HomeMy WebLinkAbout02-18-05
Estate of . 1-11' / r" i1
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
P feYY7dlcl~ No. /1.1 - oS- - ()/"S-
To:
Deceflsed.
n'lh
Register of Wills for the
County of in the
Commonwealth of Pennsylvania
Social Security No. 177 - :l'j-
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age^or older an the execut
in thelast will of the above decedent, dated () \ a."", 4 I 'ft.. f
and codicil(s) dated
)
na1'ed
,19 (,'
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendem was domiciled at death in ('
h tf' last family or principal residence at
County, Pennsylvania, with
o
",^
(list street, number and muncipality)
De e den~ th~n~
at . .:>.
Exce as f lows, decedent id not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(rt not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
--
..J <,""
7/
().o as-
,# ;J<JoS,
17/. / 'J 0
.
$
$
$
$
lvii'
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron.
(testamentary; administration c.1.a.; administration d.b.D.c.t.a.)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ., ss
COUNTY OF ember-land. J
.
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The petitioner(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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or af fi.rm.ed. u" nd subscribed { ~}! ~ __ ~
before me this _ ( L day of ~ ' _. __~ ~.
i:ft..1:"f;-::^-!r -~;"/1 t<r~- . ~
~ c f~, (/'- .. RegIster l ~
. ~
No.
d I - oS- -6/1.,:;-
p ~VflO Ids
{
, Dece2sed
Estlllte ~f
/-Ie- fen
DECREE OF PROBATE AND GRANT Of LETTERS
AND NOW / f+tr d", V ~b,,,,,, r y ~.(a')--:-in consideration of the petition on
~e I~Y;~~:~~e::::, t~a:i~!:;::e:;~~~::~ng bee; PJ;f7Z 7fore ~e,
described therein be admitte . pr te and jed of relord Is the last will of
and Letters
.5
FEES
Probate, Letters, Etc. ......... $
Short Certificates( ).......... $
Renunciation ................ $
$
TOTAL _ $
fA-
Register of Wi
C
~
ATTORNEY (Sup. Ct. 1.0. No.)
ADDRESS
Filed
....................................
PHONE
"'''~Y'''' '<":V
Thi, is to certify that the information here given is correctly copicd from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permaneni'filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
P 11336211
No.
II,IIIII1HH'hh''''''''i
,,"':' ~\.'" OF PEl;----,
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"''''''''''''h,,,,,,,,1I111111
t!~~ 9(~)~t;
Local Registrar r
Fee for this certificate. $6.00
fj}~nJ; )./ d,()-() .;-
ate
c'
tll0~; 143 ~u. '2181
COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(:~;
TYPE/PRINT
"
PERMANENT
BLACK INK
STA.T~ H,~NU"'a~R
1,HelenP.Re
AGE (lasl Il,rthday) N R
Monilia
nolds
^ ,
Da~ Hour$
2Female 3,177
8IRTHPLACE(C;tyand I AT
Slate or Foreign Counlry) HOSP'TA!-
PA '"o.."o,il] ~....o.........",O
T h.
FACILITY NAME (I' not inatitut;on, !lIve it..'et ~nd number)
Splr;t, ~"Sp',IQ\
24 -5146
DATE OF DEAHl (Month. Day, 'r'ea,)
-4. M ,'31 ,x,o~)
NAME OF DECEDENT (Firsl, Middw, last)
'"
SOCIAL SECURITY NUM6ER
5 92 Vrs
COUNTY OF DEATH
DO'" 0
fl""'."".O ~~>y)0
RACE.AJT\&'ic.onlnd;an.Black,Whlta,e
(Specify)
" Whi
SURVIVING SPOUSE
(~"',.. Q<'. m...." ....,.J
Cumberland East Pennsboro
8b 80
DECEDENT'S USUAl OCCUPATION KIND OF BUSINESS I INDUSTRV
I~\':~;,~:~,r::' "~tu~~~'.:'/i::)'
MARITAL STATUS. MlIllied,
Never Manied. Wid""""d.
