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PETITION FOR GRANT OF LETTERS
COUNTY, PENNSYLVANIA
REGISTER OF WILLS OF CUMBERLAND
ears of a e or older, apply(ies) for Letters as specified below, and in
Petitioner(s) named below, who is/are 18 y g
support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form:
Decedent's Information File No: ~ ~ - ~ ~ " ~J~
Name: JOHN L. SHATTO (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 200-22-5050
a/k/a: Age at death: 82
Date of Death: JULY 15 2012 (Stare) with his/her last
County, D ^
Decedent was domiciled at death in CUMBERLAND
principal residence at 139 2ND STREET WEST FAIRVIEW PA 17025 EAST PENNSBORO TWP. CUMBERLAND ounty
City, Township or Borough
Street address, Post Office and Zip Code r„ ,..rn~n r n AiTI r(li iNTY_ PA
Decedent died at HOLY SP1Kt i tiV Sri 1 r.,, -- ~°°•°~
City, Township or Boroug
Street address, Post Office and Zip Code
Estimate of value of decedent's property at death: $ /S f1D0
If domiciled in Pennsylvania.. • • • • • • • • • • • • • • • • • • • • • • • • • • All persopal propetn Penns ivania $
If not domiciled in Pennsylvania ........................ Personal pro erty m Coun y $
If not domiciled in Pennsylvania ........................ Personal roperty ~ . • . tY • • . • • .. • • _ • • $-~~ ~O ,,
..
...............
Value of real estate in Pennsylvania.. • • • • • • • • • • • • ' ' ' ' ' • • ~ • TOTAL ESTIMATED VALUE.... $ 2 t O. DO .
Real estate in Pennsylvania situated at: 139 2ND STREET WEST FAIRVIEW PA 17025City, Townsh pBor Boough P CUMBER CounDty
(Attach additional sheets, if necessary.) Street address, Post Office and Zip Code
A. Petition for Probate and Grant of Letters Testamentary 3o I and Codicil(s)
Petitioner(s) aver(s) he/she/t y is/are t Executo3(s) named m the last Will of the Decedent, dated a
thereto dated ~j
State relevant circumstances (eg. renunciation, death of executor, etc.)
and did not have a child born or
Except as follows: after the a the do unds for di orce had been establ shed as)def sedan 23 PaaC.S § 3323(g)orced, was not a party to a pen mg
divorce proceeding wherein gro
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 (cI ~ a P~ banle~ b.n.c.t.a., pendente life, durante absentia, durante minoritate
If Administration, c.~a. or tbb.n.c.t.a., enter date of Will in Section A above and coin le ad been established as defined
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce h
in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
NO EXCEPTIONS 0 EXCEPTIONS
...._ __ _~....,wo.. ~ ,.rnnPr search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs (attach
Page 1 of 2
Form RW-02 rev. l0/Il/2011
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND
Official Use Only
ted Name Petitioner(s) Printed Address I
DAVID SHATTO 133 OAKLEA ROAD HARRISBURG PA 17110
SCOTT SHATTO 411 FAIRVIEW AVE, WEST FAIRVIEW, PA 17025
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 Decedent, 'tioner(s) will well and truly administer the estate accor~ g ~ iaw.
Sworn to or affirmed d subscribed before Date ~I I
me 11G~ day of ~~ Date ~ 2 1 2-_
Date
By ~ Date
For the Register
BOND Required: ®YES Q NO To the Register of Wills:
Please enter my appearance by my signature below:
FEES'
.
.. /~ j~
$ ~ ld ~ ~'l.s Attorney Signature:
... .................
Letters
( 3) Short Certificate(s)..... .
( )Renunciation(s)........ .
( ~ )Codicil(s) ............. 15•Q~
( )Affidavit(s)........... .
Printed Name:
Bond ........................
Commission .................. Supreme Court
Other .......
-
~ ID Number:
........
131 ~ t
.~7
i X _ Firm Name:
Address:
....... r~.:~
...... ~ p r.._, :z:1
Phone: ~~b7 ~"
......
Automation Fee ............... _
T_ r;~~~
Fax: '• --`
_.
~,
JCS Fee . ....................
