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PETITION' FOR GRAN" OF L~TT~RS
REGISTER OF' WILLS OF ~ ~ l~ r~ ~~ L- ~~ ~~ _ COL~N'TY, PENNSYLVANIA
Petitioner(s) named below, who is~lare l8 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: `3 F} n! r2 A ~. • ~'
(Assigned by Register)
rr--~ ~ J.
a~k~`a:
a/kla: 5ocia15ecnrity~ No• ~U~ 4`jC% '~~~
Date of Death: :~ !Q~/li ~ r~2Y ~ ~ ~ ~~' ~~ Age at death:
Decedent was domiciled at death in C a n1 i3 f;r2 ~ ~.,~ ~ County, ~~~-~ (Stare)rwith his/her last
principal residence at ~ ~~ ~ .1 )Ch//=~/,~.'~ ~ ~~ jyr~-~ V`r~t~-~ ~~ c.~ rn~f~~-A-~~ -~
Sweet address, Pest Office and Zip Code City, Township er Boroc~h County
~~
Decedent died at ~~ ~ ~~~ l -F f} 1.t~1 C I y ~ ~ ~ y ~-~..~ t...~ ~ M ~~i"'~~/l~ j~
Street address', Post Office and Zip Code City, Tess-nshzp OF 8erongh County Stale
EstiB~ate of value of decedenY"s property at death:
If domict7ed in Pentrsplcmria-- -- - - - - - - - - - - - - - - - - - -- - --- - ~ Pe~~ ProPe~y
If ~sa~ domics7ed in Penns~lr~sia . ... . ... . . . . . ... . .. . . . . .Personal property m Penns}~aaia
If Rot douric~7ed in Pennsyl~ia_ _ __ _ _ _ _ _ _ _ _ _ • - - - - - - - - - .Personal property in County
YalueofrealestaCeinPenaaylrania--------------------•--------.._.._..-------------------- ~ .
TOT~I. E'STIl1~iATID VALiIE_ . _ . $ :G ~, ~`CU 0.00
Real estate in Pennsylvania situated at
attach ~ditional sheets; iJ'necessa~~
Street address, Post Office and Zap Code Cry, Township or Beroni~ C~15'
~~'~A. Petition for Probate and Grant of Letters Testamentary _
Petitioner(s) aver(s) hefshe~they is~are the Execmor(s) Barred in the last Rill of the Decedent, dated ~ t ~1~ ~ L • 2 ~ , L ~ ~ anti Codicil(s)
thereto dated
State rei~aat ciren~stances (Gg. rea~cistio~r, de~e of executor, eiG)
Except as follows: after the ezecation ofthe instrum~t(s) offered for probate Decedent did not marry, was not divorced, was not a party to a pending
divorce proceeding whereiB the ~onnds for divorce had been established as defined in 23 Pa_ C.S. § 33230.), and did not have a child bom or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person_
® NO E~CEPTTONS Q ERCEP'TI0~1TS
B. Petition for Grant of Letters of Administration (If applicable)
c_t_a, db.n_, db_n.c_La, penden#e liter darrante absentia durante minorzfate
If Administration, GL~ or db.t~ctr~, enter date of WiII in Section A above and complete list of heirs.
1=orm x~-oa rev 1(t 712011 Page 1 of 2
Except as follows: Deeederri. was not a party to a pending divorce proceeding wherein the g<oands for divorce had been established as defined
m 23 Pa. C.S. ~ 33230) and was neither the victim of a ladling nor ever adjudicated an incapacitated person_ , ._
Q NO RXC,EPTIONS Q >/XCEPTIONS _
Petitioner(s), after apropersearch has/have ascertained that Decedent left no will and was survived by the follon use (if~p) an~~~aitach
~a'
additional sheets, if necessar}}: ,~,~ _ ,_ _
Oath of Personal Representative
C011~IMOiEALTH OF PE~N[N`SYLVANIA }
} SS.
CO[JNTY OF
Official L'!se Only
.V ,. .,.
Petitioner(s) Ptim~ed Name Petitioner(s) Printed A ` ~ . _.
'0-~,J ~ ~A~2 ~, I-4-~2cn;~ ~ i ~ ~~ ,~w ~ .. /
,--c~~i J~1 ~~/i~upr~ l~ ,~ JU£~v~'~ ~= `~`t~ _ _ / 7~~~~I
..
,r- t h ~
` C,.-7
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h.__.. .,
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The Petitioner(s) abo~fie-named swear(s) or affirm(s) the statements in the fore~oiug Petition are trae and coact to the beslG;,g!f~e know I2~~ and belief
of Petitioner(s) and that, as Personal Repr"sentative(s) of the Decedent, the Petitioner(s) will well and traly administer the estate asxordin~ to law_
Sworn to r aDinned d subscnbed before ~cG~-t. e-~~-'l- ~e /~ ~ " ~ 3
me - ~~'day of ~I.~ t~+~c~- Q.~,~f'~ .. ~~~.- Date / ~ ~l'' /~3
~- Date
T RPgL4tel'
I30~D Required: Q YES Q NO
FEES:
Letters --------------------
( Short Certificate(s). _ - - _ _
( ) Renunciation(s)_.. _ _ _ . _ .
