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HomeMy WebLinkAbout12-10-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Estate of Pauline C. Kerlin also known as Deceased Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) COUNTY, PENNSYLVANIA File Number a r - - /rya ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / aze the executor last Will of the Decedent dated November 27, 2009 and codicil(s) dated (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 Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; durance minoritate) 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. or d.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. Decedent was domiciled at death in Cumberland (List street address, town/city, township, county, state, zip code) County, Pennsylvania with his /her last principal Decedent, then 86 years of age, died on November 27, 2009 at Social Security Number 166-12-5223 named in the Spirit Hospital Q ~ ° j C'7 ,-'~ ti ,'~ '~~ _' ~.; ;•7 O -r- <<~ ~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 situated as $ 1,000.00 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: , ~ /1 / ,.~ Sargent Bankert, 773 Lancaster Boulevard #5, Mechanicsburg, PA 17050 Form RW-02 rev. 10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland SS y 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 affumed and subscribed before me the ~ D~ day of ~~'~ Signature of Personal Representative ~~ ~ rJJ ~^ <;; a .i7~..r~- ~ t `cJ r e Register Signature of Personal Representative t...3~Ln Z ~ - c~t `~ ~ _= r ;~ nn _ / ~' ~. File Number: cam- ~ ~ ~~ _ ~ `~" ~` Estate of Pauline C. Kerlin ,Deceased Social Security Number: 166-12-5223 Date of Death:November 27, 2009 AND NOW, ~ I~ ~'-P,rn,hP,a' ~'~'~ ~~ consideratior~ the foregoing Petition, satisfactory proof having been presented be ore me, IT IS DECKEh~, at Letters o~ i ~ ~-- ~ ~ ~-- are hereby granted to in the above estate and that the instrument(s) dated ~,D V Y.~GI'- a-7 a~ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))~of Decedent. FEES Letters ............... $ •~ Short Certificate(s) ........ $ Renunciation(s) .......... $ ~; ~l ... $ ~ 3 So S ...$ ... $ ... $ ... $ .. $ ... $ TOTAL .............. ~~ '~~ of Attorney Signature: Register of Wills Attorney Name: john NY. Eakin Supreme Court I.D. No.: 6351 Address: Market Square Building Mechanicsburg, PA 17055 Telephone: 717-766-3172 Form RW-02 rev. 10.13.06 Page 2 of 2 705.805 REV (01/07) ~ I ~~ 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 15692568 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~ ~ ~ N0~12 8~2~9 Local Registrar o Date Issued ~_ ~ " ~ p ~ ' " r- O -T'r Z M ~~ -'r~ ~~ --i '~' ._ ..Q ., T r a I RE,y „RggS COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS r PRINT IN uuwENr CERTIFICATE OF DEATH aru awr lCew Inchuctiena and ex8MD198 On F8V@FSe) orate ~„ 1. Name d Decedent (FNs4 nedde, W4 radax) 2 Sex 3. Sodd S•curnY Nunmer 1. Dare d Dash (Month. day Yeerl 12 _5223 November 27 2009 Female 166 _ , Pauline C. Kerlin Age (~ SNm~y) lkxrer 1 under 1 8. Dare d BNth 7. and cetera a 8e. Pklce d Deem Cheri once 5 . Hare 1ArMee Hospital: Other: MorNro ~ 8 6 March 8 , 1 9 2 3 Hanover , PA ^ Inpen.m ^ ER r oatpeaat ^ DOA Nadrg Ibme ^ Rrritlence ^ onwr - spealy. ~ Yrs. ' Bb. Camry d Dam Be. Clry, Boo, Twp. d Deem Bd. Eatery Norm (a nd meDloan, give awes end reeMa) B. Was Dxeddd d Hbpenb Orlpin? No ^ Va 10. Race: Arrwrken Indan, Sleds. Nedb, etc. oro~ Holy Spirit Hospital ("re~'~Cii6i'~ '~°~" Mexken, wdro Rben, ebJ Whit e • Cumberland East Pennsb 11. Dxededb lleud IDnd d work dare mod d xa. a nd arere 12. Wa Receded ever b ma 13. Decedafa Educenan (SDedM oM' ~•d 9red• cen91•~) 14. Wrpd Stelae: Monied, Never Mated, 15. Survivirq Spouse (11 wire, give maiden name) te`'", lance d Work d Bus6rcel U.S. Amwd Forces? Elementary I Secendary (P12) CORage (1.4 or 5+) w i a a " ''~" 9 s~ n aura ^ yB8 ~ Na Waitress Re tS. Decedent's Matbg Auras (Swd, dN / rown, stets, zip ~) oereaera'a PA we m° ems" ,?c Deceaem ~wea In U PPe r A 11 en T~ ~l Ya 1063 Allendale Road, Apt. D . . A`~'R°'"'~'Tasate ~;r.de~m»n Cumberland T°'w""~? nd. ^ woe ~n1 Mechanicsbur PA 17055 o c~,~ ,~, ~„~, 1.F s (Fred. Ies6sulAx) ~ta~p~i Ru~nYc _ t,~Wd9 p '~s~ier~rsr:CK2I'Lmemel n ro ra~ S 20b. Inbnanl's MaYMq Atldaa (Sired, ceY /corm, afar, =O code) PA 17070 New Cumberland 753 Ironstone Road w r an , , 21a. Memos d Diepodnan r I~ Crematlon ^ Donanm 21b. Dare d DispoeiGOn (Manor, day, yarl 21c. Place a phpcedion INar a cam•l•~'y, aalerory a curd pirx) lid. Loanon (Cirylrovm, date. zip cotlel PA 1 7028 Grantville , ^ send ^ RemwdBansrere ~ wa aDawlbnAudwdzed Nov, 28, 2009 BFH Crematory ^ N ? Y r ^ a o by NeAed ICararw ~ 22a d F `ureLSxvbe Licema (a actlnB a ) 22b. lkenee NuMN 22c. Ndro end Address d Fadlay FO 012342-L Stone & Murray F.H.,408 3rd.St.,New Cumberland, PA 17070 EJ /~ ~ `. ~ , ~, ~ Iran z3at any vdwn aer8ykq 23a d my krbwledge, deem axared rime urns, rite and prece cared. lsivreaxe and Ntlel 23b. ti[are Nundar 23c. ate Signed (MOnm, day. rd•o ~naax~avbledlmwdeedhro ~ Q l~ ~+~5. -1~ OL r'` .., • , c d dam Q .. . trite ~ to Medcel Examiner r C,ororwr for a Reason Omer men Crematron a Donedon? r e d Tkne pace, 25. Dare Pronounced Daetl (Made. day, yad 26. Waz sea Reler 24 f ~~ 77 . f aerre 2x28 mud be tampbred by Person /~ ^ Ya ru No care pranances dam. y : V ~ ~ M. -_ ~ "'~ ~ CAUSE OF DEATH (8ae InsVUetbne snd ezampNe) r Approxkare wervel: Pan II: Enter other 2B. Db Tabaao Ua Codnhuie b Dam? Nen n Pen I n 'xi cmrsa b m d ^ Y ^ P d d ln ' . g e un e y g r w y ng a non 27. Pen I: Enter me drip d eanre - d'eeaas, kquna, or cenipncatldw - and dwGF/ ceased the dam. 00 NOT sorer remknel evenly each a cerdlec arrest, ~ Ored b Deem out not reeu ^ Na ^ Unknmm i rag une ease on eedl doe. wq the eliolo BY. li el dnr itlraa elbn w arred, a venbtpder Abri b ry ragr r r ~ ( 1 , ~+ T n * ~ F m d 1 ' ^ ' I' 1 `t t V~ y r '1 l~ ~ I T `1 ~ r ~ rJ I J P L E v a r~ L r 1' 1~ V 29. a Female: ^ Nd pregirrN within pal year n ~mrYtlArip n r~atlil ~ a. Due b (a a e mrwquenca dl~ ~ ~ ^ T ~ /~ T I D f~ ~ i /' ~ /l )1 ^ Pregtent el tkne d deem (~ ' l 1_ l / 1 4 r ^ Nd pegneM, bd pregirnl wmb 42 days J-- ` b ceridtlorr. n airy. b, ' EIMOE~Y[q CAUSE a Duce to (a m a wre4rence o7: i r ^^ / n z T, ^ d dam , ~ , -) y a ~1 l ' 1 ^ Nd Wt pegriMt 13 days io 1 year rM nad red m M , p ,l e o a (dlsew a and il erenre reeulo'n9 n dew) LAST. Duero (a a e mrequea» d): i y T ~.t ,~j {~ bBlae dam ; ~ ) ~ ~ 1 ~ 1 F~ 0 I V 1 SM ^ Unknam B pregMnt wlmin m. peat yar d. • age. Wa en Albpay 30h. Were Auropey Fbdkpe 31. Meawr d Deem 32e. Date d bjury IManm, day, year) 3ffi. Dacrbe How InKey Oxunetl 320. Piece d Injay: Home. Fenn. Swd, Factory, anu Rradkq, eb. Ispedh, Perimned! Aveiable PAOr ro Cerroletion ^ Ndaal ^ Haraeitle d Care d Dam? ^ ant ^ ~q Ins 32d. rime d Injury 32a. bhey d work? 32t. N Tranepaledon klhey (SDedlY, r ^ Pedaetrren ^ P ^ Varna, d kllury (Sired, dry / bwn, ddel ~B• - ^ Ya ~ No ^ Ya ^ No ^ Suidde ^ Cerdd Nd be arermkwd M. ^ Ya ^ No aeenge Dnuer/Operaror Wwr - Specaj^ 33a Canner (dwnk ody awl rawuced dedl, cad oartpbred Item 23) h m 33b. endTare d Certlhr n /~ /~ k J • T (. V !7 N o ~ A M p2. T ee p •n cdamre I> 1 mr a dam when amnw am aara axvrad mwbma ereree(a)wdnwawraddad-------------------------------- ~ ewred re l d • DMe slgn.a (MOmh, day, vn 33d N b ley i yd Tonw B , • Pronmaioblg and adtlryn9 ( urn PrawiacnB dadh and «dnrroB ro taus d dewll To ar bat d my rel•w1•dB•, dedll e«urrad d mw two rrela, reW prea, nd due>o d» awa.(a) and msxwr r raered- - - - -- -- - -- - - -- - - - ^ . 33c. Lfcerlw 1um~ er /(, ~L M J 'f 3 ~ b b T • Marital ExanlrowlCaarr a tlw heW d exemkrelren end I a Matlpdb,,, b my opwm, deem axurred d the time, doe, end piece, ens sue to tlw ceuee(a) eM mums r stared- 34. Nerve end Axkwa iPgreon Who canPkwa caw d oeear (IMm 2'!) typo / PAa 35. Repwbefa S~ end Drebex ~ r ~ I I ' I ~ I ' I ~ I 38. ale Fnad (MaMr, d•Y•Y••d C; v,; ~ ~~ .;l~~p~ ,Y`jO;j N ~ ~) St .~i') . %-a.•, p c~i r 1 Pa . t ~ r' 1 ~ ~~ . V Dispodnar Pemdt No. ~T ~~ ~.rT LAST WILL AND TESTAMENT I, PAULINE C. KERLIN, of the Township of Lower Allen, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses he paid by my Co-Executors, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, in equal shares unto my children, namley: SANDRA BROWN and SARGENT BANKERT, share and share alike, absolutely and in fee simple. Provided, however, that if either of my said children shall predecease me leaving lawful issue to survive me, then and in that event I order and direct that the share provided above for such deceased child shall be paid over and distributed unto his or her said lawful issue per stirpes, said issue to take the ancestor's share by representation and not per capita. LASTLY. I nominate, constitute and appoint my children, .SANDRA BROWN Lcw oFFices MARLIN R. McCALEB and SARGENT BANKERT, Co-Executors under this, my Last Will an~Testam~,t, `_~ h to serve without bond in this or any other jurisdiction. ~~ -~ ~° ~ ~ ~; eac :~~~ c-~ . ... ~ ~' - c ~ -,~ ~ F -, p .:~ ~ ~ -p ~ -' s s r~i `+ L, r7 IN WITNESS WHEREOF, I, PAULINE C. KERLIN, have hereunto set my hand and seal to this, my Last Will and Testament which consists of two (2) typewritten pages to each of which I have affixed my signature this ~_ day of A.D., One Thousand Nine Hundred Ninety-Five (1995). yyn'' ~ ` Ur rx.