HomeMy WebLinkAbout01-24-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of ~'~.P i'-~fror /~. ~s ~''~P..~ ,Deceased ESTATE NO: 21- 1 1- d~ 1 ~~
a/k/a:
a/k/a:
a/k/a: SS NO• / ?~ - ~ ~ -~ ~ ~ ~~
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE .SECTION `A' or ~B'I AND "C" as
applicable:
,RA. Probate and Grant of Letters Testamentary or pAdmirlistration c.t.a., or d.b.n.c.t.a. (co Otte Part C also)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters ~~,~T_ ~ „~ ~~ Qi' under
the last Will of the above-named Decedent, dated / ,~V/,~// and codlcll(s) dated
S„e~,~,
(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 a ecution of the
insttwnents offered for probate; was not the victim of a killing, was never adjudicated an incapacitatedape r , s'd was oot a
party to a paadio~ divoroe proceeding at the time otdeath wherein grounds for divorce had been est~ iehed as defined in
23 Pa. C.S:A. § 33?3(gk
^ B. Grant of Letters of Administration
applicable, enter d.b.a., pendent life, dnnnte absentia, donate
C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived b 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 d complete list of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a pa to al pendi~divc
prooeediag wherein grounds for divorce bad been established as provided in 23 Pa. C.S.A. § 33 ~c$pt as foAows:
t_~
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THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family r principal residence
At 3 ~ 3' ~ ~ /,cy /~i- . li o /11rtG h.:., °i~Fr .marl' ~f~' / O „~','
(Street address with Post Office and Zip Code, Municipality: Township, l3oroygii, Cify) i,
Decedent, then ~_ years of age, died ~,~, ~ a~ e ~~ at ~~ ~ i- : s 6 ~ ~. ,~~
(Month, Day, Year of death) (City and State where death o`qr )
Estimated value of decedent's property at death:
If domiciled in PA All personal property $ _, ~s''Gd~ oO
_If not domiciled in PA Personal property in Pennsylvania $ !i
_If not domiciled in PA Personal property in County $ _ I_
Value of Real Estate in Pennsylvania $ i ~-
Total Estimated Value $ ~- ~, 0.00
Location of Real Estate in Pennsylvania: (Provide full address if possible.) ~~
Signatare(a)
Name(s) & Mailing Address(es)
.~s ~ i3to
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action lry the Court ', i'aBe i of s
r
OATH OF PERSONAL REPRESENTATIVE
Commonwealth of Pennsylvania ~ SS
County of Cumberland
The Petitioner(s) herein named swear or affirm that the statements in the foregoing Petit}oil are true and
correct to the best of the knowledge and belief of Petitioner(s) and that, as personal repr~sejntative(s) of the
Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before a this Z~~' day of
Zo ~ ~
For the Register .
DECREE OF PROBATE AND GRANT OF LE
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Estate of ~~-~-Y[Gt, /~ , [jrp~l'7 ,Deceased File Number: 21- 2D I 1 I - a r o ~
AND NOW, this ~ day of _ ~ Zo ~ ! , in consideratio df the Petition on
th reverse side hereon, satisfactory proo having b en presented before me, IT IS DEC1~~D that Letters
Testamentary _ of Administration are hereby gra~nt~d to:
// ~/~ (If applk~ble, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
~Sbui (~ 7S QJ/it~Pil _ __ ' in
the above e~#ate and that instf~uments(s) dated _ t / / ~/ I Zo t ~ described 11n th-~ petition, be
admitted to probate and filed of record as the lases ill and Codicil(s) of Decedent.
_ o -~
Register of Wills
FEES:
Letters...... °~
Will ........................ ~S o0
Codicil(s) .................
( )Short Certificates Z~f .
(.~) Renunciations....... -
Bond ............................
Other ............................
