HomeMy WebLinkAbout09-09-10PETITION FOR PROBATE AND GRANT OF LETTER'S
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVA1~iIA
Estate of Doris D. Carey File Number ~/_/v _~ / ~4 ~
also known as
Deceased Social Security Number 197-OS-7081
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
I
® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executor ~
last Will of the Decedent dated 9/26/2007 and codicil(s) dated
amed in the
(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 inst
was not the victim of a killing and was never adjudicated an incapacitated person:
For probate
rument(s) offered
,
B. Grant of Letters of Administration
(lfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia; durance mino
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followi pouse (i
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Mate)
fV
at>~irtd heirs: {~'
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Name Relationshi
i
~,` r
n S -µr-t
(COMPLETE INALL CASES:) Attach additional sheets if necessary. ~
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal resident
Coun Meadows Retirement Co unit 4831 East Trindle Road Mechanicsbur Ham on Townshi Cumberland Count m `t`~
Gl# `'~
~ ~
at
PA 17050
(List street addres.~ town/city, tawnshtp,.county, state, zip code) -
Decedent, then 92 years of age, died on June 8, 2010 at Country Meadows Retirement Commu
ity,
4831 East Trindle Road Mechanicsbur Ham on Townshi Cumberland Count PA 17050
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $
25,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
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 undersigned: the appropriate form to
Si lure T d or rinted name and residence
t
3~ s~ R ~T
,~ ~,
Form RW-02 rev. 10.13.06 ~ 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 cmrrect 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 d subscribed ~~ ~~
befo a the ~~ day of
Z~ v
Fo the Register
Signature of Personal Representative
Signature of Personal Representative
Signature of Personal Representative
File Number: ( Q 9Zl„ ~ _ -~= ~;
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Estate of Doris D. Cazey , Dece~ed ~ ~ ~
.~"
Social Security Number: 197-OS-7081 Date of Death: June 10 2010
AND NOW,,,9~ 2~~0 , in consideration of the foregoing Petition, sa 'sfactory proof
having been presented before me, I I DECREED that Letters Testamentary
aze hereby granted to David C. Carey
i the above estate
and that the instrument(s) dated September 26, 2007
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. +
FEES
Letters ..............
$ ~ ~
'st of s
Short Certificate(s) ........ $ 4•~ Attorney Signature:
Renunciation(s) .......... $
Automation Fee $ 5,00 Attorney Name: Edmund J. Berger
JCS Fee 3.50
$ 2 Supreme Court I.D. No.: 53407
. . . !
$ /L~ of
$ Address: 2104 Mazket Street
• • • $ Camp Hill, PA 17011
... $
... $
' ' $ Telephone: (717) 920-8900
... $
TOTAL .............. $/U7• So ~`
Form RW-02 rev. 10.13.06
Page 2 of 2
!~,
Estate of Doris D.
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OATH OF SUBSCRIBING WITNESSES
~,
REGISTER OF WILLS ~
Cumberland COUNTY PENNSYLVANIA va `°
^'~ ii w
i r
Stephen B. Killian and Ann Cook-Majiros , (each) a subscri
(Print Name/s)
the ®Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, deb
say(s) that she / he /they was /were present and saw the above Testator /Testatrix
and that she / he /they signed the same and that she / he /they signed as a witness a
the Testator /Testatrix in her /his presence and in the presence of each other.
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4'7
"'C' i
Deceased
ins; witness to
;e(s) and
sign the same
the request of
(Sig»at/ure) ~j r ' ~^ , '
~1!! /tsy~/iG~V'~'dGN
(Street Address)
o U~ ~ !9 / X746
(City, State, Zip)
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Executed out of Register's O~c ~
Sworn to or affirmed and subscri ed ~ _
before me this c~ ~ ~ d ay ~ ~ u '~
~~
of OI
i u
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarisation.
.~
(gnanoe)
o~'T' /OJ~ ti ~
(Street Address)
(City, State, ip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
Notary Pub c
My Commission Expires:
(Signature and Seal of Notary or other official qu ified to
administer oaths. Show date of expiration of Not 's Commission.)
Form RW-03 rev. 10.13.06
105.112 REV. 1105
(FEE FOR THIS
CERTIFICATE $6.00)
WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR ~/- ~0-~ / Z~
TO DUPLICATE BY PHOTOStAT OR PHOTOGRAPH.
