HomeMy WebLinkAbout11-17-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate oiF Mildred G. Hikes
also known as
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMP'LETE 'A' or 'B' BELOW:)
~/ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Co-Executrices
last Will] of the Decedent dated September 29, 2008 and codicil(s) dated
(State relevant circumstances, e.g., renunciation, death afexeeutor, etc.)
named in the
Except as follows, Decedent did not marry, 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 incapacitated person:
0 B. Grant of Letters of Administration
(/f applicable, enter: c. t. a.; db.n.c.t.a.; pendente liter durance absentia; durance minoritate) rv
4
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spo~i`-s_e~any) and~rs
Administration, c.t.a, or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) 7 ~ ~"
l7 ~ L:7
(COMPLETE W 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
419 Appletree Road, Borough of Camp Hill, Cumberland County, Pennsylvania 17011
(List street address, town/city, township, county, state, yip code)
Llecedent, then 83 years of age, died on November 7, 2008 at Cumberland County, Pennsylvania
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
`T'OTAL
situated as follows: 419 Appletree Road, Borough of Camp Hill, Cumberland County, Pennsylvania 17011
$ 210,000.00
$ 180,000.00
$ 0.00
Wherefore, Petitioner(s) respectfu!!y 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:
or printed name and residence
Sharon Copp Roach - 2 Rusty Drive, Mechanicsburg, PA 17050
~-'~ ,~ ~ ~ r/ ~ _~ ~~I~imberly Copp Deardorff- 115 Wyndham Way, Harrisburg, PA 17109
COUNTY, PENNSYLVANIA
File Number ~ ~ U~ (~~~-r"
Social Security Number 20[-16-1040
Form Rw-nz rev. 10.13.06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
The Petitioner(s) above-named swear(s) or 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, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmend and subscribed
before me the ~ I day of
C~~m ~- ,~
For the Register
Signature of Personal
of Personal
Signature of Persona! Representative ~ O €~.~
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File Number: ~~ ~ ~ y,-7~ ~ ~ c~
Estate of Mildred G. Hikes
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_, Decea~d
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Social Security Number:(~201~-16-1040 Date of Death:November 8, 2008 {V
AND NOW, ~~ ~~ ~ .I L1' I V(~1 ~(~hl(l~~ 1~~, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Testamentary
are hereby granted to Sharon Copp Roach and Kimberly Copp Deardorff
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Wi 1 (and Codici s)) of Decedent.
FEES ~ ~~
_ R inter of Wills
Letters ....~~.~~~?,l7t~U. , $ ~ . ~ ~~ ~~
Short Certificate(s) .. (~.... $ ~`~ Attorney Signature: _
Remanciatlon(s) .......... $ Bruce J. Warshawsk Es wire
- ~l'~ $ ' ~ Attorney Name: y~ 9
... $ J
... $
... $
... $
... $
... $
... $
_ c.~ ~' X60
TOTAL .............. $ ! I'f
Supreme Court I.D. No.: 58799
Address: 2320 North Second Street
Harrisburg, PA 17110
Telephone: 717-238-6570
Form Rw-nz rev. ln.l3.n6 Page 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate. `s6.0O
P 14• ~ 0 ~ 2 9 7___
Certification N~In~ber
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dul~~ filed tir.ith n;: a, [.~,ha! R~,l~trar. The ~~n~~ina1
ccrtific.rte ~+~if± tte !tlr•:A:Ir1~(c°,l ,r, the 5iate Vital
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IEV ttrzoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
'RINT IN
ANENT CERTIFICATE OF DEATH
~.,~ ^
K INK (See instructions and examples on reverse) sTATE FILE rvuMBER ,~ 1 Q~ 11~~
1. Name of Decedem (Fst. middle, last, suXix)
Mildred G.. Hikes 2 Sex
Female 3 Social Security Number
201 _ 16 ~ 1040 4. Dale of Death (Month, day, year)
November 7,2008
5. Age (Last Blrthtlay) Under t year Under 1 day 6. Dale °f Slnh (Month, day, year) 7. Binhplace (City and slate or for eign wuntry) Ba. Place of Death (Check only one)
Months Days Hovn Minutes H°SPlta: Other'.
83 Yrs. Februar 14 1925 Columbia Pa ^Inpalienl ^ER/Outpatient ^DOA ^NUrsing Home [Residence ^01her Specily.
66. County of Death 8c. Cfty, Boro, Twp. of Death Bd. Facility Name Qt not institution, give street and number) 9. Was Decedent CI Hispanic Originp ~) No ^Ves 10. Race. American Indian. Black. Waite. etc.
(If yes, specify Cuban, ($pe rty'te
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Cumberland Camp Hill 419 Appletree Road Mexican,PuenoRlcanetc.) .
