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HomeMy WebLinkAbout08-29-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF C u n~ a>E ~ ~- ~~ ~ COUNTY, PENNSYLVANIA Estate of L 0 t s ~ • 5 t'F w~92r File Number ~ ~ ~ ~ ~ ~ 6\ 1 also known as ,Deceased Social Security Number 1 ? I ' n 1 - ~~ ~' $ 7 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: {COtLIPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that PetitionerO is f are the ~k ~ c u Td 12 named in the last Will of the Decedent dated a /r a I ~ G 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 inshument(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.n.; pendente life; durante absentia; durante naiaoritate) Petitioner(s) after a proper search has i have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Ad»tinistratioit, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ti:_~ - _ ,_ . ` (COMPLETE IN ALL CASES:) Attach additional s/:eets if necessary. - ~ Decedent was domiciled at death in ~U rn/3ER l ANO County, Pennsylvania with his /her last prin~'rp-al'residenceYat ~/$3 3 '~/2/NJ+. r R°!/D /hEcF~.9N, /cStt?GtRG . t/9/NPDISN Tdv'.^'S'y/P ~Ezrun/SY~/hN..9 / ~as~a) (List street address, town/city, township, county, state, zip code) Decedent, then 9~_yearsofage,diedon ~ 21 U at C'ou./TRy /r1~t40oGuf (,UFsT -Stt~~~ Decedent at death owned property with estimated values as follows: ~y (If domiciled in PA) All personal property $ S~ 0 ~ ~/ b~ (If not domiciled itt PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 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: Signature T ed or rioted name and residence Icy R D ~- STEw~i RT ' 2, ~ D ~ / ru G ~o F}O NF_a C~,MI3F_/1LVgNt~ ~, l7~7D Form RVV-U? rev. 10-13.06 Page I of 2 Oath of Personal Representative -- ~~ ;~, COMMONWEALTH OF PENNSYLVANIA - ~ ~' - ~~c~ COUNTY OF ~~ ~ t~~~ ~ ~" The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the fort~~~-~ing Potion are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as pers~al repre~tative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ~~ Sworn to and affirmed and subscribed •,C ' `~(~` ~. ~-~- Signature of Persona! Representative Benfore me this ~I t-, day of ~ ~it.,tl_C~ L,~-F. , 2008. ~.i ~ ~ !"1':~~-~~ File No. ~ -~ • Q ~' Estate of 1~i S L_. ~~-~'tA,~.~ ,Deceased. Social Security No; 111 Cl`7.4 ~$ 7 AND NOW, Z~"~ ~~'~ ` t'A. ltAt.~o-i , 2008, Date of Death: ~ ,[ t~, ~~ ~ ~ I .~ 2 c~~fr in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters ~P~-1~Y~-fr~•It~~ ~-~ are hereby granted to ~ - tTlhCArc'~ ~ . 5-1-'~~~arh- in the above estate and that the instrument(s)dated Z~~ ~5I'O(~n described in the Petition be admitted to probate and filed of record as the Last Will (and Codicil(s)) of the Decedent. FEES Letters ........................... Short Certificate(s) Renunciation .............. Affidavit ( ) .................. Extra Pages ( }....... Codicil ............................ JCP Fee ....................... Inventory ...................... Other..w!.ll.`.~«~'~ TOTAL........ egister of Wills ~ ~ $ g.~~ ~;~ ~ $ Attorney Signature: $ 1 . ~~.' Attorney: EDMUND G. MYERS $ I.D. No: 20558 $ . ~`~ Address: Johnson. Duffie. Stewart & Weidner, 301 Market Street P.O. Box 109, Lemoyne. PA 17043- $ ~~ 1?~.l'~ Telephone: 717-761-4540 OCAL 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 th~it the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will he forwarded to the State Vital Records Office for permanent filing. ~P i4~4312 Local Registrar .