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HomeMy WebLinkAbout10-20-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATF, AND GRANT OF LETTERS Estate of WILLIAM L SHATTO a/k/a: a/k/a: a/k/a: 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 e.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 ~O ~-~ `/- ~~`~ 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. GS.A. § 3323(8):_ ^ B. Grant of Letters of Administration (If applicable, enter d.b.a., pendent life, 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 e.t.a. or d.b.n.c.t.a.. enter date of i~%ill in Sectie~n A and complete list ~~f 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.5..4. § 3323(~except as fgtlows: :CJ __ _~~ Name Address t~ `~nshi to Decedent - -L _ --- t a E_? l7SE .ADDITIONAL 3Hh;h:TS 1F V F,CGSS.IRI _ J C~ ~'~ THIS SECTION MUST BE COMPLETED: ~~ Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 80 FRONT ST WEST FAIRVIEW PA 17025 W FAIRVIEW TWP (Street address with Post Office and Lip Code, Municipality: Township, Borough, City) Decedent, then 81 _ years of age, died 5/28/2009 Estimated value of decedent's property at death: If domiciled in PA If not domiciled in PA _If not domiciled in PA _Value of Real Estate in Pennsylvania Location of Real F,state in Pennsylvania: (Provide full address if possible.) 80 FRONT ST N/ FAIRVIEW PA 17025 Deceased ESTATE NO: 21- ~~ t~ ~ ~ ( ~ LJ CAMP HILL PA 17011 (Month, Day, Year ofdeath) (City and State where death occurred) All personal property $ _ _1.1100.00 Personal property in Pennsylvania $ Personal property in County $ _ _ $ 52,000.00 "Total Estimated Value $ _ 531100.00 Si~naturc(s) ~~'ame(s) & Mailui~ Address(es) U U (1v Interim Form RR'-U2 revised I '?b lu h~ C'umbcrland County pcndinti action h~ d~~c Court Pa~c I nl 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 before me this _~: day of C ~ -}c, ~ ~_ ~_ _, ~ (.j ~ l --- ~ r o _x-, - i~ r- °iTt ~"4s -- ~-~~ ~- For the Register -. .- ~,~ __ DECREE OF PROBATE AND GRANT OF LETTERS - ~ ~ ~ __,_, Estate Of ~-~.-' ~ ~ ~ ~ ~,l b~~ ~ L ~ ~~(.~,.- ~-~ ,Deceased File Number: 21-~.(} i1 - AND NOW, this ~~ day of (~, ~ ~ C. I~-(' I ~-) O ~` , in consideration of the Petition on th\reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters -~Testamentary - of Administration are hereby granted to: (It epplicabk, eater c.ta., d.b.n., d.b.nc.t.a., ate.) 4 ~' V ~.k ~ ~ ~j GL ~ ~ ~`'. in the above estate and that instruments(s) dated admitted to probate and filed of record as the last ~ 1 `T described in the petition be Codicil(s) of Decedent. Glenda Farner Strasbaugh, Register of Wills ~~~ ~ (~~`,~~ ~~ ~~-=~ ~ `~~ r~ ~~ x' FEES: Will ........................ /~5"a c7 CJ Codicil(s) .................~ (~3) Short Certificates 1~ ( ) Renunciations......._ Bond ............................ _ Other ............................. ................................._ Automation FEE......... _ 5.00 JCS FEE ................... 23.50 ~ca~: TOTAL ................ $ Phone: _ Fax: I~~,~X Interim Form RW-02 revised 1226-10 by Cumberland County pending action by the Court Signature of Counsel Required to Enter Appearance Atty's Signature __ PRINTED Name: Supreme Court ID No.: Address: Page 2 of 2 OCAi_ REGISTRAR'S CERTIFICATION OF DEATH W~-~NING: It is illegal to duplicate this copy by photostat or phoi:ograpf,(. F.c I~~yr ihi, i~rrit~i~ale" )(,,il+' --- P--1~18_yS~3 _. Certif~iratirn N)(mhh~~ ITEM # .~ SI~OULD READ AS FOLLOWS,: /~.~ - da- ~y~1. i l~~l, i~ alt .. ~!i(~. )h.,, j1~~ Inii,rmltion hue ~*ivet~ i~ 1pLZh_OFp x~,~,+~~ fN~~ to~ft_k~[]1 ~rf~lcli 11 II a i I, ,inai Cutificaic, ilf Death ;, ~~ ~ ' !(.~~ i~ricd ~~ th I ~: r.t)~If Kc~~)su~ar. ~Iht~~ f~ri;~inal `, ~ ~ r~ `, ~~ ~`, )i x~~L[e ~~;li `~~ t r.,uclc~l tit the ~tilti' Vital at I. c.] v y 5. 2~ ~11'~U1'tj'" t)~II~(' ~1'l r 17 i~1I lt'llt II)1I1 rte. o - ~ `~,,r' MAY 3 0 2009 ~'F~9,gJ,t' _ ~44~. LLB ~ ~a~.-rte ., xr,i~l~ , . _. ~~ t,f .ll Kral"rl~.lr Date I~suul c7 _ a~ ;.x.~ - -, -r1 ;`, '_ _ ._ ,_ . r"rl r,: t hJ ~i i i'1 .~ ' 7 _.__. x-.,,1 r~ --~ T I REV 1lrzoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS / PRIM IN IMANEN7 CERTIFICATE OF DEATH 4CK INK (See instructions and examples on reverse) CTGTF FII F All UIGF[) t. Name of Decedent (First, middle, lest, suRlxl 2. Sex 3. Sadal Seadry Number 4. Dale of Death (Month, day, year) William L. Shatto Male 162 - 16 -4432 M 5. Age (last Birmdayl Under t ear Under 1 da 6. Date of Birth Month, de , r 7. Bidh era Ci and stale or mr ei count ea. Place of Death Check onl one Mpnms Days Hours Mimaes Hoapilal: Other 81 Yrs. Mar 1 6 1 9 2 8 Eno 1 a Pa Inpatient ^ ER r outpahenl ^ DGA ^ Narsmq Hpma ^ Reeieexe ^ other speniy 86. County of Deam &. City, Boro, mop. 1 Death gd. Facility Name (II not instituson, give street and number) 9. Was Dacetlent of Hispank Origin? ~] No ^ 'les 10. Race. American Indian, Black, White, etc. Cumberland E. Pennsboro Holy Spirit Hospital (II yes, specify Cuban, MexicanPuennRicanelc' ISperily) White 11. Decedent's Usual atlon Kind of work tl ona B urin most M world Iifa. Do not stale retlretl 12 Was Decedent ever in me 13. Decedents Etlucation (Speedy only highest grade comp leted) 14. Marital Status: Marred, Never Married, 15. Surviwnq Spo use III wile give maitlen Hamel Kind of Work Kind of Business) Industry U.S. Armed Forces? Elementary !Secondary (0-12) College (1-4 or 5+) Wrdow'ed, Divorced (Specity) , Wreck Master Railroad ®rea^Nn U k Married Irene K. Marsh 16. Decedent's Mailing Address (Street city I town, state, zip model Decedents Did Decedent t~I FF State Pennsylvania Live ina I7c Actual Resitlence t7a Decetlenl LivetlMdSt Pennsboro Ves T 80 Front Street . . pu , _ wp mwn:nip? oeLemeslwad within t7b. cDUnry_ Cumberland 17d ^AO West Fairview Pa 17025 t citylBoro 18 Falher'S Name (First, middle, last, sufllx) 19. Mother's Name (First, middle, maiden sumamef John L. Shatto Margaret C. Kreitzer 20a. Inlonnant's Name (Type I Prinll Irene K Shatto lob. Informant's Meiling Address (Street, city I town, slate, zip code) . 80 Front St. West Fairview Pa 17025 27a. Method of Disposition ^ Crematon [] Donation 21 b. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or other place) 21 d. Location ICiryl town. state, zrp code) }~ Burial ^ Removal from State r Was Cremation or Donatlan Aumorizetl ^ omens c.: 'by Medical Examiner/coroner7 ^yea^Nn June 2, 2009 Blue Ridge Mem Gardens H bg , P a 22a, Si to of F rat service Licen (or parson act) as such; 22b. license Number 22c Name and Address M Facility S u 11 i va n F u n e r a 1 Home - J ~ FD011897-L Complete ms 23a-c Doty when cenllyeg 23a. To the best of my knowledge, death xcunetl at the lime, date and place slated. (Signawre antl title) 23b. Ucense Number 23c Date Signetl IMonth, day, veer) physician is not available at lime of death to cengy carsse of tleam. Items 2426 must be completetl by person 24. Time of Death 25. Date Pmrrouxetl Dead (Month, tlay, year) 2fi. Was Case Raferretl to Medical Examiner !Coroner for a Reason Other Irian Crematon or DonNion? who Dronounces tleatn. ' IiL~ /l. M. MR ~!Y ~~~G7 S ^ vas ^ No , Approximate interval: CAUSE OF DEATH (See instructions and sxamples) Pad II. Enter other sionifrranl cnrMitions conlrihutina to death 2B. Ditl Tobacco Use Convibute to Death? Item 27, Pan I. Enter the chain of events -Diseases. injuries, ar xrrrplicalions - Inat tlireMty rarrsed the death. DO NOT enter terminal events such as cardiac arrest, Onset to Death but not resulting in Me untlerlyinq cause given in Pan I ^ vas ^ Probably respiratory arrest, or ventricular librillakon without showing the etiology. LI51 Doty txre cause on each line. ^ Unknown o IMMEDIATE CAUSE (Final tllsease or ,~y V, , +~ ~yq t ~{~~ ~ condition resultin in Ikath) 7"\ 'IU ~ '~ '> ~ 29. II Female g ._ ~ a y~ D .~~~ ' ~lLCG.~C~((G~ ~"-•ti i ^ 7 Due to (or as a consequence oQ. Nat pregnant within past year Segue ball`y/ list corMiaora, N any, b I6adlr tO me C811ae IKIed IXI lne d ^ Pregnant al bme of death ^ g . Duo 10 (Or as a aortae Emer 91e UNDERLYING CAUSE quence off: N01 a nI, bW n y Dr gna preg ant within 42 tla s (disease or injury mat initialed the c events resWling In Beam) LAST. of death ^ Due to (or as a consequence ol). Not pregnant, but pregnant 43 days to 1 year d- before death ^ Unknown d pregnant within the past year 30a. Was an Autopsy 30b. Were AWOpsy FirMings 31 er of Death 32a. Dale of Injury (Month, day, year) 32b. Describe How Injury Oxurretl 32c. Place of Inlury~ Home, Farm, Street Facmry. PedormeT Available Prior to Completion ^ryp ^ Office Building, eec. (SpeciN/ of Cause of Death? Nawral Homicide F-~ rte( ^ Ye Idl N ^ v ^ N ^ Ax"lent ^ Pentling Investigatan 32tl. Time of Injury 32e. Injury at Work? 321 Il7rensponatian Injury fSperAlyJ 32g. Lxation of Injury (SVeet cry I town, state) s o o as ^ Suinde ^ Could Nol tie Delerminetl ^ Ves ^ No ^ Driver/Operator ^ Passenger ^ Pede5lnen M ^ Omer ~ Speciry: 33a. Cerdfler (check pnty ore) 336. Signature an tae of Hitler • CedNying physican (Physician cenirying cause of deem when another physician has pronounced tlealh and completed Item 23) ~ ' ~ 1 1 ~ Tp the beet of my krawkdge, death occuretl due to the cause(s) erM manner as stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~ `/ %S-l " • Monouncing and cenltying phyeiclen (Physiuan both pronouncing tleath and cert'dyirlg W mouse of death) 