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HomeMy WebLinkAbout04-13-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WII.,LS PETITION FOR PROBATE AND GRANT OF LETTERS II Estate of JEAN ELEANOR BURLISON ,Deceased ESTATE NO: 21- 4~ " ~ ~ Z a/k/a: JEAN E. BURLISON a/k/a: a/k/a: SS NO: 159-24-9875 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 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 under the last Will of the above-named Decedent, dated 6/1 /1990 and codicil(s) dated h-; 3 See attached Statement. (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 ; instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated party to a pending divorce proceeding at the time of death wherein grounds for divorce had been 23 Pa. C.S.A.. § 3323(g): No exce tions. f~°N - -+~, of t~e ` -'~ aspAka -,,_. defined iu,:. ; -a ~ ~'.:; ~- : r-; - ~~ ~ _~ .. `'~ ^ B. Grant of Letters of Administration ~' ~" (If applicable, enter d.b.n., pendent life, durante absentia, durance minontate) ~' 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 (If 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(g), except as follows:- THIS SECTION MUST BE COMPLETED:Hamilton County, Tennessee, Decedent was domiciled at death in~atlit~a~lt'9,~i~o~~ ~~ his/her last family or principal residence At 6407 Kni htsbrid a Road Hixson TN 37343 (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 84 years of age, died 3/8/2011 at Chattanooga, TN (Month, Day, Yeaz of death) (City and State where death occurred) Estimated value of decedent's property at death: If domiciled in PA All personal properly $ If not domiciled in PA Personal property in Pennsylvania $ 1,300.00 If not domiciled in PA Personal property in County $ Value of Real Estate in Pennsylvania $ 123,000.00 - Total Estimated Value $ 124,300.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 408 E. Coover St., Borough of Mechanicsburg, PA c;,...e.,,..oie~ j Name(J &,Mailing Address(es) ~s..o......~.,, ` Marjoriep: Seiler 6407 Knightsbridge Road, Hixson, TN 37343 Paee 1 of 2 Interim Form RW-02 revised 12.26.10 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 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 subscnbed b fore. me this 13~ _ day of 2011 _ ~ _ r or the Register c •~~ ~ z~ ~~~ ~ ;--, -~„ ~.. DECREE OF PROBATE AND GRANT OF LETTERS -x~ ~~ ~~ - ~' =~ -:- ---, _~~ -- ;-~, i -= ~.~ p -~, Estate of JEAN ELEANOR BURLISON ,Deceased File Number: 21-~_- ~~ a/k/a SEAN E. BURLISON 2011 AND NOW, this ~ day of , in consideration of the Petition on the reverse side hereon, satisfactory proof aving been presented before me, IT IS DECREED that Letters x Testamentary - of Administration are hereby granted to: --- (It applicable, eat c.~~h., d.b.n.c.t.a., etc.) MARJORIE~.~ 5E1LER in described in the petition be the above estate and that instruments(s) dated 6/1/1990 admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasba h ~ l,J .~l,f~-- Register of Wills FEES' Signature of Counsel Ret~u~red to . .T-- Letters ....................$ 260.00 Will ........................ Codicil(s) ............... (3) Short Certificates 12.00 ( )Renunciations....... Bond ............................ Othe~~~d~. Jr~. ...... ......................... Automation FEE......... 5.00 JCS FEE ................... 23.50 .