HomeMy WebLinkAbout04-0578PETITION FOR PROBATE and GRANT OF LETTERS
also known as
Deceased.
Social Security No. ~ol-[~- i571'4
NO.
To:
Register of Wills for the
County of (_)j~xJ,~,~a/nd
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of ague or older an the executoF
in the last will of the above decedent, dated
and codicil(s) dated
/
in the
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~_.lA/mbe~l~nd Cou~l. ty, Penn~lvania, with
h ['~; _ last. f.amilE or prirkcipal residence at
C.c~ H'~'I/ ?/4 l'lOI ! -
! I (list street, number and mJncipality)
De. cendentsthen ~ years ~f age, digd
at [x)~ hcte_ ~Jzi~r~,~~ [:e.~v~..c PJ~,~ H-ill ?/+ I']Ott ' .
Except as follows, decedent d~d not marry' wa~ not divorced t{nd di~l riot have'a child born or adopted
after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent 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 follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codiCil(s)
presented herewith and the grant of letters. ~:,_ :'
(testamentary; administration c.t.~t~; administ~:4fion d.b.n.c.(?.)
theron. '
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL,TM OF PENNSYLVANIA
COUNTY OF C t~kVY~ [~ F--~/'~' D . f
I:~.ore me this 1~ 'T~" day of, [ __
.y / , iste
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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Estate Of
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~"LLI~t E I~/ frO0 ! in consideration of the petiti°n °n
the reverse side hereof, satisfactory proof having been present_e~ before me,
IT IS DECREED that the instrument(s) dated] - ] ~-~ ~'~
described therein be admired to probgl/e and filed of record as the last will of
and Letters -l'-~%r~~ T/~/~ ~
are hereby granted to '~i t. Lq [~A C_. t~tA3K~
FEES
Probate, Letters, Etc .......... $ ~ ~' 0~)
Sho~ Certificates( ~ ..........
~n .~..~.~0.. $.
s. iO, O0
TOTAL __ $
Filed ...................................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
I05.8115 RI!"," 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duh.' filc~l
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanem
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
No.
Local Rcgislrar
JUN '1
Date
H105.14~ Rev. 2~87
NAME OF DECEDENT (F~ ~;~C,6, La~)
~. Farrell R. Brown
Cumberland
DECEI~NT$ USUAL OCC[JPATION
UoSo
Camp Hill
KIND OF BUSINESS I INOLISTRY
770 Poplar Church Rd.
~illiam Charles Brown
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
I SEX SOCIAl. SECURITY NUMBER DATE OF D~ATH (MOral% Day.
,. Male 1~.61 _ 12 --8714 · ~ May 28, 2004
S~ er Fm'algn Count/I ~os~l~.: E~:xm~m E] °°~0 I OTH~
Fr. I~""'r-I I ~ ~il .~O ,-~'~
FACJ U TY NAME (11 flO~ InMY(uM~t. glv~ ~rNI ertl nunl~'~ ~ ORIGIN? RACE -Amencan Ird~ B~ack, V~t,, et
No r~-'] Yes [~ if yel~, ~cify cu~n, (specify)
Nest. Shore Healt.h & Rehab. M.x~.,,.~R~.,.,=. I1~0 Whit.e
Yev~]
~,~ , .... , wi~6~--e~~'~
OECEDENTS l?a. SIMe
(SN In~uctlom
~,~ ~) ~. c,x~ Cumberland t.,,,,~,? ~75. ~-I
~u.~,~ Camo Hill
mevlt~ng In e~e~) .-.--~
MOTHER'SJiI~ME (Fk~t, Mid(~e.
11. l'nereM ~e ~nz~con
INF~N~ ~ILI~ A~SS (S~ ~ S~ ~ ~)
~. 712 Old ~er Rd., Lewises, PA 17339
~TE ~ ~ ~ ~ ~S~lTl~. ~ ~ ~, C~ L~AT~N - ~ S{~, ~ ~
~G~e 3, 2~ ~Zndi~ ~p Na~iona[ C~ ~nvi~1et P~
WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONEk?.
W~ AN AUT,~ Y { WERE AIJ¥~"OT FINDIN08 I ~ER OF ~TH ) ~TE ~ INg~ I TIME ~ INJURY DE~RtBE MOW I~URY ~URRED.
~RF~ME~ ,AV~~
~ ~ "~ ~l~ i~. M. ~c.
SIGNATURE AND TITLE OF CERTIFIER
UCENSE NUMBER DATE SIGNED (Monl~. Day.Year)
~ME ~D A~E~
OATE FILED (M~,
OF
FARRELL R. BROWN
I, FARRELL R. BROWN, a domiciliary of Valrico, Hillsborough
County, Florida, being of sound and disposing mind and memory,
and above the age of 18 years, do hereby make, publish and
declare this to be my last will and testament, hereby revoking
any and all former wills and codicils made by me.
ARTICLE I
I devise all my property, real, persOnal or mixed, wheresoever
located, to my wife, ELLA M. BROWN, should she survive me
for a period of thirty (30) days, to have and to hold as her
property absolutely to the express exclusion of my children now
living, hereafter born, or adopted.
ARTICLE II
In the event that my said wife, ELLA M. BROWN, should not
survive me by thirty (30) days, or in the event that our deaths
occur simultaneously or approximately so in the same accident
or calamity in such a manner as to cause doubt as to which of
us survived the other, then I hereby devise all my property,
real, personal or mixed, wheresoever located, absolutely and
forever, to my son, WILLIAM C. BROWN, MAJOR, U.S. ARMY, SSN:
245-68-0045, who can be contacted through MPC, Department of
the Army, and all of my children hereafter born, inc.luding
adopted children, share and share alike; but in the event that
any of my children shall have died in my lifetime leaving issue
living at the time of my death, such issue shall take by rep-
resentation and per stirpes between them the share which their
parent would have taken had such parent survived me.
