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HomeMy WebLinkAbout02-14-11IN THE COURT OF COMMON PLEAS OF CUOM~ERLS ND COUNTY, PENNSYLVANIA REGISTER PETITION FOR PROBATE AND GRANT OF LETTERS ' Deceased ESTATE NO: 21- i ~ ~ ~ °~ Estate of Rita H. Burtner a/k/a: a/k/a: 55 NO: 176-10-7187 a/k/a: Petitioner(s) who is/are l8 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: A. Probate and Grant of Letters Testamentary or ~ Administration c.t.a.,F Sfils~~~ ~ ere Part C ~nder and aver that Petitioner(s) is/are entitled to the aforementioned L~t~/O ~d codicil(s) dated ~ the last Will of the above-named Decedent, dated 23 Su,/~T'" (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 instruments offered for probate; was nt tai the t me of death wherein grounds for divorce had (been established as defio din party to a pending divorce proceed g 23 Pa. C.S.A. § 3323(g): ^ B. Grant of Letters of Administration (If applicable, enter d.b.n., pendent life, durante absentia, dursnte minoritate) C. Petitioner(s), after a propde he arc If Admire stration c t a. or d b nCCt a t e er dal llo Will in Se lion A and complete list of following spouse (if any) an ( d' divorce heirs); was not the vilim of a folr divorce hadrbeen e t bl hed as provided in 23 Pa. C.S.A. § 33230 e~xcept~as lows: proceeding wherein grounds C -n ~ ~ L • I~iIMr~P~~ "T"i ~~ . ~-~ THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 66 Rollin Dr. Carlisle PA 17013 p ty. (Street address with Post Office and Zip Code, Munici ali Township, Borough, City) Cdrl ISIe, PA 96 ears of a e, died 1/6/2011 at Decedent, then Y g (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: ~ If domiciled in PA All personal property ~ If not domiciled in PA Personal property in Pennsylvania $ _ Personal properly in County ~ If not domiciled in PA gt007 ~s Value of Real Estate in Pennsylvania Total Estimated Value S _-~ 66 Rollin Drive Carlisle, PA 17013 9 Location of Real Estate in Pennsylvania: (Provide full address if possible J Name(s) & Mailing Address(es) ;:~' Signature(s) ea~-9 i ~ ~ 9 Ut,tiV ~~ ~ Gt= o G~ e., fro/l ~ ~ ~S~'~+Iv'EGL Yit,GE 3C3o erim Fortn RW-02 revised t2.26.10 by Cumberland County pending action by the Court 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 Petition are true and correct to the best of the knowledge and belief of Peti the estate according toelaw.al representative(s) of the Decedent, Petitioner(s) will well and truly administer Sworn to or affirmed and subscribed this _~ of ~ ~~ q~~ Gcarz ~E ,~- ~ ~' ~' ~ ~ ~, G~r~ For the Register ;~ z „ ~ r - crn ~ z'_ } DECREE OF PROBATE AND GRANT OF LETTERS ~ ~ ••=-YM1 ~' ~ ~ ~_ r~ N~ T~L~ Q ,Deceased File Number: 21- _ ~~ ~ ~n Estate of ~rfi9• /~ ~~ of rl,~.~ ~ ~~ , in consideration of the Petition on AND NOW, this day the reverse side hereon, satisfactory proof having been sented before m are hereby granted ohat Letters X Testamentary .____ of Administration (If applicable, enter c.t.a., d.b.n., d.b.ac.t.a., etc.) in G~r~~cGd e • ° ~~ '~ ~ 20/G described in the petition be the above estate and that instruments(s) dated Z3 ro~-- r admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbau ~ Register of Wills FEES: Letters. Will.... Codicil(s) .............. . ('~j Short Certificates .~. ( )Renunciations....... Bond .........................:.. Other ............................ Automation FEE......... 5.00 JCS FEE...... 23. 0 TOTAL ............... ,,...~~ -5r~}~ -- Signature of Counsel Required to Enter Appearance Atty's Signature PRINTED Name: G/• 'S• '~~~/~!'f Supreme Court ID No.: Z'~-} 3S Address: ~ ~' h4~~~~s~• ~ Phone: ~'~ ~'- ~'~ ~$~f .Fax: '~ ~ 3 / Page 2 of 2 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court 105.905 REV.(1/ll) 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. Marina O'Reilly Matthew Acting State Registrar JAN 21 2011 5965273 No. Date LTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VRAL RECORDS v COMMON +3+ H,r WEA CERTIFICATE OF DEATH ER ~ ~ (Sss Instructbns end sxemplM on rovers) STATE FILE NUMB DaM d DeaOi (Moon, er. f~) 4 /'~ BIACK RNC . 2. San 9. Sodr Sea•ey HmbQ - 1 6 2011 V( ,. Hr•e a Uaoae•e 1~• ^+~•, ra. «n.) F e. Ple« a o«m ci•rx «~ Rita H • Burtner u„«r 1 0. oar d akn b. An• Na! BIMd•rl Uldr ~ HM MiMr ? ,,,e.ua. ar HrpiMl: ^ COA alMa ^ EFi / ^ I ~ ^ HuakS Ha« I~ fiaaiaerc• ^ oew - SPadh: eb wme • erd Ilu•M ~+ np 1 1/ 0 6/ 1914 a r n e s t o w n P e. w« ~ d ~b ory1ii7 ^ Y« , , n ,o. wr: Ae•ecr i•a I 9 6 Yrs. ea. Fadny ~• In na;rfiuem, yn wer and numW) (n ysa, ev.dr ~•• Wlllte ee. ca.ay a orn, x. on. mA. Twp. d own rlisle B o r o C Rollin Dr1ve 66 g M•enrk PaeM Wrn, rc:) ~ ~. MueW, Hw•r Maaed. ,a , u. surdAnp soa r. m •na, dr+ ~n rm.) Ctunberland a Donolalw . Ya 3z. w« oerarA •rr b ab , a~cram ,3. o.mmd'. 