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HomeMy WebLinkAbout08-27-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Oaklev P. Havens also known as ,Deceased Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) File Number 21 08 d ~1S ~a Social Security Number ~ ~~ ^ ~8 - °~O~Y A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the named in the last Will of the Decedent dated 9/17/1992 and codicil(s) dated none '7 - ~. _._ .-~ <;~ (Stare 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 instrumerl't(9) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~~ B. Grant of Letters of Administration ---~ ~~~ (lfapplicable, enter: e.t.a.; d. b. n. e. t. a.; pendente life; durante absentia; dura~ minoritate) C~"7 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 was domiciled at death in Cumberland County, Pennsylvania, with his 1 her last principal residence at 442 Walnut Bottom Road Carlisle PA 17013 Carlisle Boroueh (List street address, townlcity, township, county, state, zip code) Decedent, then 7b years of age, died on 8/19!2008 at Thornwald Home 442 Walnut Bottom Road. Carlisle Carlisle Boroueh PA 17(113 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 (lf not domiciled in PA) Personal property in County Value of real estate in Pennsylvania situated as follows: /S'da~',dO Wherefore, Petitionerts} respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of L.~tters in the appropriate form to the undersigned: Signature Typed or printed name and residence Sylvia B. Havens (717) 249-2529 1127 Oak Street Carlisle PA 17013 F~,-m nW-n2 rev. tn. t3.oh Page 1 of 2 (COMPLETE !N ALL CASES:) Attach additional sheets if necessary. Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition az,~ true, and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, P,~ri~u~t(s) vvil~':~Tl and truly administer the estate according to law. ~l `~`.' ~~ ~ ~ ~~ ~~'~ Sworn to or affirmeu~ and subscribed before me the °~ 1~. day f i t ~~ 1~ Far the Register ofPersonaJRepresentative Sylvia B. Havens Signature of Personal Representative Signature of Personal Representative File Number: 21 -" ~ ~~ ~ ~~~'~ Estate of Oaklev P. Havens ,Deceased Social Security Number: 0 ~9d r~ 'Ob `~~,~ Date of Death: 8/19/2008 AND NOW, ~~L~ ~~ ,200E , in consideration of the foregoing Petition, satisfactory proof having been presented before me, I"~ IS DECREED tl}a~, Lette;~..Testamentarv are hereby granted to in the above estate and that the instrument(s) dated 9/17/1992 described in the Petition be admitted to probate and filed of record as the fast Wild, (and Codicil(s~)tbf Decedent. FEES Letters ..../.~.~ ~.......... $ bCj Short Certificate(s) ••• a•••• $ Renunciation(s) •••••••••••••••• $ tai f .... $ /S .... $ ti (J i`~-~ f~ .... $ S TOTAL .••.• .. $ .... $ .... $ .... $ .... $ pU ... $ Attorney Signature: Attorney Name: Supreme Court LD, No.: Address: Telephone No V. Otto III 10 East Hieh Street Carlisle PA 17013 717-243-3341 ~o~•,n Rw-n2 ~•e~~. Jn.l3.oh page 2 of 2 H105.805 REV f01107? ~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. ~h.~0 P 14806090-_ Certification Number ~~ H105-743 REV 112006 TYPE/PRINT IN PERMANENT BLACK INK i~ ~~ his iti to certify that the information here given is orrectl~' copied from an original Certificate of Death my filed with me as Local Registrar. The original ertificate will be forwarded to the State Vital :ea>rds Office for l~rermanent fi ing. ~e ~e~..c~h~i~ U e 2 7~ 2QQ8 ~ocal Registrar '-~ <:~ ~= ~-~ Date Issued .~~~ -__ . c`.; cv _._) --~ _; , f~. c COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTfFICATE OF DEATH (See instructions and examples on reverse) RrarF Ph c NItMBFR 1. Hama of Damdenl (Frsl, midtlle, last, wfhxJ 2. Ssx 3. SO[ial seariry Number 2 694 1 4. Dale 01 DeaN Monts, ) ~~~~ A 1~3 Oakley P. Havens Male 90 _ 8 _ 0 ug. , 5. Aga (lest Birthday) Urba 1 year UrWer t day 6. Dale of BiM (MOnN, day, yeaR 7. Binhpece (CMy antl stale or for eign counhy) Ba. Place d Daem (Check Dory One) 76 MaaM DM Naxr xixaee April 13, 1932 Altoona, PA Hospital: OIM[ Yra ~Inpelient ^ERl OulpetieM ^DOA Nursing Home ^Resitlerxz QOtMr-Spacity: 8b. County of Death Bc. Ciry, Boro, Twp. of Death 6d. Fati81y Name pi rot instiMOM, gne slreel end nunMr) 9. Was Oecedenl d Hispank Origin? ~i] No ~ Yes 70. Race: American Indian, Black, WMte, etc. Cumberland Carlisle Boro Thornwald Home (If yes, specify Cuban, (Specl(y) Mexican, Puerto Rican, elcl 11. Decedents Usual Occu ton (Kind of rode done dunn most al worxi Ida. Do not stale refired 12. Was Decedent ever In the 13. Decedent's Educa tion (spedry only highest grads compkled) 14. Marital Status: Manes, Never Marrieq 75. Surviving Spouse (II wile, give maiden rwnel K'md d Work Kirb al Business / Indutry U.S. Armed Faces? Elementary /Secondary (t}i2) College (1-4 or 5+) Witlowed, Divorced (Specilyf S lvia Brenneman tg,.ea p,~ y 4 t6. Decedents Marling Adtlress (sreet, city /lows, elate, zip codal Dacatlam's Dm pecadent 1127 Oak Street Anaal Resitlan« 1Ta. sale PA Live in a t7c. ~ vas, Decedent fired in Twp. Carlisle PA 17013 ,ro. courtly r,3trtF t Township? art ar,A nd~NO, DacetleM Lived wdhm Ca li l , r s Aaaal amea al e cm/Boro 18. Fedrer's Name (First, midge, l6A, suffix) tg. Mahels Name (First, middle, maiden wmame) ' Oakle S. Havens 13mleline Patterson 20a. IMorrnant's Name (Type / PdnQ Sylvia Havens 20b. Inbmtant's MailMg Address (sweat, dty! fawn, Slate, xp soda 1127 Oak Street, Carlis~.e, PA 17013 21 a. Method d Disposition I ~Crarnalipn ~ Donatbll ~ 21 D. Date a DiapdsiOM (Monts, daY, year) 210. Plea al DepY~iMOn INeme m cBmetay, crematory a aha place) 210. Locavon (city /form, stele, xip code} ^ Removal fmm Stale j Bune l W n~nsnatbn ~ ~mhpHxad ~ Aug. 20, 2008 Hoffman-Roth Funeral Home Carlisle, PA 17013 ~ r b Y ^ Otl ie Yea ONp 22a. Funeral service L' ng as Such) ~ 22e. lkenm Number 22c. Nema antl Adwem d Fa4ilily Hoffman-Roth Funeral Home & Crematory, Inc 138504 Complete Items 23ac only when ra ~ physa:un ar net aveilabb at lime al deem to 23a. To Mr best m my knowMdge, meet accunm at ma time, date and place smlm. (signature antl gtle) ~ 23b. License Number 23c. Data slgnetl Monet, day, year) rerny cause d da.m. / -- P't ru^ J 5 5 ~(~ ~~~ D.F/I9 amp dams 2446 must M canlpleted 6y Petm^ ' 24. Time M Dmlh 5. Date PNnalrMred Deed (Moah, Oay, year) 26, Was Case Referred to MaBCaI Examiner /Coroner for a Reason Other Nan Cremation or Donation? . wta praaakes deem. I O: V~ to M. 0 gl ~ C1 ~OO ~ ^ vas ~No CAUSE OF DEATH (See Instruetlone end examples) r ApprOYlmata tnlenal: Pan II: EMa other ' 2B. DItl Tobacco Use Cmmbute to Death? Item 27. Pan L Enter tM cheat Of events -diseases, ^+W^es, a compfimliore- gat d~rec6y ceased tla deem. DO NOT solar terminal events such as tartlet arr~l, Onset to Dmm but rot rew8ing in IM undedying puss given N Pert L ~ Yes ~ Probaby rmpiretory arreel, a veMnpder hbMlalbn wiNOm showing the eliobgy. LiM oMy one cause on sad, Ilne. ' ~ No ~ Unkrawn / / ' 9 ~ ; ~ INMEdATE CAUSE IFinal drsease or ~ ~) ~ ~ / _ - O ~ /~- f- ~r condllan re&aMig m deem) ~ ~ ~ _ j„ ( +~ ( ' ~ ~ ~.- ~ e " ~ 29. II FemaM: ~ _' g. .X/~ x/`/~l/WKA(~C ~A./ // /1 (-Q%CiW` i ~ E ~ y ~ ~ - s+~4 ..c.- L ^ Due m (or as a consegnrtca on: _ l Na pregnant wMhir, pest year SaquanaaNy Ibt mrtmllone, M arty, p. laa6n to rte team Asled on Mna a ^ Pregnant al lime a dmm gg . Enter me UNDERLYING CAUSE 'Due to (or as a mrwequertce oQ: ^ Not pregrent. but pregnam witlan 42 days {9saem a inlet Mxu'mM'taied 81e p evenh rewlang m dmml UST. d dmth Due m (or es a consequerme oR: ^ Nd pre9mM. 6W P'egnsm d3 days b 1 year d. betas tleam ^ UnNnown d pregnat wMMn the pmt ymr 30a. Wm en AulapeY 300. Were AMOpsy Rndn~ 31. Melnar d Deem 32a. Date al Irprry (Mmm, daY. Ymrl 32b. DescdM How 7^N%Occurted 32c. Plaoa of Injury: Home. Fain, Slreel, Femory, Podonrwd7 Avalede Poor to Conplelion p~y NaNral ^ Homicid OMlce BuNOing, etc. (sgMiq) of Caum d omm? e J`~ Yes ~NO ~ Yes ~ No ^ Accident ~ Pendatg Inveclgel'en 32tl. Tuna of In'ry7 32e. Injury el WaA? 321. II Trensponatian Inryry lsPaOdyl 329. Loceeon of Injury (Shml, oily) bon, slate) ^ Sadde ^ Caad NM M Delemlinetl ^ Vas ^ No ^ Dlner / Operebr Q Passenger QPrxlesblan M Omer ~ SpecNy.