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HomeMy WebLinkAbout11-14-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CL~~-~ 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• Virginia R. Collings a/k/a: a/k/a: a/k/a: Date of Death: November 2, 2012 File No: ~ ~- ~ a - ~ ~ ~(~ (Assigned by Register) Social Security No: 2 o Y- O ~ '" 314 ~ Age at death• 93 Decedent was domiciled at death in Cumberland County, Pennsylvania (crate) with his/her last principal residence at 801 North Hanover Street, Carlisle, PA 17013, North Middleton Township Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 801 North Hanover Street, Carlisle, PA 17013, North Middleton Township Cumberland, Pennsylvania Street address, Poat Office aad Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: Ijdomiciled in Pennsylvania ............................All personal property $ 10,000.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ IJnot domiciled in Pennsylvania ........................Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ TOTAL ESTIMATED VALUE.... $ Real estate in Pennsylvania situated at: NIA (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough Couaty Q A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) helshe/they is/are the Executor(s) named in the last Will of the Decedent, dated MaY 17, 1988 and Codicil(s) thereto dated NIA State relevant circumstances (eg. renunciation, 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 born or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. O NO EXCEPTIONS O EXCEPTIONS [] B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durance absentui, durante minoritate If Administration, c.~a. or db.n.c.~a., 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. Q NO EXCEPTIONS Q 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, :f necessary): Name Relationshi Addres :_ Q ~:.> ~~~ r- ~~ ,- <; '.~ ~' - '~- :a i- - C .. ~. . ~ -~ G'7 ~ "" r-7 %~ ~--~ Ql "r ~ Form xw-oz rev. 10/11/2011 Page 1 of 2 f,`~C~' uatn of rersonal representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } } SS: } Petitioner(s) Printed Name Petitioner(s) Printed,. ~, Sue Ann Watkins ,. 9 4 424 Big Cloud Pass, Lake in the Hills, IL 60156 Peggy J. Eisenhart 5300 Bewdley Road, Richmond, VA 23226 - 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, the Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed an subscribed before ~ Date i i - / 3 -~ o r a- me this a of , ~ ~ Date r ~ - ~ 3 - a O!-Z By: Date For Register Date BOND Required: Q YES (~NO FEES: Letters ...................... $ ( ~ )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other (~.1{ l ~~ To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: ~~ Printed Name: Robert G. Frey Supreme Court ID Number: 46397 Firm Name: Frey & Tiley Address: 5 South Hanover Street Carlisle, PA 17013 Automation Fee .............. . JCS Fee ..................... TOTAL ..................... Phone: Fax: Email: vu,~,a, ~~~ vu,y i ~,.,/ -~1>L VI L".j(" ~ ~;~ ~ 717-243-5838 717-243-6441 rfrey@freytiley.com DECREE OF THE REGISTER Estate of Virginia R. Collings File No: ~ ~ " (2- (l ~{, (,~~ a/k/a: AND NOR', ND~iM~~.PrY ~ ~ Zt) ~ 2 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Sue Ann Watkins and Peggy J. Eisenhart in the above estate and (if applicable) that the instrument(s) dated ~'7 ~ / 7 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Form RW-02 rev. 10/11/2011 Register of Wills _ ~r 2 of 2 H)os.sos r(rv 19ni> ~ ~,~C~~RAR'S CERTIFICATION OF DEATH I F'~~ Jt~~~>~I~al to duplicate this copy by photostat or photograph. ._~., 'r ._. ,. .. L.r Fee for this certificate, $6.O~`~ii1~ ~~~ ~ 4 ~~ ~~' ~~ This is to certify that the. information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital 0?if~l-i.~v ~ "`;! ~~, ~ Records Office for permanent filing. B~t~t~~hD CCU.. PA -~ P 18 8 8 3 31~~ - ~-~~~~.