Loading...
HomeMy WebLinkAbout08-04-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of WILLIAM S SHEARER also known as COUNTY, PENNSYLVANIA File Number 21-10 ~ ~~ ~, ,Deceased Social Security Number 207-03-7448 SAUNDRA L GOTWALT Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' BELOW.) © A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executrix named in the last Will of the Decedent, dated 04/23/2008 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 i e; urante a sen ia; uran a minors a e Petitioner(s) after a proper search 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 lisf of heirs.) Name Relationship Residence ~~ C> - -r-~ i -_ - (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. 'r~., ~'` _ Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal_r~s~.ee at ~" ~~ ~ _ ~` __ 230 Haldeman Avenue, Borough of New Cumberland, Cumberland County, Pennsylvania~'~ -~=` ~, (List street address, town/city, township, county, state, zip code) -c> ~ , , V tV •. Decedent, then _~ years of age, died on 07/11/2010 at Messiah Village, Mechanicsburg, Pennsylvania Decedent at death owned property with estimated values as follows: (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania All personal property Personal property in Pennsylvania Personal property in County 110,000.00 183,550.00 situated as follows: 230 Haldeman Avenue, New Cumberland, Cumberland County, Pennsylvania 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 SAUNDRA L GOTWALT 160 New Haven Street ,; ~) ~ Mount Joy, PA 17552 Form RW-02 Rev. ~o-~s-zoos 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 ~~~~~~-~r-~~-= ~ ~` ~"` ~~{ '~~ ~..,~ Signature of Personal Representatwe SAUNDRA L GOTWALT ~~'. before me this ~_ day of ~~~ ~ ~~. '~„- - ,- t ;~ '~ ' " -fir ; ~~, Signature of Personal Representative ~y ~..•~ '~ ~'` --- t ' 9 '~ % r ~ .n ~ ` ~~ ~~~~~,~ Y~ ~ Signature of Personal Representative r ~ •~.~ ,,~~. "! • For the Regist ~ ~ •~ ,,.., ~~~ ~4 =-~ r.,~ . ~' N, File Number: 21-10 Estate of WILLIAM S SHEARER ,Deceased Social Security Number: 207-03-7448 Date of Death: 07/11/2010 AND NOW, L ~ , in consideration of the foregoing Petition, satisfactory proof having been presented be ore me, IT IS DECREED that Letters Testamentary are hereby granted to SAUNDRA L GOTWALT in the above estate and that the instrument(s) dated 04/23/2008 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. r A FEES Letters .......................................... $ ~~ll / l ~ U ~ CT (} ~ ,~ ` r ~ ~ -- ,. ,., ~- t ~ ~'' ~ r ~• ~ ~ ~ g ~ . e ister of Wills -( /~ c.. ~~~ l C~E ~- Short Certificate(s) ....................... $ ~ ( ! . ~ ~) . Renunciation(s) ............................ $ Attorney Signature: b ~~" I ~~ $ ~ `~ ~ L'` Attorney Name: EDMUND G. MYERS ~~~ C `~ $ 2~ ~ ~ ~~ C1' 1 ~-1O ~{ L 11'1(.( ~ ~ (~ J ~ $ U C% C) Supreme Court I.D. No.: 20558 : JOHNSON DUFFIE $ Address: 301 MARKET STREET $ PO BOX 109 $ Lemoyne, PA $ Telephone: (717) 761-4540 TOTAL ................................... $ .~ ,~ , ,.~ ~- ~ U Form RW-U2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 ~AL REGISTRAR'S C:ERTI~IAT1~3N ~` SEA"I"'I~~ ~I11AFtNiNG. It iS i6legal to d~pl~cate this c,:~p~ ~y p~c~tO~tt~t r~r ph~tr~g~;a~~~ f.t,-~. i~?f~ th{ ~.L~f~titf~_-~tit~ `~f~.j~r, .~P/ > ~, I;°•`i"~~~N r~F ,~~~ ~~,. ~~ b ,•G ;" ~, -r' m 74%~r. ~ ~ y' 'r I, ia~v.- ~~ iii/1, ..plf .. )~lfi~ r; ,i ~I , r 1 it 1 .~!r,{ ,t,. ,i, ~~`. a'r't . 1 t . ~Gn t i+.'::17i1?6~lli;-tllt~lp, ~~)~ ~~~);:°(j i.