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HomeMy WebLinkAbout08-16-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of ANNA E. LANDIS also known as Deceased named in the Petitioner(s), who is/aze 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 / aze the last Will of the Decedent dated May 31, 2006 and codicil(s) dated N/A THE EXECUTOR NAMED IN THE SAID WILL DIED JULY 30.2010 AND PETITIONER IS SAID DECEDENT'S EXECUTRIX (State relevant circumstances, e.g., renunciation, death of executor, etc.J 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 C.T.A. (If applicable, enter.• c.t.a.; d. b.n.c.t.a.; pendente liter durante absentia; durante minoritate) Petitioner(s) after a proper seazch has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) I Name Relationship Residence ~ rya ,~- ca - .. b ~ ~- (COMPLETE INALL CASES.) Attach additional sheets ijnecessary. ~ ~ ~? L , Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residerc~ t ~ 700 WALNUT BOTTOM ROAD CARLISLE BOROUGH PA 17013 -~- - , (List street address, tawn/city, township, county, state, zip code) ~ ___ "~~ ~ _ ' Decedent, then 75 years of age, died on JUNE 3, 2010 at 700 WALNUT BOTTOM ROAI1~-fcRLISI,E BORO. : ,~~ ~ ~ CUMBERLAND COUNTY PA 17013 '~- 'y? Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 20,000.00 (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 appropriate form to the undersigned: SHARON L. BROWNEWELL COUNTY, PENNSYLVANIA File Number ,rj) ~ I (.1 J ~ p "( (~ Social Security Number 171-28-0341 name and 104 f ~ ~ C ~ ~ 6 ~ ~L.-I S [ ~ -r~~- I "7D l ~ Form RW-02 rev. 10.13.06 Page 1 of 2 ~`,~, `~'~, 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. r Sworn to or affirmed and subscribed ~ ~ Signature of Personal Representative before me the day of ~ ~ ~^ e `~ _ r ~GID Signature of Personal Representative ° _~ r - - - , ~--- ' -- m ~~ _~ ~ _.J F r t e Register Signature of Personal Representative ,, ; ,_~ ` 1 ~qy .r?__~ ~~ Fil N b //^^~~ ~~ _ ~ V , ~~~ a e um er: Estate of ANNA E. LANDIS Deceased SocialSencurity Number: 171-28-0341 Date of Death: JUNE 6, 2010 AND NOW, lX~ ~ , ~_, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT I ECREED that Letters OF ADMINISTRATION, CTA are hereby granted to SHARON L. BROWNEWELL and that the instrument(s) dated MAY 31, 2006 described in the Petition be admitted to probate and filed of FEES Letters ............... $ Short Certificate(s) ........ $ Renunciation(s) ...... /~1.~ ... $ ... $ ~- ... $ ... $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ 9:~6• Supreme Court I.D. No.: 83993 in the above estate Address: 10 W. HIGH ST CARLISLE, PA 17013 Telephone: (717) 243-5513 Form RW-02 rev. /0.13.06 Page 2 of 2 Attorney Name: THOMAS E. FLOWER 105905 REV.(3/09) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. ~. ~~ Linda A. Caniglia State Registrar ~636~~~ ~~ No. N10S143 REV 11Y20W TYPE /PRINT IN PERMANENT BUCK INK 5 'V JUN 21 2010 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructlona and examolea on reversal Date 7. Name of Decadent (First, rtkdtlle, last, suffix) 2. Sex 3. Sodel Sealrily Number V,•, 4. Dale of Deem (MOnm, day, year) Anna E' Landis F 171 - 28 - 03 1 5. Age (Wd &Nday) Under 1 Untler 1 6. Deb m Bitlh Mmm 4a , e 7. Bin tau Ci antl state «fpe n fie, %au of Drem Check m ue Mwahs Dap Han MnNea Hospital: Other' 75 vrfi. 1 31 1935 Lo sville PA ^ mpaaenl ^ ER / oulpetbm ^ DOA Nursng Roma ^ Resroence ^ Olfwr - Spaclly: 90. Crony d Deem Bc. GN• Boro, TwP. d Duth Wtl. Family Name (n n« nedWim, give street ant number) 9. Wes Decedent of Hispanic Origin? ®No ^ Yes 70. Rau: American Indan, &eck, While, etc, Cumberland Carlisle Boro. Forest Park Health Center (M PBC p C b ( a un irerto R xan, ek.) White 71. DecetleM's Usual Oau BWen Kkd of work dpre tlud mcet of life. Do not state ranted 12. Was Decetlent ever'n the 13. DecetlanYS Etlucatlon (Speciy only highest grade wmpleled) 14. Meribl SbWS' Memeq Never MnrtieQ I6. Surviving Spouse (II wife, give meidm name) ' NiM d W«k Klnd m Busiress I Irx/ustry Food Pre Off i ' Cl naced /SpeciyyJ U.S. Amietl Forces? Elamenb / Secede 0-12 Coble WboweQ D N ( ) ~ (" °r B,) ~ oer s ub P• _ ^ yea Fl No 1 Widowed • 78. Deretlenl'9 MaiWng Adtlress (Street, city / rown, stele, zip wtle) Decetlent's Ditl DBpedem 131 Stra er Dr. AcfaM Reaiae«s 17a. Slate PA Lrve Ina , 7c. ^Ves, Decedent Lived In T Carlisle, PA 17013 ,7bcnany Cumberland na.