Signature of Counsel Required to ~nt~r Appearance
Atty's Signature
PRINTED Name:
Supreme Court ID No.:
Address:
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.50 Phone:
Fax:
TOTAL ................$ ~~~
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court
Page 2 of 2
OATH OF NON-SUBSCRIBING WITNESS(ES~
REGISTER OF WILLS
Estate of
COUNTY, PENNSYLVANIA
~eeti1
''~ .Deceased
L j IV a V ' C - ~ ~ a.~JV 1~ and C~ L°d zo ~. ~, ~-',~'t ,
(each) being duly qualified accJo`rding to law,d~epose(s) and say(s) that she / he /they) was /were well-
acquainted with ~ ~ ~Vl A pT ~ ~ P~/u end am/are familiar
with the handwriting and signature of the decedent, and that the signature of ~ ~ r~Ca ~ . ~2C' `° l/~
'n
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~,,~'(~(1 ~ . C1~~~
is in his/her own proper handwriting. j
/'t -
(Si nature)
~ 151 ~ - -rr; ~~ ~ reel .
(Street Address)
yy~~(~ct,~~~,sbv rq .~~ ~ ~ os~
(City, State, Zip)
Executed itn Register's Offcce
Sworn to ar affirtned and subscribed
before methis Z . ~ day
of ! ~-s~-.~~ 2 0 ~ t
eputy for Register of Wills
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Forra RW-04 rev. 10.13.06
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LOCAL REGISTRAR'S CERTIFICATION OF DE~-TH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17046998
Certification Number
qr ~ Moat COIIIIIONINBAL7H OF PENNSYLVANIA • DEPARTIAENT OF FIEIILTN • VITAL RECORDS
u'r"ac ~ CERTIFICATE OF DEATH
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This is to certif~ t at the information here given is
correctay copiedlfr man original Certificate of Death
duly filed with ~nel as Local Registrar. The original
certificate will I, bei forwarded to the State Vital
Records Office or permanent filing.
GG~ ~ JAN 2 2 11
~~
Local :Registrar I~ I Date Issued
~~ U54L3/1
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Will and Testameht of Bertha Alverta Greer
I, Berths Alverta Green, of Mechanicsburg, Pennsylvania, Cum 1 d County,
declare this to be my Will, and by signing it, invalidate any and all previou. R~i11s and
codicils.
Article 1. Identification of Family Members. '~I
1.1 My immediate family consists of my children Richard Eugene Gre~I ~obert
Allen Cmeen, Sherry Ann Romberger, and George William Green III. !I
1.2 Any provision made for my children and their descendants in this illy shall
inchde in addition to any children named above, any children born to me o dpted by
me after this Will is signed, and any such child is to inherit in proportion ~y other
children. Any child alive at the time that this Will is signed who is not spec fi y
granted gifts or rights has been intentionally omitted. ~ .~-
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Article 2. Appointnnelnt of Ezecntor. '~'
C!~ ~ ~"
2.1 I appoint Sherry Ann Romberger as the executor of my estate. If at -_ n,
Sherry Ann Romberger is unable or unwilling to fulfill the obligations as a ,`3
appoint George William Green III to act as executor in place of Sherry Ann er.r'•'
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2.2 I direct that no bond or security be required of my executor for any se, and
that my executor shall have unrestricted nonintervention powers to settle m e e in the
manner set forth in this Will. i,
2.3 In carrying out the provisions of this Will and administering my a ihy
executor shall have full power, authority, and discretion to do all that may
necessary or desirable to my executor in administering my estate, includin; 'gout
limitation the authority to make interim distributions of principal to those afire to
receive the principal of my estate, and distribute any or all of the income of assets of
my estate to or for the use of the beneficiaries of my estate in accordance th their
respective interests; provided that nothing contained in this clause shall req ' #ny
executor to make any such distributions of principal or income.
Article 3. Taws.
3.1 My personal representative shall pay from the residue of my estate 1 per
obligations of my estate, including any estate, inheritance, or other taxes ( d or
penalties on such taxes), expenses of my last illness and funeral, costs of stration,
and other proper charges and enforceable claims against my estate. Paymen be
charged to estate income or principal in the discretion of my personal 've to
the extent no deduction otherwise allowable is reduced thereby.
