HomeMy WebLinkAbout11-10-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
Estate ~~f Harvey E. Sheaffer, Jr.
also known as
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' nr 'B' BELOW:)
File Number ~'\ i~li_i
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the executrices
last Will of the Decedent dated February 11, 1982 and codicil(s) dated none
(State relevant circumstances, e.g., renunciation, death ofexecutor, etc.)
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:
B. Grant of Letters of Administration
(Ijapplicable, enter: c.t.a.; d. b. n. c. t. a.; pendente liter durante absentia: durartte minoritate)
Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following spouse (if any~apd heirs: (IJ
Administration, c. t. a. or d.b.n.c.t.a., enter date of 4[till in Section A above and complete list of heirs.) `~~
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Name Relationship Reside
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(COMPLETE !N ALL CASES:) Attach additional sheets if necessary.
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Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at C11
Church Of God Home 801 North Hanover Street Carlisle Cumberland County Pennsylvania 170 i 3
(List sdreet address, town/city, township, county, state, zrp code)
Decedent, then 90 years of age, died on October 18, 2008 at Church Uf Ciod Home
801 North Hanover Street Carlisle Cumberland County Pennsylvania 17013
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
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
situated as fol
e
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:
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1243 Pine Road, Carlisle, PA 17015
Social Security Number 191-26-6624
named in the
or printed name and residence
461 Willow Grove Road, Carlisle, PA 17D13
296 Greason Raad, Carlisle, PA 17015
Fo,~m rzW o~ Yep. rQ.t3.o6 Page l of 2
Additional Executrices for Estate of Harvey E. Sheaffer, Jr.
Dona M. Calaman, daughter 315 Richland Road
``! ~~' Carlisle, PA 17015
D~rlene L. Monismith, daughter 925 Franklin Street
Carlisle, PA 17013
(717) 249-7783
(717) 243-3567
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUI~ITY OF Cumberland ,
The Petitioner(s) above-named swear(s) or arm(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.
Swor!; so or affirmed and subscribed
before me the ~! day of
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For the 1ZZeglSter Signature of Personal Representative
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Estate of Harvey E. Sheaffer, Jr. , Decea~~d=,=. 'b
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Social Security Number: 191-26-6624 Date of Death: October 18, 2008 ~ "-"'•
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AND NOW, ~~ ~~'~-`F'-r'~~~'~ ~ ~ Z~J`''U , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters testamentary
are hereby granted to ~~r ~ ` ~~ ~t ~ ~u~~\P~ t ~~ • ~~y~F ~ ~ (~ ~~7~ ~c~ • ~ E 1`~`~ ~ ~ i+ a ,vti~ . l
L~~"t',tlCc. (~1 ~c~ ~CtuY\c~ l ~- d.JCA r ~~ r~ ~.. I~lor~~ Sr~e~ i~4'1 in the above estate
and that the instrument(s) dated ~ ' ~ ~~t; ~~~~~'
described in the Petition be admitted to probate and file of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters .. .3L`~.C ~ t~x ~:.. $ StCr
Short Certificate(s) ... ~~ ... $ ~ ~
Renunciations} .......... $
1,~~~,~~ ... $ 1~~
~1L.. ~~ ... ~ 1 C?
.. $
.. $
... $
... $
... $
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To~rAL ............. . ~ 3.=,c~~. ~ -
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Registero ~ir'tlls 1 '~~~ I
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Attorney Signature: ~ ' ' ~~~~ L__
Attorney Name: Michael A. Scherer
Supreme Court I.D. No.: 61974
Address: O'Brien, Baric & Scherer
19 West South Street
Carlisle, PA 17013
Telephone: (717)249-6873
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H105~t43 REV 11/2006
TVPEIPRINT IN
PERMANENT
RLACK INK
1. Name o~ Decedent ;First, middle, Iasi suKx)
Harvey E. Shaeffer Jr.
5. Age (Last BirlhdaV Under 1 year Untler 1 tlay
(~0 Months DAYS fours Minulm
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- Bb. Gounf/ of Death 3c. Clry, Boro, Twp. of Death
=~1 Cumberland Carlisle
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) - ~
STATE FILE NUMBER ` ~; • \ I ~)
2. Sex 3. Social Security Number 4. Date of Death (Month, day, year)
Male 191 _ 26_ 6624 October 18, 2008
April 23 1918 Carlisle Springs P "°ap"~`
^ mpae~
Btl. FacNily Name (It na instilulbn, give street and number)
Church of God Home
ate retired 72. Was Decedent ever in Me 13. Decetlenl's Education (Specity only hghesl gratle coml
m, U.S. Annetl Forces? Elementary / Secontlary (0-12) College (1-4 or
m ^vaa C3¢Ap g
Dapedem•s PA
Actual Residence 17a. Slate
rib. County Cumberland
t ^ ER / Outpatient ^ DOA ®Nursing Home ^ Residence ^Other - Specity.
