HomeMy WebLinkAbout04-18-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of
a/k/a:
a/k/a:
a/k/a:
Patricia B. Epple
Decensed ESTATE NO: 21- ~ ~ ~ "~% ~ ~ `
SS NO: 201 -1 8-3735
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
IAA. Probate and 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 aforementioned Letters Testamentary _ under
the last Will of the above-named Decedent, dated 1 1 / 2 0 / 1 9 9 2 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): _ _
^ 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 (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:-
Name
A rlrl r~cc
Relationship to Decedent
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USE ADDITIONAL SHEETS IF NECESSARY r ,~ :;'l
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THIS SECTION MUST BE COMPLETED: '-~' ~.,,a~ ~~~ =_ --,.=f
Decedent was domiciled at death in Cumberland County, Pennsylvania, with hisiher last family o~prncipal r "s.,iden~:e~
At 21 W. I Street, Carlisle, PA 17013 _ ~:`` ''
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then 8 6 years of age, died 0 4 / 0 6 / 2 01 1 at Carlisle , PA
(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 $ 4 0 , 0 ~~ 0
_If not domiciled in PA Personal property in Pennsylvania $
_If not domiciled in PA Personal property in County $ _
-Value of Real Estate in Pennsylvania $ 1~0 6 ~v 0 0
Total Estimated Value $ 14 b , U~ 0.00
Location of Real Estate in Pennsylvania: (Provide full address if possible.) 21 W . I Street , Car 1 i s ]_ e , PA 1 7 01 3
Signature(s)
Name(s) & mailing Address(es)
.~' John F . Eppley
231 Touchstone Drive
Carlisle, PA 17015
Interim 1-onn KW-U1. revised I.Z..'.b.IU by Cumberland County pending action by the Court Page I of Z
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OATH OF PERSONAL REPRESENTATIVE `~~ ~'~?~~~ J ,
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Commonwealth of Pennsylvania ~ ` ~~ -' '
County of Cumberland ~=~ ~ ~~ ~ ~ ~=
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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 cepresenl:ative(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 `~_~ ~ day of r
~-
For the Register
DECREE OF PROBATE AND GRANT OF LETTERS
Estate of Patricia B. - .~ ~~
Eppley ,Deceased File Number: 21- ~ _
~ (~ ~ ~ , in consideration of the Petition on
AND NOW, this day of ~`~`~ o ~
the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters
xTestamentary of Administration are hereby granted to:
the above estate and that instruments(s) dated 1 ~-- ,~C:~ -- t ~-~ ~, described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
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lenda Farner Strasbaugh, -~~ ~ r ~~;~,~~ ~ ~~~~~
~~p,~ ~~1~..~,~C~. ~-
Register of Wills ~"~"
FEES:
Letters ....................$ -~~ ~~ 1
Will ....................... 1
Codicil(s) .............. .
(~) Short Certificates l
( )Renunciations.......
Bond ............................
Other .............................
Automation FEE......... 5.00
JCS FEE .................. 23.5_0
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TOTAL ................ $ ---X5:-50
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Signature of Counsel Required to~~Enter Appearance
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Atty's Signature C /'~ ~
PRINTED Name: Stephen ~
Supreme Court ID No.: 3 6 81 2
. nogg
Address: 1 9 S . Hano~~er St .Ste . 1
Carlisle, ~?A 17013
Phone: (71 7) 245-2698
Fax: - ~
Interim Fonn RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
OCAL REGISTRAR'S CERTIF'ICATIt~N t)F D~A1'H
VUArRNING: It is illegal to duplicate this copy by photoC;tat ar phatograph.,
~~~:~~ I~~~r this ~~cl•tificate. ``;h.ia{
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105-143 REV 11/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE/PRINT IN
PERMANENT
CERTIFICATE OF DEATH
BLACK INK
(See Instructions and examples on reverse)
STATE FILE NUMBER
1. Name of Decedent (Rrst, middle, last, suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year)
Patricia B. Eppley Female 201_ 18- 3735 April 6,2011
5. Age (Last Birthday) UMer 1 year Under 1 day 6. Date of Birth (Month, day, year) 7. Birthplace (City and state or fo country) 6a. Place of Death (Check only one) _
8 6 Monde Daya Hour Mnurea
1 2 / 3 0 / 1 9 2 4
P A
Car 1 i s 1 e Hospital: Other:
Yrs , ^ InpaRe nt ^ ER /Outpatient ^ DOA ^ Nursing Home [ Reskfence ^Omer • Speciy:
Bb. County of Death Bc. City, Boro, Twp. of Death 6d. Facility Name (If not irtstlNtion, give sheet and number) 9. Was Decedent of Hispank Origin? ENO ^ Yes 10. Race: American Indian, Black, White, etc.
