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HomeMy WebLinkAbout06-18-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF ti~'ILLS OF ~ ~ COL~iTY, PEiV~SYLVA~iIA Estate of P~~~ ~~ ~.~,~ also known as T~~_~_ File Number ~ I ~ ~ _I `- Social Security Number 10 O ~ I~~ Petitioner(s), who is/are 13 years of age or older, apply(ies) for: (CO;YIPLETE 'A' or 'B' BBLOyV.) l_1~ A. Probate and Grant of Letters Te tamentary and aver that Petitioner(s) is /are the ~~~ named in the last Will of the Decedent datedOy! Ifl~ ~~~" and codicil(s) dated (State relevant circumstances, e.g., rentutciation, death 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 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 (Ijapplicable, enter: e.t.a.; d. b. n. e.t.a.; pe„dente lire; durante abse,ttia; durante n,i,torilnte) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and hei~rs`3. (If Adntirtistratio,t, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ ~, Name Deceased Relationshi (COtLIPLBTE IN ALL CASES:) Attac/r additional s/reefs if ~tecessary. t was domiciled at death in Residenc>r ~^~ '~7 ~--- ~: ; .,::: .~ -t .,- ~ ~ _ .: '::-ia y ~r=..~..~ -Y- .:.. , ...~,..1 --~ -t t° ,, -- ~.... _ .~~ . r ~..y,~ ...,...t ~ ; .::" r t vania witnhis principal residence at CJ'E <,,•' r;; s ~ ` / l_ ~ t (List sd•eet trddre.~•s, row„miry, lownsl-ip, coea,ry, state, zip code) Decedent, then years of age, died on ~~L~1~ at ~ •~~ A~ . 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 follows: Fora, R 6V-0? rein. 10.13.06 Page 1 of 2 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and tl~e grant of Letters in the appropriate form to the undersi+:ned: Oath of Personal Representative COv1~10N``l~'EALTH OF PENNSYLVANIA COUiJTY OF SS 'The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are title and correct to the best of the knowledge and belief of Petitioner(s) and that, as perso administer the estate according to law. , ' Sworn to or affirmed and subscribed ~-- before me the ~~ day of ~cx'q Q. . For the Register File Number: ~ ~ - V g ' ~'S ~ representative(s) of the Decedent, Petitioner(s) will well and truly of Personnl r.., Signnture oJPersonnl Representative ; ~ ~ ~ Signnture of Personnl Representative .~... ~, r -...,,,~ ~~~ ~~_... tz Estate of n ~ ~~ ~ 4 .,.Deceased Social Security Number: I S~ - 12. -~_3~D~ Z- Date of Death: `i -' ~ 5 - W ~~ p AND NOW,~U~.'~1~_ I $ ,~ 1 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters tY1 ~0~-+~ . • • are hereby granted to in the above estate and that the instrument(s) dated `'1-- i C~ ' `'1 L described in the Petition be admitted to probate and filed of FEES Letters ............... $ z~ .cam Short Certificate(s) ........ $ ~ ~ Renunciation(s) .......... $ ~ C~ ... $ 10 .c~l~ ... $ ... $ ... $ . C!:) ~„t ~~ ~ -r~~ Register of Wllls ... $ • • • $ Telephone: ... $ TOTAL .............. $ ~.~- tSU Attorney Signature: Attorney Name: Supreme Caurt I.D. No.: Address: as the last Wijl (and Codicil(s)) of Decedent. r-~~~~,n Rw.c~? ,~~~. lal_.v<, Pale 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, $6.00 14359147 Certification Number c C~: j G'J r`"' ..., ~ sa.~- -~ -_ _...._~...-_~._ - . __._ ~.____ _. a. _ r,"-"~~ ___~_~ ___ „~-~ - ~ ..._.~ . ~.. __._.__._ _ ~~ _ ..r. . .. .1 ' __.~..-...~.._._ _ ~ .._~~__ .~.--_____._.._...__._.. . _,, , :r - ,~~ : ~ ~ ~~ - ~:_ 1:~ ~: i - ,~ ~. c`*i M/05-143 REV 1112006 . TYPE ~ PRtNT 1N PERMANENT ICI BLACK lNK ~_ ~i Q lJ G ~• ~~ en~~ i«^ ` /9 !9 (rn r fl~ar~. E~ ..., .W ~,~...~, r '> ~, a .