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HomeMy WebLinkAbout07-19-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Rodney E. Slother also known as Deceased Petitioner(s), who is/aze 18 yeazs of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) COUNTY, PENNSYLVANIA File Number ~' ' I U ' v7~~Z_ Social Security Number 160-30-9606 ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executor last Will of the Decedent dated 12/09/2003 and codicil(s) dated N/A (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as follows, Decedent did not mazry, was not divorced, and did not have a child born or adopted after execution of for probate, was not the victim of a killing and was never adjudicated an incapacitated person: N/A B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia; duram~inoritate) named in the 0 C t~ ~.:r - n,, 3 i. ~ -- - `:..J ~- '~ ~.~ _ _ ~~ . -;, ~f`ri -' iti.3 ~~ (If CJ'E Petitioner(s) after a proper seazch has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) an~heirs Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) l Name Relationship Residence I (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 2614 Mill Road, Grantham, Upper Allen, Cumberland, Pennsvlvania 17055 (List street address, town/city, township, county, state, zip code) Decedent, then 73 yeazs of age, died on 06/08/2010 at 2614 Mill Road, Grantham, PA 17055 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 26,224.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 163,000.00 situated as follows: 2614 Mill Road, Grantham, PA 17055 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: Si nature T ed or rinted name and residence Ryan E. Slother, 1002 Apple Dr., Mechanicsburg, PA 17055 Form RW-02 rev. 10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF C~ ~~ E Q -L s3-~-! ~ , 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 affi a and subscribed before me the day of ~. -i y Signature of Personal Representative L ~ n ~ ~ r ~ ~ r-~ For the ster Signature of Personal Representative ~ n ~ ~ ~ Ca `°~: i`r i .. •7 ~'~ // Fil N b ~~ f ~~^^~~ ~7 ~~ - ~ + ~+.! r e um er:. _ O / V / ~ Estate of Rodney E. Slother ,Deceased Social Security Number: 160-30-9606 Date of Death: 06/08/2010 AND NOW, , ~ (~ in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS ECREED that Letters Testamentary are hereby granted to Ryan E. Slother and that the instrument(s) dated 12/09/2003 in the above estate described in the Petition be admitted to probate and filed of as the last Will (and Codicil(s)) of Decedent. FEES Letters ............... $ Short Certificate(s) ........ $ , Renunciation(s) .......... $ 1 ... $ ... $~L.c.1LL .. $ r ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ -9:98 Register of Attorney Signature: Attorney Name: ~/ Lindsay D. Baird Supreme Court I.D. No.: 72083 Address: 37 South Hanover Street Carlisle, PA 17013 Telephone: 717.243.5732 Form RW-02 rev. !0./3.06 Page 2 of 2 105905 REV.(3/09) r _ /'~ ~ ~ ~~~ ~ ~~ This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, m accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. Q. ~~.:~~ Linda A. Ganiglia State Registrar ~~:~~~~ H105.1dq REV 112006 TYPE / PRINT IN PERMANENT BUCK INK Oi32-280 No. JUN 18 2010 COMMONWEALTH OP PENNSYLVANIA • DEPARTMENT OP HEALTH • VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See instrurdons and examples on reversal Date midge, IasL Ndfix) 2. Sex 3. Serial SeWllly Number _.... _ ..- .._ ~.