HomeMy WebLinkAbout07-11-11IN 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:
SS NO: 201-16-1947
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION °A' or `B' AND °~C" as
applicable:
$1 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 -August 3, 2010 and codicil(s) dated N/A
(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): no exceptions
^ B. Grant of Letters of Administration
i„ appucame, enur a.p.n., pendent life, durance 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
r+uaress elatioashi te"Deced
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USE ADDITIONAL SHEETS IF NECESSARY
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THIS SECTION MUST BE COMPLETED: -n ~ >~~ r-
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or princi~Lresidence-`U'
At 11 Burners Mill Rd., Plainfield, PA 17015, West Pennsboro TavrrFnship
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then 85
Estimated value of decedent's property at death:
If domiciled in PA
If not domiciled in PA
_If not domiciled in PA
-Value of Real Estate in Pennsylvania
Carlisle, PA
(City and State where death occurred)
All personal property
Personal property in Pennsylvania
Personal property in County
Total Estimated Value
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
d Signature(s)
s 95,000.00
S
a
$ s
Name(sl & Mailino Addr...l.~~
~.Y." „~,,~~ Dennis L. Sarver
270 Youngs Church Road
Interim Form RW-02 revised 12 26 In by G~mherlaed r~~~~w ~...,a:.~ t' b h
Iloam L. Sarver
Deceased ESTATE. NO: 21- `~ ?~Q~
years of age, died 05/18/2011 at
(Month, Day, Year of death)
g ac ion y t e 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 ----t-~--' _ day of
For the Register
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Dennis L. Sarver ~
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DECREE OF PROBATE AND GRANT OF LETTERS
Estate of Ivan L. Sarver
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Deceased File Number: 21-_ I I _
AND NOW, this ~ day of 2011 , in consideration of the Pet'
the reverse side hereon, sat>sfactory proof having een presented before me, IT IS DECREED that Letteron
X Testamentary _ of Administration are hereby ranted t
Dennis L. Sarver
(If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
g o.
the above estate and that instruments s dated g~~. _ m
() A~ ~s+ ~ 20t 0 described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
lenda Farner Stras au h,_ ~ ; '~
Register of Wills ~ ~-'(~~~~(~ ll'~i t-- ¢"~~ ~!
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FEES:
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Letters ....................$ ~ ~-
Will ........................
Co icil(s) .................
( )Short Certificates ~ __
( )Renunciations.......
Bond .............................
Other .............................
.................................
Automation FEE......... 5.00
JCS FEE ................... ~ 23.50
TOTAL ................$ ~~ ~L;
Signature of Counsel Required to F.nter Annaaro....o
Atty's Signature
PRINTED Name: Marlin R. McCaleb
Supreme Court ID No.: 06~_
Address: 214 East Main Street
Mechanicsbtag, PA 17055
Phone: 717-691-7770
Fax: ~~ ~ 77'2
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court
Page 2 of 2
105.905 REV.(Ill l)
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This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in actor nc with
the Vital Statistics Law of 1953, as amended.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Marina O'Reilly Matthew
Acting State Registrar
6214012
No.
H1DS743 REV 11200fi
TYPE / PgM1T IN
PERMANENT
&ACK INK
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JUN 0 8 2011
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS N "'-~~ '^~f
CERTIFICATE OF DEATH -~ ""~ .. r- :'?1
(See instructions and axamnlns nn ravaraey ~ .'r ~~
1. Nana d Decedent (Frcel, mitltlb, lest, aulfia)
2. Sea
3. Sadel Semrity Number Don ~..7
4. DaN of Death (Month, tley, ye
Ivan L. Sarver male 201 - 16- 1947 5/18/2011
5. Age (Last BiMdeyl UMer 1 Untler 1 d 8. Dale d BiM Mmth, tle , 7. BiM ace C' erd srete a Nre' n moot !N. Plata of Deem Check a ore
ar
Mmtre Days Hours Minbea
Hoapirel: Other:
8 5 Yrs. 6 / 2 6 / 1 9 2 S L 1 ve rpo01 , P A ^ mwr t ^ ER / alpaeent ^ DDA C~3 Nnrsmg Hana ^ Resdence ^ omar - slNdry
"
Bb. Dalnry of Death Bu Cey, Boro. Twp. d Death Bd. Facfiiry Name (If rtd ireamfiDn, grva street and number) 9. Was DamdaN of Hapanb Origin? ~ ~ ^Ves 70. Race: Amarkan Indian, Black, WhiN, etc.