~ TATE X. r~ ~ ~ ~ ~.. € ~...,~ t ,. _ l•~e This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed .with me as Local Registrar.' The original certificate will be forwarded to the State Vital Records Office for permanent filing. ~ i~ a$ ocal Registrar ate Issued `~ J. F~~"'~.,.t ..Yl APR ~ ` spy p~- ~ ~ d` 4 hill v.~'h~b k~ ~e i v~ r.~ ' c;~ ra • VITAL RECORDS ~~ STATE FILE NUMBER 1. Name of Decedent (First, midde, last, suffix) 2. Sex Security Number 4. Dale d Death (Mmth, day, year) 1' a t urd - 5 Age (Last Birthday) lbtdd 1 year llrxier 1 de 6. Dale d Birth (MorNh, ,ear) 7. ( and state a br court) + M. place d Dealt (Check are) Monaw Dayc Mwrs Mrxxee HoSpitd: Cgtntt: 88 Yrs. December 29, 1918 Newport, Pennsylvania ^tnpatieM ^ER/Oulpalient ^DOA ~NurairtgFlome ^Residerxaa ^1)Iha-spacdy: Bb. County d Death tic. City, Bono, Twp. of Death !b. FaciNty Name (N not instsution, give sired and tx,rttba) 9. Was Decedent d ltispanic Origkr? ~ No ^Yes 10 Race: American kr~art, Black, tNltite, arc. Cumberland Carlisle 7hornwald Home p1 yes. specity Ctban, MexicagPuertaHican,etc.) (gpecpy) Whit 11. Deceden's Usual Occ lion Kind d work d one most d wa ' Ids. Do not state retired 12. Was Decedent ever in the 13. Decedent's Edrrratbn (Specify Dory highest grade comp leted) 14. Medial Status: Married, Never Married, 15. Survrvirtg Spo use (If wife give ntaidart name) Kutd d Work Kkx1 d Busuxass I lndus(ry U.S. Armed forces't Elementary / Secorx/ary (0-12) College (1-4 a 5+) Widowed, Divarxrd ( , ^Yes No Wid Wed • 16 Decedent's Mai4ng Address (Brest city /town, stale, zip code) Decedent's Dd Decedent 442 Thornwald Walnut Bottom Rd Actud Residence 17a, Stale ~~ Live m a 17c. ^Yes, Decedent Lived in Twp Towr~? . Carlisle PA 17013 17d.~ No,DecedeMlivedwitrtin 17D County (~aaMha~ - ianal Aawalt.kNtsd Carlisle r;ay,r~ 18 Fatlter's fvarrte (First. middle, last suffix) 18. fdditer't Name (Fkst. middle, maiden wrrtame) Christian D. Heise Catherine Steele YOa Inlorntant's Name (Type I Print) 20b. kd«mant'a MaiMtp Address (Sued, city /form, stale, zip code) Laurie Mowe - 1 1 Willi m rove Rod hani 21a Method of Dispossiott [i Crematbn ^ Donation 21b. Date d DisPosNion (MoMlt, day, Year) 21c. Place d Disposition (Name d cernetary, cnmotory a aitd place) 21d. location (qty / rown, date, zp code) (a~ Burial ^ RemovdtromState ^ ONwr • Seccrty: WuCnmadon«Don.u«tAtdfwrwd ^~ pry Wdkal Examkta t C« ^Yes /+ ril 18 2008 New Ort C@met@ 'Newport, PA 22a Sigrwta Funeral (« acting as such) 22b. License Number 22c. Name and AdMess d FaciYly ~ _ M ers Funeral Home Inc. 37 East Maln tr et Mechanicsbur PA 17055 -c onty when cerMying physiriart is nd avasade d tiros d deatlt to . To the best knowledge, deatlt occured d tfte tirtte, date and place stated. (Signature and title) (,1. 23b. lkxirtae 1Vanber 23C. DeN Signed (MaWt, day, yearj ~ auUfy cause d death. +^'~{ rv ~y F-/V ~ T`~ J~ ~•~ Il lJ ( ) ~~ 1~ r L ~ U 2f ~ Items 24.26 must be completed by person 24. Time d Death 25. Date Prortotxtced Dead Month, l day, Year) 26. Were Case Referred to Medical Examiner / Ceara for a Reason Other Nten remotion a Oortetbn? ~ who prortotatces Oeatlt t ~ •- ~ , A M. ~~ t ~, ~ ~ ( a1 ~~ ^Yes [~T1o CAUSE qF DEATH (See inaGuctforte ertd eaemp!Ns) r Approximate kuervd: Part N: Enter other ' 28. Did Tobago Use CoMribuN b Deaat? Item 27. Pan L Enter the fbNYL4lBYEDl6 -diseases, utjuries, a complications -Nat drectly caused Nte deatlt. DO NOT enter terminal events such as cardiac Brest t Onset to DeaVt bd nd resuNvp in tlw ttrtdaAying cause given h PaA I. [] Yea ^ PrdMbty respkatay arrest, a ventricular ftdiNation wsNtord showing Ute dtobgy. Ust arty one cause on each tine. t t 'e f1o [] Iksutown NdME TE AU$E (Fral)disease a r! ~ O tY~ O r j