HomeMy WebLinkAbout09-15-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of ~A 6Z o l'tiF N ~ Q ~ w l le'YI~ Deceased ESTATE NO: 21- ~'
a/k/a:
a/k/a:
~/a~ SS NO: ! 9 3. 3 to " 4 b'? I
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or'B' AND "C" as
applicable:
~ j]`A. Probate and Grant of Letters Testamentary or ^Administration c.t.a., or d.b.n.c.t.a. (complete Part Calso)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters 7E.S{,g 711 a Y\ t r under
the last Will of the above-named Decedent, dated o y • i 4 a o 0 L and codicil(s) date
__ '.
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(State relevant circumstances, e.g. renunciation, death of executor, etc.) ` ~ ~ -
Except >u follows, Decedent did not marry, was not divorced, and did not have a child born or adopted 2xt~utionti'i~'the ~'
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated ;p nd wsa oot a --
party to a pending divorce procteding et the time of death wherein grounds for divorce had been ished as ~efinedp~
23 Pa. C.S.A. § 3323(g): ~ - ~ :_ rn
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^ B. Grant of Letters of Administration
(ICapplieabk, enkr d.b.a., peadeat lice, danute absentia, duraate miaoritate)
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(pJ, except as follows:-
~~~~~~ wagress Relatiomhi to Daedegt
USE ADDITIONAL SHEETS IF NECESSARY
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence
At
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then ~_ years of age, died o 9 ' f 1 • a o 1 t at C~-m p ~ r i.i_ P>4
(Month, Day, Year of death) (City and State where death occurred)
Estimated value of decedent's property at death:
_If domiciled in PA All personal property $ (o O ~®O
_If not domiciled in PA Personal property in Pennsylvania $
_If not domiciled in PA Personal property in County $
-Value of Real Estate in Pennsylvania 5
Total Estimated Value S
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s) Name(s) & Mailing Address(esl
~'~'• ! C ~ ar ~ t , yr±
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...................... ..... rv..aw a.iv. ~ v ~r a.uun,cua.w wumy pcnamg m;wn oy [fK Lourt 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
me
~ay of
DECREE OF PROBATE AND GRANT OF
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Estate of ~ ~, J~(5 ~l//~ ~ (,i~ ~/~i )r`-YV~ ,Deceased File Number: 21-°'_~~-~ ,,_ ,.'
AND NOW, this ~ day of ~Q ~`1 , in consideration of therRetition d~
the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters
_ estamentary _ of Administration ~ aze hereby granted to:
(,, (If applicable, enter c.t.a., d.b.n., d.b.n.e.t.a., etc.)
~_c~ f O Ytc ~1~ ~_ ~__ ~ti!~~ .. ~ . in
the above estate and that
admitted to probate and filed of record as the
and
Glenda Fan
Register of
FEES: /~~
Letters ....................$
Will ........................ / ~ ~N
~~
Codicil(s) .................
(~) Short Certificates
( )Renunciations.......
Bond .............................
Other .............................
Automation FEE......... 5.00
JCS FEE ................... / 23.50
TOTAL ................$ I ~~
x-P described in the petition be
of Decedent.
Signature of Counsel Required to Enter Appearance
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
105.805 RLV (01/07)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17699559
Certification Number
•
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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 be forwarded to the State Vital
Records Office f~ permanent filing
Local Registrar
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OMMOMWEALTM.OF PENNSYIVANUI • CIEPApa'MENi OF:HEAITM • Vn'AL gEC 7l
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CERTIFICATE Of DEATH
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si~TE FYE M1ER
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rn November 4, 1947 Harrisburg, PA Rr"W
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WILL of Carolyn M. Wirth
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I, Carolyn M. Wirth, of PA, Pennsylvania, declare that this is my
will. I revoke all prior wills and codicils.
c~ _~'
ARTICLE ONE ~~ -=
D~Li1E71TI01t8 ~CQDTC~IDR; FAMILY ]IaiD PEUPY~TY~
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1.1 Family. I am not married. ~y7~~ ui ~-`~ ; `
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I have no children.
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I intentionally leave nothing to anyone claiming to be a child'
of
mine regardless of the validity of their claim.
1.2 Personal Wishes. It is my desire that my executor follow any
written directions left with this will regarding memorial services.
