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HomeMy WebLinkAbout09-18-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cu.~6 E.n ~a~/C~ COUNTY, PENNSYLVANIA Estate of i~ ELC,~F.vy 2 ~t~tVct,.vlL +~ ~ r~~" ~~-~ ©~Cn~ ~ File Number also known as Deceased Social Security Number y Z4 ,~l? O Z(~ 8 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary a d aver that Petitioner(s) is /are the _ h~R(~e ~'- ~- Lew y ^'r',~.named in the last Will of the Decedent dated e~ ~~ and codicil(s) dated (State relevant circumstances, e.g., renunciation, death ojexecutor, etc.) Except as follows, Decedent did not marr}~, 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: n ~i) ^ B. Grant of Letters of Admini (COMPLETE IN ALL CASES:) Attach udditiata! streets if necessary. W Decedent was do icile_d at death in ~ Ul ~M. Q County Pennsylvania with his /her last principal residence at ~ Gi (1 ~ tar"' (List street ttddres ,town/city, towns tip, count), state, zrp code) //~~ 'I jr I ' Decedent, then ~~ years of age, died on ~tAl (~ at _ ,~)SZ.Ti'~0.N. u V I ~ f~S Decedent at death owned property with estimated values as follows (If domiciled in PA) All personal property $ , ~ ~U , LJ'Z;} (If not domiciled in PA.) Personal property in Pennsylvania $ ..~-j-~.~- (Ifnot domiciled in PA.) Personal property in County $ Value of real estate in Pennsylvania $ ~~~. situated as Poll a~ ~t ~ l /a ~ - 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 [o the undersigned: t aignanire Typed or printed name and residence l~~ ~~t ~ ~ Q~ ~ Form R6V-0? rev. 10.13.06 Page 1 of 2 Qjapplicable, enter.• c. t.a.,' d. b. n. c. t. a.; pendente lire; durance nbsentia; durmue minoritntQl+3 CJ ° c~ ---3 Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followir.rse (if and' nd heirs.; ~(lf~ Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) _~ -~ ~ , -, , , -~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and co n~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. Sworn to or affirmed and subscribed X ~~-Cts? ~ ~i~~!~ -~~._- Sig~e oJPersonal Representative ~ before me the ~ day of C7 ~ ~ ' ' Signature ofPersona! Representative ~ ~ .v :-, c~ For the Register Signature ojPersona! Representative - '~ T' t i ~ I 8't~~ zD --, Fil ~ ~ ' J l d ~ N b - ; , t ~ um e er: i ,T W Estate of Q Ey--\-z.~~_ ~c~~sev-~c~.~c;~• ,Deceased Social Security Number: 1}2~ - 30 - ~ ~ y c' Date of Death: ~ " ~~ ' ~cj AND NOW ~~R ~ ' rg ~~ ` , m - z.~ , in consideration of the foregoing Petition, sa tisfactory proof having been presented before me, IT IS DECREED that Letters TL"_~TAfY\QYY~Y~A are hereby granted to ~r~..c~ `~~ ~c..sCtr,c>v.1.-J2~ in the above estate and that the instrument(s) dated ~ -=.~~~t -~~ _ described in the Petition be admitted too probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES 1., ~ ~ J ;~ Lettet'S $ ~{rj (Jl RegisteroJWills 'n, ~`'~ SI101'C CeihflCate S ........ ~ L,ll O $~ Attorney Signature: Renunciation(s) .......... $ ~t" ~ $l~C~U Attorney Name: J C ~ ... $ 1 l~`~ . C~~ Supreme Court LD. No.: -(~ $ Address: ... $ ... $ ... $ ' ' ~ $ Telephone: ... $ TOTAL .............. $ ~,~ . t'1~ Form RW-0? rev. 10.13.0( Page 2 of 2 ~,,,c ,.,.: ~F~. r:,~m _ _._. __ _ -__ - _._ This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph.. ~ r_,. _: - . ~,~ l..x- ~- ~ _~r.1 t i_ l-i- `7 C _ j L = ~~` _~ 8810 ~= : ~ Li. •- r =; t7T O =F1 O. 4r a~ L~ , CV `~ ~. ~~~ Linda A. Caniglia State Registrar SEP• 14 2009 Date Ntas-t43REV 1v2oos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS 068030 TYPE; PRINT IN PERMANENT CERTIFICATE OF DEATH BlacK INK (See instructions and examples on reverse) ~r~r< <„ ~ ,,,,,,ono ~~ °w a a w 0 w w 0 E z 1. Norms of Decedent (First, middle, WsL suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year) A. Eulene Cavanau h F 429-30 -8248 7/30/09 5. Age ILast BinYday) Under 1 year Under 1 day 6. Date of Binh (Monty, day, year) 7. &dhplace (City and stale or loregn Wunlry) 6a. Place of Death (Check only one) uwro,s oat's Horns Minuets Hospital: Other. 