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HomeMy WebLinkAbout02-24-10PETITION FOR PROBATE ANA, D GRANT OF LETTERS REGISTER OF WILLS OF C aM~ ~' ~ °~ n N COUNTY, PENNSYLVArTIA Estate of e~ 6~~ r;~ ~ ' t l~Q_ i.1 File Number / - ~ ~ V~~ also known as Deceased Social Security Number) 7 k ' 3e '~ ~~~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COrYIPLETE 'A' or 'B' BELOW:) A. Probate and Grant of~.etters Testamentary and aver that Petitioner(s) is /are the L~~l~ Q.C. "~ T ~ rS named in the last Will of the Decedent dated -~ 2 ~ Q 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 (Ifapplicnble, enter.• c. t. a.; d.b.n.c.t.a.; pendente life; durnnte 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: (!f Adtnittistratiorr, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) N 0 Name Relationshi Res' ° ~"> ~._: r n'1 ~: rn (~ - - _ ::" C!D -~ -' ~ ~:: (COMPLETE !N ALL CASES:) Attach additional sheets if necessary. _ ~ ~ = ,^ ~. ~ `~ _ Decedent was domiciled at death in a it. .~~ G ~ ~ 0 ~un~, Pennsylvania with his /her last principafi~`esidence at .... °`' ~ ~~ ~" A-_A4Wo~i ~r ~c.~~~rlC ~ l~ ~" (List street address, town/city, township, county, state, zip co~d-e) Decedent, then years of age, died on ~'"e-~. j ~( `Z(? ~ ~'j at ~~ (QJ ~ ~Q'~ ~ ~~. hQ ~. ~X 11'~'kl" Decedent at death owned property with estimated values as follows: .~-- (Ifdomiciled in PA) All personal property $ '` C ~ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $~Clt'c~t) situated as follows: 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 undersisned: signature _ Typed or printed name and residence o~, L lct~~Io~. ~~ ~ ~f0 2 ~M.,o~c~lc C~ v~. 1Z1:~ ~~zrt~.,a., l,~ V ~ ~~ ~ Z. Fo,~n, Kw-oz rev. 10.13.06 Page 1 of 2 Oath of Personal Representative CO~I~(ON'~VE.4LTH OF PEiti~SYLVANIA SS COi;NTY OF ~ ~l. (L~ ~ ~~ ~ Q n The Petitioner(s) above-named swearO or affirm(s) that the statements in the foregoing Petition are true and con-ect to the best of the kno~.vledge and belief of Petitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~~~'W`~ `" ~! 1 5i~nn:w•e of Persann! R~presenrnrive before me the -day of r~ ca Signnture ojPersenn! Represenrnrive --~ For the Reg;Ster Signa::u•e ojPersonnl Representative ~ ra , ~ ~ ~ ,~,,. ~ • ` ~ ~ ~~ -n ~ - - - - -p .. -. _ i C~ v ,., , .... File N//umber: ~ ~ ~ (O ~ ~~ D3 - ..,;, ~`} Estate of~~~ ~ I~Irt°`-I ,Deceased Social Security Number: I-I ~-1- 3l?- `~S ~ L Date of Death: a~II~ I ~ O AND Iv0'JJ, `~" 1 1 l~ o~(Q~ ~ ~-~ (}} I`~Pt'lr U~Qn consideration of the foregoing Petition, satisfactory proof having been presented beforte~me, IT IS DECREED that Letters -T- are hereby granted to /l ~1( I~~F 1'\ L ~1 ~d ~ ~~~~~P «J 1~ in the above estate and that the instrument(s) dated 7 ~ 1 ~ OBI described in the Petition be admitted to probate and filed of record as the last Will (and~C,odicil(s)) ofpecedent. ' FEES ~~~ ~--~ U~ Letters ............... $ Short Certificate(s) ........ $~_~ Attorney Signature: Renunciation(s) .......... $ )`I~ • . ' $ I ~,UO Attorney Name: .. $ Supreme Court I.D. No.: ~ .