Of Yea, spedly camn, Isve~M
Cumberland '. Ca~l)i~:l:er' l ~ t Church of God Home Inc. Medan, PUerb Ricers, etG)
11. Demtlad's Vaual Ocar tim Kea d work done dum most d wonin INe. Do nd sale rlMretl 12. Wes Decedent aver in me 13. DecetlenYS Educafim (Speciy mty Nghest Arede conplebdf 14. Medal Sblas' Merced, Never Mameq 15. Sumving Spou% (II woe. awe maiden name)
Kintl d Won Kirdd Business/IMUSUy U.S. Amssd Forces? Elememary I Secantlary (0-12) College (1-0 a 5i) WaoweQ Divorced IspenNl
Foreman US Govt. 6clYaa ^Na 3 married Betty M. Heimbaugh
'
16.Oecadmt
s Meiling Atldress(Street, Oily/town, state, zip code)
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aentra nor. sNb
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West Pennsboro
11 Burgners Mill Rd.
17B'®Ves, Decedent Livetl in Tw
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TowmhiP?
Plainfield, PA 17015 ,7b.cwnry Cumberland nd.^Na,DeeatleMLNedwlmm
Adual Limit d City/ Bao
18. Fethefs Name (First, made, leaf, suffix) f 9, Momai s Name (First, mitltlN, meitlen 9umem0)
Charles Sarver Nora Dillman
20e. IntormenYS Name (TVpe / PdnQ 20h InfamanYa Meaing Adtlreas (Shoal. city /fawn, sbN, zip mdej
Cher 1 A. Nickel 11 Rur oars Mill Rd. Plainfield PA 17015
219. Method d Dispoaion ^ Cremation ^ Donedm
~I Barel ^ Remeval7mmsreb ~w 27 b. Deb d psposillm IMOnm, day, year) 21 c. Pleca d Disposition (Name dcaretery, crematory a atlNr pMCe) 27d. Locaean (City/town, stele, zip code)
xCtwn,stlwlerDatNOnAdhorWtl
_ ^ puler- t by Maaol Examlrer/CeranM ^ Yes^ No 5/21 /2011 Mechanicsburg Cemetery Mechanicsburg PA 1705
22a. Sign rel Licensee (w parson such 71b. License Number 2 2e. Name end AtllNess d Fadliry
~ FD1 Myers-Buhrig FH & Cremator 37 E, Main ~, 1
Carp ens a anry c•RMin9
physician N ml avalbbN et time of tleeth to 23x. To dN best of knowledge, death accurretl et the time, date and pore sbletl. (Signature one tide)
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• 23D. licerree Number
23c. Dale Signetl (Mmth, day, year)
comfy canes of deem. ~
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,~,/ IZ, -f ~S3 Z°6 ~ ~1,~`/ 1 ~1, Gad ~
(tam 24-26 most be mm lama
p oY person
woo pmnourims deem 24. Tine d Deem
c~-~7 2fi. Dare Pmmm~cetl peed Month,
,7 ( Y.Yea(
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2fi. Was Case ReNnetl N Medral Examirer i Cacner for a Reasa Diner man Cremaew a Dureeon?
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O"~ ^ res ~ No
CAUSE OF DEATH (sea IMtruetloen end aaempls.)
