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HomeMy WebLinkAbout08-19-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Betty J. Whistler File Number 21= ~ ~ " ~0 ~~ also known as ,Deceased Social Security Number _l ~ ~ - S~ ' ~ le '7~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) ^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executors named in the last Will of the Decedent dated o- b 1,.,~ ~Ol~ and codicil(s) dated None r~c.vj (State relevant circumstances, e.g., renunciation, death of executor, etc.,l Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing, was never adjudicated incapacitated, and was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g): Not applicable ^ B. Grant of Letters of Administration (!,f applicable, enter; c.t.a.; d.b.n.c.t.a.; pendente liter durante absentia; durante minoritate) 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 above and complete list of heirs.) C`) :~ ~ . .. + (COMPLETE INALL CASES:) Attach additional sheets i necessa ~~ ~ .f ry• ~. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at X Lindsay Road Carlisle PA 17015 So Middleton Twp (Lrst street address, town/crty, townshrp, county, state, zrp code) Decedent, then 84 years of age, died on 8/14/11 at 831 Lindsay Road Carlisle So. Middleton Tw PA 17015 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 30 d'dC1,QC~ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 200,000.00 So. Middleton Twp. situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Signature Typed or printed name and residence Richard J. Whistler 72 Peachy Ann Drive Newville PA 17241 Donna E. Allen 6195 ~f#kn Avenue Harrisbur l'~~ ` PA 17111 Sharon S. Kelly 546 West: Penn Street Carlisle PA 17n 1 ~ Form RW-02 rev. 10.13.06 Page 1 of 2 f ti...:; ... Oath of Personal Representative ~ ° ,~ COMMONWEALTH OF PENNSYLVANIA ~? ~t~- ~' t ~~~? SS '=~'c_r"~~ ~ __ COUNTY OF CUMBERLAND . ~~~ C~ ~r-, ~_ ~ ~~ ~.:~ ~ _ ~: The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition a~t3~e and correct td~t~e~st of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will ill and truly' administer the estate according to law. Sworn to or affirmed and/subscribed ~ ~ ~t~ Signature of Personal Rep sentative Richard J. Whistler before the / day of ' Signature of Personal Representative Donna E. Allen S. . Fort Register Signature of Personal Representative Sharon S. Kelly Si~at~rn of l~ssa'~1 ve Cathy A. Rockey File Number: 21 - ~ 1' ~g ~U Estate of Betty J. Whistler ,Deceased Social Security Number: __ l to ~ - S ~! - ~ ~o ~ Date of Death: $/ 14/ 11 AND NOW, , 201_ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Richard J. Whistler Donna E. Allen Sharon S. Kell and Cath A. Rocke in the above estate and that the instrument(s) dated 06/06/2011 described in the Petition be admitted to probate and filed of record as the last Will (and C~rlic;l(cll ~f nP~~,~.,t FEES .~10~ c~ Letters ............................ $ a© Short Certificate(s) ..... ..... $ .... $ - ~ 6 .... $ .... $ ~a .... $ .... $ .... $ .... $ .... $ .... $ - TOTAL ............................. $ ,; Form RW-02 rev. 10.13.06 Attorney Signature: Supreme Court I.D. No.: 27763 Address: 10 E Hiah St Carlisle, PA 17013 Telephone: 717-243-3341 Page 2 of 2 Attorney Name: No V. Otto III Continuation of Petition for Probate and Grant of Letters Betty J. Whistler Decedent Name Page 1 Social Security Number Probate Requests Signature Typed or printed name and residence Cathy A. Rockey 2225 Frontage Road ir1G Q!