HomeMy WebLinkAbout05-29-09~~~'I'I'IOl~ F®]~R PAR.®]3ArI'~ A,l~TD ~RAN~' QlF ~ETTE~S
REGISTER OF WILLS OF ~ t;l -tg -13~2L/fiU.L~ COUNTY, PENNSYLVANIA
Estate of K/lea M. nnQen n ey~~. File Number ~ " ~ 9 O J~
also Known as /~ . ~ t'.7l.I]11 G /I p
Deceased Social Security Number oho.? ~ 3(p' 7(70
Petitioner(s), who is/are ] 8 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B `BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner( is /tee the ~Xe1'.Llt7''-~X named in the
last Will of the Decedent dated /~ 4~_~ ZD OZ
(Stole relevmrt circwtatartces, e.g., renu~tcintion, depth of executor, elc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the insuvment(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
^ B. Grant of Letters of Administration
(Ifappticable, enter: c.t.n.; d.b.n.c.t.a.; pendente tile; durmue absentia; durnnte minoritate) ra
C7 °
Petitioner(s) afer a proper search has /have ascertained that Decedent left no Will and was survived by the following s~it~e (if any) att heirs::_ fIf ;
AdnsittisU•atirur, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and carnplete list of heirs.) srl ~ ~ ~ -
-,-n ~ -~ •
Name Relationshi Residcpc~--; m ~~ r,.'.
ter,.
-'
`~ ..
(COMPLETE IN ALL CASES:) Attack additionat streets if necessary. ~ C°:
Decedent was domiciled at death in ~` 4.w+ Gr~mn County, Pennsylvania with l~+e+i her last principal esidence at
S8 RutG+~ ~t'.y ~no~Qi Fi1Sf rn Tivrr.: f!'tc~..[~t~4ir~/ ~~ _ ~itt•
(Lis! sweet «ddress, town/city, rownskip, counh+, stole, zip code) q T
Decedent, then 6 ~ years of age, died on ~ /O at ~ ~GG11 /7YC, E71.O~Q.
Decedent at death owned property with estimated values as follows:
.~
(If domiciled in PA) All personal property $ .`S-~ Do0
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of~~re"a~l estatee~in Pennsylvania / /f ~" $ .ZOf OOD- °'~
situated as follows: Fag ~G? s~': ~ Eno%, F~sf ~iir~s6a•-o Twto.~ tnte.~sptrflsn~/ (~ ~~
Wherefore, Petitioner(s) respectfully request(s) the probate of the last 14till 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
C~/loc ~ . E r~s
X ~' Eno/a f~!/ /7o~S-/33/
F'a•o, R6V-(/3 rev. tat3.o~ Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C U /Y~ QE~L~4/t~.D
File Number: ~~~ ~ 9" ~~ ~ ~ ~
®~ ~,c y _
Estate of /¢~/@/IQ ~ ~/1G~ 4~'4 ~ ~ lI~/l~1uG ,Deceased ~^
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
administer the estate according to law.
Swom to or affirn~ed and subscribed
n -~'/._
before me the ~-I day of
zoog
CQ
For the Register
... $
... $
is
Social Security Number: ~ ~ ~ 36 - 96 D ~ Date of Death: /ylu1. /O, ZOO f
AND NOW, ~~ ~ 2,~c` , in consideration of the foregoing Petition, satisfactory proof
having been presented before mDECREED that Letters _ T~JI~d/1~C11~4I'~i
are hereby granted to Citr~o~ ~ G~P.~ft*
in the above estate
and that the instrument(s) dated /RA
described in the Petition be admitted to
Zoo 2
and filed of recor,~l as the last
FEES
Letters ............... $ ~Q "lam
Short Certificate(s) ........ $ 3 Z -CCU
Renunciation(s) .......... $
~i LL ... $ 15 - UO
T ~..~ C..P ... $ 1l~ • l~D
... $
SS
Signature o]Tersona! Representative C~~ pL ~, ~E'~s-
Signature ojPersonal Representative n ~=-
-
~
~ ~ ~
Signature ojPersonn! Representative -=~ ~ m "~
_ _
vf~ ~
--. _. to
s)) of
Register
Attorney Signature: C~iJ~/i1/11J t e~~~e.2/~~Lt.QJ`%~t,
Attorney Name: Ci14!'~~S ~ cS~~ elels ~'
Supreme Court I.D. No.: ~8'Sr13
Address: ~ C~D kStr' ~~
... $
' ' $ Telephone:
... $
TOTAL .............. $
1~'1 P_G~~t.YLi is ~ti h4 ~~ 1705$'
7/7- 7G6-0~
Farm R6V-02 re~c l0.13.OG Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~ Fee for this certificate, $6.00
P 1518933
Certification Number
Ev it/200G
RINT IN
ANENT
< INN
etz~_nt ~
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 Vita]
Records Office for permanent filing.
