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REGISTER OF WILLS M ° M o
CUMBERLAND COUNTY PENNSYLVAT&An
SMALL ESTATES AFFIDAVIT :2: m
For Insurance Proceeds C` 'r
T to be used for Settlement of Sman Estates under
_ S
(Original Death Certificate Must Accompany this Form) N UY 71
Deceased ROURT F. LEMMER SR Case No. a� Qc
also known as Social Security No.
Before the Register of Wills of said County personally came 'ZoaALa R. L.&PEP, who resides
at 712. ROYAL L'3ONUP-T�A WILnJ0&T0fd.NL 8.8406 ,being duly sworn,
deposes and says that 1>,OOERT ` (�,Iytr>fQ d 2 a age (03 ,a resident of
$O7 - OsL.r R- %1E. Lfngt
in said County,departe this life,at on the ._ L2" f,` day of
J)CLEn6E2 A.U.20-Iq7 rd o'clock _ M., po sessed of personal
property estimated to be of the value of$ 0000 ,and possessed of real estate,the estimated value
and the location of which is as follows:
Except as follows,Decedent did not marry,was not divorced,and did not have a child born or adopted after
execution of any testamentary writings whether or not offered for probate;was not the victim of a killing,
was never adjudicated an incapacitated person,and was not a party to a pending divorce proceeding at the
time of death wherein grounds for divorce had been established as defined in 23 PA C.S.section
3323(8):
The total amount of insurance proceeds payable by PALI)'DCIJrIAL does not exceed$11,000
and 60 days have elapsed since the death of the insured.The undersigned agrees payment cannot be made
under this Affidavit if a written claim for same has been made by a Personal Representative of the estate and
no other heir(s)having preference exist or have released their benefits to the undersigned.
That said decedent left a spouse-whose name and residence is .ZF LEASRb - G.ATHERINE AL MM
LE WIER 130"1 3e16LEA aces, aEnoypf 1/A I
and the following as next of kin:
NAMES RELATIONSHIP RESIDENCE
-DONALA LEMnER SON 71a ROYAL 3MOJET -1>4. w1U111jL?9q At.
O5
�EtEt� OpERt F ceIFfIBA JR WO I o I9wt5
That the above named are the spouse&and all the known next of kin,of said decedent,to the best of my
knowledge and belief.
Your Petitioner avers there are NO KNOWN PROBATABLE ASSETS that would require an estate
proceeding. Therefore,NO ESTATE WILL BE RAW D L TERS ARE NOT NECESSARY.
Signed -
By:
Sworn and subscribed to before me this
i day of i� ,20 1`3xrt..x-� �SH 1114,4 z)�egister of Wills:
Il$jdly enter appearance in the above case this
day Qf - 20
No4D Pn11 10ty PUbltO
My Commissrgn g yp 0t COurdy = I.D.No.
R- Attorney
��ip�'N CAR(7\`vxx
BE IT REMEMBERED,that as of the day of ,A.D.20
There has been NO ESTATE PROCEEDING RAISED FOR THIS DECEDENT AND NO LETTERS HAVE
BEEN ISSUED BV THIS COURT.
Register
Glenda Farner Strasbaugh
Register of Wills&Clerk of Orphans'Court
My Commission Expires First Monday,January,2014
Donald E. Lehmer
7l2 Royal Bonnet Dr.
Wilmington, NC. 28405
717-497-2024
May 12", 2013
Glenda Farrier Strasbaugh
Regisk of Wills and Clerk of the Orphans' Court
County of Cumberland
I Courthouse Square, Room 102
Carlisle, Pa. 17013-3387
Dear Ms, Strasbaugh,
1, Donald E. Lehmer, certify that I am the only living child of Robert F. Lehmer, Sr., and
Catherine Alberta Lehmer. They had one other child, Robert F. Lehmer, Jr., who passed
on 9/22/2011.
I found a life insurance policy, owned by my father, Robert F. Lehmer, Sr. that had never
had the change of ownership, or change in beneficiary after his death. The small $1,000
life insurance policy through Prudential, will not be paid until I have a copy of the court
order appointing the administrator or executor of the estate (if one was appointed). One
was not appointed as my mother was still alive and everything was passed to her.
Prudential is requesting a small estate court order issued by the courthouse before they
process the death claim on my brother. Apparently, they need me listed as the
administrator, or executor of the estate.
Enclosed is an original of my father's death certificate, a copy of my mother's death
certificate, and a copy of my brother's death certificate. I've also included a copy of my
birth certificate showing Robert F. Lehmer, Sr. and Catherine Alberta Lehmer were my
parents.
If possible, I'd like the original death certificate of my father returned to me, as that is
the only original I have.
I appreciate your help in resolving this matter.
mcerely,
Donald E. Lehmer
_.
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STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND SHORT CERTIFICATE
I, DONNA M. OTTO
Register for the Probate of Wills and Granting
Letters of Administration &c . in and for said
County of CUMBERLAND do hereby certify that on
the 24th day of March
A.D. ,
Two Thousand and Three,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of LEHMER CATHERINE said
1 , late of LOWER ALLEN TOWNSHIP
a/k/a LEHMER C ALBERTA
in said county, deceased, to LEHMER DONALD E
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of said office at CARLISLE, PENNSYLVANIA, this 24th day of March
A.D. , Two Thousand and Three .
File No. 2003-00254
PA File No. 21-03-0254
Date of Death 3/14/2003 2� �CLZ�
S . S . # Re ister
6%*,
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL