HomeMy WebLinkAbout05-20-11IN THE COURT OF COMMON PLEASOF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS ~)
Estate of ~~ ~~-~~ C . ,C. C i - t1 ~, ~~~ , Deceased ESTATE NO: 21- { ~ ' ~ ~ 1~
a/k/a:
a/k/a:
a/k/a:
SS NO: 1~ b ' ~ .~ 37~ ~
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
~A. Probateand Grant of LettersTestamerttary or Administration c.t.a., or d.b.n.c.t.a. (ciorr>plelGePart Cals~
and aver that Petitioner(s) is/are entitled to the aforementioned Letters under
the last Will of the above-named Decedent, dated _ ____ __ __ 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 wesnd a
party to a pending divorce proceeding at thetimed death wherein groundsfor dvorce had been eetabliehed asdefirted in
23 Pa. C.S.A. §33230:
^ B. Grant of Lettersaf Administration
(If applicable; enter d.b.n., pexfett life; duranteabsattia, duranteminoritate)
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 WiIJ in Section A and complete list of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and wasnd a peirty toa pending divorce
praoeeding wherein graundsfar divaroe had been eetabliahed asprovided in 23 Pa. C.S.A. § 3323(8), except as follows:-
Name Address Relffitaa#tip to De~rt
-
~
t
:i -
,.r..i
I~ ,
USE ADDITIONAL SHEETSIF NECESSARY
THISSECTIONMUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania,
At ,,2~1 S~~ti~t+ GC~.c,.tGr= S`re.LE'T. CA~I~SLt
~~
r , r ~-~
_~ .~ _
-" ~-1 i
. ...~/ • '.4 J
his/her last family or principal residence T~
~- 1'1 013
(Street address with Post Office andlip Code, Municipaliry~ Township, Borough, City)
Decedent, then Q~ years of age, died w'S I v'Zr.71 at (;. Act-~l~L~ , ~14-
(Mon Day, Y ar of death) (City and State w ere death occurred)
Estimated value of decedent's property at death:
If domiciled in PA All personal property $ 35~, t7~'C~
If nd domiciled in PA Personal property in Pennsylvania $
[f nd domiciled in PA Personal property in County $
-Value of Real Estate in Pennsylvania $
Tdal Estimated Value $ 0.00
Location of Real Estate in Pennsylvania: (Provide full address if possible.) ~~~ SO vtiTt~4 CC.~i.C.ti(.ct_ 5'T , ~fV12.1A51..,~ . ~i4 (70 ~ 3
Si ure(a) Name(e~ & Mailing Addreee(ee)I ,
-~
CN,.~-t-t~~ti~l NJ c,
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 ~ 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. .~
=.:
..
'~
,~~- __ ~ -
~_ .
- ~~
,~~ O
T~
For the Register
DECREE OF PROBATE AND GRANT OF LETTERS
o
Estate Of ~ ~ l (..C ,Deceased File Number: 21-_~__L___-
AND NOW, this .~-~'~~ay of ~ , in consideration of the Petition on
the ~reverse side hereon, satisfactory proof havin been presented before me, IT IS DECREED that Letters
~c,/Testamentary of Administration are hereby granted to:
pf a icade, enter ct.a, db.n., db.n.at.a, etc)
~. ` ' ~~ l~' ~ in
the above estate and that instruments(s) dated described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
Glenda Farner St
Register of Wills
FEES: Sigiatureol Counsel Required to Enter Appearance
Letters ....................$ ~(~
Will ........................_~~~~1~
Codicil(s) ...............
(~) Short Certificates c~-~~ ~
( )Renunciations.......
Bond ............................
Other ............................
............................
Automation FEE......... 5.00
JCS FEE ................... _ 2'.50 5~
TOTAL ................$~,--,a~
Atty's Signature
PRINTED Name:
Supreme Court ID No.:
Address:
Phone:
Fax:
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
Sworn to or affirmed and subscribed
105.g0i Kli~ iOUf~ i ~j '-' ~ -~ J ~ X
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate. 0.6.00
P 17451080
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with ^x as Local Registrar. The original
certificate will be forwarded ro the State Vital
Records Office 1'or permanent filing.
