HomeMy WebLinkAbout03-24-11~'1~:TI~IIO~ FOR PR~B~=~T~ ~,~D GR~,~T Off' L~T~.~;1~'.`~
^~=~1 ~T~R OF ~wILL~ OF ~~~~`~~"~~'^~~'~ CUB ~~TZ~, PF~~~+Si"L'~,"_~:~~r_`~
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Estate of ___L~~ _iyj dn/ ~ ~j/ ~Gl ~/~~2- File `lumber ~ '~ -_ #- -_- ----- -----
also kno~cn as _ _ q~
------- ---- ~ Dece:aeu ~ocia S~~curit,. Nu1:;ber ~-~-,~,-~~
Petitioned s~~, ~. ho is~ i:: ~. ~~? vears of age cr olcer, applv(ies) fcr:
(CD:IfPLETE ',-1 ` or 'Li' BELOi~f':)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / aFa tre _~~~~ ~~~ ~ named in the
last Will of the Deced~~~ dated ~.-Z3 "~4'1l~' and codicil(s) dated ,_ -_.____-_-_
(Stc:e relevant circumstances, e. g., renunciation, death o,{executor, etc.)
Except as io'.lows, Deg e~:ent did not marry, was not divorced, and did not have a child born or adopted after execution of air in t~umf'nt(s) offered
nor probate, wzs not the . r~tim~of a kill ng and,,was never adjudicated n incapacitated person:_-_ ~..,,~~L"
C*-~~/ G'/ 1/111r'C~ ,~ C~~ ~~ '`~ 5 ~~ yi~'7`'~ ?`~~ J''~'l ~~wL~,a/ ~ j~pl~•-
^ I3. Grant of Letter, of Administration ~ ----
~' (rl aPPlic ble erit e.t.a.,, d.b n ~ a.: ender~itelrt ~•u-arue,~ r ra; r ?fitr ~' .~
titionerts) after a p~~-op~r search has I have ascertained that Decedent left no W~ and was survived by the following spo~~~Ci~a~any) and~k~irs: (~~
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,~Idni:nts~.~ ~t~orr, c.~.a_ c,r '-.~.n.c.t.a., enter data of Will in Section A above and complete list ofheirs.l ~~ -.-~ ~-~
~'_ _ _ tiarne Reiationship -- Res~~ CF+cN~; ;.,? -:=' ,_,J
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(CO~~IPLETE (rV <~I L L C .9SES:) Atiach adriitio~u~l sheets if necessary.
Decedent w's don~.i~:.~'d at e h in ~ County, Pennsylvania with his ! he last p-incipal residence at_ __ 2
1"List su~eel ~rddre.rs, town/,~-~;~, township, c tnty, state, zrF code) ~/ ~
Decedent, t.ien ~~ years of age, died or>~'~ ~~` at 7 %~O'~~~!~L~ ~T~!?'!ET_C-I=_'Z~!C-~S~~ ~ l
Decedent at death o~~-:ed property with estimated values as follows:
(If domiciled in P:~) All personal property ~~__~_~_.___
(I`ntt Domiciled in P~) Personal property in Pennsylvania ~________-_
(I n, t domiciled in PA) Personal property in County ~_.__-__-
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ti'a.u; ~~f rezl estate in Petulsylvania _ ~c_ ;~~2=L---.
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situated as follows: /ZG~S t -. / T~-
Wherefore, Petitioner(s) re~~~; tfully request(s) the probate of the last Will and Codicil(sj presented ~n~ith this Petition and the grant of Lett:°.rs in f~,e appropriate form to
the undersigne,,1:
[ `>i .r.iture Tv ed or arinted name and residence _._____~^_ ^
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For~r,r Rw-o~ ,~~~~ ro r ~ t,.; Pale 1 of 2
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Oath of Personal P~~~p;-~>>~l~t~ri~ ~ ~:,-~ r-' ~~
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~.i~'~,I`ii ~~~',..-_~. -I , i~F PE`~NS~-L`~~.~.NLa ~ ~~~' ...
