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HomeMy WebLinkAbout02-21-13 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: Winnifred M. Williams File No: 7 a/k/a: Winnie M. Williams • (Assigned by Register) a/k/a: a/k/a: Social Security No: 174 - 05 - 1919 Date of Death: February 15, 2013 Age at death: 95 Decedent was domiciled at death in Cumberland County, Pennsylvania (state) with his/her last principal residence at 700 Walnut Bottom Rd., Carlisle, PA 17013 Carlisle Borough, Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 700 Walnut Bottom Rd., Carlisle, PA 17013 Carlisle Borough, Cumberland Pennsylvania 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 $ 90,000.00 If not domiciled in Pennsylvania Personal property in Pennsylvania $ If not domiciled in Pennsylvania. Personal property in County $ Value of real estate in Pennsylvania.. . . . $ TOTAL ESTIMATED VALUE.... $ 90,000.00 Real estate in Pennsylvania situated at: None (Attach additional sheets, if necessary.) Street address, Post 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 October 8, 2004 and Codicil(s) thereto dated N/A State relevant circumstances (e.g. renunciation, death of executor, etc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not dilmrced, was noffr Jarty to a;"nding divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(&5ai6 did not hOe a AlMm or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. :t3 t~+ t GS O ' rT1 d Q NO EXCEPTIONS O EXCEPTIONS t~ ~u~ DzM rnrn ® B. Petition for Grant of Letters of Administration (If applicable) z C? X ~ - ° c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, d9a09 q,.~Fentid-.VuramSq mrtloritate c? C? -rt tj .y -n If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and cot*lFU list of heirs.= C-y M Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divol0le had been sit blislQ qbdefined in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. O NO EXCEPTIONS O 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, if necessary): Name Relationship Address Form Rw 02 rev. Ioizlizou Page 1 of 2 oath of rersonat representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Petitioner(s) Printed Name Petitioner(s) Printed Address Shirley A. Lucas 135 Imperial Court, Carlisle, PA 17013 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 Uedt, the Petitioner(s) 1 well and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~t Gat Date-02'o2 me day o C7) Dqk" M B :Ll ft D c~ For the Register -u DaW (n r- rn 4 BOND Required: Q YES Q NO To the Register of Wills: -0 ~t FEES' Please enter my appearance by mHiS a re lbw: t.J t-' M Letters $ 1 ) Q Attorney Signature: O ( ) Short Certificate(s)...... ( ) Renunciation(s)......... ( ) Codicil(s) . ( ) Affidavit(s)........... . Bond Printed Name: Robert G. Frey Commission Supreme Court the ID Number: 46397 :;*C; tj Firm Name: Frey and Tiley 4'lob Address: 5 South Hanover St. - F) j . / 1 Carlisle, PA 17013 Phone: 717 -243 -5838 Automation Fee. Fax: 717 - 243 - 6441 JCS Fee . Email: rfrey@freytiley.com TOTAL S DECREE OF THE REGISTER f Estate of Winnifred M. Williams File No: ~G( 7 aWa: AND NOW, r in consideration of the foregoing Petition, satisfactory proof having been resented before me, IS DECREED that Letters Testamentary are hereby granted to Shirley A. Lucas in the above estate and (if applicable) that the instrument(s) dated October 8, 2004 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of ecedent. N'qj Register of Wills Form RW-02 rev. 10/1112011 Page 2 of 2 HI05,805 RE\ 19111 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. RECORDED OFFICE OF Fee for this certificate, $6.00 ~,rl "1 nn Is to certify that the information here given i5 REGISTER OF WILLS OF o con- ctk copied front an original Certificate of Death 7 dulti tdcd with mE at Local Rc(t(str (r. The original ZOA FEB 21 PM 3: y ~ rCrtificaic \611 he forwa)ded to the Slate Vital records Office for permanent filing. CLERK OF r®~~"' ,~,.