~Np.Decedentuvadwimin Carlisle Actual limits of Crcy I Born 16. Famer's Name (First, mitlrle, lad, 5ulfiz) 19. Mom•r's Neme (First mitltlb, maiden surname) Mitchell E. Seidel g 20a. InbrmaM's Name (Type /Print) 200. IMOnnant's Maifirg gtltlress (Street, city /town, state, zip mtle) Charles M. Gehr 131 Stra er Drive, Carlisle, PA 17013 2ta. Method m Disposition ^ Crammim ^ Donation 21 b. Det• d DopnNm (MOnlh, tley, Year) 21c. Plan of Dsposition (Name m pmebry, crematory or other place) 2/tl. Locedon (Clry/ tovm slate zip rotle) ~BUnal ^ Ramavel hem slab ~w.a cr«nnm «DOntlion AUmorhM r ^ ^ ^ 6/8/2010 , , yy MMkN Enninx/Caronar! Omer- Ves No • rland Valle Mlanorial Garden r PA 22a lure of F I ce Licensee (« pe g a 22b. Licerae Nunber 22c. Name antl Atldress o1 Facility FD L Camp e s 23a-c uty when rediyng Pnyddan a nm aaailabb M tma a mom d 23a. 7o me bed of my knotM occunetl at me Ikne, date ant place stated (Signatue and tale) 23b. license Number 23c. Dale Sigred (Manm, tby, year) remly re•ae a deem. ~(,1~~, ice/ 2 ~l 3S"s ~G ~ L 3 a o~ a Hems 2626 must be completetl by person 24. Tim• of Deam Dab %onourcetl Dead (MOnm, tlay, year) 2fi. Was Case Refaned to Medical Examiner / Cororrer br aeson Other man Crematlor~ « Donetiu7 who Prmaunces tlaeM. S4 P NW. 3 a o ~ d ~ ^ Yes 1=I No CAUSE OF DEATH (SN inatruHlo antl Bxampba r Approxlmab interval: Ibm ZI. Part I: Enbr me chain m events - diereses, injuries, or complications ~ tltat tliredly reused me deem. W NOT solar terminal events such as cerdac arrest, Orreet to Deem Part II'. Enbr «ber em f I cnndtxe wntributiz t tl M bM ref resulting in the undarying cause given in Pen I. 26. Ditl Tobaew Usa DoMddne to Death? ^ yes ^ Pr bl b respiradry erred, or venlricubr librdbdon whtwul showing dre etiology. Ud only one cause on each Ina. y~ II YYEWA A a y o a ^ No ~Unkn«m condrca rewXUi9 I n Oeath) '(~~t,~~~W~ 29.MFemale ~ a. . C'~~ Duero (or as quence of): Se uentieYyy Ikt condkorte, d arty, b. ' °,1--+'~••-t /~.-~jG...•.~ ~(t~ IenGd~q tome cause liektl u kb e PregnaM whin past year ^ Pregnant at time of tleam . Enter the UNDERLVWG CAUSE Due to (or as a corisequenu olj: i ^ Not pregunt but Pregnant wimin 12 tlays (dkeeee « injury mat nreatea the a Brame rewnirg m deaml cast. of loam ^ Duero (or es a consequence of/: Nat am, but Me9n Pregnant 0.7 tlays to 1 year tl. before death ^ unlmoxm it waereM wanin ma past year 30e. Was an Autopsy P n d? 306. W«e Auopsy Findings 31. Menn« W Death ~ 328. Date at Injury (MOrah, day, year) 32b. Describe How Injury Occurred 32c. %ere of Irqury' Home, Faun, Street, Factory, e omw pvaiebb P0« t0 Completlan I-y~ rel ^ Homicide Office Buiklig, ek. (SDecr'!yJ m Cauca m Daath7 '-+ ^""' ~-y~ ^ Yes LJ NoJ ^ Yss LJ No ^ dent ^ PeMmg Irwesngatim mod. Time of Injury 32e. Injuy et Work? 321. n Transportation In1uN (SPea/Y/ 32¢ LoceWOn of injury (Street dly / Iown, state) ^ Sukvde ^ Coultl Not be Detertnirkttl ^ Vas ^ Nc ^ Or'rver/Operator ^ Pasurrger ^ Petlesirian M' ^Omer-Sperity' 33e. Cend'~er (check anFy «rel b 33b. Sigrebre antl Title r • CMnying PWrYalolan (Plryskian candying cause of deem when another physklan has Dronounced tleam and canplebtl Item 23) ~ ` To IM baN«my knowlatlpa, death oecumatltlw total UUaa(a)sntl mannrualHatl_________________________________ ~ ~ - r'-'~ • PsorrounNng and artlrying phyaklan (Phydtlen 6otl'r pranwncing dnm and cenlM1ying ro ceuae of Beam) 33c. Ucnnse Number 33tl. Dab Signed (MOnm, tley, Year) Toth WalMmy knoWNtlga, daHh aacumed stlW lime,data, acrd plan, and duarolM auae(•)and mAmter as autM__________________^ • Mtlkal EaamMr/C««1er ' ~ S ~ ~ ~ f ~ V ~ 7 / !J On iW Web «aabrlhMdon antl / or InwstlgNim, m my opmlu, tleHh oeumatl tl lW IkM, tlab, and plea, a«I «la b lW cause(s) antl marmx ss stebd_ ^ 3a. Name antl A af Person Who C~v d Cauca of Deem (ham 27) Type / PrIM tla~psa ~ ~ ~ ~ 3§, 'are Signa~tureyand~ ~ ~ Nup~rOg/~~ ~L~ ~ h~ / ]~ ~ rJ~1 / ~ °~.