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HomeMy WebLinkAbout06-29-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Ct~ --n b ~ ~ (and COUNTY, PENNSYLVANIA Estate of ~ ~ 1 ~' e f t Q ~ ~/ 4 V\ (~ /-{ ~lS ~~/ fi File Number ~ ~ R ~1.~ _ C.,'~ also known as ,Deceased Social Security Number ~ ~ 3 ° .3 L7 ~-- ~n Petitioner(s), who is/are 13 years of age or older, apply(ies) for: (COtti1PLETE 'A' or 'B' BELOW:) ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ` E' !1 ( named in the last Will of the Decedent dated 7- ~ - ©, and codicil(s) dated r-a -- ... (State relevant circumstances, e.g., rerarnciation, death of executor, etc.) ~ ~ c~ _. - - (, l Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution df~e~it~sttum~(s) offpi~ed -. .w.. for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ -`~ i'rt N ; , ^ B. Crant of Letters of Administration %'~? ~~ -? (lfapp/icable, enter: c. t. a.; d.b.n.c.t.a.: pendente life; durante absentia; dur.`aiitP~inoritnte) t`.3 , -t--~ -~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following-spouse (if any)~F1 heirs: (lf~~ Adrrtirtistration, c. t. a. ord.b.n.c.t.a., enter date of Wil! in Section A above and complete list of heirs.) (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in ~Ctv-'- ~~Y_ (a n ~ County, Pennsylvania with his /her last principal residence a[ /b~0 C(a~'~'mt~n~ Qvc+ car ~i5~1~ Pa 1'71 ~. (List street address, town/city, township, county, state, zip code) ~ Decedent, then ~~ years of age, died on C9 ' ~ ~ ~ D I ~ at ~•- ~ti i^ m vn ~ ~''~ rs + n 'r' /` P ~ e+ 4~J 4~ ~ ~ 1 e -^ Decedent at death owned property with estimated values as follows (If domiciled in PA) All personal property $ "7 (~ b~ . ZJ ~ (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:~~Q.~~r (~i1'e ~ ~ v~iP f ~~ Q ~ [~r1 S £' Y)'1 d+1 -CS ~ ~,t'fS~~~l L~ ~] t~t~V .~ t'? j~td~e -_ C~CarYMO~'f. Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: ~ Si~natytre Tvoed or printed name and residence ~ ~L1 a.~o n n ~ ~ f - c~~~~ s~ ~t~ ~~~ er Hv f Form RW-0? r~~-. lo.r3.o6 Page 1 of 2 Oatl~l of Personal Representative CO~,I~;(ON',VE"-~LTIi GF PEi`i~;SYLV:VIA // SS COUNTY OF ~~~,.~ b-2~+- 11.~.~'t d The Petitioner(s) above-named swear(s) or aft5im(s) that die statzments in the foregoing Petition arz tree and correct to the best of the kno~,vledge and belief of Petitiener(sl at:d that, as personal rzpreszntative(s) ofthe Decedent, Petitioner(s) ~.vill •wzll and truly ad;ninister dlz estate according to la~.v. Sworn to or affirmed and sub~c ~b -~ / ,~ p_ Signn.ure o~"Personal Rzpresentnnve b~rz me the f ~'\ day of ~~~ r-,~ r~ Signa:ur~e of Personni Rzpresenrntive ~ ~ ,-• ~ ~ ~ , "a_C7 C ~ FOC Ql zgister Signnrtue oJPersor~al Rzpresenmtive '~ rn ~- ~ "~: r~ ~ ; ~ ,~ a'~ ~- "L' File Number: r ~ tV ti i f~ i n i W ' Estate of _ /`Z I I C~ 1 V~ ~ ,~, "~ ' I y 1 I~ ~. - 1.1' 1 ,Deceased Social S/ecyurity Number:,_I~iL~ '~~' (~ lL' i ~ Date of Deaih:l~„ .{i~.~ :j2~~ ~ ~i/~ ~9'- AND NO'vV, ~"~'~ ~ 9.~ur1 ~`' , ~?6r~ , in consideration jof,,th~e~forzgoing Petition, satisfactory proof having been presentzd before me, IT IS DECREED that Letters /~.4 r~_~~~ J (,(,J' L~ are hereby granted to _ n (? ~' ~~1G~,;,S /~ / ~J _ in the above estate and that the instrument(s) dated / '~ ' ~f.