HomeMy WebLinkAbout10-21-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of _r1 , N E `~ ~ ~ ' ` ' ,Deceased ESTATE NO: 21- ..i(~; i l - ~ 1
a/k/a:
a/k/a:
ss No: ~-f 3~ ~ 2 ~=~~7 u ~
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION °A' or ~B' AND °~C" as
applicable:
f~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 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 many, 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(g):
^ B. Grant of Letters of Administration
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 (lf 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(g), except as follows:-
~~
,~_ _,_~
_..
_t. . _
USE ADDIT N - _
IO AL SHEETS IF NECESSARY r ;;-,
,; ,,-,
THIS SECTION MUST BE COMPLETED: -
Decedent was domiciled at death in Cumber and County, Pennsylvania, with his/her last f ily~r-principal residency `-~
At _ ~ ~ `~ ~ rL rf i~-I.t,fC~ fL (~-! Ut ~' ~'
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then '7~ years of age, died IG' - Ug - ZG~ (~ at /t'~c C~K~4 ~(1 ~ ~SJ3C~iZ [A ~~/'~
(Month, Day, Yeaz of death) (City and State where death occurred)
Estimated value of decedent's property at death:
_If domiciled in PA All personal property $ ;;1, (J; ~;C; ~ (`;~j
_If not domiciled in PA Personal property in Pennsylvania $ '
_If not domiciled in PA Personal property in County $
-Value of Real Estate in Pennsylvania $
Total Estimated Value $
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s) Name(s) & Mailing .Address(es)
u.~~~nt~- e~/ amt?:
% 70 ~_>
!Name Address Relationshi to Decedent
~~ ~~. ~~~~ ~~.~~. ~~ oy ~,uuivcuanu ~,ounry penamg acuon oy 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 ar~d subscribed
before me this ~ ~ day of
.,
q r, ~,
`.-y
For the Register _-{
is
DECREE OF PROBATE AND GRANT OF LETTERS
-~;
t ~J -
Estate of {-~ C~l Lj ~, ~ t'~t ~~ ~-' ,Deceased File Number: 21- -:~ ~ ~ 1 -_~3
AND NOW, this ~~~~ day of ~ -~G~~-~ Y ~ C~ ~ ( __, in consideration of the Petition on
t)~e 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.)
_ ~ C~`~ 111 r 1-p ~ _`~£~I ~ ~'1t!"li~'"1-e-r__ ___ in
the above estate and that instruments(s) dated
admitted to probate and filed of record as the last ill
~ ~~] described in the petition be
Codicil(s) of Decedent.
Glenda Farner trasbaugh, _ , ~ . ~<<~ ~?yt%'~~~C i~' (~ . ~~) ~'~ ~-~
Register of Wills ~ ~
FEES:
Letters ....................$
Will ........................ . C?
Codicil(s) .................
(~ )Short Certificates ~ Ur;
(~) Renunciations....... ~~ D C~
Bond .............................
Other .............................
......................
Automation FEE......... 5.00
JCS FEE ................... 23.50
TOTAL ................ $ ~'~-
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 Cumherland County pending action by the Coma Page 2 of 2
lli~~ ~rrG lL lr\ Sri r~.
LOCAL REGISTRAR'S CERTIFICAI"ION OF DEA'TE~
WARNING: It is illegal to duplicate this copy by photasrat or photograa>I'l
Fcr for (his certificate. `ib-l)(1
~_~~~~ ~?
Certificatirn~ I~ILUnhcr
I,,lrj'"p,~TN OF pf
' ~ L
_ ~ 1
,~ a _
`g9T~1ENT ~F~~p ,
.l hlti 15 ilr La`P"(; t` l'1,1; !I;r' Ifti i~rll7lilllUll het-e ~'IArC11 I`,
c,nr~~cti~ uli~ic~i €+ r. :.II~ r ~~inal Ce(titicatc ul~ [)cath
Llul~ lily ( r~•ri;h r), f~, I lr~,ll IZsrt Islrar. T'hc f~n~~inai
c lul~ic.u ~ If: I ~<,~ _uclcLl t1y .I>c~ State ~`ital
1?_un(!s ~c~ Ir1,t.,I_;1t film:r.
~~'~'_ ~ ~'i---- OAT 1 _~ 2Q1~
n
T ~ ._.~
J .~
r~ I ?_ ~ ~.,j,
r ~Jr -z_~ -W.. _..:
~{ ^ ~j
J C._ -ry .. -
~~;_~ -
.{) ....
