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HomeMy WebLinkAbout09-18-09 (2)PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF C u w- rs ~ 21 k.-~?~ COUNTY, PENNSYLVANIA Estate of ~vEL~( n.1 ~ ~~t+t~~ 5 rc,c-iL File Number ~/ ~ ~ ~VU 7~ also known as ,Deceased Social Security Number v~d 1 _ ~ & - c~ ~ Z ~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (CO,~YIPLETE A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~ XcCu Tc~ .t- named in the last Will of the Decedent dated yea ~ >/G ~ and codicil(s) dated ry % a- Q c~ a (State relevant circumstances, e.g., renunciation, depth of executor, etc.) ~ Q ~.E> -~-7 ; _-~-i Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of ~Yth~~ynent(~ffered';:; =-~ for probate, was not the victim of a killing and was never adjudicated an incapacitated person: l " rn '- r~ i ~ a G'~ -~ ~ti : ~.7 j -t i ~ '. ^ B. Grant of Letters of Administration -~ r= ~ _ ' r (lJapplicable, enter.• c.t.n.; d. b. n. c. t. a.; pendente fire; durante absentia; duranteai~'imte) ~ ,(a-~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spo~it~se (if any) an~irs: (If '-~ Adn,inisrrarion, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ Name Relationship Residence ~ (COMPLETE hN ALL CASES:) Attach ndditiona[ streets if necessary. Decedent was domiciled at death in ~ M (b e-/C,i,M~/ ~ Cotmty, Pennsylvania with his /her last principal residence at Spa t~ ~ : i~~a Mt,~~<~,v-~ l~mt ia0o Ly~sT Sou T7~ -5772~~ T ~•s2u sc~ ,P.? !7a l1 (List street address, lowidcity, township, county, state, zip code) Decedent, then ~ years of age, died on °I tS C~`' at S~t-r~» H a -Zn~~ ~ E~+~+~•t ~.r ~. j~rvi c 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 $ RpI I Ut UC90 "c'~ situated as follows: ~GU wCSr Ti_;;~;~~ fc'o,~-,~ ~CeN/~c <;,3 ~,z ~ ~.'f 17C~ ~~ 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: ~Signat~ure~ Ty ed or tinted name and residence >~:,~ t/ I~t /f N1 / ~Gn1HzJ f~ . F-,~ h+v~ 5 "mac„ lc~v cvt=5i t/i6u.i J!!~ vc .r I M~-.r-~gyv: c S,=3u~C'C~ y u~r~ / 7GS~- Foru~ R6Y-01 rev. lo.t3.o6 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cu Mi3~rz~A-,~.~.D SS 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. _ ~_„_, Sworn to or affirmed and subscribed before me the I~ ~ day of \oa.'y- a For e Register Signature ojPersonnl Representative Signature ojPersonnl Representative C-3 0 ' a_~ ~ _ (t' f ~~ Signature ojPersonnl Representative ~ ° f"' ' m ._... ' t '~~ ~ _ File Number: OL~ ~ ~ ©~1 '" ~~ ~~ Estate of ~ UL° ~ ~l Irl ~ _ -~0. ~'l rl P S T t~C Y~ ,Deceased -T Social Security Number: 02 ~ 1 - 1 ~ ~ (~~ a ~ Date of Death: _ L~ ~- ~ ~" (J"' _ , N .. ;i W AND NOW, ~ U ~ O f ~'f~, ~_~~ , ~~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters~~~r~(i ~Yl ~ ~l-•I are hereby granted to ~on~ll~ - ~ • ~~h ~~~~~ in the above estate and that the instrument(s) dated ~ " 2 ~ ' ~ (-~- described in the Petition be admitted to probate and filed of record a/snthe~last~W~ill (an~dj"Codicil(s)) of Decedent. FEES ~~lk~l l l1l.t.t L 7~~. n.~ T.o Letters , , , . $~ r o• o~ Regisrer of Wi11s i I' Short Certificate(s) ........ $ c~ ~ • ~O Attorney Signature: Renunciation(s) .......... $ ' t \'1 + ( $ 1 ~ ~~ Attorney Name: W l • • • $ l' ~, ~ e~~ Supreme Court I.D. No.: ... $~---c~- $ Address: ... $ ... $ ... $ • • • $ Telephone: ... $ TOTAL .............. $ Form RW-0_' rev. !0.!3.06 Page 2 of 2 LOCAL RECaISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. 1-r~. ITx ~,hi> rertifirate. 5(i.(1O P 15838425 Certif~izatiTTn Numbrr This i5 t<I~ certiiv that the r If~TrmatiTTn hen' <;iee'r ~s eTTn~cctly copic~i I~r/Tm an ur ;intll ~~'crt fir(tl~ ~~f Cealh duly filed with me a, I__(y~al Re~lis?r~r. ~7~~ ~.~ri~rin~il ccl'lifirutc~ ~~°ill he f(n~~~;urled to the S!aG~ `/il l Recen~d~ OIfice lilt ~erman.nt fit np~. ~~ ~ ~ ~~ l %~~~} l V~--~-'~----~,L-/--1'~---'1--L --~--- L<Trtil Ftc;*isU-a;~ i)afe I.~.ued N n C7 ' ~ Z ~ -rnv. `-'_' -~ ~ ~C ~ ~C _ 1 ~ r COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE FILE NUMBER 2. Ses 3. Social SeouiNy Nl,mba a. Dale of OeaN jMonNl, da ,year) Hlii1-V REV 11!2006 TYFE ~ PRINT IN PERMANENT BI ACK INN ( 1. Name d Decedent IFbsl, nliIXAe, last wNls) L~ Evel n B. Fahnestock emote 201 -18 -0521 Septem~er 15, 2009 5 Ayu (Last BiMdayl lAlder 1 year Under I as 8. Odle «&M (MOrM, ae , ear) 7. a (CNy ad dale a la ' uArelry) ea. Plan d DaaN (Check only ale) IAxew Data nwra Nxwws IbapNM: Other 85 r,a December 12, 1923 Camp Hill, Pennsylvania ^Irpaliem ^ERyOulpalrern ^DOA Nurwrg None ^Residence ^rnner Speary: BE County of DeaN &. Clry. Born, Twp. of DeaN Btl. Fadkly Name 111 na instiuAOn, qve sBeel ant IxaMer) 9. Was Decedent d Hispanic Ongm? I~ No ^ Yes 10. Race. Artwrican Nlawn, BLxk. Wn,le, etc '^ Cumberland Carlisle (H yes, spedly DuWn, y Sara Todd Nursing Home (Spec1j~Nhite MeaiwnPuBndRrcarl,ace) 11. Decedent's Usual 0.u 'lion Kud of rook dwle dune Imsl d workn k10. Do ml stale refired 12. Was Decrdenl ever'm th 13. Decedent's Education (Specify urgy nyoe5l grade canpleled) 1A. MarIW 5lalus'. Marrretl. Never Marrred, 15. Survwing Spouse (11 wrle. give matlen ham) Nud of Won Kind d Busxreu /Industry U.S. Armetl Faros? Elementary I SeeorWary (0-12) Cotlege (1-! a 5.) Wdowed. Diva,wl (Sp,scdyl Clerk US Government ^Yes ~No 12 Widowed 16. DecetleN's MaWq Adae55 (SNBeI. cNy !town, slate, zip cotlel Decetlenl's Did Decedent PA 1000 West South Street Actutll flesitlence I ]a. 51d1e Live Ina I7c. ^ Yes, Oecedenl Lwa1 n Twp Towmhip? PA 17013 i l 17tl~Ne DeceOerNLivetlwMin Carlisle nBCamry Cumberland d Carl s e A aalL:niNa cny;eae IB FaNeis Name (Fast nldNe. 4asL SUIUa) 19. MoNar's Nana (Fircl, mdtle,lmden wrrwm) Nellie Alberta Wolf Charles M. Bousum 20a. Inlamanl's Name (Type / Pnnll 208. Inlanunt's IAadNg Arlaess (SNO01. udY /town. SNIa, zp mde) t arrv A- Fahnestock 12 Broadmoor Drive Mechanicsburg, PA 17055 21a MaNwd d DuposOxn ^ CremaUal ^ Domlwn 210. Dale d Disposition (Hallo, day, year) 21c. Place a D15p'sUron lName d cemebry. aarmmry a dew pose) 21d Laarun (Cpy I pwn, stale, [ip uda) tp~ Banal ^ Removal hen Slala Was Cnmallal a DonNlon Aullrorlaed 2009 mber 19 S t John'c Cemetery St Camp Hill, Pa. 17011 ^ ~l ,n ArM.aMara.min«yc«on«r ^Ya.