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HomeMy WebLinkAbout04-13-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ROBERT C. ADAMS a/k/a: a/k/a: a/k/a: Deceased ESTATE NO: 21- ~_~' (,' ~~ ~ ~~~-~ SS NO: 179-12-3732 Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: D A. Probate and Grant of Letters Testamentary or ^Administration c.t.a., or d.b.n.c.t.a. (complete Part C also) and aver that Petitioner(s) is/are entitled to the aforementioned Letters TESTAMENTARY the last Will of the above-named Decedent, dated 1/22/2010 - _ under and codicil(s) dated (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 not the victim of a killing, was never adjudicated an incapacitated person, and was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in 23 Pa. C.S.A. § 3323(g): N/A ^ B. Grant of Letters of Administration (If applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate) C. 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 (lf Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section A and complete list of heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(except as ~ol`lows: q C~ Name -" Address . a USE ADDITIONAL SHEETS IF NECESSARY 1R h~ to edenilr-; !'_._~ 1-: r--- .:. ~, t.n - .,' -` ~ G,'. ' _,_ "r THIS SECTION MUST BE COMPLETED: `` ~' Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At ONE LONGSDORF WAY CARLISLE SOUTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY PENNSYLVANIA 17 (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 96 years of age, died 3/23/2011 at CARLISLE, PENNSYLVANIA (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 $ 30,000.00 - Personal property in Pennsylvania $ _If not domiciled in PA Personal property in County $ - _Value of Real Estate in Pennsylvania $ Total Estimated Value $ 30,000.00_ Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature(s) Name(s) & Mailing Address(es) f °l' a'r :- ,lQ ,, i -~.:..J~.,.~.^~ BARBARA L. NICKEL, 384 MEADE DR., EAST BERLIN, PA :17316 ;, ,~~~ i~_t.~ i ,~'~ r t t ~ 1; DOROTHY A. BECKER 57 DERBYSHIRE DR., CARLISLE, PA __ I ~..~ _ l _ Y 7Ai 7 ~ Interim Forni RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 1 of 2 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 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 before me this ~ ~~ r~ r ~ _ day of -' t ~ a n ~ For the Register Estate of l' fr ~i ~ ~ ... __F ,- --- -~, 1 4 / r ,'' /y.~° .. T f . ~, ... r i . f ! ~ z_. r- ' r-n ---- ~ - -~ Cam.} ,~ r.- 1 .~ --~ DECREE OF PROBATE AND GRANT OF LETTERS :;::~.. .. -- _~ d. ~-•~ ~ ., _~.r ROBERT C. ADAMS ,Deceased File Number: 21- ~=~~ !'fir - /~'~ ~~'' AND NOW, this ~~~?~ ~ day of ~i'~ ~ i a -:~- ~` ~ ~ , in consideration of the Petition on IT IS DECREED that Letters the reverse side hereon, satisfactory proof having been presented before m are hereb granted to: x Testamentary of Administration y (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) BARBARA L. NICKEL AND DOROTHY A. BECKER in described in the petition be the above estate and that instruments(s) dated 1/22/2010 admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. 1 Glenda Farner Strasbaugh,.~~~ f-~~~C~ ~~~~.-~~'~ i ~ ~ ~-~- ~~' Register of Wills FEES: Letters ....................$ 90.00 Will ....................... 