=1 l P 19434275 ORPHAN S' COURT-~1-`~~i` fEe~ 1 92013 Certification Number CUMBERLAND CO,, PA G Loco;! Re~-istrar Date Issued Jj Type/Print In COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS Permanent Black Ink CERTIFICATE OF DEATH Slate Flle Number: 1. Decedent's Legal Name (First, Middle, Last,'Sufflx) 2. Sex 3. Social SecNumber 4. Date of Death (M./Day/Yr) (Spell Mo) Winifred M. Williams Female 174-0-5"- 1919 February 15, 2013 Sam Age-last Birthday (Yrs) 56. Untler 1 Year 5c. Under 1 Da 6. Date of Birth (MO/Day/year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) 95 Months Days Hours Mln.tes Oct 29. , 1917 e p 7b. Birthplace (County) Sa. Residence (State or Foreign Country) BE. Resfdence (Street and Number - Include A N..) 8c. Did Decedent Live In a Township? PA 442 Walnut Bottom Rdp.t Oyes, decedent lived in Ed. Residence (County) twp. Cumberland Be- Resfdence (Zip Code) No, decedent lived within limits of Carlisle clty/bor.. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death O Married Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) O yes 10 No O Unknown O DlVOrced O Never Married O Unkn ,w 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, last) Har R. Pitten er Ray Clough 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, Ctty, State, Zlp Code) g Shirle Lucas sister 135 2mper-ial Ct_, Carlisle, PA 17013 C 1Sa. Place . Deat C ec o .y ore patient If Death Occurred Somewhere Other Than a Hos Ital: Pi+++ff " _ P LJ Hos Ice Faclllt ° P Y LJ Decedent's Home D Emergency Room/Outpatient oo Dead on Arrival _ Qg Nursing Home/L.n Term Care Facility O Other (Specify) 15b. Facility Name (If not Institution, give street and number; 151. City or Town, State, and d Zip Code SSd. County of Death Thornwald Home Carlisle, PA 17013 Cumberland 16a. Method It Disposition Burial O Cremation b Dat Dls 16c. Place of Disposition (Name of cemetery, cremat. they2 lace) P O Removal from State O D.natlon deb ~~Y-` Cumberland Valley Memoria~. oGarc~ens O Other (Specify) 16d. Locatfon_pf DI(sposl[f.n (Clty or Town, State, and Zip) 17a. 51 Z gna of Funeral Se or person In Charge of Interment 17b. License Number Carlisle, PA 17013 138504 , 171. Name and Complete Address of Funeral Faclllty Ho££man-Roth Funeral Home & Crematory, 9 North Hanover Street, Carlisle, PA 17013 m 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 t- highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent .Race eyed himself or herself to be. O 8th grade or less I. Spanlsh/Htspanlc/Latino. Check the "NO" )H White O No diploma, 9th - 12th grade box if decedent Is not Spanlsh/Hispanic/Latino. Korean O Black or African American O Korea Vietnamese High school graduate or GED completed EN No, not Spanish/Hispanic/Latino O American Indian or Alaska Native O Other Asian O Some college credit, but no degree O Yes, Mexican, Mexican American, Chlcano O Asian Indian O Native Hawaiian O Associate degree (e.g. AA, AS) O Yes, Puerto Rican O Chinese Guamanian or Chamono O Bachelor's degree (e.g. BA, All, BS) O Yes, Cuban O Filipino O Samoan O Master's degree ( .g. MA, MS, MEng, MEd, MSW, MBA) O Yes, other Spanish/Hispanic/Latino O Japanese O Other Pacific Islander O Doctorate (e. g- PhD, Ec1D) or Professional degree (Specify) O Other (Specify) . MD DOS, DV M, 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 Occupati. -Indicate type of work 2D White O Japanese O Samoan done during most .fw,,ki,g life, DO NOT USE RETIRED. O Black or African American O Korean O Other Pacific Islander AudltOr a O American Indian or Alaska Native O Vietnamese O Don't Know/Not Sure O Asian Indian O Other Asian O Refused 22b. Kind of Business/Industry O Chl nese O Native Hawaiian O Other (Specify) a O Flliplno O Guamanian or Ch.-.,,. State Government ITEMS 23a - 23d MUST BE COMPLETED 23a. Dat Pro//nounced Dead (MO/Day Vr) 236. Signature of Person Pronouncing Death Only when applicable) 23c. License Number BY PERSON WHO PRONOUNCES OR ~ ' ~rJ{/J CERTIFIES DEATH / t~ ! /2/J 5S 1?& 3L 23d. D e Sigped (MO/Day/Yr) 24. Time of Death Was Medical Examiner or Coroner Contacted? O Yes No CAUSE OF DEATH 26. Part 1. Enter the chain of events--diseases, In c. Approximate 1 mPll(/tc}a~tlons--tha Ir Ply caused the death. DO NOT enter terminal events such as cardiac arrest Interval: respiratory arrest, or ventricular fibrlllati.