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Home My WebLink About05-23-13 Reset 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 � ' _I� r U�� Name: GAYLE K. SHEAFFER File No: a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 200-24-2356 Date of Death: MAY 6 2013 Age at death: 82 Decedent was domiciled at death in CUMBERLAND County, pE.NNSYLVANIA_ (Sraae)with his/her last principal residence at 7 COUNTRY CLUB RD CARLISLE 17013 MIDDLESEX TWP.CUMBERLAND COUNTY Street address,Post Office and Zip Code City,Township or Borough CounTy Decedent died at LIFE CARE HOSPITAL WEST CHESTER CHESTER COUNTY,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 $ 28,000.00 If not domiciled in Pennsylvania. ................. ...... Personal property in Pennsylvania $ If not domiciled in Pennsylvania. ...... ................. Personal property in County $ Value of real estate in Pennsylvania.. ... ................... ............. .... .... ..... ....... $ 201,900.00 TOTAL ESTIMATED VALUE. ... $ 229,900.00 Real estate in Pennsylvania situated at: 7 COUNTRY CLUB RD,CARLISLE 17013 MIDDLESEX TWP.CUMBERLAND COUNTY (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 12, 1912 and Codicil(s) thereto dated NONE n�m n�i.rr�v r cu�ni�'i�'RU 1?R7�Tl1TiNf`FTl LIiC RT(:�TT T(1 CFRVF AC f'(1_FXF('T IT()R 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 �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,durarcte absenti¢,durante minordtate 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 �EXCEPTIONS C - _....�_ Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by th�Il�ing spousa�if an��eirs(attach additional sheets,if necessary): ,� : t'+3 �-, '-c ,1'% „� Name Relationshi �d�e{s'� �,� ' ' ,.._ . �� G,- ;:�: .-, ..,.� „i , .-� • C`; f..:; ._.. �-r� ,..-... : .__.- ._. . . ,»_. ..�.. .. -��:. . ._..__ ..._ .._.. :...� f,`, ^ �+� ``�:.� �.� Form RW-02 rev. ioiirizoli Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Petitioner(s)Printed Name Petitioner(s)Printed Address SANDRA K.SHEAFFER 1 HOLLOW ROCK LINCOLN UNIVERSITY PA 19352 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 edent,the e'io � well and t ly administer the estate accordin to law. Sworn to r af irmed an bscribed before Date "� , � � m �ay o ,� Date $ ; Date For rhe Regisrer � Date BOND Required: ... Q NO To the Register of Wills: C ,p `"'' � � FEES' Please enter my appearance by��nature�ow:�:� ��,, � � � _ �.:• , � - ._..� ";t Letters . . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature: � � � t1� . ; ;_,.T ( $ )Short Certificate(s). . . . . . 25.00 � `� f-� � .�� •-< c:a_�, �,., ,�_ .,_ ( )Renunciation(s).. . , . . . . . ,-.., " r` � � '�_=� ( )Codicil(s). . . . . . . . . . . . . - - -_�, ` _:' o `t ( )Affidavit(s).. . . . . . . . . . . f �_� :, L . r� ,, , Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: THOMAS E FLO�V�R °.� Commission. . . . . . . . . . . . . . . . . . Supreme Court _�� __;- i;.� �'::� Oth r . . . . . . . . ID Number: 83993 `=� '�`� " . . . . . . . . IS•L�a ��t{�`y1('��C.l�L;fi'Ui.