COMMONIMEALTH OF PENNSYL1~14t!IIA
pEPARTMEl4T f>F HEALTH VrrA1L RECOFID5
LOCAL ~tEGiSTR~4R°S CERTIFICATION QF [?EATH
i
i
CERT. No. T 6 3 Z 2 7'S 8 G /e ~a
Date of Issue of hle Ceitllfcetion
Name of Decedent ~~~ /~
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MISS p
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YddiM a i28f
Sex Social Security No.J`~~ ' ~ 7d~ f Date of Deat I ~- ~ /d
Date of BirtFv~O~s%-91? Birthplace ~4~,~~!~~
Place of Dea Penns Ivania
a hY Name County C .Borough or hIP
Race Occupation.~L~LZ.(~.•4 ~,r~r+Q~ - Armed'Forces? (1'es or
~1 Decedent's
_
Marital Status Cd.T~~r~__ Mai)ing Addres -~
Nurtrber SGe81 Ciry oFTiiwh State
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Informant af Funeral Director
Name and Address of
~
Funeral Establishment
Interval Between'-
. Part I: Immediate Cause ; Onset and. Death'..
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(a) ~
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Part II: Other Signi#icant Conditions ~ s.• -~, ~?
_
Manner of Death ~
'Describe how injurytoccur~2d: ~ _
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~
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Natural
Homicide r
Acc#denT ^ Pending Inver#igation ^
Suicide ^ Could not be Determined ^
Name and Title of Certifier. ~a ~~~?~ ~~_-"
p
/~ (M. ., Ll~Q., Coroner, M.E.)
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Address ~ewL. ~"
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This is to certify that the information here givetl is correctly copied from, an arigjn l certifFcate
of death duly filed wiih me as Local Registrar. The original certificate will' be forwarded to the
State Vital Records Office, for permanent,, filing. !
local Regstrar of Vital R~ce D striG No.
~ / ~ / ~ SUNSET' DR. D SPA
Date Receivetl by Local Registrar Sheet A9dress Ciy, Borou , Town3hip
Z l-/d-o 9zG
LAST WILL AND TESTAMENT
OF
DORIS D. CAREY
I, DORIS D. CAREY, of the Borough of Dallas, County of Luzerne and Cony
of Pennsylvania, being of sound and disposing mind, memory and understanding, do
publish and declare this as and for my Last Will and Testament, hereby revoking and
void any and all Wills, Codicils or other documents in the nature of testamentary disl
10II at
any time heretofore made by me.
ITEM I: I order and direct my personal representative hereinafter named to pay all my
funeral expenses and costs of administration as soon as may be practicable after my de
ITEM II: I give, devise and bequeath all the rest, residue and remainder of my
whether real, personal or mixed, of whatsoever kind and wheresoever situate, to my
ROBERT L. CAREY, if he sha11 survive me by thirty (30) days.
ITEM III: If my husband, ROBERT L.. CAREY, shall predecease me or fail to survive
me by thirty (30) days, then and in that event I give, devise, and bequeath all the rest, d
remainder of my aforesaid estate to my son, DAVID C. CAREY.
ITEM IV: If my son, DAVID C. CAREY, also shall predecease me, then and ' that
event, I give, devise and bequeath all the rest, residue and remainder of my aforesaid a to as
follows:
(a) One-third (1/3) thereof to THE BACK MOUNTAIN
Da11as, Pennsylvania; and
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(b) One-third (1/3) thereof to THE DALLAS UNITED METHODIST CHURRCH, of
Dallas, Pennsylvania; and
(c) One-third (1/3) thereof to THE FORTY FORT UNITED METHODIST'
CHURCH, of Foriy Fort, Pennsylvania.
ITEM V: All inheritance, estate or other death taxes, and any interest or penalti s
thereon, payable by reason of my death with respect to property or interests forming a of my
estate for purposes of calculating such taxes, and whether passing under my Will or C 'cil, or
otherwise, including jointly-held and other non-testamentary property shall not be appo 'oned,
but shall be paid out of the principal of my residuary estate before its division into s as if
such taxes were administration expenses and without reimbursement from the benefici 'es, at
such times as my personal representative shall deem advisable.
ITEM VI: I hereby nominate, constitute and appoint my husband, ROBERT L. CAREY,
as Executor of this, my Last Will and Testament. In the event that my said husband, R BERT
L. CAREY, shall fail to qualify or cease to act as such Executor, I nominate, constitute d
appoint my son, DAVID C. CAREY, as Executor, of this, my Last Will and Testament. I
direct that my personal representatives shall not. be required to give bond for the fai
performance of their duties in any jurisdiction.:.
IN WITNESS WHEREOF, I, the said DORIS D. CAREY, have to this, my
Will and Testament, contained in this and the preceding one (1) page and preceding on (1) page
signed in the margins thereof for purposes of identification only, set my hand and seal 's
~_ day of two thousand seven (2007).
~~
D.
2
Signed, sealed, published and declared by DORIS D. CAREY, the Testatrix
above-named, as and for her Last Will and Testament, in our presence, who, in her presence, at
her request and in the presence of each other
witnesses this ZG ~ day of
~~~~j~t!a~.. _ residing at
/~ G~ residing at
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