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HomeMy WebLinkAbout06-14-12 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 requests the grant of Letters in the appropriate form: Steven Sealover ueceaenrs Inrormation Name: Mary I Sealover File No: _21 - , ~ - ~ ; ~~ a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: 06/03!2012 Age at Death: 74 Decedent was domiciled at death in Cumberland County, PENNSYVLANIA (State) with his/her last principal residence at 100 Mount Allen Drive Upper Allen Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 100 Mount Allen Drive Upper Allen Township Cumberland PA Streel 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 $ Ifnotdomiciled in Pennsylvania ................ Personal property in Pennsylvania $ lfnot domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................... $ Real estate in Pennsylvania situated at (Attach additional sheets, if necessary.) Over 10 000.00 TOTAL ESTIMATED VALUE $ street aaoress, Post Office and Zip Code City, Township or Borough ^ A. ~ition for Probate and Grant of L tters Te t^mentarv Petitioner(s) aver(s) that helshe/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated 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 ® B. Petition for Grant of Letters 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., Prater date of Will in SP~t~n~ a ahnvo and ~.,.,,..te.e ~:^. f heir. Except as follows: Decedent was not a party to pending divorce proceedingg 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 additional sheets, if necessary): Name Relationship Address W. Scott Sealover Son 111 Greenbrier Lane r,..~ Dillsbur PA 17019 ;~ Steven Sealover Son 7 Impala Drive ~~, Dillsbur PA 17019 m ' C ~ y Form RW-OY rev. f0-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. ~j ; :___ t ~ .~ ~ Page 1 of 2 ~ ~ti County ~ ` Uatn of Personal Representative ~ .: , . , ~Ia w_ COMMONWEALTH OF PENNSYLVANIA } `rj ~-' -- r tCJ ~; :.. - "'i ;',iii f C ,t.,i.~J } SS: COUNTY OF Cumberland } Petitioner(s) Printed Name Petitioner(s) Printed Address Steven Sealover 7 Impala Drive Dillsburg, PA 17019 O~`.~ .:',.. ,.,_ 10 Thp Pafi4inrsnr/c\ oh..,.c..,.,......r .. .. -i_~ _ -- ~-~ -~ -•••••••~-~ •••~ ~•~•~~•~~~~~, ,,, ~~~y~~~~y r-C~~uu~~ aye true ana correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of th ~ent etitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~ Date me n~d of~ " ~~ ~ Date By. ~~ ~~~ Date For the RegisMr Date BOND Required? ~ YES ~ NO FEES: L _ Letters .......................................... $ ~ ` ~ (- ( (L )Short Certificate(s)......... C ~ . (' )Renunciation(s) .............. '~ , C n ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ............................................. Commission .................................. Other Automation Fee ............................ ~) _ (~C -~ -- JCS Fee ....................................... • TOTAL ......................................... $ u `' To the Register of Wills: rtease enter my appearance by my signature below: Attor igna }'~ Printed Name: David J. Lenox Supreme Court ID Number: 29078 Firm Name: The Wiley Group, PC Address: 3 Baltimore Street Dillsburg, PA 17019 Phone: 717-432-9666 Fax: E-mail: davelenox@comcast.net DECREE OF THE REGISTER Date of Death: 06/03!2012 Social Security No: Estate of Marv I Sealover File No: 21 - I,_7 _t ; ~ i e/L~ a/k/a: AND NOW, ~( •~~` •~ ~ ` l`t i ~ ~~ ~ ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters of Administration are hereby granted to Steven Sealover in the above estate and (if applicable) that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Iri ..,-,~, r,~ , Register of Wills ~ _ p ~( Copyright (c) 2011 form software only The Lackner Grou~~ln~~ ~ -~ { l-i ~~~~ ~ •_. ~ ~ (_ l~ ~ ~ ~,~ Page RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Mary 1 Sealover ,Deceased I' W. Scott Sealover in my capacity/relationship as n son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Steven Sealover (Date) (Signature) W. Scott Sealover r-- u.. o ~ ~ C,~,i `_ - (Street Address) l1_ ~ ~ ~ s ~ t i` ~ ~, .i ~.. J ~ (Gty, State, ZipJ u:.a -") ~ ~~ r^~. Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunciation and certified that he or she executed the renur~ation for the of purposes stated within on thist3-day of ~ U/V~ ,// of ~.. t/U-~Li~Y'V Deputy for Register of Wills Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) CdMM~~1lT. tH ~ r~~Vil'~ NohAal Steal 9. Dawn GIadlNter, Notary PuWb Dlllaburp eoro, YoAc county M ctxnmitslon May 1T, 201 ber, Penns. J~asodatlon o1 Notaries Form RW-OB Rev. f0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. LocA r~~.~~ ,~ c~~-r~~~r~~~r~~~~ ,~,~a~ WAIRNI ~t~-~r1~ ~, . ~ii~a~t~ th€s ~:~>~~ ~~s~r ~>f~1t~i~~t ~i 4a~~ ;e-9~= , Fcc tua this _cttifii,:at~. tih ~G(,l ~ ~ ~ ,I(n , I. >:.~12 JUN ! 4 P~1 4~ Q1 I ~,,~~~ ~~ =s~- ,~~~ ~;~~ I 1. .~:I~ t ~ It~ (( ~,~ t ~ ~Izr, may, r I u rI_ I i) ;vn Inazt (~C1 .~/,~~~p~~ ` F' ~. }I J{, ~~~' ~~ ~,; tl .. i ~ !iii: '`,~l(C rlai Vll~l Y11YJ I~VV(lr L-~.~~~~ ~, .i 1 ~1 ~Ii CUMBERLAND CO.t PA `'~-~~ ~:- ~° ~ ;-~ ~ ~ ZD12 _-- P 18484551 p .~~i ~/ / Certificati(m \„nli~L-: - TP. •mPrlnt In COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF HEALTH .VITAL RECORDS 1. Decedent's L•PI Nam r[a-/`+[ C yr uEATH _ . (Firrt. Middle. Less sum.) t. F I. 5t 2. Sex 3- social Security Numb•r . of paath MARY I_ S EA L O V E R D. (MP/Dav/vr) (sp.n M°) t F 7 6 3 sa. A{•-Left mrthdav (Yr,) Sb. Vnd•r 1 v..r s<-under 1 oa 6 - 3 O- 7 3 2 7 J U N E 3 20'1 2 pate f sl n . P rt (MO/p.v/Y..r) <sp.n M Months Mourn Mlnutu t ) ~.. @LrU. pl. ev foey antl Hn country 74 'y' gn burg gr Mechanics Penns ~vania F e b r u a r 5 1 9 3 8 a R . • (Stale Forel{n 7b. B Thpiece (COU n[y) cry) Bb- R•aldenw (Street end Number - In<lutle [ No umber a n d `?fie `n` n s y 5 V ) B . an 7 a c Old ced•nt UYe in ownshlpT Bd . R.ald.np. (ce..n[v> 7 I m a 7 a Drive pY.f, d.