HomeMy WebLinkAbout09-27-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS i (( r
Estate of C l Q.~l `(Z ~ . V~~~~h ,Deceased ESTATE NO: 21- ~ ~ ~- I L~ I
a/k/a:
a/k/a: II
a/k/a: SS NO: l `~ ' (~ ~ ' 7 ~~~
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
L9~~Probate and Grant of Letters Testamentary or pAdministration t.a. or d.b.n.c.t.. (complete Part C also)
and aver that Petitioner(s) is/are entitled to the aforementione Letters QS Q, under
the last Will of the above-named Decedent, dated ~_ and codicil(s) did ~;
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(State relevant circumstances, e.g. renunciation, death of executor, etc) ~ ~ ~ WK
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted ,afrer'execution of the
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated,~grsdfit, and`..~vas not a ;
party to a pending divorce proceeding at the time of death wherein grounds for divorce had beeives~ablished as definedln
23 Pa. C.S.A. § 3323(g): - ==i - '~'~'
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^ B. Grant of Letters of Administration
(If applicable, enter d.b.n., pendent lite, durante 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(8), except as follows:-
name
USE ADDITIONAL
THIS SECTION MUST BE COMPLETED:
Dec ent was de i filed at d at in Cumberla d Countyz Pennsylv 'a, wit his/her ]
At l ~ ~ ~ ~
(Street dress with Post Of and ip Code, Munic pality: Towns ip, Boro h, C ity
Decedent, then ~ years of age, died ~l ~ Q 1 at U e
(Month Day, Y ar of death) (City and State
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 of Real Estate in Pennsylvania
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s)
Total Estimated Value
family • principal residence
~j l Z o1.
death occurred)
$ S bU O
$ _-
$~ObZ~
Name(s) & Mailing Address(es)
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Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page I of 2
OATH OF PERSONAL REPRESENTATIVE
Commonwealth of Pennsylvania ~ SS
County of Cumberland
The Petitioner(s) herein named swear or affirm that the statements in the foregoing Petition are true and
correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the
Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
~-J ~
be~re me this ~~ ~ day of
n ~,
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For the Register p ~~ ,
~~:
DECREE OF PROBATE AND GRANT OF LETTERS
Estate of C~, C~, ~` ~ . ~ ~ (Y1C~ ,Deceased File Number: 21-
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AND NOW, this -~] day of ~~PQ~~-F ~Q r ~(~~ ~ , in consideration of the Petition on
the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters
Testamentary of Administration are hereby granted to:
(if applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
~ ~ in
the above estate and that instruments(s) dated described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
Signature of Counsel Required to Enter Appearance
FEES:
Letters ....................$ _ •~
Will ........................_ ! ~ ~;'`.
Codicil(s) .................-
(~) Short Certificates _
( ) Renunciations......._
Bond ............................. _
Other .............................
Automation FEE......-.. 5.00
JCS FEE ................... 23.50
- --
TOTAL ................$ _-
Glenda Farne Strasbaugh, -~~ f ~~,(~ '~~
Register of Wills
Atty's Signature
PRINTED Name:
Supreme Court ID No.:
Address:
Phone: _
Fax:
Interim Form RW-02 revised 1226.'. 0 by Cumberland County pending action by the Court Page 3 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograp~~
f~ec for Chi; l:ertilicate, ~;6 (IU
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+aurriIl~ ~,, ~icLl i.n fr .ln~~inal Ccnific~tt ~ 06 Ck:ath
slur ffkl_i t nh ~~,~ !~ 1 nil( Rct ititr._u~. 11 e <yri;inal
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Ht06~143 REV nrzdos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE /PRINT IN
PERMANEM CERTIFICATE OF DEATH
BucK INK (See instructions and examples on reverse)
STATE FILE NUMBER
z
1. Name of Decetlent (Flml, mtltlle, last, suffix) 2. Sex 3. Soda! Security Number 4. Oele of Deam (Monm, day, year)
Clair W. Lehman 199 -07 -7873 .s-
5. Age (Last Bidhtlay) Under 1 ar Under 1 de 6. Date of BIM Monm, de , e 7. Bi late C' erld slate a lor ei count Be. Piece of Death Chxk aril one
9 3 Maatd6 D'y6 "°~rs M~me6 12 / 2 2 / 1917 Newville P A "°6pl'al' ,o_mar~
Yrs. ^ Inpatient ^ ER / Ou~etianl ^ DOA LY Nursing Home ^ Resitlence ^ Omar - SpecBy:
M. County 01 Deam 8c. City, Soro, ~ of Deam Bd. Facility Name (If rid imlitutlm, give 6tree1 erd number) 9. Was Decedent of Miepank Orgin? ~ No ^Ves 10. Race'. Amerkan IMan, Bieck, While, etc.