My remains shall be cremated and under no circumstances shall my
remains be embalmed.
ARTICLE TWO
f3IFTS 4P ~PSRTY
2.1 Tangible Personal Property.
I direct my executor to distribute all of my tangible personal
property to my relative Charlotte Berger.
I may also leave a non-testamentary letter addressed to the
executor requesting that certain of my personal possessions be
delivered to named individuals. Although such letter shall not be
interpreted as a testamentary writing, I request that my
beneficiaries and executor carry out the requests made in the
letter. If a minor child is to receive personal property it may be
delivered to the child or their guardian or parent as the executor
sees fit.
2.2 Residue of Estate. I leave the residue of my estate to the
Trustee(s) of the Carolyn M. Wirth Revocable Trust to he added to
the trust and to be held, administered and distributed according to
the terms of that trust and any amendments properly made to it.
ARTICLE THREL
APP4INTl~iT fir' FIDUCIARIES
- Page 1 -
3.1 Executor. I nominate Charlotte Bereges to act as my executor. If
Charlotte Bereges cannot serge then Stephanie Bawer is to serve as
the executor of my will.
No bond shall be required of any executor under this will.
3.2. Exscutor'a Authority. In addition to any powers and elective
rights conferred by statute ar federal law ar by other provisions
of this will, I grant my executor the authority to administer my
estate under any procedure for informal or unsupervised
administration, or any other available procedure for avoidance of
administration or reduction of its burdens.
~} 1 ~1
On l I~ 204 at I., +(~C ~~, I hereby sign
(date} (town and state}
this document and declare it to be my will.
Carolyn M. Wirth
This document (consisting of pages including this one) was
signed and declared to be her will by Caralyn A4. Wirth in our joint
presence. At her request, in her presence, and in the presence of
each other, we
will, believing
influence. Each
M. Wirth and ea
signature is th
signed. Each of
competent witne
name.
hereby sign as witnesses to the execution of this
that she is of sound mind and under no undue
of us observed the signing of this will by Caralyn
ch other subscribing witness and knows that each
e true signature of the person whale name was
us is now more than eighteen years of age and a
ss and resides at the address set forth after our
We declare under penalty of perjury that the foregoing is true and
cor)rLe t and that this declaration was executed on
`T ~ ~ Q ~Q at 4-tl~ I C~~~' ,
(date) (town)
~ [~ ~,~
tote)
residing
fitness signature)
(town and s ate)
- Page 2 -
residing at ,,,~1~ ~> _ /~
(wz eas si~nz ure} (town and state}
- Page 3 -
WILL AFFIDAVIT for the WILL of Carolyn M. Wirth
State of ~ ~
County of ~ ~~~'
I, the undersigned, an officer authorized to administer oaths,
certify that Carolyn M. Wirth,
and
(Print name of Witness)
(Print flame of Witness)
the witnesses, whose names are signed to the attached or foregoing
instrument and whose signatures appear below, having appeared
together before me and having been first duly sworn, each then
declared to me that:
1) the attached or foregoing instrument is the last will of the
testator;
2) the testator willingly and voluntarily declared, signed and
executed the will in the presence of the witnesses;
3) the witnesses signed the will upon request by the testator, in
the presence and hearing of the testator, and in the presence of
each other;
4) to the best knowledge of each witness the testator was, at that
time of the signing, of the age of majority (or otherwise legally
competent to make a will), of sound mind, and under no constraint
ar undue influence; and
5) each witness was and is competent, and of the proper age to
witness a will.
.~ ..
Testator: ~~.
_ (Testator signature)
Witness : ~ n co )(Q ~ ~ ~(~ p „~ai~
Witness signature)
Address: o~ ~ 8 E • ~(~. S~~ l_ I ~
- Page 4 -
n
Witness:
Address:
Subscribed, sworn and acknowledged before me, ~~a,. ~ S. ~~..?2 ,
a Notary Public, by
Carolyn M. Wirth, the testator, and by
andtl~ Q ~ ~~ ~,
the witnesses, this ~ ~/~`~ day of /aa,-; ( 20~.
(Notary Seal)
Signed:
(Official Capacity of Officer)
- Page 5 -
NOTARUL SEAL
SHAWN S. HENTZ. Nohry Public
Lmculer Cigr, L Cowl
Mr Comn~bn ExDhsa Mat. i~l, 2010