85 vra. 12/9/23 Yell Co. AR. ^In Gam pa ^ ER! Outpatient ^ DOA ureirg Home ^ Residence ^Other ~ Specify: Bb. County of Death 6c. City, Born, Twp. of Death Bd. FxilRy Name (If rat instiMion, give street and number) 9. Was Decedent of Hispanic Origin? ®No ^ Yes 10. Race: Amencan Indian, Black, White, etc. • pf yes, specity Cuban, (SpeciM • Mexican, Puedo Rican, etc.) Whit e 11. Decedent's Usual Oca tiai Hind M work done du ~ most of workin life. Do nM state refired 12. Was Decedent ever in the 13. Decedent's Education (Specify only highest grade comp leted) 14 MariW Status: Married Never Marred 15 Survivin S o use QI wife ive maid n n Kind of Work Nind of Business 1lndustry U.S. Armed Forces? Elementary I Secondary (0.12) College (1d or 5+) . , , Widowed, Divorced (Specr(~ . g p , g ame) e ^ Yes [~No e • 16. Decedent's Mailing Address (Brest, city I Town, stale, zip code) Did Decedent Decedent's p enna 3 25 Wes 1 et' Dr . . Actual Residence 17a. Sate Live in a 17c. ^ Ya, Decedent Lived in T "~~ Mechanicsbur Pa. 17055 g Township? az•~A*t°D 17a ^ No'DecedenlL"aewimk' v6 teeny Cu^ti0c:- Me h i b _ c an AdualUmitsd cs urg ~!~ 16. faNer's Name (First, midde, last, suffix) 19. MoNa's Name (FrsL middle, maiden saname) Claude Wilson Suella Watson lira. InfoimanYS Name (Type I Pdnt) 206. InlonnanYS MailNa Address (Street, oily 1 town, state, zp cads) 21a. Method of Disposition ^ Cremation ^ Donation 21b. Date of DaposiUOn (Month, day, year) 21c. Place of Disposilbn Name M camel cremat or aNer I cry. pry place) 21d.localion (CRyltown, slate, zry ends) (Burial ^ Removal from Sate ~ Was Cremation a Donation Authorized ^ ONe~Spea~y: ; byMedicalExaminerlCoroner? ^Yea^No 8/2/09 St. Mary's Cemetery Wrightsville, Pa. ' lure of Funeral Service Licensee (a person acting as such) 22b. license Number 22c. Name and Addess of Facility 0-10098 Matinchek & Dau they Funeral Home, middletown, Pa. 17057 Carplete Items 23a< ony when cenilying 23a To the best of my btaxledge, death ocam;d M th frne, Da and place stated. (Si~aNre and title) 2~, license Number 23c. Date Signed (MortN, day, year) physkian a rat available at time d death to certilycauseofdeath. I ~ Cn I/t l ~O O~ 'vU 7 ~- 07-3~-~~~I • Gems 2426 must be congleled by person wla pronounces deaN 24. Tme of Death ~-f "J 5 d 26. Date Pr Dead (Monty, day, ye~ar) /~ D~ 26. Was Case Referred to Medreal Examiner /Coroner for a Reason Olfrer Nan Cremation a Donation? . D _rx. l ~ O ~_ - OW ^ Yes ^ No CAUSE OF DEATH (See InstnrcUons and examples) r Approximate intervd: tlem 21. Pan C Enter Ne cfain d events - dsaases, inryries, a canplications - Nat drectly posed the deaN. DO NOT enter lemdrel evens such as cardiac artest, r Ansel to Death s i Pan II: Eller other sifxl cendlions mntributirrq to d~N bN rot resulting in Ue uMerFying cause gven in Pan I. 28. Did To6acm Use ConhDme to Death? ^ Yes ^ Praba6ry re p ratory anent, a ven6icular Nmllatbn wrNom showkg Rw etiobgy Usl ally one cause on each fens. ~ ^ No ^ Uidlnoxn IMMEDIATE CAUSE fFnal disease a r " ( ~ condilbn resdting n aN) _~ a, _ I N ~ 1 • ~ O~ i ~Y A ~S'ON O M J 29. U Female: ^ N l ri hi D{y}e~t~o\(a as a~w7nsequen(raio~.~ ~ ~ 1 ~ p ~7~1 ~7,;/) ~ e i Sequentiaky IW condtions, it any, b. a s V V ~ I I 1) 1 V y ILG 1 V I l Jr~l ~C~ i q,~~ ~H ~ u m~~ ~ 1 ~ o pregnant v n past year t ~^ PreglaM at time of deaN lead to Ne cause Rsled on Ike a. 11C.J r Enter the UNDERLYiNO CAUSE Due to (a as a consequence ntl: i NM Mrt ^ Pr~4 Pre9~ wRNn 42 ~ ' (dsease or injury that initiated Rw c. r • events resulting m death) LASL i d OeaN D e to (a as~a consequence off: (~c ,,_ /~ ,, {~ p r ' ~ Nol M, bd 43 des to 1 ^ Pra9ra D Ys Year • d. V , „v ~ h/ Le / l u y / I a 1 i ^ Unloa~ml pegnaM wdhh the paq Year 30a Was an ANOpsy Pedomad? 