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PETITION FQR GRANT QF I�ETTERS
REGISTER OF WILLS OF CUMBERLAND CQLJNTY,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 /1 ,� �3 „�a 7
N a m e: S h i r l ev A.N i c h o l s File No: �U
_�,
a/k/a: (Assigned by Register)
a/k/a:
alk/a: Social Security No:
Date of Death: 4/29/2013 Age at death: 65
Decedent was domiciled at death in Cumberland County,pp (srace)with his/her last
principal residence at 423 Hillside Road, 17070,New Cumberland,Cumberland,PA
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 423 Hillside Road, 17070,New Cumberland,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 Pennsylvania...... ...................... All personal property $ �
If not domiciled in Pennsylvania. ............. .......... Personal property in Pennsylvania $ � -
If not domiciled in Pennsylvania. ....................... Personal property in County $
Value of real estate in Pennsylvania...... ............................... ................. $
TOTAI,ESTIIVIATED VALUE. ... $
Real estate in Pennsylvania situated at: 423 Hillside Road, 17070�New Cumberland,Cumberland l a� ���` ��
(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 4/23/2012 and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciation,death of executor,eta)
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 Q 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.
Q NO EXCEPTIONS Q EXCEPTIONS �
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Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by th�pllowing spoUs�(if an�a�heirs(attach
additional sheets, if necessary): C � �`+`' t'�'t ,�-�,
. � � � �
Name Relationshi � � '� �`..� �
Mark Nichols Surviving Son 1218 Georgia Avenue,R o� ids,I�G.�i�
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Please See Attached List ''� � � � --� °�
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Form RW-02 rev.10/11/2011 Page 1 of 2 �
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Stephen Nichols, Surviving Son, 322 Braddock Drive, Etters, PA 17319
Nicole Lathrop, Surviving Daughter, 236 Green Lane Drive, Camp Hill, PA 17011
Michele Jumper, Surviving Daughter, 121 East Water Street, Middletown, PA 17057
Kathy Worthing, Surviving Daughter, 17 Kramm Avenue, Hahndorf, SA 5245, Australia
Oath of Personal Representative �al Use Only
COMM EALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s)Printed Name Petitioner(s)Printed Address
The Petitioner(s) ve-named swear(s)or affirm(s)the statements in the foregoing Petition are t nd correct to the best of the knowledge and belief
of Petitioner( nd that,as Personal Representative(s)of the Decedent,the Petitioner(s)will well and administer the estate according to law.
Swor or affirmed and subscribed before Date
me is day of , Date
D
For the Re,;ister Date
BOND Required:�YES �NO To the Register of Wi/ls:
FEES: r�� Please enter my appearance by my signature below:
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L ers ....... ...... ......... $ �� Attorney Signature: :�-.
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( )Sl�ort Certificate(s)...... � �---� �
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( )Renunciation(s)... . .... . � �
( )Codicil(s). . ... .. ... ... Cz� � � � +�
( )Affidavit(s)... ....... .. � � � ,�..� �
Bond.. . . . ... .... ...... ...... Printed Name: �'"" � i-r€� �'�"� +��
Commission. . ... ... .... ...... Supreme Court � �� �`" "�''
O h � . . ..... / 0 ID Number: '� �--, � � � �
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Firm Name: ►--' �"' �
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.... � aw ."r'
.. ..... � Phone:
Automation Fee. .... .. ....... . ..�� Fax:
JCS Fee. . .... ..... . ......... Email:
TOTAL. . ....... ...... ..... . $
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DEC E OF THE REGISTER
Estate of �� �e ,� � J`+ File No: � " `
a/k/a:
,
AND NOW, , �� �, in consideration of the foregoing Petition,
satisfactory proof having been pres d before me,IT IS DECREED that Lett rs C�f"Q/�'�C���/`
are hereby granted to C • � S
in the above estate and(if applicable)that
the instrument(s)dated - �"/
described in the Petition be admit ed to probate and filed of record as he last Will(a d Codicil(s))of De dent.
Register of Wills
Fo,•���Rw�? ,•ev.Ioi11i2n1I Pa
�/ i�
�' Official Use Only
, �D`' Oath of Personal Representahve
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COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
c o s 1� 1218 Geor ia Avenue Roanoke Ra ids NC 27870
G��� C Nic�l� Is � . . .. . . . .
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 and scribed before M�h� � � Date �j-�- 1�
me thi �d y�of Date
$y; Date
t Register Date
✓
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Required: Q YES Q NO To the Register of Wills:
FEES: Please enter my appearance by my signature ow:
Letters. . . . . . . . . . . . . . . . . . . $ Attorney Signature:
( )Short Certific s).. . . . .
( )Renunciation(s).. . . . . .
( )Codicil(s). . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . .. . . . . . . . .. . . Printe ame:
Commission. . . . . . . . . . . . . . .. . . S reme Court
Other � . . . . . . . ID Nurnber:
, , , , , . , Fir ame: �
, , , . . , , Address:
, , . , , , , Phone:
Automation Fee . . . . . . . . . . . . . . Fax:
JCS Fee. . . . . . . . . . . . . . . . . . Email: :
TOT . . . . . . . . . . . . . . . . . . . . . $ 0.00 .
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Form RW-02 rev. 10/I1/201/ Page 2 of 2
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LAST WILL AND TESTAMENT � i r�'- � � �
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SHIRLEY A. NICHOLS -�, � Q � �
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I, Shirley A. Nichols, a resident of and domiciled in the Commonwealth of �
Pennsylvania, make, publish and declare this to be my Last Will and Testament, revoking
all wills and codicils at any time heretofore made by me.