Divoroed(Speci!y)
11a Homemaker l1b. Own Home
DECEDENT'S MAILING ADDRESS (Streel. CjjylTown, State. Z;p Code) DECEDENT'S
ACTUAL
RESIDENCE
(s..-einwuctions
on otIl.., side)
11~. Stal"
PA
"
detede"l
~.e in a
luwn.hip?
l1e.1i] Ve., de<:edenl li.ed in
c;:i 1 V/3r"
'pring
~"
>~
ffi
a
w
~
a
~
~
z
430 Hogestown Road
l&,Mechan;csbur PA 17055
FATl1ER'S~E(F;,.tMld~le,La"t)
11 Charles 1-1. Martin
INFORMANTS NAME (TypelPlintl
20a, Robert E. Re nolds
METHOO ClF DISPOSITION
. oon~'",nD B",iol I;JC'ematiun Gurnu.ailmn,Slale D
. 21a. Olr'a' pee
. SIGNAT OFFU
l1b.Countv
('umho...l",nrl
l1d. 0 ~i:i,~~~~\~~~ 01
cilylboro
MOTHER'S NAME (Firsl, Middle. Maiden Sum~me)
1j,Margaret C. Hoffman
INFORMANTS MAILING ADDRESS (Slr....l, C~y/Town. Stela, Zip Code)
~b 827 Fa;rf;eld Street Mechan;csbur PA
PLACE OF DISPOSITION- Name of C""",tery, Crematory LOCATION. Cily/TO'Wn, Slate, Z;p Code
or Other PI.ee
17-055
21Mechan;csbur
Cemeter 2ldMechan;csbur
PA
17055
"
EEORPERS
NAME AND ADDRESS OF FACILITY
'"
5
."
C mpletell S a-co y when certifyi
phy.ician i. not a.ailabl..al ~ma of death 10
cOrlifycau.eo/dealh
LICENSE NUM6ER
DATE SIGNED
(Month,Day,Y....'>
("f'cbnC'
2Jb He.
WAS CASE REFERRED TO A ME'OICAL EXAMINER /CORONER?
2.. VelD No' [3:
:A,pproximate PARTU: Otr,or.ignif,c.ntcoodiUonleQOlr1bulinglOdulh,but
. Irltervalb/llw...." nol,e""lling inlhelJ(\darlyngeau.elliven in PART I
: onset and dealh
; ,t
l:
OlJ~TOIOR"S"'CONSEQUENCEcOf)
DUE TO IOO.o.s...CONSEQlJ.ENCE Of')
""0
Natu'al !l;l
ke,denl 0
S"idde 0
Homioide
OATEOFINJURV
I"'onrh. 0". V.arl
o
o
o ~~:.cEOFINJURY
bu"Oiog..'o.(Sp.',,>,)
30e.
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW iNJUR'r' OCCURRED
WERE AUTOPSV FINDINGS
AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
MANNER OF DEATI-1
vesD Nug]
ve.O
Pend'ng 1'1V~~li~ation
Ceui<lnol b~ dUI~"'''ned
Ye.D NoD
JOb M JOe.
AI home, larm, alreel,laclOry,oIf",e
'PRONOUNCING AND CERTIFYING PHYSICIAN (Phy..clan bolh Pru<\"U"cing <le~lll and cartifying 10 cau.e 01 dealh)
To th. ~.t 01 my knowledlle, dull> o<:curr.d ;01 the Um., dete, ."d pla<<, end due 10 Ihe cau'''('1 and menne, aa ~lal.d...
o
..1(]
2b 2ib
CERTIFIER(Checkoniyonel
'l~~~FJ.:~IG"r::'~~I~~~~ejf;:"~'i::Ih~~ggC~~~':t""': I~ li:':~a~~:~:r~~'Jr~~x~i~;a~.h:t~r.~:~.~~:~~,~ .~~alh, .~I.'~ .~~.'~:~~~~,~ .i.~~_~ ?:.)..
"
'MEDICAL EXAMINER/CORDNER
~~::;':rb::I:c::~~umln.t10n andlor In,,,UlI.lien, In my opinion, d.-It> occurr.d ;otth.tl,ne, d~I.., .nd pl~c., ~nd due to th. UU"'(II\ ""d 0
3h .
