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Home My WebLink About08-23-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Charles E. DeHart a/k/a Charles DeHart also known as Charles DeHart Deceased COUNTY, PENNSYLVANIA File Number r ;~ ~ - ~ V ~ ~ _l Social Security Number 165-16-2846 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executrices ~ ~!"~`~ ed in the_ last Will of the Decedent dated December 18, 2009 and codicil(s) dated ~'' ' =` M1 r,-., ., -- s (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ ;,:; ~ X - _ -r Except as follows, Decedent did not marry, was not divorced and did not have a child born or ado ted after execution Of # _~ ,~~ ~ $') ~~ `~~ p );~in~~rume offered ,- for probate, was not the victim of a killing and was never adjudicated an incapacitated person: no exceptions ~ ~--~? °-~-- _ • }V ~~ C,H~ B. Grant of Letters of Administration C~ ' ' (Ifapplicable, enter: c. t. a.; d.b.n.c.t.a.; pendente liter durante absentia; durante minoritate) 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 list of heirs.) Name Relationshi Residence Shirley L. Boggs daughter 241 South West Street, Carlisle, F'A 17013 Judy M. Motter daughter 35 Stoney Run Road, #3, Dillsbur•g, PA 17019 (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 134 Horners Road, Carlisle, PA 17013 (List street address, town/city, totivnship, county, state, zip code) Decedent, then 93 years of age, died on August 13, 2010 at Forest Park Health Center Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $_ ~dQ~,QQ (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: L. Boggs, 241 South West Street, Carlisle, PA 17013 ~~~ yy~ , y y ern, I Judy M. Motter, 35 Stoney Run Road, #3, Dillsburg, PA 17019 Form RW-02 rev. 10.13.06 Page 1 of 2 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: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS 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. Swona to or affirmed and subscribed before me the .7~~ _ day of ~, . ~, ~ ~ i^f ~ Signature of Personal 'C~~ ~ , .~ For the R gister Signature of Personal Representative ": " rT~! 1`.,,~ '._ ~. - -~-? G~: - ~ . .1 . . ,, , . ,, Y .: .. ~ ._' ~' ~- ! f a .a , , ._ File Number: r~ + ° I L - (•~ ~ ~ ~ z> .~ ~' ~-~ ~ r, Estate of Charles E. DeHart a/k/a Charles DeHart Social Security Number: 165-16-2846 Deceased Date of Death: August 13, 2010 G~ 'C." " ! ~-r ,c~ U ~ (,~ , in consideration of the foregoing Petition, satisfactory proof AND NOW, '' having been presented bt fore me, IT IS DECREED that Letters Testamentary are hereby granted to Shirley L. Boggs and Judy M. Motter in the above estate and that the instrument(s) dated December 18, 2009 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............... $ r-. ~i Short Certificate(s) ........ $ ~( (1 • L~ Renunciation(s) .......... $ ~~ i r '41 ... $ t `' Ll 1~h~ ... $ i"-~ -~7 t _ ... $ ... $ ... $ $ ... $ ... ... $ TOTAL .............. $ ~~~~ ; °~'~ 0.00 O,f WIIIS - .., - ~~ ~1 tp c~~~.,1 , f {r~^.{. /~,~ i' ~ . ~,~ ,, j 1 f - Attorney Signature: ~ ' ' ~"- Attorney Name: onald E. Johnso squire Supreme Court I.D. No.: 16453 Address: 78 West Pomfret Street Carlisle, PA 17013 Telephone: 717-243-0123 Form RW-02 rev. 10.13.06 Page 2 of 2 rO:AL REGISTRAR'S CERTIFICATION OF DEATH 'iN~,~NING: It is illegal to duplicate this copy by photostat or photograph. I-tic +~1,r thi, ~~(-I)f;ti~)tt.