\G R[,~~ ~r~~rn~.. LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat olr photograph. Fee for this certificate, $6.00 P 177271 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will he forwarded to the State Vital Records Office for permanent filing. ~. ~~ tz~z'• A11~ 1 5~2 Q t1 Local Registrar Date Issued ,, _ _ ~___ _ _... -,-, _~.~ -~ ._,. -__ _ ___ _ "Q~ ~: '..~ r ~J ~. c.n ~~ C~ -~ r~-. ~. ,~ ~f1°s-143 REV 11n°°6 COMMONWEALTH OF PENNSYLVANIA .DEPARTMENT OF HEALTH .VITAL RECORDS TYPE I PRINT IN PERMANENT CERTIFICATE OF DEATH BLACK INK (See instructions and examples on reverse) STATE FILE NUMBER 1. Name of Decedent (Rrsl midde, lest, su6ix) 2. Sex 3. Social Secudty Number 4. Date of Death (Month, day, year) Batt Jane Whistler F 168 - 54 - 8675 Au st 14, 2011 5. Age (Last Binhdey) Under 1 r Under 1 da 6. Dale of Bktir Month, de , 7. Bi C end state or coon 6a. Pface of Death Check on one MoMM Days Hours Minutes • 84 Yrs. Hospital: .Other: 7/22/ 1927 Carlisle, PA ^ Inpatient ^ ER /Outpatient ^ DOA ^ Nurein Hans ®Residence fib. Corvdy of Deem fic. City, Bono, Twp. of Death fid. FaclNty Name (If not institution, street end number g ^ Other - Specity: • ~ ) 9. Wea Decedent of Hiepank Origin? [~ No ^Yes 10. Race: American Indian, Black, White, ek. '` ~ C>.~nberland oath Middleton map. nr yea, avectty Cuban, (~,,~ 831 Lindse Road Mexkan, Puerto liken, ero.) White 11. Decedent's Usual lion Kind of work done Burin most d wo ' life. Do not srote re' 12. Wes Decedent ever in the 13. Decedents Education (Spedly Dory highest de Kind of Work Kind of Business/Industry U.S. Armed Forces? 9re txxnpleted) 14. Marital Status: Married, Never Married, 15. Survhnng Spouse (If wife, give maiden name) Elementary !Secondary (0.12) College (14 or 5+) Waowed, Divorced (Specify) - Hamanaker Her awn home ^ Yea ~] No 8 Widowed 16. Decedent's Matting Address (Street, city I town, state, zip code) Decedent's Did Decedent 831 Lindsey Road Actual Residence 17a. State PA Live in a 1'c. ®Yes, Decedent Lived in South Middleton Carlisle, PA Glmiberland Townahrp? TSP. 17015 17b. County i. d. ^ Na, Decedent Lived within Actual limits of City! Boro 18. Father's Name (Fret, midde, last, suffix) 19. Mother's Nerve (Flret, middle, maiden surname) Irvin E. Hair Ida Mae Ma bar 20a. InfortnanYs Name (Type !Print) 20b. Informant's MaNing Address (Street, dty / rown, state, zip code) Ibnna E. Allen 6195 Mifflin Ave. , Harrisbur[T, PA 17111 21a. Method of Disposition r ^ Cremation ^ Donetidn 21b. Date of Dispositon (Montlr, day, year) 21c. Place of Dispositon (Name of cemetery, crematory or Dater place) 7 l • r (Clry/townslp~q zip code) o ~ Burial ^ Removal from State r Waa Cremation or Dorution Authorized 1"ilQClleseX '1'VJp. • ^ Other - ( ~ ' Iyy Medical t.xaminer/CoronerT ^Yes No Carlisle PA 17013 22a. S' d I Laensee or rson as ) t 226. ~ Number8/ 18 2 0122c. Name and Address oriJFeacT~Ort CC4TletE' r ~ FD 012633 L Ewin Brothers Funeral Hame Inc. Carlisle PA 17013 Complete hens 23ac Dory when certirying 23a. To me best of my knowledge, ties rrad al the Ijpte, date and place stated. (Signature