HomeMy WebLinkAbout11-08-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF C'~LtINRI~2L.I~aifl COUNTY, PENNSYLVANIA
Petitioner(s) named below. who is/aze 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 1
Name: ~f fl24nf(' (~ L4mAfL Csllw
a/k/a:
a/k/a:
a/k/a:
Date of Death: I o -'~q - 2 e I ']._
Decedent was domiciled at death in r~1216~~ County,
principal residence at
Decedent died at
Street address, Post Office and Zip Code
Street address, Post Omce and Zip Code
File No: GX ~~ ~.~ - ~~ / /
(Assi€;ned by Register)
Social Security No: Z O(o - Z~- 3S~S
Age at death: _ ~ (,
City, Township or Ilorough
Township or Borough
(Score) with his/her last
County State
Estimate of value of decedent's property at death:
Ijdomicded in Pennsylvania ............................ All personal property $ J 000 ~`
Ifnot domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $
If not domiciled in Pennsylvonia ........................ Personal property in County $ ~
Value of real estate in Pennsylvania ......................................................... $ S 0 0 t)-'
TOTAL EST/IlMATED VALUE.... $ 2
Real estate in Pennsylvania situated at: 4~ 0 ~ C (~"STatA~ ~{t!~ `~~lsn'zQ ~} I ~ ~ ` N rvz (.'S t~sA+J
(AS(och addi(iono/sheets, i('necessary.J Street address, Past Office and Zip Code City, Township ar 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 v a3 Zoo and Codicil(s)
thereto dated
County
State relevant circumslance¢ (eg. renancia(ion, death afexecu(or, eht)
Except as follows: after the execution of the instmment(s) otTered for probate Decedent did not marry, was not divorced, was not a patty to spending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § :f323(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.6.n., d.b.n.a[.a., pendente iite, durunte absentia, duran[e mirtaritute
If Administration, c.ta. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.
Ezcept as follows: Decedent was not a parry 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 ps:rson. ,.~,
^NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), after a proper search hasrltave ascertained that Decedent left no W ill and was survived by the following
additional sheeh~, ijnecessaryJ:
7~
T
n andh~ offs
Y) ~( ~<7
.s[ ~ ^ r
I r i ~°i
Name Relationshi Address ~"_-~
C7U 7c~ _
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Form RW-02 ,~e~. fniurzorr Page 1 of 2
Oath of Personal Representative
CONINONWEALTH OF PENNSYLVANIA }
} SS:
COCNTY OF
Official L'sc Only
Petitioner(s) Pnnted Vane Par, [ionegsl Printzd Address
~GL I-. 32 Q vls 9(~t~ L 2GJ~.J D
The Petitioner(s) above-named swear(s) or aRirm(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 tmly administer the estate according to law.
Sworn to affirmed an ubscribed before .~7 ~""~-~ Date (/- S- ~+ c' i Z
me t da of ~~ ~~ Daze
By: ~~.i ~°titii _._ Dace
For the Register
BOND Required:~YES QNO
FEES: JJ~~ /~/~
Letters ...................... $ L~• 6'l-'
( ~C )Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond .... ....... ... .......
Commission ................. .
Other ......
~~il~ ...
Date
Automation Fee ............... r
ICS Fee ..................... ~3..~
TOTAL ..................... $ ) 7.3. S[?
Ta the Register aj Wills:
Please enter my appearance by my si¢nature below:
Attorney Signature:
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Printed Name: - y ~t
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Supreme Court n = -=
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ID Number: ~ ~',' ~ C. G
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Firm Name: ~
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estateof_ t'~())'p('~~ ~( f(Y1~.1" C~LLf~h File No: e~~ ` ~02~ ~~ / 7
a/k/a:
AND NOW, f 1 ~h l U ~ ~/'~'/n~ r (j/ oL , in consider tion of the oregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters ~~
are hereby granted to ~CP I ~ ~~} }Q(~
_ ~ m~the above estate and (if applicable) that
the instrument(s) dated ~ 2 2(
described iu the Petition be dmitted to probate
Fo~,~~nw-nz rev.tNnrznii
of record as the last Will (and Codicil(s)) of Decedent.
