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Home My WebLink About01-10-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s) the following and respectfully requests the grant of Letters in the appropriate form: Lauren D. Metcalf, Jr., Carol M. Turner and Glenn E. Metcalf Decedent's Information Name: Estella R. Metcalf File No: 21-12 ~ U~J `~ a!k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 179-14-7536 Date of Death: 01/02/2012 Age at Death: 90 Decedent was domiciled at death in Cumberland County, pA_ (State) with his/her last principal residence at 945 Forge Rd., Carlisle 17015 South Middleton Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 945 Forge Road, Carlisle, PA 17015 South Middleton Cumberland PA Street address, Posl Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death If domiciled in Pennsylvania ...................... All personal property $ 121 000.00 If not domiciled in Pennsylvania ................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................... $ 203,000.00 TOTAL ESTIMATED VALUE E 324,000.00 Real estate in Pennsylvania situated at 945 Forge Road, Carlisle, PA 17015 South Middleton Cumberland (Attach additional sheets, if necessary.) Street atldress, Post Office and Zip Code City, Township or Borough ® A. Petition for Probate and Grant of Letters Te amen a,n Petitioner(s) aver(s) that he/shelthey is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated 07!08!2002 County and Codicil(s) State relevant circumstances (e.g., renunciation, death of executor, etc.) Except as follows: after the execution of the instrument(s) offered for probate, Decedent did not mar was not divorced, was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. §~3323(g), and did not have a child born or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ® NO EXCEPTIONS ~ EXCEPTIONS ^ B. Petition for Grant of Letters of Admini tration (If applicable) c. t. a., d.b.n., d.b.n.c.t.a., pedente life, durante absentia. durante minoritate If Administration, c.ta or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent was not a party to pending divorce proceedin wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323 (g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. NO EXCEPTIONS ~ EXCEPTIONS 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 (attach additions! sheets, if necessary): Name Relationship Address :-7 n _, - ,~~ ~ _. 1 .._- - ~, -- ~. -, r. _ _1 A_ ~ - - -, = t.. _. . Form RW OZ rev. f0-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Pa e 1 of 2 9 Oath of Personal Representative ~ .- - ofraevuseonly_„_ -',- i :, COMMONWEALTH OF PENNSYLVANIA } ` " } SS: COUNTY OF Cumberland } k - - ` Petitioner(s) Printed Name Petitioner(s) Printed Address Lauren D. Metcalf, Jr. 1914 Mary Lane (~~~~~~ j'~' Carlisle, PA 17013 j~ ui ~ ~ ,, t Name as listed in Will: Lauren D. Metcalf Jr. ' "'" ":. ~ - Carol M. Turner 28 Spend-A-Buck Drive ' Dillsburg, PA 17019 Name as listed in Will: Carol Metcalf Turner Glenn E. Metcalf 228 Pine Road Mount Holly Springs, PA 17065 Name as listed in Will: Glenn E. Metcalf The Petitianer(s),ai3ove-named swear(s) or affirm(s) the statements ' e foregoing Petition ar true a d correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) o the dent, P iti er(s) w ell truly dminister the estate according/to law). Sworn to olr~affirmed a subscribed before ~ Date ~ "- <~' -! met ' G day of L~ ~ ~ ~- ~\ ,~_ Date \ ` ~ b - ~~- By: ~~~~~T% ,~j Date ~'~ ' ~ ~ -1 For G`>e Register Data BOND Required? ~ YES ~ NO FEES: Letters .......................................... $ 360.00 ( 6 )Short Certificate(s)......... 