HomeMy WebLinkAbout01-04-10PETITION FOR PROBATE AND GRANT •OF LETTERS
REGISTER OF WILLS OF ~Um~,er~(~ COLTNT~', PENNSYLV 'VIA
/off
Estate ofi*~~ ~ y~ t~ ~~ Y File Number _ ~ ~^ ./ '.. ~U ~ /
also known as
Deceased Social Security Number ~ - ~ ~`~~
Petitioner(s), who is/are 13 years of age or older, apply(ies) for:
(CO/tiIPLETE 'A' or 'B' BELOW.)
iK.l A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~~•~•Li'JI ~ ~ ~ named in the
last Will of the Decedent dated ~~ ~ / Qd and codicil(s) dated
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:
(State relevant circumstances, e.g., renunciation, 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 Administratio
(lfappticable, enter: c. t. a.; d.b.n.c.t.a.; peitdentelite; duranreabsentia; duranteminoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) ~ heirs: (If _
Admirtistratiott, c. t. a. ord.b.n.c.[.a., enter date of Wi!! in Section A above and complete list of heirs.) C7 -
;t""`.
Name Relationshi Re A "'` "
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(COMPLETE IN ALL CASES:) Attach additiaral sheets if necessary. - ~ ;~ - ` ~ t
r., : r")
Decedent was domiciled at death in ~~1-•~t`)17 ~' '~ `~
County, Pennsylvania with his /her last principal residence at ~'
(List street address, town/city, township, county, stale, zip code)
Decedent, then ~_ years of age, died on ~ at (^~~t~~.~'~/y,~ f}~ ~{~ t ~.fi'tL o ~_1 ~ t,~ I H -
/ (~~ (S
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $_ ,~t dO p .~
(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:
Si nature II T,_ ed or rioted name and residence
Foru~ RW-0? re~~. 10.13.oa Page 1 of 2
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Oath of Personal Representative ~° ~- _; , ; =3
~ ,-~-
COMNIONWEALTH OF PENNSYLVANIA ~n 3~• ` .~
Z , ~
COUNTY OF ~'~ 7~• ~ ._~
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tru~~co~rrect toe besto~' ;_~
-: :~ ~
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s~Vill well ands ly ~ ,~, ,-,-->
~ -~,
administer the estate according to law.
Sworn to ur-affirmed a(ia~d sybscribed
before me the 6 ! ~ day of
0
LG-
For the Register
\~ ~ f
Signature of Persona! Representative
Signature ojPersonal Representative
Signature of Personal Representative
~a ~
Filye Number: Z t - ~(,~' -0(10 ~
Estate ofT /BQ,(> ~ /fit p ~ho,y. ~J ,Deceased
Social Security Number: ~ ~" ZO" C 7~S Date of Death: ~?i~Z~/~ ~'
. /,o n -T-T
AND NOW, , ~[O inconsideration of the foregoing Petition, satisfactory proof
having been presented be re me, SCREE at Letters Diwr ..v~,'~~,n~~
are hereby granted to
- in the. above estate
and that the instrument(s) dated n, i,~„ 2(p ~ , l 9 p' O
described in the Petition be admitt~ to probate and filed of record as the last Will (and Codicil(s)) of Decedent
FEES I~
Letters ............... $ (/ • (~
Short Certificate(s) ........ $ . d~
R~~e/nunciation(s) ....... .. $ -~
(i V 1 ~ ~ ... $ , c~ t~
... $~
... $
... $
... $
... $
TOTAL
... $
... $
... $
............. $ . 50
Register
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
~.
Farm RW-Q? rev. 1U.13.t7! Page 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat ar photograph.
Fee for this certificate, $6.00
P 16053158
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.
a~~ _ ~' D E~ 2 8/ 28x3
Local Registrar Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
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I, ROSE MARIE SERENE, of Apartment 315, 1 West Penn Street,
Carlisle, Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Teestament, ~
hereby revoking any and all other wills and codicils h~eref~ore_~,
made by me. ~ {
~ -~, ~„
FIRST. I direct that all my just debts and funeral ~ ~ m ~i
expenses be paid from my estate as soon after my death as ~ ~~ '~
r -,
practically and conveniently may be done. ~`,~-.~~~~ ~
t~
SECOND. I direct that my remains be interred wi_t~ir.:.~p~-+ r .'
family's burial plot located in Westminister Cemetery end ghat ~ ~~'~
the funeral arrangements be handled by Hoffman-Roth Funeral
Home, Inc., of Carlisle, Pennsylvania.