M Y 1 1009
L a -. t a ate Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See instructions and examples on reverse) „_,_~,,,
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1. Name d Decedern (Firm, mitltlm, lest, su1Ax) 2. sax 3. Social Secumy Number 0. Dam d Deem (MOnm, day, rear)
Allena M Bennett Female 202 -36 ~ 9604 May 10, 2009
5, Age (Lam &maeyl Under 1 year lMder 1 6. Dated &nh Monm, de , 7. Ci and mem w 1 ~ axn ) 9a. Pence of Death Check on one)
61
Yre. aroma w" Her' '~" May 17, 1947
Harrisbur Pa
g / Hoepiw:
^ Inpatient ^ ER /Outpatient ^ DOA °"18"
^ Nureirg Home Residence ^Other - Spedly:
Bb. Carmy of Deam &. City, Bo Twp. Death 9d. Patents Name (If rd inmitWion, ghre mreat and nunbe
r) 9. Was Decedent of Hspenk Origin? ~ No ^ Yes 10. Race: Amerkan Indmn, Smtk, White, arc.
Cumberland East Pennsboro QI yea, specify Cohen, (Specify)
88 Queen Avenue Mexicen
PuenoRican
etc
)
' ,
,
.
White
11. DecederM
e IleWl KMd d work dam Burin mom d IAe. Do not slate retired
Ki
tl d W
k 12. Was Decedent ever n the 13. Decedent's Etlucetbn (Speclly Deny highest grade compmmd) 11. Manlal Status: Monied, Never Monied 15. Surviving Spouse III rose. give maiden neural
U
S
Amend Face
?
n
or
KF1tl d Buekmu! Irltllmhy
Budget Analyst Pa State Gov't .
.
s
Elemanmry /Secondary (612) Colmge (1.1 or 5+1 Wbowed, DNOroetl (Specify)
^
vea ~Np U k Divorced
18. Decedenl'e Malang Atldress (SIreW, city I lows, smte, zip code) Decedents Dkl Decedam
A
l R
Pennsvlvania
M
88 Queen Ave due
ee
ence ,7e. sate _
Live ins 17c. Yea, Decedent LNedh Ea Ct• PF+nnshnrn
, ® Twp
Enola Pa 17025 .
TownaNp
t7b. cants Cumberland t7d.^NO, Decedent Lived welan
Actual Limes of
citylsoro
18. Fatlmrs Name (Fxm, midde, lest, suffix) 19. Homer's Name (RreL mi001e, maden surname)
Allen Hess Bernice ?
20e. Inbrmenrs Name (Type / Pnm) 2W. InlarmanYS HaRrq AdAess IStree6 city / roan, smte, zip code)
Carol Peters 427 2nd St., Enola, Pa 17025
2/e. Mmhotl of Dspo6ltlon ^ CremeAOn ^ Damlbn
® &rrel ^ Renwval hour State ~ Wp Cremstbn a Donetlon Alithonzed 21 b. Date d DlsPOSAion (Manm, my, year) 21 c. Place of Dsposeion (Name d cammery, cremmay a other pence) 21d. Locatgn ICM 1 town, stale. zip code)
^Ottrer-Spedy: by lNMael ElremlrlxlCOralar4 ^vea^NO 5/15/2009 Churchtown Cemeter Churchtown Pa
22a. S d F rat Servka llcersee (a person as ouch)
~ 22h. License Number 22c. Name aM Atltlreas d Fadiry
Sullivan Funeral Home
- D011897-L
ems 23ec only when cart ~rg 23e. To tlm best of my knowletlge, deem axurred al the dme, tlale altl puree amend. (Sipreture eM tiAe) 23b. Licence Number
23c
Dale S
n
tl
M
m
phyuden s nd eveseble at sure of deem l0 .