15.00 Codicil(s) .............. . (2) Short Certificates s. 00 ( )Renunciations....... Bond ............................ Other ............................ Automation FEE......... 5.00 JCS FEE ..... ............ 23.50 TOTAL ................ $ 141.50 Signature of Counsel Required to Enter Appearance Atty's Signature -~ ~ ,~ f PRINTED Name: ROGER B. IRWIN Supreme Court ID No.: 62s2 Address: 60 WEST POMFRET STREET CARLISLE, PA 17013 Phone: Fax: (717) 249-2353 (717) 249-6354 Page 2 of 2 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court L~C~~~AL REGISTRAR'S ~~E'"~I~=~~~ ~~'~~ ~~~ a,~~~~ 'l~,~RNING: !It is illegal to duplicate ~l~+i~°; (_~~~~ Wi'g' ,~~-~~~t~~,~;~at c~ ~~c~c a,~~~. ,,r..,1 T~ d~~ ~ !~)', (ti ;I },~ it)I~u~t~l;ltiOI~ l~c~re ~;rven i:; ~ ~~I P ` ~~~~~~, ,~~;~_ ~~-),., tl' t I ,.: z, ~~ i'I~,I~I,,f~ C'ert)flc~lte (>t [)~tUh ~~,~~; ~, ~~ '~ Q 4 ]a. d' ¢~ ri-. ['l~~~ ~,, I.,ii~al ~ _ ;~,4. ~' C Y j~Cl.'1`I ~I,I C~Z t.u k1)ill (~ V lt~a~ S F ~~'~t, .yro~ ~.~ I k `l1 )~ ,. I, 11 ILA `7 d~~~))4~ P 1711 ~ ~ ~ 7 ~_ ~~ ., . _ ~~ ~ . __-- _ ____-- _ ._._ ___ _ - :117~Pti~lii(~(1 ~'Uli ~t 'i' ~q~jM _ ~~ ~~~ ,; fNT t , ~ ~ ~ ___ ~ ~ :~ ~ o i ~ ~ ~ f { ~ ~~'? R~~t~ UL(~ I ~ --- ~ j ; n ~.. r I I - ~ ..... _. T...( ~` ~ ~ , ~ H705-143 REV 11/2008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE /PRINT IN BLACK INK PERMANENT CERTIFICATE OF DEATH (See instructions and examples on reverse) 1. Name a Decedent (First, middle, last, suffix) STATE FILE NUMBER Robert C . Adams 2. Sex 3. sodel Security Number 4. Date of Death (Monet, day, year) Male 179 - 12 - 3732 March 23, 2011 5. Age (Last Birmday) Urxler 1 r Under 1 de 8. Date a Bkdr Monet, da , a 7. Ci and state or lore' corm 8a. Piece a Deem Check on arre robnms Days Mows ksntnes • Hospital: Omer: 96 rte. 08 29 1914 Willaw Hlll , PA ^ Inpatient ^ ER / otnpatlent ^ DOA [~ Nurskrg Home ^ Residence ^ oner - speedy: 8b. County a Deam 8c. City, Born, Twp. of Death Bd. Feality Nana (If rat Institution, give street and numt>ar ,~t • ) Ccarmllrilty 9. Wes Decedent of Hispanic Origin? aaNo ^ Yes 10. Race: American Indian, Black, White, etc. G~miberland oath Middleton ~vp (" ~' ° cuben, spea • Cumberland Crossings Retiranent Mexican, Puerro Rican, arc.) Wh1te 11. Decedents Usual lion Kind of work done dun moat of life. Do not state retired 12. Was Decedent ever in the 13. Decedents Education Kind of Work (qty onN highest 9rede completed) 14. Martial Status: Mertied, Never Married, 15. Survivin S KlndaBusinesa/lndushy U.S. Armed Forces? Elemenlry /Secondary (t}72) College (1-4 or 5+) W'd0N'~~ ~D1~ (SPepN1 9 Pouse III wtla, give maiden name) Su rvisor-Cazpente Lumber Ccmpanie [~y~ ^No L Married • 16. Decedents Mailing Address (Street, city! town, state, zip code) Decedents Ethel Christman 384 Lake Meade Drive Actual Residence 17a. State PA p e in aim 17c. ®Yea, Decedent Lived in South Middleton • East Berlin , PA 17316 ~, Cl.~lberland Township? 17d ^ No, Decedent Lived within Twp 17b. Coon 18. Farmrre7.t,s~ N,~a,,m,~e (First, middle, last, suffix) Actual Limits of City / Boro 1111dt1ClS J • A,.7,,.