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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 ��_ �� . �/qq
Name: Robert E • Southworth File No: � � �
�a: (Assigned by Register)
a/k/a:
�a: Social Security No:
Date of Death: 8/2 7/2 015 Age at death: 9 0
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
principal residence at 5274 S�camore Ct 17055 �ower Allen Townshir� Cumberland
Street address,Post Office and Zip Code City,Township or Borough Counly
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 decedenYs property at death:
If domiciled in Pennsylvania................................All personal property $ 1,2 5���0 0•��
Ifnot domiciled in Pennsylvania.............................Personal property in Pennsylvania $
If not domici[ed in Pennsy[vania.............................Personal property in County $
Value of real estate in Pennsy[vania.............................................................. $
TOTAL ESTIMATED VALUE.... $ �+,2 5 0 i O O O . O O
Real estate in Pennsylvania situated at:
(A[[ach additional shee[s,rjnecessary.J Street address,Post Office and Zip Code City,Township or Boroug6 County
� 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 6/2 5/2 015 and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciation,death of executor,etc.J
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 born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
� NO EXCEPTIONS ❑EXCEPTIONS
❑ B. Petition for Grant of Letters of Administration(tf app►icable)
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 search has/have ascertained that Decedent lefr no Will and was survived by the following spouse(if any)and heirs(attach
additional sheets, if necessary):
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Form RW-02 rev.IOII[i20// Page 1 Of 2
• + Official Use Only
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTYOF Cumberland }
Petitioner(s)Printed Name Petitioner(s)Printed Address
5274 Sycamore Court
Elizabeth K • Southworth Mechanicsbur PA 17055
The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition aze true and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of the Decedent,the Petitioner(s)will well and truly administer the estate according to la .
Sworn to o affirmed an bscribe bef ��,.; o.�1r��,� `��Cn,�jwv��� Dace 4 2� 1�
me th' yU'da of , ��% Date
By: Date
the Register ' Date
BOND Required: ❑ YES � NO To the Register oJWills:
FEES: Please enter my appearance by my �g atur below:
60
Letters. . . . . . . . . . . . . . . . . . . . . . . $ /O Attorney Signat •
( .� )Short Certificates(s) . . . . . .
( )Renunciation(s) . . . . . . . . . .
( )Codicil(s) . . . . . . . . . . . . . . ,_ _
( )Affidavit(s). . . . . . . . . . . . .
Bond Printed Name: D e v 1 d H • S t n 2, E s q u i r e
Commission . . . . . . . . . . . . . . . . . . . . Supreme Court
Other , . , , , , , , , ID Number: 3 9 7 8 5
" " " " ' FirmName: StOn2 LaFaver & Shekletski
� � � � � � � � � � � `� � Address: 414 Bridge Street
n AX n i�. . . . . . . . . �o P • 0 - B o x E
� � � � � � � � � New Cumberland PA 17070
. . . . . . . . . Phone: 717-774-7435
. . . . .. . . . F�: 717-774-3869
AutomationFee . . . . . . . . . . . . . . . . . � Ema;�: dstoneastonelaw-net
JCS Fee . . . . . . . . . . . . . . . . . . . .. . . '
TOTAL . . . . . . . . . . . . . . . . . . . . . .$ f , �J 0
DECREE OF THE REGISTER
Estateof Robert E • Southworth FileNo: a'� �� � 999
a/k/a:
AND NOW, �em� � , ���`� , in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED that Letters T e s t a m e n t a r y
areherebygrantedto Elizabeth K • Southworth
in the above estate and(if applicable)that
the instrument(s)dated 6/2 5/2 015
described in the Petition be admitted to probate and filed of record s the last Will(and Codicil( )of Decedent.
� �/ '
�
Regist r of Wills
Form RW-02 rev.!0/l U2011 Page 2 Of 2
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
;
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,� r - e No. 2015- 00999 PA No. 21- 15- 0999
2 ��� ���
9 Es ta te Of: ROBERT E SOUTHWORTH
O D "� (Fiisi,Middle,Lastl
� v
��� La te Of: LOWER ALLEN TOWNSHIP
CUMBERLAND COUNTY
� �
Deceased
Social Securi ty No:
1750
WHEREAS, on the 24th day of September 2015 an instrument dated
June 25th 2015 was admitted to probate as the last will of
ROBERT E SOUTHWORTH
/First,Middle,Lastl
late of LOWER ALLEN TOWNSH/P, CUMBERLAND County,
who died on the 27th day of August 2015 and,
WHEREAS, a true copy of the wi11 as probated is annexed hereto.