~>~J a TOTAL .............. $ 6 Atty's Signature PRINTED Name: Marlin R McCaleb, Esq. Supreme Court ID No.: 06353 Address: 219 East Main Street Mechanicsburg, PA 17055 Phone: 717-691-7770 Fax: 717-691-7772 Page 2 of 2 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA ESTATalso knownEasAJEp,NBELgURLISON PETITION FOR PROBATE AND GRANT OF LETTERS: A. STATEMENT: Decedent was a resident of Hamilton County, Tennessee, when she died. Item LASTLY of her Last Will and Testament dated June 1, 1990, named her children, Marjorie B. A. Seiler, Mark B. Burlison and Jack R. Burlison, as Co- Executors of her Estate. Mark B. Burlison died on April 24, 2004; Jack R. Burlison renounced his right to serve as Co- Executor. Letters Testamentary were issued °thepChanceryOCourt by to Marjorie A. Seiler, Petitioner herein, p filed for Hamilton County, Tennessee (see exemplified co y herein). Because Decedent owned real estate in PetiBO.onerh of Mechanicsburg, Cumberland County, Pennsylvania, requests that ancillary Letters Testamentary be issued to her. ~ reNNH ~ "+ ~ E-t1' OF MEA~7N ~ ~r~'~ FlLE ~ •~ ~ ~~ C~~T9FlCA1T8 OF CLJ~G~A77i~ ~~ ~ ~, 'Female Marc} $, ~Oil~. ~ 3aaa ~ F.~eapor Renard $vrli,eon ~ _ a, > ~~ urn wr e. , ~ rntaoeooK s po.e...,n ~'"""~"`"`" ~ ~'eb 23, 1927' Mechanicsburg, PA 59x-24=9875 84 u. . 3 DOA ~ -NUreina ~~ 5 ~ -.8 I)Ihbr (SPSCMYI - '.t Yes I Nu 1 ~ ppse•nt 2 ER'OinP•11MS ~. ~ f0f Hamilton• © cHealth Center a 9t'andlfer Place t;hattanooga tom. tzn. .tt. m.r~nndn•1~ /~potudkdw~edrVivlmarta alY! ~yUndrq 1~.. Db a~ w. r~Wn' ~a'~tsa•~rMl ~3.ez'iFal "fiaEg .Warner id wed t .T gA w ~ ~ ~ 6407 K1nt~htgbrid a Road see Hamilton ~ ~, ~iixson .' ~ ~ ma.n, >s. DEC~oErmseouc~+nor+ 1>~ ~ t•.;w aNO•n ~~' eu~a~.vawn ~, , h4wloyawM~o.eaoo~~w~wa1 ~~. ~ -.Qvas Q ~] na =JsY'M9 -, but ,.. «a.) t (~v. ~ ~~ Iit4~.te 2 •~ 3 ~ 3 t,_ ,~. ea ~ ~g~cFrsnce' Baer +y erlier~ ReiiarYf ~ ,,,a ~ « a ~ #~ tan ~ tee. aw,Ap4xatY • ~i407 ICiztg~-tsbrtd~e Road; I~ar~ari8 B. SeileY p&~ughtet`~ ~ ~ $ >T21 7~ 4~3 - ~• axsrWka) (~ma .4, ~ or Wrn. ~ ter, ra.ri• e[~c..~rwt :.a®~ *en, ~. , , ~. , ~ ~ `MBChaY#~it®bur i'1K ~ oo(w~s :` bin. chasi~cs YL G2La2~f 2te. ' alb. 2t OF , - 2 n ~ RII[i1K C(OR ~ -- X2$91; ~-~ Gera R. Lsnd' ~ 3355 f $dyra~d M. ~Engl~s~~ zu ~ - - .., Lane Funeral fie: ` ~ ~ ~ 91;(~ 6 1 Ash~and~esrac~,.~h~~tat~doga. 'fN-.37415 24 :~~' ~ - ~~ _. erM+ .n+~ ang.prn. ~ ,~ r - - Qtn. , a my ~ ~,. uoEr(sE ~pc. D~~ sum hwrMn, aec rri ©sc~wautE ~t+b mt~ of ~Q ~ ~ b 13 ? _ / 3='-,l y ~f/ ~ ' - . ~ ~ : n ~ a.u and , arya evs,o m. caw 1 m.Mw,e wra , aw dwmYWb~ ~ ., .. - - .. ~ 1jAb. LICF~N3E t.1tri1BER, -~ 2EO. DATE !)~IED'(IFiaWl ~',Y~7 , ,~ . - - , ) 2E. ~. -`inv6A sha~M. ah.:d hWR. Llit?nfY aho aauN on...d,~ - ,. ~ o~+sM rW - au,~ou~ E l ~'G.tyYf/s k a+~or~ix`n>~ ~, t~ ~- - , 6: rod! ~wq ~ a ~s e n ~e•yarstn aaatM 1.~BT' ~ io but ViDt nMtltlnB ~ 9~Mr~9 OBtue ~~^ M Prt f. - PEFiF'OFiMftD4 ~ AVIeIABL£ PRIOii TO P SMIML: 1 bi ,. OF OF.A1nt ~ ~E ~~ .- ~y~.lw tYp ,,..,,Y New .:.. 31b. ~~ 31a AT 31 e. ~~--yy//; .,., p~q~.p~ ,~ .. 3,i a. ~~~.Yla~ t ~ Yee -- .,~ , 2 ~ p IctICaM fll~. L ( f'MrrypsFa AN~rnb•r, Or OM1., ~~oouub net M 1 s. . Arrt4 sbb•t,, ~Y. °~° y ^ Bu1cM! & ~ ~7•iym4we pupeinp, ab. (SPaeaY) ~ ,. .. ~ llbinicitln ~ ~ BR/tl lq/, - ~ ~ FiDA 139a PFF1l6B 1~~. tVBBI ~ P'-mil ~ ~ ~ ^-*'t ,~Z7 <.,' '-~ ~L 7 C~ f hereby certify. the above to be a true and correct copy of the original document on fl~i G..1 ~ ~ =-J hh {{~~ departmer~:. This certified copy is valid only when printed on securfty paper stowing ~ ~ ,~ _~ ~t ~ 9 O ~ embossed-s~aF~of the Department of Health. Alteration or erasure voids this certficati~ ~ ~+ ~~ -~ ~; Senn@ssee Cdde Annotated f8-3-1 1 t se ., Vi R cords Act of X977. -...K ~- ~ r rr~ c .~ ' ,. ~~ ~~~ t '~ ~ G~- ~,`(~;gj~~-f Ek'tte issued • .~. ~_ o ~~~•~~-~ 13endri~4cs ,. ~rtNi0tlCt?~n~5 - ------ - -~~. # ; ,-ca~cu e .