„ _ 19. Mother's Name (FlrsL middle, maiden surname) ~t~L7 Mintie - Wingnan 20a. Informenrs Name (Type /Print) 20b. Infomtants Mailing Address (Street, city /town, state, zip code) Barbara L. Nickel 384 Lake Meade Drive, East Berlin, PA 21a. Memos a Disposition , 1 731 6 • ^ Cremation ^ Donatlon 21 b. Date a Disposition (Monet, day, year/ 21 c. Place of Disposition (Name of cemetery, cremaro a other lace ° ~ Burial ^ Removal from State i Wee Cremation a Donation Audrorizad ry P ) 21d. Laration (City/town, state, zip code) • ^ otltar• r byMeaelEzamlrter/coroner? ^ Yea^ No 3 26 2011 Clmiberland Valle Manorial Gar s Carlisle, PA J 22e. Signature a Fu I Licensee (ar pe s J 22b. Uertse Ntxnber 22c. Name and Address of Faality ~ FD 012633 L Ewing Brothers Funeral Home, Inc., Carlisle, PA 17013 e ems 3a-c onty when ertitying 23a. To the beat a my knowledge occurred at the tlme, date and place stated. (Signature aM title) physidan is not available at trine of death ro 23b. Lkertse Number c.. 23c. Date Signed (Monet, day, year) ertlly cause d seam. '~ ~ v ~--`, P~ ~ \11 \i C.~ ~ d,CJ `l `{ ~.. _. '~ro.,~c.~~ 2.3 , ~.O 11 Hems 24-26 moat be ales 24. Time of Deem canpl by person 25. Date Pronounced Dead (Month, day, year 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other man Cremation a Donation? [/~ ' who pranourtces deem. ~ oy a©a M. ~--~~ c~,~1 a ~ , 'a c~ ~ ~ ^ Yea ~o CAUSE OF DEATH (See Itsetructiona and examples) r Approximate interval: Part IL• Enter other ' Item 27. Part I: Enter me chain a evenh -diseases, injuries, or conglk:atlons .mat directly caused me deem W NOT enter terminal events such as cardiac anesL r 28. Did Tobacco Use Contribute fo Deam? respiratory arrest, or venMaler fbrillatbn without showing the etblogy. List oay one cause on each line r Onset to Deam but Hat resulting in me underlYing cause given in Part I. ^ Yes ^ Probably i/1 IMMEDIATE CAUSE (Flnal disease a ~ /~ r ^ Unknown r ^ No l/ contrition resularg in aeath) ~ ~ ~ ~ ~ J ~ r -~ a' ~~~ ~ ~ y 29. If Female: Due to (or as a coraequerae aft: r Net farMitiarts N arty, r ^ Na pregnant within past year Nra ' ~ the cause listed pan fine a. r , tlepy b. r ^ Pregnant at time a deem Faster me UNDERLYING CAUSE Due to (a as a consequence o : t ^ Not pregnant, but pregnant wihin 42 days (assess or mWry mat Initiated me ~ r _ events resultng m deem) LAST. c• r of deem Due to or as a r ( consequence of): ~ ^ Not pregnant, but pregnant 43 days to 1 year • d. r before deem Unknown if pregnant wihin me 30e. Was en Auopsy 30b. Were Autopsy Flnangs 31. Manner of Death r Past year periomted? 32a. Date of Injury (Monet, day, year) 32b. Describe How Injury Occurred Available Prior ro Completion 32c. Place of In'u Home, farm, Street, Facto y Natural I ry ^l of Cause of Deam? ^ Momiade Onice Builang, etc. (SoedlyJ ry~ / ^ Yea ~No ^ Yes ^ No ^ Accident ^ Pending trnestgaticn 32d. Ttme of Inlury 32e. Injury at Work? 32f. If Trensportatbn Injury (S P~ 1 32g. Location of injury (Street, city /town, state) ^ Suicide ^ Could Not be Detemuned M ^ Ves ^ No ^ Driver/Operator ^ P se r ^ PedesMan ^ Omer - Speciy '` 33a. CeNfiar (check only onel 33b. Si ature of 9n ~~n9 physleien (Physician ertltyirg cause of deem when anoltter physician has pronorxaed deem and completed Item 23) To the treat of my knowedge, deaM oceurred due to the ease(s) end manner as stated _ _ _ - _ • Pronounang and oartHying ph skfen Ph - - - - - - - - - To the boat a kit Y ( yeician born pronouncing