~ ... $ 'J -U U --~~`~ ... $% Address: ... ~ ... $ ... $ • • $ Telephone: ... $ - TOTAL .............. $~ _~-~L.;~Z of 4Yills Furui RW-0' rev. iv.i~ oa ~ Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or' photograph. Fee for this certificate, $6.00 P 16354454 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. ~'.~.R~~~G~~x' FE~4 2 3/ZOitl Local Registrar Date Issued ~etn~~ -- -~_ -- =x-314 ~~ _- Y'~ N o C r~ ~ ~ ~ a ~ ~ y'~ T ~ r~ ~ ~ _ U~ C --{ .. !:., ~ c 1 Ht64te,9 itV nrsoce COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • YRAL RECORDS ~~ CERTIFICATE OF DEATH toot rx (S80 instn3ctlontP end e7(implss on rowrM) CTaTF FlI F ax IYaexl w W .,.( O U h d ni '/ S A h t. Prar a DaeEela IA+t nedde, rr, rrAn) z. gal 3. soda Sanely ra.ro.r ~. Dow d Dark 1~. rr. Y•eA 17~.- 30 - 5561 Februar 19 2010 5. Apt (lar p611dg1 UMr 1 UMa 1 5. Der a 9111 T. aml aer a ~ Pro a Darh ar roe. Dm Ibas rer HEepXaL• Oller. 71 rrs March 10 1938 Readin Pa. ^6vw.e ^enlaa.wr ^Da wlwlp ^itrr.a. ^ona- m cooly a peen ec. TeP a assn ed Felly Nre Iz m Mwdon, pr etntl ee nano.) s. Wr Deolrl a ~tl algm No rr tn. Reoe: Allydrrl bdr, Brdc, WNr, elc Cumberland Carlisle Forest Park Health Care Ctr. '' w~rn,•b.) (White 11. Decadel4Y Url rankd ra mrtd ~. Do.M elre 12 Wr DeatlaE aver r Ile 13. Dradrlys EAlcatlr (3paPiy wy ~etl led• ar ~dl 1A. lydW 90r1e: Mrded. Nara 1lnled, 15. Suryllp SPa lr M Mr, pre mabal relay qtl a Ylal IDl dB1e6rl6gehy U.B. Amed FomM ESN / mil' (412) C6Mpa (11 a 5') Wes' ~d0r (AeatYl Dock Worker ABF-Truckin ^ r« ~] Ho 1 iv taoecwn-t+wA~•rlse.a,dh/b•+l..w..:4mae1 38 Hathaway Drive ,~rpewrw msme Pa• u~`abe ne~]rr.oeo.aaeu..ab Middlesex Twp_ ~'1 T , , Carlisle Pa 17015 ar, ,;P tn.caaAy Cumberland nd.^ ~~•~++~ , . ~ qy/Flao 1B. Falefe Iblre (FIsL nidrs, rtl, aAlr) iB. Goner's Nrr IRIa, mdde, meben eumelr) John C. Dre Sr zoe.ltallwn'a Hrr RYV• / P~1 zoo. IMOlnwn'e wtlq Adder (Sner, dN rmrt, err, nP ode) 2 6 1 Dorman Lee Godl v 21a.14ad d crsoaroo 1 ®Clrlalm ^ DorYm 21D. ore d D Iwel. aer. Yawl 210. Pro d DYpara (Haa d anelwr, arrbry aolwpo) 21d. Loanm 1(2ry/bra, errs, ep adel a^„~ ^ ""eog16omB`r ~ rea~arrn.alal."'a"°1sd rr^rb Feb. 23 2010 Rollin er FH Cremator Inc Mt.Holl S s.Pa.17065 dFlnral8aeos wr r 226.UnIreN.lea 22eHaneeMAddwaFedy 501 N. Baltimore Ave. FD-011932-L llin er FH remator Inc. 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Da.a (d•~ wY ar) de•adWlwrlallolr l ltlr nr ltl lan l drb rbdlr 29 • ~a +l ~a(aa~ 976. p ye P ab a aag ln ) ot y l Torerraey blaredl•, 0erh aeelarN drbtM aae•(a)and asaerrrred_________________________________ ~~ PeabaleYq aaO arlryYq plryebYl(Plryrdrl hoMl palouxip deYleedoaWyrpbaueddeWl) dWlaaarMrtl lM d b M r r d blM d r W ^ T 39e 89d Mr ,yrq - • s•, al r e, a ,e P r era(a)rl awwr a __________________ YsdulFSaYSr/Caalr ?` ~ f l~ Onh6rY aasNntlon algla YnarlPnal,bmy apYYal, derh ooaum0rtletl•r,Eeb,ar prs,andMbtla eauea(a)alr erawraWll ^ enal Who Conerted CalwdDarh pMn 27)T /Pdd 9/. Hans aql A~dyneo[~P t ' ~ J e 1"F XJ~ s 95 rt.al.r• aId Dr6a ~ Nya6er , ~ I I ~ I ~ Fled (Aloreh, dry, y.en 13 S t 1V S ~ ~ 7 L" _ a l _ . rcxi • / e.