HomeMy WebLinkAbout10-28-11r ~~
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Scott A. Keeseman
also known as
COUNTY, PENNSYLVANIA
File Number 21-'~ I ~ -
,Deceased Social Security Number 178-5$-5431
Madella M. Keeseman
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or `B' BELOW.•)
^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the
last Wifl of the Decedent, dated and codicil(s) dated
State relevant dreumstances, e.g., renunciation, death of executor, etc.
After the execution of the documents offered for probate: Decedent did not marry; was not divorced; 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); did not have a child born or adopted; was not the victim of
a killing; and was never adjudicated an incapacitated person, except as follows:
B. Grant of Letters of Administration
{Ifappticable, enter.• c.t.a.; d.b.n.c.t.a.; pedenfelife; duranteabsentia; duranfeminodtate)
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. ord.b.n.c.t.a., enterdate of ill on Section A above and complete list of heirs); was not the victtm of a ktlling; 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 to 23 Pa. C.S.A. § 3323 (g), except as follows:
Name Relationship Residence
Cassandra Saphore Daughter 7001 Coconut Court
Dover, DE 19901
Mark E. Keeseman Father 129 Oak Ftat Road
Madella M. Keeseman Mother 129 Oak Flat Road
(If domiciled in PA) All personal property $ ~? ~ L ~ --~s -
(If not domiciled in PA) Personal property in Pennsylvania $ - m+ ~3 __
(If not domiciled in PA) Personal property in County $ °=- `~'' %~
Value of real estate in Pennsylvania $ C. ? ~' `
7 ,, ~
--t .. t "`
situated as follows: ~ V ~=~ d
t_°
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicils} presented with this Petition and the grant of Letters in the appropriate form to
Signature Typed or printed name and residence
Madella M. Keeseman 129 Oak Flat Road
Newville, PA 17241
(COMPLETE /N ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his !her last principal residence at
90 Potato Road, Carlisle, Upper Frankford Township, Cumberland County, PA 17015
(List street address, town/city, township, county, state, zip code)
~::~_;
Decedent, then ~_ years of age, died on 06/20/2010 at Carlisle Regional Medical Center, CarQe, PA 17013-- '.k"'t
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Decedent at death owned property with estimated values as follows: ~ ~ <=~ f `r`i r--,
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Form RW O2 Rev. 12-26-2010 (intedm form, pending action by the Court) Copyright (c) 2006 form software only The Lackner Group. Inc.
Page 1 of 2 ~~
~~
~ ~ ~,
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
} SS
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The Petitioner(s) above-named swear(s) or affirm(s) 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~syu~,bscribed
before this ~Tr day of
~~ ~`1
Madella M. Keeseman
_ ~~ ti:? r.r_t
~~ _,~ -
~ For`t'he Register Signature of Persona/ Representative =. Uj :~
File Number: 21-10 ~~
Estate of SCOtt A. Keeseman
Deceased
Socia curiry Number: 178-58-5431 i Date of Death: 06/20/2010
AND NOW, _ ~ ~~~ ~ ~ ~ ~' ` , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters of Administration
are hereby granted to Madella M. Keeseman
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
FEES i ;,
Letters .......................................... $ U"
Short Certificate(s) ....................... $ ,
Renunciation(s) .....................~... $ V r
$ t~3 '
$ S~'~
$
$
$
$
o,
TOTAL ................................... $
Form RW O2 Rev, 10.13-2006
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Register of t~tl
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.: _ 01624
Weigle ~ Associates, P.C.
Address: 126 East King Street
Shippensburg, PA
Telephone: 717/532-7388
Copyright (c) 2006 form software only The Ladcnar Group, tnc.
Page 2 of 2
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' ~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH
r WARNING: It isrllegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 16534950
Certification Number
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This is to certify that the information here given i
correctly copied from an original Certificate of Deat
duly filed with me as Local Registrar. The origins
certificate will be forwarded to the State Vita
5 Records Office for permanent filing.
L ~~~~~~~ Jt~i~i 2 ~/ 2050
Local Registrar T Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S. CERTIFICATE OF DEATH
($aa Instruetlona and axamPla- on ravefaey STATE FILE NUMBER
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Scott A Keeae>man Male 178 - 58 - 5431 June 20, 2010
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RENUNCIATION ~~ ' ~ ~a
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REGISTER OF WILLS = ~ `~~" ~" - ~i
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Cumberland COUNTS' PENNSYLVANIA
~-
Estate of Scott A. Keeseman
Deceased
I, Cassandra L. Saphore , in my capacity/relationship as
(Print Name)
dau>;hter of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Madella M. Kesseman
~( 22- 7.A 1
(Date) ( afore)
7001 COGOIIUt COUrt
(Street Address)
Dover DE 19901
(city, ware, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this ~ day
of ~e/'. l Zvi I
Nota
My ssion Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission J
ONWEALTH OF PENNSYLVANIA
Form RW-06 rev. 10.13.06
Notarial Seal
Nathan C. Wolf, Notary Public
Carlisle Boro, Cumberland County
Commission Expires Aprl{ 19, 2412
Pennsylvania Association of Notaries
11 -ll~
RENUNCIATION
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Scott A. Keeseman
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~~ Mark E. Keeseman in my capacity/relationsh p as ~~
(Print Name)
father of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Madella M. Keeseman
(Date) (Signature) Mark E. Keeseman
129 Oak Flat Road
(Street Address)
Newville. PA 17241
(City, State, Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Before the undersigned personally appeared the
before me thi ~ day party executing this renunciation and certified
of ~--• that he or she executed the renun iation for the
purposes stated within on day
of ~ I t .
~•
Deputy for Register of Wills No Publ Jp Y ~ . G ~ ~-tajLrr
M ommission Expires: (~,~
6 ~ ~ o I~' ~o ~ ar
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(Signature and seal of Notary or other official quali to
administer oaths. Show date of azpiration of Nota s commission. )
COMMONWEALTH OF PE SYLVANIA
NOTARIAL SEAL
JODY L. GILBERT, Notary Public
New+rille Boro., Cumberland County
s August 6, 2012
Form RW O6 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.