Cumberland West Pennsboro
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' of ye6, spedry Cuban,
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t° e /l Mexkan, PueM Rkan, ek) i
e
11. DeredelYS USUaI Otc lion Kind of wom tlorlB d une most of IBe. Do riot state retired 12. Wes Decedent Ever n me 13. tlenl's Etlucelkn (Specify only highest gretle comp leted) 14. Memel SteNS'. MemeQ Never Marred, 15. Surviving Spo use (II wile, give maiden name)
Kira m Work
Farmer
KIM of Business/ Intlustry
Agriculture U.S. Artretl Forces?
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Elementary / S ary (t}12)
~~
College (1-0 or S~) Widowed, Divometl (Specify)
widowed
1fi. Decedent's Mailing Address (Street, city i town, stale. zip code) Decedent's Did Decedent
PA
m Hampden
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id
17
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9 Kings Arms c
ua
es
ence
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a.
e
aa,
ecadam
ived
wp.
ow
Mechanicsbur
PA 17050 ,>ti. wanly Cumberland ntl.^N~~ede~l llyea w;mm
g, City/8oro
1B. Fathers Name (First, middle, Iasi, wdfix) 19. Momer's Name (FlrsL middle, maiden surname)
Ral h C. Lehman Sr Nannie Diehl
20a. Informant's Name (Type I Pnnl) 20b. Inkrmant's Mailing Adtlress (Street, my /lows, slate, zp Cade)
Linda Lehman 9 Kings Arms Mechanicsburg, PA 17050
21 a. Memod of Disposihon ^ Cremation ^ Donatkll 21 b. Dale of D'sposieon (Monm, day, year) 21 c. Plate of Dispositon (Name of cemetery, cremmory a/ Omer plate) 21 tl. Location (City f town, state, zip cotle)
~Budal ^ Remoyaihanslate ~
,a
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tlorl
ltodzad 9/23/2011 Cumberl
ley Memorial
d
e Carlisle, PA 17013
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^ve6^Na ~a
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22a. Sign~of Fu rat Service Licensee (or person actlng.. a~_._su.ch~~- zffi. Licen6e Number 22c. Name antl 0.tldress of fa(iliry Egger F u n e r a 1 Home I n e
- ,.J1~ FD 13895 L 15 Bi S rin Ave. Newville PA 17241
Complete items 23ec onry when Carl' ' 23a. Tpthe sl of my ktwwlerlge, deem occurred at the time, date antl place slated. (Signahxe antl qle) 23b. Lkrense Number 23c. Date Signed (MOnM, tlay, year)
phy9kian 19 nM eVelabe 81 tjme m deb 0 ~ '
ceroty caps6 m deem.
I
Items 2446 must be completed by person 24. Time of Deam d 25. Date Promlmcetl Dead (Month, tlay, year)
A A/vXl M/`t'RP 2fi. Was Case Relened m Med' al Examiner i Coroner for a Reasm Omer man Cremetbn ar D Lion?
wno wonwnae6 deem. M, ^ Ves Q Nc
CAUSE OE DEATH (See Instruellona antl amplea) / ~ Approximate Interval Pan IL Enlar Omer swi firant conditions canbibutlno to death 26. Ditl Tobacco Use ConlMute m Death?