I Appro.irNN IrlNrval,
Item 27. Pad I: Enter tlN chain d evenN- di6eases, inNres, a corrpkeedorrs ~ mat dtreclly caused Ire tleam. DO NOT enter rermhal events such as cerdac arrest, Onset to beam Part II: Enter Darer gonifimnt cnMPoaa mnlutwli m tlr.M
but not resdeng in ma uaNrtying cause given in PaR I 28. Dld Tdtamo Use tdbWe to Death?
^
~
re9piralay arest, or venldcuNr fibrillation wimoul showing the elNbgy. List ody one cause on each file. . Ves
bly
IMMEDIATE CAUSE IRral dis¢ase or
j ^ No ^ Unknown
cendlion resuhkg in ) C •~ /1
Kt
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II FemaN:
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a.
i .one WlA r+
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Due to lot as a awquance ofj:
She .ieq MlioeHY fist m ~.a fi~. a b_ Nol pregnant w;min past year
^ Pregnant al lirta d tleam
Enkr UNDERLYMG CAUSE Due m (or as a crosequarrs Dry: ^ Not pregnant, but pregnant within 42 tlays
(dNeese a Injury mat inlietetl me
evmre resulting m tleaM) LAST. c of tleaM
^
Due tc a
( as a cmaequame oQ:
Nd pregnant, bN gegrumt 63 days m 1 year
tl. before loam
^ Urenwwn tl pregnant whin me past year
30e. Was an Autopsy
Pedormed? 30b. Were Aufepsy F drga
AVadabN Piia W Dortgbfian 31,,. _M,a~nnar d Deem
^ 32e. Deb d Injury (Mont, tlay, year) 320. Decree How Injury OaYmetl 32c. Place d Injury: Homo, Fann, Street. Factory.
plfice Buildn
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I canna a Deem? L~SNemrel
Homicitk g, e
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^ Yes LJ No ^ Yes ^ No ^ ~~M ^ Pending Imestigelbn mod. Time of Injury 32x. Injury at Won? 321. II Tren4poReam Injury ($pedlyJ 32g. Location of injury (Street, oily /town, slate)
^ Suidtle ^ Cmltl Not b
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tl ^ Yes ^ No ^ Drna/pparemr ^ Passenger ^ Petlestdan
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338. CaRe•r (check onyy one( 33b. Signature 0 i d rabr
Qrtifylsp phyaebn (Physk:ien mRilyin9 cause d deem when aremer physicNn has PrdwurCed dwm altl carpNtetl Item 23)
To the b,retdmY knowbdgs,WN aecwnd tlu•to tlro uurN(a)eM manmra aNbd_________ 8
________________________ ~ - M- 1'
• Prvnwndng and arlllynp physklan (Physlden mom prmoutdng deem ant mdlyirlg N cause d deem) 33c. limns. Number Doe Si
j33tl. gnetl IMOnm, tlaY. Year)
TotnebeadmylmowNeg•,eaamomuma.tthshm..deN,endgMU,eneaa.mmetwee,al•ndmanRSra.MeNd-------"----"-----^ ~L.~D~1ZS •2(
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• IledkalEnmin•r/toraar t ?C~/
on Ina waN d aaanbaion em / w Masng.eron, m nn oplnbn, dealt omurnd a me nm., Irta am p.a,
wa dw to tn• c.ae.(a) wd mmner a..wed_ ^ 3a. Nacre and[\ddese ofPeraan woo caroNled cans. m Deem (nem z71 Tyua / PnM
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Diapositbn Permit No. 2
LAST WILL AND TESTAMENT
I, IVAN L. SARVER, 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 this as and for my
Last Will and Testament, hereby revoking and making void all former wills and
codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral expenses be
paid by my Executor or my Executrix, as the case may be, hereinafter named, as
soon as conveniently may be done after my decease.