~ described in tl~e Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES s . ~ j Letters ............... $ G1~ Regisref Wt1l Short Certificate(s) ........ $ Attorney Signature: Renunciation(s) .......... $ $~_ Attorney Name: - - k~ ~~7~, • • $__.~~ Supreme Court LD. No.: - ... $ ~ Address: ... $ ... $ ... $ ... S Tzlcphor,e: ... $ ~- TOTAL .............. $ i ~. , (~u;m ,41V.11' ,.. ~. ll11: 1!A ~ parry ~? r~F7 OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for ihi~ cer[itic<Ite. `~(~.l)1) P_16__4.96?69 Certilir,~uon tiumhe) This is to certif~.i that the inforl7~)ation Here g;i~en correctly copied fi~i~m ar original Certificate of Deal duly tiled with 1»e as Local Registrar. The origin certificate wi,l be forwrarded to the State Vit Records Office ;~ur pern~aucnt filing. - -~__~ Deal Registrrr Dale Issued ~7 rv ~" G ~ ° ~-~. -~ ~ <y ~ t,3 -p .. ~ r y G ~~ -~l-Zn - ~ - r .yJ~~ f , ) Z' ~ J i REV n2DD5 / -~ I V l PRIM IN w ~MANENT ACK INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See Inatructlons and examples on roveF'sel ~.__ __ _ __ Name a Deceoem IFVSt. mme. bal. onto) ~ M 2. s.. a sores Sawey NutEsr - ... _ .. .-~~ ~. Dab a own nAael. dY. Ywy Ecuw N Fw•~/wlr f63 - 30 - Tug 2/ Zav 5. Age (Last &nneavl l1Mer 7 lhldar 1 6. Dek d BiM IsAaen, M . ) ). and we a Be. Pbos M DaM arls Maea an Nan M'aaAM NOaplak Olw uy 8'! 2 IC Yra. A~R~6 91926 I ^j,~,„ ^ERlaApeew ^DDA FausispNarb ^rwilM,oe a«Mr-spay. ee Ca,nry o, Deem x. Gy, Bpo, rwp. a Ou/t !e FaNry Noma (a nor iMtlMram, pea troll eno rMlsDary /. Wr Daaaant d sFiapersb grab? No Ya ya Fes: Anrtbs asAars,lbat yMra ac ~ ~•. wraM' cm.lA • _r .~,a~n lao~s~c TW°. C,c~tE,yevz' NdtisW~ r ~Nrte~~l r~t'-ld~ C~,~ Mw~l. Pa~b Rl~n. «r., "~""' ~uny,~- I t. Daceaea's uzel o« Iqn Kira a wag gone Iwn a s.. oo nor elm rcaee t2. was Daueent esw b ma t3. Gwael<s Edueelbn (Slsadty orgy Np,w grad, wrrgbbd) u. Merv Stetsr: -anbd. Nasx lAerrssd, u. Survlvinq Spores m aer., pa. elesdan asareJ Keno d Won NiN d BwiMas / McVy U.S. ArmM Forces? Ebmentary / SesbMary (P12) Cdbge (1J a Se) WgpwW, ONacW ISwdYi R Foo ^Yea ~ 7 lNl - 16. Deceaenrs MaMg Aaaess (Scree dh /loan. wte, tip whl DsceWnt'i pfl liZY7 (-C/fiCEMOd~T A. / //Q _. r`T J AduN fksioerrw ,7a Sob I7c. ®Yat. Dacadae LMa b [.iCJG/~ T Cnn~,lsr.~ PA i ~o l3 R I>e Cu~t&~A*~o t 7d. ^ w. D.rae«e lA.a weri, , AduM Linea d D,,. /,,, tor. Famn's Name IFVSL midab, bsl. sulOal 1q. ModMr't Norma (Fig, nvdaa. meiosn aurnanMl N~ - ui f1E Sual 20a mlormanTS Name (Typo ~ Pnnl) 200. IntomMMa Mellbp AdQaa 19beeL dh /sown, swa, tiD weal (k>A; ~ 5 l~LsTw Jae . 3 S; . Ca~Ra15c~ ~!} l7o i3 21 a M.IMa a asposrtKm ^ Qe,,,a„a, ^ Dp„ aap„ zto. Dare a Disposnbn Ilawm. aY. yeal etc. Plsu a Dbpoaabn INama d amelny, amebry a olnr deal ltd . lor eeon IC iry /saws MaM, zg snyl Banal Removal Iron Sale ^ i Wn Dnmatlm a DDrsatlon Aultsonzea ^ Omer . Specrly: ~ OY I/aekal Eaasnlnar! Corarsar? ^ Yes ^ No _ .J UN C LS ~ I U / A •" OlT7v Ll~wN H/~L- ~ / ~ , ~ ,, Q V C / I TX7~i~/ ~~7 I ~~ 22a $grMfure d Funeral Servo (a parson sdiq u such) 710. Lunge NuMei 22c. Noma Mq AOareas d Fsdary - - 'Usra.11/K .~ f0/3SSc~~- - FriNe~9~- h4'/r1E 321 C~uScc-' S. GcTTV.Bu~ V~1 /)3 "' Cornp~e Hems i7a< aev when annyag 27a To Best d my laloswdpe, a.m awurreo a are lime. dale arq pba stalaa. f5prewre and Gael 23b. license NuMer YMA ~' Dm ~ (~~• ~ Mysatan n nor avadade al urre d Deem b cenT cause o' oeatn "~~ / / / ..