HomeMy WebLinkAbout10-14-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of Natalie Ann Klee
a/k/a:
a/k/a:
a/k/a:
Deceased ESTATE NO: 21- ~ f - J ~ G~
SS NO: 191-26-8195
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
~ A. Probate and Grant of Letters Testamentary or ^ Administration c.t.a., or d.b.n.c.t.a. (complete Part C also)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters under
the last Will of the above-named Decedent, dated _ ~ and codicil(s) dated
(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 time of death wherein grounds for divorce had been established as defined in
23 Pa. C.S.A. § 3323(8):
^ B. Grant of Letters of Administration
tir appucaote, 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
Address ationshi to Decgd
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USE ADDITIONAL SHEETS IF NECESSARY =-~
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THIS SECTION MUST BE COMPLETED: ~ ~ -•- f- T'
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Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family o~principal re~Idence ~
At 2110 Page Street, Camp Hill PA 17011
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then 75 years of age, died 2/1/2011 at Harrisburg, PA
(Month, Day, Year of death) (City and State where death occurred)
Estimated value of decedent's ro ert t d th•
p p ya ea
_If domiciled in PA
All personal property
_[f not domiciled in PA
Personal property in Pennsylvania $
$ 750.00
30
915
00
_If not domiciled in PA Personal property in County $ ,
.
_Value of Real Estate in Pennsylvania
$ 177,058.00
Total Estimated Value $ 208,723.00
Location of Real Estate in Pennsylvania: (Provide full address if possible.) 2110 Page Street, Camp Hill, PA
Signature(s)
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Name(s) & Mailing Address(es)
35 Eastgate Drive, Camp Hill, PA 17011
Form RW-02 revised 12.26. ] 0 by Cumberland County pending action by the Court
Page 1 of 2
OATH OF PERSONAL REPRESENTATIVE c7 ~-
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The Petitioner(s) herein named swear or affirm that the statements in the foregoing Petition} ~e true aid -~ ~-~
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
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iccgi seer
DECREE OF PROBATE AND GRANT OF LETTERS
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Estate of ~1,~~Q ~f (~ ~~ ~ ~~~ ~r ,Deceased File Number: 21- ~~ -
AND NOW, this day of ~~',f ~1 t~P/- ,~~1~ ~ , 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., e[c.)
the above estate and that instruments(s) dated
admitted to probate and filed of record as the last ill
described in the petition be
s) of Decedent.
Glenda Farner Stra`sbaugh,
Register of Wills
FEES:
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Letters ....................$ s
Will ........................ • ~~?
Codicil(s) .................
(z) Short Certificates
( )Renunciations.......
Bond .............................
Other .............................
.................................
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.50 _
TOTAL ................ $
Atty's Signature
PRINTED Name:
Supreme Court ID No.:
Address:
Phone:
Fax:
Signature of Counsel Required to Enter Appearance
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Interim Form RW-02 revised 1226.10 by Cumberland County pending action by the Court Page 2 of 2
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reversal
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Other.
rs. l.J ntour Co. , PA ^ InpetieM ^ ER I Outpetlent ^ DOA Nursing Horre ^ Residence ^ OMar ~ Speciry:
Sb. Cotuny d DeaN &. Cfiy, Boro, Twp. of DazN
Dauphin Harrisbur 6tl. F Name (If Inslhution, g' street e_nd 11aMer) 9. Wee Decetlerit of Hiapenk Origin? No ^ Yes 10. Race. American Iran, ck, White, etc.