g
e
(
on
, day, year)
cemly ranee d seam.
q,m, 21.26 p,~ b, rnrtplmad q, ~,~
wfw pralaxxes death 21. Time d Death P TX . 25. Dam Prmaarce0 Dew (MOmh, Bey, year)
May lo
2009 2s. Wes Cese Reierrad to Medical Ezaminer / Coroner for a Reason Other Ivan Cremation or Donation?
. 2: oo A. M. , Yes ^ NO
CAUSE OF DEATH (See instructions eM sxamplss) a kserval:
Item 27. Pan I: Emer tlm 131ein of evens - diseases, i ~ ~ a 1 Approximet
T ereer temYnal everts such as caraac errem
Olset m p
m Pen II; Freer Omer InanlXmnl kxa con e~no ro ma,
2s. Ditl Tobacco Use Camnbule ro Deam?
, ;
ee
reapkalay errem, a vemncWar AhnAatlgn wRhoW mlo'Mrq the etlokgy. List ass one cewe mm sac,, ~ hW nd reauAing in me undenying reuse gNen in Pan I. ^ Yes ^ Probeby
r ^ No ^ Unknown
NNIEDUTE CAUSE disease a '
C0"""0""°"x"g"' ) i a. Occlusive Coronary Artery Disease ~
D
e 29.uFemam:
u
ro la as a cansegtnnca op: ~ ^ Not pregnant wiYwn peen year
Yen mndilions, it arty, b. r
^ Pre
nant et lime d de
m
bed,q m cell9e Ymetl an line a. r g
e
Emer ma UNDERLYING CAUSE Due to (w as a cosequence oQ: r
t
~
^ Not pregnant, bW pregnant wimin 42 days
c. r
(area llinpklhay' ~
Arens nd~m r of tlealn
Due to (a as a consequence off: r ,
^ 6 ~e~ a
l. out pregnant 43 days 10 1 year
d r
~ l
^ UnkrlOwn it pregnant within the past year
30a. Was en AWOpey
Penomad? 30b. Were AWOpey Fndngs
Available Prior to Canpeaon 31, Renner d Deam
?
r{ 32a. Dam d IMury (A1anm, Bey, year) 32b. Deapnba lbw Iryury Ocalned 32c. Placed I
npry: Home Ferm, Sheet Fadary,
'
d Cause d Deam? ,
I~LNeturel ^ Homicitle
/ - OAice &a13ng. do (5
PecM1
^ Ves ~NO ^ Yes ^ No ^ Aaitlent ^ Pending Invemigetlhn 32d. Trre d hllury 32e. InMlry m Work? 321. H Trenspormtlon IMury (Speciy) 32g. Llxaeon d Injury (Street. cdy I sown, smtel
^ SuicMe ^ Coed Not be Detemtinee ^ Ves ^ No ^ Dnver / Operate ^ Pesserger ^Pedamnen
M. Oma - Speclry;
33a. CerdAer Idmdr orsy are) 33b. Sigretae end e '
• CerlNyirq phyakmn (PhysKren cerofyinp ease d deem when arather physidan hu pronounced deem and campleled Item 23) C,O rOne r
To tlr been deny Ynowletlq, deans occurred due to the carrp(y and manrernatated_'___"'---'------'-----"--'---- ^
' Pr
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m
h
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P1 -
'Ymdan Ddh pranounchq deem aM cenAylrlg to ease d deem)
nB e'
Y
9 O
Y
n (
To IM beat d my ImowMtlge, death occumd a the Srro, dam. and piers, and due to tM crna(a) end msaw u emlad_ _ _ _ _ _ _ _ _ _ _ _
----~-^
33c Licerme NixMer
33tl. Dam Signed (Month, Bey, yaarl
• MsdkalExeminer/Caater
On the bola d axaminstlon end / a Imiemlgetbn
in my oplnbn
deem occurred m the time
rs
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h May 11, 2009
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sce, en
ue to t
e auae(sl and manner ae swed_
aa. N`PFf2tF°d'€-2 P°E°: "'^~1~6'lat'B1~ ;e °~°49'4~~9
RL~~'lrype /Pdm
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- I ~I ~ I al ~ I ~ I 36.Dple ( mY
~ ~ 6375 Basehore Road, Suite 111
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PA 17050
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DlsposlAm Permit NO...(~%,J/ ~~~ T
LAST WILL AND TESTAMENT OF ALLENA M. BENNETT
I, ALLENA M. BENNETT, also known as A. M. BENNETT, currently of 88 Queen Avenue,