9. Was Decetlenl of Hispanic Origin? [~ No ^Ves 10. Race: American Intlian, Black, White, etc.
(If yes, specify taboo. (spec/
Maxim, PPedp Ripen, ale.) ~hi to
had) 14. Marllal Status: Marred, Never Martietl, 15. Surviving Spouse (ll wile, give maitlen name)
f) Witlaweq Divorced (Specil}?
Widowed
Da Depedem
Live in a 17c. ^Ves, Decedent Lived In TwD.
T ship? II~~.~,~~ GarllSle
17d. LWVp, Decedent Lived within
Actual Limits of City/ Boro
KirM of Work Kind of Business I Indus
Fisrmer Dairy Far
1s. oacaaenrs Mailing Addreaa fslreet pity / rown, orate, zip code)
925 Franklin St.
Carlisle PA 17013
18. Fatheis Name (FIrsL, midtll Iasi s ) 19. Mothei s Name (First, mltldle, naitlen surname)
Harvey ~. S~ieaffer Sr. Tressie Goodling
20a. InfOnnanl's Name (Type! Print) 206. InlonnanYS Mailin Address (Street, chy / own, stale, v code)
Darlene Monismith 925 Franklin ~t., ~arlisle PA 17013
21 a. Method of Dispositon ^ Cremation ^ Donation 21 b. Date of Disposifwn (Month, day. year) 21 c. Place of Disposition (Name of cemetery, crematory or other place) 21 d Location (City! town, state, zip coda)
® Rurial ^ RemPVanrPmstate '. waacmmaranproanaliannmhpd:ed October 22 2008 Letort Cemetery Carlisle PA 17013
^ Othe ~ - Speciy: ~ by Medical Examiner /Coroner? ^ Yes ^ No
22a. signanura/of Fy rat Sg aee (a person actirg as such) z2b. Licenae NUml»r 22c. Name and Atldress of Facility j~offman-Roth Funeral Home & Crematory
- -.--9 ~l-v~r- 138425 of n Ta v_.... ____ c~ n__i _ _i _ n
Compkte'~,tems 23at Dory when cenilying 23a. To the best of my krwwletlge, death occurred al the time, date and dace stated. (Signature and tlhe) 23h. Ucense Number 23c. Date Signed (Month, day, year)
physician is not available at lime of death to
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Items 2a-26 must be completed by parson 24. Time of Death 26. Date Pronounced Dead (Month, day, year) 26. Was Case Referted to Medical Examiner I Comner for a Reason Other than Cmmalb or Donalipn?
who pronounces death. 1 ~ xT P M. / ` C~~y~~~~ ~ ~ ' ~ ~i Q 3' ^ Yes ~Na
_..___ _. __..... .___ ..._.. __.._.._ _.._ ___..,..__, r nPe,,,.,,,,,,~,,,,,,.,,.
hem 27. Pan I: Enter me g2ain of evems -diseases, injures, a complicatans - Mat tlirecny ceusetl the tleaN. DO NOT enter terminal events such as ramiac artest. poser to Death ~,~~ ~~. ~~~~~~ u~~~r~ y ,;, ,:mm e , - g
but not resulting In the underlying cause given In Parl I zo. uw lopacco use camnute lp acorn?
^ Yes ^ Probably
respiratory arrest, or ventricular fibrillation without showing the etiology. List only one cause on each line. .
IMMEDIATE CAUSE IF
l di ^ No ^ Unknown
na
sease or {dpi r
condition resultirg In death)
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29. II Female:
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Due to for as a ronse uertce ol): ^ Not pregnant within past year
Sequentially list conditions, d any, b
leadinga to the reuse IisteU on line a ~ ^ Pregnant at bme al death
. pup IP for as a wnse I
Enter the I1NDEflLVING CAUSE quertce o ):
~
^ Nol
pregnant. but pregnant within 42 nays
ev'enis msuAing m detathj aLASTt~
c of death
Due to for as a consequence off: ^ Not pregnant, but pregnant a3 days l0 1 year
d 6elae Beam
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~ ^ Unknown i1 Pregnant wihin the past year
30a. Was an Autopsy 30b. Were ANOpsy Findings 31. Manner of Death 32a. Dale of Injury (MOn U, day, year) 326. Describe How Inlury Occurred 32c. Place of Injury: Home, Farm, Street Factory,
Pedoimed? Available Prior to CamlNefron ~xA
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i
id Olfke Building, etc. lSpeciryJ
of Cause of Death? m
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^ vas ^ No ^ Acckfent ^ Pending Investigation 32tl. ime of Injury 32e. Injury at Work? 321, It Tmnspatalion Injury (SpeciryJ 32g. Locatlon of Injury (Street, city /town, state)
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^ Suicitla ^ Could Not be Detertninetl
^ Yes ^ No ^ Driver /Operator ^ Passenger ^ Pedestrian
_ M, ^Other. SPecity:
33a. Cedifia Icheck only oriel
• Certif
sician (Ph
sician ceniryin
in
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rouse of death when atrother
n
ronouncetl tlealh and com
sioan has
leted h
m 23) 33b. Signature and T
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1'o me best of my knowledge, death occurted due to the rouse(s) and manner as statel _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -
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• Pronouncing end certitying physician (Physician born pronouncing tlealh and ceditying to cause of tlealh)
1'e th
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^ 33c. License Num 33tl. Oate Signed tMonlh, day, year)
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occurre
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me,
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ue to t
e cause(s) antl manner as sated_
• fAetlical Examiner/Coroner _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ rr~~ ``,~
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On the basis of examination and / or investigation, in my opinion, death occurred al the time, date, and place, and due to t
he cause(s) end manner as stated_ ^ J
34 Name and Atltlress of Person Who Completetl Cause of Death (Item 2]I Type I Print
35. Regist~aisS t aptl Disl
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~~~ 36. Dale Fled (Hoorn, day, year) Darryl GlllstWlte, 56 Ashton .St.
