HomeMy WebLinkAbout10-25-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF 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 n
Name: [.i1ArJi~At_f_r /1UtZt-t3st) File No:
a/k/a: Assigned by egister)
a/k/a:
a/k/a: 5^cial Security No
Date of Death: .fg---~~-~~-(a--C~~?~•~,r~~..;'~/i 2 .~.ge at death: 7 ~
Decedent was domiciled at death in Cunt t3/3 RC O County, P/-niNA . (Swie) with his/her last
principal residence at 2too J3 r3+y-r CRr-8k oLr-iZVA~r> MFcdR,yt~Slbc'ILG C'~nt/SEr2c/sdD
Sheet address, Past O(Bce and Zip Code City, Township or Borough County
Decedent died at ~~oo !3/NT C/Lr•Fle ~o~tt=/R410 ~s/nsr3t_a1-AN.7 ®r.vrtlA,
Street address, Posl Omce and Zip Code City, Township ar Borough County State
Estimate of value of decedent's property at death:
/jdomiciled in Pennsy/vania ............................ All personal property $ (, 1 r 7,~p , c p
Ijnot domiciled in Pennsy[vania ........................ Personal property in Pennsylvania $
Ijnot domiciled in Pennsy!vania ........................ Personal property in County $
Value ojreal estate in Pennsy/vania ......................................................... $
TOTAL ESTIMATED VALUE.... $ , "z io . o
Real estate in Pennsylvania situated at:
(Attach ndditional sheen, ifnecessary.) Street addreas, Port Office and Zip Code City, Township or Borough County
[~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 _ I -I 4 -D L and Codicil(s)
thereto dated
Slate relevant circumstances (e.g. rrnanciation, death ofexecatar, eteJ
Except as follows: afterthe execution ofthe instrument(s)offered for probate Decedent did not marry, was not divorced, was notapartyto apending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), 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., pendente (ice, durance absentia, durance minoritute
If Administration, c.ta. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.
Except as Collows: Decedent was not a party to a pending divorce proceeding wherein the grounds far 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 hasPoave ascertained that Decedent left no Will and was survived by the, following spouse (if any) ant~irs (attach
additional sheeb~, ifnecessary): C>O ra
ct i
Name
Relationshi 1~ 'C .'_
Address ~~~- -t c._,
Z = N ["
f.rl
cr,
~' a
C: 7C
r
_.,
`
~ tv
o+
~'.
'.:.J
T.
ri
r~rt
Fa~m RW-0Z ,~r~. 1ni(uzntt Page 1 oft
Oath of Personal Representative
CONIMONWEALTH OF PENNSYLVANIA )
} SS:
COONTY OF
fr. f,l`~i:' V I Only
r,~r .
R~la~~;i_R .'1h''~I~~
?~1 OCT 25 AM I I ~ 26
Pz[i[ionzr(>i P: rated Vane Pz[[[icnensi Prin[ed:~ddress
M1_c.//,~ n1. u2~rLt/ IBS -I~t.c.. Pet r N A, t737a
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) ofthe Decedent, the Petitioner(s) will well and tmly administer the estate according to law.
Sworn to or affirmed and ubscribed before v~,.-. ' ~_ Dace t O -•; r / Z
me this d y of s ,e.~ , ~ ~--z- Date ~/~ T lip
BY~ c Date
t e Register - / Dale
BOND Required:~YES ~O Ta the Register of Wills:
FEES: "V Please enter my appearance by my signature below:
Lett s ...................... $
( /~ )Short Certificate(s)...... ~(~
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commissio[ ................. .
Other ~ ........
........
Automation Fee ....:.......... ~~~s~=~~
1CS Fee... .
TOTAL ......................
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Faz:
Email:
DECREE OF THE REGISTER
Estate of File No: ~ I - ' ~ ~ / ~ ~/
a/k/a:
AND NOW, _,~~~ ~ 9vla---, in cons'deration of the foregoing Petition,
satisfactory proof having een presented before me, IT IS~D"EC~REED thatLet~ers ~
are hereby granted to Ly ~qy~~(.~ Vv . r t.a -ti J
`~ ~ l-- in the above estate and (if applicable) that
the instrument(s) dated 1 tJ(e
described in the Petition be admitted [o probate and filed of record as the last Will (and Codicil(s)) ~~~~~~, \
IAI fU I ~~`~~~ttY1~Y:bfi~ ~ t'v
of
Forrn R4V-02 i~ev. lOq l/101/ ~ I ~~v r vpage
,,
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
~,~a~~l~al to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
2(142 OC7 25 AM I I ~ 25
~RPI-U~N'S UOURr
P 18 8 $ 31(~-BERLAND CO.. PA
~6
Certification Number
pe/Pane In
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filet] with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Olt~ice for permanent filing.
