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Home My WebLink About03-22-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF ~j,//y,~~,~GL/}~y(j 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 request(s) the grant of Letters in the appropriate form: Decedent's Information !n~ I Name: ~ OV ~ . t"_. !.~ ~k~2 File No: ~L ~ ~ I ~ " (J',`~ t!~ a/iv'a: o s= ~ (Assigned by Register) a/k/a: a/k/a: Social Security No: / ~-,3 ^ /~ .-- ~ Date of Death: /f/JT~¢~e~~ ~(/, ,Z,~// Z Age at death: _~~~~~.,~ Decedent was domiciled at death in Cuho~ r~i~ County,l~GrsY~Ys/~tiwVY/,~(state) with his/her last principal residence at y!i ! Z _~/~fZ` L./si LG- ~1.e~ G%+-/Q~~/,•... r _ ~.w. ~. ~-.~, ~ , ~ Street address, Post Offce and Zip/Code Decedent died at ~ „~~S ;B~t ~2.f ~~y S~ Street address, Post Office and ip Code Estimate of value of decedent's property at death: City, Township or Borough County ~ City, Township or Borough r ~ ~ County If domiciled in Pennsy[vania ............................ All personal property $ If not domiciled in Pennsy!vania ........................ Personal property in Pemrsylvania $ If trot domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsy!vania ......................................................... $ TOTAL ESTIMATED VALUE.... $_T Real estate in Pennsylvania situated at: - /-a~ v." ." - 7~ (Attach additional sheets, i(necessary.) Street address, Post Office and Zip Code City, Township or Borough Count A. Petition for Probate and Grant of Letters Testamentary /~~- ~"ia-3 'z--y Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated ~a,L. /?,/ ~ y3i and Codicil(s) thereto dated 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(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 Administration (If applicable) ~°~'3 c. t. u., d. b. n., d. b. n. c. t. a., pendente life, durante absentia, durante minoritate If Administration, c.t.a. ord.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 a pending divorce proceeding 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 (ifany) and heirs (attach additional sheets, ifnecessury): n ~; Name Relationshi Addres~-O ~ , ~~= . ~ r- Y to r} ~ ~ ~ ~ , .~ 1,--, ,--- ~.~ O.7 '*7 _ _ ~ _~., _ _ r l.~ i O ~. T M Form RW-02 rev. /0/!l/20/! Page 1 of 2 Oath of Personal Representative COMYtONWEALTH OF PE//NNSYLVANIA } CGJ~»1~~/~~~ } ss: COUNTY OF } Official L'sc Only Petitioner(s1 Printed Name Petitioner(s) Printed Address ti~ ~, C rr~E~c yG?.~3 c,~cc~.s-/~ 1 c~.aa~,~ ~'i~. ~ ~-3 ~~~c C . C v,c~. 3 Cz~- hr ck.,~ry -v ~ G~D~c/G'~t.~ ~/~ /~-3 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) of the D~dent, th^Petitio~er(s) wilhwell and truly administer the estate according to law. Sworn to or firmed subsc ibed me 's r day of ~y~! ri _ , For the ?egis,~r BOND Required: YES ~NO FEES: Letters ...................... $ , (.'~ (~ )Short Certificate(s)...... ~' ~ ~~) ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Conunission ................. . Other ...... .. i ~~;i~ ........ ~ a Automation Fee ............... . ~ ~ JCS Fee ..................... TOTAL ..................... $ ~ ~ ~ Ci Li Date 3 :L!'-~ 2- Date Date e~~v~! - 1~ Date To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: ~ ~Q ~=C7 ~~ ~) ~ ~ ~ rn ~7 ~ ~ _. ~ _-; -; Printed Name: - ~ Supreme Court ~_ ~ ~, -E~ - _~. i.._~ ID Number: ~~~. _"' _- _ _~ Firm Name: a ~* ~'~ i Address: Phone: Fax: EmaiL• DECREE OF THE REGISTER Estate of -~~U('~ ~ ~~(+~~/e.{"` File No: ~.~ ~ (~- (. ~~~ a/k/a: AND NOW,~i,jC ~~ ~~ ~.~'~ ~~. ~ ~7J ~.~' ~o~.~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREE that Letters ~ ' ~ ~`~ ~ are hereby granted to _ ('>{~ ~~ ~. thTl ~p r Ct-fl .L _ .__ ~~__._i_., . ~ , ~'~~ ~r _ ,. _ , _ _ ~ ,n _ r, in the above estate and (if applicable) that described in the Petition be admitted to probate and f led of record as the last Will (and Codicil(s)) of Decedent. Form R6V-02 rev. l0/11/2011 Page 2 Of.2 Register of Wills LOCAL R~~~~t~~~~;i~`~"1+~,~TI+~I~ C~ ~~ ~~ VNARNING: It ~s~t~~gaik~~ad~y~Qate tt`)R~ ~C,t~y by ph®tost~t ~r phi*.. :° f-tC h ~!li:, ci'!