~. ~ + ri".;lili(~ ~ i~]!M ', c' C~rf %llit(~i ,D;..t dil"~,~',9`~ti'~li~~. ~~)t.` t1Vt'~'.il~i~~f~ r" , JIJL1~2//010 _. • ..._. ~._..._. .._. ...~. _..__.. Lt .y. .._.. _. P\,~ i•-~ ~M3 _, , . _ .__ -~-) t...• ~,, _: _. ~' ~ ,t .. --. t ' .. -._- ~ _~' COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ "'' _ .=-- ~ CERTIFICATE OF DEATH =1~ ~% "': ~ - ' ` •' (See instructions and examples on reverse) STATE FILE NUMt}~.Pl' I"`V ~ :3 ~~) - . -, REV 11/2006 PRINT IN ANENT ,K INK M 1. Name of Decedent (Flrst, middle, last, suffix) 2. Sex 3. Social Security Number 4. Date of Death.{Monet, da~~) William S. Shearer male 207 - 03 ~-7448 July 11,20 10 5. Age (Last Birthday) Under 1 year Under 1 de 6. Date of Birth (Month, day, year) 7. Birthplace (City and state or for ego country) 8a. Place of Death (Check only one) MonUS Days Hours Mlnulee Hospital: Other. 9 2 Yrs. April 1 , 1 91 8 Lemoyne , PA ^ Inpatient ^ ER /Outpatient ^ DOA ~ursing Home ^ Residence ^ Other • Specify: 8b. County of Death Bc. City, Boro, Twp. of Death 8d. Facility Name (If not ltstitutionl give street and number) 9. Wes Decedent of Hispanic Origin? No ^ Yes 10. Race: American Indian, Black, White, etc. Cumberland U er Allen PP ~eSS~Cc.1') 1/l ~~l° (lfYea.apecffycuben, M i P Ri ( (specify) ex can, uerto can, e d.) whit e 11. Decedents Usual tion Kind of work d one d udn most of wodd life. Do rat state retired 12. Was Decedent ever in the 13. Decedent's Edtaatbn (Specfy only highest grade comp leted) 14. Marital Status: Maned, Never Married, 15. Surviving Spo use (It wife, give maiden name) Kind of Work Kind of Business /Industry U.S. ed Forces7 Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specify) postmaster postal servic ~es ^~ 12 widowed 16. Decedents Mailing Address (Street, cth' !town, state, zip code) Decedents Penns 1 v a n i a Dld Decedent y 230 Haldeman Ave. Actual Residence t7a. State Live M a 17c. Yes, Decedent Lived in Twp. Township? Cumberland ,7d. Nd,DecedentLivedwithin ,7b.County AdualLinrlsdr New Cumberland Cty/Boro 18. Father's Name (Flret, midde, last, sufix) John W. Shearer 19. Mother's Name (Flrst, midde, maiden sumenre) Effa Cornman 20a. Informant's Name (Type / Pdnt) Saundra L G o t wa 1 t lob. Infortants MaliMg Address (Street, city /town, state, zip code) . 160 New Haven St.,Mount Joy,PA 17.552 21 a. Me of Disposition j ^ Cremation ^ Donation ~ I 21b. Date of Dispositbn (Month ,ear) 1 5 2 01y ~ Jul 21c. Place of Disposition (Name of cemetery, crematory or other place) C e m t e r N t d i t I G 21d. Location (City 'town, state, zip code) Budal ^ Removal from State Was Cromatbn or Donaton Authorized ~ y , e n o w n a . a n ap A n n v i .11 e, P A 1 7 0 0 3 by Medical Examiner I Coroner? ^ Yes ^ No ^ Other • Specify: lure of Fun ice Lkrensee (or person acting es such) 22b. License Number 22c. Name and Address of Facliy FD-013163-L Musselman FH&CS,324 Hummel Ave.,Lemoyne,PA 17043 omplete Rams 23a~c only when certifying 23a. To the best of my knowledge, death occured at the time, date and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year) physican b not avaRable at time of death to certry cause W death. Items 24.26 must be completed by person h d th 24. Time of Death 3 U~ A 25. D1ate Pronounced Deed (Month, day, year) 1 ( ( I ~ ~ O 26. Was Case Refered to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? w o pronounces ea . M. O U f ~ O ^ Yes ~No CAUSE OF DEATH (See instructlcns and examples) r Approximate interval: Part II: Enter other sianifaaM conditions contributing to death 