HomeMy WebLinkAbout09-12-12Reset
PETTPION FOR GRANT OF LETTERS
REGISTER OF WILLS OF ~~~ d COUNTY, PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Lt;tters 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: KDnn~~ fp a ~ ~~5~
a/k/a.
a/k/a:
a/k/a:
Date of Deatb: __~-? pl ~
Decedent was domicilCed~ at death itt C ti M 6~fj ona i
principal residence at ~!.lYa.ll~fnd~ neat-~..T-"i'.~~
Decedent died at
File No: ~~
(Assigned by Register)
Social Security No•
Age at deatb: , (a r]
~Ir,
Cosaty
atroet addKee, Peat Glace and T1p Cow City, Tewnhip tt nereagh •.
Estimate of valve of decedent's property at death:
ljdoarlaUd In Purttsylvaek........... .
/jnordornicf4dhr Pm ................ All personal property
ljnotdoiwicAadTnPmarn~A~ ........................ ParaoaelpropatyinPamsylvaoia
VaGte o ms! esArre ie P ~W a& ........................ Persoval property in County
j eenayl,+ania .........................................................
TOTAL ESTIMATED VALUE... .
Real estate in Peonsylvmia situated at:
(Attach additional sheeu, tfrreacerary.J Street addrevv, Poet Oflke sad TJp Code
'1
Coasty - Shh
/00000 -~
S
a
a
a r.-r,--e-o-,,,M. ~
/nD Doo. 00
City, TovresWp or yak Canary
A. Petltion for Probate and Graut of Letters Testameatar.~
hereto dateds)aver(s) he/shdthey ts/are the Executor(s) named is the Isst Will of the Deadeot, dated d
-~C ' ~ ~ and Codicil(s)
Sate relevant circumhacp (es rnvradMlan, tny, ylrrsacr6r, anal
Ezcept as follows: efterthe execution oftbe instrument(s) offmod forprobate Decedentdid notmeuy, was notdivorced, wan not aparlyto apendivg
divorce proceeding wherein tbe grounds for divorce had been eatebliahed as defined in 23 Pa C.S. 3323
adopted; and Decedent wen neither the victim of a killing nor ever adjudicated m inc hated § ~ (B), and did not have a child bom or
NO EXCEPTION3 Q EXCEPTIONS mac person
^ B. Petition for Graut of Letters of Administration (tf applicable)
uaa, d.b.n., db.n.cta., Peadertre luet dtirante absentia
If Adminiatratton,ata, ordAa,eta, enter date of WiD ie Section A above and complete list of 6ein mtnorirare
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the
in 23 Pa C.S. § 3323(8) and was neither the victim ofa killing nor ever adjudicated m ~ 8rounds for divoroe bad been established as defined
Q NO EXCEPTIONS I+.IL tucapac rated perse~n.
CEPITON3
Peritioner(s), aRera propersearc6 haWhave aecettained that Decedent left ao Will andwas
additional sheets. ijnecexsary): survived bytbe folYowirigspotise(ifarry)aod heirs (attach
ueacnoetr m rue rcuuun ot: awnttuxt w pruoate anu tutx
Form RW-01 rev. ID/1//!0/I
O C-' ~' t ....
Form RW-02 rev. 10/11/10/1 ~ ~-' ~ _'r-j
r"-- rn
O+ ~~ n
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF Clui.Y'rlberla~l d } ss.
'CL~ °~" ~
Petitioner(s) Printed Name Petitioner(s) Printed Address .
~i~r~`~ ~ ~
', cl-4~e,i1
uR.
I;
4
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the best of [he Imowledge end belief
of Petitioner(s) and that, as Personal Representative(s) ofthe the Petitione~(s)~w~'ill~.(,w•c.ll en~/d~t~uly administer the estate a~ccord~in~g to law,.,
Swots to tlirmed subscribed before , ai~t ~ ~y!(~L Da~~
me this / y of ~1'Z Dace
By: Date
Far the egister ~~
BOND Required: Q YES ~ O Ta the Regtarer of Willa:
Please eater my aooearauee 65' my siQaature below:
FEES: ~/~
Letters ...................... S l
( ~) Short Certificate(s)...... ~f-
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commissio ................
Other i/ ........
Automation Fee ............... .
JCS Fee .................... .
TOTAL ..................... $ 0.0(t
Attorney Signature:
Printed Name:
Supreme Court
ID Namber.