-~~~~..~ ~~ ~/~ A' ,y 6 R N ~ .2 3 ( % ~ L • ...~ ~ N t'. 02 f ''. O 1 ~ Hems 2a.M mull oe conlpselea W person wro pra~pmces d am 2a. Tans Deem ' P 25. Oab PrabM¢ad Oaad labntn, dry. Yayl 28. Was Goa Rebrra0 b MaaW Eaarniw / CaaMr br a Bassin OtM Isan Crararlm a Darbn? . I . M. 1 oZ 0 j It N ~ .Z 1 - 02 D i O ^Y„ ~ CAUSE OF DEATH (Sea Irsatrucllona ersa e:ampNa) I ApDrwMMb interval: em 2 ~ Pan I Enler the sham d evenb - cheeses, ipunes, a swrtlpaatione - Istl Qsec9y mead Ir Beads DD N0T center terainM evens sum u uraac arrest part l: EtMM dtMr ~ ~ ?e. Die TaMem Uas GsMlEles b Deals? . . OreM b Deatll ~esprawry arest. a ventrciAar fiErilaew wMdA aMwYq tlM eldopy. List wry ens cease w etm Fne i Od nd b le Doss n Part I. ~~ q ~ Ya ^ I /' _ ~ O IMMEDIATE CAUSE Finat Disease a / ~ caienlon resunmg n MI _i a l . (~ i 2q. N Female: . , s ~ Due b (a as s conee0uenp dl: Nd DeOMrs wean OM year Sep.:e logy Yst WriQtbna, a any. b ^ pragMra al Fall d as11 leadrr~ to IM uuaa Ya,ed On lira a Emer Iha UNDERIYWG CAUSE Due b (a as s conseµlsrca oQ: ^ ~ ~y ~~ ~ rypl Iasease a mNry mat mnbteo me c. events ~esummg m aeaml UST. d tleOl Dos b la as a wnsearente M: ^ Nd pregra Out pragsrs a3 dys b 1 year tl. I galore eMtlt ^ lA'eanam I preprs srebr M Pea yar _ 30a Was an ANwsv PMamee' 70C Werc ANOpaY FrtiOnq{ AvaaaDN Pna to Conglenon 71. IMmar d Dram 72a. Dale pl Ir~ry IMpnln. daY~ Y.ar) 72E. Daatripe Hnw Injury DCCUrtaO 3h. PbW d IbnM, F aylaY gins, $bMl. faaay, of Cause a Deam7 ~taatunl ^ tsortvcbe ( ogee Buedlq. ~. lSOWYI ~ ,~ nn [, ve `T ^ ves ~a ^ AccWaM ^ Penang Inves,galan 72n Time of lrryury 72e. Injury al WaF ~ 721. 11 TranapOrlafipn Inaay 1$patilYl 32 lo[stbn a 9 Injury ISreel. ctly I sown. stmt ^ $Ulpih ^ Dwle Nol tK DatermiMd M ^ Yes ^ NO ^ s~^9ar ^ ^ Dmel I Operate Pa PeaealNn aver spar: 77a ..«-.p, ,rnr:~ ~ sne 330. $gnsnwa and Tak Cenitying pnya~nan innys<~an ceMnng cause a Beam when aratner pnysican Has praqunpe0 seam one canpeMa Hem 171 _ to In< xar or my vnowkage. aeetn «weree aue to Ilx uuselal sne manner as smea _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ P ,onovncing sne cenaying pnysicbn IPrrySCwn Dorn prarourcing oeam one cennymg ro Dose of waml Tom. east or my sno..bege. ee,m «curraa n me ume. aMe..ne pres. ana eaa to the ausNq ores m.nrrer as srnad ^ 77c. Laense NuMM 730. DMe SigrM IMOmn, Day. earl _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Asaa~ul Evamine. r corona O ~ / ~ / J V Dn me pans or a aminatbn ana : or ~nvestignion, m my opinion, seam «currea s the time. ate, and pl.ce. ana aue m sne uusNal ana manner as amea_ ^ y W me and Awress d Panm Wne CampMNd G uw d D ea m IM m 27) Tyy Prvn e t` ~ . ~•~. S - i ~~ ~ / y ~ 2 ~ ~ g . ~ 4 slaVSr (~ wEl~-IMC~U /7 fa~d'pt55 I/e+'/~ u~n a .: ~ b a .c ,sn ~ - I O l i 10 t o IL I 36 Dare I(d IMOnm aaY. vearl Z /~- ?