HomeMy WebLinkAbout02-20-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Earl L. COUISOn File Number 21-09- Ol'~~l
also known as Earl Coulson and Earl Lerov Coulson
Deceased Social Security Number 174-05-1471
Michael L. Coulson
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or'B' BELOW.)
QX A. Probate and Grant of Letters Testamentaryand aver that Petitioner(s) is/are the Executor named in the
last Will of the Decedent, dated 02/26/2002 and codicil(s) dated
State relevant circumstances, e.g., renunciation, death or 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 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
app rca e, en er: c..a.; ..n.c..a.; pe en e r e; uran e a sen ra; uran a moron a e
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs(If
Administratlon, c.t.a. or d.b.n.c.t.a., enter date of ill in Section A above and complete list of heirs.)
~z
Name Relationship Residence -._
r..i
~ _.,~ __. „r ,._ .
l.~ _,
_. ,
- --~ ;
_.. ,._ ,
-- --
- ^~ -1. i .;.. ~;
_ ~
'
i l
~
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
_~
~r
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
O ~,.~
One Longsdorf Way, Carlisle, South Middleton, Cumberland, PA 17013
(List street address, town/city, township, county, state, zip code)
Decedent, then $7 years of age, died on 02/03/2009 at Cumberland Crossings One Longsdorf Way, Carlisle, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA)
(If not domiciled in PA)
(If not domiciled in PA)
Value of real estate in Pennsylvania
situated as follows:
All personal property
Personal property in Pennsylvania
Personal property in County
100,000.00
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:
Signature Typed or printed name and residence ~
Michael L. Coulson 104 Oak Ridge Roa
Carlisle, PA 17013
Form - Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
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 affirmed and subscribed
before me this ~~ day of
?'{Z.r2
n
1~
~ /
~(%~
For the Register
File Number:
AMOUNT $
Estate of Earl L. Coulson
,Deceased
A/IVA Earl Coulson and Earl Leroy Coulson
Social Security Number: 174-05-1471 ~j Date of Death: 02/03/2009
AND NOW, ~e ~~~~-~~ ~~ o ( , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT I~ DECREED that Letters Testamentary
are hereby granted to Michael L. Coulson
in the above estate
and that the instrument(s) dated 02/26/2002
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
IS BOND REQUIRED? ~ Yes QX No
ARE THERE ANY MINOR HEIRS? ~ Yes QX No
FEES
Letters ............................... ........... $ 210.00
Short Certificate(s) ............ ............ $ 20.00
Renunciation(s) ................. ............ $
JCP Fee $ 10.00
Will $ 15.00
Automation Fee $ 5.00
$
$
$
$
$
$
TOTAL ....................... ........... $ 260.00
Signature of Personal Representative C7 ~ -I-~
~ ~ ~,
-
'"'
S i
~ rn~
Signature of Personal Representative I
T_, t, ~ ;
.__ - ~:~ C7 _ t_ .._
`.l J1
T
~
t
~
~~ r t
21-09- Q\'~~ _ ' --- t~
O
Ati
Supreme Court I.D. No.: 21458
Saidis, Flower 8~ Lindsay
Address: 26 West High Street
micnaei ~. ~.vuisvn
Carlisle, PA 17013
Telephone: 717-243-6222
Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
Attorney Name: Robert C. Saidis Esq.
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, 56.00
P 15004010
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with nee as Local Registrar. The orir~inal
certificate will be forwarded to the State Vital
Records Office fin- permanent filing.
~. ~~~.t~,~,b~t~x' F E1~ 4~ 2f~09
Local Registrar Date Issued
r~
C7 ° -
~;
;-
--~ ..~, -
_.