30b. Were Autopsy Findrgs Available Pnor b Completion 31. Manner of DeaN 32a. Date of Injury (Month, day, yearf 32b. Describe liow Injury Oaumed 32c. Place d Itylpy: home, farm. Street, Fadary, of Cause d DeaN? ~ ^ Hanicide ORce 9uRd ~, n9~ ISP~M ^ Yes ~ ^ Yes ^ No ^ Acddent ^ Pendrg Investigation 32d. Tme m Injury 32e. Injury at Work? 321, If Transpmtalion Injury (Speci/yl 32 Laration of In' Street c I town, state 9~ Nry ( M I ^ Suicide ^ Could Nq be Determined ^ Yes ^ No ^ arve l Operates ^ Passenge ^Pedesbian M '~7 33a. Ceditier (dceck any oral 33b. S afore and Title of Certilie • Cerglying physician (Physidan certiyvtg cause of deaN when another physoian has pronounced deaN and completed Rem 23) To th b t f k l 1^, _ IV e es o my now edge, death accurted due to the causefs)and manna as stated_________________________________ ^ • P i d i i W) / ronounc ng an ced ty ng physcian (Physoan bmh pronouncing death and certitying to cause of deaN) To the best of my knowledge, deaN occurted at the time, date, and place, and due to the cause(s) and manner as sated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • Medkal Examine I Coroner 33c. Lice se Number 33d. Date Sgned (M ,day, year) ~ ~ ~' ~~ ~' 3 ~- (1 On the basis d i ti nt / i i ~ 3 ~ v exam na on a a nvest gation, in my opinion, death oxared at the lime, date, and place, arM due to the cause(s) and manner as stated_ ^ ~^' 34. Name and A d dres sal Per son Who Compte tad C 27f Type ause of Dee~em f Pn M Regi ignaNre and fist' r s 36 D FR ~ ~ p,,~ ~ . ~ g ~ ~ p l C k ' ~ I 1 t ~ x 4 v ~ t' u '-` N ~ ~ _ v I ' ~ . ale etl (Monty, day, ye f r~ DispositionPenndNo. Uo?SS~ 7 Pl 1 ~ r v t~ ' y LAST WILL APdD TESTAMENT OF A. EULENE CAVANAUGH d ALBERT D. STUART, P. C. ATTORNEY AT LAW 273 N. UNION STREET MID DLETOW N, PA 77057 I, A. EULENE CAVANAUGH, of the Township of Lower Swatara, County of Dauphin, and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will c~ ~ _.,_I and Testament, hereby revoking any and all wills by me at ?time ~, -.:_ ~ e~ ~°~t C7 -ry ~ heretofore made. `~` -- .. -~ ,: ~,~ c.~ :: , :~: ITEM I : I direct that al l my just debts and funeral ex~~~es ~all< t~.;~? _ ... .e..s. i. ~.__ paid by my hereinafter named Executor as soon as convenien~t.ly~may b4~?don~e ? rv after my decease. ITEM II: I give, devise, and bequeath all of my property, real, personal or mixed, wheresoever situate unto my children, BRUCE S. CAVANAUGH, 16~i Eddington Avenue, Harrisburg, Pennsylvania; BRIAN 4J. CAVANAUGH, 1129 Winnipeg Drive, Corpus Christi,Texas; DAVID M. CAVANAUGH, 447 Mapleclif~F Drive, Stone Mountain, Georgia; and SANDRA A. SELLERS, 15 West Main Street, Shiremanstown, Pennsylvania, in equal shares, share and share alike, absolutely and forever. In the event one of said children shall predecease me leaving issue, then that which would have been the share of said predeceased child, I give, devise, and bequeath to the issue of said predeceased child, and in the event of such decease without issue, I direct that the share of said child shall be added to the shares of the surviving children. ITEM III: I direct that the legacy of share of real or personal property falling to any minor under the provisions of this my Will shall be held by my trustee hereinafter named, in trust, to invest and reinvest the sarne, to collect the income, and after payable all expenses incident to the management of the trust, to use and apply as much of the net income and principal as may be necessary in the sole