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HomeMy WebLinkAbout06-18-09PETITION FOR PROBATE AND GR.~NT OF LETTFR~ REGISTER OF''«'ILLS OF COUNTY, PEti~S~'L~'1NIA Estate of ~/ ~ ~ /~ ~~ ~'I`eylh File Number ~ ` ~ ~ ~~"' also known as ,Deceased Social Security Number ~ 701 -a ~' ~g 4~ l~ob~~~ L ~h Jr Petitioner(s), who is/are 13 years of age or older, apply(ies) For: (CO;YIPLETE A' or 'B' BEL06V,•) ® A. Probate and Grant of Letters Te tamentary and aver that Petitioner(s) is /are the t,1<<°L~SrD+" named in the last Will of the Decedent dated ~~ I 'r 1 `l So and codicil(s) dated ,--, c~ _~ (State relevant circumstances, e.g., renu»ciation, dear/: of executor, etc.) C,~- ~ v~ - ~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution q~t}~-~'tgst3timenoffet~ti ~ ,' for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - ~ ~ "'- t~? ,~~~ ~...~ ~~, t--. `~ ^ B. Grant of Letters of Administration ~ Ci --r~ ~' • ' _ .: f (lfnpplicnble, enter. c.ta.;d.b.».c.t.a,; pe~tdetrrelUe; durnntenbsentia, durnNt~uur~~ritnte) ~ , Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) an~1 eirs: (!f Adntirtistration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list ojheirs.) (COtYlPLBTEINALLCASES:) Attachndditio»alsheetsifnecessary. Decedent waLS dodmiciled at death in ~~1'u~tbPrlri~ ~ County^pennsylvania with his /her ]ast pprincipal residence at JS I~'IerDec ~~t u/Rl/~I /1` ,r3U77~~ SOt/T~j /~t°r,.p~ih ~G~D~ tl~r~ghdf I fit' l dab (o (List street a dress, torvtt/city, torvnsltip, toasty, state, zip code) T Decedent, then 7 ~ years of age, died on (v C ~ / at d .~© Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ r©~, ~~ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA} Personal property in County $ Value of real estate in Pennsylvania $ ©<QQ situated as follows: Wheretbre, 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: Sim azure /I r // Tv //ed``or pr``i''nted name and residence // /~ ,,QQ ~~CJp~~ h~~h ~1r Tq !~~ ~~ Wa/h~]~ ~C y~ J~ l7~ Forst RVV-0? rev. !0.!3.06 Pd~e I Of 2 Oath of PeI-sonal Representative COti1~lONbb~EALTH OF PENNSYLVANI_A C~ -~Y~~1~~~-mil : SS COUNTY OF 'The Petitioners} above-named swear(s) or affirms} 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 try administer the estate according to law. S4voCn to or affirmed and subscribed ~~~ ~ ~ ~~ m `~ -T?'~ r~ ~ ~ before me the ~_ day of ~~ r the Register Signntw~e ojPersonal Representative Signature ojPersonal Representative - -- ors Cb °; > ~7 -~ ~ -~-1 ,~- File Number: ~ ` Q ~ ~~~ Estate of l~ 1 U'{~ ~ ~ • ~re- h j'~7 ,Deceased /m C Social Security Number: ~ ~ 2 Z ~! 7 b )~/ Date of Death: ~L.lf'~.~ ~ l ~vU AND NOW, '_ l) - '_~Lh "~ .tilt , ~!-,~i-n coi sideration of~the foregoing Petition, satisfactory proof having been presented before m~ IT~IS DECREED tha~.~,etters l-PS /'n0_i`)~/.C ~L~ are hereby granted to rye in the above estate and that the instrument(s) dated ~JC.{~L((~ described in the Petition be admitted to probate and filed FEES ..LD.Fv..... $ Letters .. ~~ ~-!_..1--- Short Certificate(s) ........ $ Renunciation(s) .......... $ (,~~// ... $ /S ... $ ... ~ ... $ ... $ the last Will, nd Codicil(s)) Register of Y~ Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: ... $ • • $ Telephone: ... $ TOTAL .............. $ Signature ojPersonal Representative ..~._ , ~:,3~. - Z ~ ~, ~:r, . a-. ~ .t ~_ t'.-} s rr,,~rn Rw-o1 ~~~_ r~.r~ .~~ Pale 2 of 2 10.505 RG~ dil/11'i Fee for this ecrtificate• $6.00 5. Aye (Last Biruway) ~,^F =°. _. __ . , Mnxlw an lware Mxia•e '] $ Vre. 8b. County a Death Bc. Cny, Bao, Twp. of Deett P 15663500 Certification Number H705-113 REV 1112006 TYPE /PRINT IN PERMANENT BLACK INK 1. Name a Decederd (First. rredde, 11. Decedenys Usual Bon KMtl d Kind d Wak Homemaker 16. pecetleM's Meiling Atldress (Street. 35 Maple Ave. Walnut Bottou 18. Fatlrer's Neme (RreL nutlde, lest. s .) i J rz U 0 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. This fs 1v rertil~~ thaC the information mere given correctly copied from an ori~~inal Certificate of Devi duly filed vt~idl me as Loral Re~_istrar. The origin • certificate ~'r~ill be forwarded to the Slate Vi Recor ~ Offirr for enn~ ant filing. (~~ Q o .1 Regisrrur~7 ~ Q~ate',-~ssued 'J ~- / l l~ ~ rya ~ ~ n ~: -~ )-;.~^r.n ~ rte),°~ 1 ;a 70m ~ _ ~ J~ , ~ ,.-~ _~ `.' ,. ~ -. ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ~ CERTfFICATE OF DEATH \ ~ ~',~ ~ c`-1 „ =~ (See instructions and examples on reverse) STATE FlLE NUMBER rv 2. Sex 3. Sooad Security Nanbar 4. Date a Death (Month, day. year) _ ..... _. .,. - Bonn T.,.,e 1d Anna Kind a &nMess / UxkMry Homemaker tavn, slate. by c«le) 17266 ~zsiyyccao,. •.>.7 10 19 30 ^ IrgeBenl ER I WryeliaM ^ DOA ^ Nursing Home ^ Resklence ^OMar ~ Sped?. Bd. FedMy Name (lf not mstnulbn, gwe street and armber) B. Was Decedent a tfspaMc OrigM? ~ No ^ Yes 10. Race: American IMian, Blade, Whee, ek. (n yes. apecnY' Cuban, l~+'M /~~ M +(~ Maxi~,,wanoRican,aN.) White stn 12.. Was Decedenlr ever in ttw 13. Decedent's Education (Specny oMy highest prede caripleted) 14. a~~ 1~ ~rr~ ~r Mame4 15. Sumving Spouse III vMe, give maiden namel U.S. Armed Faces? Elementary I Secondary (0.12) CoNege l1J a 5t) ^vea ®NO 10 rs. Widowed DBCBtlBM~a Pennsylvania etooaedem n~.®vaxDeaeamuwedM South Newton Twp. Aqua Residence na. sate T~~,? 17d. ^ No, DeceOeM LNed wnhM CAry / Bom 17b.camry Cumberland Aaual t.imilsa 19. Mdher's Name (Rrst, middle, maiden wmeme) Marv Fehl Les r E . Fo ~ 0 20b. Inbmianrs Mekng Aoaecs (sraa. an. cacao, aw•..w ~1 ZOa. IMomaM's Name (Type /Pmt) i •• " Robert L. Frehn Jr. 49 Water St. Walnut Bottom PA 17266 21b. Dale a Disposition l~oah, ~Y Year) 21c. flats a poposilim (Name d cerrelery, crenretay a Wren plecel 21 tl. Location ICM / town, state, zip cede) 21a. Mated a piaposnion ®CremaBOn ^ Dorekm ^ Bade ^ RemovallromSlate jwaacranMlbnarlMnalbnANlrodutl June 15, 2009 Smithsbur Cremator Smithsburg, MD 21783 ^ Other - " . M kMdkal Exemlrrx I Caoner7 ®Yes ^ No zza. ~'ae ~unerel sa sach) zw. Licmrse Nariber zzc. Name and Adaeae a Fadaly y 112 W. King St. pA 17257 L. .G~~ FD 011776-L -ffiidcei' FlAleral Borne Iti1c• r P•O. Box 336x Shi~slxlrgr tae end hTle) ._ 23b. L.icenw Number 23c. Dale Signed (Month. day, Year) carpets oars z3a c omy when w z3e. To are ben a my towwkdga :seem oaarad~ a me lme, mle and nee smled. lsgne G ~ ~/~ y /~ 4 physuden'e nd available el Grre of tlaatli to /,•,'1\ \ ~~ y 2•~y S y C/ } n (1 f .