L
$ ~.~ 1 ,
Email: _
U; ~-.~ 3) ~._..
.....................
TOTA ~. ~ J
DECREE OF THE REGISTER - x; rv ~-~ ~;
'~ ~
~a ~ ~ ~
of HN L. SHATTO
Estate JO aL
File No: ~c~[
/k/
a:
a
AND NOW, l ~ , in conside ation of th foregoing Petition,
satisfactory proof having be resented before me, IT IS DEC ED that etters
are hereby granted to V
in the above estate and (if applicable) that
the instrument(s) dated
described in the Petition be a
fitted to probate and file
of ecord as the last Will (and Codicil(s)) of Decedent.
Register of Will t'
Page 2 of 2
Form RW-02 rev. 10/11/2011
IOS.ROS KEV (9111)
LO ~p~ AR'S CERTIFICATION OF DEATH
,. i (•,
W ES- il~~g to duplicate this copy by photostat or photograph.
.1 I L
'ee for this certificate, $6.00 ~~ j ~ ~~~
P
~~ ~; ~~ This is to certify that the information here gi~~en is
correctly copied Pram an original Certificate of. Death
duly filed with me as Local Registrar. The original
,,,,_~~~~;_, _ certificate will be forwarded to the State Vital
Q~~'J i~~~~ Records Office for permanent filing.
1~7~145~~~~c~.,~~a
~~
Certification Number
Type/Print In
Permanent
B k k
7
/ (
Local R gistrar Date [slued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
f"CQT1Ctf"JSTF AC 1'fFATN
lac In
1 -- -- -
. Decedent's Legal Name (FIrsT, Middle, Last, Sufflxj 2. Sax 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell MO)
John L. Shatto Mals 200-22-6060 Jul 16, 2012
S a. Age-last Birthday (Yrs) Sb. Under 1 Y•ar Sc. Under 1 Da 6. Date of Birth (MO/Day/Vear) (Spell Month) 7a. Birthplace (City and Stale or For•Ign Country)
HarNSbu
Months Days Heun Minutes Februa
17
1930
,
ry
62
7b, girtnplate (eol,ntY)
g For•Ign Country) 8b. Resldenu (Street and Number-Include Apt NoJ Bc. Did Decadent Liw in • Township?
Residence (State o
r
a
P
A
.
139 2nd St. ®v.:, d•tedenc lire In East Pennsboro twp.
a d. R•aiaent• (county)
CumWrland Be. Residence (Zip Code) Q No, decedent Ilved wlthln limits of <Ity/bore.
9. Ever in US Armed Fwces7 30. MarN:al Status at Time of Death Q Mauled ® Widowed 11. Surviving Spouse's Name (If wife, gH• name pdor to flnt marriage)
Ves Q No Q Unknown Q Divercad Q Never Mewled Q Unknow
12. Father's Name (Pint, Middle, Last, SuMx) 33. Mother's Name Prior to Fint Marriage (Pint, Middle, Last)
John L. Shatto Catherine Kreltzer
14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, C1ty, StaN, Zip Cede)
Scott Shatto 80N 411 Fairview Aw West Fairview, PA 17026
a ateo eat ...!~..°^.Y..on. ..............................,,r ................................... .....
...........................:..............:....................... , ........................... ...
................ ............................
IT Oath Oceurrctl Somewhere Other Phan a Hospital: u Hospice Facility L-I Oeced•nt's Hom•
t
~~~
l
I Pa
I
en
t
f Death Octurrctl In • Hospital: In
Em •ney Room/OUtpaN•nt m D••d on Arrival Nurain Home/LOn -Term Care Faelli Other (SpetlfY)
iSb. Facility Name (If nH inati$ tle~ gly street and number;
Oly pl Oapltal 15c Clty or Town, State, and Zlp Code 15d. County of Death
Camp HIII, PA 17011 Cumberland
16a. Method of Disposition Burial ® Cremation 16b. Date of OlsposRion 16c. Plan of DlsposRipn (Name of cemetery, crematory, or other plan)
~, Q Removal from state Q Donation 2012 Evans Cremation Service
Jut 18
$
' Other (S 1 ) ,
€ 16d. Location of Disposition (City or Town, State, and Zip)
Leola, PA 17640 17a. SI t o1 Funeral Service Lleensee or P•non In Charge of Interment
Bla.te A. gauow 37b. License Number
FD-13646-L
17c. Name and Complete Address of Funeral Fatuity
8uI1Nan Funeral Home 61 N. Enola Dr. Enola, PA 77026
~ 18. Decedent's EtlucaHOn -Check the boz [hat best describes the 19. Decedent o1 Hispanic ONgin -Cheek the 20. Decadent'a Race -Cheek ONE OR MORE rcus to Indicate what
highest degree or level of school completed at the Hme of death. box that beat describes whether the decedent the decedent considered himself or heneH to b•.