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11. Decetlenre Usual Ibn IOrM of work done du rmst of Itle. Do rat elate retl 12. Wee Decedent ever ht the 13. Decedent's Edlaetbn (Seedy Dory highest grade osmpleted) 14. Merllel SteNS: Meme4 Never Marred, 15. Surviving Spouse pl wile, gNe maiden name)
IOM o1 Wak KIM of Buelneaz/Indtreby U.S. Amled Forces? Elementary / SecoMary (a12) Cdbge (t~ or Se) Wkbxed, ~o~ IsPe~Yyl
Ci t Govt . ^ Yea ~No Widowed
- , . s ailing Add (S ,dyltown, stag, rip 1rY
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r_' Dacedanra ennsy vanla Did Decedent
Mtual Residence 17a. State Live Ina
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yes, Decadent Livetl in
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1fi.County ~3~1Dh 1_n 17d. "q
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1B. FaNers Name (Flrst, middle, lest, sufix) 19. Motlrer's Name (Flrst middle, maiden sumeme)
Patrick Jennin s Doroth Cellar
20e. InlomrenYS Name (Type / Pnnt) 20b. InlomianYe Mallhig Adtlress (Sheet, clry / Irnvn, stare, zip mdel
Patrice K. Fehl 35 East Gate Dr., Camp Hill, PA 17011
21 e. McNOd of psposition r E~krre~~ ^ Doretlan
^ Burial ^ RemovelhomSrete ~ W
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o 21b. Data of Dlepostllm (Momh, day, year) 21 c. Plaza of Dispoeilion (Name of camelery, crematory a other place) 21d. Locetlon (City I town, state, dp codel
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^Otlar- rhy YedkN ExrtlkrerlCoroner4 ®Yee No ~.~~~ ~ Holl'nger amatory Mt. Holy prings, PA
22a. ~ re Funerel Service rrsee (or pe 'rg ) 226. Licenee Nrmiher 22c. Name end Adtlreae d
~s 903 ~ ~ ~~ i~ 17011
Campkte Tierra 23ac any wlxm certilyag
physician u rat availede et time of tleaN ro 3a. To the krwwkdge tlea at Ne tl to pl ed. (Signature en e
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ense umber
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perlfiy reuse oldeaN. ~ ;~~ s~ v~ I ~
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nenre 2x26 met 6e compbted by person 24. Tkne of N 25. Date Pronounced Deed (M day, year) 26. Was Ce erred ro Modica! Examiner /Coroner for a Reason Other then Cremation p Donatan?
who prwaurces deem. 1 V M. ~ I ~ ` ^ vas No
CAUSE OP DFJITH (See InetruMlons end a:ameba) r Approximele interval:
hem 27. Pen I: Eller Ne Blain of evens -diseases, inpmes, or CerrQYKbflen3 -that tlirecty caused tl1e deaN. DO NOT enter terminal events such as cardiac anesL t Ousel a Death
respiratory arrest w vemnculer fibmlatbn widaN showing th ebokgy
List ony one reuse on each IMe Part II: Enter other simificant conditlons canMheine to tleaN
but not resuMng In the underrying cause given in Pan I. 2B. Dld Tobaxo U potshots to Deam?
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dINEDb17E CAUSE rFin9l disease a r No ^ Unknown
CarldNm resulting in deem)
=~ ~ ~, ~ ~ ~ 29. If fame
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Due to (or as a con/appuerxxr oft ~ /_ ' - r 1 ~ L i
lief condfions, d erry, b. C.C/'LW ~ ~~ ~GfJN/' ~[.G~ CC/N l r
b Huse fisted an line a. of pregnant within past year
^ Pregnant at fete of Beats
DERLYtNG CAUSE Duero (or as a consequence oQ: ~ ^ Not
pregnan, but pregnant within x2 days
(dea6% a hpury Nat niCeted the r
c of death
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eVenla resulting n death) LAST.
