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HomeMy WebLinkAbout04-06-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of LAWRENCE WILLIAM BITNER File Number ~~l ~~C1-~~ D •~ also known as LAWRENCE W • BITNER ,Deceased Social Security Number 19 5 - 3 8 - 8 412 ANN K• BITNER Petitioner(s), who is/are I8 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 E x e c t u r >i_ x named in the last Will of the Decedent dated 5/26/1970 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 (/f applicable, enter: c.t.a.; d. b. n. c. t. a.; pendente lice; durante absentia; durante mtnorttate) 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.) .,,, Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his /her last principal residence at 9 0 6 W E S T 1dALNUT STREET WORMLEYSBURG PA 17043 BOROirH OF WORMLEYSBURG (List street address, town city, township, county, state, zip code) Decedent, then b2 years of age, died on x/26/2010 at HARRISBURG HOSPITAL HARRISBURG pq Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 3, 000, 000.00 (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 this Petition and the grant of Letters in the appropriate form to the undersigned: Signature ~.. Typed or printed name and residence ~. ANN K• BITNER 906 WEST WALNUT STREET ORM Y G PA 4 Page 1 of 2 FormRW-02 rev. /0./3.06 (COMPLETE INALL CASES:) Attach additional sheets if necessary. cT Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) or affum(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 ~ ~_ ~ T For the Register C7 ~=, ~© ° ~_~ ~ ~-- _~rn ~ -; ~, c~ .._~ ~~ r.-, __ ~__ Signature of Personal Representative Signature of Personal Representative Stgnature of Personal Representative File Number: ~ ~ - ~f!~ ~ t/ _~~/ `:~C. -i° ~ Gn cr, Estate of LAWRENCE WILLIAM BITNER ,Deceased ---, Social Security Number:l9 5 - 3 8 - 8 412 Date of Death: 3 / 2 6 0 2 010 AND NOW, ~~ ~ ~- , 2010 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS CREED that Letters T E S T A M E N T A R Y are hereby granted to A1~LN K• B I T N E R in the above estate and that the instrument(s) dated MAY 2 6 , 19 7 0 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Dec lent. FEES Letters ............................. Short Certificate(s) •.•...••.... Renunciation(s) •••••••••••••••• c~,~. $ " y C~. ©O $ L~ $ c~ cf .... $ .... $ .... $ .... $ .... $ .... $ _ TOTAL ............................. $ ,0~-''~~ ~~ eg ter of ~llf~(j Attorney Signature: Attorney Name: Supreme Court I.D. No.: 2 0 8 6 8 Address: i'__331 MARKET STREET SAMP HILL PA 17011 Telephone: 717 - 7 6 3 -13 8 3 Form RW-02 rev. 10.13.06 Page 2 of 2 "~`~°~, "`fie i~ ~~~ ~ ~ ~ ~~ aye ~ ..9~ ~t ~~ ~„< ~~~~e_ i .o d~i~ ~- ~t a cep ~ ,~&E a ~~ ,~' zy~ ~ y~k[.~.,z ,ems Cc~,.x ~'~ , aLf.zfi^,^/s,aNl„ 0~z~Z,.c out~~~d.. ach c._E . ~~~~ .~~~~~~d~~~ a.«c ~l~ ~7 q =o 0 ~~ -~i ~~ ~ `. ~ ~ i --; ~_ l t~ ) _~ ~_~ -T'{ Z1 ..__ ~ N ~ _~ .. r 7T '~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Far. tin this cart tic ac X6.0O P 16176~~i Certifii,)tion ;vumbcr 43 REV 11/2008 E / PRlldl IN :RMANENi LACK INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) ~r,r< <„ ~,,,,,,,,~„ 1. Name of Decedent (Flret midde, tut srMx) 2. Sax 3. Sodel Security Nrmiber 4. D Dum (MOnm, day, Year) en male 9 ~8 --8412 ~~ S. Age (Last Birmday) UMer 1 r UrMer 1 de 6. Date d Birth MoNh, da , 7.81 ace and state ar hxei rou 8a. Place d Death Ctwtk ores Monms Days lbun ~'~ H as p ital~ Other: ~ ~ , 62 yre. March 17,1948 Harrisburg LI'Lnpetiant ^ ER / Ourpetbnl ^ DOA ^ Numing Home ^ Residence ^ Other Specify: Bb. County of Death Bc. Clry, Boro, Twp. of Deem 8d. fedfiy Name (If not iratltuaon, give street and number) 9. Wes Decedem of H&penk Ongin?