mrtdrion deatli -~ e ~ t l ~ w~ r ('~ rY~~ 1 29. N Female'. ^ r Due b (« as a consequence op: Na Weprwnl witl.ri pall ywr SaquerMiaYy ksl condiUats, Y any, b. ~ ppyrp q 1iw caws Cetad on M a ^ PregrwM at Iim. d death e . p~ b (« as a consequence oQ: t EMa ire UNDERLYYKi CAUSE t ^ Nd pWnarA. Dul peprwa wiMwr 4Y deya (disease a iwl r~~ p~ ererw rown~q n daaNt) lA8t a r ' d daatn ~ Dw b (e as a consegrence d): r ^ fdot pregnant, txs gegrtwtt 43 gays b 1 yew e d ; bdae dedh ^ lAeutoret N Pregnant witlert the past Yea 30a Was an Autopsy 30b. Ware Auwpey Fndktgs 31. Manner d Death 32a. Date d kMW1' {Month, day. Year) 32b. Desaibe How MIaY Occared 32c. Place d lrtjtrry: ttorrte, Fawn. Stntet Farsory, Perbrmed? Available Prior b Completan t l ^ Fb i id ~ N l7iia 8udbrp. dc. (SpeaYp d Cause d DeaNt? ura a m c e [] Yes 1~.Uo [] Yes [] No ^ Accident ^ Pendatg Irwestigation 32d. Tune d kMaY 32e. Iryury at Work? 321.11 Transportation kyury (SpedyJ 32p Location d kyury (Street, city /brat, aWte) ^ Suicide ^ CouW Not Da Determined ^Yes ^ No ^ Driver /Operate ^ Passertga ^Pedesldan M Other • Speciy: 33a. Cediksr (duck onty ate) h ki Pn i ti i d ' C ~ N 33b Signaturp~rW Title d Cer6lieL GJ ~ V ~- Ys an ( ystc art cer ry ng cause death wilco another physician has prarwurxred deatlt and completed hem 23) W p a Y To Nte best of my krawkMgs, rzeatlt occared dw to Bta auae(s) and manner u shad.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - .s 'S ~V/M~~..~ • Pronourtetttg and aNlyNrq phyakhn (Physician bah prorwurrckrg death and ceilitymg b cause of death) • • ~ 33c. license Number 33d. Date ' , ~ l To tlts Mp of my tutowadpe, deatlt occuned M die Ilme, date, and pha, and dw b tM cause(s) and manner ere swkd_ _ _ .. _ _ - - _ - . - ^ ' - - - - - f y~~ ©I V Z y ~ 6 ~ Q ~ ~ •~~ Q • Medical bamhia 1 C«awt On ItM W cis d axaminatlon and / a Inwstigatien, in my opinion, death occurred at the time, dale, and pieta, and dw to ins auae(s) and tnanrwr as staled.. ^ i p ~ ~~ ~ Address d Person Who ed Cause d Death (Nem 27) Type / Prnt J ' Re ar's Sxgrwtae and Disbkx Na r 3s Date fNed (Mat>» da ear) / ~.~ l ~ , y, Y ~ S O ~' 2~ ~T ~~ ~~ C~~, N P= ~Za i ~ o, r t Disposeion Perms No. ('~ ~ ,~ 1 ~ 6002 ~ t add ~ ~ a~ ~ aowes smuene~ {1 ~C:\WP60\WII..LS\BURDPEA2.WII. APRIL 7, 1997 ~ c~ - ;r'' ~ ~ ; arm {...a ~ ~~ 3, LAST WILL AND TESTAMENT r i~ E;` ' -~ ~ ~ i` ` ~' ~- . , . ~. ~'.:s -- C. i ',~ ~^j ~ -y-t1 ~. .) °.. ~. 'lam' ~ ... OF --~ PEARL E. BURR I, PEARL E. BURR, of 415 Reservoir Road, Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils by me at any time heretofore made. ITEM I - I direct my Executor, hereinafter named, to pay all my just and lawful debts and funeral expenses out of my personal estate as soon after my decease as is convenient. ITEM II - I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, wherever situate, to my husband, GALYN L. BUR.D. ITEM III - If my husband, GALYN, predeceases me, then I give, devise and bequeath, all the rest, residue and remainder of my estate, real, personal and mixed, wherever situate, as follows RUPP AND MEIKLE, 355 NORTH 21ST STREET, SUITE 303, CAMP HILL, PA 17011 Twenty-five percent (25 %) to my daughter-in-law, TERRY L. BURR, and Seventy-five percent (75 %) to my grandchild, LAURIE J. MOWERY of Williams Grove Road, Mechanicsburg, Pennsylvania 17055. ITEM IV - If my daughter-in law, TERRY L. BURR, predeceases me, her share shall be paid to my granddaughter, LAURIE J. MOWERY. If my granddaughter, LAURIE J. MOWERY, predeceases me, her share shall be paid to my great grandsons, DEVON JAMES MOWERY and KYLE DAVID MOWERY, in equal shares. ITEM V - My Executor shall have the following powers for the administration of my estate and Trust except as limited hereinabove, in addition to those vested in them by law and by other provisions of my Will: A. To retain any or all assets of my estate, real or personal, without regard to any principle of diversification, risk, or productivity. 