deem and certifying to cause of deem) 33c. se N r 33d. Date Si my owladge, seam occurred et the time, date, and place, and due to the cause(s) and manner ss Wted_ _ _ _ _ _ ^ 9~ (Monet, day, Year) ° MedkalExsmMer/Coroner w On the bash of exsminatbn and / or inveMi lion, in m _ _ - _ _ - - _ _ - _ - O ~ ~ ~ ~ ~ - L 3 ~ Z ~ ~ C 1 ° 9a y opinion, deem occurred at the time, date, and place, and due to the ce LLo use(s) and manner 86 stated_ ^ 34, Name and Address a Person Who 35. Registrar' re and D' _ ~nWe\ed Cause of Deam (Item 27) Type /Print ~ ~ 36 Date Filed (Monet. day, year) ~Yr y ~ Cjv~,~j~ v. ~ ~,~' - ~ ~~ P~~ 1,~~15 Disposdion Permit No. ~•/~,~~~ r-- ~, _~ LAST WILL AND TESTAMENT `'' ~-~ =~~' -~ ~ ~ ~7 : ,A c:~ :.~ -- I, ROBERT C. ADAMS, of South Middleton Township, Cumberlari?~;..,~ounty, :,.~, `= _ ~ ~.. Pennsylvania, being of sound mind, disposing memory and full legal age, do her`~y make; .° `~~' c_ publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1. I direct my Co-Executrices to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Cvo- Executrices of my estate. 2. My Co-Executrices may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. 3. I authorize and empower my Co-Executrices to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My Co-Executrices are authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Co-Executrices. 7~fiE 4. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my two (2) children, BARBARA L. NICKEL and DOROTHY A. BECKER, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 5. I nominate and appoint BARBARA L. NICKEL and DOROTHY A. BECKER to be the Co-Executrices of this my Last Will and Testament. 6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. 7. No Co-Executrix acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 8. No beneficiary may assign, anticipate or pledge her or his interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. 9. I hereby suggest that my personal representatives retain the services of Irwin & McKnight, P.C. as attorneys in the settlement of my estate. IN WITNESS VFv'HEREOF, I have hereunto set my hand and seal this ~,.t'"`'' day of January 2010. .~~(~.~?r` C _.('' ~~ ~,-.~-.a ~ (SEAL) ROBERT C. ADAMS 2 Signed, sealed, published and declared by ROBERT C. ADAMS, the above-named Testator, as and for his Last Will and Testament, in our presence, who, at his request, in }lis presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~'~. `~ `e .~ ~, ( ~ ~ 4 r~ 3 ACKNOWLEDGMENT AND AFFIDAVIT WE, ROBERT C. ADAMS, KAREN S. NOEL and SHARON L. SCHWALM, the Testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of their knowledge the Testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. ROBERT C. ADAMS ,--~ W .,f ,.. ~ ` ~ REN S. NOEL ~~ / 4 J ~~!!_~ fr c`. ~! .j i. ~ - .'t.% is !`L ~! i r: ~.,.~ •.~~'"t.f a SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by ROBERT C. ADAMS, the Testator herein, and subscribed and sworn to before me by KAREN S. NOEL and SHARON L. SCHWALM, witnesses, this L-L"~ day of January 2010. ~. ~~ 4 Not ry Public AM N LT"N QF PENNSYLVANIA Notarial Seai Roger F3. Ir rn?in, Notary Public Cartislr? l3oro. Cr,~rnbEriand County My Commissior, ~~x~,~reS Cot. 3, 2012 ~b~r, Par~nsy+~u•ar~~~~ !~M~~:rciati;:r, of Notaries ~ . ~~