THIRD. I authorize my personal representative to expend
funds from my estate, in such amounts as my personal
representative shall consider necessary and desirable for the
purchase, erection and inscription of a suitable marker for my
grave.
FOURTH. I give, devise and bequeath all of my household
goods, funiture and contents to my daughter, Carol A. Lorence.
FIFTH. I give, devise and bequeath all the rest, residue
and remainder of my estate unto my daughters, Carol A. Lorence
and Kimberly Boylsteen, in equal shares per stirpes witch the
bequest to Kimberly to be held in trust for her benefiit over a
four year term with Carol as Trustee. As Trustee, Card is
directed to pay over to Kimberly such portion of the Trust
principal and income as Carol sees fit annually upon tl~e date of
my death until the fourth such anniversary at which time the
full balance shall be remitted to Kimberly and the Trust shall
terminate.
SEVENTH. I direct that any and all Inheritance, E$tate and
Transfer taxes imposed upon my estate passing under my .will or
otherwise, shall be paid out of the principal of my residuary
estate.
EIGHTH. I hereby nominate, constitute and appoint my
daughter, Carol A. Lorence, as Executrix of this my Last Will
and Testament. In the event of renunciation, death, resignation
or inability to act for any reason whatsoever of Carol, I
nominate, constitute and appoint my grandaughter, Kristi L.
Lorence, as Executrix of this my Last Will and Testament. I
hereby relieve my Executrix from the necessity of posting
security in connection with her duties, as such, in any
jurisdiction in which she may be called upon to act instofar as I
am able by law to do so. In addition to the powers conferred by
law, I authorize my Executrix, in her absolute discretion, to
retain in the form received, and to sell either at public or
private sale any real or personal property owned by me at the
time of my death.
NINTH. If any person, beneficiary of this, my Lasst Will
and Testament, shall be a minor at the time of my death, then
any portion of my estate in which they share shall be held in
trust for them with Carol A. Lorence as Trustee. The
trusteeship shall end when the child attains the age oyf
twenty-one (21) years. As Trustee, Carol A. Lorence s~a,ll
provide for the care and maintenance and education of said
children and shall from time to time use either principal or
income from the inheritance to provide for these needs.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last Will and Testament, consisting of two typewritten
pages this 26th day of-June, 1990.
~' ~ -~'~
ROSE MARIE SERN~
Signed, sealed, published and declared by the above named
Testatrix ROSE MARIE SERNE as and for her Last Will and
Testament, in the presence of us, who, at her request, in her
sight and presence and in the sight and presence of eacCh other,
have hereunto subscribed our names as witnesses.
~ e.
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
I, ROSE MARIE SERNE, Testatrix whose nam
attached or foregoing instrument, having been
according to law, do hereby acknowledge that I
executed the instrument as my Last Will; that
willingly; and that I signed it as my free and
the purposes therein expressed.
ss.
e is signed to the
duly qua~.ified
signed end
I signed'it
voluntary act for
F,, ~.
ROSE MARIE SERNE
Sworn or .affirmed to and
acknowledged before me, by
ROSE MARIE SERNE this 26th day
of June, 1990.
Notary c SEAL)
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
Wendy MaNotaria! Seat ~"'~--~
Carlisle Y Y`~`t'ng~ Notar
$orou e ian~pubtic
MY Com 9h. Cumb r'
mission Expires County
~u9. 3. 1992
Ss.
We , ~,.~ .~ _ ~ •~ x r~ c 0. r~ and ~ c ~ S~ ~c~. C~ ~c~
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 ROSE MARIE SERNE
sign and execute the instrument as her Last Will; that ROSE
MARIE SERNE signed willingly and that ROSE MARIE SERNE ~eXecuted
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 that time eighteen ',(18) or
more years of age, of sound mind and under no constrainlt or
undue influence.
Sworn or affirmed to and
subscribed before me by
`~~ - ~ - ~ and
`~ ~ ~~~~^- ~ ~ « witnesses,
this 26th day of June, 1990.
Notarial Seat
NOta Pub ~ Caste Y May y;;un9, Notar
ry AL) Borough, C~~n~berlanc'Public
MY Commission Expires County
Aug. 3, 1992