HomeMy WebLinkAbout01-31-05
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Pearl S. Black No. 21-05- ooq4
also known as
, Deceased
Social Security No. 194-26-6854
Joseph W. Black and Samuel E. Black
Petrtioner(s), who islare 18 years of age or older, appl(ies) for:
(COMPLETE 'A' or 'B' BELOW)
00 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
the Decedent, dated 10-16-1979 and codicils dated
named in the last Will of
State relevant circumstances. e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
Decedent was married to Nelson S. Black. He died on March 24, 1999.
o B. Grant of Letters of Administration
(c.t.s; d.b.n.c.t.a; pedante lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search haslhave ascertained that Decedent left no Will and was survived by the following spouse (it any) and heirs:
Name
elatlonshlp
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family
Decedent, then 87
years of age, died 01-16-2005
South Middleton Township : C')
(list street, number, and mUniCipality)
at Claremont Nursing and Rehab. Ctr. Middlesex Twp. .
(Location)
f:'?
c":'
CPA
)1"'-'
~;"I
or principal residence at 50 Bonnybrook Road, Lot 49A ,
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
16,500.00
$
$
$
$
situated as follows:
None
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and CodiciI(s) presented with this Petition and the grant
of tetters in the appropriate form to the undersigned:
ignature
Joseph W. Black
Vped or printed name and resi enee
714 Petersburg Road
Carlisle, PA 17013
261 Allen Road
Carlisle, PA 17013
Samuel E. Black
PreparecI by the Peoosytvania Bar Assoclatlan
Copyright (c) 2004 fann software only The Lackner Group, lnc
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petilioner(s) above-named swear(s) or affirm(s) that 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 Deced.nt, P.tition.r(s) will well and truly administer the estate ajOrding to law.
Sworn to or affioo.d and subscrib.d ~ '41, 13 ~
-*"-' Uoseph W. Black
befor.melhisc2lS- day of 1 J~ C:./SAd
\:>> "'. .."'~ a~ Samuel E. Black
~~;:::~~w
~.c..,..!t!~
No ~~) ~ OOq4.
Estal. of Pearl S. Black
, Deceased
C')
Social S.curity No: 194-26-6854 D.\eofDeath: 01-16-2005 ":0
m:::~~~:,:~~":.clo" _,,,"., b_ ~.re:~t
IT IS DECREED that Letters 00 Testamentary 0 of Administration
,...-.. ...... .,
''':,~: , ': ,':::'--)
(c.t.a.; d.b.n.c.t.a.; pendente lite; dUrant&absentia; d~[bnte minorita!ep
, ~-./) C')
Cl ";")
G')
are h.reby granted to Joseph W. Black and Samuel E. Black,
in the above estate and that the instrument(s) dated
10/16/1979
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
~~'"'~
Richard L. Webber, Jr. Esquire
FEES
letters........................
...$ ...uO .0()
Short Certmcate(.)..,......
........ $ OJC . 00
Renunciation..... ... .....
.. $
Attorney:
Affidavits ( ),.
v.:n ~ \
~(,"'P"''d'''~(
..,$
I.D. No:
49634
Weigle & Associates. P.C.
126 East King Street
ShippensbUf9, PA 17257
.m....$ --15 ~ ao
Address:
Codicil....
m....$
JCP F.e....
%.$ I D .()D
T.lephon.S 717-532-7388
E-Mail: weigleattywebber@earthlink.net
Inventory.
m....$
Qlffer~~"""$ "5.00
TOTAL............................$ \ I D .00
Prepared by the pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW.1(1991)
-''''\ '-'.",
This i~ to certify that the information here given is correctly copied from an original cerlificate of death duly filed with me as
Local Registrar. The original certificate will he forwarded to thc Statc Vital Records Office for permanent filing.
TYPElPRINT
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PERIllANENT
BLACK INK
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WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fcc for this certificate, $2.00
li.- C\. ~eu.-&.~
Local Registrar
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Date
P 11018128
JAN 1 7 200S
No.
r....,,)
0)
Hl05,143Rev,2J81
021-04 - 0094-
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
a
0''''
r.,)
NAME OF DECEDENT (Fhl M~dte. Leal)
1. Pearl S. Black
AGE(LuIB~ay)
STATEF'lENlJMBER
'"
2. FEmale
BIRTHPLACE (Cllyand F
SlaleOlF"",lgnColmIry) HOSPrT.....,
lrrisburg,PA :;'."0
FACILITY NAME (lfnotlnoUtuticn, glveslroolendnumbar)
SOCIAL SECURITY NUMBER
3.194 - 26
6854
DATE OF DEATH (Month. Day,Yeer)
,.1/16/2005
87
"'
ERiO<J",...."0
~o
".
-..0 ~'~fy)O
RACE-Amat\canlndlan,Bleck.Wl1illl,at.
(Spooily)
10Yllii te
SURVMil<GSPOUSE
(Kwllo,g....m.ldon..mo)
,
COUr-flY OF DEATH
CJ-\
.. ddlesex Twp.
