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HomeMy WebLinkAbout06-23-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF C NM ~~R ~A~D COUNTY, PENNSYLVANIA Estate of Y ~ ~ ~" r ~' N~ ~~ u R y also known as Deceased File Number ~ I _' ~ ~ ~~ ~l ~~ Social Security Number ~ ! 3 ' ,/ ~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (~~CO((MPLETE 'A' or 'B' BELOW.) ,ICt, A. Probate and Grant of Ltittgrs Testamentary and aver that Petitioner(s) is /are the ~~~~ Ll ra /~ named in the last Will of the Decedent dated ~G+ ~~~ ~nd codicil(s) dated •`~ , n o ,, '~ ~ ' ~ ~ (State relevant circumstances, e.g., renunciation, death of executor, etc.) ' ~- C ~ N i -- ~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of tl~.iiis~ment~ offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - ~-~ --~~ ~ - © -r~ -1 i :~?_ B. Grant of Letters of Administration G~----' ' (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendentelite; duranteabsentia; durant~inoritate) ...3 Petitioner(s) after a proper seazch 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.) (COMPLETE INALL CASES:) Attach additional sheets if necessary. was mtctled at death in n ~ .... i~ /1 w -- County, Pennsylvania with his /her last principal residence at 5~ (List street address, tawn/city, township, county, state, zip code)y~ ~t ~; d Decedent, then ~ years of age, died on / 1 1/~ y 3I d, O ~O at J , ~ ~ /t 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 $ ~V ° N~ 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: or printed name and ~" /V C Llf LI+'~ ~ '1 S~~ ~+ LLSr ~d ~ C.. l+ 141Q/~tS 1 v ~ /7/lv Form Rw-oa rev. 10.13.06 Page I of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF C ~+M{3 ER LAN D 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 i"L~ before me the ~ ^d~a~y~of __y~l (~1 F Re inter in the above estate GJ or g .,. ,.-. ..- ~'- 7 ~'-~ ~ ~ ~V ~ ..i •~,"~ Q Q - _, File Number: "° Estate of Y ~ ~ ~~ ~ • ' `- ~' wI~ N 2 y ,Deceased Social Security Numbr': ~ J 3 " J ~ ~ 7 ~ ~ s Date of Death: 3 ~ , ~ ~ ~ d AND NOW, ~ ~r~ t17" ~1f-L/~'~ , ~ ~b , in consideration of the foregoing Petition, satisfactory proof having been presented bore me, I'T IS DECREED that Letters TPS~GLa"Yl C~ Y(.~ are hereby granted to _ ntr,~~rl A A 1, ip; a -+4,6 ~ :-, i ____ and that the instrument(s) dated .? " f LD " D 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) ...... Y .... $ ... $~~ ... $ id ... $ ... $ ... $ SS 'Personal Representative r~ _. Signatwe of Personal Representative ~ ti ~ L„ _ ,, C r ~ ~ C~7 ::~ Signature of Personal Representative Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: ... $ • • • $ Telephone: ... $ TOTAL .............. $ ~~~-~ Register of Form RW-02 rev. J0.13.06 Page 2 of 2 ilf~~ 1(1~ !ti `. ill l::l'. ~V' •~~(~' ~I J~.