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HomeMy WebLinkAbout11-26-08PETITION FOR PROBATE LAND GRAANT OF LETTER REGISTER OF QUILLS OF L~LI/Ylf~'`~L~~-%~ COUNTY, PENNSYLVANIA Estate o`er-~EL~~.~ f~ / t ~1 ~,~ ~Ll ~~+~ File Number ~ ' _~ ~y~, - also known as Deceased Petitioner(s), who is,'are 13 years of age or older, apply(ies) for: (C0:IIPLEI'E 'A' or 'B' BELOW:) Secial Security Number ~~~' ~ / ~A. Probate and Grant of Letter Testamentary and aver that Petitioter(s) is /are the ~~~ .+~ - /7~N~~ named in the last Will of the Decedent dated I ~ and codicil(s) dated (Strte relevnnt circumstances, e.g., reruutciatia+i, depth 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 insUument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ^ B. Grant of Letters of Administration (Ifnpplicnble, enter: c. t. n.; d. b. n. c. t. a.; pendenteli~e; durrntenbsentin; duraateminaitntej Petitioner(s) after a proper search has l have ascertained Chat Decedent left no Will and was survived by the foilowing spouse (if any) and heirs: (if Administration, c. t. a. or db.n.c.t.a., enter date o(Will in Section A above and complete list orheirs.) (List street address, town/city, township, count), state, zip code] ` " Decedent, then ~ years of age, died on ~ ~ ~~ ~ b at 3 ~ ~~mp [,:JCZZ- T ~-'~( l.%~ ~ ~~'~ Y-~-- ~~ ) ~t' / ~ 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 follow $ ~ ~.~ ~ Leo Form R6V-0? rev. 10.13.06 Pabe I Of 2 ~.,~ r _,. ,-; (COrY1PLETE 1N ALL CASES:) Attach additiatal streets if necessary. - -~ i~ _. ~, Decedent was domiciled at death in ~ ~~ ~ ~ _~ ~ ` Le~~'?~ ~"I~d County, Pennsylvania with hts /her last princ>~l residence at~• ,.3 ,tS l ~A rYIO l~l-`7 ~ la/ /a--r+G . l~/~-m P %~ Z / ! 1~~-~ 1 "]C`i y l ~ Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will il(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Oath of Personal Representative CO~I~IONyVEALTH OF PENNS`tLV,~,NIA SS COUNTY OF ~Q p~~~~~'~C~ The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con~ect 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 admiristcr t!:e estate according to law. ~~ Sworn to or affirme~~ and subscribed c;,fore me the ~_ day of ~ ` r For the Register File Number: ~I Sigrn ire of Personal.4epresenlative t '`-~ = -, ~ _ ~ "~ Signature ofPersonnl Represenlnlive - ! ~- t~,3 ~; ~, Signature ofParsonnl Representative ~ ~. -=t ~ _ C.'7 Pd ^~ t ~ ~ -- Estate of (1~„~(/(/XX~,(~ 7C , l ,~:C.('~CIQ~ ,Deceased Social Securit,~ Number: ottt~~""~1~ /8'~~~7 Date of Death: / AND NOW, ~'~. lx ~`,~,i~`~'l~?_~~',,~;~2 ~ ~' ~~~"~; , in co isideratio of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters ~~t ~.~1n(,1~1t(~ a'~.d'~ \ ~ "- ; are hereby granted to ~.. y ~.. ~~`\}~! ~ y' t ~ in the abova estate ~, and that the instrument(s) dated _ __ _ ~ ~~:~~~' ~"'7 __~._-';~~__ _ __-_ described in the Petition be admitted to probate and filed of recory\d,1~as the st Wei (and Codicil(s)Decedei.t. FEES ~~ -' Cr ~- .: ~ ,,:~.,7 ; ~ ~ ' ~ 45 ~- ~` „~ Register oJWiils `~ Letters ... /. ~~J U~ .. $ lU ' Short Certificate(s) ..~.... $~_ Renunciation(s) .......... $ l,~! l~ ... ~ l5 ... S ~.,r ... $ ... ~ ... $ ... $ ... $ ... $ TOTAL .............. S y /~ Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Telephone: Form R6V-D? rev. 10.I3.U( pa~0 2 Of 2 t. it~.SOs KF'V rU 197? LOCAL RF~ISTRAR'S CERTi~ICATI~N ~~ DEATH Wl~:RNING: ?t is illegal to dVpiicate this copy by photostat or photograph. Fee for this certil~)catc, S6.t)U ~;;r% N I h(~ :~ a c ~rtitl t;1at Cl1~ inl«tmtitron ~(r ° ~x=u n i~ Of p~~ ~ r,~~'P~( correctly .t,~ie~t11rt1)7~ ;tn ~~r)~~in~.