~ .,.~} a~ ~!$ar'G P~iCwl~,. , .~•n~9ra. A-_.. ,.!•r::~•~+! ~ _ ~~~G ~~janrerp Court fDx ~a~mt~xDn ~Countp, ~enne55ee IN THE MATTER OF THE ESTATE OF No. I1-P-200 JEAN ELEANOR BURLISON DECEASED p~T ~ ~ ~-mss ~~ Date of Death: MARCH 8 , 2 0 I 1 ~. ~ ~ ~' '? PROBAT$~ `=` ' ~ y~k~ION . =.~ c ,-r;5, r"' ~ ,_~ Executor(s): MARJORIE B . SEILER _' ~ ~,~ ~ -^ c- , `"~ ---~ -i,1 ~.etter~ ~e5t~rrrenta~rp ~ ~ ~:> -., .V; r-~ ~ _i7 ~ _i ~ `'~ ~fJ~~, it appearing to the Chancery Court that the above named deceased person has ma~'e a Last. Will & Testament appointing the above named Executor(s) to the' same, which Will has been exhibited in this Court and proved as the law directs, and the Executor(s) having qualified according to law, it is accordingly ®rDer~r that Letters Testamen ~ J Lary are hereby issued to the above named Executor(s), being now empowered to enter into and take possession of all property rights and credits of this deceased person, and to administer this estate as required by law. ~1t ~>~ tnljEr~.of, I have issued these Letters on this day of . , 2011. STATE OF TE.w~SSEE Cove of HA1uu,TON S. LEE AKE ,CLERK & MASTER By ~~ DEPUTY PROBATE CLERK I solemnly swear I will honestly and faithfully discharge the duties imposed on me according to the terms of the Last Will & Testament and by law, including the filing of an inventory, settlement, inheritance tax return, and affidavits as required by law. Sworn to and subscribed before me this --.c day of f 2011. S. LEE AKERS, CLERK & MASTER By DEPUTY PROBATE CLERK ~> ~ > CertificateQ a ~ I, CLERK & MASTER of this court, certify: i) this is a Court of Record; ii) the above is a true, full, and correct co Testamentary issued by this court in this estate; iii) these letters are still in full -force and effect as of this date; and iv) these letters appear of record in this court's Executor(s) Bonds and Letters Record. Book N0. 8 0 Pie _____ 21 . Witness my hand and seal this day of (FORM 090, REV. 2008.02.04] 20 S. LEE AKERS, CLERK & MASTER By DEPUTY PROBATE CLERK HAMILTON COUNTY CHATTANOOGA, TN;7402 REGARDING THE ESTATE OF JEAN E. BURLISON AFFIDAVIT I, Jack R.Burlison, a resident of Mechanicsburg, Pennsylvania do hereby state that I will not. serve as the Executor of the Estate of my mother, Jean E. Buriison, and hereby request that my sister, Marjorie Seiler, be appointed sole Executrix of the Estate of Jean E. Burlison. `n / /~~..~ ACK R. BURLISON Sworn to and subscribed before me this~~ day of ~~~~~~ , 2011. NOTARY PUB My Commission Expires: /a /3 v~o CO1~IIv10NWE'AL~ OF PENNSYLVANIA NOTq~gL SEAL Connie L. Holtzman, Notary public Upper Allen Towns~jp, Lumbedand Oqu~, My commissioa ex ites Dec~ader -3, 2012 ~.~ ~~, c uw o~tcss AARLW A. McCAf FSi I, JEAN ELEANOR BURLISON, of the Borough of Mechanicsburg, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare thisas and for my Last Will and Testament, hereby revoking and making void all forcer wills and codicils by me at any time heretofore made. I order and direct that all my just debts and. funeral expenses be paid by my Co-Executors, hereinafter named, as soon. as conveniently may be done after my decease. • t give, devise and bequeath my automobiles and personal effects and such household goods, furniture and furnishings as may be my individual property and not the property of my husband or owned jointly by me with him, and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto my children, namely: MAR70RI8 A. SEILER, MARK B. BIIRLISON and JACK R. BI7RLISON {or to the survivor of them if any are not then living),. the