43 REV 1t/1008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ~, ~-_ C.~~ Cj
E /PRIM IN
-RMANENT -t~t
.LACK INK CERTIFICATE OF DEATH _
(See Instructions and examples on reverse)
STATE FILE NUMBER
1. Name of Decedent (Flan, mgMAa, teal, suffix) 2. Sax 3. Social Se Number
`{ ~, ~~~ PU ~S N ~ d. Date or Daam (MOnm, dav, year]
G 4 - `jam, -07o I ~G~ oh2r $ Zo I )
5. Age (Last BlMday) Under 1 ar Untler 1 de 6. Date of Bill Monet da 7. BIM ce C and state or for ' coon Be. Pkce of Deem Check on orre
~-1 Dsys Hours Mirxnea I- ~'1 Hospital: Other:
Yrs. (~ ~O~V 0 3 1932 P,N I ` G P~ ^ Inpadenl ^ ER 1 Outpatient ^ DOA ^ N ~ ^
Bb. County of Death
&. City, Boro, Twp. of Deam urnng Nome esirkrma
Od, Facllhy Name (If not ine8tulbn, give street and number) ~ 9. Was Dacetlem of Mepank Origin? ®N
^ Omer . Specity:
10
R
A
i
Cumberland
Hampden Twp. o
Ves
(II yes, speedy Cuban,
5232 Strathmore Drive
.
ace:
mer
can Indan, Black, White, etc.
(spap8y)
Mexkan, Pueno Rkan, etc.)
11. DecedanCS Usual Occu fbn Kind pl work done
tlun most of workin life. Do trot state reti
12. Wes Decetlenl ever in the
13
Decede
t
Etl
i Whit e
Kind of W ntl
f m
s U
S
Arm
d F
? .
n
s
ucat
on (Speary only highest grade completetl) 14. Marcel Status: Marled, Never Married. I5. Surviving Spo use (H wife
Ne meitlen
Registered Nurse
o
ass/~uat
ol
r
i~
.
.
e
orces
Elementary I Secondary (012)
College (1-d or 5+)
WMowed Divorced /Specify/ , g
name)
_ ^Yaa Np 2 Divorced
- 16. Decedent's Mailing Address (Street city! town, state, zip code) Decedents pA Ditl Decedent
5232 Strathmore Drive Actual Resgence 17a. Stale Tv
Decedem Livetl in Hampden
17c ®Y~S
wnsh
,
Twp
o
ip?
- Mechanicsburg, PA 17050 „bDp„nty Cumberland ntl^Np,DepedemuYedYdmm
Actual Umiis of city /Boro
1 S. FalheYS Name (Flrst middle, last sNfiz)
19. MothsVa Name (First, mltltlle. maiden sumemej
Ephraim Padgett Kelley, Jr. Agnes Irene Kimbell
20e. Infartrem's Name (Type 1 Print)
20b. InMrmenYS Meiling Address (Street city /town, stale, zp codel
Janine P. Seilhamer
5232 Strathmore Drive Mechanicsbur PA 17050
21a. Method of DiaposPoon ^ C
21 b
Dat
f Di
tb
^
ik
rama
.
n
e o
epoe
pona8on
m (Monet, Oey, year) 21c. Place of Dispoedwn Noma of tamale cremaro or other lace
( ry. N P I 21 d. Location (City/town
slate
zip code)
-
® Burial ^ RemovallrpmSl
t
- ,
,
^
a
e ' Wgree~cr~ ernlneDonetbnAulhodzed^ Yes^ Np ctober 1 3, 201 Tri-County Memorial Grdns. Lewisberry, PA 1 7339
22e. ore of Funeral ~ Licensee (or rig as such) 22b. License Number 22c. Name end Atldress of Facillry
~
- -
FO 012342-L Stone & MurrayF.H. 408 3rd.St.,New Cumberland, PA 17070
e creme 23at ally when tertlrydng 23a. To the 1 , deem occumed at me tlme, oats are1 place statetl. (Slgnafure and lets) 23b. License Number
icier is not available m Hme of deem to . 23c. Dale signed (MOpm, day. year)
- Certlhy cause of tleem.