Q Bth grad. or less Is Spanish/Hispanic/Latino. Check the "NO" =i Whlt• Q Korean
Q No diploma, 9th - 12th grade box H decedent Ia not Spansh/MISpaMC/Latino. Q Black or African American Q Vietnamese
High school graduate or GED Completed ~ No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native Q Other Allan
Q Some college credit, but n0 degree Q Y•a, Mexican, Mexican Am•rlun, Chicano Q Asian Indian Q Native Hawaiian
Q Chinese Q Guamanian or Chamorro
Ri
can
Q Associate degree (e.g. AA, AS) Q Yes, Puerto
Q Samoan
Q Bachelor's degree (•.g. BA, AB, BS) Q Y•a, Cuban ~ Q Flliplno
anese Q Other Pscifit Islander
J
ap
Q Master's degree (a.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hlspanic/LaTino Q
Q Doctorate (s.g. PhO, Ed D) or Professional tlagr•• (Specfy) Q Other (SpecHy)
. MD DDS DVM LLB JD
21. Decedents Single Race SeH-Dealgnatlon -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Ususl Occupation -Indicate type of work
;C] While Q Japanese Q Samoan done during most of working life. DO NOT USE RETIRED.
Q Black or Afrltan American Q Korean Q Other Paclflc Islantlar Conductor
Q American Indian or Alaska Native Q Vletnamase Q Don't Know/Not Surc
Kind of Business/Industry
22b
.
Q Allan Intllan Q Other Allan Q Refused
Q Chinese Q Native Hawaiian Q Other (Specify)
Transportation
(] Flliplno Q Guamanian or Chamorro
BY PERSON WN PRONOUNCES OR 2 )(~ I LCP' Z~ o Day r 23 nature Person Pronouncing Deat n y w en app lea • c. License Num er
2N Z`~ 44 ~ ot~-
(/
P~
RTIFIES EATM
L l ~d,,~t.,
~
23~ f]+t t n (MOJr/D= Y/Yr) 24. Time ~at~
( 25. Was Medical Examiner or Coroner Contactetl7 Q Yes NO
CAUSE OF DEATH ~ Approximate
Enter the chain of events--diseases, Injuries, or compllcatlons-that directly caused the death. DO NOT enter terminal events such as cardiac arrest. ) Interval:
Part 1
26
.
.
: Onset to Death
entricular flbrillailon without showing The etiology. DO NOT ABBREVIATE. Enter only one cause p)n a Ilne. Add additional lines If necessary
t
, or v
respiratory arres
73
1
IMMEDIATE CAUSE ------------> ~n ~ ~ ~ Ci~ f
quence of):
conse
or as a
(Final disease or condition Due to (
y
T
L
resulting In death) ~
~ O rL
~R
~ G S
J
T
rI nary
b.
Sequentially Iiat condiTions, Due to (a ss a consequence of):
11 any, Iptling to the cause j
listed on Ilne a. Enter the c.
r as a conse
uence on:
t
(
D
q
ue
o
o
VNDFRLWNe CADS[
e: (tllsease or Injury that I
F initiated the events resulting d.
a5 In death) LAST. Due to (or of a consequence of):
26. Part 11. Enter other •I iflc t d'tl s tributing to death bu[ not resulting In the underlying cause given in Part 1 27. Was an autopsy p•Ao d7
Ves No
28. Were autopsy findings available
~ to romple[e the cause of death?