( ''ertit~c.ue oI [)ear %~~o~~' ~ ~~A ' ~ klul fil:~d 1a~ith „~e a. ~_ocal Rc ~isrral. Thy n)I7ina! ~ ~ '~ ~y~~ ~cttificiste will ~c forl~ard~d t+t the Stab Vst_tl <°>' a; ~ Record; ~~ffit.c ,,~ ,>eilt~.Ln~)1r filln«. `~ o ~ - ~ ~~,_ G`~ NO V 1 8 2008 ~ ~'~ENT ~~ ,Ir% ~ ----------~'--1 -~L ---- -- -- Certific~tior Nwnber `"=-.,~-~„'-~ r l.i~~al Rt.__/~tc.)) i~ar~~ r>.~ueLi rv C.-3 t_- ~ ca _,_ _ [) ' ~ I _ _ x - ._.__, N , _ CT'x -~'~ ` ` ~ _~ ~ _-i -TJ ~ N 3EV 11/2006 PRINT IN (ANENT I( INK a CONIMOPlVtlEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATi-I (See instructions and examples on reverse) ~,~7C <„ ~ ,,,,,,,,,~~ ~ y 1 i +;~~J ~ 1. NAme of Oeoedenl iFirat, midtlle, last, sullix) 2. Sex 3- Social Security Numbor ~,.: a flare of Death (MOntll, day, years Cecelia R. Pullease Female 201 - 18 .- 6877 November 8, 2008 1 15. Age 0.ast Birthday) Untler 1 year Under 1 day 6. D21e of Bltth (Month, day, year) 7. Bidhplece IClty and dale or lor eign country) Oa- Phnce of Death (Chock only one) Mpmns Days Hpn~s nniama. H s Hal'. o P _~ r Omo 82 Yrs. Sept. 5, 1926 Steelton, PA ^mpl.nt ^ER/otpte,t ^noA ^Nnr.p~n»nglRrade,ra ^~ -~,_.y I fib. County el Death 6c. City Bore Twp. of Death 3A. Fac lily Name (II npl i uL Ir lion, give slreel and ,t mbe) y. Was Doc I t I H spa r 0:g n? ®No ^ 1'es t ~ R A a tndao Etack, While, etc. r c t Cumberland Camp Hill 38 Campbell Place ill Xes cpec ly C ba I SI ec f' M canPratoR=, t) White 11. Decetlent's Usual Occu atlon Kind of work done Burin rtrost of workn I'le. Do not stale retired) 12. Was Decedent ever in the 13. Decetlenl s Education (Specify only hlghesl grade co plate 1) 14. Marital Slalus: Married. Never Marred, t 5 Ft v v rq Sporse ill le. g to •,a den name) I(ind of Work Hintl of Business I Intlustry U.S. Armed Forcos2 Elomsnlary /Secondary (0-12) Gnlleoe (t-4 or 5+) Widowed D'rvorcad (Spec!/~) - `` Executive Secrete PA Treasury D~ ^vea ®Np 12 Widowed ~ 16. Decetlent's Mailing Address (slreel, city I town, stale, zip code) Decedent's Did Decedent 38 Campbell Place Actual Residence 17a. Stale Penns Vania Live in a 17c Ves. Decedent Lived b, , ~ Twp. Camp Hill PA 17011 vb. cpnnly Cumh n mwiisl,il, and rid R] ~oj Decedent Ltoed wpm"' C Hill , u amp cat rBpm v 16. Father's Neme (First, middle, last, suKx) _ 19. Mother's Nnme IFrst, miUdle, maiden surname) Nickolas Klipa Matilda Starasinic 20a. Informnnl's Name (Type I Print) 20b- Inlormant's Mailing Address (slreel, city Mown, stale, zip enclr) --~ Mrs. Jeri L. Hamel 38 Campbell Place, Camp Hill, PA 17011 :~ 21 a-Method of Dlsposllian ®Cfentalion ^ Dnnalton 21 h. Dgle of Dlsposillon (Month, day, years _ 21c Place nl Dlepositlon (Name of cemetery. cron,alory or other placer ~21 d. Location C~Iy !sown, stale. zip codes ^ Budal ^ Removanromslate wascremalmnorDOnahonAamnri:ed ~ ^ Omer ~ SpecilY ~i by Medical Examiner /Coroner? ©Yes ^ Ne Nov. 11 2008 ~ Cremation Soeiet of PA Harrisburg, PA 17109 y 22a. Sig: ;~1 Frvice Lic (ar pars s(ng as such) ) 22b. License Number 22c. Name antl Atlclress al Facility Auer Cremation Services of Pennsylvania, Inc. / ;® _ - _ FD-010694 L 4100 Jonestown Road err Complete Items 23a-c only when cedlfying 23a. To the best of my owledge, death occurred al the lime, dalr. antl plane slated (Signature and lisle) 23b-License Number 23e. Data S~rn,<U (Month, day, year) physician