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate o[ File No: _(7l 1 I~ - (ll 0
a/k/a•
AND NOW, ~ 1~, in coast era n of the fore og inp~Petition,
satisfactory proof hav' n presented before me, IT IS CREED th~Letters ~,~ ~~' V},~ ~--v----
are hereby granted to o .c s 6, ,~,~a, v
m the above estate and if apphcabte) that
the instrument(s) dated I
described in the Petition be W probate and filed ord as the last ill (anti C (s) f Decade
V
gister o it
Fo.m RW-02 m.10/It201/ ~ Pa Oft
HI(15.805 R2V f9/I I)
LOCAL REGI~ ~'.~Cr+I,RTIFICATION OF DEATH
WARNING: It is ill ~~'~~~ co b
r -.
py y photostat for photograph,
Fee for this certificate, $6.00
P 1862810
?~f2 S~P ~ ~ '~'r~ ""'~- This is to certify Thal the informs[ion here given is
r ~~ Pf -;
o,'oy,~ tiy~, corre~ tly Lopied tram an orgmal Certificate of lleatf
g ~ duly LI~d wi[ti me as Loca] Registrar. The original
. --.....~ - ~;; z3 certrfiLat¢ will be forwarded to the Slate Vital
OfsPN
t~V~15 ~ - ~~ ,* ~ Records OtLce tar permanent filing.
g9rMfNTOF~~`P'~ .R~~K~..it~,Eg.e~- g~-FA? -5~2U12
Local Registrar Date Issued
COMMONWEgLTN OF pENNSV LVANIq . DEpggTMENT OG NEgLTq VITRL P.ECOgps
CERTIFICATE OF DEATH
Certification Number
N
N
V
=~r3 LeroY Bai tsell z. saK g. seas secv.rfv ru.,mb.rsta<e me rvumbe.:
r<grrtna.v lvrxl sb. Dndarlve.r sr. Dnaaa pa Male 199-34- Daa uP De.m tmo/Dav rl lspen MO)
r7 Mnncm Davx Npur I s. mt. or {r.cn tMn/p.v aq (span Monml n_ B 1 5 l3l eAt _ 4 _ o n
netsta. pr Fp..Ln ~,,,,..,,.,, e__ .. _ n,,. November 9a 1944 - C3r1Y91e PA reran cp,. nv)
~~kloa,a ~aaent[nyaa wl
pNemea
g
G
sa PA 17065
r[ a.{re. or r.y.I m amoral [o,.,rl.«a .c m~ rime e~ a..m.
Ntla y..da ur loess
a diploma, 9th- 13M lratle
wen ron.nl {rca..ae nr GED cnmpmc.e
some collage credr4 but no ae{tea
B c date aloe le.g. qn, qs)
Martero's tle{rca (e g. Mq, Ms, MEIn{, MEd, MSW, MBq)
Doctorate (e. [~ PM1D, Ed DI or pmferalonel tlegrae
wmta _.. ___..._
Blac4 or q/titan gmencan
Brian Intllanalan nr gleske Natlya
09/06/201 2 ~-rollin `°'°m.[arv. oam.[Prv. erom.r praeal
Oar F natal
I r
'TLF-
° Home
. ¢erto
m
o $ Cr ama tory
~O
4~ n
t
es,{e
^I lntetment l1n. 11 s umbat
cen eN
Funeral
~
Homes & -~ FD l 38612
C scoot rya Inc.
O o/Nripanlc Orlgn-C eck toes
, toes[ bait darcNbea wheCneC [he decadent SO.O cedant'a 0.ace-Chock ONE OPM
OPE racer <
I
h
d
+nrrn/HrrpanlU4 loo. Cnack the "N O"
P t
e dacetl
an<conxlderetl nrmSall or n o
n
icate whs<
ewel/xo be
I/tleca Stotts not spoolGhLHlrpanrc/LeHno.
o<
Na, n panlsn/HlaPanlU
l
Bratty
O k or glrrcan gmancan .
OK
at
np
n, Mea:rcen gmancan, CM1lcana
ox Pue oa Rican
~ gmeNl em Indian nr grarka Netrve
O qrl ntlran
n ~ Vla[nameaa
~ Ot`er Baran
v
y Cuboan
Vea a[n rsPanlih/HlaPanr4l ~ Ipn
~ Fill ~ Ne lye
O Su n~ noa<namnrxa
a
(specrM <rnn O~heneae
. Isp.nM OO<her Paclgc larander
Korn ~ O[n rKn clgc rslandrer
OMe•gxlan O Dn '< w/Nets re
elm nlaW Oan O aeeuxaso
Gp• . n .cn.morro D n.r( peapl__
' I^B mos<o/workln{IIIe.
Plumber
Construction
zE. pe Pi. en<ar men
arxe.xax
m equSE OF DEATH ' - u ve, xpr
.
iunar.o.eompnearnns--toes mracnvouxaa madotn
x ra nrvarra.4 nr yannmpmr
nbanxlon wl<n
DD N 1
ou<xnowm{cn. .
OT.m
eanl.ev
l ar ta
. OO NOT gBggEVIqTE
Enter o
gvwpKlmaf.
rminal events auto ai caralac arrax<
rmnngplgre upsE
______.___> p. raj ErcZa
(Einar m .
ra
von. ovae
FZ
Lasrt .n. una. peso .aalnonal Imes gnamaxarv i mc..var:
Dora t
D
re.r. or pominnn y
. o
e.m
r
r.xmnng m aeon) Do. o ter ar a oem.qu.nc. oil: i 1 Eder
x
b. C~j P ll ,
i --w-
raelm{I to me rtrnn
n•^e ~u ou
a
f n
m
aluence (
Uh~
n tine a. Enter (rat
I o ~
NOEgLYING UVE!
