HomeMy WebLinkAbout04-27-05
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Dorothy R. Holtry No. 21-- 05 -3q6
also known as
, Deceased
Social Security No. 174-20-0533
Gerald H. Hershey
Petitioner(s), who is/are 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 Executor
the Decedent, dated 06/05/2003 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:
o B. Grant of Letters of Administration
(c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs:
I Name Relationship Kesidence 1
"
, . '.;
.
.'
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family
or principal residence at 3131/2 East King Street, Borough of Shippensburg ,
(list street, number, and mUnicipality)
Decedent, then 83 years of age, died 04/17/2005 at 3131/2 East King Street, Shippensburg
(Location)
)
)"1'"'1
C'l
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
381.00
32,300.00
situated as follows: 313-3131/2 East King Street, Borough of Shippensburg, Cumberland County, PA
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant
of letters in the appropriate form to the undersigned:
Typed or printed name and residence
Gerald H. Hershey 126 Neil Road
Shippensburg, PA 17257
Prepared by the Pennsylvania Bar Association
Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
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 representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate~c ording to law.
Sworn to or affirmed and subscribed X _! tr j /111 !~ UA L
.-,-+L ~ l3eral H. Hershey -----a=
before me this ;}., I ( , . "day of
(jp~ ,~005
\.. W P A'1 r1 ;.",10. J\ f\Qj., '11)
For the Register
No.
21-- 05- 2:/1 lc
Esfate of
also known as
Dorothy R. Holtry
, Deceased
Social Security No: 174-20-0533
04/17/2005
Date of Death:
AND NOW, _
, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [!] Testamentary 0 of Administration
(c.I.a.; d.b.n.c.l.a.; pendente lite; durante absentia; durante minorilate)
are hereby granted to Gerald H. Hershey, Executor
in the above estate and that the instrument(s) dated
6-5-2003
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
FEES
Letters........................................$ q () . CD
Renunciation.............................. $
J.D. No: 01624
Weigle & Associates, P.C.
Address: 126 East King Street
Short Certificate(s).....................$ e> (l()
Affidavits ( )...........................$
r' "'~".!~ ( ).ui.&~..$ \':) .()~
Codicil..................................... ...$
Shippensburg, PA 17257
Telephone3 (717) 532-7388
JCP Fee.....................................$ 10. m'J
Inventory..... ..............................$
E-Mail;
OtherCk.0:1~~.:b~lS.""'.....$
-1Y~~
c::: Ji"l'\
u -u l)
TOTAL............................ $
I ~7J (J[)
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group. Inc.
Form RW-1(1991)
lllO.~)\(l) R.EV I/O)
This is to certify that the information here given is correctly copied 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 permanent filing.
11337489
No.
WARNING: It is illegal to duplicate this copy by photostat or photogra h.
Fee for this certificate, $6.00
p
{~jJL~ 'U?O<r
Date
R
'EX
ST)ll"EFllENUM8f;A
SOCIAL SECURITY NUMBER
H105.1<< Rev. 1f91
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(I::oronerl
TYPElPAtNT
IN
PERMANENT
BLACIC INK
~
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"Female ,. 174-20-0533
UNDER 1 DAY ONE OF BIRTH BIRTHPLACE (CiIy and PlACE OF OE,qH ICheck only one see in&lrUCllOOS on other, sidel
Hours Mil'lulee (Montl1.Day,~,) SIaIeOl'ForeignCounlry) HOSPITAL
,~e p . 25 , 1 921 7.ShifPeIlSh.Irg, FA ~~lilInl 0
OF DEATH FACILITY NAME (It l'IOI illli1ilvtion, OIVe$1feel and number)
k,
Shippensburg
Id,
KINO OF BUSINESSIlNDUSTAY
DECEDENT'S USUAL OC:CUp,(rION
(~t:::ll~~~U~r;::Prr:;dor
11. Homemaker 11b.
DECEDENT'S MAILING ADDRESS (Slreel. CilyfTown, Slat". Zip Codel
DECEDENT'S
ACTUAL
RESIDENCE
(S&lIins1ruclions
on O1herIlicle)
17..5111&
MARITAL STATUS. M.nled
N.....r M.rried. Widowed.
