HomeMy WebLinkAbout07-29-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
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Estate o} JOAN LOUISE FARLLING ,Deceased ESTATE NO: 21- ~ i "" ~= ~ '-~-'
a/k/a: JOAN L. FARLLING
a/k/a: JOAN L. FORNEY
a/k/a:
SS NO: 206-32-1506
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
D A. Probate and Grant of Letters Testamentary or ^Administration c.t.a., or d.b.n.c.t.a. (eomplete 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 8/4/1980 and codicil(s) dated
NOTICE OF INTENTION TO RETAKE AND USE PRIOR NAME ATTACHED HERETO
(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 tinne 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. Petitioners j, 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 compl~~e list of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a ~~to a peitti5ng diyp
proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 332~except ~follo~~:rT_
T .7 f"
tiame Address nshi tTo~Decedent
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'rJSF. 1Dni TK1~~t. SHEF."i'S 1F 'VF,L'F,SSARY
TI-IIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last famih' or principal residence
At 1402 PHEASANT DRIVE SOUTH CARLISLE NORTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY PA 17013
{Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then ~~ years of age, died
7/17/2011 at
(Month, Day, Year of death)
BETHESDA, MARYLAND
(City and State where death occurredl
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 oi~ Real Estate in Pennsylvania $ __ 125,000.00_
Total Estimated Value $ 125,000.00
Location of Real Estate in Pennsylvania: (Provide full address if possible.) 1402 PHEASANT DRIVE, SOUTH, CARLISLE, PA_ 17013
Siunaturefsl
Name(s) & Mailing Address(es)
- H _. . ,
~-+- ~ ~ ~'
CRISTINE KELLER, 3633 MACEDONIA ROAD, SPRING HOPE, NCO
/
? ^ LESLEE J. NACE, 1012 HARRISBURG PIKE, CARLISLE, PA 17013
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Uo~,." 1 nl'~
lnterim Form RW-02 revised 12.26.10 by Cumberland County pending action oy the ~ourc
~~.
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.
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Sworn to or affirmed and subscribed ~ , j ,~J~ c~ ~~ ~~~
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~} f~'y - r~ --n cV ~ _
b re me this ~ ! day of ~ _ ~ ~ f-~ ~ `?
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For the Register `. _,
DECREE OF PROBATE AND GRANT OF LETTERS
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Estate Of JOAN L. FARLLING ,Deceased File Number: 21- ~ ~- ~~ ~=~..
AND NOW, this ~ day of lam! ~ n r- ~' , in consideration of the Petition on
the reverse side hereon, satisfactory proo~ ving n presen ed before me, IT IS DECREED that Letters
x Testamentary of Administration are hereby granted to:
¢f applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
CRISTINE IKELLER AND LESLEE J. NACE In
the above estate and that instruments(s) dated s/4/19so 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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Glenda Farner Strasbaug'f~._ _L ~ (M! ¢ ~ ~ ~? ; ~~ ~- '~ ~-
Register of Wills ,
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FEES:
Letters ....................$ 260.00
Will ........................ 15.00
Codicil(s) .................
( )Short Certificates
( )Renunciations.......
Bond .............................
Other .............................
........................
Automation FEE.........
5.00
JCS FEE ................... 23.50
TOTAL ................$ 303.50
Signature of Counsel Required to Enter Appearance
Atty's Signature C `~'G` 1 c~w.--
PRINTED Name: ROGER B:~IRWIN
Supreme Court ID No.: 6282
Address
Phone:
Fax:
60 WEST POMFRET STREET
CARLISLE, PA 17013
717 249-2353
717-249-6354
Interim corm RW -U2 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
F
STATE OF MARYLAND -~~
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~~ Department of Health and Mental Hygiene _ '
- - Divisior>i of _Vital_Records
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' Please Tj~e ®r print in Black Indel"tble Ink. Ensure AL1 Cedes ~e t~gible.
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State of Maryland /Department of Health and Mentat Hygiene
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1 ~
r Certificate of Death
1: Decedent S Neme (First Middle, Last) R.a, No.
__ SAN L~UI_SE FAiZLLTNG 2. Dr#e ~ DeaBr
M~ Day , year
3. Tkns of Death
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FMS' fif~nart, give s~set ar®d nub 4b. City. Town. or Loeatlon of Death ,tc. County of Dew
TT~L, INSTITUTES OF HEALTH
_ BETHESDA MONTGOMERY
-
SeraaiE~Tluh Ibex
,
6. Sex
7, Age pn yrs. last birthday)
If Under 1 Year
f 8
Data of Birth
206-32-1506
1 ^ M 2 C~F
70
Months ~~
Hours .
Mln. (Match
Da
Ye 9. Birt
np~ace (State or Foreign
Yrs. ,
y,
ar) o
C
Uaua1 Residence of Decedent
10
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a
e b.
ounty
G}~erland 10c. City. Town or Location 10d. inskle City Urt~s ~
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1
' Carlisle
, ^-lea 2~No
0e and NuntBer
-'Ik2 ~-~- Drive South
tOf. Zip Code
1 7 01 3
'~~ ~ 0f what c~,vy? -
,4
c - United Stags
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~ t i. Marital Status
1 ^ Never Married 2 ^ M
i
d 12. Was Decedent Ever in U.S.
