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Home My WebLink About04-11-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, appiy(ies} for Letters as specified below, and in support thereof aver(s) tht following and respectfully requests the grant of Letters in the appropriate form: BRENDA A. LINE Decedent's Information Name: THELMA G NELSON a/k/a: a!kla: a/k/a: Date of Death: 03!28/2012 File No: 21 -12 - (;; (--~.~,~--Y (Assigned by Register) So at Death: 82 Decedent was domiciled at death in CUMBERLAND County, pA (State) with his/her last principal residence at 11 PARK CIRCLE, NEWVILLE 17241 NEWVILLE Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 11 PARK CIRCLE, NEWVILLE 17241 NEWVILLE Cumberland PA Street address, Post Office end Zip Code City, Township or Borough County State 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 $ 93,000.00 Value of real estate in Pennsylvania........... $ 158,000.00 TOTAL ESTIMATED VALUE$ 251,000.00 Reel estate in Pennsylvania situated at 11 PARK CIRCLE, NEWVILLE 17241 NEWVILLE Cumberland (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough County X~ A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated 09108/1986 and Codicil(s) (State relevant circumstances, e.p., renunciation, death of executor, eta) Except as follows: after the execution of the instrument(s) offered for probate, Decedent did not ma ,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. QX NO EXCEPTIONS ~ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) =s. O ~~~ =~? z-i ; T, c..a.; ..n.; ..n.c..a.; pe en e t e; ura n la; ura tmino 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 defrfieiirj~ ~ --- r -` in 23 Pa. C.S. § 3323 (g) and was neither the victim of a killing nor ever a~udicated an incapacitated person. = ^X NO EXCEPTIONS QEXCEPTIONS -~ C~ ~ ~ ~ ~`' -,, Petitioner(s), after a proper search has/have ascertained that Deoedertt left no Will and was survived by the following spouse (if any) and h i[s~a~ttach ~ r ~ ` ^r"i additional sheets, if necessary): ~ ~ `!~ ~~ C," -~ Name Relationship Address BETTY J. NELSON Daughter 1430 ASHBOURNE ROAD ELKINS PARK, PA 19027 BRENDA K. LINE Daughter 424 OAKVILLE ROAD SHIPPENSBURG, PA 17257 Form iRIN-02 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } ~: -'r ~. iC. _ _` Petitioner(s) Printed Name Petitioner(s) Printed Address `:- i h~.;"'' ,' BRENEj,4-k-EMIE ~~ 1 ~Q_,,~. ~,-1V~- 424 OAF(1/ILLE ROAD NEWVILLE, PA 17241 G,~~~K r~ i ne !~et)tloner(s) above-named swear(s) or affirm(s) the,statements in the foregoingg, Petition are true and correct to the best of the knowledge and belie', of Petitioner{s) and that, as Personal Representative(s) o the Decedent, Petllone s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~-Q- Date '" met ~, day of ~ ~ . 't ~(' ~ ~ Dace B ~~1~.~~-- "c"~ i -tom; ~ Data Y~ 5 ~.- Forthe Reghter Date BOND Required? n Yes ~ No FEES Letters ........................................ ~~ .... $ -71 ~ ~ ~~ C ( ~> Short Certificate(s)...... .... (~ (~', ( )Renunciation(s) ........... .... ( )Codicil(s) ..................... .... ( >Affidavit(s) ................... .... Bond .......................................... .... Commission ............................... .... Other f ~f , l 1, ~ c~ -~C- Automation Fee ......................... .... ~ . Q C. JCS Fee ..................................... .... .~ 3 .. ~ C TOTAL ....................................... .... $ -~('i ~ ',~(! To the Register of Wills: riease enter my appearance oy my signature ue~ow: Attorney Signature: Printed Name: Hamilton C Davis Supreme Court ID Number: 10264 Firm Name: Zullinger Davis, PC Add Burd Street Suite 6 Shippensburg, PA 17257 Phone: 7171532-5713 Fax: 7171 E-mail: hdavis~ullinger-Davis.com DECREE OF THE REGISTER Estate of THELMA G NELSON a/k/a: Date of Death: Social Security No: File No: 03128!2012 168-24-3231 21 -12 - ~,~L~ AND NOW, f f 'f~ i ` ~ ~ ~ ~(`: ~ ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to ~~ ( i1('~ f ~ ~~ . (_ I V( r in the above estate and (if applicable) that the instrument(s) dated 0910811986 described in the Petition be admitted to probate and filed of record a`s the last Will (and Codicil(s)) of Decedent. Copyright {c) 2011 form software only The Lackner Group, Inc. -k=C- r 9-ate--~t~.i ~~1.'tr_; ~,_ ~'t~ e 2 of 2 H IIN.4n, ~~r', LOCAL~~S'~I~,~'S CERTIFICATION OF IDEATH WARNIN~~;1~1 is _iile~at~t~-duplicate this copy by photostat or photograph. Fee for this certificate, 56.