- (x) 7/ S s L exaky cause d deah. 28. Was Ca ne0 to MMral Examiner / Caoner br a Reason Other than Crematbn or Donation? 24. Tana of DeaM 25. Date Prareunced Dead IMomh• ~X Y~r) Items 24-28 mun be caryk4ed M Pam 0 ~ C~ 2 M. / // y/O Q es ^ No wYn xonWnces deeM. C!~ / .. r Approximae uderrel: Ped II: Eller other ~ 28. Did Tabxco Use CoMmme b CAUSE OF DEATH (See lnstructlons and examples) iaa -Ma dredy caused the tleeth. DO NOT amen tertnmal evenly such as certliac arrea, r Onset b Death ha rot resunug nt Me undadYmB ease gHen at PM I. ^~ No ^ llnkrawn Item 27. Pan I: Emer Me chain a evens - daeases, npaure, a cornDhcet' r respiratory artesl, a veMdwlar fArealbn srnlwa showiig Me aiobgy.Aist only one cause on each kris. r ~.~~'\ 29. If Femek~ MIMEDIATE CAUSE (F~mal disease a .Y~~ n f~G ~ e~~~ r J ^ Na pragianl wkhut pan Year cardnan resMtug m death) -~ a, Due to (or es a consequence on: - ~ /~ ~- ^ Pregnant at tune a tleem ,t>'9,sd,2~' ~~°1G'~ ~~~~ ten" 'Ln~>iA r ~~ ^ Nalxeg~am,anpregnam.mNn4zdays sawamiaXy kn Iliad;, n am. b. - =9~ leaduq to lha Douse lined on Gne a. Da: to (or as a Consequence o11: i of deaM r Emer The UNDERLYING CAUSE (dsease a nnury Mal Mniaed the c, ~ eye, ~ Ys R v l (~ ~ ~+'~'~ r ^ Nd pregant, bM lxetAienl 43 tlays to t year events resulting m death) LASL Due b (or as a consequence oQ: s before daaM s ^ Unknorm n pregnant wnhM the past year r d. 32a. Date a IMu Mom r 32b. Describe Now Irqury Oaurtetl 32c. Place a Irgay: Hone, Farm. Street, Factory, 30a. Was an Aaepsy 30b. Were Autopsy Findusgs 31. Mamer d Death ry ( h day, ~) Onice aadng, ac. (Spedly) Perbrtrred? AvakaMe Pdor b Canplabn ~Neturel ^ Flonucide a Cause a Dath? 32g. locekon M Injury (Shea, dry /lam, sate) v~ ^ Accident ^ Pendrg Investigation 32tl. Tune a Injury 32e. IrMury ea N ? ~ Dmer I Oparelar ^ Paasen)ger ^Pedenrian ^ Yes ~1 No ^ Yes ^ No ^ S~ ^ Coultl Na be Detemdned M ^ Yes q~. qty. f ~' 33b. Sgnaaa entl T a Centlier 33a. Cenilier (chede only are) • Cerlirying phYacian (Physkian cedilying cause a tleath when enalrer physidan has pronaxxxb deeM ant carWaed nem 23) , To the bell a my knowledge, tlealh incurred due to the cause(s) orb mwner as slatetl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33c. License Number 33d. Dale Signetl (Month, tlay, year) • Pronouncing and cennyM9 Physician (Physklan boll piaaimcsig tlealh ant amkyMg to cause a deaM) ~ ~ 3 ~ ' To the best of my krwwnedge, death otturred ache lime,date,ant pkCe,aM dueto the cause(s)erb nanrds natekd------------------ ^ ~~~ • Medical Examiner I Coroner 34. Name ant AtlGess of Person Who Cargretetl Cause a DeaM pram 27) Type / Pdnt Dn the basis a exeminaion and I or Mvealgaion, In my apinbn, death