Armed Forces? 13. Was Decedent of His anic Ori in? S
if y~ P 9 (pacify Yes or No-
specNY Cuban, Mettican, Puerto Rican
etc.)
14. Race -American Indian,
arr
e 1 ^ Yes 2 ~ No , Black, White, et0<
'0
~ 3 ^ Wi6a_wed 4 ]j~D'woreed If Yest~ve
Yaer or Dates. 1 ^ Yes 2~ No Specify:
Speclty ~.t~ _
a ~5. Deraden~s Education
(Sl~t"aTy oDly Fughest grade softipleted) 16a Decedent's Usual Occupation
(Give kind of work done during most of working
' 18b. Kind of Business Industry
Ek~mentaryl8aeandc~r'~i-12) Oc~lege (i-4 orrr+) fem. ~ NOT use refired)
2 Nurse Healtlrare
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,°_ 17. Father's Name (First Middle, Last)
Lester B. Far 11 i ng
t~Alto~ner'~Name first Middle, Maiden Surname)
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t~~formants~fameV~laf~nship (type, Print)
Levee 3. Nac~ Daughter 19b. Mailing Address (Street and Number a ral Route r, Ci r To at
1012 Harrisburg P~e is'~e,`°~P~~I~)
20a. Mew ~-13ispon~iae -
Burr 2 ^ Gremafion 3 ^ Removal kom$tate
d ~natlon 5 ^ omer(S
eci/
) 2Qb. Place ofDfspoaition {Name of
~~ ~~~~ Date
gil
07/22/ 2011
20e. Location - City a Town, State
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p
y la ar ens ar
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21. Signet f Funeral Licensee 22. Name and Address of Facility ~~ Br th S
M01613
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630 South Hanover
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23a. Part t. EnYar the dtsaasa, a complications that caused the death. Do not enter the mode of dying, such ~ cardiac or respiratory arre~,
shock, a_tteaf't faiktre. LTSt onty one cause on each line. -
in~med~a~ Catinat _ ~
d~ease a~andr~
r~ukl~ #tide~#t} a. ~ Int~v~.8at;ueen
DeaNt
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= Due to r as a consequence of): Y10 k 11
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Sequentially list conditions, b. ~ I~,~~ ,t ~ C.11 CQ~ ~'~1S
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C if any, loading to immediate Due to (or as a consequence ory: e
cause Enter Underlying _
Cause (Disease a iin)ary 6 ~., -
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-r~uHing in deaTti) Last Due fo (or as a consequence of)• ~ - ~
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IF FEMALE:
~G 23b. Was decedent pregnant 23c. If Yes, outcome of pregnancy ~
V in the past 12 mgnths7
1 ^ Yes 2 No 1 LI Live Birth 2 LLJJ Fetal death 3 ^ Ectopic pregnancy
4 ^ Pregnant at time of death 5 ^ Other (specify) 23d. Date of delivery
M
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~ 3 [7 Unknowrt 8 ^ Unknown onth Day Year
e
Part II. Other sigruficard oonditiats contributing to death but not resulting in the underlying cause given in Part I.
23e Did tobacco use contribute to iha cause of death?
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Yes 2 i7 No 3 ^ Probabty 4 ^ tE•/ttknown
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~ 24a. Was an 24b. W
tindin
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tie
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p pletion of
se of
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25. Was case referred to medical
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examiner? ,~~..,,//
1 ^ Yes 2 3
rN Hospital: . Place of Death(Ci>eckordyone) -~
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27
Ma
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er of Death
7 In atiant 2 ^ ERlOut tent 3 ^ DOA Other.
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4 ^ Nursin Home 5 ^ Residence 6 ^ Other t x"n.
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1 aCral 5 ^
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~ 28s. Date of injury
(Month, Day, Year) 28b. Time of
injury
28c. work?at
28d. Describe hew Injury occurred ` ~ Q ~ -
- ,. -. lL
e
2
ident - ~etion
3~Suicide 6 ^ Could not b M 1 ^ Yes 2 ^ No J ~ ~ - -r'I
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4 ^ Homicide determined 28e. Place of Injury - At home, farm, street, factory, office
building, etc. (Specify) 28f. Location (Street and Number dl~u Route Number
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City or Town, State) D `
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~~ Certifier 7 9 PFysician: To the bast of my knowledge, death oxured et the time, date and place, and due to the cau
in m and ~nar as stag.
{Check 2 ~ ~fiedieel faaminer` On the basis of examination and/or investigation
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on,
one y
eath occurred at the time, da#e and place, and due to the ceuae(s) and mariner sfated.