same to be divided between them by my Co- Executors, hereinafter named, with due regard for their personal preferences and in as nearly equal shares as possible. • I give, devise and bequeath all the rest, residue and remainder of nY estate, real,. personal. and nixed, whatsoever and wheresoever situate, in equal shares unto mI' children, namely: MARJORIE A.. SEILER, MARK B. BURLISON and JACK R. BURLISON,. share and. share alike, absolutely and in fee Simple_ _.,, ._., :.. p~®(~ yci~t ~116{I boo If any of my said children shall predecease me leaving lawful issue to survive me, then I order and direct that the share which such deceased child would .have received had he or she survived me shall be paid over and distributed unto his or her said lawful issue, said issue to take the ~- - -- ~_ uw or-~,css AARLIN R. MCCALEH ancestor's share by representation and .not. per capita. I nominate, constitute and appoint my son, MARK S. BURLISON, Guardian of any property which passes either-under this Will or otherwise to a minor and with respect to which I am authorized to appoint a Guardian and have not otherwise specifically done so. Such Guardian shall serve without bond and shall have the power to use principal as well as income from. time. to time for the minor's education, support and welfare without regard to the ability of said minor's parents 'to provide for such education., support or welfare; or to make payments for these purposes without further responsibility to the minor, the minor's parents, or to any person taking care of the minor; or, in the event the funds held by the Guardian for any minor shall become, in the opinion of the Guardian, too small for proper and efficient administration, to deposit such funds in an interest-bearing account on behalf of the minor. ~~$• I nominate, constitute and appoint my children, namely: MARJORIE A. SEILER, MARK B. BURLISON and JACK R. BURLISON, Co-Executors of this,. my Last Will and Testament,. but if for any reason any of theca shall fail to qualify as such Co- -2- Executor or cease so to serve, it shall not be necessary to .appoint a substitute Co-Executor in his or her place, but in such event the surviving or remaining Co-Executors, as the case may be, shall serve with full power and authority under this, mY Iast will and Testament. All shall serve without bond in thss or any other jurisdiction. IN WITNBS3 WHBREOF, I, JEAN ELEANOg BURLISON, have hereunto set my hand and seal to this, my bast Will and Testament-which consists of three (3) typewritten pages for each of which I have affixed my signature this ~ day of 1~ ,~~~ A.D., One Thousand Nine Hundred Ninety (~,9gq}, ' .^ ~ ~ ~ ,~ ---.. ~--dtl.~ C ~y' ~,1~~-' ~' l.l,/~r:~ •,.cLy,~ (SEAL} The preceding instrument, consistin of 4 this and two (2} other typewritten pages, each identified by the signature of 'the Testatrix, was on the date thereof signed, sealed, published. and declared by JEAN ELEANpR BURLISON, the Testatrix ~~e~-n named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence, and in th8 presence of each other, have subscribed our names as witnesses hereto.. L u~w o~c~5 4RUM R. McCAL£S -3 - AFFIDAVIT~OF SUBSCRIBING WITNESS STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND Each of the undersigned, being duly sworn, deposes and says: The foregoing Will was signed, published, and declared in the presence of the undersigned on the 1St day of June, 1990, in Borough of Mechanicsburg, County of Cumberland and Commonwealth of Pennsylvania, by JEAN ELEANOR BURLISON, hereinafter called the Testatrix, who