Cumberland
Carlisle
21 W. I St. (If yes, specify Cuban,
Mexipn,PUedoRican,etc.) (Specity)
White
11. Decedent's Usual lion Kind of work do ne most of world Rle. Do not state retired 12. Was Decedent ever in the 13. Decedents Education (Specify any tughest grade compl eted) 14. Marital Status: Marded, Never Married, 15. Surviving Spo use (If wife, give maiden name)
Kind of Work Ki d Business Indus
Analyst Gvt~Nava~. Repo U.S. Armed Forces?
^Yee ~Na Elementary /Secondary (0-12)
12 College (1-4 or 5+) Widowed, Divorced (Specify)
widowed
~ ~ 16. Decedent's Mailing Address (Street, city /town, state, zip code) Decedent's Did Decedent
State P e n n s y l v a n i a Live in a 17c
Actual Residence 17a
^ Yes
Decedent Lived in T
~
i
21 W. I S t. .
.
,
wp.
County Cumberl a n d Township? 17d. ®No, Decedem Lived within C a. r l i s l e
17b
L Carlisle P A 1 7 01 3 .
Actual Limns ar _
city / Bono
~ 16. Fatlter's Name (First, middle, last, suffix) _
19. Mothers Name (First, middle, maiden surname)
Victor Boyer Ann West
y 20a. InfonnanYs Name (Type / Pdnt)
John F. Eppley 20b. Inlom~ant's Mailing Address (Street, city !town, state, zip code)
231 Touchstone Dr. Carlisle, ]PA 17013
21a. Metlad of Disposition I remotion ^ Donation 21b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory a other place) 21d. Lop'Ikn (City /town, state, zip code)
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~ ' ^ Burial ^ Removal from Slate ~ was cr«netkn or Duration Aumorized
^ Qther -Specify: ; by Medical Examiner /Coroner? ~] Yes ^ Na 4/ 9/ 2 01 1 H o 11 i n e r Cremator
g Y M t. H o 11 S r i n s 1~~ 6 5
Y P 9 ,
a ~
- 22a. Signature of Funeral Service Cleanses (or person acting as such)
~ ~ ~ : ,f_ ~,,,, p..t 22b. License Number
01 1 589E Y1c. Name end Address of Facility
HollingerFH &Crematory Mt. Holly Springs, Pa 1 7065
Complete Items 23ac only when certilyirg
phYaidan is rat avaRable at time of death to To the best d my krwwledge, dea attuned at ihs tkne, da a end place stated. (Signature and Htle)
// .
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~ 23b. License Number
~ 23c.flete Signed.( lh, riay, year)
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prtiry cage of death. ~~/
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Remo 24.26 must be completed by person 24. Time of Death 25. Date Prorauraed Dead (Month, day, year) 26. Was Case Referred to Medical Examiner! Cororver for .t eason Other than Grematlon or Donation?
•' who pmtaunces death. 2 : 5 0 PfM Apr i 1 6 , 2 01 1 ^ Yea ~ No
-^___ -• -_^• • • ~w_ •••°••w••~••~ ~••~ ~~~•,,r,~ar r nµnuunrare nrmirm.
Rem 27. Pan I: Enter the chain devents -diseases, injuries, or txxnp6cations -that directly caused the death. DO NOT enter temtkral events such as prdac anesl, r Onset to Death
t
res
irato
artesl
a venirkular fibrillation without sftowi ellob
Ust onl
h ti ran u. Doer uaarr xtrimn:arn uxruruxra turnnwung ro cream,
but rat resulti m the undo n cause
n9 ~ rM 9 given in Pad I. [a. u ooecco use ~ontnotne a ueam~r
Yes ^ Probably
p
ry
,
gy.
y one pose on eac
ne.
r
NAMEDI
TE C
S
r
1 ^ Nt ^ Unknown
A
AU
E (Final disease or ^ C
11 `i.7 ~/r.. ~ J ~ ~ p/y
condition resulting in death) /° ~~/r-~2~~~" f`-
-~. a. 29. If Female:
^
Due to (or as a consequence of): ,.~r,~ lTr~ ~ ~
C•G~
' Not pregnant wthin past year
Y w r
hst conditions, R an
p~ ~ I~ a b r
SequnegntiaRY
e
tfr
^ Pregnant at lime of death
DERLYING CAUSE Due to (or as a consequence of): ~
Eller Hta U
N ^ Not pregnant, but pregnant within 42 days
(4se&Se or utryry that inRieted the c t
events resuhirg m Beam) LAST r of death
Due to (or as a consequence oQ: r
r ^ Not pregnant, but pregnant 43 days to 1 year
~ d
r before death
Unknown R pregnant within the pest year
30a. Was an Atxopsy 30b. Were Autopsy Rrxkrgs 31. Harmer of Deem 32a. Date of injury (Month, day, Year) 32b. Descdbe Flow Injury Occurred 32c. Place of Injury: Home, Fann, Street, Factory,
Pertortned? Available Prior to Cortgletkn
of Cause of Death? ~ Natural ^ Homicide Offx:e Building, etc. (Specrty)
^ Yes ~ No ^ Yes ^ No ^ Aatdent ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 32f. H Trensportation Injury (Specify) 32g. Caption of Injury (Street, city / trnvn, stale)
^ Suicide ^ Could Not be Determined ^ Yes ^ No ^ Driver /Operator ^ Passenger ^Pedestnan
M. ^Other- Spectly:
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33a. Certifier (check onN ~) 33b. Signature and TRIe a '-
• CertMying physcian (Physician prtitying pose of deaHl when another physiran has pronounced death end completed Item 23) ' a__i
