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HomeMy WebLinkAbout10-15-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF eil.U~(~ COUNTY, PENNSYLVANIA Estate of 0 a-o 1 ~'~'1 y File Number ~, also known as ,Deceased Social Security Number jl9 g ~~ ~~8~' Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or B' BELOW.) L~ A. Probate and Grant of Lett rs estamentary and aver that Petitioner(s) is / aiet~te last Will of the Decedent dated ? e and codicil(s) dated n/1 a. named in the - ---. _ -- (State relevant cirarmstances, e.g., renunciation, death of executor, etc.) T, ~7 ~ -~'-' ~ Except as follows, Decedent did not many, was not divorced, and did not have a child born or adopted after executiorral<F}y6 i~rttmetQt(t) offered r-7 for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ ~'=' E~ t- +` =~ ~ ~ r-r ^ B. Grant of Letters of Administration ~~ (If applicable, enter: c.t.n.; d.b.n.c.t.a.; pendente life; durante absentia; durante n:inoritate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) (COMPLETE INALL CASES:) Attach additional sheets if necessary. De den w s mtcile at d ath in ~~ unty, Pennsylvania with his /her last principal residence at S t~ ~,~ ~-, tr~,.vt ~a (List street nddreas, towidcity, township, coup ,state, zip code) Decedent, then ~ ~ years of age, died on l O at f~" ~~/r/.(/S/3oda ~ /4, Decedent at death owned property with estimated values as follows: ~ (If domiciled in PA) All personal property $ .T~,~, U-s'a (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ ~` p b a o situated as follows: _ ~ F-1~e'i cy/~y V~SS'r" /-a~''ut ti~ ~' 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: ~J Form RW-0? ~-e~-. lo.ls.oe Page 1 of 2 Oath of Personal Representative C0~4~ION~V'EALTH OF PENNSYLVANLq COUNTY OF ~~3 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 ` day of ~0 c~r~ . 2~' ~` K ~ ~~ Signature oJPersonnl Representative Signature ojPersorml Representnrive ~A V/ W C7. the egister Signature ojPersonal Representative (,Yy C7 ~ - ;~ ~ / ~ 0 ~ ' ©/ ~~ ' ' " - File Number: -/ c.~ ,._t -F < ~~. A n ~ ''t _ d D ~' ~w Estate of ~b2o~~ ecease , .. ' T> Social Security Number: /68 ~~ ~ /8~ Date of Death: g ' // ' D`j cr1 AND NOW, ~' ~ ,G~~, i consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to in the above estate and that the instrument(s) dated ~ described in the Petition be admitted to probate and filed of record a~ t,>}e last Will (a~Codicil(~) o~ Decedeyrt. ~ FEES ~ """y"- -' - i/ ~ "~ ' Letters ............. . . $ R stern Wills Short Certificate(s) ........ $ ~ Attorney Signature: Renunciation(s) ... $ ~~~ w-~ s-.2 Attorney Name: ~i 17 ~ .. $ ~• • $~ Supreme Court I.D. No,: ~ ~ / b 3 $ Address: ... $ T ... $_ • • • S Telephone: ~~'z, ~3 ~ 7 a~ ... $ TOTAL .............. $ Farm RW-U_' rcv. lU.I~A( Page 2 of 2 lO5.Q05 RFC' r0'/771 D~-~~~ 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 15690362 Certification Number 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. ~~ m,. ~ SEP 6 2 9 Local Registrar Date Issued Ev t1/t005 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS wort N1lNrx~ CORONER'S CERTIFICATE OF DEATH K NIN 1132-i01 (See Instructions and examples on reverse) STATE FILE NUMBER rv ~~ , c -(-, r- --+ C.J ,.,~, i n - r,-~ > rt _i7 ~.r t17 ~ z'? +''3 r: `_ - -~ ~"`=' C~ -~ ~ <_ :~ ~ I I -, C.a ~~ 3 ._,.~ :L_ ~ _ LL:., ~t ~~ -- t .