<ed.nt eyed ins tyD. York Ba- Ruldenu (Zip Getl•) -' 9. E dLN tlec•tl•nt Ilyed within Ilmlu o1 r In U$/t ed F rcesT o ; t•I Sta<us at Time eI peath city/bo ro. tl 0 Nta tl Witlow•d ® NP ~ Unknown ]p0 Dly il. SUNNIna Spoufe s Nam (If f ' "I orca e wi e, {Iye name ri o tirs< marN ee•) Never Marrl•d ~Vnknow p ert 12. FstC hf Nam• (Firs[, dtll•, Laa<. SuMx) 1! M r N arl . a a a Prior to Flnrs Ma es Myers Mdde.La Saa. Informant's Name 34D Relati ) .~ a ~ g . eons ^ t M r_ W_ S c o t t S e a l o V e r tld ,. s r e Dac•tl•nt 16c-7 *° ' M .~.e N mD.r city st.[. ' { 2. c d ... ' , , . p p .l o 7 I m a ....................... .........°---°-°- Ss a D ... ..-.-. .......... sbur Ir D . ~ PA 1701 ~e'i - ' , ~ --° • eath ot:<grr ............................ If -.~---- n . MgaDi[al: ~..~...-..~- .-.~ o~-y on. .---...- - L 7 in Da Ueni (•- ••---- ---- ----•- D•+[h o<cgrr d so wri -- -'' `v' - e m. O Em.r Rpom/out •re other rhan a Moapi[.i: - {en<y patient O oea en Arrwa ~ Ntrrfln C711gfpiu F.allty ..f~ -o::e:~:~:-i+a~::e ....... M ]3b Pm./ _ _ _ _ { . Facility Name (i} not inftittrtlon. {Iy rtre•[ and number; 13c Clt r Racilicy O[h•r (specify) or T L M y ewn, State and Zip C° m essiah Villa a M e c lsd. cp,.nty of D•ach h a n i c s b 6 ~, p B ur p A et od of plapoaidon ur1a1 Cremation lfib. D•[a o a eai[len m b e r l a n d ~D 5 5 C O R•m l f 6 ~ ~ U oya 1 rom swc. c au et OlapofMOn (Na O Donauon m of <.met• <r•m orY, •) ° r a pther(S «I. .) p , June 8.20"12 Di 7 7 sburg Cemeter 1„1 Sfitl. Location oI plapoaiflon (City or Town, stale, and zip) 1Ta y - O U n a 7 n R O a d f n . o I Se pr arson n.. D i l l 5 b u r g a P A 7 7 0 1 9 char{. Pf Int.rmen[ vb. u<enf• umber N ~- ]T<. N.m. and compla. Addreff of Ft,n. ra F.<uity - F D - O l 2 9 7 5 - L ~ O K N F ERA H M I C SB D d ' . •ce e nt s Edvutien -Check the box that beat describes the 19. pec•dent o! Hispanic Orl{In _ Che h I hart ° ee • k th n c ac e o I led at <he time 0 30. pec•den a -Check ONE OR MORE r Indicate wha[ ~ 8th o atle o o comple I death. ox that bert ribea whether the Oacetlent • d th utl ~ cg s •n[ c nsltlered himself or h raeli [o be. Q N d m Ia SDanlsh/HlsPan 4Latino. Check the ^Ne^ Ipso ar 9tn - 12rn {rase e n d.p`d.ne la n .<k P p k O HI{n .drool {r.d..ae o csEO °pmpLted o[ spanlah/HlfPam</Lawn°. BI e O ~ r..n r A rl ~ Some toile{• cr•dI[ bu< no de ee ~Ne, no Spa nlah/Mlf panic/Latin. O A ' l Te I , asks N (] O[he •ASlan d•{ree (e.{, qq~ q3) H M•xlcan, M•xlcan America n, Chl<ano p RI<an _ an pr AI atlya n ~ Y 0 htlband ~ NaU M ior M+~ y O Uin• . e- a d.ar. '(e.{BHA, AB, as) Ore., os ei an .~ e o u. s e orrp SW, MBA) ~ Yes, her Spe nigh/His Panic/Latinp Q J O Doctors [e (• { PM1O Ed D a . - , ) or Prot•a onal de •Pen•se ~ Ot ~r P•ciflc Island. Effe (Specify) M O ~ Other (SPeclNl RaceM LLH Jp S H 21. n I• SeII-D•si{nation -Check ONLY ONE [D intllut• wha[ the tl•cedent considered h panes. 