- Items 2428 muss ne competed by person
who pronounces deem. 24. 7lme of Death
~ 1
r^s 25. Dale Prmounced Dead (Monet, day, year(
I 26. Wes Case Refen
ed t
q Medical Examiner ;Coroner for a Reason Omer Than Cremetlon or Donation?
.
A M.
V• a I (
T
- ~
/
^Yaa •lGNo
CAUSE OF DEATH (See fnetructlons anA exa
m
pbs) ~ Appmxknate interval:
Item 27. Pad I: Enter tlN them of evenLa - dseases, injures, or complications -mat tlirecthj caused me deem
W NOT
t Pan II: Enter Deter siori firanttondo . c~ntd xin 1 tlee h 28. Dltl Tobacco Use Conirlbute to Death?
.
en
er terminal events such es cardiac arrest
respiratory arrest, or ventricular fibnllatlon wimout sh me eao y ~ Onset to Death
owing logy. List onl one reuse on each line.
but not resuPong in me underrymg cause given in Pad I. '
n v.• n omr,
IMMEDIATE CAUSE IF'inel tlisease or //~~ z~
corMroon resuMng in deem) _~ a. ~ ~ ~ CQ1~'
\ C~~Y ~j r
x C
Qvrs
Duero (or as a consequence of):
. i
SequeMielly tlsi coMiAOns, if arty, b
leadirp to the reuse ksletl
li
on
ne a.
Eller fM UNDERLYING CAUSE Duero (or as a consegrrence olj:
(dheese or injury mat initlaletl me
events resultlng m tleem) LAST c
Due to (or as a coriseguence o1):
a.
r
30a. Was an Autopsy
Performed? 30h. Were Autopsy Flntlings
Available Prior to Completion 31. Manner of DeaM 32a. Date of In
fury (Monet, day, year)
32b. Describe How Ina Occurred
) ry
of Cause of Deam?
^ Natural ^ Homiatle a ,.
^ Yes ~ Na ^ Yes ^ No ^ Accident ^ Pending Imestigetlon 32tl. Trine d Injury 32e. Injury et Work? 32f. h Trensponetlon Injury (SpeciyJ 32g, Location of injury (Sir
^ Suicide ^ Could Not ce Detartnine0 M ^ Ves ^ No ^ Driver/Operator ^ Passenger ^ Pedesiran
^ Omer ~ Spea~ly
33a. Canifier (check Doty one)
• Cadlying physlcMn (Physician cedifyxtg reuse of deem when anomer physician has pronounced death all canpk+led Item 23 ~ ~ tree a of Cenlfier
To tM betl o/ my knaeledga, death oeeumW dw to the ceuee(sl end merrier a eWed _ _ _ _ _ _ ~~
• PrdlWnpfng sod ttNllying physklen (Physaian beet pronouncing tleem and certtly'rtg Ip cause of deem) _ _ _ _ _ _ _ _ ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ 33c. U'urree mbar 33d.
To fM beet of my knowledge, death occurred at the tlme, data, end place, and due to dte reuse(s) and manner u eteted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 1
• Medlnl ExaminerlCoroner --- M'I~,~ O \ 1
Gn the beefs of ezaminetbn and I or Inveallgatlon, In my opinion, deem occurred el the tlme, date, and plsce, and due to tM noos(e) and manner ea ateterL ^ 34. Name and Address I Person Who Co
mpleted Cause of D,aa`m (It9La`2_7)
35. Regismafs Signatu end Distria Number 36. Data Fled iMonet, y, year) M o,rt ~~P,~ M ,J ,%`
Disposaion Permit No. ~ ~+ ~ V
NO <J Unknown
29 II F male:
Not pregnant wihin past year
Pregnant at time of death
^ Not pregnant, out pregnant within 42 days
of deem
^ Nol pregnant, out pregnam 43 days to 1 year
before tleem
^ Unknown if pregnant wimin me past year
32c. Place of Injury'. Home, Farm, $tr961, Factory,
Office BuiMlrg, etc. (SpedyJ
cTy I town, slate]
t ~igneo rlmlh, day, year)
~ ~~
~ /Print /~
ri'(,Jy +'PG~t,I TTS,SO L
~! ~L~ F~ 1 ~ 611
LAST WILL AND TESTAMENT
.,
_,
_~
_, ,
O ~J .~_
-~
". -.....
.._. r`i ~ _..
