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HomeMy WebLinkAbout09-19-08PETITION FOR GRANT OF LETTERS Estate of _ ~ O ro-4-h~ Cr - P t e r so ~ No. (~~ ~~ ~~ also known as Deceased Social Security No. dC-'?-Oq -0z07 Petitioner(s), who islare i 8 years ofi age or older, apply)ies) for (COMPLETE= "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) islare the execut f i X named in the Last Will of the Decedent, dated AUa us-~ I O , I Q~`1 and codicils} dated N /f}- 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 documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente life, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence ~ 4 ~: ~ ~,~ Cn ''"' z ..,a ... _~ _ { _: ._ t ... `- ~ "'t7 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ - ~ ~ , Decedent tNas domiciled at death in CU wt her fa i~ County, Pennsylvania, with hislher last fam~or prihcipa} residence at fO2- Sou+t~ ~nola D~'lv~ I Evtolq P~ -?02S - E0.ft pe~tns.~oro Tow~tslh~~ (list street, tuber and municipality) Decent, them ~ ~ years of age, died Se Q Fe ~b~ $' a.Do , at ~ q ~ ~tsb w q I'~s P~ tit (T ct~~ G t ~ CouN"r I t~,t~ ocation) Decedent at death owned Property with estimated values as follows: if domiciled in PA All ersonal ro ert .................... $ ~~~' , ~'~ ~ ~ ~ (' P P P y ..................... (if nct domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ ~] S d00 , au Rea! Estate situated as follows: I Q Z. 50~+~^ Ehe{o~ ~r eve- t; ne{q t EaS~- A2viKS~jQYO 'f'cV p i Pq Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Wi11 and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence t (,v ~ _ L n M -Wallace. 3Sq C~orc(~ Read E(I~ottsbw P~ I ~ 0 2~{- RW-1 Oath of Personal Representative Commonwealth of Pennsylvania County of CUV~-~erlctNCl The Petitioner(s) above-named swear(s) and 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, Petitio~ter(s) will well and truly administer tFpe) estate according to law_ Sworn to and a?firmed and subscribed before me this _ day of ...~ c~_ ~ G~ ' ~ - ~- ~ ? __ ~--- °v G~ _: a -, _ _J~ .~ DECREE OF REGISTER ~ ~~ ~ i -rU Estate of . oocQ`i"~'`I ~ • i'~e~sa->. Deceased No. 1~ / `-7 also known as Social Secu ty No: a~ ~ - ~ ~ - Q a' ~ ~ Date of D ath: ~ D to u>n ~-N ~' , ZIT ~.- AND NOW, ,inconsideration of the Petition on the reverse side hereon, satisfacto proof having been presented before me, 1T IS DECREED that Letters testamentary ^ of Administration ((c.t.a., d.b.n.c.t.; pendente lice; durance absentia; durante minoriate) are hereby granted to L ~ ~ ~ (rt.) ct 11(Jt c in the above estate and that the instrument(s), if any, dated ~}u Q oSf { 0 I { 9q ~ described in the Petition be admitted to probate and filed of record as the Last Wilf of Decedent. FEES Letters .......... ~..... f..~.r..~........ Short Certificates(s) .....~.... Renunciation .......................... Extra Pages ( ) .... ........t~-~.l. j.j ................ $ ~~~ $ ~ o~. .T.R ..................................... JCP Fee ....`.'.~...,. Inventory .......................... Other ................................. $ J ~ Attorney: 3~ ~ TOTAL .............................$ ~ ~t '"~' "/ G1/Vw- ~toTT ~~ l~ o r r ~s a~ I.D. No: g 3`~ Y 3 Address: P O ~~ X 23 Z- Telephone: l ~ ~ ~ ~ S`~/ 2-~ 23 ~ DATE FILED: ~ ~ ~ « (~~~~ I05.805 REV (01/07) 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 145~377~ Certification Number REV nnoo6 PRIM IN (ANENT ,K INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE rV n ~ cso - , _,. C~ = ~t 1 ~ Le ., -_ Ty' C_7 'L7 C ' ~,~_ _ . DTI ~'~ _ -~1 __ 1.1 ~, ... - ~ 'Tl _ _,r -_' _ - _ _ _-..