~ ~ ^ y03 10. Race: American IMian, Black, White, etc. Dauphin Harrisburg 111 Yes, apathy Cuban, (Spgc;M Harrisburg Hospital Mexlpan, Puerlp Rkan,,etc.) 11. Decedents Uwal tlon Kind of work done du most of world IXe. Do not state rea 12. Wee Decedent ever m dw 13. Decetlenl's EdaceBon (Specfy ony hlgheel grade completed) 14. Marital BIaNs: Monied, Never Manleq 18. Sunm4rg Spouse (If who, gh'a meitlen name) ' land of Work Kind o1 Buslr~ess/Indwtry /yJ U.S. Amwd Forces? Elementary I Secondary (U12) College (1-4 or 5r) Widowed, DNOrced (Spep Director Bankin / Insur 3pYaa ^Na 12 Married Ann K. (Stricker) 18. DecedenYe Mailing Address (Smear dry /town, slate, zip cotle) Decedents PA Did Decedent Actual Residence 17a State Live in a 17c ~Ves Decedent Lived in Wormlevsburg 906 W. Walnut Street . , Twp Cumberland Tmx"'rap? 17d ^ No Decedent Lived wnhin . , 17b. County Actual Limits of Ciry / Boro 1 S. Fethefs Name (Flrst middle, last suffix) 1g. Mother's Naze (Firel, rriddle, maiden suneme) Harold Bitner Margaret MacPhail 20a. IMOrmatd's Name (Type I Print) 20b. InlormanYs McAing Address (Street cAY 1 town, alma, zip rotle) Ann K. Bitner (wife) 906 W. Walnut Street Wormleysburg PA 17043 21 e. Memotl of Disposition i ~ Cremation ^ Dmafion 21 b. Date of DisposAion (Momh, day, year) 21c. Place of Disposi8on (Name of cemetery, crematory or omer pace) 21 d. Location (Ciy I town, state, zq codel ^ Burial ^ Removal hom Stele i Wu Crematlon a Donation ANhorized ^ Other. rbyMedlplExeminerlCoronw7 ~rea^Np Con-O-Lite Vault C Ompany Schaefferstown PA Runeml sa Lk:ensee a~eng ea auto) 22b. ~~ Nwiher zzc. Name aria Addree5 of Fedliry Netmryer Nllneral Home ~ FD 013945E Complete hems 23ec ony when cerBlying 23e. To the best of my ledge, deem occune0 at Bw Brae, date end place stated. (Signature and tltle) 23b. License Number 23c. Date Signed (Month, day, year) physidan K not available at ame of deem to certlly cause of deem. hems 24-26 moat he completed 6y person 24. Time of Death (~ y x ~ 25. Prorpunced Da (Monet, r) ~j~ 26. Was Case Refened to Medical Examiner I Coroner far a Reason Odrer roan Crematlon or Donation? o wta proricurxxre death. (J ~ M. ^ Yas ~A CAUSE OF DEATH (Sea Instruplona and exampka) ~ Approximate imerval: Pert II: Erder other ' 28. Ditl Tobacco Use Contribute to Deam? Item 27. Pen I: Emer the chaki of events - dlausu, mjunu, or cemplicaBOw ~ mat dredhy caused the deem. DO NOT order lemdwl evens Audi es cardiac arrest I Onset to Deam i but tort resulti in the undo n9 ~ nyin9 cause given m Pen I. ^ Yes ^ Probably respiratory aneat a ventreuler AbnllaBon whhout showing the elbbgy. List Doty ore cause an each line. i ^ No ^ Unknown IMMEDIATE CAUSE (Feral diaeese or rr condition resWBng in deem) i ~ F ~ 29. h Female: -~ a. ¢ r K 1 `t i ~ r'~ i ^ N Due to (ar as a conaeguence oil: ~ ot Dregnanl wAhin pest year ^ P H wrnalN Xst candtims, h airy, 6. GG.! f~ ~ O y"~ r m th t t d li regnant at me of death I e caws o e on ne a. ~ to « ~ e ~~ r ( Wence on: r 1 UNDERLYING CAUSE E ^ Nm pregnant but precpant wihin 42 da Ys ar n //~~ (disease or Injury mat inPoaled the p /-~ ~ L d ~ O I b V S e. ~ events resulBng In deem) LAST of tleaM ~. ^ . Due to (or as a consegwnce olj: Not pregnant but pregnant 43 days to 1 year d i before deem ^ Unk A ithi m nown pregnam w n e past year 30a. Wes an Autopsy 3W. Were ANOpsy Findings 31 Man r of Deem 3'la. Date m Injury IMOmn, day, Year) 326. Describe Hex Inury Occurted 32c. Place of Injury Home, Farm, Street Fanory, Penonned7 Available Prior to CamlNetbn Natural ^ Homicitle Office