ ~ tV REV 112008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS PRC7T IN ~+~ CERTIFICATE OF DEATH cN lNlc (See instructions and examples on reverse) STATE FILE NUMBER 1. Name d DedederN (RreL nidEk. leaf, aAfix) 2. Sae 3. SadN Sewrily NunMr d. Date d Deem (Monet. day, yeerl William Clare Seely, Sr. male 372 - 14 = 6685 July 18, 2008 8. Age (feel BMn0aY1 lklea 1 Ueda 1 8. Data d &rlh (MONK, r) T. Bktlgle« ( and Nate a ) 9e. Place d Deadl ChaCl one) lases oars Vlaias kave« FtOSpilal: DmeR a9 yr,. July 18, 1919 Buckley, MI ^Irpelienl ^ERr UAlaoem ^DOA ®NurNrp Home ^Reaidence ^OCar~SpakFy: 9b. Camry d Deets Bc. Ciry, Boro, Twp. d DeNh 8d. FadGy Name (If mt YuatuBon, give NreN and nuNar) 9. Wes Dendanl d FN epenia Origin? ®No ^ Vea 10. ftan:Americen Indian, Black, While, etc. Cumberland Middlesex Twp. (If yea, speody Cuban, (Specify) Claremont Nursing & Rehab. Ctr. Meeken,PuabRinn,NC.) white 11. DendenYS Uwel lion d wade dae du' moN d We. Do nd amts retlred 12. Wee Decedent ever ro the 13. Decedem'e Educetlat (Speoey mty hlgheat grade canpleted) 14. MaRlal SeNS: Married, Never Mamed, 15. SurvWing Spouse (ll wife, give maiden name) IOnd d Work KvM d Buseieee / hMuahy U.S. Armed ForoeaT Elementary r Secandery (P12) CoNege (1d a s~I Widowed, Divorced (Specilyl A fiance Re airman A fiance Re air ®vw ^Np 12 Widowed 19. DecedaWa Meig Address ISVeaL nY / form, amts, ap codel 1000 Claremont Road Decedents DM Decetlam adaNReawaaa ,y,.g,,,, Pennsylvania Uvelne „~.®yeBp~,,,l~;n Middlesex T ~ Carlisle PA 17013 t7b. County Cumberland Torm~? ,7d.^Np, lYacredaA Uved wNhm , AduN l.lmilHd caty/Saro 18. Fetlafs Noma (F1aL nedde, led, adMr) 19. Mdlar's Name (FkN, ndtlda, maiden eumeme) John Seely Frances Thompson 20a. InlmranYS Name (typo r Pma) 20b. hilananYe Mating Addrex (Strati, dry r town. Net., rip Dade) William C. Seely, Jr. 1616 Creasman Circle, Mechanicsburg, PA 17055 21a. MNhotl a DleP«ltlm ^ Cremeam ^ Doneeon 210. Dale d DLSpoNnon (Mash, day, year) 21c. Plea d Olepoeltlon (Name a cemetery, aemaay a oUa pace) 21d. Locatlon (City /town, Nate, zip code) ® Baal ^ RanovallranSNe j YNfeepelttetiataDonetlonAutltorlaed ^ olna ~ spedly: ; M NA,dlal Ea.mxmr I ceraarT ^ Yes ^ No Jul 22, 2008 Y Rollin Green Cemeter g Y Lower Allen T<•Tp . , PA 17 011 22a. d F Service (a a8 auh) 22b. U«nee Hurter 22c. Name and Address d FecNity - FD 013 340 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 CamplNa harm 23ea say wlan nmyap 23a. o the beN d my knowktlge, deem accurted et der time. dale end place staled. (SlpaWre and tNlel 23b. License Number 2&. Dare Signed (Monts, day, Year) phyakan le riot avNleble et tlme d deem to , cerWy cause d daetli. Mans 2429 moat Da nornPlNed by Person 24. Tmle d Death 25. Dale P Deed IMaNn, day. Year) 28. Wes Ceee Referred ro Mednl Eaeminer /Coroner fora r Men remation a Daatbn? who praauces deem. M. l ^ yes CAUSE OF DEATH (Sea Inatruetlone sad emPks) r r Approumate intervN: Pert 11: Enter scar ~ ~ 28. Did Tobacn Uae ConldMe to Oeam? Item 27. PM L Ems tla ~J>L.B1~6 - daeasea, BMeies, a cromPanBOns -Col daectly nosed tie deem. DO NOT enter IartYnei eva8s such as nrtlfec erresL r OnsN to DeNh bu! Hal readting ro the aslaryMp cause given in PeR L ^ Yes ^ Probably mepkelerY srreN, a verhiaNa IDMetlon withtBX