is not ava7able al lima of death to cedily Cause of death- Items 24-26 must be completed by person 24. Time of Death 25. Dale P pounced Deatl (Month, day, yenr) 26. Was Case Relerred to Medical Examiner f Coroner for a Reason Other Than Crpmal~on or Donalion~ whe pronounces death. ,1 ~` A. ry1 E ~ ~i N~ ~ ~ ~~ ~ 1 ~ Ci C~ ~ ^Yes ^ Na CAUSE OF D ATH (See Instructions end examples) ~ Approx Hale interval. n Pan II: Enter olhor 65 n1(Icant condil'LOr~cynl I olio to al 28. Dld Tobacco Use Contribute to Deathr Item 27, Pen I: Enter the eheln of events-diseases, Injuries, or compfceflpns- Ihnt dlreelly paused the deall>, DO MOT enlerlom,inal events such as cardiac anesl, Onael to Death but not resulting L, the untlerlying cause given m Pod `. ^Yes ^ Probadty respiratory arrest, o! ventricular librillelion wthoul showing Ilse elielogy. Llsl only Ona cause On each line- ] ! ^ IJC ^ unknown IMMEDIATE CA 95E (Final disease or { ~ j n ^ p i ~ ~ !~f condt II m Ihl { V i `, 1 I/ ~ ~ ~ ,D j~ a u F to - ~ _~ a 1 I V Y1 t V ,~ V I 1~ r - ^ Due to ( s a cons 3que a pl) _ 5 a e F tly f sl o dl'o s Y y b, ~ o -~ ~, ( ~ ~ ~ ~ ~ U ~ ~ ~ ~ ~.. ~ ~ ~ ~~" ~) ~ ~ i ~ pr n~ I d' t t II e I- I d I ne a -W -- ~ ~"~ N t t rag t ~ d : t yeas ^ P . aria I t f t t n a c . Due to or as a consa Enle the UNDERLYING CAUSE ( q, once oli, , ^ Not preg L hul pr_pna,t v lh n a2 days - (disease or injury that In Bated II e = events resulting to tlealh) LAST. ~ nom) ~ ~~~ f{ I'\ of daah Due to (or as a conssquence ol): ^ Not pregnant, put pmanant a3 days tp t year d. ~~ t bemre dean, ^ Unknown .I pregnant wAhln Ilte past year 30a. Was an Autopsy 30b. Were Autopsy Endings 31. Manner of Deelh 32a. Dale of Injury (Month, day, year) 32h. Describe How Injuy Ocnrrred ~ 32c. Plane of Injury- Home, F-arm, Street. Faclpry. Pedormed? Availahle Ftior to Completion Nelural ^ Homicide I 011ice Boildino, etc. (SpecilyJ of Cause of Dealh7 ^ Accitlent ^ Pending Investigation 32d. Tme of Injury 32e, Inj S ^ Ves ~o ^ Yes ^ No ury el Work? 321. II Transpa,afinn Injury (Specily) , 32x. Locplion of Injury (SVeel, city /sown, slate) ^Yes ^ No ^ Driver I Oporalor ^ Passenger ^Parlaslrian ^ Suicitle ^ Cpuld Nol be Dewm,ined M '. ' I-- -- . 33a. Ced far (cheoN only oriel e ^Olher Spw:ily: - -- --- -- --- 33b. Slgmh re A,d Tll I I 1 Cerl'ly rig phys'c en Phys'c a rlyng car 5e I l .all t' _ II pl ys hag pro,o need tlealh a td co nplglod Isom 23) - ~ ?~ 1 ~ ~ ~ I - o the best nl my knowledy de lh ccurred Aue to the cau (Ia,tl ttanter as stalad_________________________ i ` ________I.1'I _~ I / ~ ._ __ __ _ ~ a g r h A d n Q e ~ l 9 tl ic l I 4 _ . ..-__.___ .-__--___-_ N bi r L c n3n n p Sn Manth r e t v ^ p3 l r u TeU at (he me nl l I lacn a,d Bur n Il, nd na mar as slated_ _ _ _ _ _ _ _ _ _ e eal oc l a a) a • Med cab Examf anerk Coroed l\ ~ L~ ~ 7 ~ ~ ! ' ` ~_ i ~ i ~ / ~ ~ ~ _ _ _ _ _ _ _ _ ~ On the Uasls of examination and I or nvesttgal o, ', ny op t lot r' th occur'at of Ihn lime, (Intr ,rid place and cl,re In the cm se(n) and m - - _ - a ,Her as stalarl ^ , -- - - -- -- --- I- ' _ ,n lV ne a t A I l I~a ~n, Who C pwt t ~n sr of Din h ~ , , al Type. r Pr n ~;~~ ~-1~'V~1 I' n I I~ L. ' L~ I ~ ~ ~ ~ 35 RegtslrtF al tr and a .m ; -~36-Dale Fled ~t ~ ~~la.~..~2e_~ ~ xl ' I ~1! 1~ I ~~ / G Y y~^o,lh d y, year) -~' ~1 s I " t U ' ' ~%~r~o~~,~ _~~_L~~' I-~ Chi U ~c-h f~~> + l~ I ~ + _~_ 6 Dispnailion Permit No. _ 03D9DD8__~~^_ ~'` j ~; N i 60 . - t-~ - - _ Last Will and Testament ~J Cecelia K. Pullease -~~ ~--~ ~n N On this~~.