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HomeMy WebLinkAbout08-29-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cc~m3 lZl. A>\! ~7; COUNTY, PENNSYLVANIA Estate of L-r N ~SF}~ C . ~e~7,el.l~ i J~ also known as Deceased File Number oL ~ - ~~ ~ ~~ ~~ !i Social Security Number (~9 ~ ~--~7Z2 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (~COOMPLETE 'A' or 'B' BELOW.) ~I L'1 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the 11.1 }~ S last Will of the Decedent dated _ ~ ((1 , ~_ O ' ~ n'~ named in the 1...~ ~~ and codicils dated i (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as follows, Decedent did not many, was not divorced, and did not have a child) bom or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitatedl~iperson: 1 Q(,(~' ^ B. Grant of Letters of Admi Petitioner(s) after a proper search has /have ascertained that Decedent left no Will Administratiot:, c. t. a, ord.b.n.c.t.a., enter date of Will in Section A above and com, pfappticable, enter.• c.t.a.; d.b.n.c.t.a.; ~endente life; durante absentia; durante minoritate) (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in (List street nddress, towidcity, township, county, state, zip code) County, was survived by the following sp C~ (if any) and~rh,,,eirs: (If list of heirs.) _ ~ -- n w -E , ~'° - = ~ ~ C' - Residences -r 7~ r-- - r 7-~ _ CA _ -.. _~ i,= r- ~ A tnia with his /her last principal residence at _ - .. W - , Decedent, then ~_ years of age, died on ~ ~ at ~ e~7i~DlV ~ ~ ~•QS.~, +/~' Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal prop~rty g D/t) (If not domiciled in PA) Personal property ~n Pennsylvania $_ SON (If not domiciled in PA) Personal property ~n County $ ~(} ~ (,V Value of real estate in Pennsylvania $ !~ bR( situated as tollows: ', Form RW-03 rev. 10.13.06 i Page 1 of 2 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented ~~vith this Petition and the grant of Letters in the appropriate form to the undersigned: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF C(.IY11~j EIS` f~N , The Petitioner(s) above-named swear(s) or affirm(s) that the statements i the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representatives) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. i~ Sworn to or affirm/e~d anyd~-subscribed before me the oLq+,- day of n , b~-.~ ~-1~ F the Register ~. _ S nature afPersonal Represlentntive Signature ofPersonnl Representative Signature of Persoi:al Repres ntative ~~..,~ t7 n rn ~• ~ ~ -T;; l~ 'T_C7 ~ _ _.-, m tV . -3 ~-, 3~ ~~ . l__~ ~=~ `~ File Number:_ _ ~ al-o~- ~~~ ~ tU Estate of h n _r~ / ~ ,/'~ ~,(,(~ ~ ,Deceased /} 1 Social Security Number: ~~`~ - ~~j' 7p2 0~- Date of Death: ~'1~ "D~ ~1 _: . _ __ AND NOW, , _ ~-WR , in cons deration of the foregoing Petition, satisfactory proof having been presented bef re me, IT IS D ED that Letters are hereby granted to `~(,lS(,~,/'1 ~ , . ~ nv/} r' in the above estate and that the instrument(s) dated - - Q described in the Petition be admitted to probate and filed of record as the last ill (and Codicil(s)) of Decedent. FEES Letters ............... $ . Register of Wills ° Short Certificate(s) ........ $ , Ren nciation(s) .......... $ ( ... $ ... $ .. $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ Attorney Signature: Attorney Name: I i Supreme Court LL~. No.: Address: Telephone: Form RW-0? rev. !0.!3.06 i Page 2 of 2 ossos aev col o~) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 14542781 Certification Number 3 REV 112006 / PRIM IN IMANENT 4CK INN 1. Nara a Decedent (Flrd, mitltlle, reel, LINDSEY CHAR] 5. Age (fast BinMavl un 8 4 Yrs. ounry a Deem Mowr. I Dsys I faun This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. r~ ^ V - 1 S ~S Local Registrar ~;» ~ I71atr*. Issued ) -~=-' ~. , , _ , - ~ ' -~~ '~ ,` _, = ~, - -, ~ . _, - _ . ~ - _ , :....Y ~_... ~~ .~.. _ ..• _~ "~ _ . ~ - . t•.,aJ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF tfEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE FILE NUMBER 2. Sex 3. Sodal Searlly NumOer ,. t 4. Date a Death (Ham, tlay, year) M 7RA in ~~~3 AUGUST 13, 2008 6 Dek of Binh (Monet daY year) 7 anladea ICM a,„i w i ww, ~_ ~ 19/16/1923 I Harrisburg &. Coy, Born, Twp. or Deem 04. Fepl6y Name pl nd instllullon, give sheet and number) - - ' '-- ""' ""+•' m arc. uo na ante relied a Wak Kira d Bueiress / kdus Con acto /2. Was Decedent ever In the U.S. Armed Faces? 13. Decedents Etlucelion Ekment /B r ' pA Railroad vea ^No e orxlary I 12" eC I6. Deadem s Haling Addresa (SbeeL cNY /town, date, orb code( 5 Decedents ~ West Ridge St., Carlisle PA ACVa1Re6~ 178'~1B PA , 17b. County Cumberla I6. Famd's Name (Fpd, middle, red, sutldl _ Edward Depew 'gl Zoe IaomenYS Name (Type / Pnm) Susan A. Spear 21e. Mahpd a Oisposilion ^ Cremeaon ® Bond ^ Ramovd Irom Sate I wee Cramatbn «Donation Aumonud 21$ ^ od»,r . SP+dN: _ ~ M Medkal I:arnmar! CorenerY 11 v. .,_ `FD~1'S"3'~45L ahem U ER I Owpetlent U DOA ^ Nurskg Homo ^ Residence ^Olha • Specify: 9. Wes Detodam a Hispanic Ongin7 Ll No ^ Yes 10. Race: Amerkan Indian, Rleck, Whne, ere. (u yes. apecNy cuben, YY (~l~ Mexken, Puerto Rican, etc.) 'mPkkd) 14. Mental S+NS: Married, Never Monied, 75. Surviving Spouse (M wile. give maiden name) or 5+) Wxbweq Divorced (Speciy/ Widowed Did Decedent the Ina 17c. ^vea. Decedent Uved in Towrehip? Twp "°. ®"°, Deceaem trued wtlhin C a r l i s l e ...... _.----` Actual lions a City / Born 2W. IntamanYs Malirp A m (SIreeL chy /town. arek, tlP coda) 56 Wes Ridge Street, Carlisle, PA 17013 witlon (Monet, day, year) 21c. Place of Dlepoaiaa (Marne d cemdery, crematory a other place) 21d. L«atlon (coy /lows, state, dP cede) 2008 Prospect Hill Cemetery Harrisburg, PA 22c. Name eM Address a Facnny Neumyer Funeral Home I 13 ~ wriplete hems 23ac only when canilyraig phYdran b not avaiebk at time d deem k 23e. To the had wkdge, deem oecuned at the fire, tlek and place stetetl. (Signahxe antl title) cMKy cause d deem. ~I ~ Meru 2426 met Da co+IPlebd M Person ~ who prorpalces dedh. 24. True a beam 25. Dek Praplaxed peed (Monet, day. year) M. Nam 27 P 1 CAUSE (See Inetrucdona and exrsrpNs) . an : Eater tlN I -dLsemea, liJude+, a co+Miatlor'e -that directly caused me deem. DO NOT eder lermktal ewms h i i Approxkwk rv suc reap as ardx arrest. relay erred. a vemrkxAar nMNatbn wdlxfa shoMng the aNdogy Ud only one ease on each Noe. r Onset b Da ~ IFral)d~eese a dedh r i ~ +. RFSPITORY FAILURE COPD ; Duero (« as a amseguerce oq: i Xd ~ b ~ i tales IAfed m Nn e a. ~ em+r me URDERLYMGI~CtAaUdSE Due to (a as a oonsaquance op; ~ C. (~n ~M) LASTg i ~ ~ . Duero (a as a cansequena ot); ; r - d. r r 30e. Wee an Aumpsy Perlonned? 