24.00 ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ............................................. Commission .................................. Other Will 15.00 JCP 23.50 Automatino Fee 5.00 Automation Fee ............................ JCS Fee ....................................... TOTAL ......................................... $ 427.50 To the Register of Wilts: Please enter my appearance by my signature below: Attorney Signature: ~~~ ~ ~ s r Printed Name: George F Douglas, III Esq. Supreme Court ID Number: 61886 Firm Name: Salzmann Hughes, P.C. Address: 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 Phone: 717-249-6333 Fax: E-mail: gdouglas~salzmannhughes.com DECREE OF THE REGISTER Date of Death: 01/02/2012 Social Security No: 179-14-7536 Estate of Estella R. Metcalf File No: 21-12 ~ ~~ a/kla: - - AND NOW, ~ ~~,~`l l It~'4 IR 1 ~ ~) rt h S"Lc i ~ oc _ , in consideration of tre foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Lauren D. Metcalf, Jr., Carol M. Turner and Glenn E. Metcalf in the above estate and (if applicable) that the instrument(s) dated 07!08/2002 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Register of Wills ~('~ ~'V~ ~VL~ ~•~- Copyright (c) 2011 form software only The Lackner Group, Inc. ~ ` Page 2 of 2 HI05.805 REV (9/11) LOCI~~,,REGLST~f~~pR'S CERTIFICATfON OF DEATH WA FNC'; It is illegal",t<o~ duplicate this copy by photostat or photograph. Fee for this certificate, X6.00 ,i ~ ~ _ ~„(~ 'T'his is to certify that fde information here giver) is (t l ~ ° ~ (:orrectly copied frouj an original Cerrific~te of I~cath duty filed with m(:' as 1~oca] Kegistrar. 'Ihe original C~E~fi!. (^ certificate will be li)rwarded to the ;hate Vital ~~~~w~~~r~ '~('II {rT Records Office fo) i~ermanent filing. ~, t .. P ~.. ~ 1 ~. ~ ~ ~ (~ __ ~~.{cr~ ~~eat 1t~__~-rc-c~~ z-J A~{ _3 1Z 012 _. Certification Number ~ L.ocal Registrar Date [slued ~.. Typ</Print In Permanent Black Ink .w-1 '-f .-1 T~ COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH .VITAL RECORDS P'FRT~F~f'.ATG AP f")~ATH _. _. 1. DecetlenYS Legal Name (First, Middle, Last, SufFlx) 2. Sex 3. Social Security Number 4. Date of D<Mh (MO/DayJYr) (Spell Mo) Estella R. Metcalf 179-14-7536 January 2, 2012 5a. Aga-Last Birthday (Yrs) Sb. Under 1 Vear Sc. Under 1 Da 6. Dn[e of Birth (MO/Day/Vear) (Spell Month) 7a. Birthplace (City and State or Foreign Country) 90 Months Days Hours Minutes Aug _ 27 , 1921 7b. Birthplace (County) 8a. Resltlence (State or Foreign Country) Bb. Residence (Strict and Number -Include Apt No.) 8c. Oid Decedent LWe in a TownshipT 945 Forge Rd . Yes, decedent Ilved 5n M i dd7 on _ twp. ad. Realden~e (county) Be. Residence (Zip Code) Q No, decedent Ilved within limits of city/bor0. 9. Ever in US Armed ForcesT 10. Marital Status at Time of Death Q Married WI owed 11. Surviving Spouse's Name (If wFfe, glue name prior to first marriage] Q Yes ®No Q Vnknown Q Dworted Q Never Married Q Unknow 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name PrIOr to First Marriage (First, Middle, Last) Thomas W. Rosen Ethel N_ McE1ro 14a. Informant's Name 14 b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zlp Code) 28 S nd-A-Buck Dr_ Dillsbur PA 17019 ~ p spice Faculty ~ - y Decedent`s Home Th H plt l H h h ¢ V os a o ere Ot er an a : L~ If Death Occurred in a Hospital: L~ Inpatient _If Death Occurred Somew Q Emergenry RoomJOutpatien[ Q Desd on Arrival Nursing Hom</Long-Term Care Facility Other (Specl/y) - e~ 356. Facility Name (If not institution, glue street and number; 15c. City or Town, State, and Zip Gode 35d. County of Death' a Road 945 Fo P 16a. Method of Dlsp ifion [~BUrial Q Cremation ra 16b. Date of Disposition 16c. Place of Disposition (Nam! of