~„ : ( DlepoeMoa Pamr No`'... L~~~~~31'C, lawtemp LAST WILL AND TESTAMENT OF ]ohn C. Drey I. I, ]ohn c. Drey, residing at Carlisle, Penns~rlvania, being of .sound mind and in the contemplation of the certainty of death, do hereby declare this inst~c~ument t~;be my l ast wi l l and testament. ~p ,~, _ ~- ~ ::~~ ~ J ~,, '! I hereby revoke al l previous wi 11 s and codi ci 1 s . ;?; ~ ~ „~ ~ ' ; - :7~:.:; ~, ,.. ;;:.~. III . r-~~~ ~:~ ~-=- I direct that the disposition of my remains be as follows : ~.~ Vi=i ~ ._:::: , ~,~; Funeral arrangements shall be made by Dorman ~. Godlove, ]r. -- ;.., IV. I have compiled a list of my personal belongings and my disposition of these items and have left this with my personal papers. I direct that these items be distributed as shown in the written disposition. v. I give all the rest and residue of my estate to the following individuals, share and share alike: Dorman ~. Godlove, ]r. If none of my designated beneficiaries survives me, I give all the rest and residue of my estate to Laurel Godlove. If neither Dorman ~. Godlove, ]r. nor Laurel Godlove, survives me, I give all the rest and residue of my estate to my heirs as determined by the laws of the state of Pennsylvania, relating to descent and distribution. vI. I appoint Dorman ~. Godlove, ]r., to act as the executor of this will, to serve without bond. should Dorman ~. Godlove, ]r. be unable or unwilling to serve, then I appoint laurel Godlove to act as the executor of this will. I herewith aff11ix__ my signature to this will on this the ~7''l day of i-~~~U9 Page 1 lawtemp at ~~~' ~ ~ S ~o s r ~ n the presence of the following witnesses, who witnessed and subscribed this will at my request, and in my presence. ~-~` John C. Drey ATTESTATION CLAUSE on the date above written, john c. Drey, well known to us declared to us, and in our presence, that this instrument, consisting of ~_ pages, is their last will and testament, and john ~. Drey, then signed this instrument in our presence, and at john ~. Drey's request we now sign this will as witnesses in each other's presence. Further that ]ohn c. Drey, appeared to us to be of sound mind and lawful age, and under no undue influence. w~tn Address : ~~ Y" ~ ~ ©~~ witness: Address : ~ ~ .S f'~-'y G ~ 2, ~V C c~, ~- ) ~ S ~ .~a J~~ ~~~~r Witness: Address: ' ~ l STATE OF Pennsylvania COUNTY OF Cumberland Before me, the undersigned authority authorized to take acknowledgments and administer oaths, personally appeared: john C. Drey Page 2 ~~ e lawtem who after being having duly sworn or affirmed to tell the truth, stated: 1. That john C. Drey declared this instrument to be their last will and testament to the witnesses. 2. That .john c. Drey signed this instrument in their presence. 3. That the witnesses signed as witnesses in the presence of aohn c. Drey and each other . 4. That john C. Drey is well known to the witnesses, and the witnesses believe john c. Drey to be of lawful age, of sound mind and under no undue influence or constraint. f officer ' Title of officer: C My Commission Expires : ~ ~» ~ ~.~ Z LZ1 3 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Flora M. Vogt, Notary Public North Middleton Twp., Cumberland County My Commission Expires May 21, 2013 Member, Pennsylvania Association of Notaries Page 3