-~
~.. R~t~Kk~~x' Malt 17/20»
Local Registrar Date Issued
C7 a-,
,~ ~_
_- _,
-, . , .,
- .,
_,
,~
-_ - c- =
._
_, _ __ :.,
~,
-"' , ,
M10S113 REV 11/Iip6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
T DER/P~RI~N CERTIFICATE OF DEATH
BUCK INK (See Inshuctlons and examples on reverse)
1 _~
t.~ )
-_~
0
1. Name d Daredenl (Fl«r, middm, ~. edla) 2 Sax 3. Sodal SeaNry Number 4. Date d Dwn (Mmn, mY~ Ymr)
Mary Claire Leithead Female 156 -12 - 3751 Ma 14, 2011
s. Age (Last BirtlbaY) l1Mer 1 lbder 1 m 8. Dab d Simi Mann, 7. and emm a tarsi Be Plus d Dwn Clrck err
g3 ~^• may= "°~ "~"° Jan. 20, 1918 Philadelphia, PA "°`°"" °neL
Yts. ^ Inpetlent ^ ER / Ou~stlem ^ DOA ~ Nasinp Nate ^ Reslderra ^ OBrr ~ Spactty:
80. county d Deatli Bc. Cry, Berm, Twp. d Death Bd. Fatlely Name (tt rel arnnNOn, Siva waet ard rwrna) 9. Wm Decedent d HkPardc Odgm7 ~NO ^ ym 10. Rene: Arnaken IMm, Bkdc, WMIe, ek.
Cumberland S. Middleton Twp. Cumberland Crossings Retirement (~ ~ ~) ( Whit
i e
• 11. Dacemm'a Usual KM d wok dar mmt d We. Do nd alma 12 Wes DecMenl ever h ne 13. DecaleriYe Edcanm (Spetlly ally tnglrM grede mmpmmd) 11. MadW SmOn: Memen, Never Martbd, 15. Surwwng Spare (tt wie, give maiden reme)
wxbwatl
~0~ (sP•~r1
Katl d Waa KM d Buenree/ lydreay .
U.S. Armed Faces?
Elemenmry I SemMery (U12) Comega (1~ err 5t)
Exec. Assistant Carpet Mf ^ vas ®Na
• 16. DeraOalYS MaiMg Address Isaeet dN/town. state, zq code) De~'t~s
a
d ll
a
17
s PA Live inl 17c
Decedanl LNed in Twp
^ Yea
221 S. College Street
ge
ea
erKe
a.
tem .
,
.
TP7
L"°°aiB""
oa
C~Tmherland 17d.C7~
Carlisle, PA 17013 ,7b.caamY ,~
d
Carlisle cayrsao
1B. Panels Name (FgaL rnidme, IasL sumx) -
Edward Charles Leithead 19. Motlrfs Name (Fast, niidme, mamw aumame)
Veronica Bergen
20a. mfamam's Name (Type I Pma) 200. InlomrmYS Meileg Atltlrew (StrwL ary I bwn, smm, zlp catle)
Edward Leithead III 62 Fairview Avenue, ChathanY NJ 07928
21 e. Meltbd d D'npositlon ®Gemanm ^ prgyai 21b. Dam d ~
Ma
~7
• (Madh,my Year)
2011 21a Plan d Dnpwnbn (Name d amelxy. aawmry «dhar place) 21d. lgcatlon (Clry rbwn, stare, zlp cede)
C
li
l
P
17013
l
,
y
^ a.ld ^ RemwWtremsmre ~ wwraametlaraDaratlalA Herne &
ar
s
e,
A
Hoffman-Roth Funera
^ q~,. rnyawwE:.mb.rlcororrr r.^No
Furierel sarviw Uarrw ( aamg w such) 2?n. Lxeree Nanbar 71c. Name and Adhew d FacAily Hof fm'an-Roth Funeral Home & Crematory
. ~ 013144E
Cmpeb' 23ac aeY whw aNlyxq
plryeldmk rel avWbkadmeddwnm 23t To tlr Oep d mY IarowmdAa, dmtli et m smretl. (Sigremre entl amt
~ 29b'.nliam Nuri(h~a
y/~5
!1 `~
) 23c. Date SgQred (Mmdt, day, yasr~)7
~1
-~
Lx
~'
cerlNy team d deem ~ _/
,
'I \ T ~
I
', oC~
,1
~ zaze mwt ne mmmmd W parson 2a. rme d Dann 2s. lbm Pmiwnnd Dwd (Made, aey, wd ze. wm caw R•moadym r~amm Exar~iner I tears mr a Reaea, ob« tlrn cremadon a Danetioa?
