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PETITION 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 request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: Lenora G. Everitts
a/k/a:
a/k/a:
a/k/a:
Date of Death: March 28, 2012
File No• ~~~ ~ - (-~ (_ r-( 7 (,!
(Assigned by Register)
Social Security No:
Age at death• 80
Decedent was domiciled at death in Cumberland County, Pennsylvania (Stare) with his/her last
principal residence at 323 Wolfs Bridge Road. Carlisle, PA 17013 Middlesex Twn. Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 323 Wolfs Bridge Road, Carlisle, PA 17013 Middlesex Twp. Cumberland PA
Street address, Post 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 $ 125,000.00
If not domiciled in Pennsylvania ........................Personal property in Pennsylvania $
If not domiciled in Pennsylvania ........................ Personal property in County $
Value of real estate in Pennsylvania ......................................................... $ 160,000.00
TOTAL ESTIMATED VALUE.... $ 285.000.00
Real estate in Pennsylvania situated at: 323 Wolfs Bridge Road, Carlisle, PA 17013 Middlesex Twp. Cumberland
(Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough County
A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated February 14, 1986, and Codicil(s)
thereto dated N/A
State relevant circumstances (eg. 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 bom 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)
c.t.a., d. b. n., d.b.n.c.t.a., pendente life, durante absentia, durance minoritate
If Administration, c.t.a. or db.n.al: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 spou~f any) and hekr'~(attach
additional sheets, if necessary): ~ ~
Naroe Relationshi Address `, ~- ~>
Laura E. Bock Jones Daughter -~-" m r..a
233 Polecat Road -
_
Landisbur PA 17040 ~ o
Teresa L. Culbertson Daughter 6 Richland Road =J ,`- ~ ~-> :~
... -,;
Deborah L. Talbot Tchaha-Batipe Daughter 237 South Boulevard, P. O. Box 5401-A.o "=~ -; ~'
Charlotte NC 28217 ~ ~-
~.cA
i'-
- t~
- : ,``~
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Form RW-02 rev. 10/11/2011 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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Petitioner(s) Printed Name Petitioner(s) Printed Addre ;~~ni i r
Laura E. Bock Jones t' ~ r-,
233 Polecat Road Landisbur PA 17040 ~~.~~~~~`~ ~ "~~'' ' '~.r; , ~A
Donald L. Culbertson 6 Richland Road, Carlisle, PA 17015
The Petitioner(s) abo~ a-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 Jedent, the Petitioner )will well d truly administer the estate actor ing to law.
Swoin to or affirmed and subscribed before Date
me this day of ~ , ~i,, ~ Date ~b I ~-
By: ti~ 6 j i i l ~~Z ()')~'~) Date
~ c ~. C- ~T -~=' J~-
For the $egister Date
BOND Required: ~ YES A NO
FEES:
Letters ...................... $ 310.00
( $) Short Certificate(s)...... 20.00
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ........
To the Register of Wills:
Please enter my appearance by my signature below:
Attorney 'nature:
f
Printed Name: Marlin R. McCaleb, Esq.
Supreme Court
ID Number: 06353
Firm Name: Law Offices -Marlin R. McCaleb
Automation Fee ............... 5.00
JCS Fee ..................... 23.50
TOTAL ..................... $ '35$~
-~~ = ~~ c
Address: 219 East Main Street
P. n. Rox 230
MechanicsburQ,PA 17055-0230
Phone: 717-691-7770
Fax: 717-691-7772
Email: marlinmrcaleh(p~mcn_snm
DECREE OF THE REGISTER
Estate of Lenora G. Everitts File No: ~ ( ~ ~ - G ~ -] (;
a/k/a:
AND NOW, ~~ 1~ i l ~ ,~ L ~ 1~ , _s ~ _, in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Laura E. Bock Jones and Donald L. Culbertson
in the above estate and (if applicable) that
the instrttment(s) dated February 14, 1986,
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
Form RW-02 rev. 10/11/2011
f - _ r I
Register o Wills
FOCAL REGISTRAR'S CERTIFICATION OF DEATF~
-~~_NC~:~ 4'~s ~egal to duplicate this copy by photostat or photograph.