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Tile ~: t;'l~;l-iC',1' ~ 1 .,~1)t'~-li~P.l?~ S'.VC.~1r~J~ 01 3t1iCa7{~~~ t~l<:~ CiiC ~".~?tl'.Ii~f'.llt~ :l; Ci1C 1(,I~.~',01',l? ~:.~ItIC!1:~ai~~. i:.l~_ _..a ~ .i~,;:T .0 Chc, }"'~_..Oi
li:e 1<170'%ti;Cd?? ali~:~ . ,l~f Of Pf°~:ilOIlcrl,~i and Chat, a5 (71-;OI,31 [e~l~:;i Ci_ltl~~l'~:~~~ (~~~ tl:;: i>eCedelli, hctltl0l;<'; '."ii; ~~~~~.. 3;:~ trlli`:'
a~minister tl:e e~t~~_t~ ,~Cordin~ to lae~.
S~voru to or afrirrr,e, ,~I1d subscribed
r, r~ ~ ITi~ the _ ~ _ _ da_~ of
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>r tl~c ,Z~~;~ter
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Si;,iature ~~j F~rs~, i F.~pr~s~'~1t~tt~L~e
File Number_
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(_.,~tate of ~'~~f /r~G~/ // ~G[~k~ y,[''/Z'' . D~~;~e.~s~~I
~i / p- ~ -}'ice
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~~;ciai :~~ .~urit,:~ Nulaber~_~9~'C/~!/~l0 DaI~ of De~~t1;: ~. ~" _-!~_---- -
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_,-'' _, ~ _, In COIF-I~jCIai1011 '` Che j_~~r~b01n~ h.,Titl~;li, ;'~~l;S~:ICt01~' ~r00f
Laving ,peen i,re~~ ;'~~ `,~efore me, IT IS DECIZFLD that Lett-;ors- -~ ~eS'J`~i7!7G!y_~/ /L ~~ -___-- -
are he eh~.~ ~r~~'~~.~ -~~~ --- ,~ -_~
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described in the I';;ti~ ~~n be adm:ttcd t0 ~-~robate and tiled of r ~~~~Id as the last `~`~~iil (al~d (~ d~~:~l(s)) of Illcce~i~.~.
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Letters ....... ~ ~---1., ~ ~d ~~l,t
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Short CCrtif C3tC~:~~~ ti~ .
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Sut~ren;e. C'ourC I I). No.:
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Pale 2 ~ f 2
OATH OF SUBSCRIBING `WITNESS(ES)
GIST R OF WILLS
~Gt ~ ~r' ~~ OUNTY, PENvSYL~VANLA
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Estate of ~"~ ~'~ ~'''~ °'"' ~7 ~~ /Z~~~~'~- Deceased
-- __- _~~;a2`~i) a subscribing witness to
(Print Name/s)
the j~},~%iil ^ C;c~dicil(s) presented herewith, (e )being duly qualified according to law, depose(s) and
say(s) that sh~! he they was /. re present and saw the above Testator i Te atria si`m the same
and that she ~he they signed the same and that she , h~e ~ they signed as a witness a.t the request of
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the Testator i C'e trix in ~~/ his ~ presence and in the presence of each other. ; ~'•~ ~~~
(Sig~tatw•e) (Signature) l~Yl~/r(r /'7 `"^ ~' !~~' •~~ f ~~ L-~
(Street Address) (Street Address, ~ -~,
(City, Slate, Z.p)
Executed in Reh ister's Office
Sworn to or aff~.rmed and subscribed
before me this ___ day
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Deputy far Re,Ji~ ter of Wills
C/~-,r~ c'.-c~'~-c- ~ ~',~ o' ,~2-mil
(City, State, Zip) ---'---`s -
Executed ~~ut ~~f R;~~ ister's C?f fice
Sworn to or affirmed and su~sc:ril:ff~d
."~ ti"~~
before me this ___ ~~.~~,; ____ da}~
of 'E
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~~t~ry Public;
~1y Commission Expires:
(Signature and Seal o`Notary or other officia': qualified to
administer oaths. Snow date of expiration of ~`otan~'s Gxnmission.)
