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HomeMy WebLinkAbout06-03-10PETITION FOR PROBATE AND G/~RANT OF LETTERS REGISTER OF WILLS OF ~u rM ~°f'~r~a hr~' COUNTY, PENNSYLVANIA Estate of ~~`~~ / ' w( 'e ~ C ~~~5 also known as Deceased File Number ,V I - ~ V" r ~l Social Security Number ~~ - ~~ -' ~ lr Petitioner(s), who is/are 13 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ^ A. Probate and Grant of etters Testamentary an v that Petitioner(s) is /~ [he z="Il L' C r{ 1/"~ named in the last Will of the Decedent dated eC j2/` J- ~i~~odicil(s) dated /VGl ~ -- (State relevmtt circumstances, e.g., renunciation, death ojexecutor, etc.) w n ~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after executiot~fffQ instrume4~'s) offer~rl ;• ; ?7 G. -~-, for probate, was not the victim of a killing and was never adjudicated an incagacitated person: ~ ~ ~ `- a ' ` ' c: _~ m t r_ . rn~ w x- ^ B. Grant of Letters of Administration - (ljapplicable, enter: c.t.a.; d.b.n.c.t.a.: pendente lire; durante absentia; duran{~, irate) -- _ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following~sp¢~e (if any)bwti heir5~: ~1~~ Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete fist of heirs.) .~ ,~- ~ '•~> -- ,~ ~ Name Relationship Residence ~ I (COMPLETE INALL CASES:) Arrac/i additional sleets ij Pennsylvania wit~jhja~/her last principal residence at ~_ (List street address, towrtsciry, township, count)! state, zip code) ++ J ~ ~ Decedent, then ~~ years of age, died on 51 z ~ l ~V at Y' S S Decedent at death owned property with estimated values as follows: , ~,~ ~ ~ ~,~ e!j (If domiciled in PA} All personal property $-- /~UC~~ VU~lJ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in Counry $ Vial1ue of real estate in Pennsylvania S _ 1 $ .Sd v situated as follows: ~1 ~ ~ ~ ~ ~~^ ~'r'+•~ (Gl Form R6V-0? rep-. ro.13.06 Page 1 of 2 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: Oath of Personal Representative COMIVIONWEALTH OF PENNSYLVANIA SS COUNTY OF V 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 ubscribed before me the ~ day of Fort Register C~ N ~' ~t Si~nnture of Personn! ep esentative -~ ~ ` j-;-.~ Signature of Persa~al Representative `. - ~~ j ~ W { ;, - ,~ ~ Signature of Persona! Representative ~ ~ CJ _ _ rTk ~ < File Number: Estate of ~ n a M / V 1~~-.~V r ,Deceased ~~ T Social Security Number:~~~'c~~ ~ ~ ~ ~ Date of Death: ~ ~ ~~ ~~~~ AND NOW, _~~ ~~ , ~~, in consideration of the foregoing Petition, satisfactory proof having been presented before me, I DECREED that Letters are hereby granted to ~~ ~ in the above estate and that the instrument(s) dated ~ 02 02 ~~ described in the Petition be admitted to probate and filed of reco d as the last Will (and Codicil(s)) of Decned/ent. FEES ~ /~ ~ ~ba ~ u.~- Letters ............... $-6~iucs~_- Short Certificate(s) ........ $ Attorney Signature: , Rey uilciation(s) .......... $ $~ Attorney Name: ... $~ Supreme Court I.D. No.: .. $ q r~ $ Address: ... $ ... $ ... $ • • • $ Telephone: TOTAL .............. Form R6V-U' rev. lU.(3.U6 Reg~rter ~~ _~ t '7 -- 23~' d Y~ Page 2 of 2 105.805 REb' 101107) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph., , Fee for this certificate, $6.00 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 Offi ~ for anent filing. Local Registrar raI Date Issued C'? _° }'i ~~ C... ~;'..] C r _ _- _ ~ rn W r~. _-~ _-- _ - -- -- . _ -- .. _ ~~" v~ ~ _ a ~ = 7 ~.~ C7~ 4^_.. _.~ ~- _ zQ-In ~ '-' ~J, M1asl.J REV n2oo6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~~ _ _"- ' ttPE PRINT W PER6IANENr CERTIFICATE OF DEATH -~ W ._. ( T') r ~'"a (Sea inetruetions and exampba On roverse) STATE FILE Nun1~M r '• ' ~ ~~ 0 1. Nm d DNCaa1rN IFvp. ntlOa, fill sdnsl 2. S•s 3. 6oasl S«unlp NuniWr 1. 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M• z•^0 I an ar ynq also •a PranotlsOrN ana aa1^Yn8 yAlrpcin IPMscwn Dan pawncrg aw aneawbw.+wNp wrrwawwwwa ^ wrwwn. aw aneq.a ltl T ta b a r ~ e/O ------------------ . , . wr aa ya. w oaw O Nr er • E w /e C I..~ lw asar NYOfesl wr W. «rl« ~,..«b..6.«naa«~a«n.6.~a...w~P.w.~.