~~`~ Nov 2 2oi2 Certification Number Local Registrar Date Issued Type/Print In COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS Perm.nent CERTIFICATE OF DEATH State File Number. B y~{ Z V~ r v y 7 lack In k 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. D/~s/}t/yy~o°f. D/eath (MO/Day/Yr) (Spell Mo) L°/Yf~J~~ 3161 U /V </l~ Vir inia R_ Cullin s F 204 03 Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Year) (Spell Month) 7a. Birthplace (City and State or Forclgn Country) Harrisbur , PA ~1 93 Mpntha Daya Hours Mlnutea Septanber 4. 1919 7b. Blrthplsca (County) D$u hs.n ga. Realdence (Store or Foreign Country) Bb. Residence (Street and Number -Include Apt No.) Bc. Old Decedent Vve In a Townshi 7 N ~h Middleton pA Hanover St 801 N or [wp. J~Yes, decedent Ilved In Bd. Residence (county) G~m)l~erland _ _ 8e. Realdence (Zip Code) QNO, decedent Ilved within limits of city/boro. 9. Ever In US Armed Forees7 10. Mar ital Status at Tlme of DeKh Q Married idowed 11. SurvWing Spouse's Name (If wHe, gNe name prior To first marriage) Q Yes ~ No Q Unknown Q Dl voreed Q Never Married Q Unknow Father's Name (First, Middle, Last, Suffix) 12 13. Mo[her's Name Prior to Fint Marriage (Pint, Middle, Last) ' . Charles H_ Dotter Failor Ethel B_ 14a. Informant's Name 14b. Relationship to Decedent 14C. InformPnt's Iing A d s (S et and N bar City,~jtte, 21p_CpdeJ 2L L~Yle 171116 Lake to ~ ~ ~ t~i B ~G'1 , . , ouc a ig Sue Ann Watlc i.ns Daughter 424 eat ec on one _ ................ ..................................... ...va..........................__._ .,............~:....a..tt.............................Y....... .........._................... th Occurred in a Hospital: ~ In Lien[ ~ )If Death Occurred Somewhere Other Than a Hospital: ~ Hospice Facility ~ Decedent's Home If D 8 ea Emergency Room/Outpatient Desd on Arrival Nursing Home/LOn -Term Gfe Fadlify Other (Specify) t yy 15b yyllty Name (If not Inss~s~tl ,glue tree[ and number, ~ltir,~v~G( ~!- oo~ lSc. City q ,~ wn, State apd ZI Code iSd. Co my of Dea h ~p /f S~C O [.~- 6+-4r 16a. Method of Disposition Q Burial Cremation 16b. Date of Disposition 16c. P ce of Disposition (Name of cemetery, crematory, or other place) Q Removal from State Q Donation other(sp.afy) 11/3/2012 Evans Cranation SErV1CES 16d. Location of Disposition (Clry or Town, State, end Zip) 17a. Signature W u al Service Licens n harge o`Interment 17b. License Numbs, FD 012633 L Leo1a, PA 17e. Name and Complete Address f Funeral F 111 PA 1 701 3 Carlisle H ver St 0 S ef ~ ~" , . ano . Ic(a1a r =nc _ 63 unera Ewin Brothers ~ 19. Decadent'a Education -Check the box that best describes the 19. Decadent W Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indleate what ~- highest degree or level of school completed at fhe time of death. box the[ beat dezMbes Whether the decedent the decedent considered himself or herself to be. Q 8th grads or less Is Spanish/Hispani4Latino. Check the "NO" B"Dyhite Q Korean If decedent Is not Spanish/Hlspanic/Latino. Q Black or African American Q Vietnamese ox Q No diploma, 9th - 12th grade b ~ ~ J~}f igh school graduate or GED completed sO rvo, not Spanish/Hlspanic/laHno Q American Indian or Alaska NaHVe Q Other Asian Q Soma college credit, but no degree Q Yea, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian Q Assoelete degree (e.g. AA, AS) Q yes, Pue KO Rican Q Chinese Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) ~ Yes, Cuban Q Filipino Q Samoan Q Mesta is degree (e.g. MA, MS. MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) Q Other (Specify) MD DDS DVM LLB JD 21. Dec~ant's Single Race Self-Designation -Check ONLY ONE to Indicate what the decedent wnsidered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work [~"Oyhlte Q Japanese Q Samoan done during most of working Iih. DO NOT VSE RETIRED. Q Blaek or African American Q Korean Q Other Psclflc Islander ~-rp~prgBS r Flcywers Q American Indian or Alaska Natlve Q Vletnsmeae ~ Don't Know/Not Sure Q Asian Indian Q Other Asian Q Refused 22b. Kind o1 Business/Industry Q Chinese Q Natlve Hawaiian Q Other (Specify) Q Filipino Q Guamanian or Chamorro Floral Des1 er on Pronouncing Oeat On when app Ica a 23c. Icense Num er Mo Dey r Signature ounc gE COMPLETED 2 a. Date Pr ~~ ~ ~ ~ gY -ERSON WHO PRONOUNCES OR ~~ f~ U/L!