Loading...
HomeMy WebLinkAbout12-11-09~,_ PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Dorothy H. Mellott File Number 21-- (~ °/' / /yip also known as D. Hazel Mellott !1 ' ( ~~ ~r;,, „ , 0 ,Deceased Social Security Number 183-07-8396 Jane Petitioner(s), who islare i8 years of age or older, apply(ies) for: (COMPLETE A' or `8' BELOW.) ~X A. Probate and Grant of Letters Testamentaryand aver that Petitioner(s) is/are the EXeCUtrIX named in the last Will of the Decedent, dated 12/05/1991 and codicil(s) dated Sfate relevant amumstances, e.g., enunciation, death o/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 apprca e, en r c..a.; ..n.c..a.; en e r uran a sen a; uren mmon a e Petitioner(s~ after a proper search has/have ascertained that Decedent left no Wiil and was survived by the following spouse (if any) and heirs(/f Administrahon, c.t.a. ord.b.n.c.t.a., enter date of Wll in Section A above and complete list of heirs.) Name Relationship Residence C'7 0 a .; ~ ~ ~ ~ "7 .I"1 rTl ~-j ~„~ i_._. , =, -~ ; r.~ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. -; ~ -C,~ Z7 ~;; ; -~,.~ Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal rest`d~' n~ at = - "` '?'a 206 Roxbu Road, Borou h of Shi ~ --r ~'~-~' ry g ppensburg, Cumberland County, PA . ~, -...~ ~. t (List street address, town/crty, township, county, state, zip code) „~. "~` Decedent, then 9Q years of age, died on 12/05/2009 at Chambersburg Hospital, Chambersburg, PA 17201 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 910,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ value of real estate in Pennsylvania $ 90,000.00 situated as follows: 206 Roxbury Road, Borough of Shippensburg, Cumberland County - - - - - i.opyngrn ~ci ~~uo roan somvare onry i ne LacKner hroup, inc. Page 1 of 2 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: ' ~ ~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland } 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 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 this ~ ~ -day of ~~ ~~ For the Register ~/ Jane L. Carl .,~ File Number: 21-- Zoo q 0!146 Estate of Dorothy H. Mellott ,Deceased Social Security Number: 183-07-8396 ~1 q Date of Death: 1 210 512 0 0 9 AND NOW, ~~~' ~ ~~' 200 ! , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Jane L. Carl in the above estate and that the instrument(s) dated 12/05/1991 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES / / Letters .......................................... $ l~ l0 ~ • 00 Short Certificate(s) ........................ $ ~d , pQ Renunciation(s) ............................. $ JQ/i l ~ $ (S. UO ~C~ $ 2 3.50 l .l "F~'~'lA'I'l Ot'1 $ S0 0 $ $ $ $ $ $ TOTAL .................................. $ <`t ?J' .~~ Attorney Signature: r Attorney Name: Jerry A. Weigle Esquire Supreme Court I.D. No.: 01624 Weigle & Associates, P.C. Address: 126 East King Street Shippensburg, PA 17257 Telephone: 717/532-7388 Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 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 16085960 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 forwards to the State Vital Records Office for pe an t filing. a" Local egistrar ~ c Date Issue CO `p° `' I~ .~ ~ ~ n :~~ 1 :~7 C~ ©~ - -~=x _ ~ ~ `.Y H11~ / PRIM N~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS .'~, ~~ ,~ ~ ~ CERTIFICATE OF DEATH ~ '*~ (See InstruCtlona end examples OII roverse) FTaTF FII F NIIIaAFN h 1. Nr« a Da«dam (FkaL olds., br, orator) z. S« 3. soar Seary NumMr 4. Deb a 0«b lwodn, dev, roar) D. Hazel Mellot Female 183 - 07 - 8396 December 5 2009 5. Aq M1+r Bieday) lAdar 1 IAxbr 1 8. Dab d BMh T a and sub a M. Plea d D«1h ab Ilomrn Carr Maur MwW HoepMl: Otter: 90 Yrs. 10-14-1919 Pinola, PA ®Imgatiem ^ER/OulpaMnl ^DOA ^Nraeirp Hone ^ReaMence ^Otler-Spedy: m. CaaAy d Daalh &. Cb/, Boo, Twp. d Oerh Bd. Feoay Name (B not kegWYOn, gy+• rrael ur comber) B. W« Daudenl d F#padc Oren? ®No Y« 1G. Race: AnenrAn kiden, Bock, WhM, eb. ( Franklin Chambersburg Chambereburg Hospital ~+~~,•~) White 11. D«adwta lhmel d workdde moats ee. Do not ame 12. W« DaeaOem ever b ri 13. DaeatlamY Earotbn (Spady ony hlghar Dada wm bledl 11. Moir Sul«: Man W, Nwar Mamed, 15. Survrvinp Spo u« („ ~. Ah'• new ~) IOrd d Wok IOr d Brbkr«lhm6rty U.S. Amed Fa,c«4 FJerwltary 1 Sacadery (412) College (1-4 a 5t) ' wbaed, Dhemd (SpsaTyj homemaker ^ Y« ®rb 12 years widowed 18. DeaderA's McMMq AoUme (Sroe1, dly/bwn, sub, nP coda) DeceMm's Did Dxetlem l R A U N 17 Sub PA n ^ Y D d Ll d b T a• i 206 Roxbury Road a r ae erce 1 c. as, ece em ye wp. T ~ior aw Shippensburg, PA 17257 1ro.caady Cumberland 1Td.f7a~~Da~a d,rX~b Shippenaburg ~,1~ 18. FtlMfa Name (FYeI, nidds, br, edbc) 1B. Motllere Name (Foot nidds, mrden euname) Harvey B. Kauffman Lucinda Ellen Stale 20e. M1lamed'a Nanr (type! Prkd) 2W. kdomeml Maap Addre« (Sleet dry / bm, our. zp rode) Jane L. Carl 2227 Abbotsford Drive, Vienna, VA 22181-3220 21a McCntl d Dbp«Idm r ^ Cre,«aon ^ Dorwbn 21b. Dab d DlepnNm (Moon. day, year) 21c. Puce d Ddp«iYa, (Name deemwry, amebry a olAx plsm) 21d. laeeon (ciy/ban, amb, xlD oodel ® Burro ^ RrmmW Ban Sub i Wr Cr«rlbn a ooMMr Autlad«d ^ pl,a. , bysrabrEx«e«r/eorarbn ^ v«^ No 12-12-09 Spring Hill Cemetery Shippensbur PA 17257 22A SigrMe d Fuwal parean stag «aucn) 226. Llcwea NurmMr 22c. Name end AtlM« d Fadey - ~ p, FD-012984-L Fo elsan er-Bricker Funeral Home Inc. Shi ensbur PA 17257 Conybb Mme 23e-c any w4en anAyinp 23a. Tome heard deafi oca,rred etas lbe, deb end plena abed. (Siprure arM tltle) 23b. Llaaw 6(z5/ 23c. Ore Silted (MmN, tlry~Y«r) phyakbn. nd avaaa0b r G« a deem b ceray aawadmn. /~ H-i ,~ ~ v ~{/ ~~ J7~•d +~i~/r/ ~'/~ RAI $13/11-L DL~+.eMbC/5 to0g Mme 2428 mr1 M mrrpMbd by parson 21. rime d D«Ih 25. Deb Prormarc•d Daed (Mont, dry, year) 2& w« Cue Madral Examiner / Coroner M a Reason Wwr 3bn Cromadon a Danriml wro prarmorbon tleWr. //1 A M. l~eeeAtbcr~ S y00 ^ Y« No CAUSE OF DEATH (Sea Imtruetbm sM eaampha) ~ Approxknele YNerxel: Pen II: Ema tiger ' 2B. Ditl TdMmo U« CarrLule b Deae4 Can 2T. %n I: E,«r Yb f~Jl-0Y~1k - die«eea, iyuiea. a canOkcaharb - r1r 6recey f8aled Mle dMh. W NOT Bnbr bmYnal arena each «fPlaaa scot, Ores to D«m hd nd reeddnp In 1M undadlkp c«« pen In Pan L ^ Y« ^ PmhaMy rerpray an«I, a verdmineN witlbd elgxYq 1M slbbgy. tJr ady are ca«e an each Me. i ~ t~ LcT N0 ^ lllllalalm eeLEgATE USE F dheaee a m ,y i Mlb 29. I Famab: r n aa n 1 _~ e. ~ ~ r n nt rdmin ^ Na I Due m (a « e d). - r ~ p« year preg a ^ Pregenl r tkne d death kal mndliMa, X airy, b ^ b narbe IY1etl an kne e. Due b a « e r E~UIOERIYSxi CAUSE (r ~' Not prepenL but pregnant wehn 42 days ad«m rs LAST c. r ~n do e d M ^ ve a ew q e ~ Due b (a « e wrrsperce d): r Not pregnem, bd prepeM 43 tlaya b 1 year brore darn d ~ ^ llnlamwm X pra med whin Ne er ear p p y 90e. W« n Adapay 90b. Ware Autopsy FMapa 31. 9?i. Dale d Injury IMonu, day, year) 32b. Dearbe How mJrmr Oocurtetl 32c. PYce d Inuy: Home, Fans, Suee4 Facbry, Padomed? Ayallehle Pda b ConOletbn N k l ^ N i id Ofiro Bulklkg, etc. ISPet*rl a ce«. a D«M1 e ae on u e N ^ Y ^ Y ^ N ^ AccIdBN ^ ~A Inv«ligallon ~. TNre a Iryury 92e. ~'r Work? 321. a TrwpoMlion Injury (Spsrryl 32g. Luwtion d bNY (Street dY I bwn, state) « o « o ^ Salado ^ CarAe Nd M Drermbad ^ Y« ^ No ^ DdrerlOperela ^ Paeeaga ^ Pade«un M Oebr- Spedy: 33a. C•mfier (deck omy ab) Y, h akbn (Ph w'cian aene b awes d death rAen ar,aMr • CMII mono r ed tl«m and c let« Ib 29 r+ian lea m 33b. SIIyWUre aM T d Cen2ier ~ g p y y y p D m a ong rn ) r P / To 1M