BuiWing, etc. (SpsciyJ of Cause of Deam? / ^ ^ Tana M Injury mod 32e Injury et Work? 321 If Tronsponatbn Irpury /Spealy/ 32 Locetkm of in u (Street I f t t k ,--, ~J•fJO ^ Vea ^ Vea ^ No Acddent Pend4g ImesllgeBm . . . g. j ry awn, s a e) c y ^ Sukide ^ Could Not ae Drtenruned ^ Nu ^ Yes ^ DrNerl Operetar ^ Passenger ^ Pedestrian M ^ Omer' Specify: 33e. Cer9fier (dteck Doty one) 336. Signature antl Tdle Ce ' • CerlKying phyalclan (Physician pnifya,g cause of death when erwtlrer physkien has pronounced deem antl cengkMd Item 23) To ills but of my krlordadge, deeth>courreddw to the pusga)eM manneruateted___--------'------'---------'----^ - ~+ SrLi¢r- • Pronourcing and rxrtMyhq phyal[Mn (Physldan both pronowdng death and cenltying to cause of deem) h f k l d d h d m d d d l ^ 33c. License Number 33d. D (MOnm, day, year) To t e but o my now e ge, eat oaune rt w me, ate, an p ace, end dw to mw puu(e) and manner u eutad_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medlin Examner/Coroner Ls L 1 5 Z ( ` ~~ a/O On tM hula of enminrtbn aM / or ImroatlgMlon, In my oplnlan, death occunad rt 1he time, doe, and plop, arM dw to the eeuu(s) end manner ae etete4 ^ 34. 1 Pe ~~ 38. Regietret Wre eM urtlyF./ I ~j I / ~ ~ ~ I ~ 38. Date Fllpd (Mon day, Yur) This i~s tLS certif. that the intcirn?;1t=t1r~ i~cre t~i~en correcU~v copird in>m an uriginFal C~eriifi.atr t?` I)cat duly filled ~ti~irh sne ac Luca1 Re_istrar. The ttri~,in< certificate ,~iEl t~~e f«r~~~<u~ded !n tf3e Statc Vit: Rcrord~ Ok~l~i~c !:7r ~~ernlancnt filiai~. 1~,~,,, i~~ MAR~Z_9 2 Ip - Local Registr._u~ Date Issued r-..x C7 ~' C o - ~~. ~ x.• ^' Z ~ ~ ~ ~rn I - ~;v . ;fir r\ c7~ -7 `-, _ ^~ - _.~ ~ --i .~` C.T1 , ' DlepwitionPermhNO. # O4ZO271 / OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS cuneFRLAND _ COUNTY, PENNSYLVANI~- ~} c ~ ~~ ~~~ - _. Estate of t e ~tRr F. h1Tl I TAM RTTNFR eKe I IWRFNCF W. BITNER `'-~f'~}eceased , '! J ' ~ fV Rl erR ia. GiWGRICH , (each a Subscribes witness tgz (Print Names) Cn 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. (SiSr+an+l'e) ,. (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills 1779 WEST SCNWARTZ BLVD. (Street Address) j,ADY LAKE FL 32159 (City, State, Zip} Executed out of Register's Office Sworn to or affirmaed~a,,nd subscribed before me this ~c~~~ day of _,~L1.2 ~~_ Notary P is My Com ssion Expires: {Signature and Seai of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.} NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrumetu(s} at time of notarization. Form RW-03 rev. 10.13.06 __-=-- MYRA A. Tl1Gi~R g,~iti't" ~ MY COMMISSION t OD 892317 ~: ~~Pf~t:~~~ BaWedThruRENofarYUPubMcUmlavellete OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of LAWRENCE WILLIAM BITNER ,Deceased DOUGLAS BITNER and DAVID W. REALER (each) being duly qualified according to law, depose(s) and says(s) that she / he /they was /were well- acquainted with LAWRENCE WILLIAM BITNER and am/are familiar with the handwriting and signature of the decedent, and that the signature of L A W R E N C E WILLIAM B I T N E R to the foregoing instrument purporting to be the Last Will and Testament/Codicil of LAWRENCE WILLIAM BITNER is in his/her own proper handwriting. -~ __ . E ~ ' i' (Signature) 377 CYGNET DRIVE (Street Address) ATGLEN PA 19310 (City, State, Zip) Executed in Register's Office Sworn to o:• affirmed and subscribed before me ±his ~"~ ~~' day of ! ~' , 2010 . n, eputy for Register of Wills (Signature) 2331 MARKET STREET (Street Address) CAMP HILL PA 17011 (City, State, Zip) ~~ c= , - ! ~~ ~ o ~~ ~ -, ~ ~~ ~__ _ .-` ; -, t. s ~ ~ -~'° ~ t~J r-- , t.Jt rn Form RW-04 rev. 10.13.06