28. D'xf Tobacco Use Contribute to Death? Item 27. Part I: Eller the drain of events -diseases, injuries, a complk;atlons -that directly caused the death. DO NOT enter terminal events such as cardiac arrest, r Onset to Death but not rasuRing in the undertying cause given in Parl I. ^ Ves ^ Probably respiratory ertest, or ventricular fibdllation without showing the etiology. List only one cause on each Nne. ~ J j r No nknown ^ ~ am ~ IMMEDIATE CAUSE (Final disease or ~ ~ ~ ,, condition resulting in death) _' a M `~•~'~' - P~ (/«~~~ ~ ~ (~•-e ~ ~ ~ 29. H Female: Due to (or as a consequence of): ~ Not pregnant wthin tear P~ Y Sequentialry1y list conditbns, R any, b, ~ leading to the cause listed on line a ~ ry'1 t,~.~„Q ~ pt,Q X12. i /~ < cc.~(~^ U(L ]Pregnant at time of death . Due to or as a cons uence o r Eller the UNDERLYING CAUSE ( ~ +1~ r , Not r ant, but pant within 42 da s ] P ~ We9 Y (disease or Injury that Initiated the c r events resulting m deem) LAST. r ~-~ of death • Due to (or as a consequence of): r ( ~ ~~ ^ Not pregnant, but pregnant 43 days to 1 year b f d h d ~ _.- e ore eat ^ Unknown H pregnant wittun the pest year 30a. Was an Autopsy 30b. Were Autopsy Findings ner of Death 3 32a. Date of Injury (Month, day, year) 32b. Deacdbe How Injury Occurred 32c. Place of Injury: Home, Fartn, Street, Factory, Performed? Available Prior to Completion ~ Natural ^ Hartpcide Office Building, eic. (Specily,~ ct ~~ of D~dt? ~({ ^ Yes I /I No ^ Yes ^ No ^ dent ^ Pendng Investigation 32d. Time of Injury 32e. Injury at Work? 32f. if Transportation Injury (Spedly) 32g. Location of Injury (Street, city /town, state) T`• ^ Suiade ^ Could Not be Determined ^ Yes ^ No ^ Driver /Operator ^ Passenger [] Pedestdan M Other -Specify. 33a. Certifier (check onty one) 33b. Title of CertNier • CertHying physician (Physidan certHying cause of death when sootier physician has proraunced death and completed Rem 23) / ~ To the best of my knowledge, death occurred due ro the cause(s) and manner as afated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pronouncing end certllying ptryskian (Physician both pronouncing death all certifying to cause of death) To the best of my knowledge, death aceurred at the time, gall, and place, and due to the cause(s) end manner as ataterL. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. ^ 33c. License Number _ 33d. Date Signed (Mont ,day, year) / • Medical Examiner 1 Cororxr - ~S~~C.~ ~ ~ 7/r z `v On the basis of exsminatlon and I or,invesNgation, In my opinion, death occurred et the dme, date, and place, and due to the cause(s) end manner ea atated_ ^ ~ ~~ nd Address ofof P eted se of Death (RerA27LType /Print ~ /[j Registrar's Signature and District Number I ~ / I ~ `I ~ 36. Date ( da , ear ) ~ /~~ ~ L~~~ ~ ~~_`Z~~~~^ " /~ ~~~ / ~ O Disposition PermR No. O y ~a ~ a ~ Last Will and Testament ~.,~ .~ r. -:~ ~ ~.~_ ,~, :.,~. '~ c'~~ WILLIAM S. SHEARER : `-~ _~, !=-`~' :_.. ,; .. .~ .~ ~ ._. ... I, WILLIAM S. SHEARER, of the Borough of New Cumberland, Cumber~an~:;Countp --;-> , Commonwealth of Pennsylvania, being of sound and disposing mind, memory understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II TANGIBLE PERSONAL PROPERTY I give and bequeath my motor vehicle(s), household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto my daughter, SAUNDRA L. GOTWALT, if she survives me. If my daughter, SAUNDRA L. GOTWALT, predeceases me, I give and bequeath the same unto those .