Loading...
HomeMy WebLinkAbout03-22-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBER_LAND___ COUNTY, PENNSYLVANIA Estate of Olwyn Mary W Otter File Number 21 •~~ -- ' ~ ~' also known as ,Deceased Social Security Number 171-01-4285 Jane O Shoop Petitioner(s), who is/are 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/are the - :'__ named in t-~~ last Will of the Decedent, dated and codicil(s) dated -- ,--. - -_~ ~ __ - ~. -- -- J-i,I , '_~ _ 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 ~f tie In'strume~nt(s) offered `_ for probate, was not the victim of a killing and was never adjudicated an incapacitated person: -~~ --_ -, , _._ _:~ ~ .r 1 . ~l © B. Grant of Letters of Administration ~,t, ~~.~~ ~ ~ c~. ~_ ~ (it applicable enter c t a ; n c t a.; pe me ite; rante a sen a, urante m~ n ate =G~ Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (/f Administration, c. t. a. or d. b. n. c. t. a. , enter date of Will in Section A above and complete list of heirs.) Name ~-~~c~ ~ J u~%~~ . "~`~v ~IeBc~r.2 2rz~ ,~~~v ~~~~~a Relationship esidence ~q , ,r.Xi ~;j,3 ~~ , ~. 5, ~.. .33,E David W Otter 3 Son 243 N. Middlesex Road ~~ ~ Carlisle, PA 17013 ~v.~.~ Mark V Otter Son ~" 9 Prospect Ridge I -- ..- - - ,. , ~-~ ane O Shoop Daughter 1572 Boiling Springs Road COMPLETE /N ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at Messiah Village, Mechanicsburq, Upper Allen, Cumberland, PA 17055 (List street address town/city, township, county, state, zip code) Decedent, then ~_ years of age, died on 01/04/2011 at Messiah Villa e, Mechanicsburq, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All persona! property ~ (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: 2,900.00 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: Signature Typed or printed name and residence c~a~ Jane O Shoop 1572 Boiling Springs Road Boiling Springs, PA 17007 ..,,,,, ....-.,~ nC~. ,~-.a-wuo Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 I . ~~' COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland Oath of Personal Representative } 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. Sworn to or affirmed and subscribed ~~~ Signatur of Personal Representative ' r ~u Jane O Shoop ~.~ before me this _,~.,~~--~ day of , -- ~-~ . ,_ . _.... _z_~ ~~ ~~ --~.~~~, ~. Signature of Personal Re resentative 1 ~~ 1. ( p Ary_- ~`~ J For the Register Signature of Personal Representative _ ._ , j ._.r_~ ~..., _.! I ~,. c Z;>. _. . - ~ ~.~~ ~7 File Number: 21-/~- C ".~~' Estate of _ Olwyn Mary W Otter ,Deceased Social Security Number: 171-01-4285 Date of Death: 01/04/2011 AND NOW, < , . 