^Nd , e ep . • 22a. re d Few a person aclnp~s such 22h Lkeree Number 22c. Name and Address d Fadiry • - ~ / FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055 s an Is nW a ~ lal* al ome a soul io cer ~ ~y W" ~ ' ~~ ~~ w~~~ ~~„•a •, • "°'"°""'°'°". 1'"~'",wa a,ar r..wl r _ ~ ~ <ao. krcanse nanoe, ix. uale sprlea tmmm. day. yearl rmyuaseaaeam. C .' ~'~dli~~.\~. Q-'tAJ ~~~ ~(<~l C) / r l.. ~~ ,. Q.~_~.~ 1~ 1 ~fl')~ Items 2a~26 muss a coml0eled by ye,sal 24. lone of Daam o TA.~... ,.-~, ..~ 25. Data Prawax:ea tread lHalm, aay, year) 2fi Was Case Referred to Medical Esartww / Corater fa a Reason other Iran Cremetxx, a Da,ahun? wlq paalxxes deem -y ~ :. ] M A ~ t ' ^ 7'es ~No . U O[ Y f CAUSE OF DEATH (See Ms4ueUOns a eaemplee) r Aypoxunal0 inlenal' Pan 11. Enter aver 5~5d[d SH?~5-NfldIIGIAN141G ~dD, 28. Ob Tabaao Use CalbdAe to Deatll? Item 2.' Pun 1. En1aI tlla I~si~ yi lyl gyyi}x -diseases, uyu,w~s a umpgcrUOns -Neal d1eNy causetl Uie aeaN. DO NOT ante lernxi W evunls such as colder anasl, glwl to loam EW rlal Iesulliny in Uw unaaryng rouse gven In Pal 1. ^ Yes ^ PrcAxbly lesgralay artezl. a venUx:War IatNleUm wnlioul shomng NIB eNObyy. list only ate cause al earn km. ^ N k U HIYEDIAT r mwn o E CAUSE III anal daeaaa a ~ a t,,,f, h.~ ~ C.u, . V r\ ~~~ m,dum rasWWlg n deaN) -,~ a 2s. N Femaq'. ^ Due to (a ua a consequo Ice oQ. j ` Na pegnanl wUlwi pawl year SiVua ~uaay 4al ~vldlnul,. ,I any b l~ayyyy la Na roux Msted m WIe u ^ ,uy,Iall al hma W Waal P . Duo to col I Emel E~ UNOERLYIND CAUSE lot es a Iseymnce u j NW 1 NII 1 Ahm a2 31 ^ pagnan P•u~uul w ys Id.u.,;u a xqa llu0 xuh.,Ia ryw I j vaas ,ua,n~ny~I~ du..ln) LA~r W duelll Uun IB (Or as a [alaequat[e all. ^ Nol peynanl, bA pngwrd 47 days 10 I yBar tl UWe death ^ Lhxmown / peyna,g warm are past yea 70a Was an Autopsy 300 Were AWCpzy Fuxlings 31 Manner of DaaN 32a Dale al Iryury IMmNI, aay, yawl) 32b Descrbe How Injury Occaretl 32c. PNCe d Irqury. Home Farm. SVeel. Factory, Pedurmad? Avadaae Prq, to Canpleaal ^ ~ Orc BWldnp, ek. (Spegly) of cease a Daam? l+„wlal Hona~ ^ Yas `~ Im ~ ^ Yea ^ No ^ Auunem ^ Pamm~y Inve9igawn 32a- Tam a mjuly 72e Inp,ry al workv 32L N Laaponalial Iniun (svecJyl a2y Localall a Iryury (steel, qty I town slate) v ^ Swada ^ Coultl Nol fie UBlertninea ^ Yes ^ No ^ Dover / Operala ^ Passenger ^Pulk Iron ~ M. I ~gher ~ Spur ry: 33a Cenerel jcneck Dory -j 330. 5g ~ I a TnN d CeNlie~ ( CMNyin9 W'Y lPny icw ly y ~ IJ th 'I pFy h-spaxwrcetl ceeth dal ca*yNeleO Item 23) L To arc best d mY Imo ledge de In tad d t IA e() d at claled_ _ _ _ _ _ _ _ ^ ~ ~ a "' ~ ~^/ h\ • Pronouncing and cenNying physician IPhysx.a lulu p,aiounuhg uaaN a tl ceiUry ng m cause of JaaN 1 33t. Lwensa Number 33tl Da Sglwd IMalln tlay, ye- j f~ 11 dr i To Nw hart « my knowledge, deem occunetl al Ina lime, dale, and place, and due la Ifw cause(s) Mid manner Bs staled_ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ G 1 • Medical Eaamma I Coromr ~~~ 0 ~ Y ~ { t ti S ~ ~ 1 / 2uo On Ne Basis of Nomination and 1 or inveshgalion, In my opinion, deaN occurred al Ina nme, dale, and plow, and duo 1a tM cwae(a) and maarer as tWled_ ^ 3g Name and Addles5 W Porson INnu Cwnpleled Cause I Deem plem 271 Type I Pnm o ; Reyi y ,ynauie' m DI rx: umL ~ ~ i ~ I ~ I ~ I 36 Dal Files (Hplm, aay Yeall ~ ~ ~ ~ P - 0 ~'u1 ~ w m ~ ^ n`D L I I • $~ ~ xo ~ ~ f~~-u°* Anr.y. Lz.r-tt~.. P t (~O Diaposihal Penat Ne. v,3~9 4 a w LAST WILL AND TESTAMENT OF EVELYN B. FAHNESTOCK C7 C:~ °r7 i r-_ ~ ..