~_ ~,(~ t^( ;,, t r ,,~~~ ~~`~ +'1 "1 his i> tc1 ccltil~~ t4lat the. i),tormati~>n here liven is /1'+~~,P fy,~~ ~;yrr~~-t1~ c1.~}~ied )ri r) ~,tn O)-)final C'ertific~~te ~f Death ;,``t~'• /'.•~, il~lly tiife(.1 ~~~ith r)at a~. I,tic~ai Registrar. ~t'he c)ri~inal ~~' ' ~ ~r€ ~ Yip: etc ~ i11 1,~~. (t:1r~~~zru!E~d tc~i the ;Mate Vital ~~q! ~ ,~ ! !~~~,,; LL~ f~~•ctirds Ot-fi~~e ti,( p(~~rn)anent t)ling. ,d ~^' ~~ _ ,.; ~`'\.o```°q ~~~~`,V y ~~. ~~~`~~~~~~Oex- AU 1 fi 1 fl 10 ~'~ ENT `~ , ,,, ___ _-------- ., „>~,C'~'~ ~ .,~C~lf }Z:;%'l~~t~il~ ale ISS1.1~4~ S~._) C.w 3 1 ~: 1 ~ `~ ~-) ~ i r . - _- T~ ) <- ;,`-~ G~~ _ ; ._ { I ("~ • __ ' ._~ , - y ---'^ -i -- • " •":? t ~ a ~~ ~-- ~.. N105.143 REV 11(2006 TYPE /PRINT IN PERMANENT BLACK INK W a ~I ~I ~'~~ '~J ~`` , r'1 w U O O w z COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH ices inal.ru•rfr,n• ArIfI PYAFr1nIP_A en reversal ,....r~.-„~.,,,..o~~ 1. Name of Decedent (First, middle last, suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year) rI~S ~ ~ ~'t'14.T ~ Male 165 - 16- 2846 Aug. 13, 2010 ~'hQ , 5. Age (Last Birthday) Under 1 ar Under 1 de 6. Date of Birth Month, da , ar 7. Bi ace C and state a forei coon 6a. Place of Death Check onl one Months Deys Hours Minutes Hospital: Other: 93 vrs July 3, 1917 Jim Thorpe, PA ^Inpafient ^ER/Outpatient ^DOA ~NursingHonte ^Residance ^Other-Specify 9b. Counry of Deatli fic. Ciry, Boro, Twp. of Death ed. Faciltly Name (If not institution, give sweet and number) 9. Was Decedent of Hispanic Odgin7 ~ No ^ Yes 10. Race: American Indian, Black, While, etc. if b C (S~/~ - (tf yea, spec y u an, White Cumberland Carlisle Forest Park Health Center Mezicen, Puerto Rican, etc.) 11. Decedent's Usual Lion Kind of work d one dun roost of wo Ida. Do rat state retired 12. Was Decedent ever in the 13. Decedent's Educatbn (Spedty Dory hy)hest grade completed) 14. Madtal StaNS: Mooted, Never Married, 15. SurvMng Spwse (If wile, give maiden name) DWorced (Specify) Widowed KnW of Work Box maker KadoiBusinessllndustry Naval Depot U.S. Amred Forces? ®vea ^ Ne Elementary /Secondary (0.12) 10 College (1-4 a 5*) , widowed • i6. Decedent's Mailing Address (Street, city /town, state, zip code) Decedent's Did Decedent Mi d d 1 e se x Tom, pA Live in a 17c oa~edam Lead in ~ Yes 134 Horners Rd. _ _ . , Actual Residence 17a. State Cumberland T°"w'e'"p? rid.^Na,DacedentLivedwkhin Carlisle, PA 17015 'm•c°"nry ActualLimtlsof CiylBoro 1 H. Father's Name (First, middle, last, suffix) Unknown 19. Mother's Name (First, mddfe, maiden surname) Louise (unknown.) Dehart 20a. Informants Name (Type / PdnQ Shirley Boggs 206. Infomtant's Mailing Address (Street, oily /town, state, zip code) 241 S. West St., Carlisle, PA 17013 21 a. Matted of Disposition r ^ Cremadon ^ Donadon 21b. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or other place) 21 d. Lacatbn (Ciry /town, state, zip code) • f> A^ ~ Buriel ^ Remevalfromstate ~ wa. ~ « c~ ~ Aug. 17, 2010 Letort Cemetery Carlisle, PA 17013 Y~ ~/ Na ~ l ^ n • 22a. ~ u Fune Se • L' (« acting es such) 22b.1-icertseNumber 22c.NameandAddressofFacillry Hoffman-Roth Funeral Home & Crematory, Inc. • ~ 013144E 219 N. Hanover St C Complete ems 23ec Doty whence ' 'rig physicia is riot avaNable at time of death to ture and tRle) / 23a. To the best of my knowledge, death oa:urrerl ~t the time, date and place stated. (Si~gna ~ /` d t,' ] A f 23b/JLice`ns/e N~u-m`ber ~] '7 ~[ / ~ ~ 23c. Date Signed (Month,/day, year) ~J 1 ail 7~ ~ ' ~ ` ~ ~ cerofy cause of seam. , ~..~ t. ~.K-~-~ Y` ~ (,~~~ ~ /v', /~. /V ~l r 07 J1 ! - . - U S u-~ • 24 Time of Death , day, year) 25. Date Prorauraed Dead (Month o Medical Examiner / Coroner for a Reason Other than Cremetan or Donation? ed t 26. Wes Case Refe rr kerns 24-26 muss be completed by person • who pronounces death. . (~~ ~~ ~' (V•. / // ~G( u ) ~l'- ~~ <~rJ'~~' r ~ w ^ Yes l1~rvo CAUSE OF DEATH (See instructions and examp es) r Approximate Interval: Part II: Enter other ~x+nifr= t conditions contdb~tlng tc deg(p, iven in Part I cause nded in lfi i th t b 23. Did Tobarxo Use Comribule to Death? bl ^ Y ^ p b Gem 27. Pan L Enter the chain of events - dseases, injudes, a complicatforrs -that directly caused die death. DO NOT enter terminal events such as ardiac anest, r Onset to Death . y g g ng n e u ut ra resu a y ro respiratory arrest, a ventricular flbriNatfon without showing the etiobgy, Usl Doty one cause on each line. ~ No Unknown r IMMEDIATE CAUSE (Final disease or r ~,.,QL/!/2 ~ 7rt /A ( G ! ~ ~ condition resulting in death) - 29. It Female: ^ Not pre nant viithin past year ~~ a Due to (« rice oq: ~ r ~ ~ r f~ any uent~ally list conditions if S e . - g ^ Pregnant at tlme of death 42 d ithi ^ , . , 6 t l e a~dmg >o the cause fisted on fine a. Due to~oJ.ae uence oQ: Enter the UNDERLYING CAUSE ( ~ (disease a injury that inkiated the I %~ r - ays n Not pregnant, MA pregnant w of death but r nant 43 da s to i ear ^ Not r nant P a9 Y Y a c. events resuking m death) LAST. r , P 9 Duero (or as a consequence oq: r ~ before death p egnant wittrin Me past year ^ Unknown if r • d. 30e. Was an Auropsy 30b. Were Autopsy Findings 31. Manner o1 Daeth 32a. Date of Injury (Month, day, year) 326. Descdhe How Injury Occurred 32c. Place of Injury: Home, Farm, Street, Factory, Office Building, sic. (Speaty) Pedonned? Available Prior a Completbn f D th? f C ~Naturel ^ Homicide ause o ea o ^ Accident ^ Pending Investigatlon 32d. Time of Irqury 32e. Inryry at Work? 32f. tl Trensportel'an Injury (Specify) 32g. Locetion or injury (Street, city /town, state) ^ Yes No ^ Yes ^ No ^ Yes ^ No ^ Ddver/Operator ^ Passenger ^ PedesMan ^ Suicde ^ Cook! Not be Determined ~ ^ Other -Specify: ~ Certifier ( ~ ~) sician has pronouaad death and completed Item 23) use of death when anotlar h in Ph i i n lfl i h bi C H 33b. Signal rid T of Certifier ~ ~ ^ . /) ' ( J' ~ p y y g ca ng p ys an ( ys cer ert c a • y deaM occurred due to the esuae(e) and manner as stated _ _ _ _ _ _ _ _ _ ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _'~ To the beet oT my imowbdge ~ i , • Pronoundng and certitying phyeklan (Physidan both pronouncing death acrd cerb'fyfrg to cause of death) ^ 33c. Lkense Number 33d. Date Signed (Month, day, year) To ti,. bast or my knowedge, death occurred et tM Hme, date, and place, and due to the cauae(e) and manner ore stated- _ _ _ _ _ _ _ . _ _ .. _ _ _ _ _ _ kt, 03 ~~tt54 E 8 l ~ 3 ~ 'lp i u • frladical Examiner/Coroner On the baele of szaminetion and I «Investigatbn, In my opinion, death occurred M the time, date, end plan, end due to the cause(s) end manner ea elated.