declared said instrument to be her Will. Each of the undersigned then signed his/her name as a witness at the end of said Will at the request of the Testatrix and in her presence and in the presence of each other. The Testatrix was, at the time the Will was executed, over the age of eighteen, and, to the best of the knowledge of the undersigned, of sound mind and not under any restraint or in any respect incompetent to make a Willa Each of the undersigned was acquainted with the Testatrix at such time. The Will was shown to the undersigned at the time this and was examined and verified by each of them as to the signatures of said Testatrix and of the undersigned. = _ _ ~, ~F ~~ iT~ .. Sworn to and subscribed before me % ~~ arlin R. McCaleb This 3~s~" day of ~?l1.CG.t/ 2011. NOTARY PUBLIC ,,.,,E~~,^~~.~~-~_:~ ~ ~_~~~~~~~ ,;~.~ :~~ fdctaraf 5eai I Charles E. Shie;ds !i;, ; iotary: ?uoiic My Commission Expires: ~ Rgonroe Twp., Cu:nberiand County i y mom is ion Ea;pires J4ne 2D, 20'! 2 atilSember, Penrsyivania nsscciaiicn at U^':,roa IN THE CHANCERY COURT OF HAMILTON COUNTY, TENNESSEE IN THE MATTER OF THE ESTATE OF ) JEAN ELEANOR BURLISON ) Docket No. (j - 1~ -~-o v Part II, Probate Division • Deceased. ) PETITION FOR TESTATE ADMINISTRATION ITEM 1. PETITIONER Your Petitioner is MARJORIE B. SEILER. Relationship of Petitioner(s) to the deceased was daughter. ITEM Z. PERSONAL REPRESENTATIVE. Petitioner seeks to have MARJORIE B. S appointed as personal representative for this estate and verily believes said person stands ready, willing and qualified to undertake. the office as required by law and will furnish bond as directed by the Court. ITEM 3. DECEASED. The deceased, JEAN ELEANOR BURLISON, hereinafter Decedent, died on the 8th day of March, 2011, at the age of eighty-four (84) at Health Center at Standifer Place. Decedent's residence at time of death was: 6407 Knightsbridge Road, Hixson, TN 37343 ITEM 4. WILL.. The document offered for probate was executed on the 1st day of June, 1990, and the names of all attesting witnesses are: Marlin McCaleb and Susan H. Goodridge. The original document offered for probate is herewith presented to the Court for probate. A true copy of the document is tendered herewith as exhibit to this petition. ITEM 5. OTHER DOCUMENTS. Petitioner is not aware of any instrument revoking the document being offered for probate. Petitioner avers that a search has been made for a subsequently dated will or codicil, and none has been found and verily believes the document being offered .for probate constitutes Decedent's Last Will and Testament. ITEM 6. DEVISEES & LEGATEES. The following are the devisees and legatees under the will: M 'orie B. Seiler 62 Dau hter 6407 Kni htsbrid e Road Hixson Tennessee X7343 [Name) [Age) [Relationship) [Mailing Address) [Zip Code) Jack R. Burlison 60 Son 805 Old Silver S rin Road Mechanicsbt7.r PA 17055 [Name] [Age) [Relationship) [Mailing Address) [Zip Code) [Name) [Age) [Relationship) [MailingAddressJ [Zip Code) ITEM 7. HEIRS. The following are those who are not devisees and legatees under the will wh would otherwise be entitled to Decedent's property as heirs at law if there were no will: [Name) [Age) [Relationship) [MailingAddressJ [Zip Code) [Name,1 [Age) [Relationship) [MailingAddressJ [Zip Code) ITEM 8. DISABILITY. Those persons listed in Items 6 and 7, if any, who are under disability are: None. ITEM 9. VALUE. Estimated gross value of this estate for Tennessee inheritance tax purposes i $121,500.00. Estimate of the fair market value of the estate to be administered is