~~
Register of Wills j~~ ~,~ i ~i ~l
Q , Page 2 of 2
~~
r .. 'U I ~ nC, - I' I
LOCAtF,~~ST 'S CERTIFICATION C)F DEAI' ~I
WAFtNI / •ts I~ plicate this copy by photostat or photograph.
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Y~C~ k ~ ~ i, g '^ li..w
Far !iu thi Crrti l~ic:)!e. S6.OU
P 18801786
Cl tufiration ~un(n,:r
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OCCOber 29a 2012
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. Amenamen<z
Olzposl<lon perml<NO. O 1 S ~J 2Z REV OT/3DI1
Last Will and Testament of
I, Clarence Lamar Chubb
whose address is 4601 Chestnut Avenue, Camp Hill, PA 17011
declaze that this is my Last Will and Testament and I revoke all previous wills.
I am not currently married.
I have four child(ren) living, whose vital information is as follows:
Name Address Date ojBiAh
Lee Ann Trayer Marysville, PA 6-20-60
Kelly Lynn Hoon New Cumberland, PA 3-29-62
Clarence Lamar Chubb Etters, PA 1-20-63
Kristen Kay Pool Mechanicsburg, PA 3-22-~
I have grandchild(ren) living, whose vital information is as follows:
Nacre Address Date ojBirth
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T'i ;'n
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CA "U 4 Cr.iC
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Page ~ of _S pages Testator's initials
I make the following specific gifts:
To my son, Clarence Lamar Chubb I leave all my tools
To my daughter, LeeAnn Trayer, I leave the blue kitchen table
To my daughter, Kristen Kay Pool, I leave the wall clock in the living room
To my daughter, Kelly Lynn Hoon I leave the remainder of my real and personal
property.
Kelly Lynn Hoon will distribute any additional personal items according to my wishes.
Page ~~ of ~ pages Testator's initials
I give all the rest of my property, whether real or personal, wherever located,
to Kelly Lynn Hoon
my Daughter
or if not surviving, to
my
All beneficiaries named in this will must survive me by thirty (30) days to receive any gift
under this will If any beneficiary and I should die simultaneously, I shall be conclusively
presumed to have survived that beneficiary for purposes of this will.
I appoint Kelly Lynn Hoon
mY Daughter ',
of New Cumberland, PA
as Executor, to erve without bond. If not surviving or otherwise unat~le to serve,
I appoint
my
of
as Altemate Ex~cutor, also to serve without bond. In addition to any powers, authority, and
discretion granted by law, I grant such Executor or Alternate Executor any and all powers to
perform any acts, in his or her sole discretion and without court approval, for the management
and distribution; of my estate, including independent administration of my estate.
[TII$ REST OF THIS PAGE IS LEFT INTENTIONALLY BLANK]
Page 3 of ~ pages Testator's initials
I publish and sign this Last Wil] and Testament, consisting of `!j typewritten
pages, on ~~- ~3 - ~`I ,and declaze that I do so freely, for the
purposes expressed, under no constraint or undue influence, and that I am of sound mind
and of legal age.