Divorced (Specdy)
Never married
'7c.Dv."clteedenlliYedi~
White
SURVIVING SPOUSE
~1 w~e, 11'\19 maiClefl name)
o
1M
:-
~
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.
313~ East King Street
115. Shippensburg, FA 17257
FATHER'S NAME (First Middle, lasI)
1.. Elmer L. Hol tr
INFORMANT'S NAME (Type/Pfinl)
Gerald H. Hershe
METHOD Of DISPOSITION
&mal [1g C..mllion 0
0I1lef (SpIc~
Cumberland
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li\I.in.
town.hlp?
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17b.~unt
Shiooensbura
citylboro
17257
r. 21 2005
LICENSE NUMBER
".. FD 011776-L
'Tothebelllo!myknowledge,dH'hoecun'ed"'hetime, dl.I,and p1.ce lilted
(Signalure and T~la)
PA
PA 17257
Occlusive Coronar
DUE 10 (OR AS ACONSEQUENCE OF)
Disease
23b. 23c.
w..s CASE REFERRED 10 ME"JXtC L EXAMINERlCORONER?
Y1s NoD
",
,Appro~im"1 PARTI!: Olhersignilic.nteondkionsoonlribu,inglodllath,bul
:int.fYalbelween nolresulhnginlheundlrlyingc.ustgi~ninPARTI
lOfHI.r.ddealh
i
D.(rE PRONOUNCED DEAD !MonIh, Dsy, Year)
April 17, 2005
"
DUE 1O(Ofl AS ACONSEQUENCE OF)
DUE 1O{OA ASA CONSEQUENCE OF)
d,
WERE AUlOPSY FINDINGS
A'#.ILABLE PRIOR 10
COMPLETION OFCAUSE
OFDEJlfH?
MANNER OF DEATH
OKrE OF INJURY
(Mon1h,Day, Year)
TIME OF INJURY
INJURY ATWORK?
DESCRIBE HOW INJURY OCCURRED
N,'u.al
M.
o
o
HomiCide
Yes D NO)it! ve& D
281. lItD.
CERTIRER (Chack only one)
'CERTIFYING PHYSICIAN (Pt1ysiol8n certr:yiog cause oj death when alodher physician hilS pronounced dea1h and compjeled Ilam 23)
To lh8 boNl ofmy knDWledgll, death OC(:UfTH due 10 the ceuae(.).nd 'NmMr.. allI.d. .
No 0
Accldenl
P,ndlnglnvellilll'ion
o
03011. 3l1tl. M.
O PLACE OF INJURY .AI home. lerm. .,.111. leClory, ollie'
building, ItC. (Spac:~y)
...,
Yes 0 NoD
SIGNATURE AND T
Coroner
Suicide
",
Could not bedetlrmined
'MEDlCAL EXAMIHERICORONER
On lhe blell of 'lIlmlnatlao .nd/or Inv'llls-tlon, In my opinion. death occurred.1 the time, date,'OO place. .nd due lothe C'U18(I)'OO
m.nner...tllted........... ......... ..... ......... ................ ......................... ... ....................
31..
REGISTRAR'S SIGNATURE AND NUMBER
o 31b.
LICENSE NUMBER DKrE SIGNED (ManU'. Day, YIIlr)
o 31c. 31d. April 18, 2005
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
(Item271TypeorPrintMichael 1. Norris, Coroner
~ 6375 Basehore Road, Suite III
~ 3l1. Mechanicsburg, Pa. 17050
.PRONOUNCING AND CERTIFYING PHYSICIAN (PhYIIICoafl bolh p1Oflounc")Q death and carl~ying 10cause 01 deetll)
To the belli 01 my knowledge, dellth oceurnd II thellmll. d.,., .nd pl.ce..nd due IOlhe &.uM(lj.nd menner .."eted..
1~/~(f1
DArE FILED(Moolh,Day, I1lllr)
...