M«da9'NOrbdga, daallr eccn•rad d«M1M eauaya)a„dmwerr abud_________________________________ , • Pmr,or•,ekM •~ ••~Ne PMM~ (RgaMen ban pmmaraip daelh and certlyip b sues d d«m) nd ~arxamMrtle lk„e dr b d d blM d d ^ T 93c Lkame Numbs r 93d. Dale Silted (Noah, daY~ yul / ~ , a, a p a, an ue ca«a(al « mreerraub __________________ MdIeY Examb«!Ca«er' • M ~~ ~~ ~ \ "i ~~ ~O;O 1 onw MOb de«Mn«bn andla ,umy opkdon, drrh mdrlhetN«,dau,aM puss, and dos tolM pu•a(a)antl manerr aMSOL ^ 3/. Name and Atldre«aPerean rota CarrpMlM Caus~etof Deelh (Mm P'~ lTypUO I Pr1i~m) etrare Si eawe end Diems 3s Rs b FMd M D d , ~ A N J ~ ~ "' l ` r~ . p p . a , ay, y«r ~ v- ~i~~^ ~-~Z~~ Dbpaidam Permb No. na c~ '. .- c~ ~ , ~-~ ~ ~~; ~ "q ~ t r l7 LAST WILL AND TESTAMENT -i~rn' ~ , ,' ~y, ~~ C~ C'> I, DOROTHY H. MELLOTT, of 206 Roxbury Road, Shippensburg, C>#r~and ~oun~,~ N i,? Pennsylvania, being of sound mind, memory and disposition, do hereby make, ~ublish~' and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my dust debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give and bequeath the full sum of TEN THOUSAND ($10,000.00) DOLLARS to my grandson, DENNIS W. CARL, on a per stirpes distribution basis. THIRD. I give and bequeath the full sum of TEN THOUSAND ($10,000.00) DOLLARS to my grandson, KEVIN L. CARL, on a per stirpes distribution basis. FOURTH. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, to my daughter, JANE L. CARL. FIFTH. In the event my said daughter, JANE L. CARL, should predecease me or is not living on the thirtieth (30th) day following my death, I then give, devise and bequeath the rest and residue of my said estate, in equal shares, to my grandsons, DENNIS W. CARL and KEVIN L. CARL, on a per stirpes distribution basis. (SIXTH. I nominate, constitute and appoint my daughter, JANE L. CARL, to be the (Executrix of this my Last Will and Testament; if she be unable to fulfill the duties MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 of Executrix, I then nominate, constitute and appoint LESTER W. CARL to be the Executor of this my Last Will and Testament. In the further event that neither the said Jane L. Carl nor the said Lester W. Carl be able to fulfill the duties of Executor, I then nominate, constitute and appoint my grandsons, DENNIS W. CARL and KEVIN L. CARL, to be the Co-Executors of this my Last Will and Testament. SEVENTH. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, DOROTHY H. MELLOTT, have hereunto set my hand and seal to this my Last Will and Testament, written on two pages, the first page signed for r identification only, this day of 1991. `~' (SEAL) This instrument was by the Testatrix, DOROTHY H. MELLOTT, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. ~t~Yrda ~ y/r~i -2- MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND , I, DOROTHY H. MELLOTT, the Testatrix whose name is signed to the 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. ~`~ ~%,`' Sworn or affirmed to and acknowledged before me by DOROTHY H. ELLOTT, the Testatrix, this ~'~r day of ~e/~~~ 1991. NOTARIAL SEAL Jerry A. Weigle, Notary Public Shippensburg, PA Cumberland Courtly My Commission Expires July 31, 1994 MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND , We, C~'C~(~ and the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw DOROTHY H. MELLOTT, Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her 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 the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. ~/7aaa/a ~f yf Sworn or affixm before me by ~j and witnesses, this to day of 1991. ~\ r NOTARIAL SEAL Jeny A. Weigle, Notary Public Shippensburg, PA Cumberland County MY Commiss'xm Expires,luly 31, 1994 MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257