`.1 _l ' ''- ,. t . Cfi 1. Nrr d DBCedera (Riq, nedde, rr, sWhl 2. Sa8 3. Sarl Seaeiry Nimber 0. Dale d Death IMalm, ht', ywer) Dorothy P Sawyer Female 168 - 24 ~ 3185 September 11, 2009 5. Aga (tar Bktlre/l Under 1 Untler 1 8. Dsle d &M 7. err eUr a h. Platy d Deem (Check aria) 78 ~°"" °"' "°"~ M"` Nov. 18, 1930 "°'0M°'' °Mi°'' Vn. G r a ri t 11 a m , P A ^ irgehnl ^ ER r aApakeM ^ DOA ^ Nursing Nana Reeldenu ^aMr, Spealy: Sb. Cway d Oerll &. Cky, Dse1h ad FedWy Name (M riot Inetllutlan, gM elreN end rgmbeq 8. Wr Oscerkd d yneMnk Origin? ~NO ^ Yr 10. Rxe: Amrkan hdien, &eck, WMn, en. Cumberland East Pennsboro 2 State Highway (n''°'•'D°`"~'Cibin• ( MsHinn, Puerro Ripn, en.) whit e 11. Deoedra'e IIrW d work d one roll d W. Do rid smr 12. Wr Decoded ever In tlr 13. Deceded'e Edutetbn ISpsdy say Ngheet grade turrp bled) td. MrKel Statue: llamas, Never llamas, 15. Surviveg Spo use (II wife, give maiden name) Kkr d Work Kintl d Brrirree r kidrhy U.S. Atmed Force? EMmsnhry! Setondery (6t2) CoWge (1 J a 5<) WMovro4 DlvorcW (SpedM do roomer 2t ^Yaa 11 widowed 18. Decedem'a MdkgAddrra IStreel, cKY! rotor, arb, rib code) 2 State Highway Decedenl'e DN Decadent Ackrm ReeWenr I7a.SWe Penn SX,] Vanl a LNena 17a~Yr,Ikcedem Livedr East. Penn Qhcl Yfl Twp. TONi°" ? htest Fairview PA 17025 p rid. ^ No, Decedent Lwad wlMn 1?c. cdam Cumberlan:i , Adad LnNnd Ciryl Bea ~ B. Fellers Name IFkr. nettle, feel. avAk) 19. Matlw'e Nome IFlrd, nedAe. meMen sumrne) Roy S. Eppley Viola Frances Rohr 20e. IrikmlM'e Name (type / Phd) 20b. InportrnYS MUkp Atldsee (SbeN, col' / faun, ear, rip aodei Lee Sawyer 1665 Sawyer Lane, Mechanicsburg, PA 17050 2ta. MNlgd d aeprilbn ^ Crematlm ^ Darrrlon 21b. Dale d 00prigar (Mall, day, yrr) 21c. Plxe d DrprNan (Name d dmNery, cremalay a omr proof 21d. Locaeon (Ciy! Iwm, sale, zip code) ~`°' ^ R""°"Mtran3'°'e 'w..crerlWbn«DamnenAntltodrd ~ Se t. 16, 2009 P Rollin Green Cemeter g Y Cam Hi11 PA 17011 P w Mwd EerrlMar r teener? ^ Yr ^ Na ^ . speeEy: , FrrW Lseree (a preon xArq r sudl) 22b. Litanr Numbr 22c. Name end Addreu d Fait' ~i~. G2s~•n~c FD-013163-L Musselman FHS><CS, Inc.,324 Hummel Ave.,Lemoyn2,PA17043 gems 23ac ddl' wtrn CItINyYlg 23e. To the beet d my knorMdge, hell al the tlme, dale ell place elated. (Siprkra end imel 23h. Licerre Number 23c. Dale Sgned (Marsh, day. year) phyec~ Y rid 9ve11bb el Ikrr d ham n rrpfy rare d heh. tlrr 2d,2a neat a mnplrea M Irrean 24. Time d DrUr A rX . ~`• Dan Pronorinced Deed (Month, hY, Year) 28. Wr Car Rehrred to MedtN Examiner! Coroner for a Reason Otlrr Ihen Cremagm a Ddrtgn? whopalarncae drm. 3:00 A. M. September 11, 2009 ~vea ^Na CAUSE OF DEATN (See InetrtedUoru end a*wtnPleal r Appoxkrte Marvel: Pan II: Edx Darr 26. Did Tdrem flee Caerihrrle ro Orih7 Mrri 21. Pen I: Eder tlr Gh~..dl1f5011- dreaer, nM~, a aBnplceHpr - Nd drsdy erred tlr bath. DO NOT solar Mrtend evema such r anAec erresL r Orel b Drm bd not rruNing In qr teredying ceuee gNen r Pert I. ^ Yr ^ Probably ieeDkeM ernr. a vrennaer IBrrelon wghad aMrwq tlr egokgy. Lkt ody oro rut m each err, ~ r ^ No ^ UNcmrm 7E CAUSE Fril dlawe a "'~i01A~ Spontaneous Hemorrhage 2s.nFemer: ~ ,. ^ Due b la r a ccrregtrnce d): ~ Nd pngrenl wdm pen yrr IM Caniar.Nawy, b. Cancer of the Lung ; a W d I ^ Pngnenlrlme adrm Due a m na a. pus ro (a es a consequence of): ~ Eder W Y E l Dl lLL M S C AU S ^ Nd pregnenL Mrs pregnant within d2 days y r e ~I ~ d y r v i ~ ry (eval~b readerq m death) LASE. c~ r d drM Oue n (« r a consequence oQ: r ^ Nd pregnem, hd prepnent d3 days l0 1 yrr d. ~ bNOre hem ^ llnkmwn N pregrerq wMNn err past yet 3r. ~~ 3ab. Wen A ~Fe> 31 . k l enner d Drtlr 32a. Dale d tr(lwy (Mmdt. day, yrr) 32b. DeeaiW Now HQury Oocumd 32c. ~ d Idav: Nar. Farm, Slroel, Feaay. ~ } ~ ~ ( J~NaNr ^ Hadcitle rig, ek. (Speabl d Ceur d DrM7 ^~ ~~ ^~ ^~ ^ Acddenl ^ Pandng Itlon 32d. TrM d kgury 32e. ~Y al Wark'y 321. N Trenepatatlm In(ury ISOen/Y1 32p. Locellon d Inj~ay (Brit, sly! tam, state) ^ SukJde ^ Could Nd be Debmrrd ^ Yes ^ No ^ Drher / Operant ^ Peeeerper ^Pedarhn M Ogrr ~ SperN/y: 33e. CralNr (sleek sly err) 33b. Sgnehee end Tpr d • ~gl~ri~lPlrydderrprtllyNngcerwaaernwanerrnerphy:d.nnrprara.,cadsm.ndarnWerelrm231 Coroner - ----------------- To the MMdmy blewYdpa,drM aawnd dr totM earys)eerd mrnwrateeed----------- ^ • Iq ~ 0 t (PhYsiden bolls pronaankq hob end eatllykip ro tear d deeMl T tM MMd k Md d M d rtlM fk d r d Y d d nM d d ^ 33c. Lnenr Number 33d. Dab 9ipled (Mash, ht', Yrtl e my now ge. r aecrme r, e , en p ce, ri ------------------ r e erw(e)an mennerr wile . s alWE d rc September 14 2009 e a.r rrer ororrr On tlr bash d rrnnrbn err / a mveetlpetlen, In mY opMap deem aeunsd r tM tlrr, Ma, end pro, ref dr to tlr eweNsl antl menmr r etmeL , 3d."err`mac'~i°ae°~"°i~" m°~'°1°rb°r~°;dD~o~one~elPnd -Reprrr'aslgneaeeandDlstnclNumber~ I '~I ~ 1 d I ~I yl ~•~y.a r~t~ i ~ f'~U 7 . 0e 111 Ad~ R 7 / : 1705 Mechanicsburg, P DlePOeifion Permq No. _ (/ -J ~'^ ~ 7 09- ~~ LAST WILL AND TESTAMENT c-~ o _~ DOROTHYOP. SAWYER ~ u' c' _ _' ' ~' y ~ .,, cri I, DOROTHY P. SAWYER of West Fairview, Cumberland County, Pe~nsy~Yania ~~. c _- ,~ being of sound mind, memory and understanding, do make and publish this, my L;~~t Wi11~1d Testament, hereby revoking all wills and codicils by me at any tone heretofore made. ITEM 1: I direct my Executor hereinafter named, to pay the expenses of my last illness and funeral expenses from the property passing under this Will as an expense and cost of administering my estate. ITEM 2: All expenses of administering my estate and all inheritance, estate and succession taxes, including interest and penalties payable by reason of my death, which may be assessed or imposed with respect to my estate, or any part thereof, wheresoever situate, whether or not passing under my Will, including the taxable value of all policies of insurance on my life and of all transfers, powers, rights or interests includible in my estate for the purposes of such taxes and duties, shall be paid out of my residuary estate as an expense of administering and with apportionment, and shall not be prorated or charged against any other gifts in this Will or against property not passing under this Will. ITEM 3: Upon the sale of my house, I give, devise and bequeath the sum of Five Thousand ($5,000.00) Dollazs to each of my then living grandchildren. ITEM 4: I give, devise and bequeath unto my beloved children, LEE R. SAWYER and LESLIE F. SAWYER, in equal shazes, the rest, residue and remainder of my estate, real, personal and mixed, whatsoever nature and kind and wheresoever situate. ITEM 5: In the event either LEE R. SAWYER or LESLIE F. SAWYER predecease me, his or her shaze shall go to their children, in equal shazes. U // deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon the Trustee in this pazagraph or elsewhere in this instrument. c.) To mortgage real estate, and to make leases of real estate extending beyond the terms of the Trust hereunder. d.) To borrow money from any part, including the Trustee, to pay indebtedness of the Trust, and taxes, and to assign and pledge assets of the Trust therefor. e.) To pay all costs, taxes, expenses and chazges in connection with the administration of the Trust, including a reasonable compensation to agents. f.) In the discretion of the Trustee, to unite with other owners of similaz property in cazrying out any plans for the reorganization of any corporation or company whose securities form a part of the Trust. g.) To vote any shazes of stock which form a pazt of the trust. h.) To assign to and hold in the Trust an undivided portion of any asset. i.) To do all other acts in their judgment deemed necessary or desirable for the proper and advantageous management investment and distribution of the Trust. j .) No bond shall be required by law and no surety shall be required on the bond. My Trustee need not account to any court in the exercise of any power or discretion. k.) My Trustee shall be entitled to reasonable compensation for services in administering and distributing the Trust property, and to reimbursement for expenses. 