Article 4. Distribgtioe of Est:te.
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Page 1 of 4
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4.1 The following shall apply to the beneficiary provisions of this Will:
4.1.1 The survivorship period shall be 30 days. In order to inherit, an indi 'dual or
organization must be alive or in existence on the 30th day after my death.
beneficiary, except the alternate residuary beneficiary, must survive me to ' ~rit under
this Will. ~,I
4.1.2 Any property left in this Will shall pass subject to any encumbrance q'r liens on
the property. ',
~'
4.2 Speeific Gifts.
4.2.1 I leave my diamond brooch and mother's ring to my daughter, Sh
Romberger. Should Sherry Ann Romberger fail to survive me, nothing steal p~Ss under
this section. '~
4.3 Residuary Estate.
I leave my residuary estate, that is, the rest of my property not oth
specifically and validly disposed of by this will or in any other manner, incl lapsed
or failed gifts, in the following manner:
4.3.1 I give the residue of my estate to my children in equal shares.
4.3.2 Should any of my children fail to survive me by 30 days, then the cl~k~n of my
predeceased child shall receive equal shares of my predeceased child's spar . ''
Article 5. No-Contest Provision.
If any beneficiary under this Will contests or attacks this Will or an o fits
provisions in any legal manner, any property, share or interest in my estate a ~o the
contesting beneficiary under this Will is revoked and shall be disposed of 'that
contesting beneficiary had predeceased me without children.
,~ Artiele 6. Donating of Organs at Death. il~~ ''
6.1
Article 7. Funeral Wishes. I' ~'',
7.1 Upon my death, I wish to be buried. In addition, upon my death, I diet ;that I be
buried in Churchville Cemetery, 51 S. Harrisburg Street, Steelton, PA 1711 ~Ibts have
already been purchased.
Article 8. Witness Affidavit.
Page 2 of 4
I request that the attesting witnesses to my Will make an affidavit b$folxe a notary
public stating such facts as they would be required to testify to a Court in o~ddr to prove
such Will.
~'`
In witness whereof, I have subscribed by name this I day 20~
Bertha Arta Gteen
Page 3 of 4
...
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Attestation Cla>~e and Affidavit of Witnesses
State of Pennsylvania
County of~~n~ier~o~-- ~.t1~-
Each of the undersigned being first duly sworn, states that on this day
20~:
1. I am of legal age and competent to be a witness to the Will of Berth
Green, the Testator.
2. The Testator, in my presence, and in the presence of the other witne
signatures appear below;
a. Declared the foregoing instrument to be his Will;
b. Requested me and the other witnesses to act as witnesses to his Wil]
this affidavit, and;
c. Signed such instrument.
3. I believe the Testator to be of sound mind, and that in so declaring a
was not acting under any duress, menace, fraud, or undue influence.
4. The other witnesses and I, in the presence of the Testator and each o
affix our signatures as witnesses to the Will and make this affidavit.
First witness: fi~ ~~ Q v
Print name: •~+,ob6~,k
Address: /// ~ ~ ~. /y/
Second witness. c.,~~
Print name: .Fs~^I-~.Lr N S 4 ~ r
Address: l 1 l S. ~. a rr; s5 ~° f} 1~ r o
Third witness•
Print name: ~aff~,~,, /y ~ ;~g/
Address: /1% JTF-rvrlf ,/' , /~/~ /7 / 0/
Given under my hand and offici this ~ day 2
Signature: 1
Pri>~
Notaty public
My commission expires: t l
whose
to make
signing he
now
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COMMONWEALTH OF PENNSYLVANIA
Nohrial Seal
Vk;kl Y. Patoeiper, Notary PuWiC ~~
Cily o1 Harrhbay, Dauphin County
Page 4 of 4 ~~~ t:xvkes Nor. s, so~2 !,
nsylvanie AawdaNon or Notaries '
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