Agnes I. Paasu -:_ =~=;
"-: i
I, AGNES I. PAASU, of Silver Spring Township, Cumberland County, Pennsylvania,
being of sound mind, disposing memory and full legal age, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made
by me.
1. I direct my Executors to pay all of my debts, funeral and administrative expenses as
soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession
and other death taxes imposed or payable by reason of my death and interest and penalties
thereon with respect to all property composing of my gross estate for death tax purposes, whether
or not such property passes under this Will, shall be paid by the Executors from my estate, and
that none of the aforesaid taxes shall be prorated among those persons or entities named herein or
otherwise beneficiaries hereunder.
2. My Executors may, at their discretion, compromise claims, borrow money, retain
property for such length of time as they may deem proper; lease and sell property for such prices,
on such terms, at public or private sales, as they may deem proper; and invest estate property and
income without restriction to legal investments unless otherwise provided hereunder.
3. I authorize and empower my Executors to sell any realty and/or personalty owned by
me at my death and not specifically devised or bequeathed herein, at public or private sale or
sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could
do if living. My Executors are authorized and empowered to engage in any business in which I
may be engaged at my death, for such period of time after my death as seems expedient to said
Executor.
4. I give, devise and bequeath all of my estate of every nature and wherever situate to my
children, JANINE P. SEILHAMER and DAVID P. KLINE, share and share alike, the child or
children of any deceased child taking the share their parent would have taken if living.
5. I nominate and appoint JANINE P. SEILHAMER and DAVID P. KLINE to be the
Executors of this my Last Will and Testament.
6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty
(60) days.
7. No Executor acting hereunder shall be required to post bond or enter security in this or
any other jurisdiction.
8. No beneficiary may assign, anticipate or pledge his or her interest in any income or
principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or
otherwise reach any such interest.
9. I hereby suggest that my personal representatives retain the services of Irwin &
McKnight as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ •~ J' day of
August, 2007.
~~' (SEAL)
AGNES I. PAASU
Signed, sealed, published and declared by the above-named Testatrix as and for her Last
Will and Testament, in our presence, who, at her request, in her presence and in the presence of
each other have hereunto set our names as subscribing witnesses,
~% f
~ ,~
t'•+.,-r
---~~~
r
r r /~ /
-C
.~-
ACKNOWLEDGMENT AND AFFIDAVIT
WE, AGNES I. PAASU, CHERYL L. CLELAND and TRACI D. SMITH, the
Testatrix and 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 that she had signed willingly, and that she executed
it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the Will as a witness 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.
G-~
A NES I. PAAS~/U'////j'', ~ %~
L="1 / ,
C:~'~
CHE L L. CLE A D ~
TRACI D. MITH
COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF CUMBERLAND ,
Subscribed, sworn to and acknowledged before me by AGNES I. PAASU, the Testatrix
herein, and subscribed and sworn to before me by CHERYL L. CLELAND and TRACI D.
SMITH, witnesses, this L3'-' day of August, 2007.
C:UMNyUNVVEfi~CTht OFT1ENFdSYLVANIA
~tJotarial Seal
~R B. Irwin, Notary Public
Carlisle Boro, Cumbertand County
My Commission Expires Oct. 3, 2008
Member. Pennsylvania Association Ot Notaries
C7 _~,
O
RENUNCIATION l ;
,_._ ~--
ri
~.,
REGISTER OF WILLS ~_ ~ :-_ _
<vr~~~~/ COUNTY, PENNSYLVANIA ~ _z=,
i.~'~ ~_:
-; 's
Estate of ~~'~ S ~ ~~ ,~~~ _ ,Deceased
I, ~~, a P~/,,~ ~ , in my capacity/relationship as
` (Print Name)
qdv,~ E S6n/ ~f r' c~~ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
~~~ ~ ,,
(Date)
l./.-x-a-s~~-~~
~ ..~~..~~,,
Executed in Reg>esttr's Q~ce
_..~ : r
gnature)
(Str`ee/t Address)
(City, State, Zip)
Executed out of Register's Offtce
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation or the
purposes stated within on this -- day
of C
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission.)
Form RW-06 rev. !0.!3.06
dMONWCALTM OF PENNBYL\/ANIA
NOTARIAL SEAL
r_AURA a. TARASEWICH, Notary Public
Susquehanna Twp., Dauphin County
a ^ey Commission Expires Aug. 30, 2012