( )Codicil(s) . . .. . . .. . .. . .
( )Affidavit(s)...... _ - - . _ _
Bond ........................
Commission_ _________________
O,,th~~e~~r -------
._Ld.1! .. . _ .
Q ~ ' B/I f'y----
Automation Fee . .. . .. . .. . .. . . .
JC~SFee- --------------------
TO~AI,.._ ..................
$ ~~ ' x
-- ~~ ~,
~~~,
G~ . 1^ ~.
j-C c'
3-:~ a
$ -•9=99"
~ ~ ~~ ~ ~
Ta the Register of Wills:
Please enter my appearance by n;y signature below:
Attorney Si~ature:
Printed Dame:
Snpreffie Conrt
ID 1V'umber:
Firm ~ame_
Address.
Phone:
Fax:
Ema~l_
D~CR~E OF' THR REGISTER
r Cj
Estate of ~Q, / ,/~- Fie ~To: 2: ~ ' ~.~ ' d / L~ /
a/k/a:
A1~PD NOW, ~~~, inconsideration of the foregoing Petition.,
satisfactory proof having been present d efore me, IT I3 DE D that Letters ~ ~G! /YK' - I"
are hereby granted to ~ i
Nf /11" y ,Q ~ n ~, _, n ~ ~~ in the above estate and (if applicable) that
the instrument(s) dated ~ ~--
descn-bed in the Petition be admitted o probate and
ForaiRi~-02 rev IOllh°?Dll
of record a last W- (and Codicil(s)) Decedent_
~ ~
Register of Wills
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Type/Print In COMMONWEALTH OF PEN NSVLVANIA DEPARTMENT OF HEALTH • VITAL RECORDS
Permanent C'FRTIGIif"ATG if"1C ~IGATLJ
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1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Numbe rJ` Y4„Date of Death (Mo/Day/V r) (Spell Mo)
Sandra Lee Chronister emale 180-50-7995 January 18, 2013
Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Day 6. Date of Birth (Mo/D ay/Year) (Spel l Month) 7a. Birthplace (City and S tate or Foreign Country)
~` "]rj Months Days Hours Minutes NOV 24 ~ 1937 Car'1-181@ i PA
7b. Birthplace (County)
8a. Residence (State or Foreign Country) 86. Residence (Street and Number -Include Apt No.) Sc. Did Decedent Live in a Township?
Penns lvania 699 Mohawk Rd _ ~IYes
decedent lived in TT
F
kf
~
8d. Residence (County) ,
~~er
ran
orr
twP~
Cumberland 8e. Residence (Zip Code) Q No, decedent lived within limits of city/bo ro.
9. Ever in US Armed Forces? 10. Marital Status at Time of Death ~] Married Q Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage)
Q Yes ~ No Q Unknown Q Divorced Q Never Married Q Unknown John Clair Chron~.ster
12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last)
Harry Miller Elizabeth Cornman
14a. Informant's Name 14 b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Codej
o John Clair Chronister husband 699 Mohawk Rd_, Newville, PA 17241
~i ..........................................................
......-
....................•----........-.. 15 a. Place o Death (Check onl one
.
Y
----...................-----•---........-------
~
0 P
If Death Occurred in a Hos ital:
p~ In anent .
....
:
...-•-----...........-............-...0...........-.....-.........-----......~
-"'--'--•--•••••••••-•--•-•••••----•~
:If Death Occurred Somewhere Other Than a Hospital: Hospice Facility Decedent's Home
Q Emergency Room/Outpatient Q Dead on Arrival Nursin Home Lon
Q g / g-Term Care Facility Q Other (Specify)
•
z 15b. Facilit Name (If not institution, give street and number;
599 Moh
k R
d i5c. Cit or Tow State, and Zip Co a lSd. County of Death
y
~
1
aw
oa N
ewvi
le, PA
7241 Cumberland
m 16a. Method of Disposition Burial Q Cremation 166. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place)
~ Removal from State Q Donation
Jan 22, 201
Westminster Memorial Gardens
_
- Q Other (Specify)
16d. Location of Disposition (City or Town, State, and Zip) 17a. ature of Funeral Service Licensee or Person in Charge of Interment 176. License Number
- Carlisle, PA 17013 013144E
E 17c. Name and Complete Address of Funeral Facility
Ho££man-Roth Funeral Home & Cremato 219 North Hanover Streit, Carlisle, PA 17013
18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to indicate what
~ highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be.