• 4. Dale of Deelh (Month, daY• War) Rodne E Slother Male 160 - 30 - 9606 June 8, 2010 5. Age (lam eirmday) Under 7 r UMer 1 der e. Data of snn (MOMn, 7. BiMplero Ci aM NNe a brN Ba Pbca d DeaM (Check oNy one) FbePNal: Olhen Nwww ~" ~"' Naw.e November '5.,1937 72 r re. Phili bur PA ^bpatbnt ^ER/Outpaaent ^DOA ^NUrehg Nate ReabenCa ^Olher-SPaciN: !b. Ccunty of Deem &. City, Twp. Death Btl. FeNNy NNre In mt kmmulbn, glue Meat erN numbsrl 9. Weer Decadent of HiapaNC Organ? No ^ Yea 10. Race: Amedcan IMlen, Black, Wnr, ek. Cumberland Upper Allen 2614 Mill Road (nyea,apeciyclban, ( Mexican, Puerto Rican, eb.) White 11. Dxrems UNNI Ocmr ' n Nkq d wog gar dur' most d worts lib. Do not Nab ream 72. car DscadeM aver in the 13. Decedent's Educelbn (Spedfy onN hgMN 9rem carobted) 14. Madbl SbaM: Married, Never MNdsq 15. Surviving SPaae (II were, give meben name) Kintl d Work Kkb d BiwkNbs / Indwey U.S. Amrd Fomr7 Elements f Sewn . Diverted ISPedM ry dory (P72j Callega (1-4 a St) tens Federal Gov't fir.: ^Np 12 T~ivorCed • 18. Decetlent'6 Mailing Adaer IsIreN, dry /town, mrc, zip coda) Decadanrs DM Decedam Pennsylvania 2614 Mill Road AcbW RaeMNxe ,?.. sNe over b a nt. I~ vas, Detaemx lived b LTnrnr r Al 1 Pn P^ Grantham, PA 17055 R Towwhip7. 1?D. CouMy Cuuberland ntl. ^ Na, DecedaN urea wN,in AduN umb d cm / Bom 1B. Famer'e Nona (Firer, midtlle, bsL Mfix) 19. Mother's Name (FkN, middle, rtaldm~ wmema) Edward Slother Swisher 20a Infomrnr9 Name (Type / Prbtl 20b. IMamanl'8 Mailirg Address 19reN, city / bwn, Neb. xV ergs) an E. Slother 1002 A le i 21 a. MegwO d DiepoaNtn ^ CrNnatlon ^ Dorrstn a 21b. DNe o/ DlepoeNbn (Mom, tlay year) 27c. Plea d DbpoNtlon (Name d camNary, aemNay a Omer place) 21d. LacaNOn (City /tam, Nab, zp ads) yam. Burial ^ Renxrval frem Sim ~ Wr Craautlorl a DonWOn Autllorkrad ^ t5aier - SpedlP: M YtlkN ExerM1Y / CaranYt ^ Yea ^ No June 14 2010 Ph' 1 ' / n 22A. SIpiN d BM pamm actlrg r each) 220. Licarxe Number 22c. Name andAddres~ d Faceity 8 Mark t Pl W • - ~ FD - 014889 e aza a Malydezzi Funeral H Y ~. To dr Mst d my lopMedpe, deem occurred N me time, date ens plea sbbd. ISigrture antl tnbl 23D. Lkmse Number 23c Data si ned IM m tl phyNCbn m not a N dms d deem b . g tn , ay, Year) teNh caw. a darn. Items 2428 mwt be canpMaa by perm 21. Time d Deem pTX . 25. Dab Prwiwnced Deetl (MOMh, deY• YaaA 26. Wr car Rebrred b Medtal Examber / Caaner br a Beeson Dtne! man Crematlon or Donation?. carp prdrlellrlas arth. 6:00 A. M. June 8, 2010 ~rr ^No CAUSE OF DEATN (Sae IrYSructlona arts sxemPbs) , Approdmre knenN: Item 27. Pan I: Enter gia glad d ewN, _ dleeaees, kry'udes, a ampkaaon+-that tlaedry caner MB deem. W NOT rmlx bmanal evenb Sucn as cardiac BrteN, Onset m Death k t Pan II: Emer ohm but rct readgng in me umenyirg Cause given n Pen 1. 28. Dr Tobaa Use CoMibub b Deem? ^ Yea ^ ProNbty resp a ory armL a rentmrar IlbtlNetn wilhoN showing me eaobgy. LIN afY aM Uur a earn line. IYYEDIATE CAUSE IFlrW tlieaeee a ^ ~ ^ Unknown amkbnrewlbngm j -), .. Chronic Obstructive Pulmonary Disease 2r.uFNnN.: DW to (or r e araegwrka op: ^ Na preplnt wrNn peN year Sequenwey Net tmastne, a airy, D, r barn to the woes Wed a hr a. ^ PrepnaM r nme d deNh Enbr I~. urxlEpnnNO causE Uw m (or r a amevaent. a): ^ Nd pregnant, biA pregnant within 42 days (dsrr aeaw Nm InANetl gr c. evenk rewlUt~g In deem) LAST. of tleam Dw to (or m a oPraequerce of): ^ Nd Pegnan. but preglent 43 deYa b 1 year d, bebre deem ^ Unknown i pregnant Nnlai me peel year 30e. Wes an Au1PPVy Pedormed7 3W. Were Aukpsy Flndngs AraNada Pda to Cmiplatbn 31. Mariner d Deem 32a Data of Injury IMam, der%Yeaq 3ffi. Desabe How Injury OtPlnetl 32c. Place d Injuy Homer. Farm, 9rom. Factory, OYCe & i b S if d Cewe d Deem? ~Netural ^ Hombitle r e . ( paz yl ~~~yyy ^ Yea ~NO ^ Vr ^ No ^ Accrem ^ Pendng Inveatgetlon 32tl. Tine d injury 32e. Injury at Wak? 321. If Trensponetbn iryury (Specly) 32g. Location d InMNy (SIreN, cNy / bwn, Nre) ^ Sukitl• ^ Could Nd be DNerminr ^ Yes ^ No ^ Dnvar / Oparebr ^ Passenger ^Prastdan M gher ~ $oetlly: 33e. CeAf (ardr oNY one) 33b. SiPlebre ' CarlNykq Phyeblen IPnyaiden oeNly'rg caws d deem wMn+nogier phyNden hr Pronouncatl Mein aria amgelr Kem 23) To 1M heN dnq bpwledq,dum a«umr as to m.wae(p end menrrcrraMS1________________________________ ^ ' P e tl Y - one r rarrrnc q rl Oar Ydrrg phyNdrl (Physkbn bdh pronasxirq Beam antl ceralyirq b our d tleath) To the MNdmybmbtlpe,tlrdleaumd NlM tbm,gels,eM placer, and OUebtlw wra(q and mannxasWad__________________ ^ 33e. license NumSer 30d. DNe SN~re (MOnm. tlay year) YaNcal ExeminxyCeronN • Dn ms brb d armbrm nM / a Inveatlgelbn m m o mNn drm aeeumtl N tM tl tl June 9, 2010 , p , me, Y eY, aM PYb, er dr r the wwNel mtl IMlxbr u stmad_ IJ L 34. Na BriM07 d P W1p C~,use d DeYn (Ib °roQQr°L "ir°c m 27) 7 /Pmt 35.R r'SSgrretueandpstnd ~I ~ l ~l ~ I I ~l 38. pNeRlr(Math,tlay,yrr) . e e 1. r 2 6375 Basehore Rd. , Suite /~1 : o , v JUN Il d/~' Mechanicsbur Pa. 17050 ~ ~ ObpoNlbnPermnNt. 0479718 rv c o ~~ . : a ~ C _ . . , .j - .. ~"> ` w V~ ~ ~ -_~ '! :. ~ i ._. 7 Q~~ ~.~.-` t ' i U~.~ 3 -. _ 1~1 ;~ 1. Name d Dece(kM (F,N, LASS' WI~~ AND TESTAMENT OF RODNEY E. SLOTHER I, Rodney E. Slother, currently of 2614 Mill Road, Grantham, Pennsylvania, Cumberland County, P.O. Box 174, 17027 being of sound mind and memory write and declare this as my Last Will and Testament. Any former wills and or codicils are made null and void. First of all, I declare m_y oldest son, Ryan, as Executor of my estate. If he is unwilling or unable to serve in this capacity, then I appoint my younger son ,Luke, as Executor. He is to see that the expenses of my last illness and burial are paid as soon as practicable after my decease. These expenses are to be paid from the proceeds of my insurance policies. Funeral is to be at Beezer-Heath in Philipsburg, PA. It will be a private funeral, no large expense. I desire the pastor of Lanse Evangelical Free Church, Lanse, PA to bring a salvation message. Burial will be in Philipsburg Cemetary where I have purchased a burial plot. I leave all my worldly possessions solely to my two sons, being Ryan Eric Slother, and Luke Jason Slother, to share and share alike. My desire is that the house would remain for my sons. However, if it should become a burden to them; they should sell the house and the money be divided equally. My X- wife, former Lois J. Watts, is not to come on the property at any time. IN WITNESS OF: This is my Last Will and Testament signed on this day of ' ` , 2003. Witnessed b~ ~~~ (seal) Notarial Seal Jay M. Zimmem~an, Notary Public Upper Allen Twp., Cumberland County My Commission Expires Mar.16, 2006 Member, Pennsylvania Association Of Notaries ~ ~ ~ -v c.._ ~ ~" `, ; ~ _ ,:; ~~~ ~ j ~ ~,, .a7 ~_ ;i U ~ C7 p ... c., . ~ '~-~, a ~ < . ~ to . .~ r y t~'t ~~~ - : ~ OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Rodney E. Slother ,Deceased Ryan E. Slother and Luke J. Slother (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with Rodney E. Slother and am/are familiar with the handwriting and signature of the decedent, and that the signature of Rodney E. Slother to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Rodney E. Slother is in his/her own proper handwriting. (S natur ~riV~. (Street Address) (Ciry,~State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ day of .....-'- (Signature) ~o ©~c > ~ ~'c ~~. (Street Address) / ~~ ~ L~ ~ia ~ ~~~ .~ (city, state, Zip) Deputy for Register of Wj N 0 p `~ ~ ~? +~ -u ~~ __ ~ ~ r- ~ rn '~ ~ Z ~ -~ ~ '' t n r=-7 _._ - ~_~O~ ~ ~ ... _' ~ cam ==; _. rri ~ - ~~ c to • .~ ~ ~~~ Form RW-04 rev. 10.13.06