Item 27. Part I: Enter me chain of events - dseeses, inluries, or compNmtiom ~ coal directly caused me deem. DO NOT enter terminal events such as cardiac arrest, Onset Io Death but not rasusl,g in the undedying cause given in Pan I. ^Ves ^ Prebably
respiratory amsL or ventdcular fibrillation wittrom showing me elklogy. List only one cause on eaM line. _
) ^ No ^ Unknown
&NEDIATE CAUSE (Final d5ease or ps; ,~~ !~
oondidal resultln
in Beam)
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C
~ 29. II Female:
g
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I
($/ Y~ 17i\
a
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~~~ ^ N
t
m
imi
s
Due to (a as a con rice op: o
pregna
w
n pas
year
Se uenHellIyy Yst contllsans, II any, d
l
di
m th
F
t
d
li ^ Pregnant al lima of deem
^
ee
fq
e cause
s
e
on
ne a.
Ente the UNDEflLYMG CAUSE Due 'o (a as a consequence oQ: Nol pregnant, bm preananl wimin 4'! tleys
(disease or inlury mat irgtialetl me
events resultin
In death) LAST
t of tleeth
^
g
I« as a con I
Due io sequecoe o )'. Not pregnant, but pregnant 43 tlays'a t year
Belpre cream
d
^ Unknown N pregnant wimin Ina pest year
30e. Was an Autopsy 30b. Were Autopsy findings 3t. Manner of Daam 32a. Date of Injury (Monm, tlay year) 32b. Describe How Injury Occurted 32c. Place of Inlury: Home, Fenn, SlreeL Factory,
Pedamatl? Available Poor to Comdelim I~'
N
l
l ^ H
kitl Office Bwldirg, ek. (Specify)
of Cause of Death? a
are
om
~J
e
^ Yes ~ No ^ Yes ^ No
^ Accident ^ Pentling Investigehon
ffitl. Time of Injury
32e. Inlury at Wark?
321 II Trensportation Injury (5
32g. Locel'ron of injury (Street, city /town, 6latel
kitl
^ S
^ C
ld N
t b
D
i
l
tl ^Ves ^ No ^ DrNerl Operator ^ a55e ede6trian
u
e
ou
a
enn
rre
e
e M' ^ Omer ~ Specify.
33e. Cenirwr (check only me) 33b. Si naNre a _ ./7
• CartKying phyeiden (Physiden cenAying cause of deem wren another physician has prorwuncetl deem aM mrtplelatl Item 23)
io ltw FeelWnry knowbdg•, deem occurred tlue to the ceueq•)end manner ee etekd____________________._____________ ^ /jam-/ J
• Pronoundng and terldying physician (Physician boll) pronouncing d,selh and cerNyirg to Cause m deem) 33c. Lin Num ~
r 33tl. Dale Slgnetl (Month, day, year)
To Ihs Dest of my knawbrlge, seem occurred et the time, date, erM place, end due to the cause(s) aM manner es etaled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ ~ ~ (Q ~" / r ~ M ~~~ 7- / 1 1
• Metlkel ESeMrler/Coro,wr
On the basis M exeminatlon and / or Invesdga[lon, in my opinion, death accurretl et me time, dale, eM plate, eM due to the cauae(sl end manner as 8leted_ ^ 34. Name and Address of Person Who Comdeted Cause of Deam ptem 27) Type! Print
36. Regisha~G lure and ,D,'s\\trirJ~N1erap ~r I 1 1, 36. ate Filed (Monm, day, year)
Disposition Permd No. - U ~ c7 ~ ~ I t
LAST WILL AND TESTAMENT
I, CLAIR W. LEHMAN, of Lower Mifflin Township, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking any and all
former Wills or Codicils made by me.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary
expenses and all inheritance taxes (whether such taxes may be payable by my estate
or by any recipient of any property) shall be paid from my residuary estate as soon as
practicable after my decease and as part of the administration of my estate. My
Executor shall have no duty or obligation to obtain reimbursement for any such tax so
paid, even though on proceeds of insurance or other property not passing under this
Will.
