The URL can be used to link to this page

Home My WebLink About01-09-14 PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF C u m b e r 1 a n d COLJNTY, 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 II Q Name: N a n c y A • D i l s n e r File No: 2�'�`��2V a/k/a: N a n c y A n n e D i 1 s n e r (Assigned by Register) a/k/a: �a: Social Security No: 18 6-3 0-5 8 6 6 Date of Death: 11/2 7/2 013 Age at death: 7 5 Decedent was domiciled at death in C u m b e r 1 a n d County, P e n n s y 1 v a n i a (State) with his/her last principalresidenceat 9�8 Alison Avenue 17055 Mechanicsburg Borough Cumberland Street address,Post Offce and Zip Code City,Township or Borough County Decedentdiedat 503 N 21st Street 17011 Camp Hill Cumberland PA Street address,Post Office and Zip Code CiTy,Township or Borough County State Estimate of value of decedent's propeRy at death: If domici[ed in Pennsylvania................................AII personal proper[y $ 8 i�� • �� /f not domiciled in Pennsy[vania.............................Personal property in Pennsylvania $ If not domici[ed in Pennsylvania.............................Personal property in County $ Value of rea[estate in Pennsylvania.............................................................. $ 2�� • 0� TOTAL ESTIMATED VALUE.... $ 2 O 8�O O O . O O RealestateinPennsylvaniasituatedat: 9�8 Alison Avenue 17055 Mechanicsburg Borough Cumberland (Altach addiuona!sheetr,lfnecessary.) Street address,Post Office and Zip Code City,Township or Borough County �-�a � A. Petition for Probate and Grant of Letters Testamentarv •��: � � Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated �1/2�1� �a�jCodicil(s) thereto dated �" �"" '� � W � --�-- � r-� State relevant circumstances(e.g.renunciation,dea[h ojexecutor,etc.) '��("" F._a Fry-j t'T'# r- � m o �r � Except as follows:after the execution of the instrument(s)offered for probate Decedent did not marry,was not r�l,5�as not a party t�a p'e`Ading divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323(g),a��di�ot�ave a�ld bor"i"i�o� adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. �-� p �; � �;� � NO EXCEPTIONS ❑EXCEPTIONS � :� � T ' � �a �" �,�, v� � ❑ B. Petition for Grant of Letters of Administration(If applicable) y' ""� 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 ❑EXCEPTIONS Petitioner(s),after a proper seazch has/have ascertained that Decedent left no Will and was survived by the following spouse(if any)and heirs(attach additional sheets, if necessaryJ: Name Relationship Address Form RW-02 rev. IQ']1;2011 Page 1 Of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COLJNTYOF Cumberland } Petitioner(s)Printed Name Petitioner(s)Printed Address 9�8 Alison Avenue Patricia A • Allen Mechanicsbur PA 17055 The Petitioner(s)above-named sweaz(s)or affirm(s)the statements in the foregoing Petition are true and correc[to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the Dec nt,the Petitioner(s)will well and truty administer the estate according to law. Swcrn to1�or{.�affirmea and ubscribed before ��1�C�... C�,� Date . I I C� � � me ' �v.-.- �lay of , �� Date By. Date For the Register Date. �� G Q i`�'t � � � � � Q BOND Required: ❑ YES � NO To the Register of Wil[s: � -,� � � :z� --i � FEES: Please enter my appearance my ' �u�elo�;, � � /� 00 � � d �o �a Letters. . . . . . . . . . . . . . . . . . . . . . . $ V Attorney Signatu• : � � � p, Cr ( 5 )Short Certificates(s) . . . . . . '1.5. D0 , � e'� p � � � ,, � � ( )Renunciation(s) . . . . . . . . . . '� � � � � : � � � � ( )Codicil(s) . . . . . . . . . . . . . . �.... ( )Affidavit(s). . . . . . . . . . . . . � � E 4--+� 1 e � Bond . . . . . . . . . . . . . . . . . . . . . . . . . Printed Name: a v i d H • . �'0 n 2, Commission Supreme Court Other . . . . . . . . . ID Number: 3 9 7 8 5 "'�nh �c . . . . . . . . . t5�o0 �en� 15 �� FirmName: StOnE LaFaver & Shekletski �� 5�� Address: 414 Bridge Street P • 0 • Box E � � � � � � � � � New Cumberland PA 17�70 . . . . . . . . . Phone: 717-774-7435 . . . . . . . . . � Fax: 717-774-3869 AutomationFee . . . . . . . . . . . . . . . . . Email: dStOn2a�StOC121aW- net JCS Fee . . . . . . . . . . . . . . . . . . . . . . . ��J• 'J�v TOTAL . . . . . . . . . . . . . . . . . . . . . .