HomeMy WebLinkAbout06-03-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Barbara V. Corl File Number 21-10 ,- ``~~ 7
also known as Barbara Virainia Corl
Deceased Social Security Number 176-14-3719
Ro er W. Corl
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 named in the
last Will of the Decedent, dated
All personal property
Personal property in Pennsylvania
rte.]
__ ~~ ~
State relevant circumstances, e. g., renunpahon, death of executor, etc. C..
~_~ C
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the~s~ment(~offerdd
_~In t
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - -
- .-' ~~
0 B. Grant of Letters of-Ad~inistr~tion i~• -,T-~, , y-,-;: ,f `_,.w, ' `~ ~~
app scab e, en er: c a.; .n a ; pe ente i e; urante a sentia; urante mmontate)
Petitioner(s) after a proper search has/have ascertained that Decedent le Will and was survived by the following spouse (if any) an~ieirs: (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.)
Name Relationship Residence
Barbara L Daum Daughter 12440 Haydon Ct.
Fishers, IN 46038
Roger W. Corl Son 19 Mel-Ron Court
Carli le PA 1701
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
19 Mel-Ron Court Carlisle Middlesex Cumberland PA 17015
(List street address, town/city, township, county, state, zip code)
Decedent, then ~_ years of age, died on 04/09/2010 at Holy Spirit Hospital E Pennsboro Twp Cumberland Co., PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) $ Over 5,000.00
(If not domiciled in PA)
(If not domiciled in PA)
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 rorm ro
the undersigned:
Signature Typed or printed name and residence
~, Roger W. Cori 19 Mel-Ron Court
~ /%/~ ~ , ~ ~ Carlisle, PA 17015
~ ,~ .'Ls, ( ~ ~ ~,c;~~
Form RW-02 Rev. to-fs-2oos
Personal property in County
and codicil(s) dated
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 1 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. _ ~ n
Sworn to or affirmed and subscribed
before me this ~~ day of
~,
^ ,9 ---^
r the Register
Signature of
Roger VHF
Signature of Personal Representative
Signature of Personal Representative
File Number: 21-10 - ,~j(,(
Estate of Barbara V. Corl , Decea~ ~
r ~ Q --~
e~
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Social Security Number: 176-14-3719 Date of Death: 04/0912010 ~-
E3Z ~'T'1 `~?
AND NOW, , in consideration of the foregoing Pei, tisfac~ prodf^' ~ F~`+~,
F..., r
having been presented before me, IT IS DECREED that Letters of Administration ~~~ ~~~ '~'~ T.
_.~ 4..
are hereby granted to Roger W. Corl ~ -~ ~ !k ,`~__
:.n in th~abov~;e~t~te~
and that the instrument(s) dated UD ~ ' z
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ..........................................
Short Certificate(s) .......................
Renunciation(s) ............................
Will
JCP
Automation fee
TOTAL ...................................
Form RW-U2 Rev. 10-13-2006
$ 45.00
$ 8.00
$ 5.00
$ 15.00
$ 23.50
$ 5.00
$ 101.50
. .... ~ ~
Attorney Signature:
Attorney Name: Patricia R. Brown IEsg.
Supreme Court I.D. No.: 27474
Salzmann Hughes, P.C.
Address: 354 Alexander Spring Road, Suite 1
Carlisle, PA
Telephone: 717-249-6333
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 2 of 2
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS C(,`
Htos.143 REV ttnaa
PERAUNENtI" CERTIFICATE OF DEATH
BLACK INK (See instructions and examples On reverse) RTATF FIl F NU MBER
~~
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t. Name of Decedent (Fksl, middle, last, sulfa) 2. Sex 3. rdy Num 4. Date of Deam (Honor, my, year)
~`l4
3719 April 9, 2010
female ~b~'
_
_
Barbara Virginia Corl
5. Age (Last BiNdeY) Under 1 a Under 1 6. Doh of BiM Momh, de , r 7. Birth tt C' and state or fee' tool 8a. Place of Deem Check on one
88 "'°""'° °e" "°'""` ""'"°°° September 19,1921 Grove City, PA Hospital: Omer:
_
Yrs ~] Inpedent ^ ER I Oulpedent ^ DOA ^ Nursing Home ^ Residerce ^ Other - Speciry:
6p. Caunry of Oeafh 6c. Cary, Bono, Twp. of De6m
land
b
C ed. FadNry Name (II na instiNlion, giu° street antl number) 9. Was oecedarn of Hispeni< Organ? ~i No ^ Yes 1D. Race: Amercan Indian, Black, White, etc.