,_, ..
~~ee for this certificate. $b L1 ,, "This is to certify tf?at th( infi)rmatior. hc(v Liven is
;~~_`~~~~~o ~~~ is Ego
c(n-rectly coded t)oin ,z^ iJJ~inal CertiriL (t~~ of Death)
duly filed ~~ith n(e sip Luca( [2egish-ar. "71 e ori~iu(al
C~ERK ~F cc°~rtifir.(te v~ill he i~:,r~„arded to the Sate ~,~ital
~RPf~ANlS ~.C:)~iT R.'cords OPfice PIJr u~ rn)zuient riling.
P 18 3 2 9 ~~'"~~J~ ~~,~~; ~o Pa
Certification Number t_~,)rd Regisu~ar [late C;s~.(tx1
Type/Print In COMMONWEALTH OF PEN NSVLVANIA _ pEPARTMENT OF HEALTH ~ VITAL RECORDS
Permanent
0
~_
1. Decedent's Le ~ ~ .._ .--. s a State Flle Number:
gal Name (First, Middle, Last, SufFlx)
2. Sez 3. Social Security Number 4. Date of Death (MO/Day/Vr) (Spoil Mo)
Lenora G_ Everitts
Female 214-30-1824 March 28, 2012
Sa
A
L
.
ge-
ast Birthday (Vrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Vear) (Spell Month) ]a. Birthplace (Cit
and Stat
F
y
e or
oreign Country)
80 Months Days Hours Minutes June 10, 1931 Sh u MD
]b. Birthplace (County)
8a. Residence (State or Foreign Country) Sb. Residence (Street antl Number -Include Apt No
) 8c
Old D
d
.
.
ece
ent Llve In a Township?
PA 323 wo1£s Bridge Road QQY
es, decedent eyed In Middlesex
8tl. Residence (COUn[y) twp.
8e. Residen a (Zip Code) ]_ 3 ~ No, decedent lived within limits of
city/bore.
9. Ever In US Armed Forces? 10. Marital Status at Time of Death ~ Married Widowed 11
S
i
i
'
.
urv
v
ng Spouse
s Name (If wife, give name prior to first marriage)
Q Ves ~ No Q Unknown Q Divorced [) Never Married ~ Unknow
12. Father's Name (First, Middle, Last, Suffix)
'
13. Mother
s Name Prior to First Marriage (First, Middle, Last)
Frank Hebb
Anna M_ Banner
14
f
'
a. In
ormant
s Name 14b. elatlonship to Decedent 14 t' Mallin Address ( treet and N rttber, City
Laura Jones ~
State
ZI Co
h
S
~~rPO~
c
G ,
,
aug
ter
2
eca~ Road
Land' isb
:
~
`aJ_
~g ~
....
.... ......................°-°--........°--... ......°---...°-° t
-~ ...................................a: ate o ea
If Death Occurred in a HosPltal: [~ In .......................... ec on Y one ---.-...... --. - -.--,...... - -.- .
patient
.. --
If
h
_
.....
_
_
Deat
........
Occurred Somewhere Other Than a Hospital:
~ Hospice Facility Decedent's Home-
Emergency Room/OUtpaTlent Q Dead on Arrival
a~ Nursing Home/Long-Term Care Facility Other (SpeclTy)
15 b. Facility Name (If not Institution, give street and number; •SS
c. City or Town, State, antl Zip Code 15d. County of Dea[h-
323 Wolfs Brid a Road
Ca lisle PA 17013 Cumberland
16a. Method of Disposition BuHai 0 Cre merl
on 16b. Date of Dlspositlon 16c. Place of plspositlon (Name of cemetery, crematory, ther place)
p Rempyal fr°'^ state p D°naTi°^ M
r
ar 31 , 2012 Cumberland Valley Memorial
Other (Specify)
Gardens
S6d. Location of Dlspositlon (City or Town, State, and Zip) 1]a. 5 e of Funeral Service Lice or P
r
i
Ch
e
n
n
arge of Interment 1]b. License Number
Carlisle, PA 17013
013144E
E 1]c. Name and Complete Atldress of Funeral Facility
8
'03 Ho££man-Roth Funeral Home & Cremato 219 North Hanover Street Carlisl
18
D
d
'
P
.
