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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 InformationI
Name: Patricia A.Wills File No:
a/k/a: (Assigned by Register)
&Wa:
a/k/a: Social Security No:
Date of Death: February 1,2013 Age at death: 68
Decedent was domiciled at death in Cumberland County, Pennsylvania (state) with his/her last
principal residence at 99 ERe Drive,Carlisle,PA 17015 South Middleton Township Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at Carlisle Regional Medical Center,361 Alexander Spring Road Carlisle,PA 17015 Cumberland PA
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 Pennsyl vania........ .................... All personal property $ 297,400.00
If not domiciled in Pennsylvania. .... ..... .......... .... Personal property in Pennsylvania $
If not domiciled in Pe nnsy lvania. .. .. ................... Personal property in County $
Value of real estate in Pennsyl vania..... ..... .................. .......... ........... .. ...... $
TOTAL ESTIMATED VALUE. .. . $ 297.400.00
Real estate in Pennsylvania situated at:
(Attach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or Borough County
91 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 July 29,2012 and Codicil(s)
thereto dated
See Renunciations and Oath of Subscribing Witnesses
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 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(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 0 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,durante absentia,durante minoritate
If Administration,c.t.a. or d.b.n.c.t.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(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person.
®NO EXCEPTIONS 0 EXCEPTIONS e— w fn m
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by th lying spou if an arfiPheirs(attach
additional sheets,if necessary): M C'>
Name Relationshii
`e. r' V
Form RW-02 rev.1011112011 Page 1 of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA I
SS:
COUNTY OF CUMBERLAND
Petitioner(s)Printed Name Petitioner(s)Printed Address
Mary Ellen Judge-Caulfield 34 East Cedar Street,Massapequa,NY 11758 (516)316-8292
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 thezecedent,the etitioner(s)will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed before Uk Date 2-(a
in day o Date
B Date
For the Register Date
BOND Required: 0 YESNO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters. . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature:
Short Certificate(s).. . . . .
Renunciation(s).. . . . . . .
Codicil(s). . . . . . . . . . . . .
Affidavit(s)... . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . I . Printed Name: Crag A.Diehl,Esquire
Commission. . . . .. . . . .. . . . .. . . Supreme Court
Other ID Number: 52801
. . . .. . . Firm Name: Law Offices of&i A.Diehl-`' rn
P" Address: 346 Trindle RC& M C'>
t� c7-; 77
.. . .. . . Camp Hill,PA iil[04� C-�-
.. . . . . . Phone: (717)763-7613,-,
Automation Fee. . . . . . . . . . . . . . Fax: (7 1 7 763-82T3
JCS Fee. . . .. ... . . . . . .. . . . . . Email:
TOTAL. . . . . . . . . . . . . . . . . . $
DECREE OF THE REGISTER
Estate of Patricia A.Wills File No:
a/k/a:
AND NOW, in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED that Letters
are hereby granted to
in the above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent.
Register of Wills
Form RW-02 rev.1011112011 Page 2 of 2
H105.805"N(9/II)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
RECOiRD7n OFr-,CE OF
t
Fee for this certificate, $6. Cis F 7jj OF #L.L S I,,,1fJr«""°---- This is to certify that the information here given is
1+t111+I�p�TH pF correctly copied from an original Certificate of Death
26 Fn 1 ��t+moo `rte; duly filed with me as Local Registrar. The original
a certificate will be forwarded to the State Vital
CLEIRK 07
° Records Office for permanent filing.