REGISTRAR'S SIGNATURE AND NUM8ER
Zu.'^ A" :Ir.~,Jw ))y;,,,fy~___~~ lill.v.J.ill!
r
-.
Register ofWilIs of Cumberland County
,
OATH OF NON-SUBSCRIBING WITNESS
Estate of /-!f'/rYl P. r}J1lfld S
Also known as
-
No. ;). / - ()S- - () I (P5
.
, Deceased
I\.\t~ )f~
~/ ~f'~Y-:,.
(each) a subscriber hereto, (each) being duly qualified according to1'aw, depose(s) and say(s) that
familiar with the signature of flr/f" /) R.yvI/:Jds. ,testat_of(oneofthe
subscribing witnesses to) the codiciIlwiII presented herewith and that '" "- believelbelieves the signature
on the codiciIlwiII is in the handwriting of ;-I cI i''1 P J?) ""Id; to the best of
0", J knowledge and belief.
1,1) a alA )J .::;t~
(Name)
Sworn to or affirmed and j,ubscribed
Be re me this / e /1 day of
,/ ' ,200~
if. fS'f?I1fz('J
(Address)
D-r
IYl ~cJ,q n I C'> bV'J
p<\
hlo~d,^ L ~~~
Register Q
c, ~c I/\-
Deputy 1
f21~Z;~-
(Name)
~7 r:~4i 1J1~~.L.~ rCCI
(Address) ~ ~'7
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LAST WILL AND TESTAMENT
I, HELEN P. REYNOLDS, of Silver Spring Township, County of
Cumberland and State of Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this
as and for my Last Will and Testament, hereby revoking and making
void all former wills and codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral
expenses be paid by my Executor or Executors, as the case may be,
hereinafter named, as soon as conveniently may be done after my
decease.
SECOND. I give, devise and bequeath all the rest, residue
. )
and remainder of my Estate, real, personal and mixed, ~B~~soe~r
'-)
and wheresoever situated, unto my husband, MERVIN S. REYNOLDS,
1
absolutely and in fee simple, if he survives me.
\'
THIRD. If my husband, MERVIN S. REYNOLDS, does not-surviv~me,
,.
then and in that event, I give, devise and bequeath my entire said
Estate in equal shares unto my five (5) children, namely, ROBERT E.
REYNOLDS, MILDRED E. SCEARCE, DORIS L. HYSER, SHIRLEY ANN FAKE, and
WILLIAM I. REYNOLDS, share and share alike.
Should any of my said children predecease me, I order and direct
that the share of my said Estate which would have been distributed
to such deceased child had he or she survived me be distributed to
his or her issue per stirpes, said issue being substituted for
their deceased parent by representation and being entitled to only
been entitled had he or she survived me.
LASTLY. I nominate, constitute and appoint my husband,
MERVIN S. REYNOLDS, to be the Executor of this, my Last Will and
Testament, but if for any reason he should fail to qualify as such
Executor or cease so to serve, then I nominate, constitute and
appoint my son, ROBERT E. REYNOLDS, and my son-in-law, WALTER H.
FAKE, JR., or the survivor of them, to be the Executors hereof, all
to serve without bond.
IN WITNESS WHEREOF, I. HELEN P. REYNOLDS, have hereunto set
my hand and seal to this, my Last Will and Testament which consists
of two (2) typewritten pages to each of which I have affixed my
signature this '-I.du day of UJ/Jaf"NJh- A. D., One Thousand Nine
Hundred Sixty-seven (1967).
::r&1t:r; ffJ Jit~.~ ~,
/
(SEAL)
The preceding instrument, consisting of this and one (1) other
typewritten page, each identified by the signature of the Testatrix,
was on the date thereof signed, sealed, published and declared by
HELEN P. REYNOLDS, the Testatrix therein named, as and for her Last
will and Testament, in the presence of us, who, at her request, in
her presence, and in the presence of each other, have subscribed
our names as witnesses hereto.
,-~...u.-,.
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