THEREFORE, I, LISA M. GRA YSON, ESQ. , Regi s ter of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certi fy tha t I have thi s day gran ted Le t ters TESTAMENTARY to:
ELIZABETH K SOUTHWORTH
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, a11 of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 24th day of September 2015.
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
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LAST WILL AND TESTAMENT �� � r`�
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OF c.� `��
ROBERT E . SOUTHWORTH
I, ROBERT E. SOUTHWORTH, of Lower Allen Township, Cumberland
County, and Commonwealth of Pennsylvania, declare this to be my last
will and revoke any will previously made by me .
�
ITEM I : I bequeath my automobiles, household and personal
effects and other tangible personalty of like nature (not including
cash or securities) together with any existing insurance thereon,
to my spouse, ELIZABETH K. SOUTHWORTH. Should my spouse, ELIZABETH
K. SOUTHWORTH, predecease me, I bequeath such tangible personalty
and insurance thereon to such of my children, PETER K. SOUTHWORTH
and JAMES E. SOUTHWORTH, as are living at the time of my death.
ITEM II : I devise and bequeath the remainder my estate, of every
nature and wherever situate, to my spouse, ELIZABETH K. SOUTHWORTH,
subject to my directions concerning the disclaimers trust set forth
in ITEM IV.
ITEM III : If my spouse, ELIZABETH K. SOUTHWORTH, predeceases
me, I devise and bequeath the residue of my estate, of every nature
wherever situate in equal shares to my children, PETER K. SOUTHWORTH
and JAMES E. SOUTHWGRTH. Should any of my above named children
predecease me, I devise and bequeath the share of such child to his
issue, per stirpes; and should any such child of mine leave no such
issue living at the time of my death, I devise and bequeath the share
of such child to my issue, per stirpes .
Page 1 of 6
ITEM IV: I remind my spouse, ELIZABETH K. SOUTHWORTH, and
her personal representative, guardian, or agent acting under Power
of Attorney, that she may disclaim any part or all of any
distribution to her herein made . In particular, it may be desirable
for her to disclaim a portion or my estate, and if she does so, the
disclaimed portion shall pass to a separate DISCLAIMER TRUST for
the following uses and purposes :
A. To pay the net income therefrom to my spouse,
ELIZABETH K. SOUTHWORTH, for and during her lifetime in su�,h
periodic installments as the non-spouse Co-Trustees shall find
convenient, but at least as often as quarter-annually.
B. As much of the principal of this trust as the
non-spouse Co-Trustees, in its sole discretion, may from time to
time think advisable for the support of my spouse to maintain her
in the station of life to which she is accustomed at my death, shall
be either paid to her or else applied directly for her benefit by
the non-spouse Co-Trustees after taking into account her other
readily available assets and sources of income .
C. The non-spouse Co-Trustees may apply the net income
of this trust for the support of my spouse, ELIZABETH K. SOUTHWORTH,
should she by reason of age, illness or other cause, in the opinion
of the non-spouse Co-Trustees, be incapable of disbursing it .
D. In addition to the above provisions, my spouse shall
have the power to direct Co-Trustees to pay to her or to apply out
of principal in each year, including the year of my death, an amount
not in excess of the greater of Five Thousand ($5, 000 . 00) Dollars
or five (50) percent of the then aggregate value of the trust
principal . This power is non-cumulative and can be exercised only
Page 2 of 6
by an instrument in writing signed by my spouse, and delivered to i
Co-Trustees . �
E. Upon the death of my spouse, ELIZABETH K. SOUTHWORTH, the
Co-Trustees shall distribute the balance of the principal and any
accumulated and undistributed income in equal shares to my children,
PETER K. SOUTHWORTH and JAMES E. SOUTHWORTH, and in default thereof,
to their issue, per stirpes .