-?iCi, a!c~, ',f).;)U `~~~~G i~}l~fl 2 ~ ~1'} ~: ~~I - ~~;' #~71i s; I ~ j%, , ~ t~) ) c~ r~~ <= ~~ ,,~~ ~~.~.J~~ ~~~ ~°~ Dive. -----_ ---- --- - ---- - -- _ _ 2 - -- 1 !.~~1'1(t L3l3~+i1 tit I7!~1~3' -_. -,i-% ~~t ~ li ~«' :',!t - p Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS Permanent /~C ~Tf C~I"ATIC ~~ NI O t~ O_ - - - -- - Stat¢ File Number: 1. Decedent'sy gi3l NaE,m= (Fit, Middle, Last, Suffix) ~5¢x1~ 3.$Q~taj Sfiyyrlty~ly,(ri~er 4. ate of Death (MO/Day/Vr) (Spell Mo) Bo Cl raver a 1 / .3 t5 4 / LS / 6a. Age-Last Birthday (Vrs) 56. Under 1 Vear Sc. Under 1 Da 6. Date of Birth (MO/Day/Vea r) (Spell Month) 7a. B' h lace (CI d Stat~o{Foreign Country) M th D `F t ~ g e on s . gon r , YES avs Hpgrs Mingt¢s 4 / 2 9 / 1 9 2 2 8 9 76. Birthplace (cggnty) westmore an Sa. Resldence (State or For¢Ign Country) 8b. Residence (Street and Number -Include Apt No.) Sc. Did D¢cetlent Live in Towns1.Ipj Pennsylvania 461 2 Carlisle Rd_ fires, d¢<¢tlen[uy¢e lnDicKa.nson t Sd. Residence (County) wP- Cumber 1 and 8e. Resldence (Zip Code) 1 7 3 2 4 ~ No, decedent Ilyed within limits of city/boro. 9. Ever in UwSy rmed Forces? 30. Marital Status at Time of Death 0 Married Widow¢d 11. Surviving Spouse's Name (If wife rA ive nam i f . , , g e pr or to irst marriage) Ves p No ~ Unknown ~ Divorced ~ Never Married ~ Unknow 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior [o First Marriage (First, Middle Last) , Arde11 Graver Nellie Mitchell 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State Zip CotleJ o G , Ronald Graver son 4620 Carlisle Rd_ Gardners,PA 17324 ~ .......................................................... ......................................,........ lsa: P ale o Deal... c e< onl one ..............):.... .............................. If D h _ __ ...... ... ......... ..... ....... eat Occurred in a Hos Pital: In patient (If Death Occurred Somewhere Other Than a Hos Ito l: ~ ~~~~~~~ .w p HOS ice Facill """"""" P ty LJ Decedent's Home ~ Emergency Room/Outpatient ~ Dead on Arrival ~ Nursing Home/Long-Term Care Facility Other (Specify) • 156. Facility Name (If not institution, give street and number) lSC. CIty or Town, State, and Zip Code 15d. County of Death i ur i 1 risbur PA Dau hin 16a. Method of Disposition Burial ~ Cremation 166. Date of Disposition 16c. Place of Disposition (Name of cemetery r Co or othe l , ry, r p ace) ~ Removal from State ~ Donation o[n¢r (sP¢<Ify) 3 / 1 9 / 201 2 Westminster Memorial Gardens 2 16d. Location of Disposition (City or Town, State, and Zip) 17a. Signature of Funeral Service Licensee or Person in Charge of Interment 17b License N b . um er ~ Carlisle PA 1 701 3 oL 4 01 1 58 c 9E 17c, and Com 1¢t tldfess of Funeral Facility SN~'P N ¢l`~ ~ _ a imore Av~_ Mt_Ho1lySprings,PA 17065 HollingerFH&Crematory Snc_ ' m iH. Decedent s Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE rac t i d i-- es o n icate what highest degree or level of school completed at the Hme of death. box that best describes whether the decedent the decedent considered himself o h lf r erse to be. 8th grade or less Is Spanish/Hispanic/Latino. Check the "NO' ~ White ~ K orean ~ No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. ~ Black or African American 0 Vletna m ere ~ High school graduate or GED completed No, not Spanish/Hispanic/Latino ~ American Indian or Alaska Native ~ Other Asian 0 Some college credit, but no degree ~ Ves, Mexican, Mexican American, Chicano ~ Asian Indian Q Native Hawaiian Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamani Ch ' an or a mono ~ Bachelor s tlegre ¢(e.g. BA, AB, BS) Ves, ouban Filipino Sam oan 0 Master's degree ( .g. MA, MS, MEng, MEd, MSW, MBA) ~ Ves, ther Spanish/Hispanic/Latino ~ Japanese Q Oth er Pacific Islander 0 Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) ~ Other (Specify) . MD DDS, OVM LLB JD 21. D cedent's Single Race Self-Designation -Check ONLY ONE [o indicate what the decedent