0 5 Imfelr or herself to be. 23 e 's U a OCCU patio -Indi t k ^i tlu ^: T I v ca e tYPe of work ~ ~ r ~ O Pacltic Is ort o o kin{ IIh ^ DO NOT USE RETIRED. LJ Ame an or Alaska N ~ x .l` ' "'y' p A,l,. r .n o osn: ~~~~ O o xn w/Nqt S..r. L i c_ P r a c t i c a l N u r s e O R. u. d ° tl e O Fwneae O N u M D Bt,pin.f.n nd..ftrv ~ O o..amenl.,w. o'ch.morro ~ other (specify) . x~nd pf ^ r ITEMS Z!a 28d MUST BE COMPLETED 23a. Dat Prono n Dead (MO Day/Yr) 23 Health Car e PERSON WMO PRONOUNCE ' ! OR !`- f Peraen Pr Desch (Only w • ublel 23c. L c3 RTl FtES DEATH -' lp - V \ \ • car pr 1u ~/^ n i N f tent. .,mbar I 2 d. Dac sl{n.d q Da /vr) ~ / \ ~ v 2a. Tim. f DeeEn • ~ I 23. Was M•diul Ex•mi r Cprenar COn[a •d T ~ rg vas CAUSE OF SEA 1 „ i 26. P Ente, tnii na }e r aP r• Dry rr Vent- ~ S n laeasas, Inlu ilea, or <°m Pllca[Ipna-that dlrec[IY caused c • death. 00 NOT en[ r t art I r cu bri ll ~ A m'te [l g g a erminal a uch as urtliac arrest o Icheut showln{ the •tloleN. DO NOT ABBREVIATE, E ~ s int I ^ L S .a.r only °n. u..a. °n a Iln.. Add addlupnal cane, Ir n.<ea:are ~ one.[ e D ~/~ iV ° __> eath (Fine Etl lose or cpndi[lo.. '' _• - -.. D ~2 ~'J ~ t`~ rofw[ n{ in tle.ch) y. ( as a confaquen<e Pr): ' ® ~+`. . i +a a tcn. ~.g : , v ^ //J ( eggence °fl. { n Gh ~ '-`'--~ . Enter tha , -~.C_ ~/.. UNpERLY1Nti CAU E -- M1 Due [o (o (d r inlury t r as • cpna•q uence ot): e nts result f d. I ) h d eath LAST (pr of a cent •q u•nu of): - -- 26. pan II. Enter other s nlllcan d b ~ ux not r s w[Jn{ In ch. gntl•riyln{ at,f• {w.n In P.a I zT. w sv as di O r T~ 28. W n{f • labl< r ' g co e ause th• c I deathT o coO y 39 f~'I~ 30 DId T b e t p . o acco Vae Contribute to DeathT { within Paat ai 31. of DeatM1 O n `n ;me et deacM1yv e cu~ ° P ° r ' g ~ ~ a d o :{n.nt e„t P w Ina data f d r ~N n n ° ewn i h o ~ ~' ° ; ^ d t O t ° . ao t~{e dn . ~Ie. dava m 1 rear b.mr. tl.ar 32. Date or Injury (M°/pay/vr) (spell Monti.) O sI O u.. k..gwn p e{n.nt wmmn [3 p cgwd t D. d rm nad onn .. l) 3. Time ) ry 3a. Plats o} mjury (e. {r home; construction site farm sch ; oo 35. Location °/ Injury (Street and Number, Cley, 5[a •, ZIP Code) . Injury • ork 37. If TranaPOrta<ion InluN. SpecJty: Ir•lurv o ~ [- O Driver/O Pera [or Q Petlestnen ~ Describe How <cumed. O Ne ~ en{e O Pa a r O ocher (sPe<IN) - 39a. C~rtMe'^C Peck only one) ~Cn rtify E hysician - T° t e best gf m kn l y ew edee, death occurred due tp [h• c use(s) end manner st to '~ • 6 Certi Nln{ physician - To the best of my knowled d li {e. ~ M•tl ta eath o red • the ,date, ntl p ce nd d to =u ae( r car m Exa min r- On the basis of exeml atlon, and/or inyes<I{a tlon in UTe s a ma tad i i at ~ (((~~„ p a Y op n on, rretl ax the t ms, d ,and I ce, f ue co h ause(a) d ed nd d SI rtitier: t c ~ Title oI rtlTer: er: 6~~.,OG lG ~{ ~ j; and 2d P n n i i u mP •t nB ram 26 C/a BLS j LTG ~ 39c. at D ed (MO/p ~ ~ v 4 ~ aY/ r) /i s F r_ COI IZ- 0. Re{Iat mDer Rre a 51{na ~ 4T ~~ a a rtrar F a r) 3. Amentlmeniz Disposhion Permit Ng. ~~ ~/ / V / ^~ H305-143 - REV OT/2011