cemetery, crematory, or other place) ~ Q Removal from State Q Donation other (spetlty) Jan _ 6 , 2012 Mt . Zion C 16d. Location of Disposition (City or Town, Slate, and 21p) 17a. f Fun! k ens or Person In Charge Of Interment ~ 17b. License Number Churchtown, PA 17007 // ~~ 013144E ~ ITC. Name and Compl<te Address of Funeral Facility Ho££man-Roth Funeral Home & Cre to 219 North Hanove S e ~' 18. Decedent's Education -Check the box [hat bast describes the 19. Decedent of Hispanic Orlgln -Check the 20, Decedent's Rac -Check ONE OR MORE races to Indicate what highest degre or level of school completed at the time of death. box that best describes whether the decedent Che decedent considered himself or herself to be. 0 8th grade or less is Spanish/Hispanic/Latino. Check the "NO" S White Q Korean Af i n A ic n Q Vietnamese Bl k i i L i or ac r ca mer a span c/ at no. 1__I {~ No diploma, 9th - 12th grade box If decedent is not Spanish{H Q Hlgh school graduate or GED completed ®No, not Spanish/Hlapanic/Latino Q American Indian or Alaska Native Q Other Asian ~} Soma college cr¢dlt, but no degree Q Yes, Mexican, Mexican American, Chicano Q Allan Indian Q Native Hawaiian Puerto Rican Q Chinese Q Guamanian or Chamorro Q Yes , [7 Associate degre! (e.g. AA, AS) Q Bachelor's degre! (e.g. BA, AB, BS) Q Yes, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Ves, other Spa nlah/Hispanic/Latino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, Etl D) or Profess{ona{ degre¢ (Specify) Q Other (Specity) _ . MD DDS DVM LLB JD 21. Oecedenf's Single Race Self-Destgnatlon -Check ONLY ONE Co indicate who[ the decedent ronsidered himself or herself to be. 22a. Oecedent'z Usual Occupation -Indicate type of work ~~]] White Q Japanese Q Samoan done during mast of working Ilfe. DO NOT USE RETIRED. rj Black or African American Q Korean Q Other PaciRc Islander Ct~enpl.]ter Specialist Q American Indian or Alaska Native Q Vle[nameae Q Don't Know/Not Sure Q Asten Indian Q Other Allan Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawahan Q Other (Speclty) Naval Depot Q Filipino [] Guamanian or Chamorro ITE 5 29a - 23 UST BE COMPLETED 23a. Dat< Pronounce Dead (MO Day r) 23 .Signature Person Pronouncing Death On y when app Ica a 23c. License Number BV PERSON WHO PRONOV NOES OR CERTIFIES DEATH 23d. Date Signed (MO/Day/Yr) 24. Time of Death 12 ~ 25 AM 25. Was Medical Examiner or Coroner Contacted? Q Ves No CAUSE OF DEATH gpproxtmate 26. part 1. Enter the chain of a cots--diseases, in)uries, o mplications--that directly caused the death. 00 NOT Inter terminal a ents such a ardlac arrest Interval: /OT AB/BJREVIATE. E ly one cause~Q Add additional Tines If necessary Onset to Death respiratory arrest, or ventricular fibrlllatloyyn wit`houtrsho_wing Yh¢ e-tio/lpgy. DO N /(~na L T ~ T- r ,/ ~J / ~ {/' j, ~`I ~ / ` IMMEDIATE CAUSE _______________y a, L l`~NG G J / L (Final disease or condition Due to (or as a consequence of): resulting In death) b. Sequentially Iisf conditions, Due [o (or as a consequence of): If any, leading to the cause listed On Rne a. Enter the - UNOERLYING CAUSE Oue to (or as a consequent! of): (disease or Injury chat initiated the events resulting d. - nce In death) LAST. Due to (Or as a conzequ of): ,g 26. Part 11. Enter other i iflc n n Iti on[rlb iln h but not resulting in [he underlying cause given In Part I 27. Was an autopsy pertor edT Q Vez No ~ 28. Were autopsy findings avallabla to complete the c of death? < ~, NO Q Yes 9! 