ITEM V: Should any person entitled to a share of my estate
not have attained the age of twenty-five (25) years at the time of
distribution to him or her or, in the opinion of the Co-Trustees,
be incapable of disbursing his or her share because of illness or
other cause, I devise and bequeath the share of each such issue to
the Co-Trustees hereinafter named, IN SEPARATE TRUST, to hold,
manage, invest and reinvest the share so received, and the
accumulation of income thereon, and to use and apply the income and
principal, or so much thereof as, in the Co-Trustees ' discretion,
may be necessary or appropriate for such child' s support and
education (including college education, both graduate and
undergraduate) without regard to his or her parent ' s ability to
provide for such support or education, to make payment for these
purposes, without further responsibility, to such child or such
child' s parents or to any person taking care of such child. Any
principal or income not so applied shall be distributed to such child
absolutely when he or she attains the age of twenty-five (25) years
or become competent . If he or she dies before obtaining age
twenty-five (25) years or before becoming competent, the trust shall
terminate and such shares shall be distributed to his or her personal
representative .
Page 3 of 6
ITEM VI : The interests of the beneficiaries hereunder shall
not be subject to anticipation or voluntary or involuntary
alienation.
ITEM VII : 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 oi my estate and shall be paid from my residuary
estate without apportionment or right of reimbursement .
ITEM VIII : I appoint my spouse, ELIZABETH K. SOUTHWORTH, and
my sons, PETER K. SOUTHWORTH and JAMES E. SOUTHWORTH, or the survivor
of them Co-Trustees of any trusts created by this my last will .
ITEM IX: I appoint my spouse, ELIZABETH K. SOUTHWORTH,
Executrix of this my last will . Should my spouse, ELIZABETH K.
SOUTHWORTH, fail to qualify or cease to act as Executrix, I appoint
my sons, PETER K. SOUTHWORTH and JAMES E . SOUTHWORTH, Co-Executors
with the same powers and duties of this my last will .
ITEM X: I direct that my Executrix and Co-Trustees and their
successors shall not be required to give bond for the faithful
performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I, ROBERT E. SOUTHWORTH, have hereunto set
my hand and seal this _� day of , 2015 .
�
ROBERT E . SOUTHWORTH
Page 4 of 6
SIGNED, SEALED, PUBLISHED and DECLARED by ROBERT E .
SOUTHWORTH, the Testator above named, as and for his Last Will and
Testament, and in the presence of us, who at his request, in his
presence and in the presence of each other, have subscribed our names
as witness s .
414 BRIDGE ST . , NEW CUMBERLAND, PA
Wi � Address
_„� �
� , . � 414 BRIDGE ST. , NEW rUMBERLAND, PA
Witness Address
COMMONWEALTH OF PENNSYLVANIA .
. SS .
COUNTY OF CUMBERLAND .
I, ROBERT E. SOUTHWORTH, the Testator 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.
�
ROBERT E. SOUTHWORTH
Sworn to or affirmed to and acknowledged before me by ROBERT
E. SOUTHWORTH, the Testator, this � day of ��ipY� ,
.
2015 . ��
___ ;�
- � �.-
COMMONWE6�LTH OF PENNSYLVANIA ,!J�✓��.� `���-1 r ,. '
NQTARiAL SGAL �__�' " N o t a r y"�Fub�i c
JENNIFER A. �,tEARKLE, Notary Public
New Cumberland Boro.Cumberland Co. �
My Commission Expires July 7, 2015
Page 5 of 6
COMMONWEALTH OF PENNSYLVANIA .
. SS .
COUNTY OF CUMBERLAND .
W e, `r�-�� �. .I"�v� a n d ����`�-��� � t h e
�
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 Testator sign and execute the instrument
as his last will; that Testator signed willingly and that he executed
it as his free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testator signed the
will as witnesses; that to the best of our knowledge, the Testator
was at that time eighteen or more years of age, of sound mind and
under no constraint or undue influence .
�A
tness "'
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Witness
Swcrn to or affirmed to and acknowledged before me by
_ `��/ ti�� tt. I,�x�� a n d \_�-��. L . \'6�y��� , w i t n e s s e s,
this � day of ;����Q , 2015 .
, –r'��j`�
MMQNWEAITH O�NN__SY�VANIA /
CO ___ -�-�r-�ub 1 i c
--
N�;�rAR1AL S�A pubiic --.-- __�..—
JENNIFER A. NfEARKLE, Notar/
New Cumberland Borofe��by 7�20�6'
My Corr,mission E.xP
Page 6 of 6