~ Date Issued Ev,uzoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS RINT IN `NENT CERTIFICATE OF DEATH p <wK (See Instructions and examples on reverse) ~r,r< <„ t ,,,,,,,,~„ , I , ~ /~ , ~ Q 1. Name of Decedent (Ffrsl, midtlle, last, sumx) 2. Sex 3. Social Security Number 4. Data of Death (Month, tlay, year) Lois L. Stewart female 171 - 07 -4587 Aug. 21, 2008 5. Age (Lass Birthday) Under t year Under 1 day 6. Dale of Birth (MOntq tlay, year) 7. Birthplace (Ci and state a lore' coUnl ) ea. Place of Death (Check only one) 9 2 ~~~~ na" ~"'~ ~°"'~ Feb . 7 , 1916 Tyrone , P A "°~Pi~l aher Vrs. ^bryafienl ^ERI OuIpaCrenl ^DOA ~NUrsing Hane ^Resitlence ^Other-Specify: 8b. Counry of DeaM 6c. Giry, Boro, Twp. of Deam Bd. Facility Name (k na insMUtion, gA'e street and number) S. Was DerRdenl of Hispanic Origin? No ^Yes 10. Race: Amakan Indian, Black, White, etc. Cumberland Hampden Twp. (If yes, seedy Cuban, (Spae'/M Country Meadows Mexicen,PuertoRicen,etc.) white 17. Decedent's Usual Occu tan Kind of work tlone Gunn most of wn life. Oo not stele retired 12. Was Oecetlenl ever in the 13. Dacedarrcs Edutal'ron (Beatty only highest grade completed) 14. Markel SIGNS: Mameq Never Marred 15. Surviving Spouse (If wile, give maiden name) Kind of Work Kind of Business /Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 ar 5+) Wklowed, Divorcetl (Specify) Oth n ^Yes Jg1No 12 2 widowed 16. Decedent's Mailing Address (Street, cRy I town, slate, Lp code) Decedent's Did Decetlent 22 Boeing Rd. AduM Reswence ,7a. state P e n n s y l v a n i a use m a 17n. roe, De°eaem Livetl m Ham d e n T h ~ ~ '~ New Cumberland PA 17070 pwna ip, ro. c°anty Cumberland 17d. 0 No, Decedent Lived within , Actual Limits of Ciry/BOro 18. Famer's Neme (First, middle, last, wfkx) t William •/V. Largent 19. Mother's Name (First, mMdle, rtraiden surname) Jennie McMurtrie 20a. Informant's Name (Type /Print) Richard E. Stewart 20b InformanCs Maiktg Address (Street, city ! trnm, slate, zip code) 22 Boeing Rd.,New Cumberland, PA 17070 21 a...M~~et//hod of Dispositon i ^ Grematiar ^ Donation 21h. Data of Dispodtion {MmM, tlay, year) 21 c. Place of Disposikon (Name of cemetery, crematory or dher pace) 21tl. Localron (Giry I sown, slate, zip code) IZy Budal ^ Removal rrom State j Waa Cremation or Donaton Authodzed Aug . 2 6, 2 0 0 8 E a s t l a w n C e m e t e r y Tyrone , P A 16 6 8 6 ^ Iher ~ Specity~ ~ by Medlal Examiner I Coroner? ^Yes ^ No 22a. S' urgCf Funeral Licensee (a person acting as such) 22b. Lcense Number 22c. Name and Address of Feclfily .ate- ! -t'.L~tin~~'~-- FD-013163-L Musselman FH&CS, Inc. , 324 Hummel Ave. , Lemoyne, PA 17043 ate Items 23a-c only when cenitying 23a. T° the best my knowledge, deem occured al the time. dale and plays staled. (Signature and tttle) i 23b. License Number 23c. Date Signed (Month day year) physician is rwt available at tlme of tlealh to /~ , cenily cause of death /E ~ %7 - ~ ~ 7S~ ) ~> Items 2426 must be cpmpleted by person 24. Time of Deem 25. Date Pmnolmced dead (MOnlh, tlay, year) 28. Wa& Case Referretl to Medical Examiner /Coroner for a Reason Other Ivan Creniahon or Donation? who pronounces deem. ~ M. _ 7 ~~,U ^Yes o CAUSE OF DEATH (Sea Inetroctlons and examples) ~ Approximate interval Item 27. Part I: Enter the dla'n of events - tliseases, injuries, or cnmpNCefims - that dlrecGy causetl the deem. 00 NOT emer terminal events such as cardiac anesl. r Ousel to Deem i i G Pan II' Enter other ' ~ ~ ' ~ but not resukkg In the undenying cause given in Pan I. 26. Did Tobacco Use Contd6uL= to Deam? ^Yes ~ Probably resp retory arrest, or ventr cular 6nllaaon wahat showing the etiology List Doty one cause on each Gne. r r IMMEDIATE CAUSE (Final disease or ^ No ^ Unknown condition resulting in death) -~ a Z r 29. II Female. Due to for as a consequence o ~ ^ N°I pregnanr within pall year Sequentlally list contlaions, If any, b. ~ leafing to the cause Gated on line a. ^ Pregnant al lime of death Due to or as a con Enter the UNDERLYING CAUSE ( sequence alj: ; ^ Not pregnant, but pregnant within 42 days (dlseese a inpry mat ilMiatetl me c of death events resulting m death) LAST. Due to (or as a consequence off: ^ N°I pregnant. Dul pregnant a3 days !o t year d before deem ^ Unknown it pregnant within the past year ills. Was an Autopsy Pedamedl 3gb. Ware Autopsy Fimkngs Avallade Prior to Compk'flon 37. Manner of Death '' 32a. Date of Injury (Mmm, day, year) 326. Descdba How Injury Ocwmed 32c. Place of Injury. Home, Fann. Slreel, Factory, al Cause pf Dflam? rr ~~~~ ~~ fCN+alural ^ HGmicide OXke Building, etc. (Specify) ^ Ves ~ No ^Yes ^ No ^ ACCitlenl ^ Pending Invasligation 32d. Tine of Injury ffia. Injury at Work? 32i. II Transportation Injury (Specify) 32g. Laation of Irryury i51rae1, city 1 town, stalel ^ Suidde ^ GeuM Nol be Determined ^Ves ^ No ^ Dover /Operator ^ Passenger ^Petleslnan M ^Omer- Speciry~ 33a. Certifier (check only one) 33h. Signature antl Tdfe of Certifier • CaNNying physcian (Pnysidan cenirying cause of death when andhar physician has pronouncetl deem antl compleletl Item 23) T ~ p 7 ~ ~ o the hest o/ my knowledge, tlmM occurretl due to ltro cause(s) and manner as shred_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ZLC~Lr.L~' //L.-~'~ ~ ~ • Pronouncing and certifying physician (Pnysidan born pronoundng death and cemtying to cause of death) To the beat of my knowledge, deaM occurred at fire lime, date, and place, and due to Me cause{s) and manner as stated- _ _ _ _ _ _ _ _ ~ ^ • Medcal Examiner /Coroner - ~ _ - - _ _ - 33c. License Number f ~ ~ - ~ 33d. Data Sign d IMOnih, day, year) ~' ~ I~" ~ ~ ~ ~ ~ ~ ~~ , On the heals of examination antl / or investigation, in my opinion, death occurred al the time, date, and place, and due to the cause(s) and manner as stated- ^ 34 Name and Aotlress of Person Who Completed Cause of Death dra m 27) Type I Print 35. Reg; r e an I ''Tg ~~~~ ~ ~C7k ~ ~ ~ `~ 3yB/gale Fded ( nth, tlay, year) /- ~ °/ ~T >f s Disposition Permit No. ~ ~ ~ 6 ((~ f7C ~i~~~~~~~~1 ~.~~t ~ir~ ~.~b ~e~t~n~~~t OF > ; ~_ ,,.~ ,.~r 1 LOIS L. STEWART ~= =; -; .. r ~~ I, LOIS L. STEWART, of Mechanicsburg, Cumberland County, Pennsylvania, being~:of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all ~Nills or Codicils at any time heretofore made by me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my last illness and fiineral from my Estate as soon after my death as conveniently maybe done. ARTICLE II TANGIBLE PERSONAL PROPERTY I give and bequeath my household and personal effects, including my grandfather's clock, and other tangible personalty of like nature (not including cash or securities) unto my son, ~ciCIIARD E. STEZVART, and his wife, nAYE STEi~'ART, or the surviv:,r oftiiern. ARTICLE III SPECIFIC BEQUEST 1 dive and bequeath the sum of THIRTY-FIVE THOUSAND ($35,000.00) DOLLARS unto my son, RICHARD E. STEWART. Should lny son, RICHARD E. STEWART, predecease me, I give and bequeath the same unto his then-living issue, per stirpes. ARTICLE IV REST, RESIDUE AND REMAINDER I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever situate, as follows: A. One-half (112) thereof unto my son, RICHARD E. STEWART, provided that should he predecease me, I give, devise and bequeath his share unto his then-living issue, per stiipes; and B. One-half (1/2} thereof unto my son, WILLIAM J. STEWART, provided that should he predecease me, I give, devise and bequeath his share unto his then-living issue (ineh-ding adopted children), per stirpes. ARTICLE V UNIFORM TRANSFERS TO MINORS In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5307 ei ~~ey., or tiic applicable ~niforin Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be.. My Personal Representative may, designate as such Custodian any institution or person, including; my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. 2 ARTICLE VI PERSONAL REPRESENTATIVE I name, constitute and appoint any son, RICHARD E. STEWART, Executor of this my Last Will and Testament. Should my son, RICHARD E. STEWART, fail to qualify or cease to so act, I name, constitute and appoint my son, WILLIAM J. STEWART, alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~~T ~~ ~ day of February, 2006. ~~ ~ ~~~~~'C.~` (SEAL;1 LOIS L. STEWART SIGNED, SEALED, PUBLISHED AND DECLARED, by LOIS L. STEWART, the Testatrix above named, as and for her Last Will and Testament and in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. A Witness ~I~~// i Witness , 3 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I, LOIS L. STEWART, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do Hereby aclrnowledge that I signed and executed the instrument as my Last Will and Testament, that I signed it willingly; and that I signed it as my fi-ee and voluntary act for the purposes therein expressed. o ~ ~~~~ LOIS L. STEWART Sworn to or affirmed and acknowledged before me, by LOIS L. STEWART, the Testatrix, this_~ ~~~ day of February, 2006. Notary' ublic _ _ ,- ` My commission expires: ~ (SEAL) COMMONWEALTH OF PENNSYLVANIA Notarial Seal Elizabeth L Tregler, Notary Public Lemoyne Boro, Cumberland Courtly My Commission Expires Nov. 7, 2009 Member, Pennsylvania Association of Notaries 4 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA . ss COUNTY OF CUMBERLAND We, ~ 7~/Yt a h' ~ ~- tit ?~~ ~`~~ and /1'1,~~('c~i%~C' ~ i r , f~ u't'/~ ,the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument as her `Last Will and Testament; that she signed willingly and that she executed it as her free and volwztary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our lrnowledge, the Testatrix was at that time at least 18 years of age, of sound mind and under no constraint or undue inf]uence. G'L~lGz' y ~ •../ ~'1 ,~ L/ ! Swon1 to or affirmed and subscribed to before me by i)~ > ~~r r~' ~ C~-° ~~ ~ y Eri'J and /J7i~~.' t r?-k' e=T ,~ - /~ u t f ,witnesses, this ___~~~ _ day of February, 2006. In ~ 1~- C.~~. ~} -; -- otary Public ~ ~ COMMONWEALTH OF PENNSYLVANIA Notarial Seal Elizabeth L. Ziegler, Notary Public L-emoyne Boro, Ctunberland Courrty My Commission Expires Nov. 7, 2009 Member, Pennsylvania Association of Notaries