C~~ ,ctii'~ierbexvt~' OCh 24/2012
Local IRegistrar Date Issued
COMMONWEPLT FpENN9YLVANIA•pEPTRTMENT OF HEALTHVITAL RECORO6
H CERTIFICATE AF I]FATM
e Flle rv m
caaabt'a L¢gal rvama tFnz<. Mlam¢. LazL suHlrl z_ sea 3. soda s¢cpaN NumDerst o t. ni Daan (Mn/Darnr) (sp¢II Mo)
D
at
Wandalee Burlew Female 204-30-7373
October 22, 2012
a
ge as Irthavy IYrs) 56. Vnaar 3 Year 6. Dace °i BIrtM1 (M°/Day/Vear)19pell Men n) Irtnplaca ICIN aria Stitt or Foralgn Country)
Ta
s=
~~: r 1 m
.75 Mnnmx Dava
.Ip
mntes oct 27, 1936
,ppiIa SS 55i3~~• ry TD. arrcnplaa aoanat r..mw
aa. R¢xlggnAcc lstaa nr FnralBn coun<ro gb.1 /Sentlllla<~Clv@'-Inauaa gp<rvnq ac. aD«.a.nt uvamaTnwnsmpa
1 b tl
Y
D[r<x, aaaa¢nt nvea m
_ t,,,
ge. geam
¢nc¢ Icoun<rl
ea. aaaDJena Izle eoa.) prvo, aee.eent nvea wlmin nmma m cl<v/Dn•°
.
s In us q^maa m¢xv ar al B<atlmx a Tlmenat Dea~ M I a O wmnwe 31. survlNng spouze'x rvame Of wlie. elw na a prior Da gist ma.rLRel
o .a= Yl oonknnwn lsp of 0 lee r~0u
err
k
VO
n
nown Malvin Burlew
12. rom..x amel r Mlame.LS, are.l
v° 39. o<
M tier's rv.m. r r
a< dam.
¢IFlrst. Mmm., aq
Charles I
Wic]card
_
E_ Ruth Jones
16a. Iniorman['a Neme 14D
gel
<I
M1l
'
.
a
°na
p to O¢c¢tl¢nt 16c. Inlormen<
s Melling gatlresa IS[reet antl Numner, cIN rstete, 21p Cna¢]
Malvin Burlew h
usband 175 Hill Drive York Ha en PA 17370
s ._ ...................__._..........:..__..... ............................... .. ...._~ ~ osES.:......<... .
..........
u Daun oacn.rea b. a Hpaplml. CY"i,;panent tI1 Dean a so,.;ewti~ e~dm~:'rna~'a'il mi:....._ Zv:~iiiiv "'-._..-"y;~"oaaaem s Hom
'esci
Hnepa .-..
..
-~ ¢
Emergency Room/OUipaVent O Deatl on grHVal ~ Q( Nuraing Homa/ten -Term Care GaNIIN Other (SptrclNl
1 D. F IIN Name (II no<Ins<Itutl°n
l
e
t
t
t
b
, g
u
s
ree
an
num
er; c. Clty or Town. Sta[a, ane Elp cone SSa. CnunN of O¢atn"
Bridges at Bent Creek M
h
i
ec
an
csburg, PA 17050 Cumberland
Foa of Dlxposltion urle O Cremation 166. at Disp°sltlon S6c. Place of Olapnxltlon ( oI cemetery, crematory, or ntner place)
ban al
'°
S
to BplDnn.finn
ct 2
i
e
'€ C
SV
eC
O
6, 201 Prospect Hi
l
Cemetery
M
O
t
6tl. Loca<I°
n
oi Olzp°sltlon Iclty or T n, State, antl Zlpl
17241 w
lewvill
P 3Te r o/ Funeral C arge of Interment 176. Llcanae Number
e,
A 013144L
late gaereaa m Fnneral Famlw
1
an
~ HO££
ti-RO n
FUneral Homo & C ems 219 N h H o
E
o Ca al P 1
30. Oecetlent'x Etlucat n - ck me bar ena<bazi tlescabes <M1e 19. Oaceaen[ of Hlspanlc Oagln - Hack ene 20, ¢cetlent's Rac - Cnack E OR MOPE races <n Inalca<e wna<
nlenest aegrae nr level of scno°I cnmple<ea at the tlma °i tle
tn
n
b
a
, r t
a<
axt aeicrlbaa wneMar [tie aecaaant tn¢ tlecaaant cnnslaaretl M1lmzelf or nenelf w De.