acurred a Me IMre, doe, orb place, grid due to lne cause(s) end manner as sleterL Shippensburg family Practice, Ltd. J / 3s. ,eRled(MOnm,day.Year) 46 Walnut Bottom Road 35. Regislrer's Sgnalure a t ~ umber I /~ i / I r^ ~ ~~ 200 ' Al Dislpsition Pertnlt Nn. 0 3 3 3 5 'y p 17) 530.5117 1 tV C~ ( _ ~ ~,e~ LAST WILL APdD TESTAMENT . -~-, ~~ i , "' -_L ~ -~ ~ ~ ,:~ rn --- r r~ I, VIOLET E, FREHN, of Walnut Bottom, Cumberland Co>~n~-~~~Per~syl~ana, - - ~ ~.r being of sound mind, memory and disposition, do hereby makegihblish:~and : s .G' declare this my Last Will and Testament, hereby revoking and making w~oid , all wills by me at any time heretofore made.. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved husband, ROBERT L. FREHIQ, SR., absolutely. THIRD. In the event my said husband predeceases me or is not living on the both day following my death, I then give, devise and bequeath my said estate to my son, ROBERT L. FREHN, JR., on a per stirpes distribution basis. FOURTH. I nominate, constitute and appoint my husband, ROBERT L. FREHN, SR., to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint my son, ROBERT L. FREHN, JR., to be the Executor of this my Last Will and Testament. FIFTH. I direct that my personal representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, VIOLET E. FREHN, have hereunto set my hand and seal to this my Last Will and Testament, this 11th day of January, 1980. .- _ __ ~ ~ ~ ~ SEAL) MARK AND WEIG LE -1- Attorneys at Law Shippensburg, Pa. This instrument was by the Testatrix, VIOLET E. FREHN, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as wi COMMONWEALTH OF PENNSYLVANIA ; SS COUNTY OF CUMB)RLAND I, VIOLET E, FREHN, the Testatrix whose name is signed to the fore- going instrument, having been duly qualified according to law, do hereby acknoca- ledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed., Sworn or affirmed to and acknowledged .before me by Violet E, Frehn, the Testatrxa this llthday of January, 1980., ,. A1ary E. pavers, Ftatary Pu'~tic S`oi~~en;burg, PA Cumberland County My Commission Expires July 27, 1982 COMMONWEALTH: OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, Jerry A. Weigle and Nancy J. Monn the witnesses whose names are signed to the foregoing instruments being duly qualified according to laws do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed -2- MARK AND WEIG LE Attorneys at Law Shippensburg, Pa. willingly and that she executed it as her free and voluntary act for the purposes. therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as tai,tnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age and of sound mind and under no constraint or undue inf" Sworn or affirmed to and subscribed before me by Jerry A. Weigle and _ Nancy J. Monn witnesses, this~llth day`,~of January, 1980. ~~'' J t~.~LQ_ ~ , XI.,Q ~~1 t_Q~~~ h?ary . Savers, Ra~2ry Au'~lit S~iapen;burq, PA Cumhe;tand Ceurty t~hy Canmluion Expire6 July 27~ 1982 MARK AND WEIG LE Attorneys at Law Shippensburg, Pa. -3- i sJ -a--<~ ~ / < < ~; r: ~