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HomeMy WebLinkAbout07-27-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of LESLIE JO BYERS also known as COUNTY, PENNSYLVANIA File Number 21 •-- ~ ~ - ~ ~ ~~.~ ,Deceased Social Security Number 178-54-6939 PATRICIA A. FULLMER and BELINDA K. BAER Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' BELOW.•) ^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executors named in the last Will of the Decedent, dated 01/19/210 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ^ B. Grant of Letters of Administration app Ica e, en er c..a.; .n.c..a.; pe en e r e; uran e a sen ra; uran a mrnon a e Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse I;if any) at;fci,~eirs: (If Administration, c. t. a. or d. b. n. c. t. a., enfer date of Will in Section A above and complete list of heirs.) c7 ~° c~ ..__ ~~ ~- Name Relationship Residence .m z7 '~ _ ~' C.: %~ ~ } 1. ~ ..~ ~~' _...i • s .r-~~ W (COMPLETE /N ALL CASES.) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his !her last principal residence at 100 LOVERS LANE, Newburg, HOPEWELL, Cumberland, PA 17240 (List street address, townlcity, township, county, state, zip code) Decedent, then ~_ years of age, died on 07/03/2010 at 187 Newville Road, Hopewell Township, Newburg, PA 17240 Decedent at death owned property with estimated values as follows: (If domiciled in PA) Ail 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 situated as follows: 100 Lovers Lane, Hopewell Township, Newburg, PA 17240 ~~, ~~~~``~ 5 U© Unknown Unknown G , ~ ~~'~ ~'C' 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: Signature Typed or printed name and residence - ~ p~tU'.~--. C~ ~-- ~ - ~ .~ ~L- PATRICIA A. FULLMER 187 NEWVILLE ROAD Newburg, PA 17240 Form RW-02 Rey. ~o-~s-zoos BELINDA K. BAER 520 ROXBURY ROAD Newville, PA 17241 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. Sworn to or affirmed and subscribed re me this / ~~/ day of ,' Signature of Personal Representative pATRICIA A. FULLMER Signature of Personal Representative BELINDA K. BAER ~.,., •r r-~ .~ . _, . Signature of Personal Representative ~ ~, ~ ; ". -~ ~ ~ ~ a _ ~' - - ~, ;; ~ ~ ~--~ s-w-- _ ~J ...- ~ .. ~ > ~ ~.J .v ~ ~ ~ `.. J ~' File Number: 21 "' ~ ~ ~ ~~~~ - ,~ - - > Estate of LESLIE JO BYERS , Decea~gd~`-+ ~ ~- ~ y *;'; i . C7~ Social Sec rity Number: 178-54-6939 Date of Death: 07/0312010 AND NOW, ~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before , IT IS DECREED that Letters Testamentary are hereby granted to pATRICIA A FULLMER and BELINDA K. BAER in the above estate and that the instrument(s) dated 01/1912010 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)............ Renunciatio/n(s ...... ..................... L T~ i ~; 1 TOTAL ~~ $ C'~''" $ ~~ $ ~~: ~ $ ~; C:; Attorney Signature Attorney Name: Hamilton C. Davis Supreme Court I.D. No.: 10264 ~ Address: Zullinger-Davis, PC P.O. BOX 40 ~ Shippensburg, PA 17257 ~ Telephone: 717-532-5713 ~ ~ Form RVI/-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 u - ~ ~.. ~;~~. REis-~~AR~~ ~~~~~~~~~~ ~-~ ~~I~r~ ~~1e,~~,~N~t,l~: ~t is ifiegai to dupiicat~ this ~z;.KpY b~ ~ah~teas~tat sir phnto~t~~~at+, , t1 ill, .. :'Iii)r!.':t1:' ~(~ +, )(' P 164878~~ ~~~~~~~td ' /78 ~sy ~9.3~ 7S~ ~/° ~~ ,;:,,. ,;,r I~~,i~~ ~, It~r i L11i~ ~Ilaj t~l~ il~it)rmati(~u ht.~re ~i~~tn is ~i'ti ~(,~~ - ~~~' r ~ ttl'(~l .iti i't,~ ICi~ f[~'il~ ,tll (M!"I~?lll~i~ ~ C'f'~l~ll.