~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee f+n- the ~ertifi~ate. ~6.t)0 P__16514865 Certificati+~n '~utnrer This is to certify that the infonnatiun here given is correctly copied fr.un an original Certificate of Death duly filed with me as Local Registrar. The original certificate will brt~ forwarded to the State Vital Records Office for permanent filing. l~ ~1~~ o/ 4/201 Lo et~ .'trar Date [slued r~ _ n ca ._ ~, .y `- O ; ~ c~ _~ ~ ~ `j „-zC~ ~ • ~- ~, tom] -T-I ,~ - _ _>t.,r - ) .r _'L~ rv ~ -. i .i l b ---i ._ % 4._.i ~ ...,j • DEPARTMENT OF HEALTH • VITAL RECORDS COMMON WEALTH OF PENNSYLVANIA N1as1HS REV nnoas TYPE/Pf1HHTW CERTIFICATE OF DEATH PERMANENT (See Instructions and examples on reverse) STATE FILE NUMBER ' BLACK HIK 2 Sa 3. saw S.cuHY NariMr t. DW d Datdi Matlh. dry, Y•N +. N.n»aD.naatRrr.maa.,mnwt~q female 1 93 - 1 2 - 9445 Verna G. Newbur ~F,k.a~,Ia~ m. UMa t 6. Ga d BYm Moan. 7. BHHMaw and rw a DNr s. Aqa Isar amd.vl UMa t aara b.ra Nan Mnar June ~~ _/ 1914 Sunbury,Pa. ^hpaBarH ^ER,alroriml ^~A ItGNarrwNaa ^A"bN10' ~0in'r' 14 95 Yr. • Bao, 7wR d Darn Ba CHI' , Bd. Fecily Nan Ili aq iinnlloAOn. Va• aar and ruaM s. Wa Daoatler d Hhpaac Orlpin7 No ^ Ya 10. Pxa~: Mrtwam ndMn. &adl Wlka. elc. 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DO NOT ad«bmYnl sraN a«A coWacam4 r Orwtb DWn ' wpirebr/aneelawaY.ila®r4Hw+XMAanoaNq lha alobBY.Ur wNona arc made M. ~ - fra., ' TE~CApUS~ FaW dbana ~~/ i qmb(«ws ~ r w maYam, H amY, b. !/1 " L l~-~I'Ya(n / ~ ~UNDEBLYW~GYCpAeUaSE ~ Dw b (« a a anaquarrca oQ: i (Qbaaaana nKy ~) LASF~' e. ~ e+a.e NWa Dwbl«u.wnaNlN~a1~ i d. 91 d Dam 37a. DaN a Wan lam. ~a r•N 92b. Deeam. Ftaa WaY t7aiaiM 1. Dawdeaa Uaatl d aak dam mw d ~ ~ KiMd Waa lardBurims./hdmby U.S. ArmM FaaiY ,/ , • Ebmenlary f Saandery (o-12) CoHaW (1J «5.) ^Ya No J L Dr Daw tlerH rap 18. Dewdrn's Ma'inp Adtrw (Sheet, dH I Wn, rw. zq code) AdW Rasbaaa 17s. stye Pa _ Lia h. 17c ^_ Y~ Dewdar IA+d h rwlnhg7 n ud a D rdN . 52 Center Drive 17b.ca.Hy ae e O, na ('nmharl anA Adw umna ~ tz*I u; 1 1 _ _cyl0aro 18. MoHrr'i Nan (Faal nddda. mrden eurwn) '&Famef:N„n.IFYat.nddd.,Iw,auHa) Harvey Goodman Ma me Hockenbroch tab. hbmw'. M.iq Aadreaa (Sher, dIY l b.r, rW, iq axl.l 20i"d°""'d~'"a"°m'Da~pr") bert Newbury R 4518 Hillside Ct. Harrisbur Pa. 17110 wda) ma o Dre d D'upwam (Aban, d.Y.Ywr) 21u Pbw d Dmporam (Nan d arnat.rri «anW°rY a oma pael 21b , 24 t,e. laallm lCHr, bwn, a ^ ~~ 2+•~• dD~°°H°^ ^ oa>A.u,.rr:+° Bear ^ nemw.ttrmisw. ~ ^Ya^Nn . June 3, 2010 Northumberland Mem.Pk. Sunbury,Pa. 17801 r/ ^ ~" py ro d F Serriw each 22b. I1wn1s Naib.r 22t Noma ad Addra.d F.r3lY Sunbury,Pa.17801 nk Funeral Hm Bl ~ 010186 L ., a NUMa zx.~wn . s ledMwnd.r.Yw) zx.Da ty Gmpbm Ww23ac aaYwMncMlfyYq 29.. TOm.bwdmr pbwledpe,dam ram Hma,dw ar p4a sWW. (sHP•M•and Me) /~ ( ` ~NF ~~ / eT l ~ 2~ /!~ A~" y mYT 1 '3.~St V'•+IV ((~~'' ~~ Yt (('''t' r,~ 1 ^;3 ~ {'a I+ VERNA G. NEWBURY+ of the City of Shamokin, Coun'fy-~%~ ~'~ ofi Northumberland and Commonwealth. of Pennsvlvania+ bei ng of:~~~nd ~.