1.) The assets distributed or payable to my Trustee, hereinafter named, as a result of my death including, but not by way of limitation, assets received as part of my Residue, proceeds of life insurance policies, and proceeds of employee benefit plans, shall be administered by my Trustee in accordance with the Trust created hereunder. If my Trustee is the beneficiary of any life insurance policy on my life or the beneficiary of any qualified pension or profit sharing plan, the proceeds of such policy or plan shall be treated by my Trustee as though received as part of my Residue. These proceeds shall not be subject, however, to debts and taxes to which they otherwise would not be subject. ITEM 8: In the event any beneficiary and I die under such circumstances that the order of our deaths cannot be established by proof, or should any beneficiary and I die as the result of a common disaster, it shall be conclusively determined for all purposes of this Will that I survived the beneficiary. ITEM 9: I hereby nominate, constitute and appoint my beloved son, LEE R. SAWYER, of Mechanicsburg, Pennsylvania, to be my Executor of this my Last Will and Testament. ITEM 10: I hereby nominate, constitute and appoint my beloved daughter, LESLIE F. SAWYER, of Enola, Pennsylvania, to be my Contingent Executrix of this my Last Will and Testament. ITEM 11: I hereby nominate, constitute and appoint LEE R. SAWYER of Mechanicsburg, Pennsylvania, as Trustee of any Trust created in this Will. ,~. ~ ,. ITEM 12: If LEE R. SAWYER dies, or becomes unable or unwilling to serve as trustee during the term of the trust, I nominate, constitute and appoint KATHRYN SAWYER as Trustee of any Trust created in this Will with the same purposes and powers as described herein. IN WITNESS WHEREOF, I have signed this Will on this ~ ? ~~ day of 2005. ~ ~ TESTAT Signed, sealed, published and declared by the above Testatrix, DOROTHY P. SAWYER, as and for the last Will thereof, in the presence of us, who, at the request of and in the presence of DOROTHY P. SAWYER, and in the presence of each other, have hereunto subscribed our names as witnesses thereto. fitness Address ~ Gbh-- ~-(y;wt~t~~ ,~ r~~ i ~~ ~~ i ess ddress COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF DAUPHIN I, DOROTHY P. SAWYER, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge 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. . -~l TE TATRIX // /, _ We, ~~~ C~ ~+~-~ and ~,~1 ~,t.~./,L,ASt,- ~~~~~~, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as Testatrix's Last Will; that DOROTHY P. SAWYER signed willingly and that DOROTHY P. SAWYER executed it as Testatrix's 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 witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ITNES r. ~ ~ ~ ~,: ll ~, ~ , ~~ ~1~ ~ ~Lt,~G~~'~~~iu--~- Subscribed to and sworn or affirmed before me by the above-named witnesses, and subscribed to and acknowledged before me by the above-named Testatrix, this~jf~ day of ~~ , 2005. f/p:dsawyer\Will TARY PUBL C OONIMONdVl~A9:'4'M OP P~INS1~t.VANIA NC3TARIAL SEAL BARBARA E. PALMER, Notauy Public City of Harrisburg, paa:~phin Camly ~-Ci0~1UYliaSicil 1l^. ~r,_„s't~;'~