`~11C l~f liC~ilh _ ~` ~ cl ~~~~~~"; ~,- ~ ~ 1jP` Il~i't~ ",', rCfl 1~1 ~, l,tlr:~lll ~.E;~'+~Yi'~ll- ~~f1tr, ill-l<~lllit~ ~ - ,~. ~ ~ ti.~CI I~ ,,~~~ ~~.ti~ ~7. ;~ t~~~ lr(#e~l [u the St~tl~ ~' it~ll :~' 3~y~ >'.t'_.!+-C!~ 1?1j?+.'t.' i;f) ', ._lll;itlt'l7~ f1~1llt.? ~ .c~ ~~~,, • , ~ =~ rn Fv _ '-r'~ - ; ~., ,, r ... ~ } _ ~. Tr' j `T~ ~_ ~ i _ ,Der H105-143 REV 11/2006 TYPE /PRINT IN PERMANENT BLACK INK Dl w °w w 0 O r~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ('p CERTIFICATE OF DEATH (See instructions and examples on reverser 1. Name of Decedent (F.irst, middle, last, suffix) Leslie Jo Byers 2. Sex 3. Social Searmy Number V 4. Date of Death (Month, day, year) Female 170 - 54 - 6939 ~~ .3 Zoiv _ 5. Age (Lest Birthday) Under 1 ear Under 1 da 6. Date o1 Binh Monts, da , ar 7. Bits lace C and slate a brei count Ba. Place of Death Check one Months Days Hours Minutes Hospital: Other: • 51 vrs. 4-15-59 Carlisle, PA ^ Inpatient ^ ER /Outpatient ^ DOA ryry~~--~~~ ^ Nursing Home [.]'Residence ^ Other - ~~ 8b. Coun of Death ty • 8c. C' Boro, T Ay, wp. of Death Bd. Facility Name (If not irtstituGon, give street and number ) 9. Wes Decedent of Hispanic Origin? No ^Yes 10. Race: American Indian, Black, While, etc. Cumberland Ho swell Tw P P • 187 Newville Road (Iryea,specdycuban, (~,/~ Mexican, Pueno Rican, etc.) White 11. Decedent's Usual Occ tbn Kind of work date du ' most of workin Me. Do rat state retired 12. Was Decedent ever in the 1 3. Decedent's Educelbn (Specify Doty highest grade comp leted) 14 Marital Status: Ma ri d N M i d 1 S i Kind o1 Work Laborer Kind of Business/Industry Hoffman Mills U.S. Armed Forces? ^ Yea ~ No Elemert~ry /Secondary (0-12) 1 years College (1-4 or 5i) . r e , ever arr e , Widowed, Dnrorced (SpecilyJ widowed urv 5. ving Spouse (Ir wife, give maiden name) • 16. Decedent's Mailing Address (Street, city /town, state, zip code) Decedent's Did Decedent PA 100 Lovers Lane HO ewe 11 TW ActualReskience 17a.Stete Livelna 17a~Yes,DecedentLivedin. P P Twp. Newburg, PA 17240 Cumberland Township? 17d. ^ No, Decedent Lived wtthin 17b.Counry ActualLimifsot_ City/Born 18. Father's Name (First, middle, last, stAfiu) 19. Mahers Name (First, middle, maiden surname) Dean E. Fullmer Patricia A. Eckert 20a. Informant's Name (Type /Print) 20b. Inormant's Mailing Address (Street, city /town, state, zip code) Patricia A. Fullmer 187 Newville Road, Newburg, PA 17240 • 21a.M-yet~hod of Disposton ~ ^ Cremation ^ Donation i l ^ R L'1 B f 21 b. Date of Dispositon (Month, day, year) 21c. Place of Disposition (Name a1 cemetery, aemetory or other place) 21 d. Location (City/town, state, zip aide) ur a emoval rom State r WaeCrernetionorportetionAutftonzed ^ Other - ' by Medical ExaminerlCoroner? ^Yes^ No • 7-8-10 Parklawns memorial Gardens Chambersburg, PA 17202 22a. S' azure of F e nsee r person acting as such) ~~ 22b. License Number 22c. Name and Address of Facility ~ FD-012984-L Fogelsanger-Bricker Funeral Home Inc., Sh:ippensburg, PA 17257 Complete items 23a-c only when cenitying physician is not available at time of death to 23e. To the best of my krawledge, death occurred at the time, date and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year) cenity cause d death. ~ ~ ~ - i lJ~ u /~ ~,t l ~ ~~ -/ ~~ ~ lT u I 3 Z'G~ v ` I ' • ttems 24-26 must be completed M person who pronounces death 24. Time o1 Death 25. Date P ronounced Dead (Month, day, year) [ s ? T i 26. W a s Case fieferred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? . J /r J h D~ 0 u / M. ^Yes ^ No CAUSE OF DEATH (See