~tD. SrnVPF~sd:~ ~ LAST WILL AND TESTAMENT OF ALICE M. AUSTIN I, Alice M. Austin, of Bendersville, Adams County, Pennsylvania, do make and publish this my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct that my Executor hereinafter named first pay out of my general estate all of my just and legally collectible debts, funeral expenses, expenses of administration of my ''! estate, and all state and federal transfer inheritance taxes, estates taxes and any and all other death taxes becoming due with respect to any and all property required to be included in my 'gross estate for tax purposes, regardless of whether such property passes by the terms of this Will; and the transfer of all such property shall be free and clear of such taxes. This provision shall apply only to transfers I have made of my own property. SECOND: I give and bequeath all of my pictures to my daughter, Annette A. Bream, to be kept or distributed in accordance with my wishes. THIRD: I give and bequeath the sum of Five Hundred ($500.00) to the Hospice Program of Adams County, Lutheran Home Care Services, 1075 Old Harrisburg Road, Gettysburg, PA 17325. ,.:, C7 c- C i ~ t; FOURTH: I give, devise and bequeath all of the rest, residue and remafer of rr~ r--- estate as follows: ~ r..: ~r ~? ~ ~__? --`, A. One-Third (1 /3) thereof to my daughter, Annette A. Bream: ~ ` ~ ~ ` ~~ =_i ~J B. One-Third (1/3) thereof to my son, Anthony Charles Austin ~' ~ ~ "' ca -, C. One-Third (1/3) thereof to my son, Donald Stephen Austin, Jr. FIFTH: I nominate, constitute and appoint my daughter, Annette A. Bream, as Executor of this my Last Will and Testament and I expressly direct that she not be required to give bond. In the event my daughter, Annette A. Bream, does not survive me or in the event she fails to Page 1 of Will dated iy ~' - ~~ , 2004. ,~ ,,, ~ ® ~~, _ f~~~~2~ qualify as Executor within thirty (30) days after my death, I nominate, constitute and appoint my son, Anthony Charles Austin, as Executor of this my Last Will and Testament and I direct that he not be required to give bond. In the event my son, Anthony Charles Austin, does not survive me or in the event he fails to qualify as Executor within forty-five (45)days after my death, I then nominate, constitute and appoint my son, Donald Stephen Austin, Jr., as Executor of this my Last Will and Testament and I direct that he not be required to give bond. I authorize my Executor to sell any and all of my real and personal property at public or private sale and to 'make, execute and deliver unto the purchaser or purchasers thereof good and sufficient deeds, bills of sale and assurances of title therefor. IN WITNESS WHEREOF, I, Alice M. Austin, the Testatrix, have to this my Last Will and Testament, set my hand and seal this ~~ day of ~ ,Two Thousand 4 and Four (2004). -~~.~~ ~ /~ d .7-(SEAL) Alice M. Austin Signed, sealed, published and declared by the Testatrix, Alice M. Austin, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~~~~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF ADAMS SS. We, Alice M. Austin, Richard E. Thrasher and Shen C. Senjabs~8h the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority 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 knowledge of each of the witnesses, the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. / ,~ Alice M. Austin ~` 1 j Richard E. Thrasher ~ ~.~_ Subscribed, sworn to and acknowledged before me by Alice M. Austin, the Testatrix, and subscribed and sworn to before me by Richard E. Thrasher and .sharY; 4. 5.~,.r L~era/, ,witnesses, this ~ day of f~/~ 2004. • ~ T.~~ Notary Public My Commission expires: CoMMOruwEALTH oi= P ENNSYLVAN~A Notarial Seal Leslie R. Grimes, Notary Public ~'tY CommiurcJ Born, Adams County Member, sston Expires ~' 23.2007 Pennsylvania Association Of Notaries