11. Decedent's Usual Occ alien (Kintl of work done B urin mast of workln life. Do not slate retired) 12. Was Decetlent ever in the 13. Decedent's Education (Specify only highest grade completed) 14. Marital Status: Married, Never Married. 15. Surviving Spouse (II wile. give maitlen name)
Kintl of Work Klnd of Business /Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specily^
Le al Secr_etar Dunla Attorne ^Yea ~No 12 Widowed
tfi. Decetlent's Mailing Adtlre:,s (Street, city I town. state, zip code) Decedent's Pa Did Decetlent
Slate Llve Ina 17c
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Decedent Liv
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419 Appletree Road .
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Cumberland T°wn~hi°' 17d ~N°
DecedentLwedwilnin Camp Hill
Cam Hill Pa 17011 ,
Actual Limits of „ity t Boro
"b c°°n"
18. Father's Name (First, mitltlle, last. sufllx) 79. Mother s Name (First middle, maiden surname)
Ammon C. Co Mar Kauffman
2Ca. Informant's Name (Type / Prinp 20b. Informant's Mailing gddress (SlreeL city I town, state, zip toilet
Sharon Ro,3ch 2 Rusty Drive Mechanicsburg, Pa 17050
21 a. Method of Disposition ~~ Cremation ^ Donation 216. Dale of Dlsposklon (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 21tl-Location (City I town, slate, zip code)
^ Bun
^ RemovallromSlate ., Was Cremation orDanationAuthodzed
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^ November 10
2008 er Cremator
Hollin Mt Holl
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^ Other - S i by Medical Examiner /Coroner?
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22 re o era) Servke Licen on adinq as such) 22b. License Number 22c. Name antl Address of Facility
011654-L M ers-Horner Funeral Home Inc 1903 Market Street Cam Hill Pa 1701
Complete Items 23ac only when cenitying 23a. To the bas CI my krwwledge, death occur at Vte time, date antl place slated, (Sgnature and IMIe) 23b. License Number 23c. Date Signed (Month, day, yeap
physician is not available at time of death to ~ ~ .~yl f ~ I 0 _ _ ~ oO
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cenify cause of death. ~ (Qy
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Items 24-26 muss t>e completetl by person 24. Tme of Death 5. Date Pronounced Dea (Month, day, year) 26. Was Case Relerred to Medical Examiner I Coroner for a Reason Other Than Cremation or Donation?
who pronounces tlealh. l f ~, M. ~ a o o ^ Yes ~~
CAUSE OF DEATH (See instructions and examples) ~ Approximate Interval. Pan II: Enter other significant conditions conlribulinp to tlealh, 26. Did Tobacco Use Contrinule to peathc
Item 27. Pan t, Enter the cl aintyf pvmt5 -diseases, Injuries, or complications -that tlirectly caused the tlealh. DO NOT enter terminal events such as cartliat arrest, Onset to Death but n01 resulting In the untlertying Cause given in Pan I. ^ Yes ^ Probably
respiratory arrest, or ventricular fibrillation without showing the etiology. List only one cause on each lure.
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^ No ^ Jnknawn
IMMEDIATE CAUSE 'Final disease or
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29. II Female.
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condaion resulting In death) _~ a
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(f /y~.t~ `fry l
C•' ~(~iT L7 ^
Due to (or as a consequence of): t Not pregnaN within past year
Sequenlialty list conditions, if any, b ^ Pregnant at lime of tleatn
leading to the cause listetl on lute a. pus to (or as a consequence of)' t ^ N°I pregnant, but pregnam within 42 days
Enter the UNDERLYING CAUSE t
(disease or Injury That initialed the c t
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th) LAST
of death
events resu
ng in
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Due to (or as a consequence op. ^ Nat pregnant, but pregnant 43 days m I year
d. t Delon death
^ Unknown If pregnant within the past year
30a. Was an Autopsy 30b. Were Autopsy Fintlings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred 32c. Place of Injury. Home, Farm. Street, Factory.
Pedormed? Availaole Prior l° Completion
of Cause of Death?
alural ^ Homicide OAice BuilQng. etc. (Specily)
^ Accident ^ Pending Investigation 32tl. Time of Injury 32e. Injury z! Work? 321. If Tmnsponation Injury (Specily) 32g. Location of Injury IStreel, city / Iewn. slate)
^ Yes Idf~
~'°Y ^ Yes ,~'~ ^ Suiatle ^ Could Not be Determined ^ Yes ^ No ^ Driver! Operator ^ Passe r ^Pedestrian
M ^Other ~ Specily:
33a. GertNler (check only one) 33b. Signature and T fifer
n (Pnysinan cenirying cause CI death when another physcian has pronounced tleatn antl completetl Item 231
Certi in h siciz
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mowletlge, death ocairtetl tlue to ttre cause(s) and manner as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
of my I
To the Oes
• Pronouncing and rertitying physician (Physcian both pronouncing death and cedltying to rouse of death)
^ 33c. Lcense r 33tl. Date Sjgned (Month, day. year
To the best of my knowletlge, tlealh ocwmed at the time, date, and place, and tlue to the cause(s) antl manner as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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On the basis of examination and / or investigation, in my opinion, death occurred at the time. date, and place, and due to the cause(s) antl manner as slated_ ^ ~ N/a~me and Address//ol P,erson Wh Compl led Clause of Death (Item 27; 7yp,, I Pnn
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' 36. pale File (Mont .day, year)
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V Disposition Permit No. ~ 0(i _ ~JO~
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LAST WILL AND TESTAMENT OF
MILDRED G. HIKES' ~,
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I, Mildred G. Hikes of 419 Appletree Road, Camp Hill, Cumberla~Count~
Pennsylvania, make this last will and testament and revoke all earlier wills ~~
and testamentary dispositions.