shoNng the e8dogy. List anty as u en each line. r e'Flo ^ Unknown i WEgATE CAUSE IF W 6 e sease a tarddon reaAYg h damh) -,~ e, ~ ~ ~ ~ 29. II Female: ^ ' ~ Dw ro (a as a amseWence ofJ: Not pregnant wimin peat year w tat oOMtlom, d arty. b, v V Ir r y,yq~b e ease kled n lne a r ^ Pregnait et Bete d death EnMr 6r IAOERLYINO CAUSE Dw ro (a as a comepance ol): ~ ^ Nd pregnant, bd pregnant wimin 42 days (deeeseaY~,y dlN c r ~ of nedt evems malag m deetlt ) LASE. r Due to (a as a carrsequence og: ~ ^ Not pregnant, but pregnant 43 days to 1 year d. r before seam Unknovm H pregnant wMai Ca peal year 30e. Wan an AtNOpay 30b. Were Aula{ay FegYgs 31. Healer el Death 32a. Dale d kryury (Monet, day, Year) 320. Wsal6e How InWry DCCIIrteO 32c. flea d kllury: Home. Farm, areal. Faclary, Performed? AveNehle Prior to Completlm ~l~ ^ •CJ ~~a OIBn BuNding, ek. (Spedlyl d Case d Dealh7 ^ Yes ®'F1o ^ Vas ^ No ^ Acddail ^ Pendnq Inveatlgeaon 32d. Tnra d InWry 32e. roBBY at WorN'r 321. N TrampatNbn IMury (SPedyl 32g. Laraaon d In)ury (SUeel, dry /town, Nets) ^ Suidde ^ CadO Nd be DNertnined ^ Yes ^ No ^ Ddver I Operate ^ Peaesnger ^Pedeeldan M OIMr-SP~Y 33e. CerCaa (dank amy one) 33b. Slgralure eM Tale d CeRNler ' Cartxykq phyaiden (PlryNdan oaatyNg Haas d d961h wfan andher physltien has prenamcetl deem antl canpleted beet 23) To tla baN dmy lmonledge, tleeN OCHUrtaddw lofts Ceues(e)ertl mennanenlad_________________________________ • fl'~nde0 uM ~Wh9 phyNelen (PhvNderi bdh prmannig deem and nrtllyig b nwa d deaml To Cm hul d m W wl d d tl d t tl tl d M N le d d ro th ^ 3&. Ikenee Nwaer 33d. Date 3lgned IMOnm, nx Yom) y a e ga, se l oaurre e a rne, e , a p as, en ue e auee(sl and manner ere ststed_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ ~ / Z ~ ~ , • Ali Cr t t d i tl d I i l tl I b d h ^ ! ( ~ es a we am ne on en a nvn ys m, n my opn n, aN oecurtstl N fM tlm,, date. aM plea, end dw b tM eews(e) end menrar u aeNad_ 3/. Name eM Atld d Perem Who Completed Ca Use ol Deem (Ilem 27) Typ e /Print / ~ 1J ~ / ~ ~~ ~ I ~' - R~(~~ i 36 l~ta (M dt. day. Ywr) 7 O ~I 1 ,/ / ~~ )'I Y' ~ ~ D "/ ~ ~ V ~~G•' ~CYIP ..: ~~DrF Dispcwtlian Permit No. Q ZZ (,~~ V O LAST WILL AND TESTAMENT OF WILLIAM C. SEELY, SR. I, WILLIAM C. SEELY, SR., of the Township of Lower Allen, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. r._ C"7 "-~' 1. ~ o `:~' =, ~ ~ :-r-~ I direct the payment of all my just debts and funeral ~Ten~s ,~~*~ ~ as soon after my decease as the same can conveniently be ~l~~e': :~' _' ~ ~ -- 2 r All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, real, personal and mixed, I give and bequeath to my wife, Elizabeth A. Seely, absolutely and in fee simple. 3. In the event my wife should predecease me or should die within thirty (30) days from the date of my death, I give, devise and be- queath my entire estate to my children in equal shares. ~. I nominate, constitute and appoint The Commonwealth National Bank guardian of the estate of any of my children who are not of age on the date of my death, and direct that said guardian in its sole discretion shall apply principal as well as interest for the main- tenance, education and support of such child or children when the same is in their best interest without the necessity of petitioning