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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 Information n p
Name: Evalvn M.Lewis File No: L I - I�' �'�n �
�a; (Assigned by Register)
alk/a:
a/k/a: Social Security No:
Date of Death: 7une 12 2013 Age at death: 90
Decedent was domiciled at death in Cumberland County, PPnn.ylvania (Stare)with his/her last
principal residence at 4905 E Trindle Rd Mechanicsbur� 17050 I�u�r�e� Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at HarrisburQ Hosnital HarrisburQ 17101 C Ifar r�s6v�q �,F1 � � Da���f►rti ���}1
Street address,Post Office and Ztp Code City,Township or Borough County State
Estimate of value of decedenYs property at death:
Ifdomiciled in Pennsylvania............ ................ All personal property $
If not domiciled in Pennsylvania. ...... ... .............. Personal property in Pennsylvania $
Ifnot domiciled in Pennsylvania. ....................... Personal property in County $
Va[ue of real estate in Pennsylvania...... ................................ ................... $
TOTAL ESTIMATED VALUE. ... $ �400� DD0.00
Real estate in Pennsylvania situated at: �V 0�--�
(Attach additional sheets,ifnecessary.) Street address,Post Oftice 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 February 2,2011 and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciadon,death of ececutor,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 bom or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
Q 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,durante absentia,durante minoritate
If Administration,c.t.a. or d.b.n.c.�a.,enter date of Will in Section A above and�mplete list�f heirs.�
w rn
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for�tv6�e had be n�estab�h�as defined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated peL9�n� � — �
rn ± c-, ;--- cr' 'Zs
Q NO EXCEPTIONS Q EXCEPTIONS � r� r'— h--, �:.q-' �-�,
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the f9�lo�a,n�spouse�if any�`and��tYeirs(attach
additional sheets,if necessary): � � '� C' ��,
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Name Relationshi iA:ddFess - -
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Form RW-02 rev.10/II/2011 Page 1 of 2 f�
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Oath of Personal Representative o�-���ai use on�y
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petitioner(s)Printed Address
David B.Lewis 34429 Owls Nest Road Lewes DE 19958
Carol A.Lewis 55 Pine Rid e Circle,Enola,PA 17025
Patti L.Baer 1211 Hi hlander Wa Mechanicsbur PA 17050
The Petirioner(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 De e nt,the titioner(s 11 well and truly administer the estate according to law.
Sworn to or affirmed a subscribed before /`��/ 7 � Date Z 1� ���
me t �s �`�day of� ��; , ��(� �ate 7 � 3
By: N�����._ G�1., p Date .�'�- I�6' !_�
�
For the Register n Date f, � �i.�
�
'� .'�i � � G7
p �' r— �,.;. i3
BOND Required: Q YES Q NO To the Register of Wi[ls: � z r –°' ��
x► N �.a� �� .�
FEES• Please enter my appearance by my�n3tu�?bela�t ;,�
• '� - :r. � :::z
Letters. . . . . . . . . . . . . . . . . . . . . . $ �� � �•�l'�-> Attorney Signature: �`� �-: �,, '� '�"t ��
' � ""(
( �''� )Short Certificate(s). . . . . . [y�'.�;Q �'' �' -'�' "�" �
c� c � �'>
..._
( )Renunciation(s).. . . . . . . . � :x� �.� "�' •--2
( )Codicil(s). . . . . . . . . . . . . ._� —i ,_. ,�
( )Affidavit(s).. . . . . . . . . . . � Cs1 ^ '"�
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Scott W.Morrison
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other . . . . . . . / ID Number: 83943
'1r14�e.iril[�r,r��tti'�. . . t�-L��
— , ^ . . . . . . . . i�i.C.`� ;� Firm Name: Scott W.Momson
?' . . . . . . . . I Gi.�'L? - Address: 6 West Main Street
. . . . . . . . P.n_Rnx 232
. . . . . . . . New Bloomfield,PA 17068
. . . . . . . Phone: (717)582-2300
Automation Fee. . . . . . . . . . . . . . . �?_C� Fax: (717)582-4220
JCS Fee. � � Email: cmnrrisnnlaw(al . .cel nfiirvlink.net
TOTAL. . . . . . . . . . . . . . . . . . . . . $ � �A:96 �
DECREE OF THE REGISTER
Estate of Evalvn M.Lewis File No: �" /..3— �'7,���
a/k/a:
AND NOW, f��`� (`�� � �(.l �(./ ,��, in consideration of the foregoing Petition,
satisfactory proof having been presented be ore me,IT IS DECREED that Letters Testamentarv
are hereby granted to David B.Lewis,Carol A.Lewis and Patti L.Baer
in the above estate and(if applicable)that
the instrument(s)dated Februarv 2 2011
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s})of Decedent.