~ 33a. cenFABI (ChOpk c^YY one) 336. signature artd TiJ~Ia of Ce ~ er , • CallryMg phye{clen IPhysinan ceNNin9 Pam of nmm wtlen anaMr physician hoe prMwicetl tleaN end mmpletsd Man 23) / /~ ~~ / ~ ~/ ~ To tM MH of my Nma4tlge, dmlM occurred dw to Uu ceuee(s) end memter ea sletsl _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ypl t/ v' _ Pronoundn9 antl ~YN9 DNYebkn (PnYSldan Dom prawalcln9 death and ceNlpng b team d dmml 7p th t M f M dM d M h tl 4 ^ 33c. L'ICerne Number 33d. Date Signed (Madh, day, Year) ' e OSx ge, e o my ee occurred el t ma,dare, antl p e a, end due to lM ewse~3)and manner ae ebted______________ ____ • IAed1g1 ExsmherlCoroner ~~ ~~~^v 2 p ~/ ~/ 1- //~ ~ ~!n OG Dn tM Msls of examinatbn end) or Inveallgmblt, In my opbbn, deaM occurrM et the Ilene, dale, and plain, end due b lM cause(s) eltd mann er as maled_ ^ 3a. Name arts m 1 Person Who eletl Cau lml a D9ath (Meet 27) Typa / Pnnl ~ 35. Rag r SgnaWre and DisNC bar - la ~ ( I~1 t 161 .Date Fded (Monet, day. rear) U`L°.~ AYl \'tl S l MQ X303 N r~F,~ ~ c ~)~~c.. ~ ~ - Pti IlOlaS V Disposition Permit No. O~s'~3~a~ c -~ LAST WILL AND TESTAMENT ~+ ,~:_ ~..~ ~~ 1-.1_."' --~' ice-{ r~ I, OAKLEY P. HAVENS, of the Borough of Carlisle, Cumberland: ,~-Coun~, ,_ > - ~ ~~. Pennsylvania, being of sound and disposing mind and memory, do hereby make, -publish arnl declare this to be my Last Will and Testament, hereby revoking any and all former Wills`ar Codicils by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 2. If my wife shall survive me by thirty (30) days, then I give, devise and bequeath all of my estate, both real and personal property, unto my wife, SYLVIA B. HAVENS, absolutely. 3. In the event my said wife, SYLVIA B. HAVENS, shall predecease or fail to survive me by more than thirty (30) days, then I give, devise and bequeath all of my estate, both real and personal property, in equal shares, unto my children, JEFFREY HAVENS and GAIL HAVENS. 4. I nominate, constitute and appoint my said wife, SYLVIA B. HAVENS, as Executrix of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my children, JEFFREY HAVENS and GAIL HAVENS, to act in such capacity. 5. I direct that my Executrix or Executors shall not be required to file a bond to secure the ~~ ;~ . O.P.H. Page 1 of 3 Pages faithful performance of their duties in any jurisdiction. 6. I authorize and empower my personal representative(s), in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind farming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS WHEREOF I have hereunto set my hand and seal this ~ 7 day of ,,~ f , 1992. ~~ i ..~~,~. ~ (SEAT,) Oakley P. avens SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and. for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, i_ll the presence of the said Testator and of each other. l_ ,,," ~j a .~ Page 2 of 3 Pages COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. I, Oakley P. Havens, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Oakley P. H ens Sworn or affirmed to and acknowledged before me by Oakley P. Havens, ±he Testator, this ~ ~#ti day of ,,~y¢.te.,-~Lc~ ~ , 1992. Notary Public COMMONWEALTH OF PENNSYLVANIA ) ~e tEVow~se~~ SS • Carhsie Coro, Cumberland County COUNTY OF CUMBERLAND ) My commission E~ires Dec. 23.1995 the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Oakley P. Havens, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue 1992. Sworn or affirmed to and subscribed before me this i7~ day ofi~~':ti,~ Notary Public Notarial Seal K E. Wises, Notary Publ'~c Pa e 3 of 3 Pa es carti5{e , Cumberland courriy g g My Commission E~ires Dec. 23,1995 Address /~ ~sf ~~ ~i` ~~~,-I~~ ~' X1/3 --