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Home My WebLink About06-11-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, 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: Donna_L,Negley Decedent's Information Name: David L. Hawkins ai7c/a: ai7c/a: ai7c/a: David L. Hawkins, Sr. Date of Death: 05J11/2012 Decedent was domiciled at death in Cumberland County, File No: 21-12 "-" ~? ~' / (Assigned by Register) Social Security No: Age at Death: 77 PA (State) with his/her last principal residence at 152 Bullshead Road, Newville 17241 North Newton Cumberland Street address, Pos[ Office and Zip Code Ciity, Townstnip or Barough Coumnty Decedent died at 752 Bullshead Road, Newville, PA 17241 North Newton Cumberland PA Stree¢ ad&ess,. Post Office and Zip Code CiiGy, Tawnsknip or Bonwgh Counrty SBate Estimate of value of decedent's property at death: If domiciled in Pennsylvania ...................... All personal property $ Ifnotdomiciled in Pennsylvania ................ Personal property in Pennsylvania $ Ifnotdomiciled in Pennsylvania ................ Personal property in County $ Value ofreal estate in Pennsylvania ................................................................... $ 50,000.00 TOTAL ESTIMATED VALUE 5 50,000.00 Real estate in Pennsylvaniia siOWated a¢ 152 Bullshead Road, Newville 17241 North Newton Township Cumberland (Attach additional sheets, if necessary.) Street address, Paso Once and Zip Code City, Townshiip ar Boroaagh ^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 Countty 11/22/2010 and Codicil(s) State relevant circemrostances (e.g., 2nundation, 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 bom or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ^X NO EXCEPTIONS ~ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.ta., pedente life, du2nte absentia. durante minoritate If Administration, c.ta or db.n.c.La., enter date of Will in Section A above and comulete list of heirs. Except as follows: Decedent was not a party to.pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323 (g) and was neither the vtdim 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): ~ r..~, ~-rU ", Name Relationship ~~ r~~ Address C ~_.. a <: % ~~r i:. ;- ~ ~- ; ? t ! ~: t ~ t...l ~ '. tt '' _ r._ ~~ W ~.~ ``~ v Form RIN-02 rev 10.f f-20f 1 Copyrignt (c) 2011 form software onEy Tine Laclaner GroaJp, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } oef~~~;ai use only Petitioner(s) Printed Name Petitioner(s) Printed Address Donna L. Negley 202 Whiskey Run Road Newville, PA 17241 Name as listed in 717-776-7801 The Petitioner(s) above-named swear(s) or affinn(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 }Fre Decedent, P tits er(s) will well and truly administer the estate according to law. Swom to or affirmed an subscribed before (~ C Date C~ ~ / ~ ' /..~_ me this day f ~ 4~>> -~ DaRe By; Date For the Register DaRe BOND Required? ~ YES ~ NO FEES: ~~~, ; ~% t,7 Let~e-s...; ...................................... $ i ~ tom! (~ ~~jShort Certificate(s)......... • ~. ( )Renunciation(s) .............. j ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ............................................. Commission---------------------------------- _ Othe l,~ ~ ;I i ' ~% Automation Fee......-. ..-•---------------- ~ ~ 1 ~ '- JCS Fee ....................................... '__ ' ' ` TOTAL ......................................... ~ /; ~~ ~ Cr7 -. To the Register of ~Ils: Please enter my appearance by my signature below: Attorney Signature: / ~~ . % ~, ~ , Printed Name: Richard L .Webber, Jr. Supreme Count ID Number: 49634 Firm Name: _ Weigle 8. Associates, P.C. Address: 126 East King Street Shippensburg, PA 17257 Phone: 717-532-7388 Fax: 717-532289 E-mail: rwebber@weigleassociates.com DECREE OF THE REGISTER Date of Death: Social Security No: Estate of David L. Hawkins File No: a/k/a: David L. Hawkins, Sr. 05/11/2012 164-30-3424 21-12 ""-' h~~ AND NOW, o~ C ~? ~` ~ G . 