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HomeMy WebLinkAbout10-25-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS / / Estate of John Lamont Black ,Deceased ESTATE NO. 21- 1 l "" / ~~~ a/kla: J. Lamont Black a/k/a: alk/a: SS NO: 201-16-oz17 Petitioner(s) who isJare 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) islare entitled to the aforementioned Letters ~ "~==under the last Will of the above-named Decedent dated and codicil(s) dated ~" "'° ~~ ~C~ t.~-~-j r-1 -~ ~:, r-- ~ - , ,-~. ~' ~ ~ (State relevant circumstances, e.g. renunciation, death of executor, etc.) `` ~ ~n ~ C;I ~ .~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted aft~ttion~the instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated peel, and was"•not a y _.-_ party to a pending divorce proceeding at the time of death wherein grounds for divorce had been e~s~biished as~fine~~t~.; 23 Pa. C.S.A. § 3323(g): t,, c:ri G t.- --r, ~ B. Grant of Letters of Administration (If applicable, enter d.b.o., pendent lite, durance absentia, dnrante minoritate) C. Petitioner(s), after a proper search, haslhave 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 erection 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:- .~a~~ Haaress xetanonsm to 1)eced~ Vonnie R. Sheriff 07 N Walnut Street, Mt. Holly Springs, PA 17065 daughter --------------- VICkI L. Brownawell Yankee Drive, Mt. Holly Springs, PA 17065 daughter IF mt THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 282 Walnut Bottom Road, Carlisle. Carlisle Borough. PA (Street address with Post Office and Zip Cade, Municipality: Township, Borough, City) Decedent, then 86 years of age, died 10/11/2011 at Harrisburg Hospital (Month, Day, Yeaz of death) (City and State where death occurred) Estimated value of decedent's property at death: If domiciled in PA Ali personal property $ 10,000.00 _If not domiciled in PA Personal property in Pennsylvania $ _If not domiciled in PA Personal property in County $ -Value of Real Estate in Pennsylvania $ 70,000.00 Total Estimated Value $ 80,000.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 128 Wynnewood Drive, Carlisle, 17015 Signature(s) Name(s) & Mailing Address(es) Vonnie R. Sheriff, 507 N Walnut S.t., Mt. Holly Springs, PA 17065 r.. - Vicki L. Brownawell, 2 Yankee Drive, Mt. Holly Springs,PA 17065 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Paee 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 , ~/'>^, re this day of ~ ~ ~~ ~~ v r t Register ._ -~ c ~ ^ ~=: ~? ~ ~ ~' c.a l DECREE OF PROBATE AND GRANT OF LETTERS ~ ~ ~.~ ' .' _~~~~ ~ ~~ _~ _~, Estate of John Lamont Black a/kJa J. Lamont Black ,Deceased File Number: 21- ~rf ~:~ // ~~~ ; .ter, AND NOW, thi J'' day of , in consideration of the Pe~rtl'~tion on -'~' the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters -Testamentary x of Administration are hereby granted to: (If applicable, enter c.t.a., d.b.n., d.b.n.at.a., etc.) Vonnie R. Sheriff and Vicki L. Brownawell in the above estate and that instruments(s) dated admitted to probate and filed of record as the last Will s) of described in the petition be ~'lenda Farner Strasb~~ Register of Wills c~~- FEES: Letters ....................