~ / ~ l3 ~ f ~6~ pa r' to Filed (MOnm, tlay. Ynr) , ~ J /7' G ~~ f r / pl G 5 . LG.+~-av.^ / r w Z.C DlsposiWan Pertnrc No. ~` ~" l ~y ~ `~~ .J n b r 0 --~ p A ) -? -tJ ,, ~_ ~ . c ~ :.::'~~ - f) v1 f ~~ ~ __ ~ -~r-~ ~~ _ `( `~ J W _ ` o , ~-, cx, ~ , '~.a~~t ~iYY ac~cb ?~e~ta~nYe~t of ~~~~ ~. ~.ac~~i~ I, Anna E. Landis, of 523 S. West St., Apt B, Carlisle, Pennsylvania, being of sound mind, memory and understanding, do hereby publish and declare this to be my Last Will and Testament, hereby revoking and declaring null and void any and all wills and Codicils heretofore written by me. ITEM ONE: I direct that all my just debts and funeral expenses, including the reasonable cost of a grave marker, shall be paid from my estate, as soon as practicable after my decease, as part of the expense of the administration of my estate. ITEM TWO: I order and direct my hereinafter named Executor to pay all estate and inheritance taxes levied against my estate prior to distribution. ITEM THREE: I give, devise, and bequeath all the rest, residue, and remainder of my estate wheresoever situate to Charles Gehr, of 131 Strayer Drive, Carlisle, Pennsylvania, 17013. ITEM FOUR: I nominate, constitute, and appoint Charles Gehr, of Carlisle, Pennsylvania, as Executor of this, my Last Will and Testament. My Executor shall not be required to post bond other than his personal assurance for his duties as Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last Will and Testament, consisting of one (1) typewritten page, this ~ day of in the year of our Lord two-thousand and six (2006). SIGNED: ~~~'yur~• ~ . ~ G~wd'"'~ ANNA E. LANDIS, Testator ~., C7 c =" ~.7 2~ :}--~ 4~ __l_e ;" ;vr ~ CT _. _ . ~ ~ - . .. .,`~ ~ ~ ~ ~ ~) --1--~ __ / - .y~. .x. ~1 ~© J C=~ ~ 'r. ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BOROUGH OF CARLISLE I, ANNA E. LANDIS, the 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. SIGNED: ~ ~~ ~, - ANNA E. LANDIS, Testator On this, the ~I day of ~ 06, before me, a Notary Public, the undersigned officer, personally appeared A E. LANDIS, Testator, known or proven to me to be the person whose name is subscribed to the within Last Will and Testament, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. C EALTH OF PENNSYLVANIA Notarial Seal Jane Adams, Notary Public Carlisle Boro, Cum d My Commission Expires Sept 6, AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF BOROUGH OF CARLISLE The foregoing will, consisting of ~ typewritten page(s), was, on the ~~ day of ~ , 200, signed, sealed, published and declared by the said tes~tor as and for his/her~st Will and Testament, and it is hereby acknowledged that said testatrix appeared to be of lawful age and sound mind and memory and there was no evidence of undue influence. We, at her request and in her presence, have hereunto subscribed our names as attestin>? witnesses: Witness Address ~~ On this, the ~ day of (~~ , 20Q~, before me, a Notary Public, the undersigned officer, personally aph~ed ~"I}~ S . t~Jl -.~ ~- ,known or proven to me to be the person whose name is subscribed to the within Last Will and Testament, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set m~hand and official 5 AL) Notarial Seal Jane Adams, Notary Public Carlisle Bom, Cumberland County lyl fission Expires apt. 6, 2008 of ~ , r tness Address On this, the ~,~ day of , 20~ ,before me, a Notary Public, the undersigned officer, personally appear 5 1.1~ ~6~ ,known or proven to me to be the person whose name is subscribed tot e within Last Will and Testament, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set r}~y hand and ARY PUBLIC L) Notarial Sergi; Jane Adams, Notar;v r'unlid Carlisle Boro, Cates."•:~r,and ~~utf}~,yy My Commissian ~~ ~?ires Sept: 6, 2008