8th grade or less
No di
loma
9th - 12th
d is Spanish/Hispanic/Latino. Check the "NO" gJ White Q Korean
p
,
gra
e
Q High school graduate or GED completed box if decedent is not Spanish/Hispanic/Latino.
® No, not Spanish/Hispanic/Latino Q Black or African American Q Vietnamese
Q American fndian or Alaska Native Q Other Asian
Some college credit, but no degree ~ Ves, Mexican, Mexican American, Chicano ~ Asian Indian Q Native Hawaiian
Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese ~ Guamanian or Chamorro
0 Bachelor's degree (e.g. BA, AB, BS) Q Ves, Cuban Q Filipino 0 Samoan
Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispanic/Latino Q Japanese Q Other Pacific Islander
Q Doctorate (e. g. PhD, EdD) or Professional degree (Specify) Q Other (Specify)
(e. MD, DDS, DVM, LLB, JD)
21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work
[~ White Q Japanese Q Samoan done during most of working life. DO NOT USE RETIRED
Q Black or African American 0 Korean Q Other Pacific Islander .
Q American Indian or Alaska Native Q Vietnamese )~ Don't Know/Not Sure Laborer
~ Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry
Q Chinese Q Native Hawaiian Q Other (Specify) Electric CO _
Q Filipino Q Guamanian or Chamorro
ITEMS 23a - 23d MUST BE COMPLETED 23a. Date ronou ed Dead (Mo/Day/Yr) 236. Signature of Person Pronouncing Death (Only when applicable) Z3c. License Number
BY PERSON WHO PRONOUNCES OR
CERTIFIES DEATH ' , , ~
~ ~ ~~~~
23 d. Date 'gned ( o/ /V r) 24. Ti pf D~tFj.~
/
/
~
) ~
l
JAG-
`/
LJ 25. as edical Examiner or Coroner Contacted? Q Ves No
CAUSE OF DEATH
Approximate
26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval:
respiratory arrest, or ventricular fibrilla ion wi
t
h-fout s//Fj~o~"wing the/ etiology. DO NOT ABBREVI/A7TE. Enter only one cause on a line. Add additional lines if necessary Onset to Death
~
~
/
/
C~ ~ ~z
IMMEDIATE CAUSE ---------------> a. C~_ C'--` -2 r-r~{
--~(/~C ~,~ l ~•\ .7 Y"`C\ Q ? ill
(Final disease or condition Due to (or as a consequence of):
resulting in death)
b.
Sequentially list conditions, Due to (or as a consequence of):
if any, leading to the cause
listed on line a. Enter the c.
UNDERLYING CAUSE Due to (or as a consequence of):
¢
._ (disease or injury that
initiated the events resulting d.
~
V in death LAST.
Due to (or as a consequence of):
v
0 26. Part I1. Enter other significant conditions co ntributine to death but not resulting in [he underlying cause given in Part I 27. Was an autopsy performed?
~ Q Yes o
-- 28. Were autopsy Findings available
. to complete the cause of death?
Ves Q No
29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death
E
u° Q Not pregnant within past year
Q Pregnant at time of death Q Yes Q Probably
N
k Natural Q Homicide
°'
0 Not pregnant, but pregnant within 42 days of deatf o ~n
nown
Q Accident Q Pending Investigation
Q Suicide Q Could not be determined
ti Q Not pregnant, but pregnant 43 days to 1 year before deatF 32. Date of In'ur Mo Da
y ( / y/Yr) (Spell Month)
Q Unknown if pregnant within the past year 33. Time of Injury
34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code)
36. Injury at Work 37. If Transportation Injury, Specify; 38. Describe How Injury Occurred:
Q Yes Q Driver/Operator ~ Pedestrian
No 0 Passenger 0 Other (Specify)
3 a. Certifier (Check only one):
Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated
Q Pronouncing 8. Certifyi g physi tan - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated
Q Medical Examiner/ or O the is of examination, and/or investigation, in my opinion,
d^eath occurred at the time, date, and place, and due to t{h
e cause(s) nd (m~a~nner stated
l
J
,~
Signature of certifier: Title of certifier:
~ License Number: I l ~ ~~ -] ~~~
39~~~ Cddress ^dJ Zip C e of Per
Completing Causef+ e (Item 39c.
~; i red (Mo/Day/Yr)
-
~ ~ ~ J' ~
JJ ( ~ C L_ )
/
40. Registrar's District Number 41. Registrar's Si~~re
'
~ (
~,
~e
-
~/~ 42. Re istrar File Date (Mo/Day/Yr)
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~_.~.ray.~iyc-~ - ~ QA1~-~~~lCk~
a ao~
43. Amendments
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~~\\ / ~ ~ H105-143
Disposition Permit No. Ooh ~~ V LC.~--~ REV 07/2011
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LAST' WALL AND TESTAMENT
t-
_.~
I, SANDRA L. CHRONISTER, presently residing at 699 Mohawk Road,'_I~ewvlle,
Cumberland County, Pennsylvania 172 1, being of sound mind, memory and disposition, do
hereby make, publish and declare this my Last Will and Testament, hereby revoking and making
void all Wills by me at any time heretofore made.