$ � • D DECREE OF THE REGISTER Estate of N a n c y A • D i 1 s n e r File No: �� ' �`I- ooa B �a: Nancy Anne Dilsner AND NOW, � � � � , , �� , in consideration of the foregoing Petition, satisfactory proof having been presented befare m IS DECREED that Letters T e s t a m e n t a r y are hereby granted to P a t r i c i a A - A 11 e n _ in the above estate and(if applica�le)that the instrument(s)dated 3/31/2 010 _ 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 2W-01 rev. l�'11i201/ a � HI05.805 REV(9/II) ��-��-��g V LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. RECORCI�D UFF[CE OF Fee for this certificate, $6.00 ,,,��"""��--.. This is to certify that the information here given is R E G I S�'E R 0 F �'i L!.S ��,,��p�TH OF pF�;y__ correctly copied from an original Certificate of Death �,��'�o� = _`��; duly filed with me as Local Registrar. The original ;'�� :��N �� t i� �.Q �6 �� .� z� certificate will be forwarded to the State Vital :° �' a� Records Office for permanent filing. ; ?,r _ ,r� �' , P 2 010 3 9 8 5�oPHANS�COURT ��q9lM oE�`��'~?' �a a�3 r3 Certification Number �-.,'ENT Gl3MBE.�tLAt�D C4., PA """"""�� Local Registrar Date Issued Type/P�int In COMMONWEALTH OF PENNSVLVANIA�DEPARTMENTOF HEALTN•VITAI RECOROS PefTa^e^� CERTIFICATE OF DEATH State File Number: Black Ink 1.Deced�nt's legal Name(First,Middle,Last,Sufflx) 2.SeK 3.Social Security Numbar 4.Date of Death(MO/Day/Yr)(Spell Mo) Nanc Anne Dilsner Female 186-30-5866 November 27 2013 Sa.AQe-Last Birthtlay(Yrz) Sb.Untler 1 Year Sc.Under 1 Da 6.Date of Birth(MO/Day/Vear)(Spall Month) 7�.Birthplace(City antl State o�Forelgn Country) Moncns oays r�ours nn�nutes Harrisbur P�nna lvanla 75 February 3� 1938 7b.Birthplace(coun2y) Dau hin 8a.Residence(State or Forel¢n Country) Bb.Residence(Street antl Numbe�-IncluEe Apt No.) Bc.Did Decedent LWe In a TownshlpT Panns lvania 908 Alison Ave 0 Ves,tlecsden�Ilv�d In �`^�P• Sd.Resitlence(COUn[y) C.vnberland Se.Residence(21p Code) 17055 �No,tlecedent Ilved wi��in Ilmiis of Mechanicsburrz ci:y/coro. 9.Ever in US Armed Forces? 10.Marital S�atus ai Time of Death Marrletl � W�dawetl Il.Surviving Spouse'S Name(If wlfe,glve name prior to fl�st marrtage) �Ves �No 0 Unknown � Divorced �Nevar MarHeC 0 Unknown 12.Father's Name(Firsi,Mltltlle,Last,Suffix) 13.Moiher'z Name Prlor m Firsf Marrlsge(First,Middle,last) George R. Niasley Olive M. Coble 14a.Informant's Name 14b.ftelationship to Decedent 14c.Informant's Mellins Address(Street antl Number,City,State,Zip Code) Patricia A. Allen Daughter 908 Alisor Ave Mcchanicabur Penna lvania 17055 G - - - - - - - - --- --- -isa. ace o eat ec o e - - - - - -. - - - - - If Death Occurretl In a Hospltel: �InpeHent Ilf Death OcCUrretl Somewhele Other Than a Hospltal: ❑Hospice Faclliiy b DeCetlenc's Home � O Eme�gency Room/OUtpatlenS O Deatl on Arrival � Nu�sing Home/LOng-Term Caro Facllity O Other(Specily) o� i5b.iacllity Name(If noS Institutlon,give strea[antl numb�r) '15c.C�ty or Town,SCa[e,anA Zip Cod� 15tl.Co�anty o�Oe�th � Hol S irit Flos ital Cam Hill Pen lvania 701 " 16a.Method of Dispasitlon � Burlal � Cremailon 16b.Dafe of Dlsposition 16c.Vl�ce of Dlzposliion(Name of cemetery,cremaiory,Or oiher place) � o n�mo�ei r�o",scac� o oo„ee�o., Drc. 03 .'