(10 ' L`1 ~~~ ~ ~ ~o+ ~: ~I This is to certify (bar ;hc infor)n~(tio)J heJe :CJveJi i; correctly copied fitni::(n cjrJ_(nal Certificate o1 -~cath ~~~~~ ~~ duly tiled with n~< i~, I_ot ~(I {ZegJ,~U~ar. T-~il urit.nu(1 ~~~N,S v0~~r re)t)ficate w~-I hi t Ir~i,.Jrcied to the tit:.tc L ti~l' CUMRF~I A~l~' r~ PA dZeLords (lffire fO~ - t r ;7,(~)e,u ii-~(~«. P 18329349___ Certification Number 3 Type/Print In Permanent~~ 3 3 - 218 Black Ink R ~~~.c~,e,~~ A.P,R-- _11.2012. L(ca- Regi~tr)r I)at( -,~rjec! COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH VITAL RECORDS CERTIFICATE OF DEATH 1. Decedent's Legal Name (First, Middle, last, Suffix) 2. Sex 3. Social Secu rlty Number 4. Date of Death (MO/Day/Yr) (Spell Mo) Thelma G Net on Female 168-24-3231 Ma 2 Sa. Age-Last Birthday (Vrs) Sb. Untler 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Year) (Spell Month) ]a. Birthplace (City and State or Foreign Country) t ' Months Days Hours Minutes F u l t o n C O 11 P I $ 2 ]b. Birthplace (County) Sa. Residence (State or Foreign Country) eb. Residence (Street and Number -Include Apt Np.) Bc. Dld Decedent Llve in a Townships Penns lvania 11 Park Circle s, decedent lived In TT~rtl-r Necrt r~ _twp. Sd. Residence (County) ' Cumber 1 a n d 8e. Residence (Zip Code) ~ No, decedent lived wlihln limits of city/born 9. Ever in US Armed Forces 30. Marital Status ai Tlme of Death Marr ed Widowed Il. Surviving Spouse's Name (If wife, glue name prior fo first marriage) ~ Yes ® No Q Vnknown ~ Divorced Q Never Married Q Unknown 12. Father's Name (First, Mltldle, Last, Suffix) 13. Mother's Name Prior to First Marrla (First, Mldtlle, Lasi) Charles E_ Strait 01a B. dyne 14a. Informant's Name 14 b. Relationship to Decedent 14 c. Informant's Malllns Address (Street and Number, Clty, Slat Zlp Code) i ~ o Brenda K. Line Daughter ur ppens 424 Oakville Rd Sh G _ ........... .............°••-°............__......... ...----...........----..................., If Death Occurred in a Hospital: ~ InpatlenY ~ - 1 a. P ace o eat _ .........-°---°-°--....._............. ~~.. oj,,y one ......_. ..... .....-° --- --- °- °--°-.. .---. ....... ...... ..... 1f Death Occurred Somewhere Other Than a Hosplta l: ~ Hospice Facility Decedent's Home Q Emergency Room/Outpatient O Dead on Arrlyal • 0 Nursing Home/Long-Term Care Facility Other (Specify) 15 b. Facility Name (If not InsYKUtion, glue street and number; ISc. City or Town, State, and Zlp Code lSd. County of Death Cumberland 16a. Method of Dlsposltlon 0 Burial ~ Cremation 16b. Date of Dlsppsltion 16c. Place of Dlsposltlon (Name of cemetery, c matory, or other place) pRempyalfrpmstac¢ pDOnauon 3/31/2012 Hollinger Crematory Other (Specify) c 16d. Location of Dlsposltlon (City or.TOwn, State d ZI ) Mt. Ho11y Springs ~A X7065 1]a. Signet re of Funeral Service Licensee or Person fn Charge of Interment /~ // 1]b. license Numb FD 1389 L ?x ` / E 1]c. Name and Complete Address of Funeral Facility Newville PA 17241 A i i 8 v Spr ng E er Funeral Home Snc 15 B ~ 18. Decedent's Education -Check [h¢ box Ghat best describes the 19. Decedent of Hlspanlc Orlgln -Check the 20. Decedent's Race -Check ONE OR MORE races to Intllcate what I- highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent cpnsidered himself pr hers¢If to be. 8th grade or less Is Spanish/Hlspanlc/Latino. Check the "NO" $] White ~ Korean No diploma, 9th - 12th gratle box If decedent Is not Spanish/Hlspanlc/Latino. Q Black or African American Q Vietnamese 0 Hlgh school graduate or GED completed $] No, not Spanish/Hlspanlc/Latino ~ Am¢rlcan Indian or Alaska Native Q Other Asian Some