First, I appoint as my Executors Sharon Copp Roach and Kimberly Copp
Deardorff.
Second, I leave to my good friend Betty Lou Kost of 8 Gale Road, Camp
Hill, Pennsylvania, $25,000.00 but with no right of survivorship.
Third, I give the following close friends each $1,000.00 but with no right of
survivorship: Barbara Wessels, Ann Ferraiolo, Christine Sylvestor, and
Dorothy Bogart. Their addresses are listed in my phone book.
Fourth, I give the following relatives each $5,000.00 but with no right of
survivorship: Betty Bohr, Jerri Bohr Sechrist, Marlene Bohr, Stacey Bohr
Witmer, Brian Bohr, Wade Deardorff, Lee Deardorff ,Stacey Dorwart, and
Lisa Shindel.
Fifth, I give my brother Robert L. Copp and sister in law C. June Copp each
10,000.00 with the right of survivorship.
Sixth, I give the following relatives each 25,000.00 with the right of
survivorship: Mildred Denison Dissinger, Sharon Copp Roach, and
Kimberly Copp Deardorff.
Seventh, I give the Harrisburg Symphony Association $10,000.00.
Eighth, if I am still seeing James Hadley Bailey, he is to get $5,000.00 but
with no right of survivorship.
LAST WILL AND TESTAMENT OF
MILDRED G. HIKES
Page 2
Ninth, my house, car, 2.09 carat diamond ring, furniture and household
items are to be sold and my account with Edward Jones (Sean Ferguson
agent), Met Life stock, CD's, if any, checking account, etc to be redeemed
and the money used to take care of the foregoing bequests.
Tenth, any money left over after paying taxes, expenses and bequests is to be
divided equally among those named in Second, Fourth, Fifth and Sixth
paragraphs.
Executed at Camp Hill, PA this ~~' . c'~ day of September, 2008.
/~° i~,~~~.c~~z~:~ti .~ ~ ~' ~~~~~ (Seal)
-~ Mildred G. Hikes
Published to us by the Testator as her Last Will and Testament, dated, signed, and
sealed by her in our presence, and at that time signed by each of us as witnesses in
the presence of the Testator and of each other.
~``~'~ ~ , • ~~ ~ , ~ ' , ; Date ~ ~' ~~~-°
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would hope that Myers Funeral Service would be used for my cremation and that no
funeral service would be held, but if my relatives do not like that idea ask my niece
Kimberly Deardorff if she will preside. And if you have a service, please have a catered
party afterward at Prosser Hall in the Camp Hill Borough Building to celebrate my
wonderful life. Scatter half of my ashes in the Susquehanna River and the other half,
scatter around "Bill's Tree" at Ski Roundtop.
OATH OF SUBSCRIBING WITNESS(ES)
Estate of
REGISTER OF WILLS
~~l Zvi ~~-'I ~~„~, COUNTY, PENNSYLVANIA
~1d~~~ G- ~h ~s
~2 l,-~ l (i S a~~ ~`lLtr~a~~ f ~~ (~' !1 i'S
Deceased
(each) a subscribing witness to
(Print Name/s)
the ill ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she ! he / he was /were) present and saw the above Testator / esta~tri~x ~ sign the same
and. that she / he /the \ signed the same and that she / he the signed as a witness at the request of
the Testator estatrix in her his presence and in the presence of each other.
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(Sign~atureJ ,
(Street Address)
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(City. State, lip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
Deputy for Register of Wills
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this ~ ~ day
Not Public
My Commission Expires: (,l"~'~~,t ~~ ~.
(Si~tature 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 original or copy of instrument(s) at time of notarization.
Form !.'W-03 rev. /OJ3.06
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Jennffer N. Grove, Notary Public
Silver SP~n9 Tt^tP~. Cumbettand County
My Commission Expires Jan. 28, 2012
Member, Pennsylvania Association of Notaries
`f 1 ~ I ~~~ l~ ~~~ ~ ~~ l~~f
(Street Address)
(City. State. Zip)