2 B. To invest in all forms of property including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduciaries as they deem proper, without regard to any principle of diversification, risk, or productivity. C . To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms and conditions as they deem proper. D. To borrow money from any person or institution including my Executor and to mortgage or pledge any or all real or personal property as my Executor, in his sole discretion, shall choose, without regard for the dispositive provisions of this instrument. E. To compromise any claim or controversy. 3 F. To exercise any option, right or privilege granted in insurance policies or in other investments . ITEM VI - No interest of any beneficiary under this Will or any Codicil hereto shall be subject to anticipation or voluntary or involuntary alienation, of the principal, interest, or both. ITEM VII - All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered part of the expense of the administration of my estate and shall be paid from my estate without apportionment or right of reimbursement. All such taxes on present or future interests shall be paid at such time or tunes as my Executor, may think proper, regardless of whether such taxes are then due. ITEM VIII - I appoint my husband, GALYN L. BURD, to be the Executor of this my Last Will and Testament. ITEM IX - In the event that my husband, GALYN, predeceases me or is unable to serve as my Executor, I appoint my granddaughter, LAURIE J. MOWERY, to be the successor- 4 Executrix of this my Last Will and Testament. I direct that my Executor or any successor- Executrix shall serve without the posting of bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /'~ day of 1997. ~O ~i ~ csE.~,> PEARL E. BURD residing at residin at ~ ~'u /'~- g ~~ 5 Witnesses: COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . SS. WE, PEARL E. BURR, /~ ~s~.. ci ,and ~~ (~- ~t~~~D ,the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing will, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and to the best of his or her knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. PEARL E. BURR, Testatrix Subscribed, sworn to, and acknowledged before me by PEARL E. BURR, the Testatrix, -and su scribed and s orn to before me by and C-- ,witnesses, this /U day of , 1997, Notary lic (SEAL) rrorA~n~~ A~ lEK3HANN SCHlU5&ER, Notary R~o1a~K 6 Camp HN! Soro, Gumberta~sd County, Pa3 r~~y C.arrarn-ssia+~ ~~~r~a itif t !~, C~RTIFIC~TIO~vr ®~' NO~'ICI; UNI~IJR P~. O.C. Rule ~.~{~) REGISTER. OF tiVILLS .QLf~~~ COUNTY; PEV;~7SYLVA!v'IA Name of Decedent: Date of Deatl:: '"[ ! ~ Ic~~O File Number: ~a~ - ~~ ~ ~ ~~ Date Letters Granted: `~~~~ «.~ ~~~"'`-'' 1 To the Register: I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the~fo~llpowing beneficiaries of the above-captioned estatz on Name: Address: ~ ~, ~ E~ '21~ hl~tLU~MS ~eO~E ~ t~{~~s ~ ~~~~~ 1~ .~ (If mare space is needed, attach separate sheet,) Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except: ~ ' ~~~~~ N. +. _ .:~ !,'..,. ~ ~r.y fwd /~ Date-~*,,~JLi/J ~' ' a Q ~,._ ^ :,- x..1, ~ ~ .~. ~- C7 C_r ~ '~ ~ 'y l - ~ ++..+~ ,....1 [I ~ ~ . ~.~ ~.~ f 1 Representative Narne of Person Filin, This Form ~,~~s i~ti~ur9rns ~E ~~ Address Tzlepho~~e 'I ~ Form RW-08 rev. 10.13.06