~ Ves No
~' 29. If Female: 30. Dld Tobseeo Us Contribute to Dea[h7 31~~Ma~~nner of Death
l Q Homicide
Q Not Pregnant wi[hin Past Year Q Yea QQ Probably
b Unknown (gr,racurc
Q Accitlent Q Pending Investigation
~' Pregnant at time of death
regnant wlthln 42 days of death
n
nt
but
N
t ~ Q Suicide Q Gould not b• determined
,
p
Q
preg
a
o
s to 1 year before tleath
nant 43 da
t
b
t 32. Data of Injury (MO/Oay/Vr) (Spell Month)
y
,
u
preg
Q Not pregnan 33. Time of Injury
Q Unknown if pregnant wlthln the past year
34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, Clty, State, Zlp Code)
36. Injury at Work 37. H Transportation Injury, SpeclN: 38. Describe How Injury Occurred:
Q Yes Q Driver/Operator Q Pedestrian
Q No Q Passenger Q Other (Specify)
39a. C er (Chet ionly one):
th occurred due to the cause(s) antl manner statetl
l
d
d
k
p,
ea
now
e
srtNying phy Itian - To the beat of my
Q Pronouncing 6 Grtlrying iclan - To iha be my knowledge, death occurred at the Lima, date, and place, and due to !ha cause(s) and manner statetl
tl
Q Medical Examiner/CO a On the minatlon d/or investiptbn, In my opinion, de th o ~ red at the time, date, and place, and tlw to the~c/scale(s) and manne/r~stJate
D ~~~
-
V/
/
Signature of certifier: Title of urtiflar: ~ License Number: ~
39 b. e, Addrcs and p ode o Pe n Com atl g Cause of Dea h t 26) - // 39c. Dat BSI ed Mo ay fl~
eilrtrar s DlatrlR _ R•g strcr'a Siina re .. 42. •i • to Mom/ y
7 '- 1 a?--o`~ibZ
S 43. Amendments
0762166
Disposition Permit No. REV D7/2011
LAST taILL AND TESTAMENT
OF
JOHN L. SHATTO
n
3NOLD~ SLIHH Re $AYLEY
¢~Oau~r eraeerv
.wrv H~u,Paxxsnvewu ~aou _
~,
I, JOHN L. SHATTO of L~Test Fairview
Cumberland County,
Pennsylvania, declare this to be my Last twill and Testamen
hereby revokin y reviousl t~
g an will p y made b
y me.
I - I direct the na
,. yment of all my just debts and
funeral expenses out of my estate as soon as may be practi
after my death, cal
II - I devise and bequeath all of my estate of what-
ever nature and wherever situate unto my wife, Shirley A. Shatto.l
III - Should my said wife predecease me, then I
devise and bequeath all of my estate of every nature and where-
soever situate unto my children, David B. Shatto and Scott M.
Shatto, Rer stirpes.
IV - I appoint my wife's mother, Evelyn G. Burkey,
guardian of any property which passes 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. Such guardian shall have the power to use principal as
well as income from time to time for the minor's support and
education (including college education, both graduate and
undergraduate) without regard to his or her parent's ability to
provide for such support and education, or to make payment for
=hese purposes, without further res onsibilit
p y, to the minor or
.o the minor's parent or to any person taking care of the,,.,,
iinor ,.-_~,
n G"? -
j f J i ~'
~~ , _~,a g~, ~-
~ N
~~
-- ~ "7
G..
V - I appoint my .wife, Shirley A. Shatto, Executrix
of this, my Last Will and Testament. Should my said wife fail
to qualify or cease to act as such, then I appoint the said
Evelyn G. Burkey to act in this capacity. Neither of my
personal representatives shall be required to post bond in this
or any jurisdiction.
IN WITNESS 6VHEREOF, I have hereunto set my hand and seal
on this, the ~/-~~ _ 7~day of
1978.
~f
ohn L. Shat o ~ (SEAL)
Signed, sealed, published and declared by JOHN L. SHATTO, Testa-
tor therein named, on this and one (1) other sheet of paper as
and for his. Last Will and Testament in our presence, who, in
his presence, at hi"s~request and in the
have hereuntcs~ bs ribe '~ Presence of each other,
~~ ~'dur names as attesting witnesses.
. ~ ~
r
,~ Name + ~' ~ f` ~ r'' ~,.~...