29. If Fej al<: N 30. Did Tobacco Use Contribute to DeathT P b bl 31. Manner of Death icid r l Q HD N t ot pr<gnanC within past year j3 [] Yes Q ro a y a u a m e i d ,~ [] Pregnant a[ time Of death Q NoC pregnant, but pregnant within 42 days of death Q.FIO Q Unknown gation Q Accident Q Pen ing Invest Q Suicide Q Could not be determined ~ Q Not pregnant, but pregnant 43 days fo 1 Year b<fore death 32. Date of Injury (Mo/Day/1'r) (Spell Month) ~ V nknawn If pregnant within the past year 33. Tim! of Injury 34. Place of Injury (e.g. Home; consfiuc[fon she; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation InJury, Specify: 38. Describe How Injury Occurred: Q Ves ~ Driver/Operator ~ Pedestrian Q No Q Passenger [] Other (Specify) 39a. ~,artifier (check only on¢): annar .~ rtifying physician - To the best f m wledge, d< th occurred due to the cause(s) and m stated Pronouncing 8 Certifying phY a he best y knowledge, death occurred at the time, date, and place, and due to the c se(s) and manner stated h occurred at the Lima, date, and place, and due to the cause(s) and Mannar stated t of ! nation, and/or investigation, In my opinion, des Medical Examiner/Coroner-'- n Y ~ / J v ~ ~ j7/ GL ~^ b ~ ~' License Num er: / Signature of certifier: Title of certifier: 39b. N dross and Zip Code of Person plating f Death 6~af- 39 . O teilg (MO/Day/Vr) 40. Registrar's DistticY Number 41. Regis<ra ature ~ ~~ o Da y r 42. ~ Is~r'r File Date M ^~ O 43. Amentlmints rrGG [~ f~ H105-143 Disposition Permit No. L) ~~ ~ ~ ~t 1 REV 07/2011 LAST WILL AND TESTAMENT I, Estella R. Metcalf, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do publish and declare this as and for my last will and testament, hereby revoking any and all wills by me at any time heretofore made. Item I. I devise and bequeath all my property, real and personal, in four equal shares, to my children: Lauren D. Metcalf, Jr., Carole Metcalf Turner, and Glenn E. Metcalf, and one share to my six grandchildren to be divided equally among them. Item II. If any of my children should predecease me, that child's share will go to its issue, per stirpes. If any of my children die without issue, that child's share will go to my surviving children. Item III. If any of my grandchildren shall be deceased, his or her share will go to his or her issue per stirpes. If any grandchild should die without issue, his or her share will go to my remaining living grandchildren in equal shares. Item III. I nominate constitute and appoint my son, Lauren D. Metcalf, Jr., and my daughter, Carol Metcalf Turner, and my son, Glenn E. Metcalf, as my Executors. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of ~ 2002. Estella R. Metcalf Signed, sealed, published and declared by the above-named testatrix, as and for her last will and testament, who at her request, in her presence, in our ~esence, ~ T ~_, and in the presence of each other, have hereunto subscribed our res as . -, Cj attesting witnesses: ~ ~~ ~ : . -;.z-~ ~, c- '~ .,; ~,.. _. . 7 `° ^-_~ ' - .~- _ ~. = _ .~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. '~ 1 We ~ ' W and ~ ~ ~" ~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her last will, and that she signed willingly and that she executed it as her free and voluntary act for the purposes therein contained, that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. r u'r i Sworn to and subscribed before me this ~? ~ day of C~.~~, ~ , 2002. Notary Notarial seal A~Oips F Douglas, 111, Notary Public Carllsie Boro, Cumbeiiand County My Commiiasi~m Expires June 26, 2003 ,- ,.. COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) ss. I, Estella R. Metcalf, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~F Estella R. Metcalf Sworn to and subscribed before me TN this ~_ day of _, 2002. No ry ` Natar4~! Sed f9oreGlxr~ctar~d~ Coirrty M~-oonm~Nelon Expires ,Nne 28, 2003