~ - ;-~i _ . ' Vic. ; ~~~ __i ~ h ~~", ' D 3 .r- I, EVELYN B. FAHNESTOCK, of Monore Township, Cumberland County, ~, I C~~ Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all wills by me at any time heretofore made. 1. I direct that all my debts and funeral expenses be paid as soon as practical after my death by my Executor hereinafter named. I direct that all taxes that may be assessed as a consequence of my death shall be paid from my residuary estate as part of the expenses of the administration of my estate. 2. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to my three sons, RONALD A. FAHNESTOCK, DONALD A. FAHNESTOCK and LARRY A. I FAHNESTOCK. In the event any of my aforementioned sons should predecease me, I direct that the share such deceased son would have received hereunder be given to hi.s issue surviving me per stirpes. 3. I hereby nominate, constitute and appoint my son, DC>NALD A. FAHNESTOCK as LAW OFFICES SNELBAKER. BRENNEMAN & SPARE Executor under this my Last Will and Testament, but in the event he should predecease me or fail to qualify, I nominate, constitute and appoint my son, LARRY A. FAHNESTOCK, as Executor ~ under this my Las± ~~1i11 and Testk::~;,. t. I hereby direct that no person serving as Executor hereunder shall be required to post bond to secure the faithful performance of his duties in the Commonwealth of Pennsylvania or in ~ any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on Two (2) pages this 21 S` day of April, 2004. ;.. ~ :1 ~~? ~a,~~~.<~~ (SEAL) Evelyn B. Fahnestock Signed, sealed, published and declared by EVELI'N B. FAHNESTOCK, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. (SEAL) `;' ` .~ C:c~-e_~ (SEAL) C~ ~ LAW OFFICES SNELBAKER. BRENNEMAN -2- & SPARE COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND GOONEY, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, 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, 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 that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. We, EVELYN B. FAHNESTOCK, KEITH O. BRENNEMAN, ESQUIRE and JANE J. ~- ~ .., ~ , tatrix LAW OFFICES SNELBAKER. BRENNEMAN & SPARE SS. ~---~ Witness ,~ Witness Subscribed, sworn to and acknowledged before me by EVELYN B. FAHNESTOCK, Testatrix, and subscribed and sworn to before me by KEITH O. BRENNEMAN, ESQUIRE and JANE J. GOONEY, witnesses, this 21st day of April, 2004. ~~ ._..-d...w _-.. J~ Notary ublic ~` COMMONWEALTH OF PENNSYLVANIA Notarial Seal Susan L. Matrazi, Notary Public Mechanicsburg IBoro, Cumberland County My Commissian Expires Nov. 24, 2007 Member, Pennsylvania Association Of Notafies