",
~gnature of Testator
~,,` "'
Printed Name of Testator
We, the undersigned, being first sworn on oath and under penalty of perjury, state that
On r~ ( ~ ~3~.~ ~O ~ , in the presence of all of us, the above-named
Testator publisHed and signed this Last Will and Testament, and them at Testator's request,
and in Testator'' presence, and in each other's presence, we all signed below as witnesses,
and we declaze }hat, to the best of our knowledge, the Testator signed this instrument freely,
under no constraint or undue influence, and is of sound mind and leg~d aga'
Signatute of\ 'mess
X ARC/ ~, ~z~'~~~5
Printed Na e df~W/,fitness
~C 1r~60,2 if'!i_ ~G~Ji?~~3"~~
Address of Withess
Signature of Witness
Printed Name of Witness
Address of Witness
Signature ofVl~tness
Printed Name df Witness
Address of Withess
Page`f of ~ pages Testator's initials
Notary Acknowledgment
State of ~'C~ A'~e'~t ~i~ An i n
Coun of ~ ~~.~Ci o ,r 1 rx ~~ r~
_ ~
On ~s~ ~ ~~ l C~ the
testator, a d -- ,
and Y ,the witnesses, personally came before me and,
being duly sw ' ,did state th t they are the persons described in the above document and that
they signed the gbove document in my presence as a free and voluntary act for the purposes
stated.
"7 i ~ ~~
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Notary Public, ~n and for the County
State of
My commission expires:
Seal
Pages of ~ pages
Testator's initials
r,:,
;=,
OATH OF SUBSCRIBING WITNESS(ES) ~
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REGIy~TER OF WILLS ~ x= __ ~
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C v +}- h c r J °- rJ COUNTY, PENNSYLVANIA. ~
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Estate of ~- (`- ~~`` c °~ ~ P ~" c_ rv. ~- a- L 1-, „~ ~ ,Deceased
{~ c ~p talc c ~~ s~ -~ rv~>> ~-~ ~)^ , (each) a subscribing witness to
' (Print Names)
the, Will ^ CodicilO presented herewith, (each) being duly qualified according to law, depose(s) and
they was were present and saw the abov Testate/ Testatrix sign the sam
at
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h
h e
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~y signed the same and that gh he /they signed as a witness at the request of
he
th
she
and that
th~Testa Testat six i her / is presence and in the presence of each other.
(Signa(ure) (Signature)
l
i (Street Address)
(Street Address)
~
~
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L/
/1 /h F~ ~
DU+ 1
t (City, Stare, Zip) ~, (Ciry, Smte, Zip)
Executed in Register' Office
Swom to or affirmed aid subscribed
before me this ~_ day
of ,
Executed out of Register's Offzce
Sworn to or affirmed and subscribed
before me this _ day
of
Deputy for Register o ,Wills Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date rit expiration of Notary's Commission.)
NOTE: To be taken by OfficeY 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 ~~'
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
No. 21- (a~~~ 17
Estate of C ~ ~- r c n (~ {. c, rn ~--~ c h~b_, Deceased
UNAVAILABLE WITNESS AFFIDAVIT
I ~ e 1 1 - ~, d r being duly sworn according to law, depose and say
that I, the At~orney ^ Personal Representative in the above referenced ]Estate, declare that
m ~.; ., i t~ .~
and
-~
vrhose signatur'~(s) appears as subscribing witness(es) to the ~ Will or C] Codicil of the above
Testator is/are pot readily available to prove the signature to the Testator by reason of
I ~ -moo
~ r- < ;
Sworn to or a
' nne and subscribed
of
~~ da -
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Signatur f Counsel/Personal Repratve o
'~ ~ ; z~
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s
I3ef re me th y T~ ~ ~
-s ~~:.1
Y , 2~~ r-~, ~ _ -
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Deputy for Re ister ills ~ W
.r
(Must sign inRegis4ef's Office)
', OATH OF NON-SUBSCRIBING WITNESS 1,,
G, ~ e ~ 7 ~ `-- ~, ~° (- and 1'\e-be~C C(3~. C~ U V
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
he i~is/thgy are familiar with the signature of the abo Testat of the ,~ Wil] or 0 Codicil
presented her with and that h /she hey elieve s e signature on the~(Will or ^ Codicil is in
the handwriting of the above Testator to the best of h' he their knowledge and belief.
Sworn to or Ilffinne an subscnbed
Before me th s _~_ day of
1f ~ , 20 ~~
~ ~ ~t~-
( ~~~f ~ ~,
Deputy for egister ills
(Must sign ih Register's Office)