LAST WILL AND TESTAMENT
I, DOROTHY R. HOLTRY, presently residing at 313-3I3Yz East King Street,
Shippensburg, Cumberland County, Pennsylvania 17257, being of sound mind, memory arld
disposition, do hereby make, publish and declare this my Last Will and Testament, hereby
revoking and making void all wills by me at any time heretofore made. .
FIRST. I order and direct the payment of all my legally enforceable 4ebts and
funeral expenses as soon as may be convenient after my decease.
(.;j
SECOND. Since the passing of my brother, Wesley L. Holtry, who passed away
on July 3, 2002, my nephew Gerald H. Hershey has advanced funds toward my maintenance
and for the settlement of the said Wesley L. Holtry's estate from which I solely benefited. It is
my express intent and desire, after payment of my funeral expenses, to reimburse the said
Gerald H. Hershey for any and all funds advanced on my behalf either directly or indirectly
through funds advanced to the estate of Wesley L. Holtry that he can document in writing. Such
expenses advanced as of the date of this my Last Will and Testament total approximately Eight
Thousand Dollars ($8,000.00).
THIRD. I give, devise and bequeath all of the rest, residue and remainder of
my estate, real, personal and mixed, whatsoever and wheresoever situate, to my nephews,
GERALD H. HERSHEY and EDGAR J. HERSHEY, or the survivor thereof, provided that
they survive me by a period of sixty (60) days.
FOURTH. I nominate, constitute and appoint GERALD H. HERSHEY, presently
residing at 126 Neil Road, Shippensburg, Pennsylvania 17257, to be the Executor of this my Last
Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute
and appoint BETSY A. GRAHAM, presently residing at 1122 Greenspring Road, Newville,
Pennsylvania 17241, to be the Executrix of this my Last Will and Testament.
FIFTH. I direct that my personal representative(s) shall not be required to give
bond for the faithful performance of their duties in any jurisdiction,
SIXTH. I hereby direct that 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, including any interest or penalty imposed in connection with such
taxes, shall be considered a part of the expense of administration of my estate and that such be
paid out of the rest and residue of my estate.
~P:~ltdf:J If;ltll'~~ (SEAL)
WEIGLE & ASSOCIATES.. P.~:,___ATTORNEVS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
SEVENTH. I direct my Executor to retain the services of JERRY A. WEIGLE,
ESQUIRE, with offices located at 126 East King Street, Shippensburg, Pennsylvania 17257,
with respect to the settlement of my estate due to his familiarity with my affairs.
IN WITNESS WHEREOF, I, Dorothy R. Holtry, have hereunto set my hand and seal to
this my Last W~~estament, . en on two (2) pages, the first page signed for identification
only, this . day of ,2003.
rik7 .rr'~SEAL)
WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to
be her Last Will and Testament, in our presence, who at her request and in the presence of each
other, we believing her to be of sound and disposing mind and memory, have hereunto
subscribed our names as witnesses.
\". {2,tl; ~'{D, t. (CIYI ItJ
a~);:r)W0Y
~~~%7
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
I, Dorothy R. Holtry, the person whose name is signed to the 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.
/X~'7~hY'lf/~
. /. '
././.,
Sworn or affirmed to and acknowledged before
me by D~pTHY R. H~~~~Y~e Testatrix,
this ~~ day of lJrv ---, , 03.
W'
NOTARIAL SEAL
Je' A. Weigle, Notary Public
Shippensburg, PA Cumberland County
My Commission Expires October 7, 2006
. ~. ~ _ 4.~
WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
W"7:..7~le1JL;n"'E , l\au,' mSroo(-::J ,
and ~LV~/' L.~ ' the witnesses whose names are signed to
the foregoing instrument, being du y quahfied accordmg to law, do depose and say that we were
present and saw Dorothy R. Holtry, the Testatrix, sign and execute the instrument as her Last
Will; that she 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; and that to the best of our knowledge the Testatrix was at the time eighteen
(18) or more years of age and of sound mind and under no constraint or undue influence.
~ Pat; ~'Id A
Sworn or affirmed to and subscribed before me
by 4.d;ii~~A 1.... -C/W] ()
fuUJIl f\\. S~
and KdJecca 1..-. /J//rr;;
witnesses, this <;itjday Of~ 1,2003.
-,.
WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397