~ ...,.t ~
_ r
-
-> >~, -
.l~-~ t~~
:__,
:.,
- '
-c, r-~;
i , .:.:.i
N ' _,
~-r l
_ _~
l
C
H/06-143 REV 112W6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE / PRINT IN
PERMANENT CERTIFICATE OF DEATH 1-}
BLACK INN See instructions and exam lee on reverse ~ ~ (~ `~ ~ l l~
P ~ STATE FILE NUMBER
~I
'a
U
0
3. Socid Security Number 4. Dale d Death (Honor, day, year)
1. Name d Demdenl (Flrst mitldle, last, sWfix) 2 r7
a1
.
e
Ear?. Coulson 174 - OS- 1471 e~/ucw 3. aoog
5. Age (last artnmy) Under 1 year Under /day 6. Data of BiM (Honor, tley, r) 7. &rmplece (City and state or foreign cax4ry) 6a. Place of Death (Check onty one)
me`
1921 treason PA Hpapiml: o
87 "'~"'° °"` "°'"' "'"~°° March 28
,
_
~
/
yre, ^ IrgaeaM ^ ER / ONpedenl ^ DOA LJ Nursing Fbrita ^ Residence ^gher -Specify:
80. Caunry d Deam &. Ciry, Born, ~. of Deem Sd. FadAty Hama (II mt'""~~''''''son, gve street and number) 9. Wes Decedent d Hispenk On~n? Q No ^ Vas t0. Roca: Airedcan Iridari, Brock, White, etc.
(sped/
S (
~ G
C
~
~
Middleton
d S k-osslv~~
White
v""`
'~"•^^~
MdmnwanoR
icarldo)
.
Cuntberian
11. Decedent's Usual ~ Kiid d work dare ~ most d wo ~ rile. Do rot aorta re' 12. Was Decadent ever in the 13. Decedent's Education (Specfy ady Mghesl grarm mrtyxeletl) 14. Mental Selus: Monied, Never Married, 15. Surviving Spouse Ilf wife, ghre maiden name)
Kind of Work Kind d Busbwss I IMustry U.S. Amend Forces? Elementary / Secondary (o-12) Comge (1-4 or 5+) Widowed' Divorced (Speci/yf
Wid
d
Engineer Teleph~~ra Co. owl
prey ^Np 2
. t6.Decedent'eMadirgAdMesslSlrcet /lown,smte,Zipcode) Decedent's PA lNdDecedem rrg~ $, Middleton
Decetlenl LNedn Tw
17c
Yes
s
Gre Lcn~sdorf Way .p
,
p.
Actual Resklnke na.
eta Township?
Cumberland ,Td.^ Np. oamaB~d uwa wmm~
Carlisle ?~. 17013 t?e. cpann Actual l;mlmd ciry/19ao
18. Earner's Name (First, midda. last, suffix) 19. Homer's Name (Flm, mdtlle, maiden surname)
Annie Wri ht
ZOi InfomisnYS Name (Type / Pnnq 20b. Informant's Maili~ Address (Street, cdy /town, smte, zip code)
Michael Coulson 104 Oak Rid e Road Carlisle PA 17015
21 a. Method d Disposition ~ ^ Cremetlon ^ Doneaon 21 b. Date of Disposition (Manor, day, year) 27c. Plats d Dispoailbn (Name d cemetery. crematory a other place) 21d. Loceeon ICiry / rown, slate, zip code)
{~~ Banal ^ Removal horn Smte ; was cnmatlon er DOne6on autlrodzad
• February 9 2009 Mt. Zion Cemetery Carlisle PA 17013
^ aher - ~N; ) M Medkal Esamlrer / Coramr7 ^ Yes ^ No
zza.sig dFUnarwservim azsacn) 22b.UcensaNumbar 22c.NameendAddrassdFedliry Hoffman-Roth Funeral Home & Crematory
. ~ 013144E
Items 23es only when certllyiig d my , deem acarted a , date eM place . (SigmNre end title) 23b. Lkensa NurAar 23c. Date Sigrmd (MOmh, daV Yaar)
~~ at unm a deem ro
s
a ,~,
Z ~ ~ N s~ s s s a 3 a o09
mdNy me
a
ea , w
hems 24 26 must d cempleled W person 24. Torre of D
eem 26. Date P (Honor, tley, year) 26. Was Case Ralened to Metliml Examkmr /Coroner ror a Reason Omer t remotion or Donation?