� I�•�� Firm Name: FLOWER LAW,LLC ��kpY1,�1�,� . . . . . . . . �S,(� Address: 10 W.HICTH ST . . . . . . . . C'ARI.ISI.F.,PA 17013 . . . . . . Phone: (717)243-5513 Automation Fee. . . . . . . . . . . . . . . �, � Fax: (7171 241-4021 JCS Fee. . . . . . . . . . . . . . . . . . . . . � Email: TnM I.nWF.R-I.AW_CnM TOTAL. . . . . . . . . . . . . . . . . . . . . $_-��'— DECREE OF THE REGISTER Estate of GAYLE K. SHEAFFER File No: �'�� 7 U � a/k/a: AND NOW, �l � ,_<��, in consideration of the foregoing Petition, satisfactory proof having been p s nted befo me,IT IS DECREED that Letters TESTAMENTARY are hereby g anted to SANDRA K.SHEAFFER in the above estate and(if applicable)that the instrument(s)dated OCTOBER 12,2012 described in the Petition be admitted to probate and filed of record as the last ill (and Codic�l�s)) of Decedent. � �n � -U� Register of Wills � /�o� �y ��n /��/� �� ,�i.{ l. '��/J��'t, Form RW-02 rev.10/l//20!l P e 2 of 2 . �w: .. ._��.. ..�:��„,�,��.�.�� .�ns.,y�, .�:m . H105.805 REV(9/il) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 R�C�� :'�°'''�= (�y� This is to certify that the information here given is i r . :.. ,,,,i„a„ ;� �'"�p�1N OF pF�---._: ��,��'j�,j� (��-_ ; � � � ,,��,o��, _ iyyf_ correctly copied from an original Certificate of Death `o p'L` _ G` duly filed with me as Local Registrar. The original :.��1� �r��Y �� `� �' certificate will be forwarded to the State Vital ?r' �;�� 2 �� zi r i� _� Records Office for permanent filing. �` a: i O *�� P 19 4 3 6 0 7 4 ��c�.� � � '°`��°q9rM- E�a~?,'' , � ��- M1�f 9 /20t3 , „ c�:�� . , ��. o ...�.� N��S C u;�� ; .----„ENt,o,,,,, � Certification Number��B��L Q�� ' �� Local Registrar Date Issued Type/Print In C (7N��LTH OF PENNSYLVANIA�DEPARTMENT OF HEALTH�VITAL RECORpS Permanent _ Black Ink CERTIFIGATE OF DEATH Stafe File Number. � 1.Decedent's Legal Name(Ftrst,Mltldie,Lasf,S�ffix) 2.Sex 3.Soclal Sccu�ity N�mbe� 4.Datc of Deaih(MO/Day/Vr)(Spell Mo) Gayle K_ Stieaffer Female 200-24-2356 May 6, 2013 Sa.Age-Last Birthday(Vrs) 56.Unde�1 Year Sc.Under 1 Da 6.Dat�of BiKh(MO/Day/Year)(Spell Month) 7a.Birthplace(City and Stafe or Forclgn Coun[ry) 82 nno�tns oays Hou�s nni.,uces MaL' S� 1931 i in 7b.Blrthplace(COU�ty) 8a_Resitlence(SSate or Foreign Counfry) Sp.Residence(Street and Numbe�-Include Apt No.) 8c.Ditl Decedent Live In a Township7 PA 7 Country Club Rd Q4 ves,a«�a�„�u�ed i� Middlesex t,,,,P, Sd.ftesldence(COUnty) . Cumberland 8e.Residence(Zip Code) 17015 �No,decedenf Iived wlthin IlmiSS of city/boro. 9.Ever in US Armed Forcas? 10.Marital Status af Time of Death � Marrlad � Widowed 11.Surviving Spouse's Name(If wife,give name prlor io first marriage) �Yez �Na �Unknown � Divorced 0 Never Married �Unknow 12.�atheri NN e(FJrst�,Middle,Last,Suffix) 13.Mqt Na PrloJ�o First Marriage(First,Middle,Lasi) �r� eCJi Y Mi�c�re� wise 14a.Informant's Name 146.RelaTionship to Dccedent 14c.Informant's Mailing Adtlress(Street antl Number,CI[y,State,Zip Code) 0 Sandra Sheaffer dau hter 1 Hollow Rock, Lincoln Universit , PA 19352 G _ � isa.v ace o oeac c ec o e _ If Deaih Occ�rred in a Hospital �InpaCient � �If Death Occurred Somewhere Oihar Than a Hospital ❑Hospfce Facilify b DecedenYS Home � O Emergenc Room/OUtpatianC O Dead on Arrlval � O Nursing Home/Long-Term Care Facilffy O Other 5 I Pecify) �'i 1�biF�lty�fafne(If rwtJr��u4lnrL�v�str�afar��umb�1 Y, 15c.qty orTOwn,State,antl Zip Code 15d.County of Death HL"E iY0 1 CS t e`� L F7est Ctzester� PA 19380 Chester 16a.Me[� sitlon Burial � Cremation 16b.Date of Disposition 16c.Place of Dlspo5lHOn(Name of cemetery,crematory,or other place) .