HomeMy WebLinkAbout03-18-10REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Charles Robert Woods Overton
also known as
File Number
Deceased Social Security Number 431-16-4016
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executor named in the.
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last Will of the Decedent dated February 25, 1986 and codicil(s) dated r-~'"'
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(State relevant circumstances, e.g., renunciation, death of executor, etc.) ;, ~ ~ i ~ _ .
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution oC-tlie-iustr~ment(~.offered'
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: Adjudicated incompetent 4-~~~06t5, Cutter Co. - T-
B. Grant of Letters of Administration ~ ~
(If applicable, enter: c.t.a.; d. b.n.c.t.a.; pendente liter 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: (/f
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 County, Pennsylvania with his /her last principal residence at
4905 Trndle Road Mechanicsburg Hampden Township, Cumberland County, PA 17050
(List street address, townlcity, township, county, state, zip code)
Decedent, then 94 years of age, died on December 24, 2009 at Holy Spirit Hospital, 503 N. 21st Street, Camp Hill, PA
17011
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
$ 430,000.00
__._ __
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:
~l 1 . -' Peter Van Duzer Train, 3802 Dorset Drive, Mechanicsburg, PA 17050
~; p `V A~.~tlraft.rC' ,,L~8.1.r`A.
Fnrm RW-02 rev. 10.13.06 P11T,e I Of 2
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 the ~ ~, day of
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r t e Register
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Signature of Personal Representative
Signature of Personal Representative
Signature of Personal Representative
File Number:
Estate of Charles Robert Woods Overton
Deceased
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Date of Death: December 24, 2009
Social SQecurit+y111Number: 431-16-4016 `~ ~ ~~
AND NOW, ' +`~) 'v `~t~~ ~~~s1~--~ in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Peter Van Duzer Train
in the above estate
and that the instrument(s) dated February 25, 1986
described in the Petition be admitted to probate and filed of recgrd as the last Will (and Codicil(s)) of,Decedent. ~~ ~
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FEES
$ , VV
Letters .......... .....
$
Short Certificate(s) . .......
Renunciation(s) ... ....... $
... $
... $
... $
... $
... $
... $
TOTAL ...... ........ $
Register of-~'ius ~ 'l j~
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Attorney Signature:
Attorney Name: Jo eph K. Goldberg
Supreme Court I.D. No.: 46782
Address: 2080 Linglestown Road
Harrisburg, PA 17110
Telephone: 717-703-3600
Page 2 of 2
Fnrm RW-02 rev. 10.13.06
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee fitr thi; certifi~_ate ti6.0O
• _P 15_934351
---- C'crtificat on vtunbcr
U REV 11/2006
I PRINT IN
RMANENi
Thi`; iti to certitY~ that the inl</rmation here gi~~en Is
correctly copieei~lrvm an original (certificate of Death
dul~~ t'ile<l ~~~i(i~ rrle as 3_,tical Re~~.~trar. T'he original
certificate ~~-~l! Ito: ior`rtiarded to the State Vital
Records Oifice tirr permanent filin~~.
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Local Re17isiraf Date ls~ued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
resxa Incfnsrtiens and examples on reverse) STATF F11 F NIIMRFR
2. Sex 3. Sadel Secudry Number 4. Date of Death (Month, day, year]
1. Name ol0ecedenl(First midMe, last. suffix)
Age (Last BlrlhdaY) Under 1 er Under 1 de 6. Date of Birth Monts, d r 7. Bi lace C' eM state a fee' ceu Sa. Place of Death Check all one Other
5
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:
Meets Deys Hours Minutes .rw7 HosD
Jan 9 1915 • s LLB Inpatient ^ ER I Outpatient ^ DOA ^ Nursing Home ^ Residence ^ Omer -Specify:
94 Yr6.
Twp. of Deam Ed. Facikty Neme (If not insthNion, give street and number) 9. Was Decedent of Hispanic Odgin? No ^ yes 10. Race: Amerkan Indian, Black, White, etc.
City
Boro
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ISOa'iM
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,
,
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ee
80. County of
(If yes, specify Cuban,
Cmnberland E. Pe>;msboro Hol S irit HO ital Mazican, Puano Rican, etc.) White
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12. Was Decedent ever in me 13. Decedent's Educetlon (Specify onry highest grade completed) 11. M ~~Stap~~ e~ ~/ r Martied, 15. Surviving Spouse (II wile, give maiden name)
Decedent's Usual lion Kind of work done dud mwt of workin life. Do not slate retire
11
.
U.S. Armed Forces?
Kits of Work Kits of Business I Industry Elementary I Secondary (412) ~ Ctollege (1-4 or Sa) • dv _-,
Naval Officer US Na ®Yea ^ Np JT VWCIl
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16. Decedents Meiling Address (Street, city I town, slate. zip code) T~,,,,,,,~
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Dacetlent's D
State Pennsylvania Live in a t7c. [Ves, Decedent LNetlAlas'F^i~ TwO
Actual Residence t7a
4905 Trindle Rd. .
Tpwnahlp?
