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HomeMy WebLinkAbout06-19-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA Estate of Doris A. Soeneer File Number ~ 1 ~ D / ~ ©~~ also known as ,Deceased Social Security Number 105-14-6557 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) 0 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EX2CUtrIX named in the last Will of the Decedent dated 9/28/2001 and codicil(s) dated r•~ n v :: (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ 0 ~ is a, Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after executiotr~f~e instrun~t(s) o~'e7cd f C7 ~ t r ~ ~_.) for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ % ~~_ ~,-• , -r~ ,r ~ ~ ~p ~~~ ~ ~. B. Grant of Letters of Administration ~ (]f applicable, enter: c. t. a.; d. b. n. c.t.a.; pendente life; durance absentia; duta7i 7hbritate~ - _ i-1~ - r•: Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following s t}~pus~ (if any)~d heirs;(/f; 4 Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) O Decedent was domiciled at death in, Cumberland County, Pennsylvania with his /her last principal residence at ~ 1a f4...n I~.'/ F~wlr,~ l08 PA 1-~Bgr i ~ a t l l~ ~,.~ L~./ (List street address, town city, township, county, state, zip code) Decedent, then 96 years of age, died on 6/2/2009 at ManorCare Nursing Home 1700 Market Street Camn Hill PA 17011 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 20.000.00 (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 follows: 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: 5ignat e Typed or printed name and residence Juanita E. Hendricks 4041 Caisons Court Enola PA 17025 l3D 57~. Form RW-02 rev. 10.13.06 Page 1 of 2 (COMPLETE INALL CASES:) Attach additional sheets if necessary. 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 administer the estate according to law. ~ ~~ Sworn to or affirmed and subscribed before me the 'v' day of u9 Q •Q- •~ ~...sL or the Register of Personal ve(s) of the~ecedent, Petitioner(s) will well and tru Signature of Personal Representative Signature of Personal Representative File Number: 2-i ~ ~q "d5~11 CQ `~~~-' - . Estate of Doris A. Spencer , ~~ed ~ r ; ~ "` r r r^~ Social Security Number:105-14-6557 Date of Death: 6/2/2009 i=~~ _ ~ "`'' --~C7-r~ ~' z AND NOW, \~ , ~-~ , in consideration of the foregoiigition, sa~acto~ pra~f having been presented fore me, IT IS DECREED that LettersTestamentarv b --a ~ ~ ' '~'' are hereby granted to Juanita E. Hendricks Q Y ",• in the above estate and that the instrument(s) dated ~ `o~•$ "~~c' ~ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters .......................... Short Certificate(s) ••..•..•. Renunciation(s) ••••••••• ~~LL ~~ C~~c~ma~~ 1 ~ TOTAL ............................. $ ~\~ •C~ ~~ $ 2-~ ~ CEO Attorney Signature: $ ~ S ~O Attorney Name: Gerald J. Shekletski. Esquire $ i~ '~ Supreme Court I.D. No.: 40486 $ 5 -cX~ $ Address: 414 Bridge Street New Cumberland PA 17070 Telephone: 717-774-7435 Farm RW-02 rev. 10.13.06 Page 2 of 2 rna_cna 25~~ m~(n-~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $6.00 P 154?58Q9 Certification Number I Ev nnaoa RINT IN WENT K INN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) ~T,tF F„ F u„i„~, w c~ ~- G.. T-, ~. r ~ 1A r ° l'' ~~ t r- t~3 .." ~^ ~ . -. ~ .., C.. ~~ ~ -~ ~`T'( •• 0 t. Name d Decedent (Firot, mitltlb, IBN, sutlix) 2. Sex 3. Soda) Securiy Number d. Date d Daeth (Month, day, year) Doris A. Spencer Female 105 -14 z 6557 June 2, 2009 5. Age (Last Blrmdey) Under 1 ar Umer 1 6. Date of Bits (Monts, my, r 7. Si ace (Ci ell slate or to ~ celua) Be. Plea d Death (Check on one) Mawr pare Iburs Iwnum Hospital: Other 96 Yra. March 2 191 3 Hart Lake Pa ^Inpalienl ^ERIOutpatient ^DOA [~NUramg Hama ^Resitlence ^Other-Specify: Sb. Couny of Daeth Bc. City, Born, Twp. d Deam Bd. Facility Name (II not klslilutkn, give sheaf and numher 9. Was Decedent of Hi spank Origin?