'i ,c'1~~? ~.. ~ ~ ~ ~ C ~ , in consideration of the foregoing Peti~tian, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Jane O Shoon and that the instrument(s) dated in the above estate described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES ..~ Letters .......................................... $ ~ ,-;~ ~~. _.~ Short Certificate(s) ...................... $ ~' Renunciation(s) ............................ $ ~(i s ~~1 ~T~l~'7t~ f rC'f') $ j . ~~~ Att..,.,,., „,y„a~u,~. Attorney Name: Supreme Court I.D. No.: $ Address: Telephone: TOTAL $ ~l~ ~ Form l~tN ~2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 . ~~~~a~! ,,~ ~' 1.~~..ngl~,t.(St~ i~'-~1c.; ..,f''~„;yq k-~n~ ~"~, ~a l~~~~~~~k ti.? a~~~~. .ir. .,... ~ ~ ~. .,,; .. _ •;:~ . , Y~~ `` f~ ~, ~ ~~ `i l t' . 1-i~1t t)11 ~ lr1-l" r-' i ~ t:_`i~ i,~ ~ `fir" l ~ r(. t. ~~~' ar,~~: C'rri~i.t~la~ ~.Ct)c~xt~~ <. ,, { `" ~Ss: ' ,q, .~ ~ :t N~.~_"!_1`e}1'i;!' ~ I~~' {~hl~i11~21§ r '~" b}p.,. a ~~ - _. +. ? I , ~ i ~I ? ~ ! ! I :., .~4,,: ~:w 1,, 17027501 ~~~ _ /~L / ~,~ ~ a-• ,,1 ~++~~ ~~ ~ ~ ' F~~ ~ ;~•~,t ~.. ;~..~ - r ,, -c/ _ --~ -_._ , _i.~ c- ~ - ~ -- - i-, ' . l ~- aQ~~N3 NEV tl40pti ' - ) .. - TYPE ~ PRWT IN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS r ' PERMANENT -...~~ .. &At,K lNK CERTIFICATE OF DEATH `' _^ (Ses Instructions and examples on reverse) r t • ' r I a Name a Decedan (Fret, nW6s, last, s,r,0,) STATE FILE NUMBER" ~ ~-'`- ,`~ O lwyn Mary W . Otter z. S"` ' s0pi1 Nun , oar a oe s Aga (last arolwrl txlder t year Urwar I gay 9 3 ~'r" aY. Nws ran„r.s Yrs 1D. Counry of t)eath ec. Ciry, Boo. Twp d l>oatn Cumberland Upper Allen 1 t. t>.cedent's usual Knd d wok gone moss d W. Do Kra a was P r e ~ ~1'r~t~ Secretor hur IB. Oecedal's WIWg Arftrsu (Streel pY I form, star, zp mde) 100 Mount Allen Drive, Room 257 Mechanicsbur PA 17055 IB FaIMr's tarty (Frsa, manic, foal culls) 20s Inlormarr's Nary (Typo /Pmt) 21a Merrod d Olsvosrm ^ Bwul ^ Rsmaa hom Stale ^ Onyr - sr>.~ Furyal s.mc._Ix«IS« (« Wnprl(aWry 23a< ady when gran a naavaraa0b at sme d r>wb ao ~h pose a rlean. Female 171 atnt.°.y'''"`) s.Wba&rorrMaw,ea,r,..,., .,,_. _ _ - O1 - 4285 January 4, 2011 June 21, 1917 Shenandoah, PA °ini 8d. Faddy Nan. (0 na rryD4p10rt, gIn sueq as nWn0ar1 ^ ~M1 ^ ER / Oulpawrrt ^ DOA ~ Nursrtp 1lorry ^ Resrderroe ^~ `~Y ` / 9. Was OrtcedarN d -Mspelac O^9in? ®~ ^ ya 10. Rate: AmalrDln Yr0y1L Black YMr1s. tMC C' S~J 1 C~ V I ~ I (u Yes. spetXy CrrWn, lSpectiry~ e. N4atipn, Paaxb Ripe, Me.) na srar retr I2. was D.cearr .wr n un t 7. DecedertYs Educatan (SOecrry «W nrgfyat as Whit e Ipp~uy U S. Amwd ForW? EINMntary / $acorWa71012) ~ ) 14. MarMY Sutus: Munatl. Nwer ManaO, i5.:iurvni^9 gPprsa Itl wh. qw erasn nary) C ^Yw ®No 12 Cdlepe(1~«S.) Widawd,Orwrpd(Specr/y) 1 Widowed ~' oa o.adarl Aclwl ReaaaiD, 17a gar PA lire n a T ~ 17c. ®Yw. Decedent lived n ~) e r A 1 ~ rs n 