HomeMy WebLinkAbout01-26-10PETITION FOR PROBr~TE AND GRANT OF LETTERS
REGISTER OF WILLS OF COUNTY, PENNSYLVANIA
Estate of CC. ~ Lt r ~~ a ~ ~ ~.n fi 2 ~^ File Number ~ /~/0 -o0 8~
also known as
,Deceased Social Security Number _%(p,~j -~y-~~ fJ
Petitioner(s), who is/are 13 years of age or older, apply(ies) for:
r(COt1~IPLLTE A' or 'B' BELOW.)
U-s A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~)(~4~ ~f-~ x narned in the
last Will of the Decedent dated~~ „`~ °l/y~Q~ and codicil(s) dated A~nre,•
(State relevant circumstances, e.g., renunciation, death ojezecutor, 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:
^ I3. Grant ot'Letters of Adminis
(lfapp/icabte, en[er.• c.t.a.; d.b.n.c.t.a.; pendente lire; durante absentia; durante 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
Admirristraliotr, c. t. a. or d.b.tt.c.l.a., enter date ojWi11 in Section A above and complete list of heirs.)
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in ~ ~ ~ ~ Gr County, Penns lvania with his /her last principal residence at _~/D O
~~rv6 to K ~lJal YY>_ec_nn•J[GC ,r~u ~4l70 5'
(L(Jt aheet add, cas, [own/city, rownshrp, county, state, zrp code) /,,
Decedent, then ~_ years of age, died on _l~lp ~7~~i~ at ,3~• Y3pm
Decedent at death owned property with estimated val-uTes-as f o°ll~o'ws`'-
(Ifdomiciled in PA) All personal property $ :~,~ f~,Bd
(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:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with [his Petition and the grant of Letters in the appropriate form to
the undersigned:
Signature Ty ed or rioted name and residence
pev
Ulr~ (Z D !~
Farm RW-0? ,~,~. 10.13.06 Paae 1 of 2
Oath of Personal Representative
COMiVIONWEALTH OF PENNSYLVANIA .
SS
COUNTY OF 1dIdCCJdcY1(,l
The Petitioner(s) above-named swear(s) or affirn~(s) that the statements in the foregoing Petition are hue 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 affirm~ed/and subscribed
before me the /~tL/~ -day of
•~! Q
..~-~.~
For the Register
Segntttttre of ersonal Repr•esen[a[ive
Signature ojPersonnl Representative
Signature ojPersonnl Representative
File Number: `` ,' ~(~-~(~~~
Estate of ,Deceased
Social Security Number: {IQJ7'I`f - 9L(oC~ Date ofDeath:~1.ZQJ / 20117
AND NOW,t~jlQ, .«o~./a !y'~ ~,
having been presented befo~re me, IS CRE D t t Letters
are hereby granted to _ ;~/A~a~ ~ `7,, , ~J).._
and that the instrument(s) dated~~~ 2~ b% ;
described in the Petition be admitted to probate and filed of
FEES
Letters ............... $ , ~O
Short Certificate(s) ........ $~
Renunciation(s) .......... $ "'~
~t ~~ ... $ J~.cSL7
... $_ 2~~
•Or1 ... $ ~; c7 0
... $
... $
... $
... $
... $
... $-=~t
TOTAL .............. $ f ~ ,BO
in consideration of the foregoing Petition, satisfactory proof
in the above estate
record as the last Will (and Codicil(s)) of Decedent.
Register of i! s
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
r-~rrrr Ryv-o? reg. ro.~3.or; Page 2 of 2
105.805 REV (01/07) ~ ~ / ~ I~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 16168717
Certification Number
' This i~ 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
Recor ffice for a nt filing.
.Bl 2 ~ ~~
egistrar Date Issued
Htosta3 REV td2000 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
nPE / PRalf IN
PERMANENT CERTIFICATE OF DEATH
suet mac
(See Instructions and examples on reverse) STATE FILE NUMBER
;2
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Linda Weldon 0 Golfview Road, Camp Hill, PA. 17011
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Disposaion PermH No. 6~0~ ~7 :~
LAST WILL
I, CALVIN B. ROTZ, JR., of the Cumberland County,
Pennsylvania, declare this to be my Last Will, hereby
revoking all prior Wills and Codicils.
FIRST: I direct that the expenses of my last illness
and funeral be paid out of my estate as soon after my death
as is convenient and expeditious in the judgment of my
ExecUtri x, herei n.~ftAr na.me~?,
SECOND: I give, devise and bequeath my entire estate to
my daughter, Linda R. Weldon, and to my son-in-law, L. Keith
Weldon, or the survivor of the two, in equal shares, share
and share alike.
THIRD: All estate, inheritance and other death taxes,
together with any interest and penalties payable with respect
to property or interests therein subject to taxation by
reason of my death and whether passing under my will or any
codicil thereto, or otherwise including jointly held and
other non-testamentary property shall be paid out of the
principal of my residuary estate without apportionment.
FOURTH: I hereby nominate, constitute and appoint my
daughter, Linda R. Weldon, Executrix of this my Last Will. I
futher direct that she shall not be required to post any bond
to secure the faithful performance of her 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, which consists of one (l; sheet of
paper, dated this ~~ ~'f' day of ~-P,Q/`~ 2008 .
~~~~~ ( SEAL j
Calvin 8. Rotz, r.
R. SCOTT CRAMER
Attorney at Law
5. S. Market St.
P.O. Box 159
~uncannon,PA 17020
The writing contained on the preceding page was signed
and sealed by Calvin B. Rotz, Jr., and by him published and
declared as his Last Will, in the presence of us, who have
hereunto subscribed our names as witnesses at his request, in
his presence, and in the presence of each other.
~~ ~~
COMMONWEALTH OF PENNSYLVANIA)
)SS
COUNTY OF PERRY )
I, Calvin B. Rotz, Jr., testator, 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 or the purposes therein expressed.
t ~.
Calvin B . tz~ Jr ._-
SWORN or affirmed to and
acknowledged before me by
Calvin B. Rotz, Jr., testator,
this ~! s~ day of ~~~'/ 2008
R. SCOTT CRAMER
Attorney at Law
5. S. Market St.
P.0. Box 159
Duncannon,PA 17020
NOrARIN. ~.
7UDY M. IR, Notary Pubic
Duncwnon 8o~q, PeRY GovtM.y
My CAmn~lon Expbeg May 25, 2011
COMMONWEALTH OF PENNSYLVANIA)
)SS
COUNTY OF PERRY )
We, [/~ . r~~l~fi'C.:~/`Ij?~/Z and ~OS~C'~O~t ll~. ~,~?~m~..,
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 testator sign
and execute the instrument as his Last Will; that Calvin B.
Rotz, Jr, signed willingly and that he executed it as his
free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the testator
signed the will as witnesses; and that to the best of our
knowledge the testator was at the time 18 or more years of
age, of sound mind and under no constraint or undue influence.
~~~~
R. SCOTT CRAMER
Attorney at Law
5. S. Market St.
P.O. Box 159
Duncannon,PA 17020
SWORN or affirmed t a subscribed
to before me by ~ ~~2~~~~~~
and ~;; D~-e~'h GU. 2~~~ , witnesses,
this ~ ~ day of ~~~~`~ 2008.
OpMMONWEALTH OF PENNSYLY~I!-
NCYrAR1AL SEAL
]UDY M. HE~lNINGER, Nary Publk
Duntannon Born, Perry ~ X11
My Cofflti115~011 Expk~es May