considered himself or herself to be. 22 a. Decedent's Usual Occu potion -Indicate ty e of work p White ~ Japanese ~ Samoan done during most of working life. DO NOT USE RETIRED. Q Black or African American ~ Korean ~ Other Pacific Islander ~ American Indian or Alaska Native ~ Vietnamese ~ Don't Know/Not Sure Laborer 0 Asian Indian ~ Other Asian ~ Refused 22b Kind of Business/i d t . n us ry ~ Chinese ~ Native Hawaiian Q Other (Specify) ~ Filipino 0 Guamanian or Chamorro Manufacturing ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (MO/Day r) 23b. Signature of Person Pronouncing Death (Only when a licable 23 pp c. License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH ~1+~f~ f ~(~ Z(1('j~ 23d. Date Signed (MO/Day/Yr) 24. Time of Death (/ Q s'O/Y TL3 [A/~Ir- (ia f ~~O { J- O~ ar. 2S. Was Metllcal Examiner or Coroner Contacted? 0 Yes No CAUSE OF DEATH _ Approximate 26. Part i. Enter the chain of events--diseases, injuries, or com piications--that directly caused the death. DO NOT enter terminal events such as cardiac arr t es interval: respiratory arrest, or ventricular fibrillation without showing t he etio logy. D O N OT ABBREVIATE. Enter only one cause on a line Add atlditional lines if . necessary Onset to Death it / S • s IMMEDIATE CAUSE ---------------> a. ~~ O C~~~~I/~ lw. Tr~.n r ~r.~ (Final tlisease or condition Due to (or as a consequence of): resulting In tleath) Sequentially Ilst conditions, Due to (or as a consequence of): if any, leading to the cause listed on Ilne a. Enter the ' UNDERLYING CAUSE Due to (o as a consequence of): ' (disease or injury that = Initiated the events resulting tl. - in death) LAST. Due to (or as a consequence of): S 26. Part II. Enter other significant condi[IOns contributing t d th but not resulting in the underlying cause given in Part I 27 Was a t . n au opsy pertor ed7 ~ Yes ~JS Np m 28. Were autopsy findings available to complete the cause of death? d ~ Yes ~ No 29. If Female: 30 Did Tob U C o . acco se ontribute to Death? 31. Manner of Death ~ Not pregnant within past year ~ Ves 0 Probably Mural ~ Homicide Q Pregnant at time of death ~ NO ~ known ~ Accitlen( 0 Pending Investigation N t b m i- Q o pregnant, ut pregnant within 42 days of death 0 Suicitle ~ Could not be determined ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/V r) (Spell Month) ~ Unknown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, CIty, State, 21p Cotle) 36. Injury at Work 37. If Tra nsportatlon Injury, Specify: 38. Describe How Injury Occurred: Q Ves ~ Driver/Op¢rator ~ Pedestrian ~ No ~ Passenger ~ Other (Specify) 39a. Certifier (Check only one): ~~ Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated ~P•onouncin 8 Certif i h i i T h b f g . y ng p ys c an - o t e est o my knowledge, tleath occurred at the time, date, and place, and due to the cause(s) and manner stated Q Metlical Examiner/Coro e - On the sis f to Ion, and/or Investigation, in my opinion, dea t h occurred at the tim¢, date, and place, and due to the cause(s) and manner t t d s a e - t- s Signature of certifier: Title of certifier: VQ Licens¢ Num bcr: O S- O /K~ (e 7. 39 ame, Address and 21p Co f P r COm pleting Cau(3 of Death (Item ) s e ~ 3 .Date SI ned (M ~ay/ ) q L O C.. ~V ~ ~ / ~ C/~ Q ~ ' R y J D//I 40. Registrar s DistHR Number 41. Registra Sure r ~ 2. Registrar File Date (MO/Day/Yr LAC PJIiC ~ 43. Amendments p~ ~i H105-143 Disposition Perm It No. ~~ 1 l~ REV 07/2011 :f n ~II ~ Y ^- r".~ II ~~ Q .