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HomeMy WebLinkAbout09-13-12Reset 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: Romaine M. White File No: ~~ ~ l~ L C ~'~ Ewa' (Assigned by Register) a/k/a: ~Wa' Social Security No: Date of Death: AuQUSt 29, 2012 Age at death: 85 Decedent was domiciled at death in Cumberland County, pA (scare) with his/her last principal residence at 736 East Louther Street Carlisle PA 17013 Carlisle Borou h Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 736 East Louther Street 17013 Carlisle 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 $_ 4,000.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ ]f not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsydvania ......................................................... $ 90 ~~~ ~~ TOTAL ESTIMATED VALUE.... $_ 94.000 00 Real estate in Pennsylvania situated at: 736 East Louther Street 17013 Carlisle Cumberland (Attach additional sheets, if necessary.) Street address, Post Ofiice and Zip Code City, Township or Borough Count Y 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 April 19, 2007 and Codicil(s) thereto dated State relevant circumstances (eg. renunciation, death of execu[or, 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. Q 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, durante minoritate If Administration, c.t.a. or db.n.c.ta., 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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ~NO EXCEPTIONS Q EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spo~ (if any) and ~rs (attach additional sheets, if necessary): Name ~ Relationship ~ Address --rn~C ? -~T. r~ Form RW-01 rev. 10//1/2011 ~~ _ U;; ~ W T7 7 _ ~. y _, D , ~4 a `~ t~ Page 1 of 2 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 D cedent, the Petitioner(s) will well and truly administer the estate according to law. Sworn to affirmed d s scr'bed before Lt,~ Date ~' - /~ ja met 's ~ day o 2 ~ Date By. ~ Date For th? Register Date BOND Required: Q YES (~ NO To the Register of Wills: FEES: Please enter my appearance by my sienature helnw~ Letters ...................... $ 2~~ .(') t..1 ( L~ )Short Certificate(s)...... } jp , [)~ ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ........ Automation Fee ............... ~ ) JCS Fee . .................... Jr-- TOTAL ..................... $ . Attorney Signature~~ ~/ l Printed Name: Stephen J. Hogg, squire Supreme Court ID Number: 36812 Firm Name: Law Offices of Stephen J. Hogg Address: 19 S. Hanover Str Pt 4te 101 (Carlicle_ PA 1701' Phone: 717-245-2698 Fax: 717-245-0829 Email: DECREE OF THE REGISTER Estate of Romaine M. White File No: ~ ~ - ~ ~ _ ~Cja •~ a~k/a: AND NOW, ~~j ~~~,ti jL~? ~ f~. }`~ ~C j , in consideration of the foregoin Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to in the above estate and (if applicable) that the instrument(s) dated _~ i ~~'~~ described in the Petition be Form RW-02 rev. 10,111/2011 to probate and filed of record as the last Will (and ~' ~(~('(,~~rJ(/l 1 2 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } lJ '- '.F -r `^ : ~ } SS: COUNTY OF CUMBERLAND } Ji __ _ _ H105.805 REV (9/11) - - - - - - - r~l~'~~'~ ISTRAR'S CERTIFICATION OF DEATH ~~'`' s ille al ,'~ ; .~,_ G,p~~Q g to duplicate this copy by photostat or photograph. Fee for this certificate,:~~ifQ l L ~E~ ~ 3 ~,~ ~~ ~ ~J This is to certify that the information hej~e given is correctly copied from an original Certifica~:e of Death duly filed with me as Local Registrar. The original ` ~_- ' ~ certificate will be forwarded to the ~aate Vita) ORPt~N`~ '.~UI~~S ` Records Office for permanent filing. P 18 6 2 ~~~D C0~' ~ ~i~~~~~~ A~~ ~~ Certification Number Local Re i~.trar g Date ]sued Type/Print In COMMONWEALTH OF PENNSYLVANIA Permanent DEPARTMENT OF HEALTH ~ VITAL RECORDS Black ink CERTIFICATE OF DEATH 1. Decedent's Lae ..~~... ...