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HomeMy WebLinkAbout09-22-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland COUNTY-, PENNSYLVANIA File Number _~' I ~ - ~ ~ ""' Estate of Donald G. Prosser also known as 171-30-6882 Deceased Social Security Number Petitioner(s), who isJare 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW:) Diann Kay Prosser ExeCUtriX named in the a A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the last Will of the Decedent dated 6/2611984 and codicil(s) dated NIA (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 instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration (If applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente life; durante absentia: durance minoritate Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following s~u~ (if any) 'atld heirs: (If--~, Administration, e.t.a. or d. b. n. e. t. a., enter date of Will in Section A above and complete list of heirs.) ~_ ~ ~"~ _ '^:~ J. ,~ -~ ._m f r__ _ _ `'~ G (COMPLETE W ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CNeW Cumberland PA u 17070nsylvania, with his /her last principal residence at _--- 430 7th Street (List street address, town/city, township, county, state, =ip code) Decedent. then 74 years of age, died on 7/19/2011 at Holy Spirit Hospital Camg Hill Cumberland Co.. Penns Ivania Decedent at death owned property with estimated values as follows: ~ 1 450.87 (If domiciled in PA) All personal property ([f not domiciled in PA) Personal property in Pennsylvania Personal property in County S (lf not domiciled in PA) ~ Value of real estate in Pennsylvania 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 Diann Kay Prosser Page 1 of 2 Form KW-02 rev. 10.13.06 _ - ;i - Oath of Personal Representative , ~' ~-~ -„ ~-~ ^ - :a) (~.~ r ; ;tom COMMONWEALTH OF PENNSYLVANIA : _ SS ~ _ : . . ~ --, . =r - ,,- COUNTY OF Cumberland --+ •= The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are trEe and correetto the`~e~f 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 ~ _2 of Personal Representative Signature of Personal Representative Signature of Personal Representative File Number: ~~ ~ ~ ~ ~ ~ ~ ©~ Estate of Donald G. Prosser ,Deceased Social Se rity Number;171-3 -6882 /j ~ ~ Date of Death: 7/19/2011 /~~ /`~ ~ , in consideration of the foregoing Petition, satisfactory proof AND NOW, ' Testamentary having been presented before me, IT IS DECREED that Letters are hereby granted to Diann Ka Prosser in the above estate and that the instrument(s) dated June ~n i yon described in the Petition be admitted to probate and filed of reco~~ a~he last Will (anal Codicil(s))~of FEES ........ ......... L • ~~ ~ $ gister of W is f ~ . i~~ li~~~~2~~ etters ......... Short Certificate(s) ••••• ~ $ ~ Attorney Signature: ` e unciation(s) •••••••••~•••••• ~' • $ ~ Attorney Name: Donald F Davis Esa ~' $ . . $ Supreme Court LD. No.: 7442`1 ~O eox 205 $ Address: ... . $ New Kinostown PA 17072 ... . $ _-- ... . $ $ Telephone: 7171 909-2339 ~-- $ / TOTAL ........................... .. $ ~ ~ Page 2 of 2 Form RW-OZ rev. 119.13.06 I ~' L~CJCAL REGISTRAR"'S CERTIFIC:ATIC)N C~I'M ~~' ~ ~"r`¢~~~ ~~ WRRNING: It is illegal to r~upiicate this copy by iahotostat or pY•'otc:>~.i $"<'"' l~cc fur tlu~ rt~rtili~:uc_ S(~..Y)(I „~ ~4 Ot P~ ~ ~~ fy ll .,, ,, tl ~ ).: t 11 I ~ : 1 ~Itti ~- ~ ~r'~~'' ~~f'?. r '°~ ~ `~I ~.LI I, ,I_ .I , i. '1 ~s ~ ~ ... ' 1 z ,, I , allai a l~ ~ ` a, ~ A.