3tlb. Were Autopsy FavNnge Areiebk Prror to Completion 31. Mama a Deem 32a Dde a I M+Y (Meet, day. year) I ry ry 320, Deeaibe How 1 'u Ocaxretl a cdee a Deem? n 7~' wtad ^ Haaaa ^ Y•• [~NO ^ Yes ^ No ^ Aaitlenl ^ PerMlrq Irneatlgaaan 32d. Time a IMu'Y 32e. InYpy at Work? 32f. II Tren h ^ Sukdtle ^ Cab Na be Delermkbtl ^ Ves ^ No ^ DrNer ta 33a. CMifrer (dept cry are) M ~ Omar • C•~g phytkien (Physician cerelyug tees of deem when artaha POY+~ has pronounced deem and canpleted Item 23) To the Wal d my Imowkdpe death «arretl due to me ~. S' , a ae(a)eM mameraat+ted.____________ • Pralolmarp and oenHyhlg Phyekian (Phyaidan bom _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Praraaa;ag deem eM cenNying to cause a dMlh) T _ ^ ome bed a m y know'kdga, Hem warred d the Nme, dare, and place, and due to me esuaNs) and mamt« as elated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • kbdksl ExamMm /Coroner _ ^ 33c. e nc., 34 N. 2nd St., Harrisburg 230. Lkense Number 23c. Dale Signed (MOmh, tleY, Year) 26. Wes Case Referred ro M d Examner /Coroner for a Reason Other then CrenlaUOn « Donation? ^ Yes Pan II: Eder Deter ~ 2B. Did Tobacco Uae Com~uk b Deem? but nd resuninp k me uriddtyktg ceuee gNen in Pen I. ^ vas ^ Prebeay ^ No UnNnown 29. Hfamak: ^ Nat pregnant willan past year ^ Pregnant el lima d death ^ Not Pregnant, but Pregnant wNhin 42 days a deem ^ Nd pregrunt, an pregren113 days la I year bekre tleam ^ Unkrown it pregnant wimkl the pad year 32c. Place of Injury: Home, Farm, Street, Fadary, Ofice Buddrg, dc. (SpscrfyJ ury (Spedty/ 32g. Location of Injuy (Strad, dry! faun, skle) ^ Passdger ^Pedeelnan ~+od rnk a censer On IAe beds a ezamirutbn one I « Inveetigatlon, k my opkkn, death occurred at 1M tlme, dare, end plea, and due k me auae(a) one manner ea etaled_ ^ 25698 3/. Na I antl Address of Person Vvho Canpktetl Cause of Death Regkhar' SignaWre an0 eta NympeW (/ I ~I r I a7~ / I / I 3s. Date ~ Mon , m~ r) LpEBANON • VA MEDICAL CE n;~~,•;,~ o„~„ ti 0d( 2' 2 8 511 P Date , i (Mori Y, year) ~ >3 ~ 71 va/Pool t7 ez~ c. 3 p ~' - G ~_- _ ~ - _ j OATH OF SUBSCRIBING'~WITNESS(ES~_'~`~ ,~; ' ,__. ~~ . - GISTER OF WILLS ;=-' ~ ~ ' ,~ - COUNTY~ PENNSYLVANIA ~ -~' ^' ~ _, ~I .~d `~:Q c.' -: Estate of ~ ~ . Dec eased 'L" i ~ ~s~ ~ ' ~ ~~' ~ ~'~~ ~ (each) a subscribin witness to g (Print Name/s) the Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that ~h~}he /they ~~ were present and saw the above Testato /Testatrix sign the same and that, _ ~ he~he /they signed the same and that ~~she he /j they signed as a witness at the request of the Testator / estatrix in ~ his presence and in the ~re~ence of each oth r. ~.~ , .. (Signature) ~/ (.1~ ~ r (Street Address1 ~~- ~ a~3 (city. stare, zipl Executed in Register's Offue Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills ,~ ~n (Street dddress) ,~~h d ~~ / dc~'C~ (City, Stbte, Zip) Executed out of Register's Office Sworm to or affirmed and subscribed befor$ me this o2 (~ ~ ~~ ~ Y of ~u 4iU~~ aoo S~ Notary Public ' My Commission Expires: N 0/~ a.