HomeMy WebLinkAbout04-20-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of ,Deceased ESTATE NO: 21- ~ ~~ 4 / I
a/k/a:
a/k/a:
a/k/a: SS NO: /7~ - ~~-- ~~~~
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 under
the last Will of the above-named Decedent, dated ~~ ~,Z .~'~d ~/ and codicil(s) dated /1/D'it/ L=
(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-tip a pending~divorce
proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(g~pt as fo]tows:
Name
Address
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USE ADDITIONAL SHEETS IF NECESSARY
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THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in umber d C unty ennsylvania, with his/her last family or principal residence
(Street address with Post Office and Zip Code, Municipal :Township, Borough, City) `
Decedent, then ~ years of age, died / / at ~
(Month, ay, Year of death) (City and State where death occun
Estimated value of decedent's property at death:
If domiciled in PA All personal 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 $
Total Estimated Value $
Location of Real Estate in Pennsylvania: (Provide full address if possible.) /~' ~"~'~~
Signature(s) Name(s) & Mailing Address(es)
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Interim Form 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
~°+ S S
COUNTY OF ~ 4t,rti ~.~t' • ~ c~ .~ l'~
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 ~-: j ~ :~., ~$'~,/~~,~ ~:/
/~ ~ ~ Signature of Pr" rsonal Representative
befo e me the ~ (.~ ~ day of
Signature of Personal Representative
For the Register Signature of Personal Representative
n -' :ate
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File Number: / ~'.-~ ~,~ ~ =-~
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Estate of ~V ~ ~ l~C% Dec ~ ~ ~ ~ -'
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Social Security Number: ~ 7 ~'- ~~ J ~. ~:.~ ~ Date of Death: ~ ~ / ! ~~ ~,/ / ~- `- ' _ ; i
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AND NOW, ~ ~~ ~% ~ 4? , ~~ l ~ , in consideration of the foregoing Petition, satisfactory proof
having been presented bef me, IT IS DECREED that L tters ~ J~~fhPn ~'Cl/"
are hereby granted to ~-Tr L - ~~~
_ in the above estate
and that the instrument(s) dated r ~ d ~
described in the Petition be admitted to probate and filed of record s the last Will (a Codicil(s)) of D edent.
4 ~ f
FEES ~ -~C.J
/ ~ ~i C,~Lti Register of ~ /~
Letters ............. $ ~f ~ ~ L/ ,s
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Short Certificate(s) ... ~.:. $ , ~I Attorney Signature:
Renunciation(s) .......... $
° • ~" /`~ Attorney Name:
• • • $ ' ~~ ~ Supreme Court I.D. No.:
y ... $ %~~
$ Address:
... $
... $
... $
$ Telephone:
... $
a..
~~-
TOTAL .............. $ ~
Form RW-02 rev. !0.13.06 Page 2 of 2
~ ~ ~ ~'0~ ~'y 91
LOCAL REGISTRAR'S CERTIFICATION ~JF DEAT~~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
F"ee for this certificate. $6.00
P 17450632
Certification Number
9
This is to certify that th~~ infortnat+on Iere given is
correctly copied from an ~~riginal Certifi.:a~e of Death
duly filed with rage as Local Registrar. Tl)e original
certificate will he for~~arded to the ~ tote Vital
Records Office fi;)r per)irinent ~'ilin~;.
L.~ve,. ~~ I~ A~''~ 2011
Local Registrar ~ Date '~~ssued
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H1at>143 REV 112008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPEIN
,,,~ CERTIFICATE OF DEATH
(See lnstructlons and examples on reverse) STATE FILE NUMBER
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1. Name d Deaden (Fart, nidde, brt, w86c) 2. Sex 3. Soda) Seailty Nuriber 4. Dam d Deem (Matra, mY, Y•a)
174 -O5 - 2852 A ril 14 2011
5. Aga (last Birtlwleyl lJrtdx 1 UMer / 8. Dab d Bldh 7. BI and state a Be. Pba d DnBt t]tedc one
Montlre Sys Floae AituM HospBal: Omer.
9 5 Yrs. Dec . 2 3 1 91 5 Car 1 i s 1 e Pa ®Irtpamd ^ ER I Outpatled ^ DOA ^ fVuroktp !tone ^ Reelmnce ^ Other - seedy:
8b. CauMy d Deetlt Bc. CBy, Boro, Two. d Deem Oil. Fadltly Name (B rtol InstlhNon, give sheet and camber) 8. Was Decedent d HNpeac OdpM7 g] ~ ^ yw 10. Race: Arrrdan Milan, Black, WNm, etc.