college credit, but no degree ~ Ves, Mexican, Mexican American, Chlca no ~ Asian Indian ~ Na[IVe Hawallan ~ Associate degree (e.g. AA, AS) ~ Ves, Puerto Rican 0 CM1lnese 0 Guamanian or Gham orro 0 Bachelor 5 degree (e.g. BA, AB, BS) Q Ves, Cuban ~ Filipino 0 Samoan 0 Master's degree (e.g. MA. M5, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hlspanlc/Latino ~ Japanese Q Other Paclflc Islander O Doctorate (e.g. PhD, EdD) or Professional degree (Specify) O Other (Specify) . MD DDS DVM LLB lD 21. Decedent's Single Race Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occu patlon -Indicate type of work ~j White 0 Japanese ~ Samoan done during most of working Ilfe. DO NOT USE RETIRED. ~] Black or Atrlcan American Q Korean ~ Other Paclflc Islander H O T.7 S 2 W l f e American Indian or Alaska Native ~ Vietnamese ~ Don't Know/NOf Sure ~ Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry ~ Chinese O Native Hawallan Q Other (Specify) Q Filipino ~ Gua manlan or Chamorro ITEMS 23a - 23d MU3T BE COMPLETED 23a. Date Pronounced Dead Mo Day r) 23b. Signature of Person Pronouncing Death (Only when appllca bleJ 23c. Ucense Num er CERTIFIES DEATH PRONOUNCES OR Br Ch 29, 2012 23d. Date Signed (MO/Day/Yr) 24. Time of Death Approx . 1:00 A. M. 25. Was M¢dlcal Examiner or Coroner Contacteds Ves Q Np CAUSE OF DEATH Approximate 26. Part I. Enter the chain of events--diseases, Injuries, or tom pllca[lons--that directly caused the death. DO NOT enter terminal events such a ardiac arrest Interval: respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a Ilne. Atld additional Ilnes If necessary OnseT to Death IMMEDIATE CAUSE > Non-Sma 11 Ce.l1 Carcinoma O£ the L11I1Q (Final tllsease or condition Due to (or as a consequence of): resulting In death) b. _ Sequentially Bst contlitlons, Due to (or as a consequence of): If any, leading to the cause listed on Ilne a. Enter the _ UNDERLYING CAUSE Due to (or as a consequence of): (disease or injury shat initiated the events resulting d. In death) LAST. Due to (o as a consequence of): S 26. Part II. Enter ocher sl¢nlflcani conditions conirlbuting to death but not resulting In fhe underlying cause given In Part I 27. Was an autopsy p rformetls P.a Q Ves No ~ ZB. Were auYOpsy flntlings available _ to complet¢ the cause of deaths ~ Yes ~ No 29. If Female: 30. Dld Tobacco Use Contribute [o Death? 31. Manner of Death E ~ Not pregnant within past year ~ Ves [] Probably ~ Natural 0 Homicide s ~ Pregnant at <Ime of death Q No ~ Vnknown 0 Accident 0 Pending Investlga[lon ~' ~ Not pregnant, but pregnant within 42 days of death ~ Suicide 0 COUItl not b¢ d¢terminetl ~ ~ Not pregnant, but pregnant 43 tlays to 1 year before death 32. Date of Injury (MO/Day/V r) (Spell Month) 0 Unknown If pregnant within the past Y¢ar 33. Time of Injury 34. Place oT Injury (e.g. home; consfruct)on site; farm; school) 35. Location of Injury (Street antl Number, City, Sate, Zlp Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: 0 Ves ~ Drlv¢r/Operator O Pedestrian ~ No ~ Passenger ~ Other (Speclty) 39a. Certifier (Check only one): Certifying physician - To the best of my knowledge, death occurretl due to the cause(s) and m r stated ~ Pronouncing Sa Certifying physician - To the best of my wledge, death occurred a[ the time, date, and place, and due to the cause(s) antl manner stated ~Medlcal Examiner/Coroner he ba of min /or Investigation, In my opinion, death occurred at the time, date, and place, and due fo the cause(s) and manner stated Signature of certifier: Title of certiflerChiE` £ Deputy COr011 E!lilcense Number: _ 39b. Name, Address and Zlp Cod¢ of Person Comp ting Cause of Death (Item 26) 6375 Basehore Road Suite/61 39c. Date Signed (MO/Day/Vr) Mathew S_ Stoner, Chie£ De ut Coroner Ma 1 40. Registrar's District Number 41. Regis[rafe~~ t~yre 42. Registrar Ff a Date Mo Day r 43. Amendments DISpOSItlon Permit NO. U f ~ V 1 tom-' REV O]/ Ol] ~. LAST WILL AND TESTAMENT I, THELMA G. NELSON, of North Newton Township, Cumberland County, L_c_ -~' _ a ~_, ~~ ~, _i' ~~: _`. <-_, Pennsylvania, declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including --- m~~xavemarker and all expenses of my last illness, shall be paid from my j ~ C..`. ~uary estate as soon as practicable after my decease as a part of the istration of my estate. ITEM II: I bequeath those articles of my household furniture and furnishings and those articles of my personal effects and personal property ~as set forth in a separate memorandum, which I shall place with my will or `deposit with my attorney, to the persons therein designated. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to my daughters, BRENDA K. LINE and BETTY J. NELSON, providing they shall survive me by thirty days. ITEM IV: Should either of my daughters predecease me or die on or before the thirtieth day following my death, I devise and bequeath all of her share of my estate to her issue, per stirpes, living on the thirty-first day following my death. Should there be no such issue following on the thirty-first day following my death, I devise and bequeath such share to my issue, per stirpes, living on the thirty-first day following my death. ITEM V: I appoint Farmers Trust Company of Carlisle, Pennsylvania, HAMIITDN C. DAMS ATTGRNEY Ai LAW NEWYILLE & SHIPPENGGLIRG PENNA. guardian of any property which passes outright either under this will or otherwise to a minor and with respect to which I am authorized to appoint a "guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in ,~ , . '~ its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use I~principal as well as income from time to time for the minor's support and education (including secondary, college education, both graduate and undergraduate, professional and other education) without regard to his or her. parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. ITEM VI: I direct that all taxes that may be assessed in consequence of ~my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration Hof my estate. ITEM VII: I appoint my daughter, BRENDA K. LINE, executrix of this my last will. Should she fail to qualify or cease to act as executrix, I appoint BETTY J. NELSON, executrix of this my last will. ITEM VIII: I direct that my executrix or guardian or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on four (4) sheets of paper, dated this ~_ day of ~~ ~ -(/~ 1486 . s~~"r-~_. ..C~. ~~ ~e .p,,,, . (SEAL ) Thelma G. Nelson HAMILTON C. DAVIS ATTORNEY Ai LAW N EWVILLE & SHIPPENSBURG PENNA. ~ ~~ ~ `~. The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the testatrix, was on the day and date thereof signed, published and declared by the testatrix therein named, as and for her Last Wi11, 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. -~~~ residing at -Syr ~~~ 9 ~- . / -- l~ ~ ~ residing at PiG+~~ / ~< < . HAMILTON C. DAVIS ATTORNEY AT LAW N EWVILLE & SHIPpENSBl1RG PENNA. . t COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. .~ I, Thelma G. Nelson, the testatrix 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. G o~ _ .~~~~~~ S EAL ) Thelma G. Nelson HAMILTON C. DAVIS ATTORNEY AT LAW NEWVIL LE & SHIPpENS9URG PENNA. !Sworn to or affirmed and acknowledged (before me by ~,~/ynA (,: ~!/2(S'o„ , the testatrix, this _,y ~-~ day of ~ D~' n~. ~~P ~ , 1986 . VELDA M. SEASE, Notary Public ~~ Shippensburg, Cumberland Co., Pa. ~~ ~~ ~ My Commission Expires April 16, 1990 Notary Public COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND T , ~ . ~ n -Q and ~ f ~ ~ ~ ~-L t ~ the witness(es) whose name(s) are (is) signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were (I was) present and saw the testatrix sign and execute the instrument 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 (my) knowledge the testatrix was at that time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ~rcK.la k. Leh ~e and ~ II. N.: 1-/-o n C. ~ v71' w/itness (es) , this ~ day of S2Df+C~ rl C r' 1986 . II VELDA M. SEASE, Notary Public 1 n Shippensburg, Cumberland Co., Pa. G.~'`~_ //~ _ My Commission Expires Aprii 16, 149D Notary Public