KIND OF BUSINESS I INDUSTRY
r}araront Nursing & Rehab. Cntr.
AS DECEDEil<T EVER IN DECEDENT'S EDUCAnON MARITAL STATUS. MBn1Bd.
U.S. ARMED FORCES1 ISpoclfyon rad.aomplo.... NovarM.n1ad.Wklcwod,
VeoD Nc~ Elom;;:r12100nd0r; (''::SS.') ,.Wi~JSgeclfy) ".
12, 13. ...
17.. Sl.ete PA Old 11... Kl Veo, decedanl lived I. South Midcll.eton
dacadenl
~in.
lownsNp?
etlylborc.
Bb. Cumber land
DECEDEJIlT'SUSUALOCCUPATION
(~":w.~~:O~U:~~::::'
llL er 11b~rlisle Shoe Co.
OECEOEJIlT'S IlINGAOORESS(StraelCltylTcwn.Stolll.ZlpCcd8) DECEDENT'S
50 Eonnybrcok Rd., Lot 49A ~~~D~NCE
(S....lnslructlons
18.Carlisle PA 17013 onOll1e...lda)
FATHER'S NAME (Firsl. Middle, Last)
tB. Frank W. R. Sa hare
INFORMANT'S NAME (TypoIPMnt)
20L h W. Black
METHOD OF 01 mON
IlIJrIsJ~Cremeticn[1""'ovalfrcmSl.etllO
Olhef(Spoclly)
RALSERVICELlCEN
':.c:4!__
CcmpIare ~omo 23e-o only when cortIlyIng
phyok:lonllncleveleblelltUm.Dfdestl1to
c:ertlfy CltIJS. Dfd..Ih.
.,
l1b. Coontv Cumberland
17d.O=h~~"'::cf
MOTHER'S NAME (Ant, r.Ilddle. Mlldan Sumamt)
18.Anna IJe..valt
INFORMANT'S MAILlNGAODRESS (SlrMl. CltyfTcwn. stele, Zlp Cede)
2Ob. 714 Petersbur Rd., Carlisle, PA 17013
PlACE OF DISPQSITlON. Name cfCamat.ry. C"'fnIIlory LOCATION _ CltyfTDWf1, Stele. Zip Code
01 Other PIIlCtI
21c~t. Zion Cenetery
DonallonO
.21L
. SIG TOR
Allen, PA
21d.
PA
IlIms N-26 must "01 completod by
ponKlnwhopronounceld""th.
21. PART I' [_r","dlo_, '"Jun.. orcomp'...."'n. ""Ic~ _.dlllo d_th. CG nol...., "'" m.... of dying. ouch ...."',.. .r..op'I'Ot<IIy.lTOo~ oh...k orh.."....I.....
U"G"'Y o.........Gn.och "...,
Other sJgnlncam oooditlcno trtbuUngtodeetn,but
nolfll$\Jltlng IntllaundanyingClluseglvanln PART I.
IMMEOlATE CAUSE (Final
dloeau01 conditicn
....uIUnglndoleth)_
CII-F
DC4.IORAS~CONS.OUENC.OF)
OUETO(OR~SACONSEOU.NceOF)'
Sequ..,llallyNotOOl1<l1tione
Ifany.leadingtolfllnllldialll
. CllulO,Ente,UNDERlYlNG
CAUSE(DI_OI"'jury
thaI Inltleted """"10
ra.unlrlgondeeth)LAST
WAS AN AUTOPSY WERE AUTOPSY FIi'tDINOS
PERFORMED? AVAILABlE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
E
DUE TO (OR AS "
SEQUENCEOFJ
MANNER OF DEATH
Natural ~ Homicide 0
Accidant 0 Peodlngln'lfiUgaUcn 0
Suldde 0 Could nol be dalarmlnad 0
DATE OF INJURY
1_.0."..0<)
T1MEOFINJURV
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
Ye.O NoD
JOe. 30d.
LOCATION (St"'Bl.CilylTcwn,Stalll)
301.
e'
YeOONCS
...
PLACE OF INJURY
OuIIdlflg,""(~)
30..
JOb. M
Athcmo.ferm,street,ledory,oIIice
'-0
,.0
28L 28b.
CERTIFIER(Checlcon~cn.)
.l~~Nf J'~lf!=':;r..if':I'h~~~':t';.S:trgrha:~~:~(:r~~h;1~~I~a~lh:~~~.~~.~.~.~~..~~.~~~~~.~.I.t~.~~.)...
".
'PRONOUNCING AND CERTIFYING PHYSICIAN (Ph}'Siden both pronoonclng daalh end cortifylng to Cauoa oIdealh)
Tothl bIIt of my knowlld~. d..th occulTed It the UmIt, d.lI. end pl...., and du.1o th. ...u...(.) .nd manner e. .tII.d
DATE SIGi'tEO(Mcntn, Day, Year)
1- /7---0--;-
.MEOICAl. EXAMINER/CORONER
On tho bul. of .umln.lJon .nd/or In.....t1l11llon, In my opinion. dulll "".Ulred.t III. Urn.. d.lI. and pl.... .nd duo to tho..u".l.).nd
m."II8I"..."'tad...