NOTE: "ro be taken b -Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of n,~~ariz~aion.
Forst RW-0. rev. 10 /~'. ~~6
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OATH OF NOi~-SUBSCRIBING `~~ITNESS(ES):, _ w
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REGISTER OF WILLS ~:_
~~ ~'~'~~~~ cc~~ COUNTY, PENNSYL~JANIA
Estate of }~
Deceased
/2aG~~ ~ ~ 7L~~Y~~ and --,
(e~ being du_1~.~ qualified according to law, deposes} and say(s) that she he they ~~~ as / w~ well-
acquainted with __ ~~7 ~4"'~ l~ ~~~~.-7`-~C` '~ _ atlc'. am/~~e familiar
with tht handwnt,ng and signature of the decedent, and that the signature of ~' ~ '~
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to the foregoing; instrument purporting to be the Last Will and Testament'Co ~ ;il of f~~-Z.r,~ r.~, eC
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~~ ~%1~7`w ~ ~ is i his her own proper handwriting.
(Ja~aatiu~e)
(Sb~eet Adclres~)
(Cit>>, State, Zi;:;1 ---
Execccted in R~ b ister's Office
Sworn to or aflir~,~led and subscribed
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before n~~e thi:; ____ ~~ ~-' _~ day
f ~,
of ,
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Deputy for i?e:;i~'er of ~~,riiis
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lSignat<<re) ~~~~~ ~ L i ,~r-~~ ~~, ~ f~
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(Street A'' rzs~~C7 ~~/~L.~"~G~~ ~~
(City, State, Zip) J
Form R 1'V-04 rev. I G' 1 `. %h
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I, RAYMOND H. BURTNF,R, of the Borough of Carlisle, Cumberland! County,
Pel~nsylvania, declare this to be my last will and revoke any v~~ill previously made by me.
~~ 1. I cl~:vise and bequeath ail of ~~~y :;state ~;f eery r7ature a;1d z~~herever situate ~.o my
dal~ghter, ANN B. TRAVIS, providing that she shalll sl~~~rvive me b~~ thirty days.
II. Sl~i~~uld my said daughter, Ann B. Travis, predecease me or die on or before the
~' thirtieth day following my death, I give, devise, and bequeath all of m~ estate of
every nature and wherever situate to her issue per stirpes living on the thi~~l:y-first
~~~
day. following my death.
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III. ._~ 11 federal, state and other death taxes payable because of my death. ~~ ith respect
~'~~ to t he property forming my gross estate for tax purposes, whether or not. passing
Linder this will, including any interest or penalty imposed in connection ~,vith such
tax_ shall be considered a part of the expense of the administration of m~ estate
and shall be paid out of the principal of my estate w;~ithout apportionment ~~r right ~~
of reimbursement. ~~
~,' IV. I ~~ppoint my daughter, ANN S. TRAVIS, executrix of this my last will. Should
f m~,- daughter. Ann B. Travis, fail to qualify or cease to act as executrix. [appoint
~~1~;~ son-in-law, HAROLD L TRAVIS, executor of this my last will.
V. i direct that my executrix or her successor shall not be required to give bond for
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~~ the faithful performance of her or his duties in any jurisdiction.
I~1 WITNESS WHEREOF, I have hereunto set m~,~ hand a.nd seal this,~~-~~a'~-~ ay
~f
of September 2010
YMOND H. BURTNER
a ~:~ pi'e~eding lnstl'ill~~lent, ~.;C~nslS~i:i~ vi ii"iiS ali~I one O~hei ~y'pc'JVl-1ltE;l1 ~)dge
identified by the signature of the testator, Raymond H. Buri:ner, was on the dare and date
thereof signed, published and declared by Raymond H. Burtner, the testator thea'ein
named, as and for his last will, in the presence of us, who, at his request, in his presern;,e,
and in the presence of each other have subscrihed our names as witnesses hereto.
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