Personalty, $1,500.00; -Real Estate $120,000.00, with said real estate being situated in Mechanicsburg, PA. ITEM 10. BOND & INVENTORY. In the document offered for probate: Bond is: ^ NOT WAIVED ~ WAIVED in Will at Page 3, Paragraph 1. Inventory is; ~°NOT WAIVED ^ WAIVED in Will at Page ,Paragraph - PREMISES CONSIDERED, PETITIONER(S) PRAY: 1. That the Will be proved and established, probate of said Will be granted, and the same ordered forrecord; 2. That the Clerk & Master be directed to qualify the personal representative and to issue letters as directed. by the Court; 2 3. That notice by publication: ^ be given for creditors of Decedent's estate requiring them to file their claims. Tennessee Code Annotated § 30-2-306(a); ^ not be given. Tennessee Code Annotated ~ 30-2-306(f) 4. That if bond is required and if the inventory reveals the estate exceeds the amount as set out in this petition, the personal representative be required to increase the bond accordingly; 5. That the inventory be waived or that 60 days be allowed for its filing; and 6. That the aff davit pursuant to T. C. A. § 30-2-301(b) be waived or that 60 days be allowed for its filing. 7. That, for a decedent who was 55 years older at the time of death, the affidavit of notice to TennCare be filed within 60 days pursuant to T.C.A. § 30-2-301(b)(5). Marjorie B. Seiler, Petitioner 6407 Knightsbridge Road, Hixson, TN 37343 STATE OF TENNESSEE CHANCERY COURT OF HAMILTON COUNTY: Sworn to and subscribed before me this ~ day of April, 2011. S. LEE AKERS, CLERK & MASTER Deputy Probate Clerk WE ARE SURETY FOR. COSTS IN THIS CAUSE. BAKER; KINSMAN, HOLLIS, CLELLAND & WINER, P.C. 701 Market Street, Suite 1500 Chattanooga, TN 37402. _ Telephone: (423 756-3333 By: re S. Clelland, BPR #14 2 3 MASTER'S REPORT TO THE HONORABLE JEFFREY ATHERTON, CHANCELLOR: From an examination of Petitioner and witnesses under oath it appears that the facts stated in the petition are true, that the Will dated 06/01/1990, is the true and entire Last Will of th8 Deceased, executed and proved according to law, that to the best knowledge of Petitioner the estimated gross value of this estate for inheritance tax purposes is $121,500.00, and that after proper qualification letters be issued to: Marjorie B. Seiler. The executor, Sharon McCombs Bond: `Waived ^ Set at $ Inventory: ^ Waived E Sixty. days are allowed to complete and file an accurate inventory of the probate estate of the deceased pursuant to T.C.A. § 30-2-301(a) Affidavit: ^ Waived ~ Sixty days allowed to file the affidavit pursuant to T.C.A. § 30-2-301(b) This ,~_ day of Q ,rte.. ~ , 2011. ~- -~ c~-~.. . LEE AKERS, CLERK & MASTER 4 N~ASTER'S ORDER PURSUANT' TO T'.C.A. ~ 16-16-201 From an examination of Petitioner(s) ~ nd witnesses under oath it appears the facts stated in the petition are true, the will dated `~- j -~ ~ ~ y is the true and entire last will of Decedent, executed and proved according to law, to the best I:nowledge of Petitioner(s) the estimated gross value of this estate for inheritance tax purposes is S ,and that after proper qualification and pursuant to T. C. A. § 16-16--201 letters are to be issued to: 1`{ ~~~ ~ ~. ?~ 5 ~` ~.~ Q.~ ~G acv ~-~ ~ _ _ Bond: ' Waived ^ S * at S - Invento ~ - -- -- -- - _. ------ ry= ~ Waived 60 days to file accurate inventory of the robate estate. T.C.A ~ ,0 2 ,01(a} Affidavit of Notice to each devisee or le,atee: ^ W ed 60 da s to file a~aavit. T C A_~ ,0-2-~01(b). - _ ~.