�/ 0 Other(Specify) Cremation Society of Pennaylvania 2 16d.Locatlon of Oisposltlon(City or Town,State,antl 21p) 1]a.Slgnat�re of Fun I Serv e or Person in Charge of Interment 176.Licenze Number � Harrisburg, Pennsylvania 17109 FD-138948 E17c.Name antl Complete AdEress of Funeral Facility 8 Auer Cremation Services o£ Penns lvania Znc. 4100 Joneatown Road Harrisbur Penns lvania 17109 18.Oecedent's Educatlon-Check che box thaS bezt describes ihe 19.Decatlent of Hlspanic Origln-Chetk the 20.DecedenYs Race-Check ONE OR MORE races to indlcaie what m highest Aegree or level of school completed at the time of death. box that best describes whather the decedent ihe tleceden2 consitlered hlmself or herself to be. � Sth graEe or less I5 Spanish/Hispanic/LaLno. Gheck the"NO" �White � Korean � No diploma,9th-12th grade box if tlecedent is not Spanish/Hlspanic/LaUno. �Black or African American � Vletnamese � High school gratluste or GED c mpleied �No,not Spanlsh/Hispanic/LaHno O American InElan ar Alaska NaHVe � Other Asian � Some college cretlit,but no deor e �Ves,Mexlcan,Mexiun American,Chicano O Asian Indian � Native Hawalian S C Puerto Rican O Chlnese Q Guamanian or Chamorro � Associate dagree(e.g.AA,A5) �Ves, Samoan 0 Bachelor's tlegree(e.g.BA,AB,BS) �Yes,Cuban 0 Filipino � Other Paclfic Islantler Q Master's deQrce(e.Q.MA.M5,MEng,MEd,MSW,MBA) �Vez,other Span{sh/Hlspanic/Latlno 0 Japanese � Ooccorate(e.g.PhD,Etl�)or Professlonal tlegree (Specify) �Oiher(Specify) .MO DDS DVM LLB 1� 21.Decedenf's Single Race Self-Designatlon-Check ONLY ONE to indicate whaC the tlecetlent conslderetl himselt or herself co be. 22a.Decetlenc's Usual OcwpaLOn-Indluie type of wor �White �Japanese 0 Samoan done durinQ mosi of working I(fe. DO NOT VSE RETIRED. � BlackorAfriCanAmerlcan � Korean � OCherPacificlslander DTBft & Blu¢ rint Des1 neY � O American Indlan or Alaska Naxive �Vietn�mese 0 Don't K�ow/NOt Sure 2Zb.K{nd of Buslness/Industry p Aslan Indlan O Other Aslan O Refused � �Chinesc � Nafive Hawallsn � Other(Specify) O Filipino �Guamanian or Chamorro Manu£acturin ITEMS 23a-23d MUST BE COMPLETED 23a.Date Pronounced Dead(MO/Day Vr) 23b.SiQnature of Perzon Pronouncing Death Only when appilcable) 23c.Licenze Number BY PERSON WHO PRONOUNCES OR � ' � ^L�� '20� ,^.� ��I� ��Z�j CERTIFIES DEATH 23d.Daie Slgned(Mo/Day/Yr) 24.Time of Deac;� No T ^, ' 25.Was Medical Examine�o�Co�oner Contactetl? O Yes CAUSE OF DEATH � ApPrOx{mate 26.PaR I. Enter the shain of evenis--tllseases,Inj�ries,or complicatlonz-that Elrectly caused the death. DO NOT enter teerominal events such as cartliac arrest, � Interval: respiratory arrest,or ventricula�fibrlllatlon without zhowlnQ the etlology. DO NOT ABBREVIATE. Ente�only one caus n a Iine. Add atltlitional Ilnes If necessary. 1 Onset to Deaih 1 A ' IMMEOIATE CAUSE -------------> a� � (Final tl�s�as�or conEl<lon Ou�to o as�cons�q • � 1 resultlng in tleath) � � b. � Sequentially Iise contlitions, Due t0(o�as a consequen 1): i if any,leatlin¢to th�cause I Iistetl on Iine a. Enter the �� Due to(or as a consequante of): � UNGERLYING CAUSE � � (disease or inJury that � ¢ IniHatetl the events resulting d, as a con nce ' In death)LAST. Due to(or seque of): 1 � 26.PaK 11. Enter other ' Ifl t tl'tl t�ibutina to tleafh buf not re5ulilnH��the untlerlylnQ wuse g`� 27.Was an autoPSY PeA9!metli � Ves Ig No � 2B.Werc autopsy findingz avallabis �l1d.la++n0h�a , �'� P�� Y� to wmpleie fhe cause of deathT 4 O Vei O No b 29.If FefY ale: 30.Dld Tobacco Use Contribute to DeathT 31. er of Deaih o [g Nof pregnant wi<hin past year � Yes � Probably �Natural 0 Homicide � Pregnani at time of death � No [��lnknown O A�cident � Pentling Investigatfon �' � NoY pregnant,buc pregnant withln 42 tlays of deach O Suicide 0 Coultl noi be deSerminetl r � Not pregnant,but pregnant 43 tlays co 1 year before death 32.Date of Injury(MO/Day/Yr)(Speil Month) 33.Time ollnjury � Unknown If Pregnant wlthin the past year 34.Place of Injury(e.g.home;tonstructlon slie;farm;school) 35.Location of In)ury(Streei and Number,Clty,County,State,21p Code) � 36.Injury at Work 37.If Transportatlon InJury.Specify: 38.Describe How InJury Occu��ed: ` � Yes 0 Drive�/Operotor O Pedestrian � No O PaszenQer O aher(Speci(y) � 39a.Certifler-physiclan,certifled nurse pracHHOner,madical examinar/co�one�(Check only one): � ertlfylnp oniy-To the best of my knowledge,deaih occurretl due to the cauze(s)and mann r statatl. �ronouncing&Certitying-To the best of my knowletlge,tleafh occurred at the time,date,antl place,and due to the cauze(s)antl manner sbted. a � Metlical Examiner/COroner-On the bas�s o7ya�m7naUo�a vestlQaHOn,In my opinlon,tleath ocacAurred at the Hme,tlate,and plsce,antl due io the cause(�y),fd.