170. Canty _ Cum r 1 a n d nd. ^ ND, o.c.eart lined warn ~. AeOwI lillMS d 19. Modyr'a Nary (First, n1ipW, nyasn surryne) GY /8010 me Mar Jane Hu hes Mrs . Jane Shoop 200. lnbrmare'a M'w,g Addrwa 151reel ch /town, stw, rp ave.) ~~~ 1572 Boiling Spring Road, Boiling Springs, PA 17007 ^ ~~ 210. Ow d Drspo,rrar (MDntn, doY. Y•arl 21c. Paaa d DisposiYM (Nor,,, d Was CremaYOn «D«r0«r Auurrlwd °a^MrY. aemaay «aaner pan) 21a tttaaM (try / bar1, our. aP ottde- i Mwdle.lEaenrrrrc«o11u7 ®YaONo 1-6-2011 Cremation Society of PA ~~ z20.liaryeNtrrlDar Harrisburg, PA 17109 ~` "a""nOAddrasfaF~ Auer Cremation Services of Pennsy van a, Inc. FD 138312 4100 Jonestown Road Harrisbur PA 17109 23a To the oast d my Arawroga, death amnW a ay un., dab as Dla<e stabd. (SrpWtre as Dtly 230. licenw Nunber ..,._ ... _. Deny 2a-z6 mnt w oompero M Person vela W«arncn waN. 21 Trry a O.atll d O ~ 3 U 2S. Oar Prorlarrced Dead (tdoraa day, ywr) 26. Was Case Rahn ~l M. C c, 0.n u to r l-} ~ U 1 MWical E+a ^ Yw N rrtirw I Corayr for a Reason ONer drn CrenattOdr « oorw«,? AUSE OF DEATH (Sey Instruetlons rand examples) nom 27 Pant Error dr dlia0-GLfttffitli - dseasaa. nWrs. a mriprr~0oro -Thal drac9Y caused tM daaln. 00 NOi anW yrrwyl raspratay anew, a veMraCtla fi0r11apon wr0au aenb such as cardiac angst. sfawrlg tl1B aOObgY. tit odY OM Ca1W Dn eaM Wy o r APpaunate rMMVaI: Pan II: Enrr a0yr ~ Onsal b !]coot ~ T r a~~ . MIAIEOIATE CAUSE (FrW dwaw a carra0on resaAng n 4aml i a. ..1 yT Q ~'1 / ~j~~ DtA nd rewlUrp n dN undenyrrg Cabe r i groan n Pan l Q Y O pmp~, ~~ Q ~~ Ow to as a esnseQuarrce al .~ . Aa1y. o. i e>vc ~~ i9 of A/ M+~rrO r tM -G ; ~ r~'j,4~Y!• ~ /;~~ ~' 29. K~ tal+sa Yalta an wy a - z c~ r~r~~s -~i~~ F~rar 6u UNDERLYMIG CAUSE Due to (« as a mysaranca oq ( ~ ~ Ql' r '~ ~ ~,~ ^ Pre r a iw W ras«utlaq~ d~~aT~ c. r g y sl rna d dw0l lhre W (« as a carre trnq d ~ ^ ~ ~ Drgw1 ware ~ dp7 p I: 0 i ^~ PrOpaaK 011 Da9~1 tl rbya b 1 1Mr 30e Was an Autaysy 30D Were Autopsy Endings 71. Wray a Owm Penarmed? Avaaabr Prior b CantpWan , ,J 3za. Oats d NMMY (MorNh. day. Yar) r 320. OacnDe Nag Iryrry Oocurra0 OelDw rtasN ^ UNuayh 1 pOplyM Mhin tlla pyl yMr uV a Cauca a Dead!? Novena [] Horracide ^ Y ~ :12C. Ot n a kMrrY: -farrr, Farm, 9rK Fadax ~~ ~ l~ es No ^ Yet ^ Acadsrll ^ Pmmrrg Invwagaaion 32d. Tme d 4yury 32e. l^NrY a Wom? 32t. II Transparuaan yyury (~,yy/ ~ ^ Srrr]de ^ Car1d Ile W Oetenrrraed M ^ Yw ^ NO ^ Omhr / Operal« ^ Paswrlgar ^PedesDy, 32g. LopOOrt a M*ry (Straat, ay I town, saw) 33a Candy (Macs arty ory, ~ ' CerWyirg POyrriciara,Pnysraan C•NtY•19 cause a oea01 wtyn arro0yr physraart nu To tM best a my tutoyledg,, d„0, «cumW aw b 0ae p0f dPam ~ canpgtea Item ?7) . c•wNgarWntwwwsme4 3 Sr9nahre and Tdb d Csr0lyr Prorlorrtcytg'^d Meg vlaYstcien