(
B
area eor cola mat
mgr
~e
oust tax
^ t. .ten eq.anP. nro (
i
.
d me a t rerurtma
~^
rn eea[M Iws l
S6. part II. Enter oMerl(gn e (o ^aa a con equencs o/):
o[e I
ca
~vi^ bu a
[ ul<I a In th
~ e unaerlving causes given rn part 1
g zv. w.a an a„<oprv vapor
.aa
o
~=
3g. n F.m. `.: za
o .rc.
pavgmm{r
ayav.N.
O No pr.{n.nt w
rmin pa<v..r DIe mn.x<o Da. <oncnhuc. to D c
cpO vaz me ous Noa..cny
~ o p
svpancanmeo a..m any
x 7Q-proe.brv
~ LM,nn
.nroaa<b
3
~ v <p~:`^:^`, bu<pragnant wlmm a3 a.ya mee.<n O
D Unknown V
igrv
O N mIp as
~
«
O V nknown v p,e uc vrcen.a as d.vr eo I rear b.ror. a.am Da ra
O q
m
yertrn[mn
I^
s
I
Y^°nf wr<nrn fns pass year .
e o
In)ury (Ma/Day/yr) Ispell Mantel ei
~
umma
~ Ceurd ba aefaxmined
O rvo lO pa eypp.ram. p Pea.x<mp Isg' . m)vrvoau.rcd:
O P .ne•r O Dena. g e ryl
a n pnVflcran-TO ene bar<e1 4 wlaa{a. aaane ed aua to Cnuc
rng & Certllying pnyrlcren my <ne bes[ a(m knowletl{a, death aural `( a
Metll<al Eaam neUC^r ne basis n tl na/ar Inyeal{aVanr rntlT ne time, aa[e~entl place, any tlue [o Me c ia(sl +nd m
nest rVga ~ ~V\ a. e on, a y raptor n, aaatn nccur<ea at toes time, data xna prate, any tlue`to tote ausala any m
a[atetl
r ~oCrla P ~ Z/~SUp ovx J v'y.o -ll 1 re NOme.r: ~°DO /t 2Yfo r
^ ~~ Ne~ 'D/.~~ GZ G P n SL nssc. sr ea fM./p.vnn
'dl n t n TI .. ~.-~ t E 9a Y 2
S
Dlapp,mpn perm,< ,. cti G7 Lj_ ~ _~~__
NlDo-las
REV O)/2011
LAST WILL AND TESTAMENT
I, KENNETH L. BAITSELL, of Middlesex Township, Cumberland County,
Pennsylvania, declaze this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
1. I direct my executrix to pay all of my debts, funeral and administrative expenses
as soon as may be done conveniently after my decease.
2. I authorize and empower my executrix to sell any rea:fty owned by me at my
death, at either public or private sale, and to give good and sufficient deeds therefor, in fee
simple, as I could do if living.
3. I give, devise and bequeath all of my estate of every nature and wherever situate
to Larry A. Baitsell, Sheri L. Baitsell and Kristen M. Baitsell, share and shaze alike.
4. I nominate and appoint Sheri L. Baitsell to be the executrix of this my Last Will
and Testament, she is to serve as such without bond. Should she die befbre my death, renounce
or refuse to serve for any reason, or die leaving any of my estate unadministered, Inominate and
appoint Kristen M. Baitsell, as substitute executrix, also to serve as such without bond, with the
same powers as aze given herein to my executrix.
~
C
~
~~ ~4
~
~~
~T
~~ ~ i~
_
Or N !"~ n=
~~; ;:
O~ n
~ y
'
~; _ .
~~.
~ ~ ~ =7
r
n`
r
Ol -
t
l7~
5. I hereby suggest that my personal representative retrain the services of Irwin,
McKnight & Hughes as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 11 ra day of April,
2001.
_~~/~P~SEAL)
KENNETH L„ BAITSELL
Signed, sealed, published and declared by KENNETH L. BAITSELL, the Testator
above named, as and for his Last Will and Testament, in the presence of us, who, at his request,
in his presence and in the presence of each other have subscribed our ntunes as witnesses hereto.
~i
2
ACKNOWLEDGMENT AND AFFIDAVIT
WE, KENNETH L. BAITSELL, CHERYL L. CLELAND and MARTHA L.
NOEL, the testator and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
testator signed and executed the instrument as his Last Will, and that he had signed willingly,
and that he executed it as his free and voluntary act for the purpose herein expressed, and that
each of the witnesses, in the presence and heazing of the testator, signed the Will as a witness and
that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of
sound mind and under no constraint or undue influence.
KENNETH L. BAITSSELi. .,
CLEL,AND
L.
COMMONWEALTH OF PENNSYLVANIA .
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by, KENNETH L. BAITSELL, the
testator herein and subscribed and sworn to before me by CHERYL L. CLELAND and
MARTHA L. NOEL, witnesses, this 11T" day of April, 2001.
;~' ~?i.
Notary Pu c
Notadel Seal
Roogger 8. Irwln, NoCary Publb
Cadiele Boro, Cumberland County
My Commission Expires Oct. 3, H
Member, Perv~SylveNa nesodedon d Notedes