^
rAn lx«rwkae death. I ~ ~ ~ ~ M, ~ , a ~ ~ ~ ym CI r~m
CAUSE OF DFATN (SSS Inetructlom and mremplea) i ApproxMem mmrvd:
h
armac arrest
Omd b Dwn
Y
l
m
W NOT Pan II: Emer other 4 ~m mriunana axvmxmre m man,
b tlr uamn
in
tales given n Part I
bd not reaulYr 28. Did Tdxeao Usa CamMde b own?
^ Y
^ P
d
b
emer mm
re
ew
rein ZY. Pen I: EriM tlr fAnlO..d@]Ote- Qswwe, , a campNunora ~ ntl daixly caused ne dmN.
rwpeamry arrest, a varmlarmr RmmUOn wehM shoxirg Ma etlobgy. Lbt orry err sum m oath Bra. ,
s eac
m y
q
.
g m
a
y
m
^ No ~merr'wn
//~ (~ //~ r,~
l (~~ 9 ~'/ I Y V P VKY• /~' ~1(L~CU.~
resultlrgsm ~e m) ~
i
~/ ~'ll°' Q ( (,I~.LYG' ((WI
~ vim. Na
t
itt
h
t
_~. s.
Due b (« m a mrreauenre ofl: ~
nn candsorr, tt ar7. e
~
~
/ n
CG ~l~K (C (~~Z Gy~ rN ply Ysur
pregnan
w
i
Pm
^ Pregimt at dre d dwM
^
.
m cum Nabd on Nr e.
~NDERLYa1G CAUSE Des b Ia w s cnneeArrnce d):
r Nd program, an Pre9rent rywdn d2 days
d dwN
(6eeew a ~Y nar minamd the
a
1
E
t
143 m
b 1
^
evam resdag n death) LABT.
Due b la m e axmprnCe ofl: .
u
pregnen
ys
ywr
l ~
d i ^ Uaurwn B praglrm walwl Br peat year
•
30e. Wm m Autopsy 30b. Ware Arimpey Fadigs 31. Maraca d DeeN 32e. Dam d Injuy (MOmh, my, year) 32b. Deecdhe How lnlUry Oaured 32c. Place d In)ury: Roma, Farm. Sheet Feclay,
O6Ke BuYmg. eb. (Syedly)
Penamed7 Avedahm Rio b ccngmtbn
d Dmm?
a c ~~ ^ ~~
~-,// alm
^
^ ^ Acddent ^ Par~mna ~y~ea 3zd rare d mpry Sze. lryay at wan 321. n Trmapomtlon lnjuy (5pearyl 32g. Lamm d Iryuy (street, ary r bwn, stem)
^ Yw L7 NO Ym
No ^ ym ^ No ^ Diiva,OParata ^ Pmsaq•r ^ P•dasnian
^ 6dcfm ^ Caub Nd be DemrminW M, Other-Specky
33• Certleer (cl k ad/ err)
rMe d
33b. '
r /~ J •~ /~
[~/'J~
t
a
l
/
/
'~
• CarnlYb9 P"Y•m~ (RM~^ ~%b9 wuw d dmN whw arMtrr lAryYdan Irm Pmt dean end anpeted Imm 23)
d
M
M ~ (
(C
.G( 'ti•fn ,/
.G~
,C
K
l•F• 1`
•'
V,
_________________________________
manrrarr a
S
Te tlrlwldmylarowmdg•,ewBaeeaarr.darbtw. enra(s)a
• Prarardng nrd caralPm9 pbyakWr (Phyakmn bM prenaxrYp men and arlnyYp m ®eee d men)
^
W 33a Number c
~
~~~ 33d. Dam Sprd (Mash, my, year)
~
/T
_
Te nw Bwtdmylorwmdg•, eaxn axwrweMtlr tlm•,mr,.nap.w,.ndarmtNSCww(e).ra nwinerrate _________________ /~1~~3
V ~ /
7
~
• Medkal ExanerwlCOronw
On dr huh d aenlmatbn and I a Inwatlpstbn, m my aphsian, dMh oaurad H tlr tlme, dam, and phr, and due 1o the catm(sl and m•ara m staled- ^
34. Nmr and Address d Who cease d omn (Imm 27) type / Pdm _
(tj ~.k ?•tc;, Michael McL
u
hli
~. peglstral ~ pNp~.t yy,.~y
I of I 1 I U
I ~ I (
`
I
36. Dam Fdad (MOmh. mY,Yea) g
a
n
_
1 '7 3 Zi~ 125 York Avenue
~~ Cf y') bcr rF y
~C
_
~ ~(
(' ,
Dlepoainan Pemil No: `~ ~ ~N1 ¢ O T~
~ ~ ~ ~l t;~>~~s
_ _.,,.:,
C7 ` _ _ -~~
F:\FILES\Clients\12918 M Leithead\12918.1.wiIL2011 ; 1
'~
;.'..c ..