IPM Dan pr«grrrxlg aaadr and - - - - - - ,------ ------------------- To the Owl a my YrgwrdYa deeM o d w ~ a tea) - ~ ~i~~f!2wG~'`(/{~~ ~~ . ccrwnd at err tar. dab. and pba, r d o 0y ' !radical Esarwyr / Corory ~aNH grid rrrrrrer w shled_ _ _ _ _ _ _ O 3JC. lKanse PM+mOer _ ^ 13d Oar S9^w IWnm ga 'wr n tty Oasu d esserlrtarion atq / « rove n eM , deraN occurred at the try, dab. and `f piece, and due r nr ewags) and mrry w tdeted_ ^ . y, l l ~/ /~ z "/ -.C ~ /~ ~ ~' a era it 3a`. Wmnm~na andnnAdOrec~nt/a~/ PersmOWM C/a~nplaro Cause of INam 27) T P~'r)(,., T r DW Fdw (MOndl. oay, You) JI~.~rH'V~~I~~r'7'~-S/~J/~~ ~~, i~/ 1/ /~~ci~/ ~1Q1 f~~. /- - ~~ /1~"c7y,~,vi~s3~R~ ~~ /70s S~ DraPCarwn Permd No. OSS 49 S'~ ~, ,~ ~~ RENUNCIATION CUMBERLAND COUNTY, PENNSYLVANIA Estate of Olwyn Mary W Otter Deceased ~~ David W Otter Son REGISTER OF WILLS OF (Print Jame) in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Jane O. Shoop ~,~ ~ L, y. `2.o i (Date) d~ r ,~',. (signa re) pavid W Otter 243 N. Middlesex Road (Street Address) Carlisle, PA 17013 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of . Deputy for Register of Wills Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on _ d;~y Notary Public My Commission Expires:-~~~3~?d-! ~~ (Signature and seal ofgyN~odtaarey or oXth~e~rao~ffvicial qualified to coMi;~~~~ ~ Y~NN~VA1V1Aof Notary's commission. NOTARIAL, SEAL Martin D. Shoop, Notary Public Monroe Township, Cumberland County My commission expires February O5, 2013 Form RW-06 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. RENUNCIATION REGISTER OF WILLS OF CUMBERLAND Estate of _ Olwyn Mary W Otter Son ~~ Mark V Otter (Print tJame l COUNTY, PENNSYLVANIA ~~ , Deceased ,,~ ~ - F__i ._.t_.~ .. '- -'1 FJ ~~ i, ~.... .. _.. - 1. _~._I f.. . _' -~-i .... _, __.., ; T e in my capacity/re~tic-nship ag"' ;,.> ~. ~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Jane O. Shoop ~ ~ ~vl~ (Date) f O "~--• (Signature) M rk V Otter 9 Prospect Ridge (Street Address) Horseheads, NY 14845 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed Executed out of Register's Office Before the undersi ned ersonall a g p y ppeared the before me this day party executing this renunciation and certified of that he or she executed the ren ciation for the purposes stated within on dray of ~~ ~- ~-~G~// Deputy for Register of Wills ~,~~~ Notary Public My Commission Expires: ~~-~~~, ,,~,~:I~ (Signature and seal of Notary or other official qualified to adCmiOnis~t~e~oOaths. h yy,~~_gf ~x„i~atigCLVAtV1As commission.) 1t1 C ~ 1jj1 ~j .. S E ~ NOT t~1~ Martin D. Shoop, Notary Public Mowoe Township, Cumberland County My commission expires February O5, 2013 Form l~W !76 Rev. >0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.