~ a n
g
raae °r leas
a
l
Is spanlin/Hlspanlc/Latlnn. Check Me " ®w Korran
~ N a, 9en - 12tM1 grade boa I! aec¢tlent Is not Spanlsn/Hlspanl4Letina. nits ~
~Blacknrgiacangmaac
plo
an ~Vetnemeee
~H
ool gratluace °rGEO COmplecea
ree ~ N panisn/Hlspanlc/Lacln° O gmer n In nor Alaska Netlv¢ O OMer 451an
tll
0 Some c°Ilege cr¢tll[
b o de
l
u
,
g
M AS) QV erlcan CM an gmeHCan. Ehlcano ~gslen
ln]lan
~ Natlve H; wellen
O ASSOCIa[adegree le. g.
RI anal
M
Cnineae
~ B z tlagr¢¢ le. B Bs) ~ Y a, Cuban
0 Flllpin° O Guaman n nr CM1am°rrn
e
Q M egret (e.g
Mh, M5. MEng, MEe, M9W, MBgI ~ lapana¢e 0
p v .. °mer 6pemanM¢wnle/Lan^O oen °av
a
er aclflc Islana¢r
~ D <a 1¢.e" Pn¢ EaDI nx proGaszlonal aeg.ea
(s
e<IN)
p
p otn¢r Is°aclNl
DDS D 6 JD
s4
n
L
zl. D°cetlent'
51ngb Ra e
Seli
Oeslgna<lon - cn¢ck ONLY ONE t° Intllcat¢ what tn¢ tleceaen<c°nsleerea nlmsell or ne.sell [a De. 22a. Oeceaen<'z V sual Occupatlan - Intllcate type o! woxk
B
M1r
e
BI
;
oKOpaa^x¢ os eauring mos<°i working llie. DO NOT VSER
~ ° 4 0 0 OMe aPacMlc Islenaer ° ETIRED.
aa
~°
n n. glaxka n.croa O o
Banie Manager S Aasiatant
O D Kn w/Not sera
p
z nli~m
.~
~ a
a
°
°
q
a
m
na
.~
mze
O a
i~
s
zzb. mna ni auanexx/Ineazcrv
O cn
exe
O Natlve Haw.n.n
~ otn¢r 1 peclN)
O F
O 6a.manlan o. cn.mnrro
BantC
sv vigzoi+w o vnor~ooia°ees oa EO a. D a pan cad D Mo D.v YN . slgna<nx n p.a my w ¢ el =. upana. Number
Za / ~ ' ° Pwnnune
<
/ p
<eg
~~~
nn6s oggTH
e
<a
z3a. D Agn IMp/p /vn rime ni ea<n
O¢rg
/Ptlso `1697
o ~
9: yl
y zs
,
. w.x MeamalE mina. nr cprnn.r epnt.aeeT o Nn
CAUSE OF DEATH
z6. pan L Enter ma -'eNaasaz. I I¢s atlana a ~ gpp.aamata
nma -- tm.en[W ca°saa ma ee.m. Do NOTemar t.rmmal e.,¢nu dam .x [arm
i
m
s .nest
m<er„al:
rexpl.acnry arrazq pr.enn¢mar bmiaann wannne
e ee°maY. Do rv BRevlgre. Enter rip °n. n.nse °n a rme- qaa aaaRlonel Ilnes g n~cezs
i
.rv
n to oeaen
O14TE CR V SE /~(~iJ'~
t~laelsaaae nr anaalaon ~ ~~~-~ i ~ SN~trS
tie o or as a nnnsa
-
-
Nnenta p~: ;
T
rexuging In ea m)
b,
lalliv un camm~nnx. Du ~
aw.~~atl rig ° me taose = m Ina ax a oonaeRnenee nip i
~
I
tm an Im¢ a` Emar ma
V
NOERLyI«o u gpsE oua to Ina as a cnnxaeaenae nn:
tl¢
r.. eme ... ~., .~xwcmg a.