ARTICLE III
I hereby nominate and appoint my said wife, ELLA M. BROWN, the
personal representative, of this, my last will and testament,
to serve without bond.
Witnesses
Initials:
Testator
(SEAL)
Page 1 of 3 Pages
ARTICLE IV
In the event my said personal representative, ELLA M. BROWN,
does not survive me, or having survived me should thereafter
die, become incapacitated, or decline to serve, I hereby nominate
and appoint my son, WILLIAM C. BROWN, the alternate personal
representative, of this, my last will and testament and request
that he be permitted to serve without bond.
ARTICLE V
I authorize and empower either of said personal representa-
tives, or any successor, to sell, lease or mortgage any type of
my property, publicly or privately, where allowed by law without
court order and without notice, upon such terms as seem best to
said personal representative, to permit beneficiaries to use in
kind any tangible personal property during probate - to settle
or pay any claims, including taxes, for and against my estate,
and all powers given the personal representative, in accordance
with the laws of the State of Florida.
ARTICLE VI
If my wife, ELLA M. BROWN, and I should die under such circum-
stances as to render it doubtful whether my wife or I died first,
it shall be conclusively presumed for the purpose of making
distributions under this Will and of property owned in an estate
by the entirety, that my wife predeceased me.
Witnesses
Initials:
Te s tato~
Page 2 of 3 Pages
IN WITNESS WHEREOF, I have hereunt~ set my hand and seal to
this, my Last Will and Testament, consisting of two typewritten
pages, upon each of which,.in addition to this Dane o~ execution,
I have signed my name at ~~/~
on this /~k da,, of r~ , ,.--_ . ~, ~ c..~,~,,.-r. ,
Testat6r
Signed, sealed, published and declared by the above-named
person to be the Last Will and Testament of that person in the
presence of all of us at one time, and at the same time we, at
said person'S request and in said person's presence and in the
presence of each other, have hereunto subscribed our names as
witnesses and do hereby attest to the sound and disposing mind
of said person and to the performance of the aforesaid acts of
execution at the place and on the date above shown.
Residin~ at .....
Residing at
esi~ing at
~TATE OF FLORIDA
CIT ZCO NT OF
We, FARRELL R. BROWN
the Testator, and the witnesses respectively, whose names'a~e
signed to the attached or foregoing instrument, being first duly
sworn, do herebY declare to the undersigned officer that the
Testator, in the presence of the witnesses, signed the instrument
as his Last Will and Testament, and that each of the witnesses,
in the presence of the Testator, and in the presence of each
°t~~~ a witness.
· ___ , Testator
~ ~~ ~O.~f/_~..~ ,Witness
an sworn to before me by FARRELL R. BROWN ,
~/~ '?/~ ~~ the witnesses, on ~his /~ day of
CO~,Hv~O~ ~l~"c ::u- ~'LOH;~n ,%~ LARGE (SE~)
axv~a~S ~U~E 2. ~85 ary Public
BO,%IDED THROUGH MUROSKI-ASHTON, lNG
N~ ao~$ss$on expSres:
Page 3 of 3 Pages
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 09/01/2004
BROWN WILLIAM C
712 OLD QUAKER ROAD
LEWISBERRY, PA 17339-9704
RE:
Estate of BROWN FARRELL REGIS
File Number: 2004-00578
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 09/28/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
Sincerely,
GLENDA FARiqER STP~ASBAUGH
Clerk of the Orphans' Court
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Aden. No.
To the Register:
I certify that notice of (bene~Jal ~terest) estate atln~nlstradon required by Rule 5,6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on .~(2,ql~ ~ :
Address
William
"71g._ 01~ £~ uoJ:_e~- ~a,t Le~i~v PA 1'7'557
! II
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name ~lLd..J~ C. ~O~
^ddress '71~ Old_ (~t,~es
Le. oi berrv PA
~Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BROWN WILLIAM C
712 OLD QUAKER ROAD
LEWISBERRY, PA 17339-9704
unnn fold
ESTATE INFORMATION: SSN: 261.12.8714
FILE NUMBER: 2104-0578
DECEDENT NAME: BROWN FARRELL REGIS
DATE OF PAYMENT: 01/13/2005
POSTMARK DATE: 01/13/2005
COUNTY: CUMBERLAND
DATE OF DEATH: OS/28/2004
NO. CD 004837
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,515.82
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,515.82
REMARKS:
CHECK# 1510
SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/29/2006
BROWN WILLIAM C
712 OLD QUAKER ROAD
LEWISBERRY, PA 17339-9704
RE: Estate of BROWN FARRELL REGIS
File Number: 2004-00578
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
5/28/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~~/A.u~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Register of"\ViUs of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name ofDecedent: _Ffi rrel I f( elf i\ Dro{,Ji\,.
Date of Death: 4 1.6 }1..Qo4
Estate No.: ~{)/f - DO 57 !~.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
I. State whether administration of the estate is complete:
Yes Ji'f No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: A~ [7/ :L()('(.
I
I,) .
, j,
" f . '-...
Signature
. (YJl#~
-
Wi w A1Yl c.... !:>rf0WtJ
Name
7/~ Old Du..aJeer Rood
Address L~i~ I PA /13jq
7/7 - 9513 -9416
Telephone No.
Capacity: j8(Personal Representative
o Counsel for personal representative
{j