~ who p°"ounces deem. 77
(31S M. ~vv 3 a-o~o9 ^Yaz pffiNo
CAUSE OF DEATN (Sea inatruetlsma and examples r Appmximam interval: Part II: Enlar atlmr smificeM condikais cuntrmutire m deem, 2B. Did Tabaao Use Contndlm m Deem?
Item 27. Pan I: Enter am Main d everim -diseases, k(ulma, or canplk:albla -met tlreUy ceased the death. W NOT sorer lentdnd events such es tartlet artasL r Onset ro Deem but not resdGg ro me underryirg cause given in Pen I. ^ Yes ^ Pmbedy
respiratory err 1. a vsdricder fEdlelian wdlwut slwwirg the elbbg/. list aMy aw muse on each Nna. ~ ^ No ^ Unknown
IMMEDIATE DAU$E IFinal diseau a ~ (~
canddron resd6g in deem) ~ a. ~ Q r C /L ~~ Q• ~ s ~-~.+^~ 29. g Female:
^
Due m (a as a mreequerxe of): Nd pregnant whtgn past Ymr
^ PregreM at flora d deem
Sepmntleky Ast mridllipns, A arty, D, '
Ie~np ro ae muse Nsted an Area Duero (a az e comequenm oQ:
^ Not pregnant but pregnant xHhn 42 days
Enror the UNDERLYING CAUSE
r d dmth
~6sa~58 a , ury eet
a.
~
~
~
am
) L
ASL
Due to for u a mnsequerKm of): ^ Not pregnant bd plegnan143 tlaYS m 1 Year
behxe deeM
d.
^ Unkmwn d pregnant wimin me pest year
30a. Was an Autopsy 306. Wars Aumpsy FlMags 31. Marxmr d Deem 32a. Date d Inury (MdM, tley, year) 32h. Dazaiihe Haw Irqury 0¢urtetl Street Faclay,
32c. P
~
Bu
Padamed? Amgebl• Prior ro Conpmticn
d Came d Dwm?
Natural ^ Honxcda ildrog ~l
OM
are
^ Yes ~ Nc ^ Yes ^ No
^ Aadcnl ^ PeMng mvestlgetion
32tl. T d Injury
32e. Injury at Wori<?
321. II Trznspartation Injury (SpsNN)
329. I m'tbn d Inpxy (Street dry /tam, slam)
^ Suidde ^ CouM Not t» Demrmined ^ Yes ^ No ^ Dover / Opemmr Patlestnan
M Other-~/Y
33a. Certifier Icheck onry one) 33b. Sgrelure a al
• CaNtying phyaklen (Pltyeidan mrtmrmq muse d deem when another physician tors praaunced dmm and almpldetl hero 23)
Ts dre baztd my knowledge, deaM OCCUrteO duemthe ceusas)end nmmmr as elried.________________________________JdJ . '~
• Prarwuncing end cenXymg physidm (Physician Edh plug deem and cergty'alg ro muse d death)
^ 3&. tic 33d. Date Signed (Manor. day, Year)
_ -- _ - - _
To tM beat d my kmwledge, death omurtetl et Ure Bore, date, MW plain, end dce to the cease(s) and mammy az stamd_ _ _ - _ _ _ _ _ _ _
dicel Fxaminar/COrormr
• N o ,]i ~ C ,... /
( J ` \ J , / /O
C I T
e
, and due to the Cause(s) and manner es sleted_ ^
On Ure basis d exemirMtlon erd I or imrestl~tion, In my opmbn, death occurretl at the Ume, dale, and pence 34 Name and Address of Person who Canpm(ed Cause of Deam (Item 21) Type /Print
36. Registrars ' and Distdcl NU,rpDar•ti t~ I t 'a I \ I O I
`
~ ~ mFilad Month, tley, year Daryl Guistwite 56 Ashton St. , Carlisle PA 17015
~
Disposition Permh No. ~- v v t S 1 ""~ i
LAST WILL AND TESTAMENT
BE IT KNOWN that I, Earl L. Coulson, a resident of 111 Petersburg Road,
Carlisle, County of Cumberland, in the State of Pennsylvania, being of
sound mind, do make and declare this to be my Last Will and Testament
expressly revoking all my prior Wills and Codicils at any time made.