1~'M white
°R~~
irit Hospital (
S
Hol
ea ~'
um
er
E. Pennsboro Twp. n
~)
p
y
l
11. Decedent's Usual den Kind of work eons dun moll d world tile. Do nb state rek 72. Was Decedent ever in ale 13. Decedents Education (SpedH anN highest grade wnpleted) 14. Menl61 Stanrs: Married, Never Married, 16. Sumving Spouse (If wtle, give maiden name)
Wdawed, Divorced (SpeciN)
KiM of Work Kind of Busirassllndwtry U.S. Amletl Faces? Elementary /Secondary (612) Cdlege (1-0 or 5~)
widowed
rs
2
Clerical Secretary Federal Govt. .
y
^Yaa ®Na
a ailin Adaaae1sn~~~.crtyltown,atita,~p~od~)
PA 17015
:aL'1131e
(
C:t
` nra Pennsylvania °,~'ea° a°~"' „< Middlesex
Stara ®Yes, Decedent uvetl in Twp.
AcM1wl Residence 17a
i
.
.
~ Mel-ttOR
1 .
CUmber all TownsMp? 17d. ^ No, Decedent Lived within
- t7h. County Actual Limits a Caryl Born
18. F yams (Rmt mi e, IeaL suffix)
Wl~`~lam fto'~gers 19. Motller's Name (Fllst midde, maiden sumeme)
Pearl Richards
ZO Inlartanr e I P'nt)
oger ~.°~or~ 211b. InlomleMS Meiling Address lStreet, city I tovm, stela. pP )
19 Mel-Ron Court Carlls e, PA 17015
21 a. Method of Disposition ^ Cremation ^ Donation
• 21b. Data of Disposaion (Month, day, year)
2010 2tc. Place of Disposilian (Name of cenretery, crematory ar other place)
Memorial Garde
land Valle
b
C 21d. Location (City /town, stale, zip coda)
s Carlisle, PA 17013
l ^ Rema,aummBtata ~ yea
~ ~e^
^
:
'i
'
a
i
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~ April 14, y
um
er
No
Yaa
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.
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E
x
^
r
s v
of Funeral Service Li~nse° ( n e<rorg as such)
/(
1 22b. License Number
013144E 22c. Name arM Address of Fadliry
Hoffman-Roth Funeral Home and Crematory Inc. 219 North Hanover St.
~ (
~
,
Compb sans 23ac any when certllying
f s
m t 23a. To I beet of mY krlowMdge, deem urtal at the tlme, date ad place slated. (Signature erd ti1M) 23b License Number
z~~ 9g~L
R 23c. Date Sigrad (Mmm, day, year)
~
~~ ~
~
ee
o
physidan is na evanabla et tlme o
certiry cease of tleam. C )
~.~. L~ a _ ~
N ~
~
T~
parson
leted t
st be com
242fi m
- It e I Deam
21. T
m Onlh. tlay, year)
(M
25. Date Plalauncetl Dead 28. Was Casa R o Metlical Examiner /Coroner for a Reason Oma than Cremation ar Dorladon?
ry
p
u
ems
who pronarKros tleam. /
/
lx~ a Z ~ A M. Q
r
/^~
- /~ t ~ / vZ ~ 1 l' ^ Yes No
CAUSE OP DEATH (See Irulrucrlons arM examples) l Approximate interval:
Pan I: Enter Me cha'n of everns - dseases, njunes, a mmplkatians -that 6rettly ca setl the death. W NOT enter tarmirel events such as cardiac anest Onset re Deam
Item 27 Pan II: Enter other 5gnka t rlditioR Iritwfi' t death
but not resuhmg kl me uMerlyirlg cause gNen m Part 1. 26. Ditl Tobacco Use Caltlibute to Death?
^ Yes ^ ProbabN
.
ale cause on each line.
respretory anesl, or ventricular fOrillelion witlgN showing the efiology. List only ^ No ^ Unknown
/
IMMEDIATE CAUSE (Final dsease a CL1Y !•~ L G v C S (lf fi ` °1' " ~ (, i '( °L, i
~ i ~ «
~
caditi« resumng m death) 29. If Female:
nant wihin past year
^ Not pre
,
.