- ^ anpleted Cause of Death (Item 27) Type /Print ho C 34. Name and Address of Person W . `` ,, 35. Registrar' tore end Disbkl tsar ~ ~ ~ ~ r~. ~ l ~ ~ ~ .Date Filed (Month, day, year) ~' 3 03 IJ.13aL~~.w~trr`t (~re ~`l + dbDl~ 5 r~v- ~h C~1l~l .S ~~e-,r ~ , . . o Disposition Permd No. ' ~ ~ '~~~ ~ F rL`L r-•,~ LAST WILL AND TESTAMENT -_ ~ ~-., " ~ ~~ ",tea. -_;-- ~~ --; c~a CHARLES DeHART '. ~ -=~ < ~=} ~. ~~ ., ~ ~~=-- -~-~ . . . ~y ~ I, CHARLES DeHART, of Middlesex Township, Cumberland County, Pennsylvania, beir~ of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I give, devise and bequeath 40% of the residue of my estate, of every nature and wherever situate to the Tree of Life Church to be administered by Pastor Dave Herr as he deems appropriate to help the poor of the church. THIRD: I give, devise and bequeath 60% of the residue of my estate, of every nature and wherever situate, to my three daughters, equally, namely, JUDY M. MOTTER, SHIRLEY L. BOGGS and EVELYN E. FIELDS, provided that should any of my daughters ~, predecease me, their shall be distributed to their issue, per stirpes, living at the time of my death. FOURTH: 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 a part of the expense of the administration of my estate. FIFTH: I nominate, constitute and appoint my daughters, JUDY M. MOTTER and SHIRLEY L. BOGGS, or the survivor of them, Co-Executrices of this my Last Will and Testament. ' „i i= l ~ . ~: ~ =,, -,- , . -r ; -> >~ -.: SIXTH: I direct my Executrix and her successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament consisting of two (2) typewritten pages, each identified by my signature, this ~~_ day of _ ~G~~I~L°~ , 2009. `~° ~ ~ ~~~-~~hl SEAL ( ) Charles DeHart Signed, sealed, published and declared by the above-named Testator, Charles DeHart, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND I, Charles DeHart, Testator, 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 Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or a armed to and acknowledged before me by Charles DeHart, the Testator, this _~ day of ' = ~. j .-- , 2009. ~AMONWEALTH OF PENNSYLVANIA NOTARIAL. - Public SHELLY SEXTON County Carlisle Boro, Cu ~ 26, 2011 v Commission Expires Apra ~~a..~c..~-~ G~ (SEAL) Charles DeHart, Testato `, ,, / h, 1 ,~ ~ lac AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND We RONALD E. JOHNSON and ~~ /~ d~ 1_%d ~%`'~ , t]he witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that Charles DeHart, signed willingly and that he executed. it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON an ~ /~ ` witnesses, this ~~' day of • ~ i~ .~~~ ~~~ , 2009. ~ .~ /~ (SEAL) COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL SHELLY SEXTON, Notary Public Carlisle Boro, Cumberland County My Commission Expires April 26, 2011 (SEAL)