- ~ r , , C. * , '~ A ,' ~.. ~y~ ~' -o ~ ,, ` ` ~~q ~ /2- JUL~1 9 X011 P 17557801 , `P ~T~~~; fti~ - ~ ~ , rh _ ------- , - _ C. rtiti~atiim \u~.nl~~rt~ ~ - C~ -,~~ _ l' ll T1 ~ l _! yy r- . t-n r._~ ~,_/u~ T ~.a .. l r'~ t . t -, - ~. i, j - - ~: 1_'~ r-Y-1 T1 (,~' ~ REV nr2oos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS E I PRINT IN CERTIFICATE OF DEATH ~RMANENi ~ STATE FILE NUMBER iacK INK (See Instructions and examples on reverse 2. Say 3. Sodal Securiy Number 4. Date of Oeam (Monet, deY, Year) t. Name of Decedent (First, middle, lest, sulTOC) Under 1 er Under 1 da 8. Dale of BiM Month, da , 7. Binh lace C and elate or cou 6a. Piece d beam Check on one 5. Age (Last BlMday) HoepitaP. Other. MgMS Days Routs MlnNes ^ Omer . S March 20 19 7 e herd Wn Inpatient ^ ER I Oulpetlent ^ DOA ^ Nursing Home ^ Resdence P•ciry' Yrs. - 9. Was Decedent of ffispank Ongm? ~[] No ^ Yes t0. Race. Amercan Indian, Bieck, White, etc. • Bb.7Canry of Death &. City, Bono, Twp. of Deam ed. FadlAy Name (If rim inslitutlon, gNe street ant number) (If yes, speciry Cuban, (SpecilyJ HOl S lrlt HOS ltal Mexican, PueM Rican, etc.l Wt'll to Cumberland East Pennsboro rk d dud most of wo tlle. Do not state refired 12. Wes Decedent ever in me 13. pecedents Educatlon (Spadly any highest grade completed) 14. Marital Status: Manied, Never Marred 15. Surviving Spouse (II wife, give maiden name) Wirbwed, Divorced /Speciry) 11. Decedenys l)suel tlon Krnd of wo one KrM of Work Kind of Businessllntlustry Elementary I ieo ary (b12) Cdlege (1-4 or St) U.S. Armed Forces? Married Diann Prosser Clerk Karns ^ Yea (~,NO 1 Did Decedent 16. Decedent's Mailing Address (Street, city' sown, stale, zip cadet Decede~s p.+ Actual Residence 17a. Stela ` Live in a r 7c. ^ Vas. Decedent Lived in Township? fwithin 7d.~z ~ DILemAS' New Cumberland 430 7th Street C ,amharla 17h. County Na d nt( 19. Mother's Name (First, mkMle, maiden surname) 16. Fames Noma (Frst, middle, lasts ) ~ ZAOR Glenn Prosser 20b. IMormenYs Melling Address (Sbee4 city I town, state, zip code) 20a. InfomreM's Name (Type I Print) ^ ear 21 b, Date d Dhposhion (Month, day, y ) 21 c. Place of Die ahbn (Name of cemetery, crematory a omer place) 21 d. Po Loceaon (Crty Itown, state, zip coda) 21a. Aletlrod of DisposAbn ~] BuMI ^ Removal horn State ^ Donatlon I ^ Crematlon Wee Crometlon or Dorretlon Aumorked by MwbM ExwrlnerlCorown ^ vea^ Nd Jul 21 2011 Rollin Green e er Can Hill Pa e. Signature of F r mce um e person acting as such) 22h. License • hems on n rlilying 23a. To a best of my knowledge, death occurred at me time, date end place slated. (SlgneNre ant Alle) physiden Is rat available at tlrne of death to Q centlY cause d death. - Ime of Death 25. Date Pronounced Deed (Month, day, year) 24 IMrne 24-26 must M cortlplmed by Dame' ronowaes deem • h . I~ 1 ~ /~ ~ i ~s /~. ~+ ~- ( LC./ . o p w r Appraximete Interval. CAUSE OF DEATH (Sae Inalructlona end exa plea) DO NOT enter terminal events such as cardiac anent Onset to Deem d the deem l . y cause Item 27. Pan I'. Enter me then. n1 events - diseases, Injures, or complkaeons -mat direct iratory artest or venoicular Abrllatlon without showing me etlobgy. List,anly one cause on each line. res p BAMEDIATE OUSE 'Fetal dseese ar mndAon resulting In deem) // ~na lo // ,1 (~ ~ / fD ~1~ ~.