{ .. FILE NUMBER ~ \ ~] LJ C~ 1 1~ 1. Name of Decedent (Flrsl, midtlk, lass, suttixl 2. Sez 3 Social Security Number 4. Da I Dea (Month, d , yeaq Dorothy G. Pierson Female 207 - 09 }0207 ~~ 5. Age (Last BimMay) Under 1 year Under t day 6. Date of Birth (Month, day, year) 7. Bidhplece (City aM stale or foreign country) ea. Place of Death (Check only one) Montns Days Han Minwes Hospital: Other: 92 Yrs 6 /4 / I9 16 Duncannon, PA IsAlnpalienl ^ERI~utp~tient ^DOA ^Nursing Home ^Residence ^Other Speciy. Bb. County of Death Bc. City, Boro, Twp. of Death Bd. FadITy Name Qf not institNion, gNe street and number) 9. Was Decedent of Hispanic Origin? ®No ^Ves 10. Race: American Indian, Black, white. etc. Dauphin Harrisburg (If yes, sPepiry Cuban, (Specify, Harrisburg Hospital Mexican,PuenoRkan,etc.) White 11. Decedent's Usual Occu tan Kind of work d one dodo most of worNi INe. Do wt slate raored 12. Was Decedent ever In the 13. Decedent's Education (Speciy only highest grede completed) 14. Marttal Status: MaMed. Never Married, 15. Surviving Spouse pl wife. give maitlen name) WidoweQ Divorced (Specify) Kind of Work KIM of Business /Industry U.S. Armed Forces? Elementary /Secondary (0-12) Collage (1-4 or 5+) Waitress Van t S R2SCUTant ^ Yes ENO 12 DIVOTCed • 16. Decedent's Mailing Address ISlreeL city /town, stale, zry code) Decedent, Did Decedent PA Live in a ~j East Pennsboro Deradenl Dyed in Twp Vas t7c 102 South Enola ]hive . . , Actual Residence 17a. Sale C> mlbeTland Township? 17tl. ^ No, Decedent Lwed within • Enola PA 17025 176. County Actual Umlts of Cary f Boro 16. Father's Name (First. mkdle, last, sudiz) 19. Mother's Name (First, mitltlle, maiden surname) C+`3arles Gatlin Stella Wilson 20a. Informant's Name (Type / PnnU 20b. Informant's Mailing Address (Steel, city /town, state, zip code) Lyn Wallace 389 Church Road Elliottsburg, PA 17024 21a. Method of Disposition ®Cremation ^ Donaton 21 b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 27d. Locatkrl (City I town, state, zip code) ^ Burial ^ Removal from Sate ~ Was Cremation or Donebon Authorized pn • 9/ 12 /08 Hollinger Crematory Fb11y Spring P A 1 7 0 6 5 ^ Other - Speciy~ by Medcal Examiner I Coroner? ry Ves ^ No ~ 22a. Signature of Funeral Se - ~ Licensee (a person acting as such) 22b. Ucnnse Number 22c. Name aM Address of Facility ~~ ~ ~ F D 0 1 2 7 7 4 - L Richardson Funeral Hone Inc. 29 S. Enola Dr. Enola, PA 17025 • ~ r; , ~ Complete harm 23a-c onN when certifying 23a. To ma ba my knowledge, death attuned at the Ume, date aM place stated. (Signaure and Gtle) 23b. License Number 23c. Date Signed (Month, day, year) physidan a not available at erne nl death to ceniy cause of death. hems 24-26 must he cempletetl ley person 24. Time of Death ~ 25. Date Pdgnounced Bad (MOnlhr day, year) ~ ~ / f 26. Was Case Referted to Medical Examiner /Coroner for a Reason Other roan Cremation w Donation? who pronounces death. y ~ M. ~ ~ ~ ^ Yes CA SE OF DEATH (See instructions an examples) t Approximate interval: Pan II: Enter other sknificanl contlltiom comribudnc to deaN, 28. Did TWacco Use Conlnbule to Death? Item 27. Pan I: Enter the chain cd events -diseases, injuries, or mmplicatbns -trial directty cemed the death. DO NOT enter lanninal even6 such as cardiac arrest, t Orlsel to Death r bN not resulting in Ne underlying cause given in Pan I. ^ Yes ^ Probably respirzlory anesl, or ventricular (ibnltation without showing the etiology fist only one cause on each line. ^ Nc own IMMEDIATE CAUSE IFinel tlisesise or ~ ~`l I' ~ „ ~ /O ) !y ,.,1- L -~ ~.L. ut~~ r coMakn resulting in death) /INi I L•Vl~ '[ {' ~ ~-L 29. It Fem N t t tth t _~ a. Due to (or as a consequence oQ: r t pregnan w in pas year o ^ Pregnant al lime of death r H any uemielty Ilel WnNlions Se b , , q . use listetl on Nm= a r t th l d ^ Not pregnant. bN pregnant within 42 days mgg o e ca ea . Due to (or as a consequence oi): Enter die UNDERLYING CAUSE', i (disease or inryry that initiated the p r of tleath events resulting in deaM) LAST. A, but pregnant 43 days to t year ^ e ~ z Due to (or as a consequence op. betore d a l d i ^ Unknown if pregnant within the pest year 30a. Was an Autopsy 30b. Yfere Autopsy Findings 31. Manner of Death 32a. Date of Injury (Monts, day, year) 32b. Descdoe How Injury Occuned 32c. Place of Injury: Home, Farm, Sreet Factory, Omce Builtling, etc. (Specityl