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UJ ~.~ t-~~.+ ... \~R iti.Jy ~~. ` J W ~ ..... a`I lliia' W ~'~~~ ~' ~ ~~ o ~~, ~,--, ~~ ~-; ~ • ~¢ F ~ ~ ff7 ~ { _ ~~ C7 D -T1 _' ~ ~ --~ ~ .. cn v ~' I, RITA H. BURTNER, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. I. I devise and bequeath all of my real property wherever situate together with all furnishings and household effects therein, and including all insurance thereon, to my husband, RAYMOND H. BURTNER, providing that he shall survive me by thirty days. Should my said husband predecease me or fail to survive me by thirty days, I devise and bequeath all of my said real property with furnishings, household effects and insurance thereon to my step-daughter, ANN B. TRAVIS, or her issue per stirpes living on the thirty-first day following my death. II. I give and bequeath all the rest residue and remainder of my estate of whatever nature and wherever situate in equal shares to such of my three adult children, GEORGE C. HOLLAND, GEORGANN BEATTY, and SANDRA ORLANDO, as survive me by thirty days. III. Should any of my said children predecease me or die on or before the thirtieth da~ ollowin m death, leaving issue, I direct that the share of said deceased child f g Y shall be distributed to his or her issue per stirpes living on the thirty-first day following my death; and failing issue, that said share of such deceased child be distributed in equal shares to his or her surviving siblings or their issue per stirpes living on the thirty-first day following my death. IV. 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.. V. I appoint my son, GEORGE C. HOLLAND, executor of this my last will. VI. I direct that my executor shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this~~ day of September 2010 (SEAL) A H. B TNER The preceding instrument, consisting of this and one other typewritten page identified by the signature of the testatrix, Rita H. Burtner, was on the day and date thereof signed, published and declared by Rita H. Burtner, the testatrix therein named, as and for her last will, in the presence of us, who, at her request, in her presence, and in the prese ce of each other ha e subscribed our names as witnesses hereto. ~~ ~~ ~ ~ ' ~ --~-- CaC,.. r- r-.7 e~'s ~ . _ .Y t ~ OF SUBSCRIBING WITNESS(ES) ~-'7-1-r n ~~~ C17 ~ 1 ( OATH ` -- :tip ~.~ ~ "[1 F "'7 ~ _'~t -- REGISTER OF WILLS C7 G ~ ~J ~ ~: ~ -~ `=~ , PENNSyL,VANIA d COUNTY ~--+ w ~ :n , Cumberlan ,Deceased Estate of ~~ H• gunner / , s ' ~ ~+ , (each) a subscribing witness to !N (print Nmne/s) d OSe S and the ~ Will ®COdicil(s) presented herewith, (each) being duly qualified according to law, ep ( ) he the /were present and saw the above Testator Testatrix sign the same say(s) that she ~ Y sh '/ he /they signed the same and that she / he /they signed as a witness at the request of and that the Testator Testator in er his presence and in the presence of each other. ~~ (Signature) ~jr/ , S. %'Y /` G~ (Signature) (Street Address) (City, State, Zip) ~, t ~/~- / ~-G! F.!/-IG.%i ~ w i (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ ~ day of ' ~ ~• ~ ~, Deputy for Register o'f W is Executed out of Register's Office Sworn to or affirmed and subscribed before me this day of Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified o mission.) administer oaths. Show date of expiration of Notary' NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. 10.13.06 OATH OF NON-SUBSCRIBING WITNESS(ES) CUMBERLAND Deceased Estate of ~~ H• Burtner 5 N ~ /S' A /~ ~~ L ~ ~ ~ ~ and lifted according to law, depose(s) and say(s) that sh a he /they was were well- (each) being duly qua and are familiar acquainted with ~~ H• Buttner Rita H. Buttner with the handwriting and signature of the decedent, and that the signature o of to the foregoing instrument purporting to be the Last Will and Testament/ handwriting. Rita H. Burtner {Signature) ~ $ Sri ? I / L ~ 3~ ~ ~~ (StreetA ess) ~°~N A~ Cn ~ ~~ ~S° 4 (Crty, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ day ~ ~ . of ' L.f-~ v Deputy for Register of W is COUNTY, PENNSn'VANIA REGISTER OF WILLS is in his/her own proper (Signature) (Street Address) (City, State, Zip) ra ,:-.~ ~ ~, m .~, -o r~ ~ C'~ r-4-, cx3 ~ ~ <7 c Y „-v r~ .~ -a ~ `" b w Form RW-04 rev. 10.13.06