~(~ ~'V~(, 1_-L.~u~ Nl v ~"l.C. /'/ __~ a. uance op: r p (or as Due kst con?tlons, N arty, W reuse Asled on line a. Enter UNDERLWNGCAUSE ~ n ~ p, ~ Due to ( as a c uerae oft. / L r °~ ~Q~~ff~ lk, L 1.-~i r (dkeaee or ~ ry mat initiated me ~-]C,TI~. c ~ ~ W l' l~ ~-- events resulting m deem) LAST. ~ pus to (or as a coraequenca o0'. tl. 32e. Date of Inryry (Mordh, day, year) 32D. Dascrbe How Injury Occurred Were ANOpsy Findings 31. Mannar of Deam 30b r 22c. Name end Address of Facility N b . 30a. Was an Autopsy Penomred? Available Prior to Completion ^ Natural ^ Homkide IBoro I 23b Licenre Number 23c. Oats Signed (Month, tlay, year) ~J2~t°l~~- T 1q ZOtI 26. Was Case Rele¢ed}o Medkel Eyeminer I Coroner for a Reeson Other then Cremation or Donehon? ^^ '!BS No I: Enter omer Djgpll' °m~cendi5ons r^" "h'~-u'~n° a deim 2B Dd Tonacco Use Contribute to Oeem? but not resultng in the untlertying cause given In Pert I. ^ Ves ^ Probably ^ No ^ Unknown 29. It Female'. ^ Nol pregnant within past year ^ Pregnant at time d death bN pregnant wimin 42 days ^ Not pregnant __ , or death ^ Nol Dregnant nut Dregnant 43 days to t year __ belore tleath _ ^ Jnknown d pregnant wahln me past year -- 32c. Place of Injury. Fbme, Farm. Street Factory, Otfice BuiMing, etc. (Specfly) a,w 320. Locadon of inlury (Street, city I town, stale) `J ~~~ ~ ~-- - U Suic'Ide U Could Nol ce Determined M. L.J Omer- 33b. T~ :33e. Certifier (dtedr only one) , CMm/bg phyblen (Physician cenilying cause of deem when anomer physkden has pronorraed deem end cortpleted ttem 23) 33d. Da Signed Mcoth, day, year) - t • To tM Mel of my imowledge, deem acumM due to tM awe(s) end manner m crated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ :~. Uterine Number Pronouncing end cerdlyln9 phyebhn (Physldan both Pronoundng deem and deNMn9 b cause of deem) -------^ ND 31 ~_ ~ Iq •I Tome beet of mY IoawleUge, death oce~ •t ma tlme, data, end plea, end dw tome eeuee(e) end manner ea slated_ _ _ _ _ _ _ _ - - - MWbel ExemlrtxlCoroner • On the Meh d exeminNbn end I or investlgeMn, In my opinion, tleeltr occurred et the tyime, date, end plea, end due to tM carae(a) end mermen m elelad_ ^ 34. Ne ~an~n a @ ~ CgptP`~ause of DeaM (Item 27) Type l not u`~ r ~~ 35. Registrels Slgnatura ant District Number ~fXl / I ~ I / I ~I 36. Data rled(M m. der, year) kV~q U Ptl pI_M)rNC_~ht.~y1,eh KCaJ,rla ~ ~ (ilh rR- ,~ O~f',4 ~~'rn~Tl~ f) ~ /9 ao /i ~ ~ D l/ Disposition Permit Na. 2 Last Will and Testarr~ent ___ H~ushand __ presently residing at Donald G P s s _-.---- -- I' Cumberland Count Pa. _17p7p . 4 p Seventh Street , New Cumberland , - ~nake, ublish and declare this to be my Last W ill and ~I estament and do hereb}~ revoke any an do hereby P all other W ills and Codicils heretofore made by me. Diann Kay_ P ro s s er _ -- -------- ---_..