SECOND. I give, devise and bequeath all the rest, residue and remainder
of my estate, real, personal and mixed, whatsoever and wheresoever situate, in
equal shares unto my children, namely: DENNIS L. SARVER, of Shermans Dale,
Pennsylvania, and CHERYL ANN NICKEL, of Plainfield, Pennsylvania, share and
share alike, absolutely and in fee simple.
LASTLY. I nominate, constitute and appoint my son, DENNIS L. SARVER,
I_AW OFFICES
MARLIN R. McCALFB
Executor of this, my Last Will and Testament, but if for any reason he shall fail to
qualify as such Executor or cease so to serve, then I nominate, constitute and
appoint my daughter, CHERYL ANN NICKEL, to serve in his place and stead, each
to serve without bond in this or any other jurisdiction.
IN WITNESS WHEREOF, I, IVAN L. SARVER, have hereunto het my hand
-~ o .
and seal to this, my Last Will and Testament which consists of two (~~writ~en ~-;
pages to each of which I have affixed my signature this ;g'1 gnc~ --- -
:~~
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C_° T
~~
`.^~~.~ "-~.,,~,~~ , A.D., Two Thousand Ten (2010).
~' ~ ~~1 ,.A ~ SEAL
The preceding instrument, consisting of this and one (1) other typewritten
page, each identified by the signature of the Testator, was on the date thereof
signed, sealed, published and declared by IVAN L. SARVER, the Testator therein
named, as and for his Last Will and Testament, in the presence of us, who, at his
request, in his presence, and in the presence of each other, have subscribed our
names as witnesses hereto.
1 ~ ~/
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L~\W ()FFICFS II
MARLIN R. McCALEB _ 2
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OATH OF SUBSCRIBING "'ITNESS(ES~J
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REGISTER OF WILLS --' c_
CUMBERLAND COUNTY, PENNSYLVANIA a° ~~
Estate of Ivan L. Sarver
Emily A. Foster
Deceased
(xa+s>$) a subscribing witness to
(Print Name/s)
the C~ Will ^ Codicil(s) presented herewith, (~) being duly qualified according to law, depose(s) and
say(s) that she /~ tx was /~ present and saw the above Testator /x'~tcx sign the same
and that she /~ /~ signed the same and that she /~ t}~agxx signed as a witness at the request of
the Testator /~3t~r?€I€ in ~~Ix/ his presence and in the presence of each other.
(Signature)
(Street Address)
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
Deputy for Register of Wills
(Signature) Emi A. Foster
219 East Main Street
(Street Address)
Mechanicsburg, PA 17055
(City, State, Zip)
Execrated oast of Register's Office
Sworn to or affirmed and subscribed
before m/e this 7 ~ day
of ~ /~ , Vii/ .
/.~'~G~~ ~ ~~~~~
Notary Public - '
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
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Fornt RW-03 rev. l0.13.06
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OATH OF SUBSCR.~BING WITNESS ES
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REGISTER OF WILLS --~ ~ -~ ~~~ -
CUMBERLAND COUNTY
PENNSYLVANIA ~~~' ;~
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Estate of Ivan L. Sarver ,Deceased
Marlin R. McCaleb
(~~l~xa subscribing witness to
(Print Name/s)
the ~] Will ^ Codicil(s) presented herewith, (~ being duly qualified according to law, depose(s) and
say(s) that ~~~ / he / tic was / saaeza~ present and saw the above Testator /~~tr~x sign the same
and that ~~t~ / he / ~ signed the same and that s}~a~ / he / t~3~ signed as a witness at the request of
the Testator / ~'~~# in d his presence and in the presence of each other.
(Sig~iature) (Signature) Marlin R. McCaleb
(Street Address)
219 East Main Street
(Street Address)
(City, Stale, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this _T~'~ ~ day
~~.
i
Deputy for Register of Wi1~1
Mechanicsburg, PA 17055
(City, State, Zip)
Executed oast of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) a[ time of notarization.
Forst RW-03 rev. !0.13.06