,
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Register of Wills �_,,�j�� �' � ����;"�,� � / � '
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Form RW-02 rev.10/l1/2011 age 2 of 2
.x.�.��.,�� ��,.� _ .
H105.805 REV(9/I1)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
R�co�c�r� ��-�<cE a�
Fee for this certificate, $6.0o R E G!S��ii l�� ��i���_�.S ,,,�����"""' This is to certify that the information here given is
���,���P�TH OF pEyy___ correctly copied from an original Certificate of Death
�y p A j',*I C� o�' ` `rl= duly filed with-me as Local Registrar. The original
;:�E�3 Jlil. 1� ;� _ � _- Zz certificate will be forwarded to the State Vital
i�`°- Records Office for permanent filing.
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CLE�K G� =* - *;
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CUMBERLAND C0. PA �99jMENj�Ea�'P�
Certification Number � '���""""" Local Registrar Date Issued
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0884381 H1DS'''�
INmosrtbn vamit No. nEV Wrm11
OATH OF SUBSCRIBING WITNESS
Estate of Evalyn M. �ewis N�,, � "� �J '(����
also known as
, Deceased
Scott W. Morrison and Leonard Baer
{each)a subscribing witness to the[�codicii�s} (�wili{s} presented herewith, {each)duly qualified according to
law depose(s) and say(s)that she/he/they wasiwere present and saw the above Testator(rix) sign the same and
that she/helthey signed as a witness at the request of the Testator{rix� in herlhisltheir presence anc� in the
presence of each other ❑ in the presence of the other subscribing witness(es).
(signafure}
SC TT W. MbRRiSON
New Bloomfield PA 17068
(Address}
C��-,
(Signature)
LEQNARD BRER
Mechanicsburg PA 17d50
�aaa�ess�
� :.�:- -�
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t� �� �,-- '�> :°,
Sworn to or affirmed and subscribed � � �` '�" :F"�� �
� P" �,..a
j�r� �--. � �,,� ...V �_�
�
bef re me this � �� day of �" �? � '``� `'�'
, -.= r�; �:� <.:
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�'�yr-P��lic �'�� V �r" '�.�"����S�� �'� �'�'" � � �=" � � -�
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(5ignature and seal of Natary or a#her NOTE: To be taken by officer authorized ta administer oaths. Please have
of�cial qualified to administer oaths.Show present the original or Copy of instrument(s)at time of notarization.
da#e of expiration of Notary+'s commissian.}
RW-2
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LAST WILL AND TESTAMENT � == `�' � �f� �
_.� �
�' r' F--a `-:( i-n
� -�= � � �.. >�`�
�F' �'- � ?: C�`. ::a
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EVALYN M. LEWIS �`' `` k" "
�� � ° ��t
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C.!'I
I, EVALYN M. LEWIS, of 4905 E. Trindle Road, Apt. 1033, Mechanicsburg,
Pennsylvania, being of sound and disposing mind,memory and understanding do hereby
make publish and declare this my Last Will and Testament, hereby expressly revoking all
other writings in nature testamentary by me at any time heretofore made.
FIRST: I direct that all my debts and funeral expenses be paid as soon after my
decease as may be practicable.
SECOND: I direct that inheritance tax on property disposed of herein shall be paid
from my residuary estate.
THIRD: I hereby give,bequeath and devise all the rest and residue of my estate and
property, real,personal and mixed, of whatsoever nature and wheresoever situated of
which I may own at the time of my death, or to which I may be entitled or of which I may
have the right to dispose a�the time of my death,to my three children, David B. Lewis,
Carol A. Lewis and Patti L. Baer, each person to share equally.
� 9 f��L)
,
EVAL M. LEW S
Page one of two
. • > � • �
FOURTH: I hereby appoint my three children, David B. Lewis, Carol A. Lewis and
Patti L. Baer, as Executors of this,my Last Will and Testament. I direct that they shall
not be required to give bond or other security in any jurisdiction wherein proceedings
may be held in connection with my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2nd day of
February, 2011.
WI SS:
- a � (SEAL)
EVAL M. LEWI
Page two of two