L PERSONAL REPRESENTATIVE:
I appoint Michael L. Coulson of Carlisle, Pennsylvania, as Personal
Representative of this my Last Will and Testament and provide that if this
Personal Representative is unable or unwilling to serve than I appoint Cathy
A. Adams of Carlisle, Pennsylvania, as alternate Personal Representative.
My Personal Representative shall be authorized to carry out all provisions of
this Will and pay my just debts, obligations, and funeral expenses. I further
provide my Personal Representative shall not be required to post surety bond
in this or any other jurisdiction, and direct that no expert appraisal be made
of my estate unless required by law.
IL BEQUESTS:
I direct that after payment of all my just debts, my property bey,
bequeathed in the manner following: -- c~ ~ -,-;
My estate is to be divided evenly between my five children; the~~ ~.' ~;
names are as follows: ,~ ~-; - -
-_ -,
~!
~, ,
Michael L. Coulson of Carlisle, Pennsylvania =~' _y `~~' '
Peter J. Coulson of Carlisle, Pennsylvania ~
Cathy A. Coulson Adams of Carlisle, Pennsylvania
Wendy J. Coulson Guise of Boiling Springs, Pennsylvania
Peggy S. Coulson Whitcomb of Carlisle, Pennsylvania
Testor's Initial
Page 1 of 3
IL BEQUESTS CONTINUED:
I further direct that if any of my children listed above shall predecease
me, that their equal share shall be left to their survivors/estate.
IN WITNESS WHEREOF, I have hereinto set my hand this 26`" day of
February, 2002, to this my Last Will and Testament.
III. WITNESSED:
Testator Signature
The testator has signed this will at the end and on each other separate
page, and has declared or signified in our presence that it is his last will and
testament, and in the presence of the testator and each other we have
hereinto subscribed our name this 26th day of February, 2002.
~~~ ~
~~ ~~
Witness Si tore
Address
- `J 6b~ ~ is Ob 7/. ~L. N ? ~.1 /' ~I O ~.~ S ~~S ~I~ I ~ ~G J .-
Signature Address
fo `' ~ ~Z GG'-'
Signature Address s.; ~ ~ /~ ~s'
C-
Testor's Initials
Page 2 of 3
ACKNOWLEDGEMENT
State of Pennsylvania
County of Cumberland
We Earl L. Coulson, of Carlisle, Pennsylvania, '~ (~ n ~ C'a ~- ~
~~ o~ ; K L~ To am eo .~ a and J o0.,,^ 7c~ ~n c~ ~a
the testator and witnesses, respectively, whose names are signed to the
attached and forgoing instrument, were sworn and declared to the
undersigned that the testor signed this instrument as his Last Wiil and that
each of the witnesses, in the presence of the testor and each other, sign the
will as a witness.
Testor ~ c~r~ .~ ~ Witness
• ~~~
Witness ~ ~ ~j ~.,,~,~ _
Witnes ,- ~
,;.
On ~~ ~ (~ , a,.ooa, before me, q~,,~,~~as
appeared ~',~ ,,.~, lu n ~ • Cc~.r-ns Fre~Y; ~ ~ Li ~ 7cnNr, ~e ~~,d d. J or~.r. Ta~.rn a~,•~
personally known to me {or proved to me on the basis of satisfactory
evidence) to be the person whose name is subscribed to the within
instrument and acknowledged to me and that he executed the same in his
authorized capacity, and that by his signature on the instrument the person,
or the entity upon behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Signatu ~i
Si nature of Notary
0 ARIAI. SEAL
LI8A ANN HIQHLANOS, Noiaty PubNc
CaAlels Borough, Cumberland Cour-ty
Commission Irea Au . 20, ~b
Affiant Known Produced ID /
Type of ID Vr N~ers ~.; ,t r'llo,,n.fr,,,~., :~
(Seal) ~ ~"
Page 3 of 3