~NO ^Yes 10 Race Arrerican lndren, Black. Whae, ek. Cumberland Camp Hill (ayes, spedty Cuban, ManorCare Nursin Home 9 M P (gp~ly~ exican, ueno Rican, ek.) Whit e I t. Deceden's lkud ~ nd d wad done dui moat d tie. Do nd slate retired 12. Was Decedent ever in the 13. Decedent's Education (Seedy onty highest grade completed) 14. Mental SMlua: Monied, Never Mametl, 15. Surviving Spouse (lf wile, give maiden name) KMd d Wod Kind d Buemeas / IMUeIry U.S. Amled ForcesT Elementary /Secondary (612) College (1-4 a 5+) Wi~wea• Dlvarced (Spedyy) Clerical F r 1 v't ^ves 7Q N0 Un Widow 16. Decedents Mashg Addroas (Street. dtY !town, slate, zip coda) Decedent's Did Decedent Pennsylvania Live ins Act l R id „ s Ham d n 4041 Caissons Ct. es ua ence ,. ere „~.~ Yea, l9ecedenl l.ivetl in r ni ? p e Tw. Enola Pa 17025 awna ° t?d.^No, Decedent Lived wthin „a. Count' Cumberland , Adaal Limited Ciy I Baro 1B. FetMr'a Name (First midAe, tut suffix) 19. Aldher's Name (Fist midde, maiden sumeme) Cad Weston Bertha K. Millard 20e. InlormenYe Noma (Type / PnM) 20b. Inlamenl's McAng Address (Stroet ciy I town, stele, zip code) Juanita E. Hendricks 4041 Caissons Ct., Enola, Pa 17025 21e. Metltod al Dispasitlon j ^ Cremators ^ Donatbn 27h. Dale d Diepceidon (Month, day, year) 21c. Place d DiapceAkn (Name of cemeMy, aemelory a other place) 21tl. Laaam (Ciy! town, state, z'ry code) }~ Bunel ^ Removal hom Slate Wy Cnmatlon or Donation Autlwrhed ^ Om.r-spadlr hyY.elWExrMnerlCoronar'y ^Yee^Na June 9 2009 Indiantown Ga Nat' 1 Cem 22a. re Service ' (a person ectlng es such) 27b. Licerea Number 22c. Noma and Address d Faciliy S u 11 i va n Fune r a 1 Home - ~ FD011897-L 1 Corrpkle Ibmi 238c ally when ceniykg 23e. Ta the heal d my krpwledge, deem ocaned at me Ilene, dab antl place daYd. (Signature antl title) 23h. License Number 23c. Dale Signed (Month day year) phyakien m M avesebb M tlrrle d deed) la , , ceddY ease d deem. _ G'1 ' /</(~.~J ~O 7 / ! ~ •~i If / Iona 24-28 nxret m cemented by penal m tl m 24. Timed 25. DeN Pronounced De (Montle, day, ' ~ ~ i 28. Was Case Relerted Metlkal Examiner /Coroner for a Reason Other hen Cremation or Donatbn? ca pronances . ea - j , ,(~ , . M. G ,~ O 9 ^Vas CAUSE OP DEATH ( Instructions end ezampba) , Approxknate interval: Item 27. Part I: Enter tlxs ffieiu.GLflkeDY - dieeesea, irNnea, a conlpliCelima - Mat dirxlly ceuaetl the deem. W NOT enter terminal events such as cemiec onset. r Onsm m Death Pert II: Enter other sipnmceM mndkkns conlmutM to deem, but not reeun n the undo ing i dying cause given in Pan I. 2tl. Did Tobacco Use Contribute to Death? ^ Ves ^ Prd x s by rMpirebry onset, w wntriwlar fibnlleaon tllow+rg me etklogy. List ally one cause m e~h line. , ^ ~ ~ ` ^ ~ 1 WYEDUTE CAUSE Final disease a 0 t candtlian reeddq M ~eem) _; a. ~ *• ~ ~ 29.11 Fema Oue t r u a con of): - ~ of pregnant wimn past year SequxA~aW kN wrldtlkrre, a any, b. r bednb b IM souse Niled an Ina e. ^ Pregnant al time of deem Eller Br UNDERLYNG CAUSE ua to (or as a consequence ' ^ Not pregnant, but pregnant wihin 42 days ( ~ ~ meted me C. I evenb rosuM Bryn deem) LAS'i. y of death Due Io (or as a consequence oQ: ^ Not pregnant out pregnant 43 tlays Ip I year d, before tlealh ^ Unknown if pregnant within me pest year 30e. Was an Aulapay Pedomxitl? 3ph. Were Aukpsy Findrgs Availebb Prior to Compbaon 31. Manner d Deem - / 32a. Dale d InjuN (MOnm, deY• Veer) 32b. Describe How Injury Occurred 32c. Piece d Injury ttorne, Farm, Streal, Fedory, d Cause d Deam7 , , ^ ~ Lp Neturd Otlke Buikirg, etc (SpeciyJ ^ Vea I-7AJO ^ Yes ^ No ^ 1 ^ PerMing Imescgelion 32d. Time d Inhxy 32e. Injuy at Wark? 321. a Trenapodalbn InluN (SPacrl') 32g. lncalkn of Injury (Street cNy /tam, state) - ^ Sukke ^ Caldd Not be Detemwled ^Vas ^ No ^ Dmrer / Operela ^ Passenger ^Petlestrkn M Omer - Seedy: 33a. Certifier (dwck any one) 33b. Sigleture ant Title of CeMlier ' CwUlYkq phYalden IPhyekian ceMyinp sane of deem w*bn erwmer physiden has Dronourlced deem end carrlpkled rem 23) To Iha beq of my knowNdpe, deaK+ oaumd dw k the ewaalel and manner ee stMad_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Prarswnckq and cerMlykp PhYaklan (Physician bom prorwunrmg deem and cediyYg to cause d death) To dsa heal d nN knowled death courted it tlta time date and la d d ro tl d ^ 33c. License Number ' .Dale Signed (Mdlm, day. Year) ' q, , , p ce, an m ta uuaNal en memler a< ihYd_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yedkal Examiner / Corerler L(~ 0!