~ `, ;; _~ .. ~- , and disposing mind, memory and understandin~+ do make, publis~i and ~~,', ~ declare this instrument as and for my Last Wiil and Testament+ hereby revoking and making null and void all former wills and testaments or pacers in the nature thereof by me at any time heretofore made. FIRST. I direct my hereinafter named Executor to pay all my gust debts and funeral expenses. I direct that my body be decently interred and that my funeral be in accordance with mY situation in life. SECOND.. A11 the rest, residue and remainder of my estate, real, personal and mixed, wheresoever situate and of whatever the same might consist, I ~ive+ devise and bequeath unto my son+ ROBERT M. NEWBURY+ and my dau~hter+ CHERYL D. MELNICK+ in equal shares, share and share alike, to have and to hold unto themselves, their heirs and assigns. THIRD. I name, constitute and appoint mY son+ ROBERT M. NEWBURY+ to be the Executor of this, my Last Will and Testament+ and excuse him from filing a bond. IN WITNESS WHEREOF, I+ the said VERNA G. NEWBURY+ have to this, mY Last Will and Testament+ subscribed mY name and affixed my seal, this 16th day of JuIY+ A.D.+ 1984. : _ erns ew urv (SEAL) Si~ned+ sealed, published and declared by the said VERNA G. NEWBURY+ as and for her Last Will and Testament+ in the presence of us+ who, at her request and in her presence and in the presence of each other, h hereunto subscrib our`names ~s attesting wit sees. r n OATH OF NON-SUBSCRIBING WITNESS(ES) ii 1ZEGI TER OF WILLS ~, V ~~ ~ COUNTY, PENNSYLVANIA ~ r - )C% ~ C~~a ~(~ i Estate of f,~r~,~~ (] /r/ ee~,(~ U~ y ,Deceased ~`1~~~,~• `~Gl/LL G<< and /V / G~d ~.~15" ~~/i1i f1L. (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with and am/are familiar with the handwriting and signature of the decedent, and that the signature of ~/~t'/1/.r1 ~ /t~~EG~,6v Ty to the foregoing instrument purporting to be the Last Will and Testament/Codicil of /~,•,t,v~'~ ~~ ty~ yKr is in his/her own proper handwriting. -i~j nature) (Sn eet A~ess) ~~ - 7~ l/ ity, Sta ,Zip) Executed in Register's Offrce Sworn to or affirmed and subscribed before me this ~L~rd _ day of ~ 1~ ,L.rt~ ~~ G) ~ /j]' / . Deputy for Register of it *~ (Signature) ~ (Street Address) ~ ` ^~ ( y, fate, Zi ) n c~ O o - ~~ ~ - ~ z ~ ~ ~~ ~' c~~ _ , : . ~= `a -„ --- - .~:. _ ,, ~. o -• c-> - , ~ Form RW-04 rev. 10.13.0( INVENTORY REGISTER OF WILLS OF C NM ~~ ~ ~ A ~~ COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA 1 SS COUNTY OF J File Number ~~ ~ ~~ ~~ ~ ~ `-f' Personal Representative(s) of the Estate of deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsificafion to authorities. Attorney -- (Name) (Supreme Court I.D. No. (Address) (Telephone) DATE OF DEATH LAST RESIDENCE DECEDENTS SOC. SEG. NO. !?'1t}y .3.1..2aJ0 ~a CEt~/TFR 1~/~-VF C'~mp/~~'~C ~ !93^/~' 1y`/S+ FIGURES MUST BE TOTALED fit; a Pr N~ ~a~K - C~~er~~;~~rE o~ ~.~Pas;-r J s9 N~r'~, ~~NK 6~ lYla-aysv; u.~ - s~v~~r~s f_ C7 .~ ~f` _ . ~i"f ~~ %~ Jt`: -,=} ~~ ~~ (Attach additional sheets as needed) ~3,33q 3 ~~~ ~ y, ~s 1 a,o 3 5F r,.., ~~ b R.. G} -^r, ~v c cx~ r.ir J .! ~~ ;- ; ,, TOTAL: I G$~6 ~ ~~ NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa C.S. § 3301(6)) Form RW-09 rev. 10.]3.06