~~ :, _, _ -; i -~~ -, -~ of my grandchildren who survive me, to be divided among them by my Personal Representative with due regard for their personal preferences in as nearly equal shares as practical. ARTICLE III REST, RESIDUE AND REMAINDER I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever nature and wherever situate, unto my daughter, SAUNDRA L. GOTWALT, if she survives me. If my daughter, SAUNDRA L. GOTWALT, predeceases me, I give, devise and bequeath the rest, residue and remainder in equal shares unto my grandchildren, provided that should any grandchild also predecease me, I give, devise and bequeath such deceased grandchild's share unto his or her then-living issue, per stirpes. ARTICLE IV UNIFORM TRANSFERS TO MINORS ACT In the event any beneficiary of my Will has not reached the age of twenty-five (25) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian for such beneficiary until age twenty-five (25) under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa.. C.S.A. §5301, et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My Personal Representative may designate as such Custodian ar~y institution or person, including may Personal Representative, qualifted to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefore to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE V POWER OF PERSONAL REPRESENTATIVE My Personal Representative shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. D. To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. E. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. G. To make such elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift, generation skipping or other tax refunds and the payment of such taxes as my Personal Representative and/or Trustee shall deem appropriate, without obligation to adjust the distributive share of any person thereby affected. ARTICLE VI TAXES I direct that all estate, inheritance, transfer and other taxes of similar nature payable by reason of my death, together with any interest or penalties thereon, and imposed with respect to any property, whether or not disposed by this Will, shall be paid out of the residue of my Estate. ARTICLE VII PERSONAL REPRESENTATIVE I name, constitute and appoint my daughter, SAUNDRA L. GOTWALT, Executrix of this my Last Will and Testament. Should my daughter, SAUNDRA L. GOTWALT, fail to qualify or cease to so act, I name, constitute and appoint my granddaughter, TRACEE S. GOTWALT, Alternate Executrix to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this 23~ day of ~9~~ 2008. WILLIAM S. SHEARER Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. -- ~~ AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. 1 ~ ~ . I'U~ ~.as k We, WILLIAM S. SHEARER, and ~' r~ (~ ~ . C f ,the Testator 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 Testator signed and executed the instrument as his Last Will and that he had signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. WILLIAM S. S EARER ~~ rtne s ~J Witness Subscribed, sworn to and acknowledged before me by WILLIAM S. SHEARER, Testator, and subscribed and sworn to before me by ~ b ~'1. +'l, ~-, Y v ~ N'tT 5 and _~ YYl t,~ ~ G- Ill. t,~ ~ f S ,witnesses, this ~~ day of _ , 2008. l~~ Nota Public CUMMONWEaLiN OF r'tiVS~+~Y~'v~~_i~:~ NOTARIAL SEAT. GAIL J. MAHONEY, Notar~~ ~=~~I~;i~ , Lemoyne Boro., Cumberland county My Commission Expires Feb.. ~ ~3~ 2.t~1 t~ COMMONWEALZH GF F'I~I~[~~Ytl~~,i~~(~`=. NOTARIAL SEAL ~~ GAIL J. MAHCNEY, Notary Eubl Lemoyne Boro., Curnber(and County ~ My Commission Expires Feb. 19, 2C~ a f? :326479v3