Lived within
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Mechanicsbur PA 17050 ry
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17b. County
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1 B. Father's Name (First, middle, last suffix) en surna
19. MomeYS Name (First, mkkfle, ma
-
(~larles Andrew Overton
20a Informant's Name (Type.) Pdnt)
' 20b. Informant's Mailing Address (Street, city I town, state, zip code)
3802 Dorset Dr. Mechanicsburg. PA 17050
IYain
Helena
21 b. Date of Disposition (Monm, day, year) 21c. Place of Disposhion (Name of cemetery, crematory or other dacel 21 d. Laatlon (City I town. slate. zip code)
^
Donation
21a. Method of Disposdion i Cremation
^ Baial ^ Removal Irom State I was cremadon a Donatfon Autttodzed p~ • 28 2009 Hollinger Crsnation Service Mt . Holly Springs , PA
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Yes^ No 6
^ Omer - S ~ W kkdlcal ExeminerlCaonM
License Number 22c. Name and Address of FacililvMaaers-Harner Funeral Home Inc
22b
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soon)
ansee (or repo a
22fl. 5 0l Funeral Service
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23b. License Number 23c. Date Signed (Momh, day, year)
Compels t ems 23ec ony when cenirying 23a. Tome my knowledge, tlealh occuned a me time, data aM place stated. (SigneNre and O!M) j~~~
iWble at fime of loam to ~,
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physi,en
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year) 26. Was Case Relert 'to Medical Examiner /Coroner br a Reason mar than Cremation or Donation?
day
to Pronounced Dea (Mon
25
,
,
.
24. Tama of Deat
Items 2b26 must be completed by person n
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^Yas No
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who praounces deem. ~. r M. v
Approximate interval: Pad II: Enter amer ~'s.•nt cond'don=_ tontrihulino to deem. 20. Did Tobacco Use Contdhute to Death?
CAUSE OF DEATH (See InetruMlons and ascamples) ~
Item 27. Part I: Enter the rhan of events -diseases, kryudes, a wmplications - met dradhy reused me death. DO NOT enter tenninel events such as cardiac anest ~ Onset to Death but not resulting in me underlying cause given in Pan I. ^Ves ^ Probably
^ No ^ Unknown
respiratory arrest or vanlrkular fibrillation witMm snowing me etioogy. Ust ordy ale reuse on each Gne. t
1
IMMEDIATE CAUSE IFinal disease or ;~~~ (~ => ~-~ 7 ~//~ • < 29. II Female-
~-'~ ~''' ~'Et`~ lam'- S~°r ~1 J " '~-1~~~~ ~ t~~ `"'~~~t~_ ~~ i ^ Nol pregnant within past year
coroPoOn resulting in Beam)
_~ a.
Due to (or as a consequence op. n ,>~ y 1 ^ Pregnant at lime of death
Sequentialryry list caokions, if any, b. /"L ~/ ~" t ^ Not pregnant, but pregnant within 42 days
leading to tle cause listed on lira a. Due to (or as a consequence off: i.~,•, "~'L of death
Enter ma UNDERLYING CAUSE ~y ~ • 7 T =-8 ~ ~ ~
nan143 days to r year
re
re
nant
out
^ Not
,
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D
(disease a Injury mat inhiated the c i
events resuhing in death) LAST. before Beam
Due to (or as a consequence op:
^ Unknown II pregnant within the past year
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30a. Was an ANOpsy
30b. Ware Autopsy Findings
31. Manner of Deem 32a. Dale of In u Monm, day, year
I ry ( I 32b. Descdbe How Injury Occurtetl 32c. Place of Injury: Home, Fartn, Street Factory,
OtfK;e BuiMing, etc. (Speciy)
Pedomwd7 AvaNable Prior o Canpletion k~l Natural ^ Homicide
of Cause of DeathT Yr'
ation
Investi
din
^ P
^
32d. Time of Injury
32e. Injury al Work?