- l tlolo .5A B' B`VIATE. ter only o se on mine. Add addttlonal lines if necessary Onset to O ath IMMEDIATE CAUSE result ngen death) condition a to (.r as a consequence of): G~ b. S,quen[Ially list conditions, Due to (or as a consequence of): - if any, leading to the cause - listed on ".I a. Enter the UNDERLYING CAUSE Due to 0 (di, ,jury that ( as a consequence of): or i initiated the events resulting d. in death) LAST. Due to (or as a consequence of): - S 26. Part It. Enter other significant conditions contributing tt death but not resulting In the underlying cause Si... in Part I 27. Was an autopsy performed? Yes r _GL Z 28. WerO topsy findings available °w U y to co plot, the cause of death? 29. If female: 30. Did Tobacco Use Contribute tI Death? O'Ves No 31.N]~ nor o Death vi Not pregnant within past year O Yes O Probably f ~latural O H.mlclde Pregnant at time .t death &rNO O Unknown O Accident O O Not pregnant, but pregnant within 42 days of death O Suicide 1p9 " Could ng t be determined m O Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (M./Da O Could not be determned O Unknown if pregnant within the past year Y/Yr) (Spell Month) a 33. Time of Injury 34- Place of Injury (e.g. home; construction site; farm; school) 3S. Location of Injury (Street and Number, City, State, ZIP Cade) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Yes Driver/Operator Pedestrian O No O Passenger O Other(Speclfy) 1 3 e,=11r (check only one): a Ce rt,fying physician - To the best of my knowledge, death rred due to the cause(s) and manner stated C O Pronouncing & Certifying physician - To the best of my knowledge, death occurred at the time, date, and place and due to the c se (s) and manner stated O Medical Examiner/Coroner - t b, basis .f examination, and/or Investigation, in my opinion, death .c.rred at the time, date, and place, and due to the c se(s) and m er stated Signature of certiffer: Title.f certlfler /-ty au t License Number: M a 3 s F'C7o7 C 39b. Name, Address and Zip Co.. of Person Completing Cause of Dea h (item 26) 39c. Date 51 n d Mo/Day/Yr) M lr M 3 b3 /~f ~,.t r~ f}vt . Hv I S r PA (tee O )zrS t 3 in 40. Registrar's Dlstrlct Number 41. Registrar's S 42. Registra Flle ate (MO/Day/Yr) 43- Amentlments asO Z 1O5-143 Disposition Permit No. H t~ [L J `r0 REV 07/2011 f4K cQ w mrn _ c~ X G-> LAST WILL AND TESTAMENT rn x c7 co in = 3> r .-.3 Ca OF 3:0. WINNIE M. WILLIAMS, also known as c? C> WINIFRED M. WILLIAM S C-) o ca n occ7 I, WINNIE M. WILLIAMS, also known as WINIFRED ] cif VILLA MV .Z rr' of South Middleton Township (mailing address: 53 Greenfield Dries, CarlisleclA N%), 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 Executrix 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 Hoffman Roth Funeral Home, 219 North Hanover Street, Carlisle, PA, in accordance with arrangements that I have made there, and that my body be interred on my burial lot located in Cumberland Valley Memorial Gardens along Ritner Highway, near the Borough of Carlisle, Pennsylvania. I further direct that all inheritance, transfer, succession, estate and death taxes, including interest and penalties thereon, which may be payable on account of my death shall be payable from the residue of my estate regardless of whether the assets upon which such taxes are based are included in my probate estate. 2. I have made no provision herein for my husband RICHARD E. WILLIAMS, not because of any want of affection for him, but because if I predecease him he will retain by survivorship whatever property we hold as tenants by the entirety. 3. I give, devise and bequeath my house and lot of land at 53 Greenfield Drive in South Middleton Township, Cumberland County, Pennsylvania, together with all of the household goods and furnishings located in it, to my sister, SHIRLEY A. LUCAS, her heirs and assigns, of 41 Partridge Circle, Carlisle, PA 17013, provided she shall survive me by a period of ninety (90) days, but should she fail to so survive me, then to such of her issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 4. I give and bequeath to my brother-in-law, RONALD E. LOWRY, of 35 Burnt House Road, Carlisle, PA, whatever automobile I may own at the time of my death. At the present time I am the owner of a 2004 Toyota automobile. 