Pedormed? P,vailaNe Prior to Completion f Oeam? f C turel ^ Homidtle o ause p ^ Accident ^ Pendng Imesngatian 32d.1ime of Itryury 32e. Injury at WoM? 321. H Trenspodatbn Inury (Specify) 32g. Locetbn of Injury (Sreet city 1 sown, state) ^ Yes ~.Ifo ^Ves [~y~ ^ Yes ^ No ^ Driver I Operator ^ Passenger ^P ^ Suicide ^ Could Not M Delennirletl M Other - S t ^ P~h 33a. Cenif r (check only one) 336. Signaure and Tttle of Ce " • CenHying phyaklan (Physician cenirymg cause of death when another physkian has pronounced death aM wmpleted Item 23) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ to the pause(s) and manner as stated d d d th _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ occurre ue ea To the best of my knowledge, • Pronouncing and celniTying physician (Physician both pronouncirg death and cenilying to cause of death) To the best of my knowledge, death ocwned at the time, deM, and place, and due to the cause(s) aM manner es atated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. License Number c~ ~ ~/J 330. Date Signed Month. day year) ~ / l ~~ • Medical Examiner I r:aroner On the basis of examination and / or invealigation, in my opinion, death occurred et the time, date, and place, and due to the cause(s) and manner as stated_ ^ ~ Name a~M~A of Person Who Comp~ltetM Cause of D~at/h~ptem 27) Type i Prim ~ /rU ~ J ~ ' • s /~` ' /~ ~.,T~~~ 2 36. Dale ed (Mo h. day, year) ,~. . V . yll ~ I t ` iMc~ ( l I / I r I 35. Registrar's Signature a I~ trio Number ~ I ~ I / 1 72~2 v ` L 1 ~"~ ~ ~ Gy '' ~ ~ \ o !/l ~ l ~~e..~ Vt.. ~ J , i - C r ____ 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~EP 1 1 2008 LG~ ~ ~`' / / Local Registrar Date Issued Disposition Permit No. V ~ .1 ~~` !a ~~ ~.1J747~ ~~~ ~CL~CL~~V~~~CL~,~~L I, DOROTHY G. PIERSON, of East Pennsboro Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: I direct payment of the expenses of my last illness, funeral and burial costs from my residuary Estate, as an expense of my Estate, as soon after my death as conveniently may be done. All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross Estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the administration of my Estate and shall be paid from my residuary Estate without apportionment or right to reimbursement. fi SECOND: I give and bequeath my automobiles, personal effects, furniture and household goods, if any, as may be my individual property, and other tang~~le ~~? ~ personalty of like nature, not including cash orr ~, ~~ securities, together with any existing insurance tY~ my , daughter, LYN M. WALLACE. ~-'-? `~ ,~ ~,~ _. THIRD: All the rest, residue and remainder of~my -., estate, whether real, personal or mixed, of which :~'~ha ~~ die seized and possessed, and to which I may be e''r~itle~ at the time of my decease, and wheresoever the s-~ne may e ) situate, I give, devise and bequeath unto my daughter, N M. WALLACE. ~~ FOURTH: In the event Lyn M. Wallace fails to '~ survive me, then I give, devise and bequeath my entire estate, whether real, personal or mixed and wheresoever situate, as follows: A. Ore-half (1/2) to LARRY M. WALLACE; B. One-quarter (1/4) to HELEN G. FLOWERS; and C. One-quarter (1/4) to DIANE L. ANHOLT. HENCHANDCRESSLER FIFTH: In addition to all powers granted by law, I ATTORNEYS ATLAVU give my Executrix (tor) , hereunder, the following powers, 22GMARKETSTREET which may be exercised without leave of court: to retain NEWPORT PA1707~4 and to invest in all forms of real and personal property; TEL 1717)5673139 to com romise claims and to abandon an ro ert which is FAx(717)567.313CI of litple or no value, if deemed approprpate toymy MILLERSTOWNOFFI(:E Executrix (tor) ; to sell at public or private sale, to 1 N. MARKET STREET e X C h a n e y p ~ y MILLERSTOWNPA17062 g , Or t0 lease for an eriod of time an real or TEL (717)589-7787 personal property, or interest therein, and to give option for sales or leases, and to give a good deed of conveyance or bill of sale for. the