,�iA�S' CCuR i +`
,t
P 19 2 � a� = 0��99=`- �P��t L ���s l�x�e`�-x�x FVB 6 1 2013
y l�El�3 Ir1p
Certification Number AND CO., AA "'Fjj Local Registrar Date Issued
Type/Print in COMMONWEALTH OF PENNSYLVANIA a DEPARTMENT OF HEALTH+VITAL RECORDS
Permanent 2013-02-065 CERTIFICATE OF DEATH
BI ck Ink state File Number,
1,Decedent's Legal Name(First,Middle,Last,Sum') 2_Sex 3.Social Security Number a_Oat.of Death(Ma/Day/yrl(Spot,MO)
Patricia A Wills Female 0.54 36 9032 Februa 1,2013
So.Age-Last Birthday(Yrs) 15b.Under 1 Year So.Under I Oily Ic Date of Birth(MO/Day/year)(Spell Month) 7a.6irthpiate{City and State or Forcjan Country)
Months Day# Hours Minutes E'e-I1S r Nt-,+W wc,37
ai 6g Se tember 11 1944 7b,Strthplao(County)
ga.Reside.-t5tate or Foreign Country) go,Rasld,nce(Street and Number-tneWde Apt NO.) lic.Old Decedent Livo Ina Township?
PA -
99 e Drive CI yes,dac«Fan i loved In top.
C�tir)ber�iand Be.Residenea(Zip Code) EO No,decedent Ryed Withln Rmits of South MidtLletan cr y/b_
9.Ever in U5 Armed Forces? 10.Marital Status at Time pf Death t3 Mauled Wldowed 11.SurvWing Spouse's N,me(It wifC,give name prior to first marriage}
t3 Vas EMNO [3 Unknown 0 Ofvorced E3 Never Married E:3 Unknown
12.Fathses Nam.(First,Middle,Last,Sum') 33.Mother`s Name Prior to First Marclage(First,Middio,Last)
Jar(le Tud Frida Steinbach
14a.InformanY'sName 14 b.Relationship to Decedent 14e.Informant's Ma)ling Address(Street and Numbar,City,State,Zip Codej
g Ma E11en Jud -Ca,.I:E ld Niece 34 E. Cedar St. , Massa f NJ 11758
G »..»__......_..»,......:. a. sea o ee
s iE Cfeath Occurred lrea HOS Rak: [�InpaiteM ltf Death Occurred Somewhere Other Than a Hos
p pttai: Ifo#Plea Facility 1�becedent#Home
Eme N Room/OUipationt Dead on Arrival NUrsin Home/LOrtg-Term Grc Facility Other(Specify)
15 b.Facility Name(If not insututlpn,glue street and numb,,; 15c.City or Town,State,and Zip Code 15d.County oT Death
Carlisle Regional Medical Center Carlisle PA 17015 Cum ri n
y16a.Method Of Disposition C3 Burial $) Cremation 16b.Dot,of Disposition 16c.9/aca Of pispositipn(Name of comotory,cromerory,or otner place)
[j Removal rrom State E3 Donation
X r3 Other(s CI Y) 2 7 20,1 3 Evaris Crecla.tion Services
16 .Loudon of Oisposition(City or Town,state,and Zip) 17 a.Signature of F ins I Service Uttnsee -_75p,in 3 Interment 17b.License Number
Leo1a, PA FD 012633 T-
H.., 2nc. , 630 S_ Hanauer St_ , Carlisle, PA 17013
ra' 18.Decedents Education-Check the box that best doscribes the 19.Decedent of Hispanic Origin-Chock the 20. ent•s Race-Chock ONE OR MORE rates to indicate what
highest degree or level of school completed at the time of death, box that best describes whether the decadent the decadent Considered himself or h.rsetf to be.
[7 ath grade or Iess is Spanish/Hispantc/Latino.Check the-No` hfre 13 Korean
t3 No diploma,9th-12th grade box If decedent is not SpanlshJHispani JCatimi. Q Stack or African American E3 Vietnam-
C]High school graduate or GED compiel:,d L".,not Spanish/Hispanlc/Latlno E3 Americo,Indian or Alo%ka,Native [3 Other Alan
B'some college credit,but no degree 0 Va#,Mexican,Mexlun American,Chicano E3 Asian Indian E3 Native Hawallan
�t As.ociata degree(a-e-AA,A5) E3 Vea,Puerto Rican O Chinese E3 Guamanian or Ch.--
1�Baehelne.degree(a.g.BA,AS,65) [3 Yes,Cuban E3 Fpiptno 0 Samoan
C3 Master`s degree{e.g.MA,MS.MEng,MEd,MSW,MBA) 0 Yes,other SpaNsh/Hispanlc/Lattno E3 Japanese E3 Other Pacific Islander
I3 Doctorate(e.g.PkO,Edo)or Professional degree (specify) E3 Other(SPeelfy)
.MD ODs AVM'LLB jD
21.Decedent's Single Rate Self-Designation-Check ONLY ONE to indicate what the dacetlent considered himself qr herself to fie_ 22a.Deodent•s Ucual ClCCUpaHgn-Indicate type of work
�'1Nhite t=Japanese 0 Samoan done during most Of working Of.- Do NOT USE RETIRED.