(If yw, sPedty CtDan, (SP~M
Cumberland So. Middleton Carlisle Re ions! Med. Conte "'°P're''°R'a'n~rt`~) White
11. DeaderM's UaW d work done moat d We. Do sat sale 12 was Deadea ever M the 13. DaatdeN'a Ettucetlon (seedy ordy N¢NSl pram axrtpbted) 14. MartW sour: Henbd, Never Herded, 15. Savtrirg spares (B wife. glue marten name)
tOnddwork KMddewirrew/IrtdWry U.S. Armed Faae4 Ebmenmry / Setbrtmry (a12) Cotlepe (1-4 «5+) wleared, Dhaced f~Nl
^ Yea Na widow
18. DeadertPs HatlMp Address (street, dry /form, amts, zlp axle) Decedenra
Actual Rettlderta 17a. Smm P e3 _ Dld Decedent S 11 V e r S A r 1 n Q
1 c. ~ Yes, Decedent Llved In T
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7070 Carlisle Pike #1 13 .
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18. Fasters Name (Firot, mldtie, test, att8lx) 1g. MoBrers Noma (Fkat, middle, rnelden surtreme)
hlone Greenwood
20a. Irtfornrnrs Noma (Type /Pmt) 20b. InfomtertPe MaOatg Address (Sheet dlY / town, slab ziP ~)
' l~; 1 1 3 Carlisle Pa. 1 701 5
21 a. Metltod d Dispaitlon ~ CremaBat ^ tkneBat 21b. Dam a DhtptxdBm (Horror, flay, year) 21c. Pence d Dlspostllat (Name d tx~rrrmry, aemahxy a ~wter pens) 21d. Loatbn (City/mwn, amen. zip code)
^ BuW ^ Removal nom Smte r Wr 1~aaratlort « Donstton Autltalasd
^ Dm.r- rbyfttttdlalExrtrhrx/Caorrr7 ®res^No
April 15, 2011
Hollis er FH/Crem~itory Inc.
Mt.Holly Spgs.Pa.1706
22a d Fttrtsrol servkxr « as z2b. Lkxare Norther z2c. Name and Address d FatBMly 5 0 N . B a ].more V e .
- FD-011932-L 'n r FH Cremator Itic. Mt. Holly Springs, Pa.17065
Morns 23st sty when oerWyYtg 23a. To d my krtorrbrlpe, deem atxxared at the tlrtre, orb and pence rtabd. (Slgrrturo end tkb) 23b. LJcenee Number 23c. Dam Signed (Month, day, year)
ptryrciert i ro1 avetlebb rt 1Mre d datlt k,
a.wy awe a deem.
Merv 24-28 rraret W amplrted by pavan
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Z 25. Date Prortaxtced Dsad (Month, dlay~,/v~r•1 28. Wes Case Referred m Medlal Exemkrer / Corona far a Reason triter than Cremetlon a Donetbn7
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CAUSE OF DEATH (Sere ImtnrcUons and examples) t ApproxMrm Mbrval: Part II: Enter oMrr ' 28. Dkl Tobacco Use Contribute m Deem?
Item 27. Part 1: Enter ms g~ ~y@ - dseaees, MJtrbs, a twmpBatlons - fuel dkedy awed me death. DO NOT Baer bnanal aveae such u ardbc evert, ~ Ones m Death but rat resddng M the utdedykq awe gNen M Pert I. Yes ^ Probably
reapirabry emast, a veadctdm fibrMatlort wltltod sltoaArtg Bre etloktpy. List say ate ease on each Brre. r
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UNDERLYNG CAUSE ~
Nd pregneM, but pregnant wlmin 42 days
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Due b (« ea a oareegtrerta d): ~, ~
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30a. Was n Autopsy
Perlonrrd7 30b. Were Aubpsy
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^ St>+cim ^ CaBd Nd be Demmkrd H ^ Yee ^ No ^ Drlver/~~ ^ Paessrtpar ^ PedesUie^
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33a. CertlBer ( aa'/ ~) ore and a
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Ta tM hart d my latowbdpa, dertA oaurtsd tiw to the cMga(s) utd ttwtrrr as Wend- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
l+rsrrotatartg and txatMyhg phyakbn (Phyaiden boor prortotrtclrtp math and txuUfyktg m awe d mom)
To m. !tart a my tmowtadpa, dsrth oeeurrad rt the tlm0. dra. and plea, std dos ro the auae(s) and mam.r a. aMad_ _ _ _ _ _ _ _ _ _ _
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On tlta bob d axrnkrtlort aril / «Mwstlprtlon, M my opMbn, dsam oaurrod rt tlts ttrtte, drta, and pba, and dw to tfr sus(s) and manrtsr a strtad_ ^ 94. Noma
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THE LAW OFFICE
of:
JAME S M. BACH
Attorney-At-La w
352 S. Sporting Hill Road
Mechanicsburg, PA 17050
(717) 737- 2033
LAST ALL ANI~ TESTAMENT
FOR
EVELYN A SETLOCK
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LAST WILL AND TESTAMENT OF
EVELYN A. SETLOCK
I, EVELYN A. SETLOCK, of the BOROUGH OF LEMOYNE, COUN'I"Y OF
C,'UMBERLAND, COMMONV~IEALTH of PENNSYLVANIA, being in good bodily health and of
sound and disposing mind and memory, and not acting under duress, menace, fraud, or undue
influence of any person whomsoever, merely calling to mind the frailty of human life, and being
desirous of disposing my worldly goods while I have the strength and capacity so to do, I do make,
publish and declare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel and
annul all my former Wills and Testaments, including codicils thereto, b,~ me at any time made, and
declare this alone to be my LAST WILL AND TESTAMENT.
AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRtJST ME WITH IN THIS
LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM 1. I direct that my Executrix hereinafter named, pay and discharge all of my just debts,
funeral and testamentary expenses.
ITEM 2. I order and direct that my bodily remains be cremated.
ITEM 3. I give, devise and bequeath all of my jewelry to my dea~:ly beloved daughter, C anyl
Lee Walter.
ITEM 4. I give, devise and bequeath the sum of $1,000.00 (One thousand dollars), free from
tax, to Wilbur Radabaugh, per stirpes.
ITEM 5. I give, devise and bequeath the sum of $1,000.00 (One thousand dollars), free from
tax, to Betty O. Thumma, per stirpes.
ITEM 6. All the rest, residue and remainder of my entire estate, wheresoever situate, and
whatsoever it may consist of, I give, devise, and bequeath, absolutely, and in fee, to
my dearly beloved children STANLEY S. SETLOCK, JR and C:ARRYL LEE
WALTER, share and share alike, per stirpes.
L A. SETLOCK
ITEM 7. I nominate and appoint C;ARRYL LEE WALTER, as :Executrix of this my LAST
WILL AND TESTAMENT. Should the Executrix named fail to qualify or cease
to act as Executrix, then I appoint STANLEY S. SET:LOCK, JR. as Executor in
her stead.
ITEM 8. I direct that my personal representatives, as well as their successors shall not be
required to give bond for the faithful perforniance of their duties in any jurisdiction.
ITEM 9. I order and direct that my Personal Representative(s) ~:iamed herein use the legal
services of James M. Bach, as Attorney for my Estate.
ITEM 10. I direct that all estate, succession, legacy, inheritance or other transfer taxes, however
designated that shall become payable by reason of my death in respect of all property
comprising my gross estate for tax purposes, whether or not such property passes
under this LAST WILL, shall be paid by my Executor out of my residuary estate.
ITEM 11. I grant to my personal representatives herein named, in addition to, but not in
limitation of those powers vested by law, to be exercised without prior application to
or approval of any court, the power and authority to retain indefinitely any property,
to invest and reinvest any assets or the proceeds derived from the sale of assets,
although said investments may not be of the character prescribed by law, to sell,
convey, assign, transfer and encumber any property, to Fray, settle or compromise all
clairns, to make distribution or divisions in cash or in kind, and in general to exercise
all powers in the management of any property hereunder which any individual could
exercise in the management of similar property ownecl in her own right, and to
execute and deliver any and all instruments and to do all acts, which maybe deemed
necessary and proper.
--~
,;
EVELYN A. F:TLOCK
---------------------------------------------------END--------------------------------...----------------
2
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss
I, EVELYN A. SETLOCI~. the TESTATRIX, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed
the instrument as my LAST WILL; that I signed it willingly; and that I signed it as my free and voluntary act
for the purpose therein expressed.
Sworn to or affirmed and acknowle before me, by: the TESTATRIX this 2nd day of March, 200.
-, ~
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EVEL A. SETLOCK
NOTARIAL SEAL
JAMES M. EACH, Notary Public
Hampden Twp., Cumberland County
M Commia~ian Ex iras M~ 13.2007
~ ~~
J S M. BACH, E SQUIRE
N ARY PUBLIC
Mechanicsburg, PA 17050
My Commission Expires: 05/13/07
The preceding instrument consisting of this and two (2) other typewritten pages, identified bythe
signature of the TESTATRIX, was on the date thereof signed, published and declared byEVELYN A.
SE LO ~ the TESTATRIX therein named as and for her LAST WILL AND TESTAMENT.
" _ ~,~~ Residing at 352 S. Sporting I Ro
FATIMA A. KIMIN Mechanics _,.,gr .~?A 7050
7`~ . Residing at 352 S. Sporting ~~~
TERESA I-~ LAUGHE Mechanicsburg, l?A 17050
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss
We, FATIMA A. SKIMIN and TERESA H. LAUGHEAD, the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that
we were present and saw the TESTATRIX sign and execute the instrument as her LAST WILL; that the
TESTATRIX signed it willingly and that she executed it as her free and ~~oluntary act for the purpose
therein expressed; that each witness in the hearing and sight of the TESTATRIX signed the WILL as
witnesses; and that, to the best of our knowledge, the TESTATRIX was, at the time, 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn to or affirmed and acknowledged before me, by: FATIMA A. SKIMIN and TERESA H.
LAUGHEAD, witnesses, this 2n day of Near h, 2004.
FATIMA A SKIMIN TERESA fL LAUGEHAD
NOTARIAL. SEAL
JAMES M. BACH, Notary Public
Hampd+~n Twp., Cumberland County
My Commraaion iM 'rte Ma 13, 2007
J S .BACH, ESQUIRE
N Y PUBLIC
Mec nicsburg, PA 17050
My Commission Expires: 05/13/07