transfer thereof; to allocate any property received or charge incurred to principal or income or partly to each, without being obliged to apply the usual rules of Trust accounting; to distribute in cash or in kind (according to the fair market value prevailing at the time of distribution) or partly in each. SIXTH: I nominate, constitute and appoint my daughter, LYN M. WALLACE as Executrix of my Last Will and Testament and my Estate. In the event LYN M. WALLACE is unable or unwilling to serve, I nominate, constitute and appoint HELEN G. FLOWERS as Executrix of this my Last Will and Testament and my Estate. In the event HELEN G. FLOWERS is unable or unwilling to serve, then I nominate, constitute and appoint LARRY M. WALLCE as Executor of_ this my Last Will and Testament and my Estate. SEVENTH: I direct that no Executrix (tor) acting under this Will shall be required to enter bond for the faithful performance of duties, in any jurisdiction. IN WITNESS WHEREOF, I, the said DOROTHY G. PIERSON, have hereunto set my ha1~ and seal, to this my Last Will and Testament, this 7~ day of August, 1999. ~..,C,L~~~ ~.~ ( SEAL ) DOROTHY G. PIERSON HENCH AND CRESSLER ATTORNEYS AT LAIN 224 MARKET STREET NEWPORT PA 1707'4 TEL 1717) 5673139 FAX (7171567-3130 MILLERSTOWN OFFICE 1 N. MARKET STREf:T MILLERSTOWN PA 17062 TEL 0171589.7787 The sheet was PIERSON, the Las have e requ~ t, Actress ~~~L writing contained in this and the preceding signed and sealed by the above named, DOROTHY G. and by her pu fished and declared as and for her Will and Te ament, in the presence of us, who subsc bed ur names as witnesses at her r r sence ~ ~ -~-- N RSON. IL OATH OF SUBSCRIBING WITNESS Estate of Dorothy G. Pierson No. ~ ` C ~ U _ i also known as ,Deceased Linda .J. Halt (each) a subscribing witness to the^ codicil(s) Q will(s) presented herewith, (each) duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of the Testator(rix) in her/his/their presence anc~ in the presence of each other ~ in the presence of the other subscribing witness(es). (Signature) Allen E. Hench 224 Market Street, Newport PA 17074 (Address) ...,r y ~ l ~ n ., Linda J. Hall `-' P.O. Box 387. New Bloomfield Sworn to or affirmed and subscribed r- before me this ~ ~ day of ~~F v~ ~ 2 t7O ~ (Address) PA 17068 -yo -~ ~ cn c7 _ ~_.,__. ~ Notary bl - -~,~ My l;ommission Expires: NOTARIAL SEAL ==~ ~ SCOTT W. MORRISON, NOTARY PUBLIC ' BLOOMfIELD BORO, PERRY COUNTY _ <__~ `z MY COMMISSION EXPIRES MAY 3, 2012 ~-- `-- `~' =a _x~ ca (signature and seat of Notary or other NOTE: To be taken by officer authorized to administer oaths. Plea~iave offici:al qualified to administer oaths. Show present the original or copy of instrument(s) at time of notarization. date of expiration of Notarys commission.) . ~. ~_. - 9 RW -2 OATH OF SUBSCRIBING WITNESS Estate of Dorothy G. Pierson No. ~~~ ©~ ~'~~~ also known as ,Deceased Allen E. Hench (each) a subscribing witness to the ^ codicil(s) Q will(s) presented herewith, (~h) duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the abo Testator(rix) sign the same and that shoe/he/they signed as a witness at the request,pf the ator(rix) in h /his/their prese a antes in the presence of each other ~ in the presence of thefAther s cribin witn ~ (es). ..- ~,,, tea.; r,: ~'' (Signature) Allen E. Hench 224 Market Street, Newport PA 17074 (Address) (Signature) Linda J. Hall P.O. Box 387, New Bloomfield PA 17068 (Address) ~: } "~ r=~ w-a r/.+ Sworn to or affirmed and subscribed -_ ~-~ r~~ - - n ;~ before; me this ~~ day of =~~ ° .~~ ~ J ~ ~ _. • • --; M tCommbssion Ex fires: NOTARIAL SEAL rn Y P SCOTT W. MORRISON, NOTARY PUBLIC BLOOMFIELD BORO, PERRY COUNTY MY COMMISSION EXPIRES MAY 3, 2012 (Signature and seal of Notary or other NOTE: To be taken by officer authorized to administer oaths. Please have official qualified to administer oaths. Show present the original or copy of instrument(s) at time of notarization. date of f;xpiration of Notarys commission.) RW-2