~~._ .. _ __ _. _ 85 yrs. M_ 1 ~ I May 18, 1927 R Idence (Sf reet and Number -Include Apt No.) 36 East Louther St _ Q Yes ®plq wn ~" ar ca sat Time of Death 0 Married ~ W Unkno ~ Dlvo reed u ~ Never Married Q Unknown L2. the 's Name (FI st, Middle, Last Suffix) ~arfl- T _ h~arston Sr _ 1 k Q k S't ~ 9' or F~ lan Count.v-~ --~ -• a iownship7 Yes, decedent lived In ENO, decedent Ilved within limits pf Carlisle Borough g .. "r "~'- Daughter~~_~~~... '929 Forbi ............ is ............................................. If Death Occurred In a HosPital: "-"""'-"'-'-"•'""""'••• t~ Inpatient -••••--- .•---•••••---a-...ace o , eat ec on one If D th O d - ~ Emergency Room/Outpatient Dead on Arrival ; ea ccurre Somewhere O[he Tlhan ~ Nu i H 16b. Faclllty Nsme (If not Institution, glue street and number; 7 3 G ~. L c u-~t-It cP S -~s^ P rs n ome/LOn -Term Gare Fac lSc. CJp. or Town_Siata, anal Zip Code C! ~E /•• / m 16a. Method of Dlspositlon J® Burial ~ C - , [ / e A l ram [ion Q Removal from State ~ Donation oth 16b. Dste of Dis position S 16c. Place of DI er (speciry) ept _ 5 , 2012 Letort 16d. Location of Dlspositlon (City or Town, State, and Zlp) Carlisle, PA 17013 17a. Signature sl Servic 17c. Name and Complete Address of Funeral Faclllty ~ HoPflnan-Roth F1.anez-al Hocna and C lg Dec d ' remato Inc 219 N . e ent s Education -Check the box that best describes the hi h t d _ _ Hanoi 19. Decedent of His ani O i g es egree or level of school completed a[ the time of death. 8 h p c r gin -Check the box that best describ h ® t grade or less Q No diploma, 9th - 12th grade es w ether the decedent Is Spanish/Hispanic/Latino. Check the "NO•' ~ High school graduate or GED completed box If decedent Is not s not 5 panish/Hispanic/Latino. No ~ Some college redit, but no degree , ~ Ves Mexican'sM i a ~ Associate degree (eeg. AA, AS) Bachelor's degree ( .g. BA, AB, BS) , ex i an Ame Icon, Chicano 0 yes, Puerto Rican ~ Master's degree (e.g. MA, MS, MEng, MEd MSW MBA) 0 Yes, Cuban , , Doctorate (e.g. PhD, Ed D) or Professional de re Q Yes, other Spanish/Hispanic/Latino g e . MD DOS DVM LLB JD (Specify) 21. Decedent's Single Race Self-Designation -Check ONLY ONE to Indicate hat the decedent considered himself Q] White Q Japanese Q Black or African A merican Kore or Q Samoan o American Indian r Alaska Native ~ Vietnamese 0 Other Pacific Islander ' Q Asian Indian Q OThcr Asian Q Don t Know/Not Sure ~ Chinese no O Nstive Hswallan Fill i ~ Refused 0 Other (Specify) p 0 Guamanian or Cham orro ITEMS 23a - 23 M ST BE COM LETED CERTFIES DEATH PRONOVNCES OR 23a. Dace Pro/nno cetl De (Mo V ~ / ~ ~ ~ ` .1aY r) 23 .~ nature o Person Pr. Nurs %~~~ ~S~f6S~l8 0 S aJ'ac yr uEATH 26. part 1. Enter She chain o_ f eve t __diseases, Injuries, or complications--Shat directly caused the death. DO NOT enter terminal events such as cardlec arrest respiratory arresT, or ventricular flbrlllatlon without howing the etiology. DO NOT ABBREVIATE. Enter onl /~~ U ~~ - V one cause on a Ilne. Add additional Ilnes If necessary IMMEDIATE CAUSE ---------_____s a. ~ ~~ ~ l '~~ / (Final disease or condition D t ~J resulting in death) q of). b. Sequentially Ilst conditions, Due [o (or sequence of): if any, leading to the cause as a con Iistetl on line a. Enter the UNDERLYING CAUSE (disease or Injury that Due to (or as a consequence of): initiated the events resulting d. In death) LAST. Due to (or as a consequence of): 26. Part 11. Enter other sianiflc t dltl h but not resultina i.. tl.a .. _ __ _ _ U S~~ t! - __ °'-•-' e.~.. .n ram J~ ~~ /NHS CG H<'L/ Hale: Not prognent within past year 30. Dld Tobacco Vse Contribute to Deaths 31. 01 Pregnant at time of death Q Yes 0 Probably M Nocpregnant, but pregnant within 42 days of death ~ NO ~ Unknown ural 0 A Not prognent, but pregnant 43 days to 1 year before death 3 ccident 0 Suicide Unknown if pregnant within the past year 2. Date of Injury (MO/Day/Yr) (Spell Month) Approximate Interval: onset to Deaen to complete the cause of death? Q Yes ~ No ~ Homicide Q Pentling Inves[igatlon Q Could not be determined ye, tribe How InJury Occurred: s ~ Driver/Operator 0 Pedestrian ~ es ~ No ~ Passenger 0 Other (Specify) C rtifl (Ch k ly ) (~C rtio I g phy I I T th b t f y k 1 tlg d th u red due to the cause(s) and m Q Pren n ing 8a Certifying ysiclan -TO th 1'lf~e~~1`at ofn /aamatt~yok/n~owlad anner staled ~ M dical Examiner/CO r - On b sis o/ K_-fNt- a Be, death occurred at the time, date, a d place, and due to the c se(s) and manner stated 1 i ntl/or investigation, in my opinion, d ~/th ,/~ red at the time, date, and place, and due to the Signature of certifier: ~ Title of certifier n/f / /cur ry~ u ( ) ddb--~Atisjad b. Name, Address and ZI Code of Per - License NumblF: ` ~a~ ~' 7 a > SG P n Completing Caus of Death (Item 26) ~A!