1 ~~ f f , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Donna L. Negley in the above estate and (if applicable) that the instrument(s) dated 11/22/2010 described in the Petition be admitted to probate and filed of record as t st Will (and Cod' it(s)) of Decedent. ,a Register of Wills Copyright (c) 2011 form software onpy Tkoe Laclooer Grouup, Ina ~'-1-~~- C~~- ~ - , :: ~~~~ itV~~~~ ~ ~~ '~~'~' .~.. (C .~~J C . ~' U , ~;,~ ;(; z,J,~ Lt); ~sl~ l; . ~( ~~( ~OIZ Jl1N I ! PM 3~ 57 _( OR~1v'~ ~iJRr P 18 5 8 6 2 5 CUMBEF~.AND CO.. PA - Type/PrInS In COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS Permanent CERTI FICOTF AF f1FATH Vl l /-~ V ' 1. Y O O 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) aaV,Ld Law~cenee TILiN){L(.J2d Sfc_ Mace a 1T 2012 Sa. Age-Last Birthday (Yrs) 6b. Under 1 Year Sc. V nder 1 Da 6. Date of Birth (MO/Day/Ves r) (Spell Month) ]a. /1 rt ~~(C~it]~p( hpla(FC d S tale or S~yyss ign Country) ~ , ~ .~ ~ F ~ Months Days Hours Minutes IIQyfIV ~JfA II (w/l YA 77 Novembl?1c 24, 1934 ]b. Blrtnplace (cpunty) haJ2 n ga. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) Hc. Did Decedent Live in a Township. PA R]Yes, tlecedenti lived In N • New~o i'L r,,,p gd. Residenpe (cp~nty) T 52 B(.c.Q.Q.a head Road CumbenX.a.nd 8e. Residence (Zip Code) ] 724 ENO, decedent Ifved within limits of city/born. 9. er In US Armed Forces? 10. Marital Status et Time of peath Married ~ Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) ~ Yes ~ No ~ Unknown ~ Divorced ~ Never Marrie Q Unknow PQ#h.~e.La AKK Wa(.t 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior tp First Marriage (First, Middle, Lasi) Samue.e C _ HaialzEn-a Mafc ~. S.n. elL 14a. Informant's Name 14b. Relaflonship to Decedent 14c. Informant's Mailing Address (STreet and Number, City, Stale, Zip Code) ~ Pa~i_e~.a Ann fiawFu».a LU,%. a 152 Bf.,(.P_P,aGLead Road NewV,i.Q.ee PA 17247 Ci ---,-,,,-- lSa. P ace o Death G eck only one _ c - If Death Occurred in a Hospital: Inpatient i _ _ _ ___ _____ _ __ __ __ __ lf Death Occurred Som ~~ ~~~~~~~~~~~~~~~ ~ ~~ ~~ ~~~~ ~~~ ~ ~ ~~~'~~~~~~~~~~ ewhere Other Then a Hospital: ~~~~~ ~ ~ ~~~~~~~~~~~~~~~~~~~ Hospice Facility ~f" Decedent's Home Q Emergency Room/Outpatient ~ Dead on Arrival _ ~ Nursing Home/Long-Term Care FacillTy Ocher (Specify) SSb. Facility Name (If not Institution, glue street and number; SSC. City or Town, State, nd Zip Code lSd. County of Death 7 52 8(.(.P.2.a head Raad Newv-i,F~-e PA 7 7241- Cumb¢h.Q.aved ~, 16a. Method of Disposition ~ Burial Cremation ~ Removal from State 0 Donation i6b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) - .~ Other (Specify) Ma 7 6 22 0 7 2 HO.P~.c-n vJz. C/cema~a~c.ecm 16d. Location of DlsposlYion (City or Town, Stale, and Zlp) 1]a. Sig tune of I rvlce Licensee or Person In Charge of Interment 1]b. License Number '$ MZ_ Ho.P~.y Sp~ung.a, PA 77065 /~~\ r ~.a.n~~ 7=D-072984-L ~ Gn p 1~oa X A ~1 ° BIL.(.Cl2e1L aa QJL e 7=u.ne~ca,2. {-lame Zn.e. 772 Ule.a~ K.i-n SX'ic¢et Slur. eJ•(.abwc PA 77257 rd 18. Decedent's Education -Check the box that best describes the 19. DecedenT of Hlspa nic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate what ~ highesx degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. ~J gth gratle or less Is Spanish/Hispanic/Latino. Check the "NO' ~] White ~ Korean n No di loma 9th - 12th rade b If d p , g ox ecedent Is not Spanish/Hispanic/Latino.. ~ Black or African American ~ Vietnamese ~ High school graduate or GED completed No, not Spanish/Hispanic/Latino 0 American Indian or Alaska Native ~ Other Asian ~ Some colle e credit buT no de ree ~ V M i , g g es, ex can, Mexican American, Chicano 0 Asian Indian 0 Native Haweitan ~ Associate degree (e.g, AA, AS) ~ Ves, Puerto Rican 0 Chinese ~ Guamanian or Cha mono ~ Bachelor's degree (e.g. BA, AB, BS) ~ Yes, Cuban Q Filipino Q Samoan ~ Master's degree (e.g. MA, MS, MEng, MEd, MS W, MBA) ~ Yez, other Spanish/Hispanic/Latino 0 Je