1:1 Black or African American 0 Kprean E3 Other Pi ctRC W. or
[7.Amoncan Indian or Alaska Native C3 Vietnamese C3 0on't Know/Nat Sure Hc&UEXTI .3�er
E 3 Asian Indian 0 Other Asian p Refusad 22b,Kind of Suskness/Industry
[3 Chins. [3 Native N-Ran 0 Other(Speeify)
0 Flltpinp d Guamanian or Chamorro Her CK4 m hcEnet
TTE 23a-ZSd MUST SE COMPLETIE. 23a.Date Pronpuncod Dead(MO ay 231,.Signature of Person ronounc+ng Death My when app to a 23c. unse Number
By PERSON WHO PRONOUNCES OR
CERTIFIES DEATH
23d.Date Signed(MO/Dayr-) 24.Time of Death
7:41 P.M_ 25.was Medial Examiner or Coroner Contacted? @ Yes Cl No
CAUSE OF DEATH i Approximate
26.Part 1.£ntar the chain pF events--Iffur-es,injuries,or eornplicatlons--that directly roused the death. DO NOT enter terminal events such as ordise arrest Interval:
respiratory arrest,or ventricular fibrillation without showing the etiology. 00 NOT ABBREVIATE.Enter Only one cause an a If—Add additional lines If necessary Onset to Death
IMME-ATE CAUSE -__ a. Pending Investigation
(Final dhoti se or condition Due to(or as s consequsnce ofh
rcsuM.2 in death)
b. t
Sequendally list eontlmonf, Due to(or as a consequence 4ry: i
if any,loading to tho cause
rrFtea on ilne a.Enter the c
UNOERL,1Nt4
CAUSE
+` nCAU SE
(disease or ury that
Initiated th event re
ulting .
In death) Due to to as a consequenee af}: 1!
LAST. Due to(or as a consequence of):
c
IT Part R. Enter other si n[fi-Or conditions concrIbirtfror t death but not resulting In the unde,tymg cause given in Part I 27.Was an autopsy performed?
P., Yes No
i
I—Were auto,#,findings avaReb a
to completo the causo of death?