°~' ) ,.-- ~ Nur3e Practioner;'tsrifieb~st rg my knowledge death occurred at the time, date and place, and due to the cause(s) and martr>er~s stated
2 9b. Signature arrctTrfle€tf car
~ ` 290. License number
29d. Date sl9ned~l?onth, aal: Year)
~~ w- ~ 4 Oo 6 qty q
J ur I ~, zoo ~
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3 0. Name and address of person who completed cause of death (Item 23a) (Type, Print) G
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Ocher sclera q t~-D
1. D (Montt; Daa1'af-rf~ ~~ 32. R 's Signature I f e p
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~`-~ ^ ,~ ORIGINAL
[~ I HEREBY CERTIFY THAT THIS DOCUMENT IS A
Date ISSUed: ~x """„""""""T'~~'~~`Y-~~-A RECL~RC1 ON FILEIN_THE _.
_ DIVISION OF VITAL RECORDS. ~~~
\V ,\\\ \\\ \ \ 1 \ \ \ \ L 141 l I I
(July 10, 2011 A"
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~ STATE REGISTRAR -'
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DO NOT ACCEPT UNLESS ON SECURITY PAPER WITH SEAL y
OF VITAL RECORDS CLEARLY EMBOSSED. y
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a tt~tiil~n~~e~t~merc~
I, JOAN L. FORNEY, of North Middleton Township, Cumberland County,
Pennsylvania, declare this instrument to be my last will and testament,
'hereby expressly revoking all wills and codicils heretofore made by me.
1. I direct my executrices to pay all of my debts, funeral and
administrative expenses as soon as convenient after my decease.
2. I authorize and empower my executrices to sell any realty
owned by me at my death, at either public or private sale, and to give
good and sufficient deeds therefor, in fee simple, as I could do ~,f ~
living. ~~ ~-- ~'
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3. I devise and bequeath all of my estate of every rm.~in~e a`14d - -
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;wherever situate to my daughters, Cristine L. Forney and ~-~ee J~ ;_=.~:_~-.
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;Forney, share and share alike, the child or children of an'~ decea~s=ed
child taking the share their parent would have taken if living.
4. I hereby state that it is my intention that my husband,
i
FRichard L. Forney, shall have no right or interest in my real or per-
sonal_ estate, nor share in any other way as a beneficiary of my estate
pursuant to the Pennsylvania Probate, Estate and Fiduciaries Code,
Section 2106. He has willfully neglected or refused to perform the
duty of support for me, and he has willfully and maliciously deserted
me, both for one year or upwards previous to the executicn of this will.;
5. I nominate and appoint Cristine L. Forney and Leslee J. Forney
Ito be the executrices of this my last will and testament; they are to
serve as such without bond.
6. I hereby suggest that my personal representative retain the
services of Irwin, Irwin & Irwin as attorneys in the settlement of my
estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 5~r
day of August, 1980.
f ~~ _ ( SEAL ).
J AN L . FORNEY ~ -__ ___
Signed, sealed, published and declared by Joan L. Forney, the
.above named testatrix, 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 subscribed our names as witnesses hereto.
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;; JOAN L . FORNEY
BETZI A. MORRISON ,
.~~,~~ SHARON L. SCHWALM },:~, ? ., .~~~, y .~n,~ t_,~~ ., ;E~;>., :~,
'S(' 'f ~ VE'i.~7 , ~:1~`ll~:~~' Y..1~T1''` _`~'_'- -, ,fJ.d ~ _~ t ti f'C~r'~'~C~1?7~" ... '' t7' ~
.. r _rs ~, it, ~,y .;~'1~i„~ , Flo ~~~ . ~ rle „ 1_Zr'r' ;~:~ thE_ ~,u~ +,r, r ~~-~•
. .~~,r~_Lr;y +,11~:.L t:r,~, tE .~t;atri ~; ~r~~~~ a.r~~~ ~'~~ ,'ut;ed t;ri~~ ~ _~ ,7 ..
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~i<:~v.'p~r fit, +;,~~ ~F~~4-;~tiLX, S-_p.1,~~~", t, !"1 C; ~t`f111 '9.5 ~ W_?;`_'S~ -.(I ..,_-„
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~; ~~'. ,. , , f~ 1, tl" 1` ~~Ill)14~ C'~l ~ i" 1; ,-'l C' 1 .. l^]~i.. F1 t. ~.~1'.3 ;i'
_, ~~ ~. '1',=._, 1~ 't:';C` ); O);j~ .', ~;~ ,;tliiYli, m„~t~l~~ '~Ct<~ I1T'.7F.,.
JOAN L . FORl`dEY
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BET A. MORRISON
SHARON L. SCHWALM
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• ~, ; , .~~1.~T'n i,n :zil,? ~~ ~~.~~>~~ 1c' 3 T~~? r~F~ . ~r~~ ~',e~ ,v JOAN L
FORNEY ,r~~ tF~:,t,~':rix, _tn~z ~ ,:, _- ,,~~,1
~.~:: sworn '.~ ~~,~,`~~,~ ':~~~ b;' BETZI A. MORRISON .I~i
,~
SHARON L. SCHWALM : "~. ?.n<~::~~~, ~>'; , f;>>_i_:_~ `f ~. ., ,-
August ! `?80
~HRLISLE B[?ROUGH, ~'~^;;~;E.°.! AND CO'i~'TY
tNY COMMISSION EXPIRES OCI. 3, 1980