--- ---y- - - ---- --- Affidavit of Notice to TennCare: - - ------ - ^ N/A 60 days_to_file affidavit. T. C. A. g 30-2_~O1(b)(5). ~- This ~ day of , 20~. S. LE>r Pale 3 of 3 pages. PETITION FOR TESTATE ADMINISTRATION Form 07~P, Rev. ?010.09 ~S EXEMPLIFICATION OF RECORDS FOR ANCILLARY ADMINISTRATION 28 U.S.C. § 1738 STATE OF TENNESSEE COUNTY OF HAMILTON I, S. LEE AKERS, CLERK & MASTER OF CHANCERY COURT in and for the said state and county, certify the foregoing is the full, true, and correct copy of PETITION FOR TESTATE ADMINISTRATION, LAST WILL AND TESTAMENT DATED JUNE 1, 1990, AND AFFIDAVIT OF SUBSCRIBING WITNESS, DECLINATION OF JACK R. BURLISON AND LETTERS TESTAMENTARY IN THE MATTER OF THE ESTATE OF JEAN ELEANOR BURLISON, DECEASED, PROBATE FILE NO. 11-P-200 as the same appears of record and on file in my office and the same remains in full force and effect. Witness my hand and seal of said court at Chattanooga, Tennessee, on this 8TH day of APRIL , 20 11 S. LEE ~kERS. CTL>~tK & MASTER STATE OF TENNESSEE COUNTY OF HAMILTON I, JEFFREY M. ATHERTON, one of the presiding JUDGES of the Ct-tANCERY COURT of said state and county, certify that S. LEE AKERS, who gave the foregoing Certificate, is now and was at the time of signing the same, clerk of said court, and that said court is a court of record, and that his attestation is in due form, and his official acts as such are entitled to full faith and credit. Witness my hand this 8TH day of APRIL , 20 11. STATE OF TENNESSEE COUNTY OF HAMILTON 1 VN, l:t1A[VC:r,LLVK, YAK 1 1 I, S. LEE AKERS, CLERK & MASTER OF CHANCERY COURT in and for the said state and county, certify that the HON. JEFFREY M. ATHERTON, whose genuine official signature appears on the above Certificate, is and was at the time of signing the same, one of the presiding JUDGES of the CHANCERY COURT in and for the state and county aforesaid, duly commissioned and qualified, and that all his official acts as such are entitled to full faith and credit. Witness my hand and seal of said court at Chattanooga, Tennessee, on this 8TH day of APRIL ~ 20 11 S. LEE AIRS. C)f EIS & MASTER LAW OFFICES MARLIN R. McCALEB COURT OF COMMON PLEAS-OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Docket No. IN RE: ESTATE OF JEAN ELEANOR BURLISON, ALSO KN011,~ AS ,~...,. ~~' JEAN E. BURLISON, DECEASED ~ ~ rv ~ ~~~~ n~n ~ ~~~ a AFFIDAVIT FOR FILING BY FOREIGN FIDUCI ri ~ `;~ AFFIDAVIT FOR ANCILLARY LETTERS ~~~'~~ ~ ---' , ,_, `~ J - ''7 c~ -,-, ~ ; STATE OF PENNSYLVANIA: ~--i `: ~-=''~ SS . _..._ ~-~ ~ - ri COUNTY OF CUMBERLAND: Marjorie A. Seiler, being duly sworn deposes and say as follows: Deponent is Executrix of the Estate of Jean Eleanor Burlison, also known as Jean E. Burlison, Deceased, who died March 8, 2011, a resident of Hamilton. County, Tennessee. Deponent desires to exercise within the Commonwealth of Pennsylvania the authority vested in deponent by virtue of 20 Pa. Cons. Stat. Ann. ~ 4101 and has complied with all the provisions of same. After diligent search and inquiry, deponent states that so far as deponent has been able to discover, the above Jean Eleanor Burlison, also known as Jean E. Burlison, is not indebted to any person in the Commonwealth of Pennsylvania, and that deponent will not exercise any power which she would not be permitted to exercise in the jurisdiction of her appointment . ~=-~~ Marjorie A. Seiler -'6r407 Knightsbridge Road Hixson, TN 37343 Sworn/affirmed and subscribed to before me this d y of r~~~ , 2 011 . ~MpNWEALTH OF PENNSYLVANIA Notarial Seal ~ Marlin R. Mdaleb, Notary Public - - Notary Public Mdchanlcsburq eoro, Curr-be+'land ~O11nty I„y CortMnlaslon Fj~ires pet. 14, 2014 r~r.,eEn, ~Nnmwn~u wssocuma+ o~ Nar~s i