33c. License Number 33d Date Signed (MOmn, day, yearj To the best at my knowledge, death occurred et the time, date, arM place, end tlue ro me causes) end manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ y'Li (~ ~ ~ j ~ i ~L -'- ~ -z y - ~„1 • Medcal Examiner/Coroner On the bests of examinnlon and / or Inwstlgetlen, in my opinion, Oath acuned M the time, date, aM place, and due to the caueee) end manner as etate~ ^ 3s. Name antl Address of Pefspn Wf~~ I¢~ Caus~o~ 1 ~t' (hem 2 7) Type I P,nl t f "9~ Registrels Signature ~ylstrtcl NNumber ~ ~) D~ F (Mon r~d 36 y e ar ) 1 l ~Y ; t' y I ".d'~ ` '~ ~ ~ f I i I ' I i I / I / y ? . a ~ [" ~ y ..~ 1 , ? r , . -_ , J~~;~ G7 Cif Disposition Permit No. pr, nrr,[w ~~rxos . I, WILLIAM L. SHATTO, of West Fairview, Cumberland County, Pennsylvania, do hereby make my last will and testament, revoking all testamentary dispositions heretofore made by me. 1. I give all my estate, real and personal and wheresoever situate, to my wife, Irene K. Shatto, if she survives mE.~ , 2. If ~-y said wife predeceases me, I give all my ' said estate, in equal shares, to my children, Michael L. ~har~:c,, Phyllis Ann Shatto, and. Kenneth G+1. Shatto. 3. I nominate, constitute and appoint my wife, Irene K. Shatto, to be my ,Executrix. If she is unable or unwilling to so act, I appoint my children, Michael L. Shatto and Phyllis Ann Shatto, or the survivor of them, to be my Executors. IIwI' Sr~ITI'~ESS Wt1~REQ~F, I have :hereunto set my hand and seal t© this myr l~.st ~-ilx and testament this ,a' ` day of June, 1979. Signed, sealed, published and declar4ci by the ave-nat~ed William L. Shatto, a-s and ..far his last gill and testao~enti , in the presence of us wht~, at °' '~ 1~is request and in his pre- ~ ~~ ,d'~'~'~, ~,.~, ,;n W=.,.~~ , ~~ ~ ,,: ~ , , ~ ~ ~. ~ ~ (SEAL ) sense and in the re sense of P each other, have hereunto sub- scribed our names as wit~aesses this ~ day of June, 19'78. ,~,"~ e ~~:. ~-- WILLIAM J. MADI~LN, JR. , ES~~UIP,,E ",w ~~°"!~ !~. 240 1~Tortb Third Street ~--~' ""' ~' Harrisburg, Pennsylvania ;_.;y 5 fir; . ; ~ ..~ y7~~ ,, ~e,~a -~ .:_~, c ~ :, "f'1 OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS ~~~ga2(~.~,~ COUNTY, PENNSYLVANIA Estate of ~ ,' % ~ ,' /~ ~/( ~ .Sf-~,Q~ ~`~ _ ,Deceased ~t2 L' ~~ (L .SIf.Q and PI/1,~ L~-- , 5 ~' G,./~ti''~ ~- , (each) being duly qualified according to law, depose(s) and say(s) that she / he /they w;~s /were well- acquainted with 64,/ j~ ~ { ,`.~/l/l L- , Sf-~i4~z' and am/are familiar with the handwriting and signature of the decedent, and that the signature of +.,v~' l I ,`A /d( ,~ s /f,¢`~j to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~ ; ; ~~~~ ~-t 5/~~~ is in his/her own proper handwriting. __ ---- Si~nature) (Street Address) r ~t,~Q.~ ~ /-~~1iZ~1.~2e-rte (Qty, State, Zrp) ~~ C~o~~ (Signnrure) ~~ ~~_ (&reel Address) (City, State, Zip) Execrated in Register's Office Sworn to or affirmed and subscribed before me this ~~_ day of~~!~(~ , ~. J ~ ; Deputy for Register of Wills For,n RW-04 rev. 10.13.06 C_~-~ ~ _t ,-,t•~ .L.~ C-j i r-- --. t~ t f~ ~ ~ ~ -; .. ~~ :_~ ,_c~ ,-~ -; _ ~' _~7