HomeMy WebLinkAbout02-10-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate Of ,/~`~ ~. rig ~' ~~,r/~/t rJ ,Deceased ESTATE NO: 21-
a/k/a:
a/k/a:
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or ~B' AND "C" as
applicable:
^A. Probate aad Grant of Letters Testamentary or ^Administration c.t.a., or d.b.n.c.t.a. (complete Part Calso)
and aver that Petitioner(s) is/are entitled to the aforement'oned Letters T o5 ~~ i., fa~•,/ under
the last Wili of the above-named Decedent, dated / O and codicil(s)) date
(State relevant circumstances, e.g. renunciation, death ofexecutor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the
instruments offend for probate; was not the victim of a killing, was never adjudicated an incapacitated p aad was a
party to a pending divorce proceeding at the time of death wherein grounds for divorce bad been eat as deed it
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23 Pa. C.S.A. ~ 3323(8):
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^ B. Grant of Letters of Admiaistration r"~ ~ ~ e j
(If applicable, enter d.b.a., pendent lire, dunnte absentia, donate ~ ~.
C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived ~ ti ;'
ri
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 completerst of ~;,-
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; snd was not a party to a pendiq~dive
proceeding wherein grounds for divorce bad been established as provided in 23 Pa. C.S.A. § 3323(8), except as follows:
Aaarlsa
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Ctunberland County, Pennsylvania, with his/her last family or principal residence
At~Q_y ~---2 ~¢ 5~ J p~~ ~s. ~ tea. /7oY_~
(Street address with Post Office and Zip Code, MuniL'ipality: Township, Borough, C ity) /
Decedent, then ~~ years of age, died at /~tc ~ Li ~sl~ ~G' r
(Mon , Icy, ear of deah) City and State where death occurred)
Estimated value of decedent's properly at death:
_If domiciled in PA All personal property S 7 O 4
If not domiciled in PA Personal property in Pennsylvania S
_If not domiciled in PA Personal property in County S
_Value of Real Estate in Pennsylvania $
rrT~~otal Estimated Value $ O
Location of Real Estate in Pennsylvania: (Provide full address if possible.) N ~/~.
Signature(s) ~ Name(s) & Mailing Address(es)
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u,m~un corm nw-vt revrsea r~.~o. r~ oy ~umocnana ~ounry penamg aCtwn oy [ne ~~ourt Page 1 oft
RF_CO~D~>n ~~~
RE~I~r~ ~;iw_ y~~~ ~
Oath of Personal Representative
COMMONWEA TH OF PENNSYLVANIA ~Q~~ FEB ~ Q PFi t~: 3b
SS
COUNTY OF QR ~,~~~QQ'F~
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition ar~~~#~~~1~i~est of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will we a
administer the estate according to law.
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Estate of_S ,Y I I~ I LCD L • ~~/L~JWC,I l~-
Social Security Number: ~~ I ' S ~i ' ~' D ~ Date
AND NOW, ~ , in consi
having been presented b~~re,,me/, S D/E~CREED that Letters
are hereby granted to ~I ILU ~~ l __, Q I~)~S
Deceased
ac~ti
of the foregoing Petition, satisfactory proof
and that the instrument(s) dated ~Q,
described in the Petition be admitted to probate dnd filed of
FEES ~n
Letters ............... $ ~i"~ W
Short Certificate(s) ........ $
Renunciation() ... ...... $
~~ ... $
.. $___
.. $ f _~
.. $
.. $
.. $
.. $
.. $
... $
TOTAL .............. $ r
.~.aomey ~~gnature:
Atto~aey Name:
Supreme Court I.D. No.:
Address:
Telephone:
in the above estate
Fa~rn RW-02 rev. l 0.13.06 Page 2 of 2
a
File I~Iumber: cal ~__" "_ ~ ~ 1 I
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~ Fee for this certificate, $6.00
I P 17047481
Certification Number
Il- I'~'~
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
Cl~n~ ~~e.~r~•Q~ FEES ~ 9 ?~ti11
Local Registrar Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(see Inetruations and sxemplss on roverae)
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CHARLES C. OWENS ~ ~
~.
I, CHARLES C. OWENS, of the Borough of Lemoyne, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this my Last Will and
Testament, hereby revoking and making void any and all prior Wills by me at any
time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after
my decease as the same can conveniently be done. I direct that I be cremated and
interred at Indiantown Gap National Cemetery.
2.
I direct that there shall be paid out of my residuary estate all estate,
inheritance and like taxes together with any interest or penalty thereon imposed by
the Government of the United States, or any state or territory thereof, or by any
foreign government or political subdivision thereof, in respect to all property
required to be included in my gross estate for estate, inheritance or like tax purposes
by any of such governments, whether the property passes under this will or
otherwise.
3.
All the rest residue and remainder of my estate real, personal and mixed, of
whatsoever nature and wheresoever the same may be situate, I give and bequeath in equal
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shares to my two children, LARRY C. OWENS and LISA K. BORTNER, absolutely
and in fee simple.
Lastly, I nominate, constitute and appoint my son, LARRY C. OWENS to
be Executor of this my Last Will and Testament. I further direct that no bond or
other security be required of my personal representatives to guarantee faithful
performance of his duties.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~'~~
day of January, 2008.
_~-~~. o ~ SEAL)
ar es wens
-2-
COMMONWEALTH OF PENNSYLVANIA )
:SS
COUNTY OF CUMBERLAND )
I, CHARLES C. OWENS, 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 same instrument as my Last
Will and Testament; that I signed it willingly, and that I signed it as my free and
voluntary act and deed, for the purposes therei ~ ressed.
SEAL)
ar es ens
Sworn and subscribed to before
me this ~5~ day of January, 2008.
. `~
otary u is
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~~
My conM„MNon gcp~ Jun 27.5011
COMMONWEALTH OF PENNSYLVANIA )
SS
COUNTY OF CUMBERLAND )
We, the undersigned, J. Robert Stauffer and John M. Eakin, the witnesses
whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw the
testator, CHARLES C. OWENS, sign and execute the instrument as his Last Will
and Testament; that the said testator executed it as his free and voluntary act for the
purposes 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 the time, eighteen (18) or more years of age, of sound mind, and under no
constraint, duress or undue influence.
Sworn and subscribed to before
me this /S>h day of January, 2008.
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MM ConNnwlon Jun !7, 1011