m team) Lwzr. Daa co Ina s a onna.Rnana oN:
zfi. p. rite. rimer xl¢n • t.n
bat not reaulnng In me tinter ulna =aaae groen In pare I
T
w
~
_
.
ant a
...n p.nnr a
x
_~ tvQ CdA.Q
t A,.g~ll.4`~`.°E'J CAnn'°~-('Q.c~L<7ES t ~appnnalnsx. .n.Dl¢
e
_ 0
a
was
~¢~a ana =ass a¢atba
yt
~ vas N
n Fem <Tenln past war Dle mb.an Vae cnmaba<e w De.cm _~,a~Ma
pnur m Daam
O vex p P
ae
~a®gn
°
a
kn
Wy < .al p Pn^ Icme
o Prag
ni aaam
o rvn ~ o
~ ~
~ p Not p.ea
o =cmen< p e amg m.esag.<mn
o bat wagnant wrcnm az saw ni aaam
o Nnt p•egn.nt, Dut pregnant a3 a.va w 1 vaa. beiera ae.<n Data II D smeme p eoum tint be eetmmin.a
of lnlurv lMn/Dav/rrl tspa man<n)
O Vnknawnir praenam wienln tna past year
.nma of mlurv
3
9a. Place °! Inlurv (e. g. M1°me, cnnz[ruc[IOn site, farm, scnn°D L°cetlon ° Injury (Street ana Number, ['l
[at
. N,S e, Zlp Caeel
36. Injury a work HTranapnrta[lon Injury ciN: Dezvlba How injury Occurretl:
oY pD er/o w oP
o Nn p P aaen ¢. 0 0 ~.izn.clNl
saa lcn Hal:
r
G
rclNlne pnY
am a
9.
rp cne best nr mY knnwlaage, seam p nma [a°a¢(al .na m A/K f5 E PQ f~C~'1 T) ON~'2
a
6
O mental Eram enlNb. - - Sme baa<m my knnaeese~
clog meyc s ^ o cl n e
cm ocmmm at me rime, a.~. ~.na ol.ae, ana aa. w we canxelzl. mane tea
i
a I n
erammaann, ana/nr m c aatmn, m m nplm n, a.am p=a.rea n. ana, a.<a, ana pla..na aa..e me t. Isl .na manna, a<ane
~
s nraminer~ ,. S J~Do 76'd5
N4I's¢ (fir<eQp~~
$Qoe76a
S~
!
T
.r:
-
3sb
N.ma. Aaarezx ana coat of parson completing tense o! Da.m Iltem zfil
39c. .<a slgnaa IMn/Davnrl
eel r Reelxo-ar Elppelure
~ 2. Rtr tray Flle D O.Y Yrl
aa
at~t-a%oe 71
~
w ~
~ ~$'.a
V
ao ia-
gmenamen[x
DHpnxlnpnPe.ml<Nn. c~n~t~aga XVLDO)3aI13,
LAST WILL & TESTAMENT of
Wandalee Burlew
I, Wandalee Burlew (a.k.a. Wanda Lee Burlew), Social Security No. , of
Newberry Township, York County, Pennsylvania, residing at 175 Hill Drive, York Haven, PA 17370,
declaze this to be my will, hereby revoking all prior wills and codicils made by me.
PAYMENT of DEBTS, FUNERAL EXPENSES & DEATH 'TAXES
FIRST: I direct the payment of my just debts and the expenses of my last illness and funeral as
soon as may be convenient after my death. I further direct that all inheritance, estate and other death
taxes, together with interest and penalties thereon, of whatever nature and by whatever jurisdiction
imposed shall be paid as an administrative expense of my estate.
DISTRIBUTION of PERSONAL EFFECTS /POST-DATED MEMORANDUM
SECOND: I may leave a written statement disposing of certain items of my tangible personal
property not otherwise specifically disposed of in this will. Any such statement in existence at the time
of my death, dated and signed by me, shall be determinative with respect to all items of tangible
personal property therein. If such a written statement is not found and identified by my personal
representative within sixty (60) days after Letters Testamentary (or of Administration) aze issued, it
shall be conclusively presumed that there is no such written statement, and any subsequently found
written statement shall be ignored.