ece
ent
e
A 17013
s Education -Check the box that best describes the 19. Decedent of Hispa nlc Origin -Check the 20
Decede
t'
R
h
F- .
n
s
ace -Check ONE OR MORE races to indicate what
ighest tlegree or level of school com pletetl at the Hme of death. box that best describes whether the decedent th
d
d
e
ece
ent considered himself or herself to be.
~ 8th grade or less Is Spanish/Hispanic/Latino. Check the "Np" White Q Korean
No diploma, 9Th - 12th grade
box If decedent Is not Spanish/Hispanic/Latino. Q Black or African American ~ Vietnamese
® High school graduate or GED completed
No, not Spanish/Hispanic/Latino ~ American Indian or Alaska Native 0 Other Asian
0 Some college credit, but no degree
Q Ves, Mexican, Mexican American, Chicano 0 Asian Indian ~ NaYiye Hawaiian
~ Associate degree (e.g. AA, AS) ~ V
es, Puerto Rican
Bachelor's de g. ) ~ Chinese 0
Q gree (e. BA, AB, BS 0 Ves
Guamanian or Chamorro
Cuban
,
Fill
~ Master's degree (e.g. MA, M5, MEng, MEd, MS W, MBA) ~ pi^O ~ Samoan
Q Ves, other Spanish/Hispanic/Latino
0 Japanese
~ Other Pacific Islander
0 Doctorate (e.g. PhD, Ed D) or Professional degree
(Specify) ~ Other (Specify)
. MO DDS DVM LLB JD
_
21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered hi
lf
h
mse
or
erself to be. 22a. Decedent's Usual Occupation -Indicate type of work
~ White Q Japanese ~ Samoan
done during most of working life. DO NOT USE RETIRED.
0 Black or African American Q Korean ~ Other Pacific Islander
Homemaker
American Indian or Alaska Native 0 Vietnamese ~ Don't Know/Npt Sure
Asian Indian ~ Other Asian
0 Refused
22b. Kintl of Business/Industry
Chinese 0 Native Hawaiian
Q Other (Specify)
FIIIPI^° Q Guamanian or Chamorro
ITEMS 23a - 23d MVST BE COMPLETED 23a. ate Pronounced QDea'd (MO Dray 236
P/,e/frsno n/~Pron Ing Death (On~wheniapO p~l~ b e 23c, License Number
~./
/~S~Ig
BY PERSON WHO PRONOUNCES OR ~o p~'L/` '~
/n~a
t/u~re/~of
CERTIFIE3DEATH
!~ Lp~ -
I
/
~
/
/
~
r,
~+V (.~L.)</ • /~ I
` Ll X)l. 1/1A ~~f ~4 / ,~/y30Dy~/~
ate Signed (MO/ ay/ r) 24. m e_ath llT-- "- ~~ {YV~ ///Y/l.- / V
~~~ 25
Wa
M
di
l
.
s
e
ca
Examiner or Coroner Contacted] ~ Ves
CAUSE OF DEATH
Approzimatc
26. Part 1. Enter the chain of gv~~-diseases, Inju rles, or complications--that directly caused the death
DO NOT
.
enter terminal events such a ardlac arrest Interval:
espiratory arrest, or ventricular fibrillation without sh fpg th etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lin
If
es
necessary Onset to Death
IMMEDIATE CAUSE -------- ------> a. ~ p ~~~ Q
~ yy
`~
_
t
(Final disease or condition Due to (or as a cp of].,
resulting in death) ~'`
/
e
lr
'.vn
b. ~l //~ // V ~ ~ n
`L V I
~
Sequentially Ilst conditions,
u
a to (o~ s a
cons
a
ce of):
If any, leading to the cause
listed on line a. Enter the
UNDERLYING CAUSE
Due to (or sequence of):
(disease or Injury That as a con
Initlaked the events resulting d.