\A ~i.~ ~ ~!'9 .~~. ~sY /YI f'- I-jr4l~ 39 ,/D t SIg d (M /D y/V) •yf R gi t ..(( DI t i t N b 41 R gl t Sig t ~ p} f 7n' ` J7 N 6 3 0 i `LO~ tX.~ oZ ~ 0 42. Registrar FI c Data ~}j'_„~1 ~..at lisle, YA 17Q 1: t~ Hospice Faclllty ~ ~~ ~_Other (Specify) is county i (Name of cemetery, crematory, or • nor arge of Interment 17b. Llcens 13851 [wp. to indicate what decedent considered himself or harsOelf to b White e, ~ Kor Black or African American 0 Vietnamese American Indian or Alaska Native ~ Other Asian Asian Indian Q Native Hswallan Chinese Filipino 0 Guamanian or Chamorro Japanese ~ Samoan Q Other Pacific Islander Other (Specify) - most of working Ilfe. DO NOT VSE RETIRED. Ofspositlon Permit No._ © 1~~ ,~c.~ H105-143 _... REV 07/2011 t ~.., y WILL OF °-~' -,~, ROMAINE M. WHITE ~~ ``' -=~' ~' ~., to , z , c -, ~ ~ ~ `'_ ~ I, Romaine M. White of Cumberland County, Carlisle, z'~ ~~ ~ -- r -~ ~ r~. w -~ r Pennsylvania, declare this to be my last Will and hereby revo (~la ~ , prior Wills and Codicils. ~~ ~_ ~ ~ x~ kp ~_ ~,-, 1. I direct that all my just debts, funeral expenses, v ~ -- `" gravemarker and administrative expenses shall be paid ~' from my residuary estate as soon as practicable after my death. 2. I direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. I direct that my entire estate be distributed as follows: A. I direct that my children, Donald L. Weibley, Carol L. Richardson, Sherry K. Short and Robert D. White be able to remove any items of sentimental value from my estate. B. I direct that the remainder of my estate be sold with the proceeds being divided into equal shares between my children, Donald L. Weibley, Carol L. Richardson, Sherry K. Short and Robert D. White. C. Should any of my children predecease me, then their share shall lapse and be divided into equal shares between their surviving children. 4. I appoint Donald L. Weibley, as Executor of this my last Will. If Donald L. Weibley should predecease me or cease to act in such capacity, I appoint Sherry K. Short as alternate. 5. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. LAW OFf'ICES OF STEPHEN J. NOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 6. I direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. ~';~J ,a,,,,, ~ `ter (,~~~~ \/., r v ~ V ,~c ~~--' IN W~IT~ESS WHER F I hau hereunto set my hand this --~'--F- day of , 2007. Romaine M. White ,~~c ~~- LAW OFFICES OF STEPHEN J. NOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and two other pages was on the day and date hereof signed, published and declared by Romaine M. White as and for her last Will 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. WITNESS NESS LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 ACKNOWLEDGMENT LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 State of Pennsylvania County of Cumberland ss I, Romaine M. White, the Testatrix, whose name is signed to the attached or 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 as my free and voluntary act for the purposes therein expressed. Romaine M. White Sworn to or affirmed and acknowled b .fore a by Romaine M. White the Testatrix, this ~ day of , 2007. ~.~.~ ~T~!!@I J.IIppQ NOTNIYl11MJC ~~0110. C~ANDQ4. MM Notary Public/Attorn AFFIDAVIT State of Pennsylvania County of Cumberland ss We,S1~•.s a •.-~ L.l~','EeSand ~Sct, ~. ,~ ~ev-~ ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her last Will; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of s nd mind and under no cons#rai o undue influence. ~~orn to or affir d nd s scribe fore me by witnesses, this -~-f- day of 2007. ..._~ otary Public/Attorney ~1lhEN J. IIOOQ NOTMY gA1C C~AIrJWL 00110.OUM~N000.. M w oawroN ours ~s-eree~ a auo~