To the beat of my knowledge, death occurred dtx to the pose(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~] ~ ~ _
• Pronouncing and ceAHying physician (Physcian Moth pronouraing death and cer6lying to pose of death) ense Number 33d. Date Signed Month day, year)
To tla beat of my knowledge, deem occurred et the time, date, and place, and due to the cause(s) end manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ A'~D ~/ ~ ~ ~ ~~~ //
• Medcal Examiner (Coroner /v
On the basis of examination end I or Investigation, In my opinion, deem occurred at ttre time, date, and plop, and due to the cause(s) and manner es stated_ ^ 34 Name and Address of Person Who Completed Cause of Death (Item 27) Type~rt
35. Registrar's n ore and
;w
36. Date Filed (Month, day, year)
~I ( I~ I ~, I OI (~Oc~~•~,~nl~ ~
Disposition Permit No. `(~ ~ ~ •5~9 ~3
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OF
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PATRICIA B. EPPLEY _~
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I, PATRICIA B. EPPLEY, a legal resident of Carlisle, CumbQr-
land County, Pennsylvania, being of sound and disposing mind and
memory, do hereby make, publish and declare this instrument to be
my LAST WILL AND TESTAMENT. I hereby revoke any and all. wills and
codicils previously made by me.
FIRST, I direct my hereinafter-named Personal Representat.i,ve (Exec-
utor or Executrix) to pay, as soon after my death as practicable,
all of the just debts and expenses of my last illness, funeral and
of the administration of my estate, as well as all inheritance,
transfer, estate and similar taxes assessed or payable by Treason of
my death, on any property or interest in my estate for the purpose
of computing taxes. My Personal Representative shall not require
any beneficiary under this Will to reimburse my estate for taxes paic
on property passing under the terms of this Will.
SECOND, I leave my entire residuary estate to my nephew, JOHN F. EP-
PLEY, of Carlisle, Pennsylvania, if he survives me. If he does not
survive me, I leave my entire residuary estate to his spou~~e, SANDRA
EPPLEY, same address.
THIRD AND FINALLY, I nominate and appoint my nephew, JOHN F'. EPPLEY,
as Personal Representative/Executor of this my LAST WILL AnfD TESTA-
MENT. If he is unwilling or unable to so serve, I nominate and ap-
point his spouse, SANDRA EPPLEY, to serve in his place. :I request
that my Personal Representative be permitted to serve without bond o
surety. I authorize my Personal Representative to do any and all
things which in his/her opinion are necessary to complete the admin-
istration and settlement of my estate and affairs, withoui~ the order
of any court .
IN W TNES WHEREOF, I have at Carlisle, Pennsylvania, this G~
day of `~cf~ 1992, set m han
Icy d and seal to this Instrument
~/ ' ' ' ° - _
Patricia B. Eppley, Tes atrix
SIGNED, SEALED, PUBLISHED AND DECLARED by the above 'T'estatrix,
PATRICIA B. EPPLEY, as and for her LAST WILL AND TESTAMENT, in the
presence of us, who, at her request, in her presence and in the
presence of each other, have hereunto signed as witnesses.
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Witness s ~~~~~
Address
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Witness Address ''
Page 1 of 2 pages
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STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
WE, PATRICIA B. EPPLEY,
Deborah Rule
ss
Denise Snider
and
the Testatrix and Witnesses, re-
sNectively, whose names are signed to the foregoing instrument,
being first duly sworn, do hereby declare that we were present an
saw PATRICIA B. EPPLEY, Testatrix, sign and execute the instrumen
as her LAST WILL; that she signed willingly as her free and volun
tary act for the purposes therein expressed; that each oaf us, in
the hearing and sight of the Testatrix, signed the Will as wit-
nesses; and that to the best of our knowledge and belief the
Testatrix was at that time 18 or more years of age, of sound mind
and under no undue influence or constraint. __
~_•
~' ~.__ Testatrix -
Witness Witness
Subscribed, sworn to and acknowledged before me by ]?ATRICIA
B. EPPLEY, the Testatrix, and Denise Snide
an
Deborah Rule ~, r ~-y.~
Witnesses , thi s 4~-- day of
November, 1992.
,~.~~
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NUT~-F~I~,L _ ~~~
SHELLY Sf:X'~~(~N, i10TARY PUBLIC ~~~
,.~ GNU
CARLISLE BO~~~.-, CUMBERLAND COUNTY -
MY COMM!S~!t'°~ EXPIRES OCT. 31. 1994 Notary~~ u 1 ' c
Membtr Rr~it~.y-.ar~ia Association oP Notaries
Page 2 of 2 pages