L.3
-- r=i
.:_{ .• ~:~~7 L_~
LAST WILL AND TESTAMENT z' -' '
I, MARY C. LEITHEAD, of Carlisle Borough, Cumberland County, Pennsylvania, being
of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last
Will and Testament, hereby revoking any and all former Wills or Codicils made by me.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and
all death taxes (whether such taxes may be payable by my estate or by any recipient of any property)
shall be paid from my residuary estate as soon as practicable after my decease and as part of the
administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement
for any such tax so paid, even though on proceeds of insurance or other property not passing under
this Will
2.
I give, devise and bequeath all of my estate, both real and personal property unto my brother,
EDWARD C. LEITHEAD, JR. and my sister, PHYLLIS L. MARTIN, in equal shares, absolutely.
In the event either of them shall predecease or fail to survive me by thirty (30) days, then his or her
share shall be distributed to his or her issue, per stirpes.
3.
I nominate, constitute and appoint my nephew, EDWARD C. LEITHEAD, III, as Executor
of my estate.
4
I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
5.
I authorize and empower my Executor, in his sole and absolute discretion, to purchase or
otherwise acquire and retain any investments of which I die seized or any real or personal property
of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in
regard to any or all property of any kind forming a part of my estate for such terms and such prices
~~
[Initials]
Page 1 of 3 Pages
as they may deem advisable; to borrow money for any purposes connected with the protection and
preservation of my estate; to mortgage or pledge any real or personal property forming a part of my
estate or to join in or secure the partition of same; to compromise any claims or demands of my
estate against others or of others against my estate; to make distribution in kind and to cause any
share to be composed of cash, property or undivided fractional shares in property different in kind
from any other share; to employ agents, attorneys and proxies and to delegate to them such power
as my Executor considers desirable and to pay reasonable compensation for such services as may be
rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may
be necessary to carry out any of these powers. In addition, I direct that my Executor shall have the
power to conduct an inventory of any safe deposit box necessary to the administration of my estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this day of
. ,.
(~, ~ (SEAL)
G~~ rthead
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and
for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testatrix and of each other.
~-
i
,~ ~-
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
/` ~ ~~ ,.~1- ,
We, Mary C. Leithead, ~~~, ~. ~=~ ~ ~ ~ and ~ W` ~(C{ C . ~ ~~~`~
the Testatrix and the witnesses, respectively, whose~names are signed to the foregoing instrument,
being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her last Will and that the Testatrix has signed willingly, and that the
Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that
to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
r
(~
Marv C. ithea , esty~rix ~
Witness
,~
L ~`
(
Witness
Subscribed, sworn to and acknowledged before me by Mary C. Leithead, the Testatrix, and
subscribed and sworn to before me by ~--,w~~ ~ X . C< <Y~ U and ~ ~~ N%~ r~) ~' . )..e~ ~h~ ~ 1~~
the witnesses, this ~~ day of ~~ -~ ~ ~ ad ~ C
G
Not ubhc
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Shelly Brooks, Notary Public
Carlisle Boro, Cumberland County
Cwnmiselpn F_xplree dup. 6, 2013
Member, Psnnsylvanla Aseociatbn of Notaries
Page 3 of 3 Pages