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HomeMy WebLinkAbout01-31-12PETITION 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: . i ~~~~de!?±'s Information +~ - u l ' "t~~ File No: 21 ~ ~: Name: Florence E Stone (Assigned by Register) a/k/a: a/k/a: 174-20-8584 Social Security No: a/k/a: 86 Age at Death: Date of Death: 01/2012012 County, PA (State) with his/her last Decedent was domiciled at death in Cumberland Cumberland principal residence at 1000 Claremont Road, Carlisle 17013 Carlisle City, Township or Borough County Street address, Post Office and Zip Code Decedent died at 1000 Claremont Road Middlesex Cumberland PA State Street address, Post Office and Zip Code City, Township or Borough County Estimate of value of decedent's property at death: If domiciled in Pennsylvania ...................... All personal property $ If not domiciled in Pennsylvania ................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................... $ Real estate in Pennsylvania situated at (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code 3,000.00 TOTAL ESTIMATED VALUE $ City, Township or Borough ® A, r for Probate and Grant of Letters Testamentaor Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated 01!21!1992 3,000.00 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 marry, 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(8), 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 ^ g. Petition for Gr^nt of et+ers of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pedente lite, durante absentia. durante minoritate If Administration, c.t.a or d.b.n.c.t.a., enter d e of ~"dill in Section A abgove and r•omolete list of heirs. Except as follows: Deced and waasnneitheathetvictim of a kllll~ng nor everdadjudlcated anei ncapaclt ted personhad been established as defined in 23 Pa. C.S. § 3323 (g) ~ r_ ; ® NO EXCEPTIONS ^ EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following,„ e (if any}~a~nd hejr~~ additional sheets, if necessary): Name Relationshi Address __~ ~ ~ ~, , .~. ~ ~ r~ ~ ~ r. c.~ Page 1 of 2 Form RW-OZ rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS: COUNTY OF Cumberland } Petitioner(s) Printed Name Christine S Crout f/k/a/ Griffie $ ~~~,C'~ "fl '~ ,~ l%'~... The Petitioner(s) above-named swear(s) or affirm(s) 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) o~ i j Decedent, PetitlonerC) wil~w,el~and` t nister the estaota ac ~ rd3in~ t~ 12aw. Sworn to or affirmed and isubscribed before ~ . , ~1 l..' Date me p'h~s ~tday of For the Register BOND Required? ^ YES NO FEES: Letters . ........................................ ( ~~- )Short Certificate(s)......... ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond .. ........................................... Comm ission .................................. Other ~'~ 1 ~; r . Petitioner(s) Printed Address 207 Meals Drive Carlisle, PA 17015 To the Register of Wills: ;~; T~ '_~ '~ , ~ ~ ' _ 7 _: - ~ ,t.f a ,C -'i. ~~ _ r` , Date Date Please enter uer~w. Attorn P to me: Bradley L Griffie Supreme Court 34349 ID Number: (, , a'~ ( -- Official Use Only Carlisle, PA 17013 Automation Fee ............................ JCS Fee ....................................... TOTAL ......................................... $ ~~ (, Estate of a/kla: Firm Name: Griffie & Associates Address: 200 North Hanover Street Phone: 717-243-5551 Fax: E-mail: DECREE OF THE REGISTER Date of Death: Social Security No: File No: Florence E Stone AND NOW, -"% t 5t t°' satisfactory proof having been in consideration of the foregoing Petltlon, ~ :~ , before me, IT DECREED that Letters Testaments are hereby granted to Christine S Crout flkla/ Griffie in the above estate and (if applicable) that the instrument(s) dated 01/21/1992 described in the Petition be admitted to probate and filed of record as the~last Will (and Codicil(s)) of Decedent. Form RW-02 reg. ~oiwzo~ i ~ ~ T, Register of Wills ~ f' /' '~~' _->~ / ; F ~`' ~' age Copyright (c) 2011 form software only The Lackner Group, Ina ~~ / ~ . , 33 'J/// 01/2012012 174-20-8584 21 ~~ ''~}~.'~ 1~..~,i'~ to ~-~up,5c:,;..~ ° , tl , ;~:~ ~~_ ~~~o~cast~t c.~ g~r~ ~. w -~-~' ;~` i.„~ CLERK Q~ ~~` ~ ~) t ( ; ~~ - .. 4RPHAI~'S CC}URz ~ :. ~;t)A~RFR' A~!~ ('~ FA `` JAN 2 4.2012 .fp ~ ~ I /~ _. ~: ~_ .j P... L' . ~ ,. ~ . _ _ .. . - ~ v~ Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORD9 1 ~ Permanent CERTIFICATE OF DEATH State File Number: 4 Date of Death (MO/Day/Vr) (Spell Mo) Florence E- Sa. Age-last Birthtl ay (Yrs) Sb. l f S6 M< 1 Ba. Residence (State or Foreign C PA 8d. Residence (C unty Curr(ber and 9. Ever in US Armed Forces? Yes ~ No Q Unknown 12. Father's Name (First, Middle, Rov Frasier _ Stone 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Vear Davs Hours Minutes Aug_ 22, 1925 yi 8b. Residence (Street and Number -Include Apt No.) 8 1000 C1ar~nt Road Be. Residence (Zip Code) Widow O. Marital Status at Time of Death ~ Mauled ~ $}Cpiyorced ~ Never Married ~ V nknown Decedent uye In l ownsny]r decedent lived in 1111 decedent Ilyed within limits of 1. Surviving Spouse s Name (If Cora M_ ress (Street and Number, City, State, s (~t1Z'1 SL1]"1C ~- `-'1-~`~" a_.__P_ ace o_f Death Checlt onl _ _ __ _ _ ... ... ... ........ urre Pµ+y~ .......................................f ... C D a[h a Facll y ~•t it •---•~-~at ~----""""""""""'~~~~~•~~~~~~~~~~••~~~~ In bent •1 a Occ d Somewhere Other Than a HosPit I: ---LJ Hos Pice ¢_ If De h Occurred In a Hospital: u pa Dead on Arrival _ ~ Nursing Home/Long-Term Care Facility Other (Specify) Emergency Room/OUtpatlent 0 16 c. Ci r Town, State, and ZIp Code 15dC C~o~~~ 156. Facility Name (It no[ institution, give street and number; ty P~1 1 701 3 C1ar~nont Nursing & RP-YJab- CP-rlter Carlisle, re 16a. Method of Disposition Burial Q Cremation 16b. Dale of Disposition 16c. Place of Disposition (Name of cemetery, c ma[ory, or m p Remqyal trom state O Dpnanpn 1 2 201 2 Mt _ Zion Ceiclete - Other (Specify) 17 51 nature of Fu eral Service Vicens Charge of Interment 1~6. Ucens fwP. caxc~iprn pf Dis~~~ Ia(~pn (city or Town, State, and Zip) 16d. Lo A MO o a- g - - FD O 1 2633 L ~ rlanLi Count P L~( ~'(Lj~e 1 701 3 0 - 111d Complete Address ot~-~lnera(~y Hie ~ 17c. E Y =nc _ , 630 S _ Hanover St _ , Carli e , PA R MORE r s [o Indicate w at awe _ ~ lers g Brot Decedent of Hispanic Origin -Check the 19 20. Decedent's Race -Check ONE O t °m' Decedent's Education -Check the box that best describes the 18 . rient ec h t e dent consid the de ;= el ered himself or hers . hest degree or level of school completed at the time of death. hi N O a b 5 t Check the /Latino i h e ~ KOrean ~- g ~ 8th grade or less . c h Hispan pa ms / box If decedent Is not Spanish/Hispanic/Latino. Black or African American ~ Vietnamese ~ tive ~ Other Asian N k No diploma, 9th - 12th grade d [_3"1t)o not Spanish/Hispanic/Latino American Indian ~ a or Alas a ~ Native Hawaiian ~(rHigh school graduate or GED complete ~ Yes, Mexican, Mexican American, Chicano Asian Indian ~ ~ Gua manlan or Chamorro but no