~l. a U l l (Sigoatur~ 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 Form RW-03 rev. 10.13.06 ~r copy of in~e of rwtariution. Diane L. Golden, Notary Pt~lic Mechank~btxg Som. Cumbettand pang My porrt~asior- i=dies Nov. 2q 2D11 Mmmber, PennsytvaMa Assooialton i ~ -- _ ~, o :_ LAST WILL AND TESTAMENT -~~ r I-CJ~ G7 ,_, ,. _. ---iil IV ~_..~t v:::. _- , _ _ _~ LINDSAY C. DEPEW }C`' =~ 7 ~_ ,.._ .~_~ .. _ ~~ ~ I, LINDSAY C. DEPEW, of East Pennsboro Township, Cumberland County, Pennsylvania, being of sound 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 other wills by me at any time heretofore made. I. I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soot as conveniently may be done after my decease. II. All the rest, residue and remainder of my estate, whether r, ~~ real, personal or mixed, and wheresoever situate, I hereby give, devise and bequeath unto my wife, PEARL G. DEPEW, if she survives me by a period of thirty days. III. If my said wife does not survive me by a period of thirty days, then I give, devise and bequeath my residence and all of my real estate known as 18 Sharon Road, East Pennsboro Township, Cumberland County, Penn- sylvania, unto my son, LINDSAY C. DEPEW, JR., my daughter, SUSAN ANN GINGRICH, and my daughter, GA,YIA NAN SISTI, in equal shares as tenants in common. IV. If my said wife does not survive me by a period of thirty days, then I give, devise and bequeath my summer home and real estate consist- ing of approximately two acres of land in',Northeast Madison Township, Perry County, Pennsylvania, unto my son, JEFFREY G. DEPEW. Page one of two Pages LAW OFFICES JON F. LAFAVER 317 THIRD STREET NEW CVM~ERLAND, PA. V. If my said wife does nbt survive me by a period of thirty days, then I give, devise and bequeath aYl the rest, residue and remainder of my estate, whether real, personal or mixed, and wheresoever situate, as foll A. One-fourth (1 /4) into my son, LINDSAY C. DEPEW, JR. B. One-fourth (1/4) unto my daughter, SUSAN A,NN GINGRICH. C. One-fourth (1/4) u~.to my daughter, GAYLA NAN SISTI. D. One-fourth (1/4) into my son, JEFFREY G. DEPEW. VI. I hereby nominate, constitute and appoint my wife, PEARL G. DEPEW, as Executrix of this, my Last Will and Testament. If the said Pearl G. Depew should predecease me, or otherwise fails to qualify, or ceases to act as such, then I nominate, constitute and appoint my daughter, SUSAN ANN GINGRICH, as Executrix. VII. No fiduciary acting under this Will shall be required to post bond in this jurisdiction or in any jurisdiction in which he may act. IN WITNESS WHEREOF, I, Lindsay C. Depew, the Testantor, have unto this, my Last Will and Testament, set my hand and seal this ~ J ~~ day of February, A. D., 1975. (SEAL) LAW OFFICES JON F. LAFAVER 317 THIRD STREET NEW CUM6ERLAND. PA. SIGNED, SEALED, PUBLISI~IIED and DECLARED by Lindsay C. Depew, the above-named Testator, as and for his Last Will and Testament in the presence of us, who have hereunto subscr~.bed our names as witnesses at his request, in the presence of the said Testator and of each other. Page two of two''Pages