$ In Yes M No
_V 29.If Famata: 30.Old Tobacco Us Contribute to O"`b? 33.Manner Death
nC7 Not pregnant within past year 0 Yes 13 Probably 0 Natural 0 fforafelde
0 Pregnant at time of death 0 No 0 Unknown 0 Accident to Pending l-.ljgatton
m 0 Not pregnant,but pregnant within 42 days of death 0 Sulclde 0 Could not be detefrritrted
0 Not pregnant,buC pregnant 43 days to 1 year before death 32.Date of Injury(MO/Day/Yr)(Spell Month)
0 Unknown if Pregnant within the Past Year 13.,T/me of injury
34.Place of Injury(e.g.home;construction site;farm;school) 35.Location of Injury(Street and Number,City,State,Via Code)
36:injury at Work 137'If Transportation Injury.Specify: 39.Describe How injury Occurred:
0 Yes 0 Ortvsr/Operator C3 Pedestrian
C3 NO 0 Passenger 0 Other(SPeclM
39a.C,ntfler(Check only one):
C3 Certifying Physletan-To the best of my knowledge,death---ad due to the ouse(s)end manner stated
E3 Pronouncing a Certifying physk-fan-To the best of my knowledge,death occurred at the time,data,and plan,and due to the ousels}and manner,stated
M Medical£xaminer/G(�yl Jp/y Own thtj jtaasis W ex ml j t�{n,an esttaation.In my opinion,death occurred at the time,data,and place,and due W the ousels)and manner stated
5tgnaturc of1R." Title of cerafler:Coroner Ucense Number;
39b.Name,Address and Zip Code of Person CO PIeiing Cause of Death(Itom 26) 39c.Dais Signed(Mp Day r)
Charles E.Hai) (.,Droner 5375 Basehore Road,Suite 1,Mechanicsburg,PA 17050 FBbruary 4,2013 0
40.R<gisirar Oistr+et Number Z.Registrars Si�affaee��f��I��.�� [� ag(sirar I C DatC y
43,Amendments _
- r
Dls,ostdon Permit NO. REV 07/2011
LAST WILL AND TESTAMENT
OF
PATRICIA A. WILLS o
rn
0
Z7 -� rn r->
1, PATRICIA A. WILLS, of South Middleton Township, Cumlrir Cot1r ty, ''
Pennsylvania, being of sound and disposing mind, memory and uneiadin ;' day
make, publish and declare this to be my Last Will and Testament, here y?evokinnd'i
s
making void all previous Wilts and Codicils heretofore made by me. e
ITEM ONE: I direct my Executor hereinafter named to pay all of my medical
and administrative expenses and all taxes due by reason of my death, before any
division of my estate is made. It is my further desire that upon my death my body
shall be cremated and any costs to be expended from my estate for this purpose.
ITEM TWO: It is my desire that my Executor, after consultation with any heir
of mine who survives me and at his own discretion, choose such articles from my
tangible personal property (exclusive of cash, stock certificates, bonds, etc.) as he
believes will be useful to such heir either from a sentimental point of view or
otherwise, and to deliver such article/s to such heir, providing no other heir objects to
the distribution. All property not so distributed is to be liquidated and the rest,
residue and remainder of my estate to be distributed as follows:-
(A) One-third thereof to Mary Ellen Judge Caulfield, to be used for
Judge family emergencies;
(B) One-third thereof to Laura J. Cole, to be used for Cole and
Harrison family emergencies; and
(C) One-third thereof to Cumberland Crossings Benevolent Care Fund,
to be used for Cumberland Crossings Retirement Community
purposes only.
(D) Should a named beneficiary predecease me or die on or before the
thirtieth (30th) day following my death, then that named
beneficiary's share shalt be equally divided between the surviving
named beneficiaries.
ITEM THREE: I nominate, constitute and appoint Kevin LaChance as Executor
of this, my Last Will and Testament, to serve without bond and pro bono. In the event
he is deceased, unable or unwilling to serve or shall cease to serve for any reason,
then I nominate, constitute and appoint Kristine Witherow, Trust Officer of Bankers
Life and Casualty Company, to serve as sole Executrix.
ITEM FOUR: I hereby declare it to be my desire that my Executor employ the
Law Offices of Craig A. Diehl of Cumberland County, Pennsylvania, for legal advice and
assistance regarding this my Last Wilt and Testament, they having considerable
knowledge of my affairs, views and wishes respecting any matters that may arise at
the probate of this instrument and the administration of my estate.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this, my Last Wilt
and Testament this y y day of July, 2012.
Z-" (Seal)
PATRICIA A. WILLS
Patricia A. Wills, in our presence, signed this instrument. Before she
signed it, she declared to us that it was her Witt and requested that we act as
witnesses to its execution. We believe her to be of sound mind, possessing
testamentary capacity, and not subject to undue influence, fraud, or coercion. We
now, in her presence and in the presence of each other, sign below as witnesses, all
on this -�2 9 YA day of July, 2012, at 99 Ege Drive, Carlisle, Cumberland County,
Pennsylvania.
i"��'✓� � �- a�L< residing at
14 residing at //A 2017X ,tP.�cu4 Caak�.c-ale , PA