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Due to (or as a mruequence o1J: r Not pregnant, but pregnant 43 tlays l0 1 year
d r before Beam
^ Urauawn if pregnant wthin Ne pest year
30e. Wes en Auapsy
Performed? 306. Were Autopsy FlMkgs
Available Prior Io Campletlon 31~ot DeeN 32a. Deb of Injury (Mordh, day, year) 32h. Descrbe How Injury Occurretl 32c. Place of Irqury: Horne, Farm, Sheet, Factory,
of Cause of DeeN'+
Natural ^ Homidde Odke Builtling, etc. (Spep7yJ
^ Vas No
^ Ves No ^ Accident ^ Pendi Investl bon
np ~ ~ ~~ Time of Injury 32e. Iryury et Work? 321 If TrerupoRatlon Injury /S-eciryJ 32g. Locatron of I u Street c /town, state
M ry ( M 1
^ Sulfide ^ CoWd Not be Deronnlned ^ Yes ^ No ^ Deter/Operetor ^ Pesserger ^ Pedesmen
M Other ~ Sped(y
33e. Certlfiar (Bradt oroy one) nature all Tit of Hoer
CsrUytnp phyaklen (Phyeaien ceNlying cause d tleaN when andher physician tres pmnouraed deeN ell completed Item 23)
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To th heN Ol mylmowladge, dseN Oeeurrod duebtM auaa(e)eM manner es rdetM_________________________________ ~ ~''
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ProrloulUrq ell crtlynnp PMa~ (Phyaidan bah praiwrcig tleeN end ro woes d daeN
cenily8q ) 33c. License Number
33d. Date Signed (MOnN, day, year)
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dNN oaurrod el tM Bete, date, end plea, end dw b the ceuee(a) arts manner ee sbted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
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On tlN heah M axembNbn all / or Inve.Upetloq m my opinbn, daNh oCeurrad N tlM thna, dm, and glee, and due to the ceuee(y end mereler u stated ^ 31. Ne antl Adtlrese o/
Pereo/n
~ C~d/p-plsled Cause of DeaN (Item 27) Typo 1 Pnnt
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38. Date ( , deY, Yazr)
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LAST WILL AND TESTAMENT
OF
NATALIE A. KLEE
I, NATALIE A. KLEE, of Camp Hill, Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament, hereby revoking any Will previously made by me.
I. I direct the payment of all my just debts and funeral expenses out of my estate
as soon as maybe practical after my death.
II. I devise and bequeath all of my estate of whatever nature and wherever situate
unto my daughters, PAMELA K. GRACEY, PATRICE K. FEHL, and KATERI K. MARTIN,
the share of a deceased daughter to be paid to her issue, per stirpes.
III. I appoint my daughter, PATRICE K. FEHL, as guardian of any share of my
estate which is payable to a person under the age of twenty-orie (21). My guardian shall have
the right to pay the income and principal to or for the benefit of said person that she, in her
sole discretion, shall determine appropriate. When said person attains the age of twenty-one
(21), the guardianship shall end and the principal shall be paid over to him or her absolutely.
I~'. I r:^minate. C~nctitl to and ~ip4int my daughter, PATRICE K. FEHL, as
SAIDIS,
FLOWER S~
LINDSAY
ATTORNEYS•AT•IAN'
2109 Market Street
Camp Hill, PA
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Executrix of my estate. If she is unable to qualify or ceases to act as such, I hereby appoint
my daughters, PAMELA K. GRACEY and KATERI K. MARTIN, as alternate Co-
Executrices. None of my personal representatives shall be required to post bond in this or any
juretion.
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IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the
~ ~' day of November, 2006.
SAIDIS,
FLOWER Sz
LINDSAY
Ai7C)RNEYS•AT IAW '.
2109 Marker Street
Camp Hill, PA
~.. L~C ,% (SEAL)
NA LIE A. KLEE
Signed, sealed, published and declared by NATALIE A. KLEE, the Testatrix herein named,
on this and one (1) other sheet of paper, as and for her Last Will and Testament, in our
presence, who, in her presence, at her request, and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
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Address
Address
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
WE, the undersigned, the Testatrix 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 Testatrix signed and executed the instrument as her Last Will
and Testament and that she signed willingly (or willingly directed another to sign for her), and
that she executed it as her free will and voluntary act for the purposes therein expressed, and
that each of the witnesses, in the presence and hearing of the Testatrix signed the will as
witnesses and that to the best of their knowledge the Testatrix was at that time eighteen years
of age or older, of sound mind., and under no constraint or undue influence.
NAT~LIE A. KLEE, Testatrix
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Witness ~-+
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Subscribed, sworn to and acknowledged before me by the Testatrix, NATALIE A.
KLEE, and subscribed and sworn to before me by both witnesses, this ~~ day of
SAIDIS,
FIAWER SZ
LINDSAY
A'1'rORNEYS•AT•IAW
2109 Market Stree[
Camp Hill, PA
November, 2006.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Sara J. Ensinger, Notay Public
Carlisle Born, Cumberland County
My Commission Expires Oct. 17, 2009
Member, Pennsylvania Associatinr7 of Notaries
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Notary Public
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