~ 1.U~ /x ! ~ Pr V t/ -l b tin ~' On IIN Mtla d axamhtalbn and I ar kvaad atlon in m o mbn dish arxromd et th tl d t d h ll d h ^ Z„~ g , y p , e me, a a, an p ce, e ue to t e pueela) ant manna as itetad_ 34 Name ant Atltlress d Peron Who led Cause d Deem pt 2 Type /Pmt sipna ro I ~I ll °Z I ~ I~ I ~ ~ ( h ear roar) ~~ ~~ s !-~1W CL Dr, Eric Binder 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 Vital Records Oyffyi~ce for permanent filing. LGnr2~ ~'l ~ ~jUN 0~4 2009 Local Registrar v.7 Date Issued Disposhkn Partntl Na. (J J- 5~C (o LAST WILL AND TESTAMENT DORIS A. SPENCER N c~ _r_ ~~ ro ~~~ ~ r ' ~ ~ ~U7~~ _'_:J~-jC~ 3~ ;~_j:.._ r --~ .z- 0 BE IT REMEMBERED, that I, DORIS A. SPENCER, ofthe Township of Valley, County of Chester, and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my last Will and Testament, revoking any and all Wills and Codicils by me at any time heretofore made. FIRST: I direct the payment of all my just debts and funeral expenses as soon as possible after my decease. SECOND: All the rest, residue and remainder of my estate, both real and personal, I give, devise and bequeath as follows: (a) If she survives me, one-half (1 /2) to my daughter, JUANITA E. HENDRICKS; (b) One-half (1 /2) to be evenly divided among my three grandchildren, RACHEL S. HENDRICKS, JAMES W. CRELIN, III and ABBY R. MILLER, absolutely and in fee simple. THIRD: I give to my Personal Representative the full power to sell and convey any personal or real property that I may own at my death in order to pay debts and legacies and administer upon my estate. This power is at the discretion of my Personal Representative and upon ~. ~J .. ;...-~' "_1 ,. r-ri r,, a ~~.~ ~ "Y t _._ ~~,` , such terms and conditions as my Personal Representative may impose. FOURTH: I nominate, constitute and appoint my daughter, JUANITA E. HENDRICKS, Personal Representative of this my Will. If she is not living or is unable to so act, I nominate, constitute and appoint my grandson, JAMES W. CRELIN, III, Personal Representative hereunder. Finally, I direct that my Personal Representative be permitted to qualify and act in any jurisdiction without being required to post a bond or other security. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 28th day of September, A.D., 2001. '~ ' -,~: ~~yr,.~Z, G~ ,~,`~u= rz ~' (SEAL) Doris A. Spencer Signed, sealed, published and declared by the Testatrix 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, all being present at the same time, have subscribed our names as witnesses. ~ O d OATH OF NON-SUBSCRIBING WITNESS(ES) ` ~ ~ r 'l f~ ~ ..i 7 , i~ ~.' f r REGISTER OF WILLS 'rv='c~j ~ t° ~=a ~~ i~3 Cumberland ~~' COUNTY, PENNSYLVANIA ~ ~' ~ c-- _.'• ~ ~; ~ _ r 0 Estate of Doris A. Spencer ,Deceased Juanita E. Hendricks and John L. Hendricks (each) being duly qualified according to law, depose(s) and say(s) that acquainted with Doris A. Spencer with the handwriting and signature of the decedent, and that the signature of to the foregoing instrument purporting to be the Last Will and Testament is in her own proper handwriting. they were Well- and are familiar Doris A. Spencer of 9/28/2001 "" John L. Hendricks ~~ (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~q+~ day of~.L..~n.e_ , ~. • C- •~~ ty fo Register of Wills (Gty, State, Zip) FormRW-Oa rev. !0./3.06