31..
REGISTRAfl'S SIGNATURE AND HUM~ . ',' e-
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do2'>tsF;~
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{;:'vC''--A- l24-l7()'2';-
l;zllldJ 1101
M.
:=:
LAW OFFICES
WILLlAM F. MARTSON. P. C.
LAST WILL AND TESTAMENT
I, PEARL S. BLACK, of the Borough of Carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind and
memory, do hereby make, publish and declare this to be my Last
Will and Testament, hereby revoking any and all former Wills or
Codicils by me made.
1.
C)
I direct that all my just debts, funeral expeti~~, "
-"I ,
~',": :"!,! c
testamentary expenses and all inheritance taxes shaJr.-;be _paid
)',;
from my estate as soon as practicable after my deb-e~e arri$ as pl!J.tt
~.. (,. .-,,'
of the administration of my estate.
C:,:')
-,.,j
-:'1
2.
I give, devise and bequeath all of my estate, both real and
personal property, unto my husband NELSON S. BLACK, absolutely.
3.
In the event my said husband shall predecease or fail to
survive me, then I give, devise and bequeath all of my estate,
both real and personal property, as follows:
(a) One-half thereof to my son, JOSEPH W. BLACK;
(b) One-half thereof to my son, SAMUEL E. BLACK.
4.
I nominate, constitute and appoint NELSON S. BLACK as
Executor of my estate. In the event he shall be unable or
unwilling to serve in such capacity, then I appoint JOSEPH W.
BLACK and Sfu~UEL E. BLACK to act in such capacity. I direct
that my Executors shall not be required to file a bond to secure
the faithful performance of their duties in any jurisdiction.
5 .
I authorize and empower my personal representatives, in thei
;. .:~~ rE&cIu
pi;ar S. B ac '
Page One
LAW OFFICES
WILLIAM F. MARTSON, P. C.
sole and absolute discretion, to purchase or otherwise acquire
and retain any investments for which I die seized or any real or
personal property of any nature; to sell, lease, pledge, mortgage,
transfer, exchange, dispose of or grant option in regard to any
or all property of any kind forming a part of my estate for such
terms and such prices as they may deem advisable; to borrow
money for any purposes connected with the protection and
preservation of my estate; to mortgage or pledge any real or
personal property forming a part of my estate or to join in or
to secure partition of same; to compromise any claims or demands
of my estate against my estate; to make distribution in kind and
to cause any share to be composed of cash, property or undivided
fractional shares in property different in kind from any other
shares; and to execute and deliver such instruments as may be
necessary to carry out any of these powers.
IN WITN'ESS WHEREOF I have hereunto set my hand and seal
this /&#i day of &ctJ.uz
, 1979.
(:P ~ ~ f3JJAA'J> /
Pearl S. Black
(SEAL)
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named
Testatrix, PEARL S. BLACK, as and for her Last Will and Testament,
in the presence of us, who, at her request, have hereunto
subscribed our names as witnesses thereto, in the presence of
said Testatrix and of each other.
~\J.~~
-rt-f1W~
',___../
Page Two
l.AW OFFICES
WIl.l.IAM F, MARTSON, P,C.
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND . .. )
SS.
I, PEARL S. BLACK , 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 the 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 expressed.
a~..J7_~ ~ /
Sworn or affirmed to and acknowledged before me by
the above Testatrix, this I&<{{, day of ~ ,1979.
~~J~
Notary MS~ENK, Nolo')' Pul>l1.
Co.IIoI., Cumbulund Co" P A
Mi; c.n.n.mlon ",pi"" Fob. 27, 1*
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND . . . , )
We, Jl-o U. &.a1Y" IlL (/,,..L I~o fl. 0 ~~
the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to
law, do depose and say that we were present and saw
PEARL S. BLACK , Testatrix, sign and execute
the instrument as his Last Will; that PEARL S. BLACK
signed willingly and that PEARL S. BLACK
executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight
of PEARL S. BLACK , Testatrix, signed the Will
as witnesses; and that to the best of our knowledge, the
Testatrix was at that time 18 or more years of age, of sound
mind and under no constraint or undue influence.
~\j. ~~
Address ~ 1.0;'" \.<:-p, ^" \
_ Co.&~,- VA, \'10\'>-
-rf~Q W~
Address dJ C_ {+1 C' J f .
(CVt LJ. ,t?c.
Sworn or affirmed to and subscribed before me this /&~
day of (/kCc4, , 1979.
/~~- ~
Notary ~c
, LEA SHENK, Nota')' PubIIo
Carlisle, Wmborlund Co" PA
Mi; ~on bpireo fob. 27, 17.