�' p R o..aif�o`PeC:e p oo.,acio� May 14, 2013 Letort Cemetery ome� s rY> 16d.locatlon of Disposltion(Cicy or Town,State,and Zip) 1']a.SI f Funer I Servl Lice Pe n in Charge of IMermcnt 17b.licens Number E Carlisle, PA 17013 013144L .§ 17c,Name and Complete Address of Funeral Facillty Hoffman-ROtti E�aneral Home & Cremat , 219 North Hanover Street� Carlisle, PA 17013 :g 18.DecedenYS Educatlon-Check the box that best Gescribes the 19.Decedent of Hispanlc Orlgin-Check the 20.Decedent's Race-Check ONE OR MORE reces to Indicate what ,- highest dagre�or level of school completed at the time of tleath. box that best describes whether the d¢cedent the decedent considered himself or herself to be. 0 8ch grade or less is Spanish/Hlspanic/Latlno. Check the•'NO" �J White O Korean � No dlploma,9th-12th grade box if decedent is not Spanish/Hispanic/Latino. [� Black or African American � Vletnamese [y� Hfgh school graduate or GED completed No,not Spanish/Hispanic/Laqno 0 American Intllan or Alaska Native � Other Aslan [] Some college credic,but no degree � Yes,Mexlcan,Mexlcan AmeFican,Chi<ano p Asian Indian � Native Hawalian � Assoclafe degree(e.g.AA,AS) �Ves,Puerlo Rican �Chinese � Bachelor's degree(a.g.BA,AB,BS) �Ves,Cuban O Guamanlah or Chamorro � F��P�^o � Samoan � MasteYS tleg�ee(¢.g.MA,M5,MEng,MEd,MSW,MBA) � Yes,othe�Spanish/Hispanic/Latino �Japanese 0 Other Pacific IslanEer 0 Doctorace(e.g.PhD,EdD)or Professionai dagree (Specify) � Other(Specify) .MD DDS DVM LlB JD 21.Deced�nC's Single Race SNf-oesignatlon-Check ONLV ONE io indicate whai ihe decetlent conslde2d himself or herself to be. 22a.Decedent's Usual Occupation-Indicate type of work White Q Japanese � Samoan tlone tluri�g mosi of working Iife. DO NOT USE RETIRED. Black orAfrican American � Korean O Other Paciflc IslanCer Seeretary q O P.merican Indlan or Alaska Native �Vietnamese Q Don'S Know/NOi Sure ? �Asian Indian � Other Asian O Refused 22b.Kind of Business/Industry � p cnir,ese O Native Hawalian O o:ner(sPeciry) p cwa�no O ��e",a�ia.,o�cne..,o��o Auto Repair ITEMS 23a-23d MUST BE COMPlETEO 23a.Date Pron u ced Dead MD ey/Yr e of Person Prono�ncing Death(Only when applicable) 23c.Ucense Number BY PERSON WMO PRONOUNCES OR CERTIFIES DEATH 23tl.Dai Sig d(MO/Day/Yr) 24.Time af Deaih M�')i�s � � ^/1 25.Was Medical Examiner or Coroner ConSacted? � Ves No CAUSE OF DEATH � � Approzimat� 26.Part 1. Enier the chaln of events--diseases,InJurles,or complicatlons--that dlrectly caused the tleath. DO NOT enter terminal events such as cardiac arrest, � Interval: respirafory arr¢st,or ventric�lar fibrlllation without showing the eifology. DO NOT ABBREVIATE. Enter only one cause on a Iine. Add addiHOnal lines if necessary. 1 Onset to Death IMMEDIATE CAUSE a. �y O�� \/��If��l7 � � ____"""""'> 1 �a_� (Final dla�asc or contl�[lon p��to(o as a co ce of): r�sulting In death) r / .