/ia's• / CERTIFIES DEATH ~~~ ~~~L of Dea ..f 23d. Date SI nod ( o/Day/Yr) 24. TI ' ~ ~ ~Y ~ Y/ 25. Was Medical Examiner or Coroner Contactsdi O Yes -No - U CAUSE OF DEATH ' Approximate 26. Part 1. Enter the chain of events--dlsesses, injuries, or compllcatlons-that directly causal the death. DO NOT enter terrnlnsl events such as cardiac arrest, 1 Interval: D h j Onset to eat T ABBREVIATE. Enter only one cause on s Ilne. Add additional Ilnez if necessary NO respiratory arrest, or ventricular flbrlllatlon without showing the etiology. DO ` - IMMEDIATE CAUSE ----------> G~rri tR.i ~~ -'~ ham' ~ ~y ( ~-SZ ~ Due to (or as a equence f): (Final disease or condition resulting In death) [ b. Sequentially list condttlons, Due to (or as a consequence of): e If any, IeadMg to the cause 1 listed on line a. Enter the ) V NDERLYING CAUSE Due to (or as a consequence of): (disease or Injury that Initiated the events rcsultlne d~ as • con in death) LAST. Due to (or sequence of): 26. Part 11. Enter other 1 Ifl t ditl t ib H t d th but not resulting In the underlying caux given In Part 1 27. Was an autopsy performed? Yes ~ 2B. Were autopsy findings available ~-. to complete the Ouse of death? Ves No 29. If Female: 30. Did Tobacco Us Contribute to Deaths 31. Mannar of Death Q Not pregnant within past year Q Yes Q Probably ~^IOatllral Q Homicide Q Prognant at Hme of death Q No ,~fJnknown Q Accident Q Pending Imestigatlon ,$' Not pregnant, but pregnant within 42 days of dean Q Suicide Q Could not be determined r. Q Not pregnant, buT pregnant 43 days to 1 year before deatF 32. Dale of Injury (MO/Day/Yr) (Spell Month) Q Unknown if prognant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construcflon site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If TransportaHOn Injury, Specify: 3B. Describe How Injury Occurred: Q Yes ~ Driver/Operator Q Pedestrian Q No Q Passenger ~ Other (Specl/y) 39a rtifler (Check only one): Certifying physician - To the best of my knowledge, death occurred due to the cause(s) end manner stated Q Pronouncing Sa Certifying physl - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated n occurred at the time, date, and place, and due to the cause(s) and manner zUted h basis of exsminatlon, and/or Investlgetlon, In my opinion, deat Q Medical Examiner/Coroner - O y ~ Signature o7 ceKifler: Title of certifier. //- U. License Number: 00(n ~"/S - L 39 Nsme, Address and~(p Cod ors Completing Cause of Death (Item 26) ~R~' L C~ 4 r !v/~ O_ $~~~ /~.S~r TT>• -Sj ~A.t~ s/.. ~iq X70/.:f 39c. Date Signed (MO/Dey/Vr) 1 1 / =.J • Z~ 40. Reg stray s District Num er 1. Reglatror ature ~1 2. fiIsLrer FI a Date Mo Day r a l- Z\o ~- Nod , a ,do\a-- 43. Amendments Disposition Permit No. ~1 l \lt ~ 1~ - H105-143 REV 07/2011 LAST WILL AND TESTAMENT OF VIRGINIA R. CULLINGS I, VIRGINIA R. CULLINGS, widow, of 841 North West Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executrices to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral services be conducted by Ewing Brothers Funeral Home, 630 South Hanover Street, Carlisle, Pennsylvania, in a manner substantially similar to the arrangements which I made for the services for my husband, Richard Cullings, and that my body be interred beside his on our burial lot located in Westminster Memorial Gardens in North Middleton Township, Cumberland County, Pennsylvania. 2. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I• give, devise and bequeath in equal shares to my two daughters, their heirs and assigns, provided each of them shall survive me by a period of thirty (30) days, but should either of them fail to so survive me, then the share such deceased daughter of mine would have received shall pass to such of her issue as shall survive me by a period of thirty (30) days, per stirpes, and, if there be no such issue, the same shall lapse and be added to the share of my other daughter. My two daughters are Sue Ann Watkins and Peggy J. Eisenhart. 3. I hereby nominate, constitute and appoint my said two daughters, Sue Ann Watkins and Peggy J. Eisenhart, or either of them, as Co-Executrices of this my Last Will and Testament, and I further direct that neither of them, shall be required to post any bond to secure the faithful performance of her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) pages, this 17th day of May , 1988. `~~ ~ ~ t • ( SEAL ) Vi inia R. Cullin Signed, sealed, published and declared by Virginia R. Cullings, the Testatrix above-named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. `~~~ "1i /~it. ~7 v a `~5 ~, ~- . v ~ © ~O _ . ~v Page 1 of 1 page u ! t_ '~ ~ r~ ~_.~ :: ~;~ r7 •'> > -'-'~-~ d ~ ~ ~T~' ~ OV G:~ C'~*~ ,~...i ew'= } ~~ ~+ h.J OATH OF SUBSCRIBING WITNESSES ~ - ~ ~ ~ `_~~ i . 1 _. '_ fc ~ .r' t 7~_,. . REGISTER OF WILLS ~'; _ ~ ~; _t, ' _ CUMBERLAND COUNTY PENNSYLVANIA ©`a- . ;''"=~ '= -- , __ ~' ~ u ~ ~ ' -c~ y p cn c~ e Estate of Virginia R. Cullings Deceased Robert M. Frey , (each) a subscribing witness to (PrintName/s) the ~ Will Q Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence of each other. ~- ~ (Signature) 5 South Hanover Street (Street Address) (Signature) (Street Address) Carlisle, PA 17013 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ day of ~•4~ ~"i`z Deputy for Register of Wills (City, State, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~ ~ ~ day of I'V ~~ t w.b.~!' 2 e l 2 /~~~.~_ Notary Public U My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. 10.13.06 oo~oNw~xn+cR~sn NOTARIAL SFX AOeERT 6. PREY, Nory/~Ywt ~aa~Ca ~ ~M OATH OF NON-SUBSCRIBING WITNESS(ES) RE~ISTER OF WILLS Ccs,,...~-~''` ~--~ COUNTY, PENNSYLVANIA Estate of ~~v~ ti~l~ 12 - I~Gt~ `~. Ot V Deceased and (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with 'l~~.c' ~ 5 ~ ~- and am/are familiar with the handwriting and signat e of the decedent, and that the signature of Vl/`.s~' ~, ~ . ~e ~ s'-~ to the foregoing instrument purporting to be the Last Will and Testament/Codicil of i (` i ~~. ~. Cv t~i ^ 5 is in his/her own proper handwriting. gnature) (Street Address) c ~s <<S~~ e~ ~~o ~3 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , _~~. Deputy for Register of Wills (Signature) (Street Address) (City, State, Zip) ^ ~ J e...l .. ~o ti : ,. ~ c~ r e~ c~ ~: ~ ~~ ~- ~_ ~ _ ,- _ , t., ~ ;w. ~~ ~~ ~ ~ ,_~ _5 i. ~ ._ - -+ ;-- r-a c~ ~ - - cn , , Form RW-04 rev. !0.!3.06 OATH OF NON-SUBSCRIBING WITNESS(ES) ff REGI TER OF WILLS ~l,,nr~,b tzf``c,~n~ COUNTY, PENNSYLVANIA u~ l ~ ~ - I 1 - I `/~ Estate of 1/ ~ f G t n ~ ~ ~` C ~ t, ( ~ c~ S ,Deceased -~S' ~ G• . ~~C ~ ti and (each) being duly qualified according fo law, depose(s) and say(s) that s~,~ke /they ws~s /were well- acquainted with ~J` ~ • ~`n 5~-~- and am/are familiar with the handwriting and signat re of the decedent, and that the signature of 1~~, r~ '~ • G-c r\ g ~-e~ to the foregoing instrument purporting to be the Last Will and Testament/Codicil of V ~ r ~ ~ ~ °~ ~ 5 is in his/her own proper handwriting. /~,k ~~ (Signature) (Street Address) ry (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before e this ~~ day of , a~J~' D t for Register of Vl'ills (Signature) (Street Address) (City. State, Zip) n ,y ~~ r~ -n c - t,-, c ~ r'f'f'-" ~' ~-. _C~ x x , .- = ,:~ ~" ~ -- , -- ;,~ ~, ~~_ ` ~ ,~ - sa ~ ' ° _ ~, ~ - A ~ ~ ~ ~~ C Lr~ Form RW-04 rev. !213.06