_~ a
Due t(a1~•or as a m/~ISB~~uence p
0(1 ` ~ ~ ( C~~( t ~ ~L Y C.
A a
' ! ((( ~ ~
d g
^ Pregrwm at lime of Beam
imi
42 d
^
ons,
ry, b
-
$$a~ouentlally list tall
bedlrg Io Ih listed on Ina a. Due to ( as ~ conse9uence on:
Enter me UNDERLYING CAUSE ` ~ [ / /
}~C.t ~ !' n ( 'L L(~G
I ~ ~/ LL S (G~
(daease a mryry That inifietetl the
~'7 r / n
ays
Nol pregnant, bN pregnant w
of tleam
s to t
ear
^ N
n
nt
re
n°rn 43 da
t
b
t
,
(
c.
vents resumnq m deem) UST. ~ re (« as a ante oQ: y
g
y
o
preg
a
,
u
p
before deem
^ Unknown II pregnant wimin ma pest year
d
30a. Wes an Autopsy 30b. Were Auopsy Fmdirgs 31. Manna of Deem 32a. Dale of Injury (Manor, tlay, Year) 320. Describe How Injuy ~~ 32c. Place of Injury: Hone, Farm, Street, Factory,
0~ Buildmg, etc. (Speay)
Penomod? Avaaeble Pna ro Completbn ~/(•~rerel ^ Hank:lda
YJ
-- d cause of Deam? ^ Atcitlent ^ Pending Imesdgation 32d. Time of Iryury 32e. Inury at Work? 321. II Transporlatbn IrNUry /SIx+<M) 329. Lawtion of injury (Stree4 mY /town, state)
77
~F
^ Yes y~ Na ^ Yes ^ No ^ Vas ^ NO ^ Drava/Oparela ^ Passenger ^ Pedestrian
^ Suicide ^ CauN Nat he Detemkned M. Oma -Spay
33h. S and Title of Ce~er''~I~_,_
33a. Certifier (dreck alN alel
Certtlying PhYeklen (Physician cemryinq cause al deem when another physbian has prawurcee deem aM mmpleted Item 23) ~ V.~ ~
Toth best of my lmowledge, death o<curtee tlue totM ause(s)ane manneraeWled--------------------------------- icense Number
L 33d. Date Sigrletl lMOnm, daY. Year)
• Prawurlcln9 aM ceellying physk4n (Physkien boor pmrlwMng deem and carl6yin9 ro cease of deem)
^ .
d
L
~ I
C~ ,l
~
C
~ (]
_ _ _ _ _ _ _
To the best al my knowledge, tluM oecurrtd et the Um•, ears, antl pMCe, aM sue to the cauu(s) and manner es sletee_ _ _ _ _ _ _ _ _ -- E
1 \ ~ 4 -
I - ;,Z U
• Meekal ExamirlalCoroner
On the Iaab of examinamon and / a InvesNgedon, In my oplnlon, deaM oaurrM at the time, dale, antl plea, antl sue to the cause(a) and manner as statelL ^
34. Name and Address of Person ,WWWfhhho Completetl Caus¢,of Deem (Item 27) Type /Print
U ,~ S InJ Ci~ID~ l' lrt~ \ ~ ~ -~ ~x f V
tlay
year)
Date Flkd IMonm
36 7~
' (I ~C ~ L ~~ l)
S ~
1
36. Regislrefs ore and Distri M _
I f Ihl
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Disposnbn Permit No. `
~L.a~t ~.ir~ at~b ~e~tante~tt of
~ar~a~ra ~. ~orY
I, BARBARA V. CORL, of Carlisle, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory, and understanding, hereby declare this instrument to be my Last
Will and Testament, revoking any and all Wills by me heretofore made.
ITEM ONE: I direct my hereinafter named Executors to pay all my just debts, funeral
expenses and administration expenses, including inheritance taxes, as soon as may be convenient
after my decease.
ITEM TWO: I give all the rest, residue and remainder of my Estate, real, personal, or
mixed, of whatsoever nature and wheresoever situate, in equal shares, unto my children, ROGER
W. CORL, of Carlisle, Pennsylvania and BARBARA L. DAUM, of Fishers, Indiana, or their
issue per stirpes.