Enola, Cumberland County, Pennsylvania, 17025-2337 being of sound and disposing mind, memory
and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking\
and making void any and all prior Wills by me at any time heretofore made.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, is to be divided into three (3) equal shares and distributed to my trusted
friends and cousins, to wit: CAROL A. PETERS, currently of 427 2nd Street, West Fairview,
Cumberland County, Pennsylvania; DENISE K. BEAM, currently of 301 Front Street, Boiling
Springs, Cumberland County, Pennsylvania; and, DEBRA J. BRYMESSER, currently of 110 2nd
Street, Boiling Springs; Cumberland County, Pennsylvania.
In the event that any of them predeceases me then her or their share(s) shall go to those
of them who do survive me.
3.
I nominate, constitute and appoint my trusted friend, CAROL A. PETERS, to be the
Executrix of this my Last Will and Testament. In the event that she is unable or unwilling to act
as Executrix, I appoint my cousin, DENISE K. BEAM to be the Executrix in her place and stead.
In the event that she is unable or unwilling to act as Executrix, I appoint my cousin, DEBRA J.
BRYMESSER, to so serve as the Executrix in her place and stead. I further direct that they shall
not be required to file bond or other security in the Office of the Register of Wills for the purpose
of administering my Estate.
S~
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ `~ day of
A.D. 2002.
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SEAL
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. ~ ~,~ - ALLENA M, BENNETT
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°` ~ v a/k/a A. M. BENNETT
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Signed, sealed, published and declared by the above-named ALLENA M. BENNETT, also
known as A. M. BENNETT, as and for her Last Will and Testament, in the presence of us, who at
her request and in her presence, and in the presence of each other, have hereunto subscribed our
names as witnesses.
- - _ ~ ~, i.
2Q09 h1AY 29 ~;P910~ 4a
OATH OF SUBSCRIBING WITNESS(ES) CI~ER~< (~,~
ORPH~n±~ ~ ~0l.lRT
REGISTER OF WILLS - ~` A
C u. 4t a~p1/f~ COUNTY, PENNSYLVANIA
Estate of /¢~~~Aq /h. ~b~c/IIJBiI~ 4~j /~j./y/. pCff ,Deceased
Char/eS E. e5g,P,~a~s Fl ~ ~a/t~ ~ !~~ed/~u" , (each) a subscribing witness to
(Print Name/s)
the ~ Will ~~~$) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he /they was /were present and saw the above T_,~`t~~t Testatrix sign the same
and that she / he /they signed the same and that she / he /they signed as a witness at the request of
the T°°! Testatrix in her ~- presence and in the presence of each other.
~c ~~.~I~2%~~ ~ ~~~
(Signature) ey/~,12.LES ~' .S/!~/EZ~.S' «r
6 Cloksrr G{~~.
(Sweet Address)
!'j1eC~zr1%csdu~ Prl ~7Ds-s~
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed~a}nd~subscribed
before me this ~,`I day
of , .~9.
putt' for R •ster of Wills
(City, State, Zip)
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Executed oast of Registe~•'s Office
Sworn to or affirmed and subscribed
before me this oZ~~ day
of , ~.
-,3~~
Notary Public
My Commission Expires:
(Signature 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.
~~,~
(Signature)'~•BO~~[~/ ~~ ~I~~~
lQ L'laase.- ~d_
(Street Address)
Form RN'-03 rev. 10.13.06