the Orphans' Court for permission to make such expenditures; I -1- direct that said guardian shall take possession o:f all insurance or annuity contracts on my life to which said minor or minors are entitled, and any and all pensions or death benefits from my employer or from any society or organization of which I am a member, said proceeds to be added to the share of each child under this Will. 5. In the event my wife should predecease me, I nominate, consti- tute and appoint William C. Seely, Jr., guardian of the person of any minor children. 6. I nominate, constitute and. appoint my wife, Elizabeth A. Seely, Executrix of this my Last Will and Testament, and in the event she should predecease me or for any reason be unwilling or unable to act as such, then I nominate, constitute and appoint i~illiam C. Seely, Jr., Executor of this my Last Will and Testament in her place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this vrf/,~ day of December, 1972. ,~ ~/ ~ .Ce~~-, ~-- ~!Q f- c (SEAL ) illiam C. See y, Sr. -2- Signed, sealed, published and declared by the above named William C. Seely, Sr., as and for his Last Will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at the request of said testator, in his presence and in the presence of each other. ~~~ ~ a~-~. -3 - OATH OF NON-SUBSCRIBING WITNESS(ES) REGI/STER OF WILLS CUw,,~jP,r~c~h~X COUNTY, PENNSYLVANIA Estate of Vlt I ~~l ~Q Deceased and ~/~ lt!f ~~ Cl~r~ ~e-c~Y,,Jf• (each) being duly qualified according to law, depose(s) and say(s)9that she / he / they~{~~was /were well- acquainted with ~, ~ lil~t~~I ice, G'~g~''ann ~~a--m/a/re familiar with the handwriting and signature of the decedent, and that the signature of ~~ rr~1 i-"~C ~'`I~/1't G2h T to the fo/regoing instr/ument purporting to be the Last Will and Testament/Codicil of ~!~! / Qrn C ` a-'r2 ~ s/is in his/her own proper handwriting. (Signature) (Street Address) w ~l ~'1 / 1 ~~~ IJ/~ ~ ~~l/ J~~ (City. State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this 0~1 da~yj of , ~~~~- Deputy for Register of ills (City, State, Zip) n.z _, n ~. L ~ c~ G ~ .i ~T"E~ ~ -_ ~ r-? N -: _~~ O ., _:; ;~~~ -*~ ~~.~ -~ ~ __ i `~ ~ c~~ ~~ ~ ~, ~- Fornt RW-04 rev. !0.13.06 OATH OF SUBSCRIBING WITNESS(ES) ~ r= o ~.:~ -- ~ ~ ,-_; REG STER OF WILLS L ~~ Glr, COUNTY, PENNSYLVANIA -n ~' - Q _ I J l J\ . ~7 ~ _~ N _.. / / f ='' tU Estate of ~L1 ~l l Q 1~/t c~,lare. Se~y S f . , ~eceased .,,~Ddjr~ ~ l~qK 1 ~ , (j a subscribing witness to (Print Names) the ®Will ^ Codicil(s) presented herewith, (eath~being duly qualified according to law, depose(s) and say(s) that ehc-/ he /~ was /~er~' present and saw the above Testator / ~ sign the same and that aka / he / tk~ep' signed the same and that she / he /they signed as a witness at the request of the Testator / ~es~atrtx in -lit /his presence and in the presence of each other. ~~. (Signature) (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills (Signature) Address) 1'~~ C Ira+~i CSJ~~nI , ~A- I7D.~`" (City, State, ZipJ Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~~~ qq day of , d~(7 Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instr ment(s) at time 9~nIiE11L HEIDI M NELtON Form RW-03 rev. !0.!3.06 N01ary ~ItC Q/111iM'OOdNr My CtammlNlon Exptnrt Jun Z7, ZOl 1