321. If Trarwporlation Injury (SpeaM) 32 Lowtan of in Street, ci I town, state
9~ NrY I ry 1
t~V
n NO
^ Ves L ^ Yes ^ No g
g
en
Accident ^ Yes ^ No ^ Dover/Operate ^ Passenger ^ Petlestnen
. ^ Suicide ^ CouM Not be Determined M. Other -Specify
33b. Signature aM Td of Cadifer
33a Centfier (check onry one)
ronouncetl death antl completetl Item 23)
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an
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CerlNying physician (Physldan cenirying cause of deem wren anomer p
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To the beef a my knowledge, deaM occurred due to the cauae(a) end manner as elate - 33d. Dale Signed (Month, day, year(
~ License Number
• Pronouncing and canltying phyalclan (Physkian born Pronouaing deem and cenirying to cause of death)
To the betsM mY knowlMge, death occured al the time,date, end place, antl due to the cause(s)and manner as stated------------------^ _ -~7 ~
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• Aledkal Exeminer/Coroner
On the Deals of examinatbn and I a Invesdgetbn, In my opinion, deaM ocwrretl at the time, date, and place, end due to the cause(s) end manner es atated_ ^
34, Name`~tl Pddress of Person Who Compl tetl Cause of Death pram 27) Type 1 Pdnt
35. Regisirar,~gnaWre and o~u I -~ I / I4 1 I / I ~ I
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' 36. Date Fil (Monm, Y, year){-,
Y~1G~~~ ~~ ?, /\t. , ;3 i ~'T ;St
L;,tit~+~f) F':l ion
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v 0366923
DisposRion Permit No.
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ER
and State of Arkansas ,being of full ale and sound mind and
memory, do make, publish and declare this to be my ~ ~#.
hereby revoking and annulling any and all Will or Wills by me heretofore made.
~Ct Y . I direct that all my just debts and funeral expen8es be paid out of my
estate as soon as practicable after my decease.
~. I give. devise, and bequeath to my wife Patric la Farrand
Overton all my real and personal property. All the rest and residue
of my estate. real. personal an8 mixed, I give devise and bequeath
to my wife Patricia Farrand Overton.
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~~ CHARLES ROBERT WOOD6 OVEHTON of the
city of Little Hock County of Pulaski
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OFFICIAL PlOBATS FORM 4 PROLi'B QODB.. dBC6. k AND R
T61e Form Hue Been OHkiaib Prser[bsd b7 the supewe Court of Arkanw for Uee Under Chs Pmbete CoAe, Aat 110 0[ t4 1flf Aar at Askarae
IN THE PROBATE COURT OF________PULN'SKI _______ __ __ COIINTY, ABSAN8A9
IN THE MATTER OF THE ESTATE OF
-Charles Robert Woods Overton
-- -- -- - ----------------------------------------------~ eceased No.-------------------------
PROOF OF WILL
We, _
and_~/_~~!_/__'_L___L!-_1%~~~!'!~_________, on oath state:
We are the subscribing witnesses to the attached written instrument, dated___~~~_~_
day of__~~~L~/ _~_______, 194_, which purports to be the last will of____Charle8~_
___ Robert__Woods ____ ertOn___________________ ___ _______ _ _ __________~ deceased. On the execution date of the
instrument the teatat___~r___, in our presence, signed the instrument at the end thereof, or acknowl-
edged h_ls____ signature thereto, declared the instrument to be h-_S~$_____ will, and requested that we
attest h is ______ execution thereof ; whereupon, in the presence of the testat_~r _____ each of us signed
our respective names as attesting witnesses. At the time of execution of the instrument the
testat_°_r _____ appeared to be eighteen years of age or older, of sound mind, and acting without undue
influence, fraud or restraint.
DATED this_~~~~__day
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STATE OF---AAKAN3AS_-------------------------------
re~e~ ~.onloKP_
COUNTY OF------------------------- -__---------
Subscribed and sworn to before me
(SEAT.)
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[Official Title]
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-------------------~'-_13 -- F3
OATH OF NON-SUBSCRIBING `VITNESS(BS)
/ ~ REGISTEK OF WILLS
~-~1~;~r h _ COUNTY, PENNSYLVANIA
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Estate of ~/'~iG~/,l~-S ~« ~ l/~~~~
~~n
Deceased
(C~ ~ /P~ry1 ~%"•~ !" ~~C+ )d'i and l ~`~ (~I~a ~t/'~t'~~t >
(each) being duly qualified according to law,~e~os s) an say )that she / he / he was were well-
~~~ ~~, ~..5 p~ and am/are familiar
acquainted with LZJ'l~/.S - t
g ~~~s ~~~ ~aL~~ C~'~?d>
with the handwriting and signature of the decedent, and that the si nature of
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to the foregoing instrument purporting to be the Last Will and Testament/Codicil of l"~'
C~lg~~s ~~,~y~ is in his/her own proper handwriting.
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(Signature)
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(Street Address)
f' N_~/~CLi ~ cS ~ ~ 7 Q5~
(Ciq,, Slate, Zip)
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(Signature)
(Sweet Address)\ ~ ~ ~ ~~ ~ ~ ~ ~ --~~
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(City,, Slate, Zip)
Executed iiii Register's Office
Sworn to or affirmed and subscribed
before me this ~ ~~ ~ ~ ~~~ ~ ~d~ay
of ~~ ,~~~ , ~~S11_L~ -
~~~.
Deputy for Regist of Wills
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