Instructions an amples) r Approximate interval; Item 27. Pan I; Enter the chain of events -diseases, injuries, or axnplicefions - that diredty caused fhe death. DO NOT enter terminal events such as cardiac arrest, r Onset to Death irato res arrest or e td l IibAll ti tth PeA II: Enter otfter sjgltilicant conditianc cnntdbutino 1~ death. but not resulting in the undenying cause given in PaA I. 28. Did Tobacco Use Contribute to Death? ^Yes ^ Probabl p ry , er v n cu a on w oul showing the etblogy. List only ate ceuse on each lute. r y ~ N ^ IMMEDIATE CAUSE (Final disease or n o Unknown ~ ~ I~ ~ t condition resulting m death) ~~Q~f f • ~ ~ r y~ l r 29.11 Female: ~ - a ~ m Due to (or as a axu ce ) A-^ t $$ i li ll i i ~~ i C Nol re nant wtthin st ear P 9 Pa Y ^ ee~puent a y st cond t ons, if any, b 6/ / '7~-l."i MG ~C a ~ leading to the cause listed on Nne a. Pregnant at time of death ^ Eller fhe UNDERLYING CAUSE Duo to (or es a consequence oQ: i Not pregnant, but pregnant within 42 days (disease or injury that initialed the r events resulting in death) LAST. c. t of death ^ Due b (a ss a oortaequerae oQ: r Not pregnant, but pregnant 43 days to 1 year • d. i t bebre death ^ Unknown II pregnam within the pest year 30a. Was an Auopsy PeAormed? ~. Were Autopsy Findings Available Prbr to Completion 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred 32c. Place of Injury: Home, Farm, Street, Factory, of Cause of Death? ~ Natural ^ Homicide ONice Buildin etc. S 9~ (pe+~h) ® No ^ Yes ^ Yes ^ No ^ Aaident ^ Pending Investigation 32d. Time of Injury 32e. Injury al Work? 321. A TranspoAation Injury (SpecilyJ 32g. Location of injury (Street, sty /town, stale) ^ Suicide ^ Could Not be Determined ^Yes ^ No ^ Driverl0peretor ^ Passenger ^ Pedestdan M Olfter -Specify: 33a. CeAifier (check only one) • CertBying physlclen (Physician centtying cause of death when another physcian has proraunced death and completed Item 23) To the beat of my knowledge, death occurred due to the cause(s) end manner ss staled _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ [~ 33b. S lure an TAIe Ail' , ~~~~ ~ D 9 -- • Pronouncing end certlfying physlcien (Physidan both prorauncirtg death and cenitying to cause of death) To the best of my knowledge, death occurred N tM ttme, date, end plece, and due to the ause(s) and manner as stated _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~ - - - ~ 33c. License Number _ ~ f,~ ©/ S L~'7 / ~ 33d. Dpppto Signed (Month, day, year) /j / • Medical Examlrter/Coroner •J , / (~ ~ ~O / t~ On the beep of exeminat nd / or investlgetbn, In my oplnlp death occunad at the time, date, and place, sod due to the cause(s) and manner es stated_ ^ 3q, Name and AQd~,cs of Pggy~on Who ~~dd C~ttse~I,oeath (Item 2~Jy~ Print ~4 /' / ~i~ Xd /L 35. Registrar's Signature umber Z ~ / ' ~ ' I ~I 36. Date Filed (Month, day, year) / - Kt 6 i 7fS /~'~~l~ ~ C G z, ~ ~/7~~ h lleib44~ - , Disposition Perms No. Q.5 ` q ~ 23 ~ r.. t ( i1 N LAST WILL AND TESTAMENT of LESLIE JO BYERS ~~ { ~ ~~~ ~ 7 ~~'~ ~~~ ~~ ~f 'A ~ '.