• b. Ll7 rOVI�F�l/� 'd(�f{�� CYLa C_Da L� �d � SequenClally Ilst condii{ons, Due to c equence of): � C�� If any,Ieading to the ca�sa � 1 listed on Iine a. Enier(he 1 UNDERLYING CAVSE D�e to(or as a consequence of): (disease or injury Shat � 1 F Initlated the events resulting d. � -� In dea[h)LAST. Due to(o�as a cOnsequence of): � �j 26.Part 11. Enter oChe�sianificanC condlHOns roMrib�Hna t d th but noi re5ulting in the underlying cause gtven In Part I. 27.Was an autopsy performed7 � ��i�i-�-t-�S� G�r'e�n'C_ t-C..v�a�l �tS.��./�� ze.we��toPSY flnd�:a�eneci� to complete the cause of deathP � O Y�s No 29.If Female: 30.Did Tobacco Use Contribufe to Deaih7 31.Manner of Death �`.. E �J Not pregnant wlthin past year O Ves Q Probabl - tg Q P�egnant at time of tleath Q No �'Unknown �Nafu�al � Homicide 4 �' � Not pregnant,buf pregnant wlthin 42 days of death � Accident � Pending Investigation � Q Not pregnant,but pregnani 43 days to 1 year before death 32.Date of In � Suiclde p Could not be Geiermined - O Unknown if pregnant within TMe past lury(MO/Day/Yr)(Spell Month) year 33.T{me of Injury 34.Place of InJury(e.g.home;construciion site;farm;school) 35.Location of Injury(Sireet and Number,City,County,Sfate,Zip Code) � 36.I�jury at Wo�k 37.If Transportatlon Injury,Specify: 39.Describe How Injury Occurred: �' O Ycs 0 Drlver/Operator O Pedestrlan � O No O Passenger O Other(Specify) 39a.Certifier-physician,certifled n e proctiHoner,medical e miner/coroner(Check only one): ` T�'),�' � Certifying only-To�he best of my knowledge,daath o red due to the c se(s)and m siated. � �$ Pronouncing 8.Certifying-To the best of my knowledge,death occurred at the time,datenand place,and due to the cause(s)and manner stated. _`" � Medical Examiner G - n Lhe basis of examination and/or InvestigaHOn,In my opinlon,death occurred at[he tlme,date,and place,and tlue to the cause(s)and manner stated. f^ Signature of certi Title of c�rtifler: A�D License Numbe�: M D�{Z�rj a G v � 39b.Name,Address and 21p Coda of Person Camplet use of DeaSh(Item 26) 39c.Oat Signed(MO/�ay/Yr) � W�n!S S H V �}oo E. M �C �^ ..JC-S7 1 3$O 40.Regfstrar's Oistrict Number 41.ftegtstrar's Sig ature 42.Registra� le Dace(MO Oay r) � 43.Amendments O �� .. � . [� �lO�i�n DlSposition PermfY No. h� l��3� R � LAST WILL AND TESTAMENT OF GAYLE K. SHEA. FFER I, GAYLE K. S��EAFFER of? Counti-y Club Road, Carlislc, Cumbcrland County, Pennsylvania, 17013, being of sound and disposing mind, memory� and understandinu, do make, publish and declare this as and for m,- Last Will and Testament, hereby revoking and making void an�� and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all lnheritance, F.state, 1'ransfer and Succession Taxes, as soon as may be conveniendy done after m�� death, out of my residuary estate. SECOND: I give �11 the rest, residue and remainder af my estate be it real, personal or mixed, or whatsoever kind, af wheresoever situate, to my children, SANDRA K. SHEAFFER and RANDY L. SHEAFFER, in equal shares. Should either of my children prede�_ease me, I give that child's share to my surviving child. LASTLY: I hereby nominate, constitute