~ In death) LAST. Due to (or as a consequence of):
0 26. PaK 11. Enter other significant co dit' t ib LI ¢ to death but not resulting in the untlerlying cause given In Part I
r
~ 27. Was an autopsy
periormed]
_ ~ Yes No
28. Were autopsy findings available
v
g to complete the cause of death?
3'
E 29. If Female: 30. Old Tobacco Use Contribute to Death] ~ Ves ~ No
~ Not pregnant within
31. Manner of Death
ast
e
'$ p
y
ar
s ~ Probably ~ ryatural ~ Homicide
~ Pregnant at time of death ~
'~ No
0 Not pregnant, but pregnant within 42 days of death ~ ~ Vnknown Q gccident 0 Pending Inyestigation
1- ~ Not pregnant, but pregnant 43 days to 1 ~ Suicide ~ Could not be determined
Vear before death 32. Date of Injury (MO/Day/Vr) (S
ell M
h
p
ont
)
Unknown If
~ pregnant within the past year
33. Time of Injury
34. Place of Injury (e.g, home; constru Rlon site; farm; school) 35. Location of Injury (Street and N
b
um
er, Ciry, State, Zip Cotle)
36. Injury at Work 3]. If Tra nsportatlon Injury, Specify:
38. Describe How Injury Occurred:
Q Ye Q Oriyer/O
perator ~ Petles[rlan
~ No 0 Passenger ~ Other (Specify)
39a. CertlFler (Check only one):
$ Certifying physician - To the best of my know) tlge, death o curved due to the cause(s) and ma
nner stated
~ Pronouncing 8v Certifying physician - To the best ~ y knowledge, death occurred at the time
date
and
l
,
,
p
ace, and due to the cause(s) and manner stated
Q Medical Examiner/Coroner O i ~R1~ my o
- r
s~
af~ I Tlpr~a d/or Investigation
In
inion
d
th
,
p
,
ea
occurred at the time, date, and place, and due to th se(s) and t~f d
~
y
Signature of certifier: ~~~/ ~ C~ ~~/ Title of certifier: /" ( ~
~.~! /-/~ /XJ c 7 Q
r
License Nu mbar:~J V l) ~~.. p .,J B
~
39b. Nam Address and Zip de of r on Completing Cause of Death (Item 26) 39c. Date Signed (MO/Da
/Yr)
y
'
40. Registrar
s District tuber 41. Regi r atu re
^ 42. Registrar File Da a M° Day
43. Amendments
Disposition Permit No. V r I ~ V t}-TJ~ H305-143
REV 0]/2011
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.~ LAST WILL ANp TESTAMENT
~- Cl
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5 _, ~.
Ir)~~ I, LENORA G. EVERITTS, of the Township of Middlesex, County
'tom
~ <1; ,
'Cumberland and Commonwealth of Pennsylvania, being of sound an
o:.,~_
posing mind, memory and understanding, do make, publish and
V
declare this as and for my Last Will and Testament, hereby revoki
and making void all former wills and codicils by me at any time
heretofore made.
FIRST. I order and direct that all my just debts and funera
expenses be paid by my Co-Executors, hereinafter named, as soon
as conveniently may be done after my decease.
SECOND. I give and bequeath my yellow gold diamond ring
unto my daughter, LAURA E. BOCK, absolutely, if she survives me.