and tilk) 23b. License Number 23c. Date Signed (Month, day, year) physidan is not available at lime of deatlt to ~ certify cause of death. '~v r "~ ~ ~ ~ I Z.Q • ttems 24-26 must be completed by person 24. Time of Dee 25. Date Pronounced Dea (Month, ay, year) 26. Was Caso Refer d to Medkal Examiner / Comner for a Reason Other than Cremation or Donation? • who praxzxrces death. O ~ C Z~ ^ Yea No CAUSE OF DEATH (See Inatructiona and examples) i Approximate interval: Part II: Enter other gjdnificant condaions contrl moo ro daaLh. 26. Did Tobacco Use Cantdbute to Death? Item 27. Part I: Enter the chain of events -diseases, injuries, or complications -that drectly caused the death. DO NOT enter terminal events such as cardiac arrest, r respiratory arrest, a ventricular fibrtaatron wtthout showi the et' Ousel to Death but not resulting fn the underrying cause given in Part I. ^ y~ ^ p~y~, rg abgy. List only are cause on each line. r IMMEDIATE CAUSE (Final disease or r r ^ Unkrwwn cnndtion resulting in death) (_, ~ + , ~ ~~ ~ ~ r `~ ~ ~~ ~~ -~ a. ~ ~ 5 ~1 to~~. \~ .e ~ ~ zs. a Fe Due to (or as a consequence off: , t Pregnam within past year n6aNy Nst candlions, 8 any, r to the cause listed mn fine a. b' r ^ Pregnant at time of Beast Enter UNDERLYING CAUSE Due to (or es a cosequence oQ: ~ ^ Nol r (dsease a kyury stet initiated the r P egnant, but pregnant within 42 days events resulting m death) LAST. c. r of death • r Due to (or es a consequence oq' r ^ Not pregnant, but pregnant 43 days to 1 year tl. r • r before death l ^ UrVNOwn It pregnant within the past year 30a. Was an Autopsy 306. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred Performed? Avalable Poor to Completion ~~~ 32c. Place of Injury: Hone, Farm, Skeet, Factory, ~, ~ of Cause of Death? rat ^ Homicide Office Building, etc. (SpecilyJ ^Yes ld'No ^Yes ^ No ^ Accident ^ Pendkrg Invastigalion 32d. Time of Injury 32e. Injury at Wok? 321. If Transportation Injury /Specity/ 32g. Localien or injury (Street, dry /town, slate) ` ^ Suicide ^ Could Not be Deternined M ^Yes ^ No ^ Driver/Operate ^ Passenger ^ Pecestdan ^ Other - Speciy 33a. Certifier (check only are( 33b. Sgnelu Tdle of Certttler • CertMying physklan (Physician certifying cause of death when another ptrysician hea pronounced death and completed Item 23) To the boat of my knowledge, death oceurrod due to the cease(s) end manner as elated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ouneing and rxrtilying physkkn (Physiran both rorwuncin death and certl 33d. Date Signed (Month, tlay, year) P 9 Mug to cause of death) _ - - - - - _ - _ - - - 33c. Lcense Number To tM best of my knowNdgs, death xcurred at the time, date, and place, end due to the cause(s) and manner as ateted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ w Medkal Examiner/ Coroner - - - , Jl (, T '' ~ ~`~,-~. ~~~~ I w On the beat of examination and / or investigation, In my opinion, death occurred at the time, deh, and place, and due to the ca o use(s) and manner as atated_ ^ 34. Name and Address of Person Wtx2l~pleted Cause ofpeath (Ile 27) T / Pdnt o 'it 36. Regishal hoe and D(~tnc~larM1b~h 36. Date Rled (Month, day, Year) I! ' `/~ ~71 l mir.E. ,.,p~ z , tl`tCC. ~ Lam! ~ ~ci. ~ ( ~ ~~ ~ J(~' Z Z.O Ll` ~ ~ Ja. ~' 1 ~ 13 r •ulr~ V f p~ Disposition Permit No.