$ ~ C/` Will ........................ Codicil(s) .................~ (L~) Short Certificates ~~p _ ( )Renunciations....... Bond ............................ Other ............................ ................................. ............................. Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ 1~U signature of Counsel Required to Enter Appe,@ra~ce Atty's Signature r PRINTED Name Ronald E Johnson Supreme Court ID No.: 16453 Address: 78 West Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 FaX: 717-243-0061 Interim Form RW-02 revised 12.26.1Q by Cumberland County pending action by the Court Page 2 of 2 // - %/.3S LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 17726851 Certification Number This is to certify that the information here given correctly copied from an original Certificate of Dea duly filed with me as Local Registrar. The origin certificate will be forwarded to the State Vit Records Office for permanent filing. ~~~ ~+-~'~.~, 1 212011 Local Registrar Date Issued H10S149 qEV 11llDOb TYPE! PfYeif N`i P ~r n ~~ -~ ~i ?.;7 ~ fT'i -~J?i +.?~©. `, 'D --1 b f• -, .-~ ti -.. ~~ ~' c~ ".~ r' [V 1, , L+'4 -~-#. r -_ "_ ?'x't W ~~ C ~' COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VRAL RECORDS CERTIFICATE OF DEATH (See Metruotlons and examples on r.veney •.,~ ~„ o ~,,,,~„ t ara. a Dore far, mmue, wt.~eerl z sea 9. Sode1 Seway Nunher ~. a 1M+h M. John teamont Black Male 201 -16 -0217 ~ ~a (W+ eanrm~ under 1 , a Dew a can ~. eM eWea e• PYn a oewr CMd ~ Yr's• "°"" °"' "°"" ""` August 2, 1925 Shermansdale, PA ! °""` vrc. lYaweaa ^ En f oaa+a.a [~ oo~ ^ ra~aw Ma.. O w.~. O ana -sPwy e, coa+r d o.en 9a ~. eorq TwP• a Dean 9d. FadaP yYlu mrot arNalkn. pea eEar and nenMn s. Wr oeceest a Maoeac o~7 „o Q rar 10. wo.: Mwioen aepn, surds wire, at Dauphin Harrisburg Harrisburg Hospital (,~ P'P~"' Po~ ; ~ white ,,,, ,,,,m ,,, ,.~) 11.OeeedrMe Ueur d,red:d me orals M. oo na eWe ,z Wu oecdan ava r, nr 1a Qecdrih Emr~YOn ~Sprly ~J ~+ Gram oomP Yrotll +~, fMNeU stabs Mrm4 Near a,s,Md, 15. SurWkq ~ +• (~ ,~•. 9a+ nridn rwne) IOM d Weds ~ 10AU1 eraretfMlrEy U.S. Nmld Facu7 Hsrr~eavy f Snbaimry (r}121 Cbkpe (1~ a 5+) WWe•ed, DHaaed IsPeaY) Electronics Tech. Y. O r,o +e.oend.r.~hddeaal3EaetalYyarn.alele,,4mde1 282 Walnut Bottom Rd. Carlisle, PA oeae~'a Pe lvania ndDeCo°'" ~mrP.ewar. ne.steb nClsy "o.(~Yw,oea.den,uwin nro. ~N1 ~ 17013 r aY a Cumberland ne. [.~~ ur.drarn Carlisle Borough „e c ~a . a,ey . atyf8oro 1&Fstl"~'"°~°~'~"d°°'`°`"~"°s Charles Black r.. 'b'MO°"""Me`~r'ndtl°"'`~`s Ruth Baer xa"damenr' "am° (r'va f "'m Vonnie Sheriff 2nE. wonw~xe wiMnp weau (sa.et ay f tarn alts, dp Wm 507 N. Walnut St. Mt. Holy Springs, PA 17065 21a. Ak1laddorPOddar ~ ^CrenuYm ^Dwaon 2iE. ore~o4Poerar (enarrr, mY•Yw) 21c. Plan aouPowo+lNun•aosnnq~~~raonwPM[.) 2,d. wcamnloMfwn wr. aP wd.) „ a ~ ^ Ruarwin I w ® October 17, 2011 Youngs United Methodist Church Sheraanadale~ PA 17090 ~ ~ ~ Y~~ ~ ~ o irr • 2sasipnraa .pro z2b.uc«r.rxroa zx,Mma.ndMOeua~Mr Carlisle PA 17013 ~ . ~ 138504 7 N. 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