DISTRIBUTION of ESTATE PROPERTY
THIRD: First, I give the following pecuniary bequest: Twenty Thousand ($20,000.00) Dollars
to my former daughter-in-law Suzanne Jane Deveney Sandoe, provided she survives me for a period
of thirty (30) days.
I give my home (located at 175 Hill Drive, York Haven, PA) and my 2002 Thunder Bird to my
beloved husband Melvin N. Burlew. I give my 2004 Chevrolet Malabu to my son Paul Lester
Sandoe, III, provided he survives me for a period of thirty (30) days.
dd "0~ aMfid38W(1~
~aroa J:n!±~-+d~o
-,.,
Wandalee Burlew
9Z ~ i! Flfr SZ la0 Zf?~~
,.- ,
_lv'.
j0 3,,,i~ ~:~; ~iSc~J3d
The rest, residue and remainder of my property (real, personal and mixed) I give, in equal
shares, to the following beneficiazies, provided they survive me for a period of thirty (30) days: (1) my
husband Melviu N. Burlew; (2) my son Paul Lester Sandce, III; (3) my granddaughter Erika N.
Sandce; and (4) my granddaughter Alissa K. Saudoe. In the event one of my above listed
beneficiaries fails to so survive me, his/her share shall lapse and the same shall be added, in equal
shares, to the shares of my other above listed beneficiaries.
My granddaughter's shares are to be held in trust for them until they turn twenty-five (25) years
of age with earlier distributions for educational purposes including but not limited to college, graduate
school or technical school. I appoint my former daughter-in-law Suzanne Jane Deveney Sandce as
trustee of any trusts for my granddaughters.
POWERS OF CO-EXECUTORS
FOURTH: In addition to and not in limitation of the powers conferred upon co-executors by
law, I authorize the exercise of the following:
(a) To hold, or to sell at public or private sale, without order of court, or to lease and
exchange, any real or personal property composing my estate and to compromise claims;
(b) To establish a trust for the benefit of any beneficiary under 25 years of age; and
(c) That my co-executors shall not be required to furnish security in ;any jurisdiction.
APPOINTMENT of CO-EXECUTORS
FIFTH: I appoint my husband Melvin N. Burlew and my son Paul Lester Sandce, III as co-
executors of my will. In the event Melvin and/or Paul fails to so survive me or is unable or unwilling
to qualify, act or serve as executor, I appoint Bill Ilgenfritz to take their place: as a co-executor of my
will.
Dated: January ~, 2006 G~/~-~~- /~tv~-"
Wandalee Burlew
Signed by Wandalee Burlew, the testatrix, as her will, in the presence of us, tvho, at her request, in her
presence, and~in the presence of each other, have signed our names as witnesses.
W<rness Address
Witness Address
I
I
i.
I
I
I ACKNOWLEDGMENT AND AFF/DAVIT
I -
I
I COMMONWEALTH of PENNSYLVANIA
COUNTY of YORK
Wandalee Burlew, the testatrix in and the undersigned witnesses to the will, the
attached or foregoing instrument, who have signed the instrument, having been
qualified according to the law depose and say:
(a) that 1, the testatrix, do hereby acknowledge that I signed the instrument as my will,
that I signed it willingly and as my free and voluntary act for the purposes therein
expressed; and
(b) that we, the witnesses, were present and saw the testatrix sign the instrument as her
last will, that she signed it willingly and executed it as her free and voluntary act
for the purposes therein expressed; that each of us 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 sound mind and under no
constraint or undue influence.
Wandalee Burlew
Witness ~ ~
C.,~ ' Y ~
Witness ~
Sworn or affirmed to, subscribed and acknowledged before me by the testatrix and the
aforememioned witnesses this 19_ day of January, 2006.
i /y ~ ~!_ ' , `
I
~ Notary Public
RICHARD R. REILLY
ATTORNEY AT LAW
(71'1) 843-5355 N9TARIAL SEAL
CORI A. SPISAK. Notary Public
Offices at the Corner of City of York. York County
Duke & King Streets ~ My Commission Exnireg May 24, 2007
56 SOUTH DUKE 5t. _.-...._._....,. _..___..
YORK PA 17401-1402 I
Fax:
(717) 845-6761