~.bDw~w~l. nwna ~ ^ F ~ H f~T~l~~ilT~'~ ? r Io2-I a t~ -~--, ^1 D ~ c ~ /0/ f' _ ' O DiepwOa, PwmN No. ~~ ~ ~ ~.s y2 v• ..- ~ ~~ ~~~ ~~ ~ ~~~~~~~~ J N G'' VY V~' ~ i7 ~ _..i~,C7 ~ c ,__l Z ;t ,~ r...~ _. -~ , ~ '..a ~" ' ANNA MAE MCCOMBS "~'"'~ _~~'~ ' ~ _... c7 I, ANNA MAE MCCOMBS, of the Boro of West Fairview, ~~~ ~"~ `.~~~, .7, •'' , -~' , Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking all prior Wills and Codicils. ITEM I. I direct that all expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM II. I give, devise and bequeath all of my estate of every nature and wherever situate to my husband, ROBERT C. riCCOMBS, providing he shall survive me by thirty (30) days. ITEM III. Should my husband, ROBERT C. MCCOMBS, predecease me or die on or before the thirtieth (30th) day following my death, I give, devise and bequeath my property located at 97 Fir Drive, Piney Glade, Rehobeth Beach, Delaware to my sister GWENDOLYN H. MILLER, of New Bloomfield, Pennsylvania. ITEM IV. Should my husband, ROBERT C. MCCOMBS, predecease me or die on or before the thirtieth (30th) day following my death, I give, devise and bequeath all the rest, residue and remainder of my estate of every nature and wherever situate, IN EQUAL SHARES, to be held IN TRUST, to the following nieces and nephews: a. To my niece, JANICE HOMER, of Ringtown, Pennsylvania; b. To be nephew, BRIAN ROWS, of Ringtown, Pennsylvania; c. To my nephew,, GREGORY RCWE, of Dungannon, Pennsylvania; d. To my nephew, MICHAEL ROWE, of West Fairview, Pennsylvania; e. To my nephew, JEFFREY WEAVER, of Camp HI11, Pennsylvania f. To my nephew, DUNCAN MCKENZIE, JR., of San Diego, California; g. To my nephew, DANIEL MCKENZIE, of San Diego, California; h. To my niece, DEANN MCCOMBS, of West Fairview, Pennsylvania; i. To my niece, SARA MCCOMBS, of West Fairview, Pennsylvania; j. To my niece, TAMMY MILLER, of New Bloomfield, Pennsylvania ; k. To my nephew, GREGORY MILLER, of New Bloomfield, Pennsylvania; 1. If any child shall die before receiving their share of this will, their share shall be placed back into the original amount to be redistributed among my surviving nieces and nephews. ITEM V. I appoint the parents of my nieces and nephews, named within this document, as Guardians of property of such of my nieces and nephews, who are minors at the time of my death. ITEM VI. I direct the parents of my nieces and nephews to appoint a federally insured institution to serve as Trustee for any Trusts established in this Will. ITEM VII. I appoint my husband, ROBERT C. MCCOMBS, as Executor of this my Last Will. Should my husband, ROBERT C. MCCOMBS, fail to qualify or cease to act as Executor, I nominate and appoint my sister, GWENDOLYN H. MILLER, as Executrix. ITEM VIII. I direct that my Executor and Guardians, or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM IX. I direct that all taxes due at my death or as a consequence of my death shall be paid from my residuary estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this the ,;1T~` day of ~~~~ , 1989. C~%~r~.-- ~- ~- Cam-.---~-~-- ANNA MAE MCCOMBS ACKNOWLEDGEMENT OF AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN ~/~ ~/~_ , testatrix and witnesses, respectively, whose names are signed to the forgoing instrument, being first duly sworn, do hereby declare that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witness and that to the best of the witnesses' knowledge, the testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. TESTATRIX s~~a (tea C~n.~~u~ ~~~ ~/I ~~a~ ~_ WITNESS ~ w~~1N~~5 r _ ~' ATTORNEY 5800 Old Jonestown Road Harrisburg, PA 17112 On this, the ~1 ~'~- day of ~-5~(~~YJ~-~-~" , 1989 before L~~r`C~,/~ /`~ the undersigned officer, personally appeared, ~~ ~ 1~7a~ ~ ~ ~ Esq. , known to me or satisfactorily proven to be a member of the Bar of the Supreme Court of Pennsylvania, and certified that ~e was personally present when the foregoing acknowledgement and affidavit were signed by the testator/testatrix and witnesses. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. NOTARY' UBLIC NOTARIAL SEAL LUANN P. GALLUP, Notary F'ubGc Harrisburg, flauphin County MY Commission Expires April 29. 1991