THLRD. I give and bequeath my platinum diamond ring unto
my daughter, DEBORAH L. TALBOT, absolutely, if she survives me.
FOURTH. I give and bequeath my diamond necklace and. match
diamond earrings unto my daughter, TERE5A L. CULBERTSON, absolutely,
if she survives me.
FIFTH. I give, devise and bequeath all the rest, residue
and remainder of my estate, real, personal and mixed, whatsoever
and wheresoever situate, in equal shares unto my children, namely
LAURA E. BOCK, DEBORAH L. TALBOT and TERESA L. CULBERTSON, share
and share alike, absolutely and in fee simple.
Should any of my said daughters predecease me leaving lawful
LAW OFFICES
S NELBAKE R,
McCALE6 & FLICKER
issue to survive me, then I order and direct that the share which
such deceased daughter would have received had she survived me
shall be distributed unto her said lawful issue per stirpes,
said issue to take the ancestor's share by representation and
not per capita.
LASTLY. I nominate, constitute and appoint my daughter,
LAURA E. BOCK, and my son-in-law, DONALD L. CULBERTSON, Co-Execu s
of this, my Last Will and .Testament, both to serve without bond
in this or any other jurisdiction-. If for any reason either of
them shall fail to qualify as such Co-Executor or cease so to
serve, it shall not be necessary to appoint a substitute Co-Execu
for in his or her place, as the case may be, but in such event
the remaining or surviving Executor shall serve with full power
and authority under this, my Last Will and Testament.
IN WITNESS WHEREOF, I, LENORA G. EVERITTS, have hereunto
set my hand and seal to this, my Last Will and Testament which
consists of two (2) typewritten pages to each of which I have
affixed my signature this /~ day of ~.~/~,f.~~~_~-~~-~ A.D.,
One Thousand Nine Hundred Eighty-six (1986).
~~, ~ ,
-a~c~~.(~'~~ i'~~ ~. ~ ~-~,~`~~ ( SEAL
The preceding instrument, consisting of this and one (1)
other typewritten page, each identified by the signature of the
Testatrix, was on the date thereof signed, sealed, published and
declared by LENORA G. EVERITTS, the Testatrix therein named, as
and for her Last Will and Testament, 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.
LAW OFFICES II
SI~IELBAKER.
MCCALEB & FLICKER
COMMONWEALTH OF PENNSYLVANIA)
. S5.
COUNTY OF CUMBERLAND)
We, LENORA G. EVERITTS, MARLIN R. McCALEB and JANET M. FORRY
the Testatrix and the witnesses, respectively, whose names are
signed to the attached or foregoing instrument, .being first duly
sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her Last Will and
Testament and that she had signed willingly, and that she executec
it as her free and voluntary act for the purposes therein express•
ed, and that each of the witnesses, in the presence and hearing
of the Testatrix, signed the Will as witness and that to the
best of his or her knowledge the Testatrix was at that time
eighteen years of age or older, of sound mind and under no con-
straint or undue influence.
~- ~1L.-Z.&.!
Testatrix
-~7 i
~~~
Witness
~ ~- ~- YTI , ~ ~-- -~ ~t
Witness
Subscribed, sworn to and acknowledged before me by LENORA G.
EVERITTS, the Testatrix, and subscribed and sworn to before me
7`tr
by MARLIN R. McCALEB and JANET M. FORRY, witnesses., this ~ ~ day
~.~
o f ~~`~-~2`. ~: ~ ~~, ~ ~ _~c +~,ca , 19 8 6 .
r
~" ~-~.
Notary public
E1GEiERCE ~. P.CsCi~ER, ~CfAR~ Pi~o_iC
RRECk;;RICSRURG ®CRfl, C4:~aEEftiA~C C~t9RV'r
~Y CO~~€SSOF~ E~PlRES ~,PR1L 6, I9R6
I~emt~er, Pene,syivania Agsoclation of W~;taries
LAW OFFICES
SNELBAKER,
MCCALEB & FLICKER