�e� tatetl. "/`, +� Tltie of certifier: ��•� License Number:�� •�"�o� Signat�re of certifier. �� 5� � �� 39b.Name,Addross and 21p Code of�krson CompleNnQ Cause` e� (�N a� ��• � y f�/ � ` 39C.Da�i�e �MO%/V�) �Yi �JO 3T f r� a- /!d!/ // �.co � 40.Reg trar's Distri Number 41.Reglstra�'s SIB��ture � 42.Registrar FI e Date(MO/Day r - �a «- 03-�,�3 � 43.Amentlments � H105-143 Dispositlon Permlc No.�q� REV 07/2012 F:\DOCS\EP\WILLS\Dilsner.Nancy 9-2010.wpd � ' � � � � � Psi �W �O � � Q '� =� � � rn � ca ,.._� �:, � �„ �� ►�.' ,-,�� r� LAST WILL AND TESTAMENT � "`' .� � "" `'� ._V � OF r� �-� � °� � -�:� NANCY A. DILSNER f�°� �' '�' "� � � +�� c.w �. ��_ �� ' � c�� ;_... j-� ._j r-- '"t7 N t/7 � � � � I, NANCY A. DILSNER, of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I : I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II : All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this will, together with any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid from my residuary estate without apportionment or right of reimbursement . ITEM III : I bequeath all of my personal property to my daughters, PATRICIA A. ALLEN and BARBARA J. McVEY, to be divided among them as they agree . ITEM IV: I devise the premises known as 908 Alison Avenue, Borough of Mechanicsburg, Pennsylvania to my daughter, PATRICIA A. ALLEN, provided she survives me . ITEM V: I devise and bequeath the residue of my estate, of every nature and wherever situate, in equal shares to such of my daughters, Page 1 of 4 PATRICIA A. ALLEN and BARBARA J. McVEY, as survive me . Should any of my daughters predecease me, I devise and bequeath the share of such daughter to her issue, per stirpes . ITEM VI : I appoint my daughter, PATRICIA A. ALLEN, Executrix of this my last will . ITEM VII : No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, NANCY A. DILSNER, have hereunto set my hand and seal this 3 t day of l ' V)��r� , 2010 . .� ^y� \ r NANCY A. DILSNER SIGNED, SEALED, PUBLISHED and DECLARED by NANCY A. DILSNER, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the pr e of e c other, have subscribed our names as witnesses . 414 Bridae St . , New Cumberland, PA Wit `1 Address ,� � , 414 Bridge St . , New Cumberland, PA Witness Address Page 2 of 4 COMMONWEALTH OF PENNSYLVANIA: . SS . C�UNTY OF CUMBERLAND . I, NANCY A. DILSNER, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instrument as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. , � �� NANCY . DILSNER Sworn to or affirmed to and acknowledged befos�e me by NANCY A. DILSNER, the Testatrix, this '��1 day of ��,� , 2010 . COMMONWEALTH OF PENNSYLVANIA ' NOTARIAL SEAL o t a r y P ub 1 i c KELLY A. BIRDSALL, Notary Public New Cumberland Boro.,Cumberland Co. ��y Commission Expires June 18,2013 Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA : . SS. COUNTY OF CUMBERLAND . We, `J�C>�'., �� . J'�-v�e and '�� . � , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatri.x sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowiedge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence . " , ; 1 .; ' tne s '� � Witness Sworn to or affirmed to and acknowledged bef�re me by �`o�c\� 'cl. �'r�hA a n d � o'��`�t.� � witnesses, this �_ day of �1��,�0�` � , 2G10 . . �.�'� G, '('�r�r�c�.� COMMONWEALTHOFPENNSYLVANIA Notary Public NOTA IAL SEAL KELLY A. BlRDSALL, Notary Public New Cumbe�land Boro.,Cumberiand Co. My Commission Expires June 18,2013 Page 4 of 4