5. I give and bequeath to my sisters, RUBY E. LOWRY and SHIRLEY A. LUCAS, all of my jewelry and articles of personal use and adornment which I may own at the time of my death, provided each of them shall survive me by a period of ninety (90) days, to be divided between them as they may agree, but should either of them fail to so survive me then the share for that deceased sister shall lapse and all of such jewelry and articles of personal use and adornment shall go to the sister who so survives me. Should both of them fail to survive me by the said period of ninety (90) days, then this bequest shall lapse and all articles of personal use and adornment shall be included in the residue of my estate. 6. I give devise and bequeath the sum of $50,000 to my sister, RUBY E. LOWRY, her heirs and assigns, provided she shall survive me by a period of ninety (90) days, but should she fail to so survive me, then to such of her issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 7. I give devise and bequeath the sum of $50,000 to my sister, SHIRLEY A. LUCAS, her heirs and assigns, provided she shall survive me by a period of ninety (90) days, but should she fail to so survive me, then to such of her issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 8. I give devise and bequeath the sum of $25,000 to my brother, RICHARD E. PITTENGER, of 571 "E" Street, Pennsylvania, his heirs and assigns, provided he shall Page 1 of 2_~~ survive me by a period of ninety (90) days, but should he fail to so survive me, then to such of his issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 9. I give devise and bequeath the sum of $25,000 to my brother, JOSEPH E. PITTENGER, of Centerville, Pennsylvania, his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me, then to such of his issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 10. I give devise and bequeath the sum of $10,000 to my brother, HARRY R. PITTINGER, JR., of Lancaster Pennsylvania, his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me, then to such of his issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 11. I give devise and bequeath the sum of $5,000 to my brother, JOHN W. PITTINGER, of 527 Thornwood Lane, Carlisle, Pennsylvania, his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me, then to such of his issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 12. All of 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 sisters, RUBY E. LOWRY, and SHIRLEY A. LUCAS, their heirs and assigns, provided each of them shall survive me by a period of ninety (90) days, but should either of them fail to survive me by the aforesaid period of ninety (90) days, then the share such deceased sister would have received shall pass to such of her issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 13. I hereby nominate, constitute and appoint my sister, SHIRLEY A. LUCAS as Executrix of this my Last Will and Testament, but should she predecease me or fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint my sister, RUBY E. LOWRY, as alternate of successor Executrix, 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 three (3) pages, this day of October, 2004 T ~ (SEAL) Winnie M. Williams (SEAL) Also bown a s Winifred M. Williams Signed, sealed, published, and declared by Winnie M. Williams, also known as Winifred M. Williams, 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. ` l R Page 2 of 2 rv OATH OF SUBSCRIBING WITNESSS) Cl) 23 M c') t37 cn ~ REGISTER OF WILLS r\) CUMBERLAND 5 a m -V a COUNTY, PENNSYLVI ~ ca c. C.J t " M ^--1 ~ Winifred M. Williams, also known as Winnie M. Williams -n Estate of , Deceased Robert M. Frey and Trisha A. Liess , (each) a subscribing witness to (Print Name/s) the S Will ❑ 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) (Signature) 5 South Hanover St. 5 South Hanover St. (Street Address) (Street Address) Carlisle, PA 17013 Carlisle, PA 17013 (City, State, Zip) (City, State, Zip) Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Sworn to or affirmed and subscribed Sf before me this day before me this day of of PC r-)c '2 a / Deputy for Register of Wills Notary Public 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. FormRW-03 rev. 10.13.06 0R-:EW-Oms OMMOMMTMCW~NNSYLV", RIALSEAL G. F" Nohry Pubft Cimbedww FM dune 4 2014