panese ~ Other Pacific Islander 0 Doctorate (e.g. PhD, EdD) or Professional degree (Specify) 0 Other (Specify) . MD, DOS DVM LLB, JO 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate whet the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work White ~ Japanese ~ Samoan done during most of working Ilfe. DO NOT USE RETIRED. ~ Black or African American ~ Korean Q Other Pacl£IC Islander ~ American Indian or Alaska Native ~ Vief na mesa [] Don't Know/Not Sure Neav y ~CZcupm eVl~ OJ~PJLLL~Oh. ~ Asian Indian ~ Other Asian ~ Refused 226. Kind of Business/In tlustry ~ Chinese [] Na[Iye Hawaiian 0 Other (Specify) LOCQ.e ~ 54 2 Q Filipino ~ Guamanian or Chamorro Z wtelLJ~.a~o vLa.2 LIJ2C-o K il'EMS 23a - 23d MUST BE COMPLETED BY PERSON WHO PRONOVNCES OR CERTIFIES DEATH 23a. Date Pronounced Dead (MO/Day/Yr) -7/1/I ' /~ f ~O ~ '1 / 1~ C ! -a'~ 23 b. $~gnatu re of Person Pranou ncing Dea<h (Only when applicable) r // / ~^; f `^ A „~s~ ~ ~~~ ~ ~ / / / / j' +, 7 i"(} 23c. LI<ense Number ~Y3CDy~/L 3 .Date Signed (MO/Day/Yr) 24. Time of eafh ~ ~ ` , N ~ IK A ~~ P•' ~~ 25. Was Medical Examiner or Coroner ContactedT ~ Ves No CAUSE OF DEATH Approximate 26. Pert I. Enter the chain of events--diseases, Injuries, o mplications-that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval: respiratory arrest, or ventricular flbriliatlon without sho Ing the etiology. DO NOT ABBREVIATE E n ter only one ca Ilne. Add additional lines if necessary Onset fo Death - es (Final diseasee or condition Due to (ore consequence of): resulting in death) - b. Sequentially list conditions, - Due to (or as a consequence of): N any, leading to the cause listed on line •. Enter the UNDERLYING CAVSE ~ Due to (or as a consequence of): (alseese or injury [hat F Initiated the events re5ulHng d. In death) LAST. ~ Due to (or es a consequence of): S 26. Pert II. Enter other si¢niflcant conditions contributin¢ to death but not resulting in the underlying cause given In Part I 27. Was an autopsy performed? O Yes ~No ~ 2g. Were autopsy findings avails bie ~+ to complete the cause of death] ~ Yes ~ N 29. If Female: 30. Did Tobacco Vse Contribute to Death? 31. Manner of Death E ~ Not pregnant within pass year ~ Yes ~ Probably ~ Natural 0 Homicide [] Pregnant at time of death I~'•NO 0 Vnknown J" ~ Accident ~ Pending lnves[Igatlon m ~ Not pregnant, but pregnant within 42 days of death ~ Suicide ~ Could not be determined ~ ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Vr) (Spell Month) 0 Unknown If pregnant within the past year _ 33. Time of injury 34. Place o1 lnJury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. lnJury a[ Work 37. If Transpo Katlon Injury, Specify: 38. Deccribe How Injury Occurred: ~ Yes ~ Driver/Operakor ~ Pedestrian ~ No ~ Passenger ~ Other (Specify) 39a. Certifier (Check only one): ~t ~Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated ~ Pronouncing 8 Certifying physician - To the best oI my knowledge, death occurred at the time, date, end place, and due to the cause(s) and m rated Q Medical Examiner/Coroner - On the basis of ex Inatign, an L_r lnvesNgaNOn, in my open ion, death occurred at th< Time, dale, and place, and due to the cause(s) end manner stated Signature of certifier: Title of certifier: ~f Q License Number: /N7 ~//~i c'1 y L 39b. Name, A. oT Person Completing Cause of Death (Item 26) ~_\ G_ Q~1S i-~,Li-~L ~ 39c. Date 51 ned ( /Day/Yr) ~ /l ~< <JZi C' C G- o / s-'/ / L ~ 40. Reglsira is DlstriR Number 41. Registrar' re _ 42. Reg i st rar Flle D ate (MO//Day/Vr) / / / ~ • 43. Amendments Disposition Permit Nq. 06 76 8 8 9 H105-143 RCV 07/2031 t r-;, ~-^r ~ r~~ ~ ~ ~°, c~ ~ r _ r~-1 ~ ..._. LAST LY~ILL AND TESTAMENT ~~ ~-~ = ~ w I, DAVID L. H.AWHINS, aka DAVID L. HAWHINS, SR. presently ~s ding at~52 Bulkhead Road, Newville, North Newton Township, Cumberland County, Pennsylvania 17241, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all Wills by me at any time heretofore made. FIl!?ST: nII?ECTI`'E FOIE CI'.E~~~TIO~' -- I direct that I be cremated. SECOND: PAYMENT OF EXPENSES - I order and direct my personal representative ~' hereinafter named to pay all of my just debts, cremation expenses, and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. ,r ~~~ THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the remainder of my ~, estate, real, personal and mixed, whatsoever and wheresoever situate equally to my wife, ~ PATRICIA A. HAWKINS, provided that she survives me by thirty (30) days. ~:~; FOURTH: CONTINGENT BENEFICIARIES - In the event that the said PATRICIA A. HAWHINS should predecease me or is not living on the 31St day following my death, I then distribute my estate to my four (4) children, DONNA L. NEGLEY, DAVID L. HAWKINS, JR., DALE L. HAWHINS and DIANE L. MOVER. ~~ Should any of my children predecease me but leave descendants who so survive me, such descendants shall receive, per stirpes, (by representation) the share that such predeceased child would have received had he or she so survived me. FIFTH: PERSONAL REPRESENTATIVE - I nominate, constitute and appoint my daughter, DONNA L. NEr'LEY t:, be t he Executrix of this my Last Will and "Testament. In the event that she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint ~~ my granddaughter, SANDY SEAUY as Executrix of this my Last Will and Testament. SIXTH: WAIVER OF BOND - I direct that m ersonal re resentatives shall not ~ yp P ;~ be required to give bond for the faithful performance of their duties in any jurisdiction. SET+TENTi-I: TES - 1 hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of administration of my estate and that such be paid out of the rest and residue of my estate. ~. ~7~ I'I'1 ~ ~~ ;~( ~= r ~n c WEIGLE & ASSOCIATES. P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 „~ ~~ ~~ i f EIGHTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary or to his or her account, no interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary. IN WITNESS WHEIZEOF, I, DAVID L. HAWKINS, aka DAVID L. HAWKINS, SR. have hereunto set my hand and seal to this my Last Will and Testament, the first page signed for identification only, this Z--~ day of ~'~,° ~ ' , , 2010. r ,. l~-v-~,.9/;~`~--r~-~=--t,.~C ~.---,-~-,.._ . (SEAL) DAVID L. HAWKINS „ ~ ,.. :,`~-v----Z.. Fr~~ ? ~=.--~-.---~~=-~-~. ~,~ (SEAL) aka DAVID L. HAWKINS, SR. ~` ~ ~ J ~' ,,~C^- /~~~ ~~ \ \v .,,~ This instrument was by the Testator, on the date hereof, signed, published and declared by DAVID L. HAWKINS, aka DAVID L. HAWKINS, SR. to be his Last Will and Testament, in our presence, who at his request and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, DAVID L. HAWHINS, aka DAVID L. HAWHINS, SR., the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. r~ .._-,._ _._.._ ~r.r.--~ ._. f -~--._ , DAVID L. HAWHINS ~ `.~. aka DAVID L. HAWKINS, SR. Sworn or affirmed to and acknowledged before me by DAVID L. HAWHINS, aka DAVID L. HAWKIN~, SR. the Testator, this _~-~""day of ,~~,r ~.~ ~ c ~~ , 2010. Notary Public NOTARIRL SEAL RICHARD L. VVEBBER JR., NOTARY PUBLIC SH!PPEIV~RURG BORG, CUMBERLAND COUNTY iry:~gY COI'~~;I"„~.;;~,fOs~! E;~?IRES Al1GUS? 27, 2014 WEIGLE & ASSOCIATES. P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 77257-1397 COMMONWEALTH OF PEl 1 SYLVANIA SS COUNTY OF CUMBERLAND , I ; / ~` '~ ' s~ We, ~ ~~~c ~`~'P and 1~~(~~f ~L~ 1F L/~(/f~t%~~~~~` -~ the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw DAVID L. HAWKINS, aka DAVID L. HAWKINS, SR. the Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the "Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me ? 1 9 and ~~/f~l ~~?'~"~, ~~ .. ~~ ~'/~l"/ witnesses, this day of ~ ~_ ..~ , 2010. ~j 1 ~f "~ 1. __ . // Noiary Public NOTARIAL SEAL. RICHAP,D L. WEBBER JP,., NOTARY PUBLIC SHIPPENS°URG BORO, CUMBERL,4ND COUNTY MY C01~1!~;iSrION EXPIRES AI;rI1ST %r', 2014 ___-_~a..----~---~ - -_~_...__.__.~_~~~ WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-7397