FIRST: I direct that the expenses of my last illness and funeral,the expenses
of the administration of my estate, and all estate, inheritance and similar taxes payable with
respect to property included in my estate, whether or not passing under this will, and any
interest or penalties thereon,shall be paid out of my residuary estate,without apportionment
and with no right of reimbursement from any recipient of any such property.
SECOND: I give my real property located at: 423 Hillside Road, New
. Cumberland,PA 17070 to Stephen Nichols,Mark Nichols and Nicole Lathrop, equally.
If one of them should not survive me, then to their issue, per stirpes.
THIRD: I give all tangible personal property owned by me at the time of my
death,including without limitation personal effects,clothing,j ewelry,furniture,furnishings,
household goods, automobiles and other vehicles, together with all insurance policies
relating thereto to my childrenStephen Nichols,Mark Nichols,Nicole Lathrop,Michele
Jumper and Kathy Worthing, equally; or if they do not survive me to their issue, per
stirpes
.�
F4URTH': : I give all the rest, residue and remainder of my property and
estate,both real and personal,of whatever kind and wherever located,that I own or to which
I shall be in any manner entitled at the time of my death (collectively referred to as my ,
"residuary estate"), as follows:
(a)The remainder to be sold and the proceeds given to my husband, and if he �
does not survive me then the proceeds shall be given to my children Stephen
Nichols, Mark Nichols, Nicole Lathrop, Michele Jumper and Kathy
Worthing, equally; or if they do not survive me to their issue, per stirpes.
. ,
(b) If there shall be no issue of mine then living, I give my residuary estate to
those who would take from me as if I were then to die without a will,
unmarried and the absolute owner of my residuary estate,and a resident of the
Commonwealth of Pennsylvania.
FIFTH: If any property of my estate vests in absolute ownership in a minor
or incompetent, my Executor, at any time and without court authorization, may: distribute
the whole or any part of such property to the beneficiary;or use the whale or any part for the
health,education,maintenance and support of the beneficiary;or distribute the whole or any
part to a guardian, committee or other legal representative of the beneficiary, or to a
custodian for the bene�ciary under any gifts to minors or transfers to minors act, or to the
person or persons with whom the beneficiary resides. Evidence of any such distribution or
the receipt therefor executed by the person to whom the distribution is made shall be a full
discharge of my Executor from any liability with respect thereto, even though my Executor
may be such person. If such beneficiary is a minor,my Executor may defer the distribution
of the whole or any part of such property until the beneficiary attains the age of eighteen(18)
years, and may hold the same as a separate fund for the beneficiary with all of the powers
described in Article SEVENTH hereof. If the beneficiary dies before attaining said age,any
balance shall be paid and distributed to the estate of the beneficiary.
SIXTH: I appoint my son, Mark Nichols, to be my Executor, if he does not
survive me, then I appoint my son, Stephen Nichols to be my Executor. If he does not
survive me, or shall fail to qualify for any reason as my Executor, or having qualified shall
die,resign or cease to act for any reasQn as my Executor,then one of my other children may
be appointed Executor. I direct that no Executor shall be required to file or furnish any
bond, surety or other security in any jurisdiction.
SEVENTH: I grant to my Executor all powers conferred on executors under
the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor
thereto, and all powers conferred upon executors wherever my Executor may act. I also
grant to my Executor power to retain, sell at public or private sale, exchange, grant options
on, invest and reinvest, and otherwise deal with any kind of property, real or personal, for
cash or on credit; to borrow money and encumber or pledge any property to secure loans;
to divide and distribute property in cash or in kind; to exercise all powers of an absolute
owner of property; to compromise and release claims with or without consideration; and to
employ attorneys,accountants and other persons for services or advice. The term"Executor"
wherever used herein shall mean the executors, the executors, executor, executrix or
administrator in office from time to time.
2
EIGHTH: If any beneficiary under this will and I die in a common accident
or under circumstances in which it is difficult or impractical to determine who survived the
other, such beneficiary shall be deemed to have predeceased me.
IN WITNESS WHEREOF, I, Shirley A. Nichols, sign, seal, publish and declare this
instrument as my last will and testament this�3 day of April, 2p 12.
, �
�
The foregoing instrument was signed, sealed, published and declared by
Shirley A. Nichols, the above-named Testatrix, to be his last will and testament in our
presence, all being present at the same time, and we, at her request and in her presence and
in the presence of each other, have subscribed our names as witnesses on the date above
written.
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ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA, COUNTY OF DAUPHIN, ss.
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We, Shirley A. Nichols and �J�I ►a r� �,ja �d�a� �'r, Q ►�
� ��v;a N, �duJ�� S , the Testatrix and the witnesses respectively,
whose names are signed to the attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the Testatrix, Shirley A. Nichols, signed
and executed said instrument as her last will and testament in the presence and hearing of
the witnesses, and that she had signed willingly, and that she executed it as her free and
voluntary act and deed for the purposes therein expressed, and that each of the witnesses at
the request of the Testatrix, in the presence and hearing of the Testatrix and each other,
signed the will as witness, and that to the best of his or her knowledge the Testatrix was at
the time at least eighteen years of age,of sound mind and under no constraint, duress, fraud
or undue influence.
, � ,
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Testat �
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Witness
,
Witness
Subscribed, sworn to and acknowledged before me by the said Shirley A.
Nichols, Testatrix, and subscribed and sworn to before me by the above-named witnesses,
this �� day of April, 2012.
,
�.
Notary Public
My commission expires on � , � 1� � �'l
� NtIT���.,SEAL
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