ITEM THREE: I hereby nominate, constitute and appoint my son, ROGER W. CORL, of
Carlisle, Pennsylvania, as Executor of this, my Last Will and Testament. Should he be
unavailable, unable, or unwilling to serve, or fail to act, then I hereby nominate, constitute, and
appoint my daughter, BARBARA L. DAUM, to serve as Executor of this, my Last Will and
Testament.
ITEM FOUR: I direct that my Executor or Co-Executrices, shall not be required to give
bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this this, my Last Will and
Testatment, consisting of ~_ typewritten page(s), bearing my signature,
this ~~^ day of ~~j.~.. A.D. 2001.
Jy
./ :~
Barbara V. Corl, Testatrix
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
BOROUGH OF CARLISLE
I, BARBARA V. CORL, the Testatrix, 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 and Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
~~ /
'_? ~-. LF
__
BARBARA V. CORI,, Testatrix
P
~)
On this, the day of ~~ -~1 ~ , 2001 before me, a Notary Public, the
. ,known or proven to
i ned officer e4~sonall appeared U
unders g ~ p Y
me to be the person whose name is subscribed to the within Last Will and Testament, and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set m~hand and official
a n-~ -
:z,
EAL~ - ~~;~
.. ~::~-~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
BOROUGH OF CARLISLE
The foregoing will, consisting of -typewritten page(s), was,
on the day of , 2001, signed, sealed, published and declared by the
said testator as and for his/her Last Will and Testament, and it is hereby acknowledged that said
testatrix appeared to be of lawful age and sound mind and memory and there was no evidence of
undue influence. We, at her request and in her presence, have hereunto subscribed oul• names as
attesting witnesses:
Witness Address ~~_S ~~ ~~ 1 l7 V 1._~
On this, the day of , 2001, before me, a Notary Public, the undersigned
officer, personally appeared ,known or proven to me to be the
person whose name is subscribed to the within Last Will and Testament, and acknowledged that
she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NOTARY PUBLIC
(SEAL)
of
Witness Address
On this, the day of , 2001, before me, aNotary Public, the undersigned
officer, personally appeared ,known or proven to me to be the
person whose name is subscribed to the within Last Will and Testament, and acknowledged that
she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NOTARY PUBLIC
(SEAL)
OATH OF SUBSCRIBING WITNESS(ES)
REgGISTER OF WILLS
~~fl N"C;( COUNTY, PENNSYLVANIA
Estate of ~ ~ ~
~~
Deceased
~~'C ~~.~ ~ , (each) a subscribing witness to
(Print Name/s)
the Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law--,depose(s) and
say(s) that , sh / he /they was /were present and saw the above Testator / ~estat~ sign the same
and that ~ sh / he i they signed the same and that `^ she he /they signed as a witness at the request of
the TestatorXTestatrix in her /his presence and in the presence of each other.
(Signature)
(Street Address)
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before1me this f~r~ day
l,k..1.o 1 ~ U V
-D--eF-p-uty or ister of Wills
Executed oid of Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by OfScer authorized to administer oaths. Please have present the original or copy of instrument(s) at tune of notarization.
Form RW-03 rev. 10.13.06
~_ r G~ ~, ~ ,~ ~~ ~~ ~ ~~ l3
('City, State, Zip)
RENUNCIATION
REGISTER OF WILLS OF
CUMBERLAND COUNTY, PENNSYLVANIA
,Deceased
Estate of Barbara V. Corl ~_
.t ~~
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~~ ~ ,
~~~
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"I , C.J
~,
i, Barbara L. Daum in my capacity/relat~oiisfiip as ~ ., =,
(Print Name) ~"I ~,
of the above Decedent, hereby-renounce tf~,'right to
Dau hter
administer the Estate of the Decedent and respectfully request that Letters be issued to
Ro er W. Corl
f ~l 1
(Date)
i ~ !t
(Signa~ Barbara L. Daum
12440 Ha don Ct.
(Street Address)
Fishers IN 46038
(City, State, Zfp)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this--day
of
Deputy for Register of Wills
Farm RW-06 Rey. ~o-+3-zoos
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
purposes stated within on }hrer~~n idaiyn for the
.tC~i
of ;^
w~.h
otary P lic
My Commission Expires:
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's commission.)
~~..T~,~,` Sarah J. Kendrick
e ,. ~ Notary Public, State of tnd'tana
x - Marion County
~ ~' My Commission Expires
~.,a December 21, 2D16
Copyright (c) 2006 form software only The Lackner Group, Inc.