Ad ress ---
Name
Address
1ENOLD~ SLIHE Ec BAYLEY
ATTORNEYS AT LAW
Cwe~r H~wv, Paxx svtvwxu iao~~
Page 2
COMMONWEALTH OF
COUNTY OF
PENNSYLVANIA)
SS .
CUMBERLAND)
I~ JOHN L. SHATTO , the testat or whose name is signed
to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it will-
ingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by
JOHN L. SHATTO, the testator this ~ y
of November ~ 19 ~g _„_,~ da
c' !~
~~~
N tary Public
Thelma S. McCauslin, Notary Pabst'
My Commission Expires July I, 1980
Camp dill, PA Cum6erlend County
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND)
signed willingly and that JOHN L. SHATTO executed it
as his free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sigh,.t of the test or signed
the will as witnesses; and that to,~-the bes~tiof ou~ kno edge t e
testator was at that time 18 or ore years f ag~,'o sound mind
and under no constraint or undue influence. ~ / '`
WE, the undersigned
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose ar~d
say that we were present and saw the testat or sign and execute
the instrument as his Last Will; that JOHN L. SHATTO
~: >~~
AT7Y IItNEYti AT LAM
=tp WNtA ~R
cr.r rra~ t~rn•AwA Uel l
this ~ day of November, ~ 19'7g
Sworn to an~ subscribed before me
~ ~'
~ ~~..
N ary Public
Thelma S. McCauslin, Notary PubRi
My Commission Expires July 1, 1980
~~~mn 'riil, PA Cumberfard Ccas~~!
CODICIL
OF
JOHN L. SHATTO
I, JOHN L. SHATTO, the within named Testator, do hereby make and publish this
Codicil of my Last Will and Testament dated November 30, 1978.
FIRST
I hereby amend item "V" of the said Will to provide as follows: I appoint my sons,
B. Shatto and Scott M. Shatto, to serve jointly as my Co-Executors.
SECOND
In all other respects I hereby ratify, confirm and republish my Last Will dated November
30, 1978, together with this sole Codicil as and for my Last Will.
IN WITNESS WHEREOF, I, JOHN L. SHATTO, have hereunto set my hand and seal to
this Codicil to my Last Will and Testament this ~_ day of ~~ c~ , 2005.
~4 ~~~
OHN L. SHA TO
SAIDIS
SHUFF, FLOWER
& LINDSAY
ATTORN El'S•AT• LA W
2109 Market Street
Camp Hill, PA
S' Q
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~G ;
~' ~.
C7 C1
Q C~
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Signed, sealed, published and declared by the above-named Testator, as and for a Codicil to his
Last Will and Testament in the presence of us, who have hereunto subscribed our names at his
request as witnesses, thereto, in the presence of said Testator and of each other.
~~~,, ADDRESS 2 ID 4 ~'~-~~
C . ~ - P~}-
J ,
~ > ~ ~ ~ I ADDRESS '~~`~I ~~Ak~`t~C ~: 1'~ ~
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
We, JOHN L. SHATTO,'1 ~torh~ E • Fro Wt.~, and / " ~'~ the Testator andl
witnesses, respectively whose names are signed to the foregoing or attached instrument, being,
first duly sworn, do hereby declare to the undersigned authority that the Testator signed and
executed the instrument as his Codicil and that he signed willingly and that he executed as his
free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the Testator signed the Codicil as witness and that to the best of their
knowledge the Testator was at the time 18 or more years of age, of sound mind and under no
constraint or undue influence.
~ ~ ~ G~
HN L. SHATTO
~Wi~ss .
W~
Subscribed, sworn to and acknowledged before me by Johns. Shatto, the Testator, and
bscribed o and sworn or a ~med to re ~e by ~~c S ~4/fJ~- and
~' ,witnesses, this day of , 2005.
SAIDIS
SNUFF, FLOWER
& LINDSAY
ATTORN EYS•AT• LA W
2109 Market Street N ary Pu 1C
Camp Hill, PA COI~IIv10NWi3_ F PENNSYLVANIA
Notarial Seal
Sara J. Ensinger, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires Oct. 17, 2005
Member, Pennsylvania Association of Notaries
2