~~1 ~`~ } ~' ~ r~~ I, LESLIE JO BYERS, of Hopewell Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any Will or Codicil previously made; by me. ITEM I: I direct that all my just debts (except as may be barred by a Statute oi' Limitations} and my funeral expenses (including my gravemarker and expenses of my last illness) shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I bequeath my household furniture and furnishings and my personal effects and tangible personal property to be divided among such of my family members as shall be selected and determined by my Executors, giving consideration, if possible, to the personal preferences of each. ITEM III: I am presently not married (being widowed) and I have no children. k1=1r~5 ITEM IV : I devise and bequeath my lot of land and the mobile home situated thereon to my brother, BRADFORD P. FULLMER. ITEM V : I devise and bequeath all the residue of my estate of every nature and wherever situate in equal shares to my parents, DEAN E. FULLMER and PATRICIA A. FULLMER or the LCS survivor of them. ITEM VI: If any property passes outright (either under this Will or otherwise) to a minor (which shall be defined as anyone under twenty-one (21) years of age) and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so„ I decline to appoint a guardian but instead authorize my Executor to distribute such properly to a Custodian selected by my Executor (and my Executor may act as such Custodian) as Custodian for the minor under the Pennsylvania Uniform Transfers to Minors Act. Provided, however, that this appointment shall not supersede the right of any fiduciary to distribute a share where possible to the minor or to another for the minor's benefit. ITEM VII: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. ITEM VIII: I appoint my mother, PATRICIA A. FULLMER and my sister, BELINDA K. BAER, Co-Executors of this my Last Will. ITEM IX: I direct that my Executors, custodian, or their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM X: The interests of the beneficiaries hereunder shall not be subject to anticipation or Cl3 to voluntary or involuntary alienation. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my bast Will and Testament, written on four (4) sheets of paper, dated this ~~' ~ day of ~ ~,~ ~. , 2010. .._~ i ' ~ -~J' . ~ _,` (SEAL) LESLIE JOB S, TEST RTx: The preceding instrument, consisting of this and three (3) other typewritten pages, each identified by the signature or initials of the Testatrix, was on the day and date thereof signed, published and declared by the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. / r-- ~~ ~' '~-J- -~ residing at S ~ , ~ ~~ ,~~ residing at 3 COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, LESLIE JO BYERS, 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 that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Q~ y'-1XJ.SL `J~ "~-~t/~t//L' (SEAL) LESLIE JO BYE S Sworn to or affirmed and acknowledged before me by LE LI~ JO BYERS, the Testatrix, this ~/' day of _-~~~t ~~~t.tC~ t 1 ~' , 2010. 1~`otary Public ~~ ~', COMMONWEALTH OF PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA Notarial Seal Angela M. Schaeffer, Notary Pubiic Shippensburg f3oro, Cumberland County My Commission Expires May 15, 2011 Member, Pennsylvania Association of Notaries ss. COUNTY OF CUMBERLAND ~~~ ~~ , , ~ ,~ , We, ~' ;~~ ~:.; C>;'~~S and 1 f r ( L ,~~~/,~~~ the witnesses whose ,--- names are signed to the attached or foregoing instrument, being du y qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or unduF; influence. Sworn to or affi ed d su cribed to T before me b ~ ~ ~ -' y., _. Ir I ~'; ~ _ ~ S and l G ~. ~ ..xa ~ f t ,witnesses, this _) ~_ ~_ day of .~~~ . , 2010. i ~~'' ~ C (~ . COMMONWEALTH OF PENNSYLVANIA ,~ m Notarial Seal N Pub1Xc, ~ % Angela M. Schaeffer, Notary Public C. Shippensburg poro, Cumberland County My Commission Ex Tres May 15, 2011 Member, Pennsylvania Association of Notaries 4