discretion of my trustee for the 1 • minor's support, well-being and education, and that the balance of principal and any accumulation of income remaining in the hands of the trustee be paid to the minor upon attaining the age of eighteen (18) years. I direct that such payments for maintenance and education may be made without the intervention of a guardian, and the rereipt of such person as may be selected by my trustee to disburse such payments shall be a sufficient acquittance. ITEM IV: I direct that all legacies, shares, or interests in my estate, whether principal or income, while in the hands of my executor or trustee, shall not be subject to execution, attachment sur judgment, sequestration or any other process for any debt, contract, or engagement of any beneficiary, and shall not be subject to pledge, assignment, conveyance or anticipation, and the personal receipt of the beneficiary shall be the sufficient and only discharge of my executor or trustee for payment of principal or income, to the extent not inconsistent with the other terms of this my last Will, ITEM V: I nominate, constitute and appoint HA~1ILTON BANK, Harrisburg, Pennsylvania, Trustee, under this my Last !Jill and Testament. ITEM VI: I direct that my children shall be given the opportunity by `~1 c5 ALBERT D. STUART, P. C. ATTORNEY AT LAW 273 N. UNION STREET MIDDLETOWN, PA 77057 my Executor hereinafter named to select for distribution such articles of household furniture, ornament and appliance as they may agree, and for purposes of distribution said items shall have the value used for Inheritance Tax purposes. ITEM VII: I nominate, constitute and appoint my son, Bruce S. Cavanaugh, Executor of this my Will, and in the event he shall predecease me, then I nominate, constitute and appoint my daughter, Sandra A. Sellers, Executrix of this my Will and none of the foregoing shall be required to 2 ~. I y enter security in any jurisdiction in which they may act. I specifically direct that said Executor or Executrix, as the case may be, shall be entitled to compensation for services rendered as such, which compensation shall be a sump equal to Five (5%) percent of my probate assets. IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will and Testament, which consists of three (3) pages, to which I have affixed my signature, this `~ `~ day of ~~-"~'~ 1985. Q , ~.~. ~',~.-~y„~,~,,g,~-(.SEAL} u ene avanaugTi ~ ALBERT D. STUART, P. C. Al'TORNEY AT LAW 273 N. UNION STREET MID DLETOW N, PA 77057 Signed, sealed, published, and declared by A. Eulene Cavanaugh, the above- named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have subscribed our names as witnesses. i Residence: ~D P.~~c. ~c,~, ~ .(~ n~ 17a~" Residence :~~~ ~ ~ ~; y~%~~~~(~'GXC ~~• i 0 ~Z~cv~~ OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS C+-~-rvcj~-u' I u-~ a COUNTY, PENIvTSYLVANIA Estate of / l ~ ~~-c.- ~2_h.~, ~'~t.t/Ce./( ce_.c-~-~ ~ ,Deceased ~~ ~ ~ 5 ~ C~ vanc~~-, L ~ 2 ~ ~ .~.~. c, ~.. tea. ~~ ~ LT-~-~ ~~'--~'-*~--- and l~ rl r1c~ u.~.~ . , (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with and am/are familiar ~_. with the handwriting and signature of the decedent, and that the signature of ~ ~~nn fc lnn~ n P ~G ynn~ r c~-c,~.y~ to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~T. Gu ~~N~ ~aVa vu is in his/her own proper handwriting. x~ ~ , ~ L~Q n c (Sig~~c u'e) l ro S ~C~Gi ~ n c; ~ ~ (Street Address) ~r~s ~u ~. /7l// (city, Smte, Zip) .n (Signature) l Gs ~~~ ~ ~~ ~ .,~ ~. ~ (St``re',et Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed be re me this ~ ~~ _ day ~ ~ ~ _ ~?•_ De uty for Register of Wills C7 r~ ~ c~ -j _ r, -t ~ ~,~ _ -~ ~-._ , - , r-n ,. - - ~ ~ . ~~~ LJ -j..l ' ~ ~ ~ '~Z v ~ ~ y. a .'-' :. - , rv ca Form RW-04 rev. 10.13.06