2.
give the sum of Five Hundred Dollars ($500.00) unto my niece, NC~MA _ -,,
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BARRICK. '_c~7 -
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Page 1 of 5
~~
3.
All the rest, residue and remainder of my estate, both real and personal property,
shall be divided into equal shares, to be distributed as follows to:
a) My son, ROBERT W. LEHMAN;
b) My son, EDGAR D. LEHMAN;
c) My son, JOHN A. LEHMAN;
d) My daughter, LINDA E. LEHl~.~IAN;
e) My daughter, DONNA D. HOWELL;
f) My son, GARY L. LEHMAN;
g) My son, MICHAEL R. LEHMAN
4.
I nominate, constitute and appoint my daughter, LINDA E. LEHMAN, and my
son, GARY A. LEHMAN, as Executors of my estate. In the event either of them shall be
unable or unwilling to serve in such capacity, then the other shall act alone.
5.
I direct that my Executors shall not be required to file a bond to secure the faithful
performance of their duties in any jurisdiction.
Page2of5
~~~
authorize and empower my Executors, in their sole and absolute discretion, to
purchase or otherwise acquire and retain any investments of which I die seized or any
real or personal property of any nature; to sell, lease, pledge, mortgage, transfer,
exchange, dispose of or grant options in regard to any or all property of any kind
forming a part of my estate for such terms and such prices as they may deem
advisable; to borrow money for any purposes connected with the protection and
preservation of my estate; to mortgage or pledge any rea! or personal property forming
a part of my estate or to join in or secure the partition of same; to compromise any
claims or demands of my estate against others or of others against my estate; to make
distribution in kind and to cause any share to be composed of cash, property or
undivided fraction shares in property different in kind from any other share; to employ
agents, attorneys and proxies and to delegate to them such power as my Executors
consider desirable and to pay reasonable compensation for such services and may be
rendered by such agents, attorneys and proxies; and to execute and deliver such
instruments as may be necessary to carry out any of these powers. In addition, I direct
that my Executors shall have the power to conduct an inventory of any safe deposit box
necessary to the administration of my estate.
Page 3 of 5
IN WITNESS WHEREOF I have hereunto set my hand and seal this ~~ day of
December 2009.
y~ cy ~~s~~~~ (SEAL)
CLAIR W. LEHMAN
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-name Testator,
as and for his Last Will and Testament, in the presence of us, who at this request, have
hereunto subscribed our names as witnesses thereto, in the presence of the said
Testator and of each other.
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Page4of5
G~-k~-~
COMMONWEALTH OF PENNSYLVANIA )
:SS.
COUNTY OF CUMBERLAND
We, CLAIR W. LEHMAN, ~N~S ~,~~ i~i~i~l~ ,and
„_..._~
'~ ~L ~ t~'yNC~A2~, the Testator and the witnesses, respectively, whose
names are signed to the foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testator signed and executed the instrument as his
last Will and that the Testator has signed willingly, and that the Testator executed it as
his free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the testator, signed the Will as a witness and
that to the best of his/her knowledge the Testator was at the time eighteen years of age
or older, of sound mind and under no constraint or undue influence.
Testator
,~/
Hess
e
~:.~ ~ ,/
Witness
Subscribed, sworn to and acknowledged before me by CLAIR W. LEHMAN, the
Testator, and subscribed and sworn to before `7~-fCit~~~ S G~ ~~/Y~F ~ and
~~ ~t_...~~~ ~J~?/~'1~- ± .~ ,the witnesses, this `~ day of December 2009.
ARY PUBL
kote~ial $ga-
Deniso A. 1aix:~n, Notary PutxiC
City of iia;tisburg, Dauphin County
~Y Commission Expires March 8, 2012
Page 5 of 5 ~' ~'~' ~Ennsvivania Associatlor. of hots