~ ^ 5 ~ m tv ~~~ ~~ `? C ~ `~' ~ ~ "y I, BOYD E. GRAVER, of Dickinson Township Cumberland ~' County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. I. I bequeath all of my estate of every nature and wherever situate to my wife, ESTHER irl. GRAVER, providing she shall survive me by thirty days. II. Should my wife, Esther M. Graver, predecease me or die on or before the thirtieth day following my death, I bequeath all of my estate of every nature and wherever situate in equal shares to such of my children, CHARLES L. GRAVER, RONALD L. GRAVER and RODNEY E. GRAVER, as survive me by thirty days. III. Should any of my children, Charles L. Graver, Ronald L. Graver and Rodney E. Graver, predecease me or die on or before the thirtieth day following my death, I give and bequeath the share of such child to his issue per stirpes living on the thirty-first day following my death; and should any of my said children leave no such issue living on the thirty-first day following my death, I give and bequeath the share of such child in equal shares to my other children or to their issue per stirpes living on the thirty-first day following my death. IV. I direct that all taxes that may be assessed in ~,.. ^~7 ~, ~~~ r: ~ r.} a 11 f ("; .,~~ ~' f ~~ :'1"i l~ consequence of my death, of whatever nature and by whatever ,~ jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. V. I appoint my sons, RONALD L. GRAVER and RODNEY E. GRAVER, co-executors or the survivor of them executor of this my last will. Should my sons, Ronald L. Graver and Rodney E. Graver, fail to qualify or cease to act as executors, I appoint my son, CHARLES L. GRAVER, executor of this my last will. VI. I direct that my executors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~ day o f,~.~t-»-~~v- , 19 9 3 . B YD E. GRAVER The preceding instrument, consisting of this and one other typewritten page identified by the signature of the testator, BOYD E. GRAVER, was on the day and date thereof signed, published and declared by BOYD E. GRAVER, the testator therein named, as and for his last will, in the presence of us, who, at his request, in his presence, and in the presence of each other have su/bscribed our es as witnesses hereto. ~'`. ..~ ' ~,~ _ /// /~~ Yyr~,,~.A a 's / F. OATH OF StiBSCRIBI'vG `VITNESS(ES) ' I ITn fern ~~ N ~=. GF3 ~ ~ r-'- :~_ ~ ~_~~ ~ GISTER OF WILLS ~~~~~ ~ ~ ~ // ~ ISYLVANL~ NTY N G~ ~ //~ ~ . ~ _ -~ y COL , PE ~ ~ +~ ~ ; ~ C.> -Tt Estate of ~ °'7 ~ G - C~~'L`~-- //wit. S. ~..~ ~}- /f//G'2--5 Deceased (each) a subscribing witness to (Print Name/s) the~Will ^ Codicil(s) presented herewith, (eaci~) being duly qualified according to law, depose(s) and say(s) that she he / hey was /were present and saw the above Testator / '£estatrix sign the same and that sh / h they signed the same and that she / he they signed as a witness at the request of the Testator / ~~~~tr~--r in her hi presence and in the presence of each other. ~_. ~t (Signature) (Street Address) (City, Slate, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ ~~~ da Y of ~'~~L~~~ , ~~ ~ - ~ "~ ~ I ~ ~. ~'~ ti~ De,ut~.or Revis=er aj gills ~.~ (signature) A-N /G'~ ,~ ~ (Street Address) (City, Stare, Zip) Execrcted out of Register's Office Sworn to or affirmed and subscribed before me this of day ~Otarv Pli~iiC '~I~~ CO:n:^~:ission Expires: iSer.ature and Sea! of Notary or other of6cia( qualified to administer oz:hs. Show date of expiration of Notary's Commissix.) NONE: To he taker by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Forrrr RW-Oj rev. !0.13.06 O NTH OF NON-SUBSCRIBING ~~TTNESS(ES) REGISTER OF WILLS ~~~~~~ `1 COUNTY, PENNSYLVANIA Estate of ,C~ a~ ~ E . ~~.1,~-V L"'~ ,Deceased G~~~ ~ ~/ei~V ~~ and (each) being duly qualified according to law, depose(s) and say(s) that she he /they was /were well- acquainted with 7"~.. J.°.`I~i1`~'~. ~ G • `~ ~~ ~~~9'VL''i'Z and am/are familiar with the handwriting and signature of the decedent, and that the signature of ~°~ ~ ~- ~, ~Zs~9'I/~_ to the foregoing instrument purporting to be the Last Will and Testament"^'~~,f ~'~j e~ ~- G/Li~-t-L.~n. is in his/her own proper handwriting. (Si~~iat~u~e) (Street Address) ity, State, Zip) Executed iii Register's Office Sworn to or affirmed and subscribed before me this ~' "C'~ day oft C~'1 ,O~%~~- / ~ f ~h ~` ~~~~~r~'~ti_ Dep~ity for Register~of ` ills ~, (Signat reJ ~~~~~ ~ ~>~~ ~. ~/ G z Z C~-l~•v is t;/a C~- (Slree! Address) (City, State, Zip) y~ l p ;~-p tv 2j rzT~ ~ t l J~ fi - ~..~ " r') '' 7 -r v ~ c,~ ~ T~ Form RW-04 rev. 10.13.06