~~ ~' ~°( ~e~ (SEAL) The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testatrix, was on the date thereof signed, sealed, published and declared by PAULINE C. KERLIN, the Testatrix therein named, 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, have subscribed our names as witnesses hereto. ~~ ~~- ~ 4`,~ LAW ()F-FI~~I-S MARLIN R. McCALEE3 OATH OF SUBSCRIBING WITNESS(ES) ~' ti -p ~-'~ REGISTER OF WILLS ;~, Cumberland COUNTY, PENNSYLVANIA ~ c~~T~-, t: Estate of Pauline C. Kerlin Marlin R. McCaleb c°., ~-a ..~ - F _: p f-r` ; < _ '_: © ~~ .~ C t "~ 3 Deceased (each) a subscribing witness to (Print Name/s) the ~ Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence of each other. (Signature) Frankeberger Building, 219 East Main Street (Street Address) Mechanicsburg, PA 17055 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills (Signature) (street Address) (City, Stare, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~D ~ day of ~~('~.BL~'2 a.t~ ~ ~~~~~ tart' Public My Commission Expires: ~ -~ ` ~~'~D (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PENNSY V N NOTE: To be taken by Officer authorized to administer oaths. Please have present the on nal or copy of ins~~(~time of notarizati n. Joette L. McGowan, Notary Public Mechanicsburg eoro., CumbeAand County Form RW-03 rev. 10.13.06 My Commission Expiros July 6, T010 OATH OF NON-SUBSCRIBING WITNESS(ES) Cumberland COUNTY, PENNSYLVANIA a r - 0 ~ ~ ll~ ~ Estate of Pauline C. Kerlin Sargent Bankert and (each) being duly qualified according to law, depose(s) and say(s) that acquainted with Deceased she / he /they was /were Well- and am/are familiar with the handwriting and signature of the decedent, and that the signature of Pauline C. Kerlin to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Pauline C. Kerlin REGISTER OF WILLS is in his/her own proper handwriting. ''(Signature) 773 Lancaster Boulevard #5 (Street Address) Mechanicsburg, PA 17050 (City, State, ZipJ Executed in Register's Office Sworn to or affirmed and subscribed before me this ---~-~- day of D 1~/71.y2Q~ , a~• Deputy for Register of W s (Signature) (Street Address) (City, Stare, Zip) e ~ ev ~ ,-; :- ~ ~ .,,o , __.. ; .. 4 ~. . - . r~ . r c ~, ~~ r,. rn . , ~ .:_, _s~r ~ ~ ~ Q t~ ~' ~7 - LL} ~ ~:~ ~ ~. C,''J Form RW-04 rev. 10.13.06 RENUNCIATION w ~ ~ _ REGISTER OF WILLS ~ -~-~ J ~`^~ ~.°.~ ~ i r `' ~ ).~ m b~e r I ay~ ~ COUNTY, PENNSYLVANIA C u ' ~ m ~ ~ . ~ ~' ... t__r"f ~((A 1~ ~ ~ ~ e ~ ` ! ~ f ~ ~ ~ _, Deceased Estate of , . I, ~ Q~ ~ ~ a ~ ~ d W ~ _, in my capacity/relationship as (Print Name) d ~ ~ ~ +.er of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to r (1Qre~.b~~ j5t ~,oo~i (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06 (Signature) x-53 ~-ron~~ane ~,~. (Street Address) ` e1~ Cil_t'Yl ~~~ ~ l~.t~lC~l f91~ I ~©~ U (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this 1 d ~'~^-- day of ~ c-Cc-- vK 'e c-~2 a~ °r ~ / ,~ ~- /,~ GG~/ v tart' Public y Commission Expires: ~7 -~-~~~ (Signatwe and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOWW ssNl Jootte L IMAowM~ N~Wy P~bNc ~COII ~i01~~ ~~