~ day of ~~.~-~, 07, Cecelia K. Pullease, being of sound, and disposing mind, do hereby revoke any and all Wills by me heretofore made and declare this document to be my Last Will and Testament. 1. I direct that all estate and inheritance taxes payable as a result of my death shall be paid out of the residue of my estate and shall not be deducted or collected from any Beneficiary hereunder. 2. I hereby give, devise and bequeath the residence I own at the time of my death to my daughter, Jeri L. Hanzel. 3. I hereby give and bequeath the automobile I own at the time of my death to my daughter, Jeri L. Hanzel. 4. I hereby direct that my great grandson, Trenton Matter, shall receive the sum of One Thousand Dollars 01,000.00) to be held in trust until he reaches the age of eighteen (18). 5. I hereby direct that my great granddaughter, Taylor Eberts, shall receive the sum of One Thousand Dollars 01,000.00) to be held in trust until she reaches the age of eighteen (18). 6. I hereby direct that my great grandson, Devin Eberts, shall receive the sum of One Thousand Dollars 01,000.00} to be held in trust until he reaches the age of eighteen (18). 7. All the rest, residue and remainder shall be distributed as follows: A. Jeri L. Hanzel -one-half (1/2) B. Tawnya L. Smith -one quarter (1/4) C. Ronald C. Eberts, Jr. -one quarter (1/4) Last Will and Testament Cecelia K. Pullease If by the time my estate is settled and Ronald C. Eberts, Jr. has not sought medical care and continue on medication prescribed for his disruptive behavior and uncontrollable rage, I hereby revoke his one quarter (1/4) share and direct that it be distributed to Tammy Eberts. 8. I hereby name my daughter, Jeri L. Hanzel, to be the Executrix on my estate. ,~ Cecelia K. Pullease Witnesses: ~~~ ~ ~ ~ ~`~`~ this `3, day of ~t,~ti~-~c- , 07 ~~~-~-~ this ,3-~-~- day of ~~~~~-; 07 ~.} ^ _ ~t~ .. ~ .. OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CltlYl~~l-~l~+D COUNTY, PENIvTSYLVANIA Estate of M -~R 1i t is ~~ k, / l9N~i~P vi Sib (each) a subscribing witness to ~ ~ (Print Name/s) the~Will G~-Eedi~e~l{~s) presented herewith, each being duly qualified according to law, depose(s) and say(s) that e they v~~f ere pre ent and saw the above T2st~ter / estatrix sign the same and that sib they signed the same and that s'e they, signed as a witness at the request of the ~ estat i in her presence and in the presence of each other. ~~ (Signature) ~/~ ~ ~, H~~ (Sigr:ataw-e) L~%I'~~~ i N ,`z'r~LZ (Street Address) ~~9Kf~' I~il~, h~; ,'19/1 Jt'7~ ~G,~- °,'~~ (City, Slate, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills ~%~~~~ ~~ t l~~ A~~~~ ~-,fl S~, Deceased ~l~ u~Jr~1~~CGL Pt%~'~~~ (Street Address) ~r'9 X?t~ f1%GI_- /~/~` i 7,111 ~7/'I - "IG3 ' `~dJ,~ (City, State, Zip) Executed oast of Register's Office Sworn to or affirmed and subscribed before me this ~ day t No ry Public My Commission Expires: Jet". / ~Ji~, (Signature and Seal of Notary or other official c~ualitied to administer oaths. Show date of expiration of Notary's Commission.) Trexler Notary And Paralegal NOTE: To be taken by Officer authorized t~~81~4G~'ier oaths. Please have present the ngma or copy o ~t~t ~ume o notarizati n. Barry K. Trexler, J.D. BARRY K. TREXLER 551 West Drive ~~y P~BI.IG-NOTARY ID 1210356 Form RW-03 rev. 10.13.06 Harrisburg, Pa 17111 717-566-1732 S4VATARA TOYIA~P, ~~~, PA, ~ MY COMMISSION EXPIRES OCT. t, 2012