FIRST: PAYMENT OF EXPENSES - I order and direct my personal representative
hereinafter named to pay all of my just debts, funeral expenses and expenses involved or
connected with the administration of my estate as soon after my death as is reasonably possible.
However, my personal representative need not accelerate and pay those unmatured obligations
which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and
pay as they become due and payable.
If I do not own a burial plot or a grave marker at the time of my death, I authorize my
personal representative, in his, her or its sole discretion, to purchase a burial plot and to erect a
suitable grave marker at my grave, and to expend sums from my estate for this purpose.
SECOND: RESIDUE OF ESTATE - I give, devise and bequeath all the remainder of
my estate, real, personal and mixed, whatsoever and wheresoever situate to husband, J. GLAIR
CHRONISTER.
THIRD: CONTINGENT BENEFICIARIES - In the event that my husband, J. GLAIR
CHRONISTER should predecease me, I then distribute my estate as follows:
A. My Executor shall have the discretion to sell any of my real estate at public
4~% or private sale. The proceeds therefrom shall be distributed in accordance
with subparagraph B below; and
~ ~. I give, devise, and bequeath thL rest, residue remainder cf my estate real,
r
~~--~. personal and mixed, whatsoever and wheresoever situate, equally to my
,; '°~ children, LARRY E. CHRONISTER, LINDA K. SWARTZ, JANET L.
SMITH and WAYNE R. CHRONISTER.
~~ti;
Should any of my children predecease me but leave descendants who so survive
me, such descendants shall receive, per stirpes, (by representation) the share that
~°~
such predeceased child would have received had he or she so survived me.
_~
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WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
FOURTH: PERSONAL REPRESENTATIVE - I nominate, constitute and appoint my
husband, J. CLAIR CHRONISTER and my niece, MARY ANN M. FINTON or the survivor
thereof, to be the Co-Executors of this my Last Will and Testament.
FIFTH: TAXES - I hereby direct that all federal, state and other death taxes payable
because of my death, with respect to the property forming my gross estate for tax purposes,
whether or not passing under this Will, including any interest or penalty imposed in connection
with such taxes, shall be considered a part of the expense of administration of my estate and that
such be paid out of the rest and residue of my estate.
SIXTH: CHOICE OF ATTORNEY - It is my desire that my personal representative(s)
retain the services of Richard L. Webber, Jr., Esquire, with respect to the settlement of my estate
due to his familiarity with my affairs.
IN WITNESS WHEREOF, I, SANDRA J. CHRONISTER have hereunto set my hand
and seal to~,this my Last Will and Testament, the first page signed for identification only, this
,~.. > ` ` day of ~ ;', ~ ' , 2009.
r
~\ ~f~ ~'~" ~i ~'~,.~~ ~ 1 ' W 1 'i~-'~ f'-{~L , :..-^'` (SEAL)
SANDRA J. CHRONISTER
This instrument was by the Testator, on the date hereof, signed, published and declared by
SANDRA J. CHRONISTER to be her Last Will and Testament, in our presence, who at her
WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
request and in the presence of each other, we believing her to be of sound and disposing mind and
memory, have hereunto subscribed our names as w
t
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
I, SANDRA J. CHRONISTER, the person whose name is signed to the 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 that I signed it as my free and
voluntary act for the purposes therein expressed.
r~
SANDRA J. CHRONISTER
Sworn or affirmed to and acknowledged before
me by SAl~DRA J. CHRONISTER, the Testatrix,
2009.
this _:~ 5'~ `~ day of ~ - ~ r ,
Notary Public
;~~
WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF BERLAND ~,-~, i
_. ,
We and ry /~~ ~ ; ~ ~--, ~ ~ ~ ~.
~,.:
the witnesses whose names are signed tot foregoing instrument, being duly qualified according
to law, do depose and say that we were present and saw SANDRA J. CHRONISTER, the
Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she
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 witnesses; and that to the best of our
knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and
under no constraint or undue influence.
r __j
~` ~ ~ r
~ ~'
Sworn r ffirmed to and sc 'b d of re me
b ~, : ,~ ~ ,
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and ~ ~~ ; '.~ ~ ' ", ,l
~,~ ~ %~
witnesses, this -~{~ ~ day of ~ ,r ~ !j , 2009.
Notary Public
.. ~~ tt ..
s td8~,"'aq ~:;
a:, ~ 4.a .
_ : ~'~:d
WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 177_57-1397