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PA 17013
Disposition Permit No. //yy ~~' }
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W I L L
I, HARVEY E. SHEAFFER, JR., of 591 Pleasant Hill Road, Carlisle,
Cumberland County, Pennsylvania, make this my will and revoke any wills or
codicils to wills by me heretofore made.
1. I give, devise and bequeath my entire estate to my wife, Mildred M.
Sheaffer, if she is living thirty (30) days after my death; otherwise, I give, devise,
and bequeath the same to my children, Doris Jean Sheaffer, Pauline T. Calaman,
Betty J. Cornman, Donna M, Calaman, Darlene L. Monismith, all of Carlisle,
Pennsylvania, in equal shares.
2. I appoint Farmers Trust Company of Carlisle, Pennsylvania, trustee
of any property which passes, either under this Will or otherwise, to a person under
twenty-one years of age and with respect to which I am authorized to appoint a
trustee and have not otherwise specifically done so. Such trustee shall have the
power to use principal as well as income from time to time for the beneficiary's
support and education (including college education, both graduate and undergraduate)
without regard to his or her parent°s ability to provide for such support and education,
and, to make payment for these purposes, without further responsibility, to the bene-
ficiary's parent, the beneficiary, or to any person taking care of the beneficiary. My
trustee shall have the same powers that I could exercise in connection therewith if I
were living, including but not limited to those set forth in this paragraph. Any such
trust shall terminate when the beneficiary thereof reaches twenty-one (21) years of age.
3. I direct that all taxes that may be assessed in consequence of my death,
of whatever nature and by whatever jurisdiction imposed, shall be paid by my per-
sonal representative as an expense of the administration of my estate,
4. I appoint my wife, Mildred M. Sheaffer, executrix to settle my estate.
If she fails to qualify or ceases to act as such, I appoint my children, Doris Jean
Sheaffer, Pauline T. Calaman, Betty J. Cornman, Donna M. Calaman, Darlene L,
~/';onismith, executors to settle same. If none of them survive me, 1 appoint Farmers
Trust Company of Carlisle, Pennsylvania, executor to settle my estate. My executors
shall serve without the necessity of filing bond, and I direct that the services of
Marion R. Lower, Attorney at Law, of Carlisle, Pennsylvania, be used in the settle-
ment of my estate.
February ~ ~ 1982 ~ ~- - 1 (SEAL)
Harvey E. S affer, Jr.
Signed, sealed, published and declared by HARVEY E. SHEAFFER, JR., the
testator herein named, as and for his last will, in the presence of us, who, at his
request, in his presence, and in the presence of each other, have subscribed our
names as witnesses thereto.
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Harvey E Sheaffer Jr. is in his/her own proper handwriting.
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OATH OF NON-SUBSCRIBING WITNESS(ES)
Cumberland
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
Estate of Harvey E. Sheaffer, Jr.
Darlene L. Monismith
and Donna M. Calaman
Deceased
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well-
acqua.inted with Harvey E. Sheaffer, Jr, and am/are familiar
with t:he handwriting and signature of the decedent, and that the signature of Harvey E. Sheaffer, Jr.
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
Harvey E. Sheaffer, Jr. is in his/her own proper handwriting.
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(Signature)
925 Franklin Street
(Street Address)
Carlisle, PA 17013
(City, State, Zip)
Executed in Register's Office
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315 Richland Road
(Street Address)
Carlisle, PA 17015
(City, State, Zip)
Sworn to or affirmed and subscribed
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before rye this rt L! day -'L ~ ~.-
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Fonn RN! 04 rev. [0.!3.06