de ~ Some college credit, gree ~ yes, Puerto Rican Q Chinese ~ Samoan ~ Associate degree (e.g. AA, A6) 0 Yes, Cuban ~ Filipino ~ Ocher Pacific Islander 0 Bachelor's degree (e.g. BA, AB, BS) MBA) SW d ther Spanish/Hispanic/Latino ~ Yes, o Q Japanese , , M 0 Master's degree (e.g. MA, M5, MEng, ME r Professi Doctorate (e.g~ PhD, Ed D) o onal degree (Specify) . MD, DDS, DV M, LLB, JD ti eceden[ considered himself or herself to be. d h mos of working Ilfen DO NIOT USEpRETIRED. -Check ONLY ONE to Indicate e durin h o 21. Decedent's Single Race Self-Designa n nese J O g on oa n Sam 0"GCih i[e apa ~ Other Pacific Islander Housekeeping O Q Black or African American Q Korean tnamese Vi Don`t Know/Not Sure f Business/Industry d O Q American Indian or Alaska Native e Q Asian h o Refused 22b. Kin ~',n• ~ Asian Indian h er ~ Ot Q Native Hawaiian Q Other (Specify) Universit of Delaware ~ inese ~ C Q plno Fill p Guamanian pr Chamorro Death (Only when applicable) ouncin P 23c. license Number ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (MO Day/V r) g ron 236. Signature of Person ~ (l ~ (~ y y w ,L BY PERSON WHO PRONOVNCES OR S0. h uq ~~ oZ O ~ O 1 a ~I \ Z~~t/l ~O?t ~n I ~ Other (Specify) F c~ E s 0 J. Date Signed (MO/Day/Yr) 24. Time or ueatn ~^7 dd yes u~ rvo 25. Was Medical Examiner or Coroner ContacCed? A n~Cai"~ ~v ,~ O l a CAUSE OF DEATH Approximate Interval: li om cations-[hat directly caused the death. DO NOT enter termnnai events such as cardiac arrest. Onset to Death ecessa if I 26. Part I. Enter the chain of events--diseases, p ry n injuries, or c lnes t showing [he etiology. DO NOT ABBREVIATE. Enter only one cause o aline. Add additional h entricular fibrillatio respiratory arrest, or v ou n wit ~ • ' `o~ ~ € IMMEDIATE CAUSE ------- ------~ a. s quence of): a c Due Co (or as (Final disease or condition ~ / O S 1" ~ 1 ( ~~ S resulting in death) b ~ ~~ ~ ,L ~, \ . Due to (or as a consequence ofl. Sequentially list condiilons, {f any, leading to the cause listed on line a. Enter the Due to (or as a consequence of): V NDERLVING CAUSE (disease or injury that initiated the events resulting d. Due to (or as a consequence ofl: In death)LAST. .. .. _ _ ~__ _. c.........e...ltu.o ~n the underlying cause given in Part I 27. Was an auCOpsy perfo w,^ed? to complete the cause of death? - Fe le: 30. Dld I opacco use ._un.. ~.,..._ --- .----~ ~ ~ Probably ~s Natural Q Accident ~ Homicide Q Pe nding Inyes[Igation Not pregnant within pas[ year ~ Vnknpwn 0 Suicide Q Could no[ be determined ~ Pregnant at time of death s of death 42 da hi y n ~ Not pregnant, but pregnant wit before death II Month 32. Date of Injury (MO/Day/Vr) (Spe ) f I ~ Not pregnant, but pregnant 43 days to 1 year nJury 33. Time o Q Unknown if pregnant within the past year Location of Injury (Street and Num 35 ber, City, State, 21p Code) ..___ _. ~......., ie a hnme. construction site; farm; school) . ortation Injury, Specify: I38. Describe How Injury vccurreu: . Injury at Work 37. If Transp ~ y ~ Driver/Operator Q Pedestrian Q N O P g ~ O[h (SP Ify) . Certifier (Check only one): knowledge, death occurred due to the cause(s) and manner stated ~~,/Certifying Physician - To the best of my death occurred at The time, date, and place, and due to the cause(s) and manner stated ne L~ Pronouncing 8. Certifying physician - To the best of my knowledOge, in my opinion, death ccu rred a<the time, date, and place, and due to the cause( ) a d rate ~ Medical Examiner/Coroner - On th basis of exa ina[ on, and/ investigqat~ion, may, v ~t 'U •~ l p n ~ ~ ~~/~~tle of certifier' ~ ~ s G t CS (~ License Number: (/i /' `/ .J Signature of certifier: [~l'.l ~ 39c. Date Sig ed (M /Day/Yr) ib. Name, [ ddress and Zip Code of Per n Completing Cause of Death Item ,26) • /•~ ~~ ~S ~ ~ 2 ~ Zy ) 7 ~ (` r d ~ I Ct i'{ k t (`J / ~/ ~/~ ) ~ • ~ ` 42. Registrar File D to Mo Day r) 1. Registrar's District Number 41. Registrar' ~ ~~ts ~3 aO ~-. -,; _ at0 I 2. Sex 3. So<lal Security Number F 174 - 20 - 8584 Jan_ 20, 2012 ,... _.... __.c. -lam al.th.,iare (City and State or Foreign Country) H106-143 / (i 1 / .1 ~ REV 07/2011 Disposition Permit No. tCi -\. \ l4 `Y WILL OF FLORENCE STONE I, FLORENCE STONE, of 139 South Pitt Street, Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and hereby revoke all prior wills and codicils. 1. I direct that all my just debts, funeral expenses, grave- marker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. I direct that all inheritance, estate, transfer, success- ion and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3, I direct that my entire estate be distributed as follows: A. I leave my entire estate of whatever nature and wherever situate to my niece, Christine Susan Griffie, should she survive me. B. Should my niece predecease me, I then leave my estate of whatever nature and wherever situate to her daughter, Alison Rebecca Griffie. ~~ c.~ -"4 ~_' a.: f .'~ _J :,~..i 'i r. ~, -~' ~~ ci_ ~ ~°' .;~? `; >~ ' ~ L"~ LAW OFFICES OFD STEPHEN J. HOGG 401 E. LOUTHER STREET CARLISLE, PA 17013 4. I appoint my niece, Christine Susan Griffie, as Executrix of this my last Will. If she should predecease me or cease to act in such capacity, I name Farmers Trust Company to so serve. 5. The Executrix of this Will shall have the power to dis- tribute my estate in kind or in cash, or partly in either. 6. I direct that no Executrix acting under this Will shall be required to enter bond in any jurisdiction. N WITNESS WHEREOF, I have hereunto set my hand this.,./~;~fday of 't c ' r. L , , 1992. <r F_ n. cc ~~ )'.fir, U; J~~~. <~ ~- ~ Q' ~~ ©= v 1 ~ ~~_ 1, ._' RENCE STONE ~ f ~j ~i/'; _" The preceding instrument consisting of this and one other page was on the day and date hereof signed, published and declared by FLORENCE STONE, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. ,~i L~ J .~ E;'.. ~; /. LAW OFFICES OF STEPHEN J. HOGG 401 E. LOUTHER STREET CARLISLE, PA 17013 ACKNOWLEDGEMENT Commonwealth of Pennsylvania County of Cumberland ss I, FLORENCE STONE, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified accord- ing to law, do hereby acknowledge that I signed and executed the in- strument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. ,FLORENCE STONE Sworn to or affirmed and acknowledged efore me by FLORENCE 1992. STONE, the testatrix, this ,.;~'>'.:~ ~~ day of ~~ ~°?~1rcr G'' ~~ ~ y • „_ ~~ ... Notary P~ric/Attor LAW OFFICES OF STEPHEN J. HOGG 401 E. LOUTHER STREET CARLISLE, PA 17013 Commonwealth of Pennsylvania AFFIDAVIT ss County of Cumberland ' ~ and °s r ~~..~.~~~; ;~ ! , '' ` j,, ~:. We , ~~~/~( ~~~~ l L ~i/!^ 5 ~ the witnesses whose names are signed to the attached or foregoing in- strument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the in- strument as her last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; 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. . ~ - -; 1,, ;`FSworn to or aff~.a;med and subscribed to before me by witnesses. this .7/,~,~ day of , ;, ~ , 19~2.~ f,. _ -~ . ~ ~ ,, ,< tart' F~ubl~icl for yf / ,. r