and appoint my children, SANDRA K. SI�E 4F�'F�t and RA1�TD�' L. SHEAFFER, to be Executors of this, my Last titi'ill and 'I'estament, the�� to ser�Te without $ond in the Commonwealtli of I'ennsylvania, or any� other jurisdiction. In the event that either ot my said children shall predecease me or be unable to act as L;xecutor of my- Estate or complete the administration thereof for any reason �vhatsoever, my other child shall act in his or her place as Executor hereof. IN WITNESS WHEREOF, I, Gayle K. Sheaffer, have hereunto set my hand and seal to this my Last Will and Testament, this �day� of�� , 2012. Gayle . Sheaffer, Testatrix Signed, sealed, pubiished and declared b5� the above-named Gayle IL. Sheaffer, TestatriY, as and for her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of said Testatrix and of each other. � ADDRESS 10 W. High Street Carlisle, P� 17013 ADDRFSS 10 W. High Street Carlisle, PA 17U13 COMMONWEALTH OF PENNSYl.VANIA : COUNTY OF CUMBERLAND . We, Gayle K. Sheaffer, James D. Flo`ver, Jr. and ��JrG L . �l�irl�%Lthe Testatr� and witnesses, respecrively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and eYecuted the instrument as her Last Will and Testament and that she signed willingly and that executed as her free and voluntary act for the purposes therein eYpressed, and that each of the witnesses, in the presence and hearing of the 'I'estat�ix �ig:ied t��e �`�1ill as �`�itnesses and that to the best of their knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. G e K. Sheaffer James D. Flower,Jr. Witness On this, the �� day of �C�• , 2012, before me, the undersigned officer personally appeared James D. Flower,Jr., F:squire, known to me (or satisfactorily proven) to be a member of the bar of the highest court of said state, and a subscribing witness to the foregoing instrurnent, and certified that he was personally present when the testator and witnesses, whose names are subscribed to the foregoing instrument, executed the same, and rhat they acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and otficial seaL (SE�I.) Notary- Public t�"��MNfC)NWEALTH OF P��':��LVANIA ��"� NOTAhIAL SEY w i�'OMAS E.FLOWER,No�?��Pubiic ra�iisle Boro.,Cumberl=.� "'cunry „,�i;�inmissian Expires Oc: _"'�,2014 ,�.y..,u.,. Reset Form oi��E ,�t`:;� , ;� ��;"r �i- i\�+�iv " '.�t �Js� '. _E,.;3 RENUNCIATI�:�ir{�' Z� �,-��"j � ��3 CL�;��`bi �;;:_ REGISTER OF WILLS , ,�i�, r,,;�,F-,�. CUMBERLAND COUNTY �i.� �i��f i c 3 c��., �� Estate of GAYLE K. SHEAFFER , Deceased I, RANDY L. SHEAFFER , in my capacity/relationship as (Print Name) DESIGNATED CO-EXECUTOR of the above Decedent,hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to SANDRA K. SHEAFFER �, \ , 2013 � (Date) (Signature) �'7� �� Qn r�-O.� �eC c�� (Streel Address) ��a �� l°t ��. (City,State,Zip) Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunciation and certified of , that he or she executed the renunciation for the purposes stated within on this�day of ,.�1.D�`'� � � Deputy far Register of Wills Notary Publi �-a, My Commissi xpires: �,��\`��J (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commissicn.) Form RW-06 rev.10.13.06