- --_ ' First. I am married to ------ . I order and direct that my just debts and funeralu xpnim~s~, t ,Ite shalllbe p~ dins Moon after my Second. estate and any inheritance and succession taxes. state or federa , p death as may be practical. wife. In the event that my said wife shall predecease me or fai s to who survive me in~rial share~,l?er ~~ Third.. 1 give all my estate to my children, if any, --- ive all my estate to my Q s -'; survive me for sixty (60) day s, l g ive my estate to: ~, stirpes. If 1 am survived by neither my wife.. nor children. then I g ~ r`- -rl .~ ~ ~' . J ~~ --,~ - - D .... ~-n to be his; hers; theirs in equal shares or their survivor xecutrix of this Will. In the event that my wine shall Fourth. l nominate and appoint my wife as E ~- ils to survive me or fails to serve as such Executrix then in such event. I nominate and predecease me or to appoint Prosser ~ Executrix of this my Last Will and Testamen . Diann Kay-- -- - ---- ointee hereunder shall be required to give any bond for the faithful performance o I further direct that no app his, her duties. I hereby authorize my Executor. Executrix to exercase all the powers, rights, discretions, uties ermitted by law with full power to sell, lease, Fifth and immunities conferred upon fiduciaries to the extent p ~~ mortgage, invest, reinvest, or otherwise dispose of th~e~~hts oC my estate. June lg ... -Day of ------------- 1 subscribe my name to this Will this at Mechanicsburg, Pa• ---- (f -~. (Sign here) ~~ 19R3 by AFBN ,111 nght~ re.cncd. r~~u~~i s~ -I~u, ~)ubllehz t1 t+~s_i tip, ,ir i , ~~ ~, ~ <<+ t11r ~,-<_,~ n~ 1~ _~, „ 41,1i,~ '~ asl ~~'ill and Testament b} the ~t~i P '~• ~ '' ~ 11Lt1 nanlcd ~ estatur ~ubsrlli>ed 1y~~~ a ~~ '"'~~ ` ':+!Ie~, ~.~~~,~ ~. ,, ~u~d in th1~ Tires°I~ec ~~f~eacl~ «th:~!~. have I~~~rrLlnt;; ' . -~ - - ~ ~ U ~~~'/~?t,~~~..~ ,, ,; Idev~. Cumberland p t ,,,,// / - ,/ ~ ~ ,~ .~ .~"/ ____ - a ( its 1 -__ (`sl itei i~-echani_csb_ur~, _ Fa, (C~it~a) {`~t~ !e~ ,, - ,+ i~-echan~~ sburg, Pa. i( its } '~~f l(~Cl'Vlt Mate of ~'ennsyl~n.ia ~~ County «f' ~ utt?b er 1-and , .. ~ +-wn i ~ e than i csburg, Pa. ona ld ----- - - - -- -- -- ___ ~'I ~~?na lv a , - -- r ~t°,Ircc~; ~ ~ George ro:~se~~ _ _ -_ +'i Alberta L. .;oox _ _ t~~h~~bk°In~dlrl} tit~~~~r °~~t~.;it ,,, ;_ ', ' `i lZ~~ond J. ~.' r. r~l co u `° << test ~r~d~i~~~t+~7~~~,ts,,c no's, r I~,' - ~ , ~i .i7~ paid ~1ili .Inca ~he~ subsc~ ihed t le tame at the paid t~ 11 n, ~ ~ ~ ~ ~ I~ '~ {,, ~ ~~cnce ~>1 ~ Bch ~-ther, <tnc] the said T ~ state-r, si J' ~~'iil and i .~,, 111!,_111_ ~ ~'~ ~f::rled said ~b i11 and declared the same t~- he his [I~i d ~t ~~~jlletimec-fthe~~ecutionofsaid Will thesaldlestatur tfe~1~ ~i,.; ,~ r•at ~. ncm~ make this °~Itid~~ ~ ~~ ~„ ~ ;, . , ` -~ ~1~~i there u is nr~ e~~idellce,~f undue i 1f111ence. ~fh° ~~ ~~ :. , ~, ~~~ _ _- .~ -- cribed .11141 ~ - ~~,,,, 26th - _ ~1a~ I,~ _ ~ une___ _ I4 ~~~ '* _ , , _.~~ ~ `---~ _ 1 (~ti~c~tan~ Public) RU's Er,RIt .: ;;Cif, .tiOT~RY PUBLIC ;r4FCHAhi!C;n!!RG Ni)R(i. `_'UMLEP,C;;ND COUNTY M'; COMMiSS' v ~Y;:i', ~ '" 1gSY ~. ,~ ~I .