HomeMy WebLinkAbout06-28-05
Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
Estateof"C--//~~el-Jte,$J-or/- No. ~I-O 5- 05~
also known as To:
, Deceased.
Social Security No. C?J B~ -/l." p~- Yo
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, and the execut~ r named in the last will of the
above decedent, dated -;::ru I'Z e: .;:C /, I '9 94:> , 20
and codicil(s) dated '
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Ca~1.ber Icz~ounty,
Pennsylvania, with h~1ast family or principal residence at
.7.t;~':L.5 ,~hA'%: 01 05/ ~-.::.ha..rl Ie P#-/7dSZJ
. (list str et, number and municipality)
Decedent, then B3.. years of age, died ~n e ..y' ,20 o!r- , at
Except as follows, decedent did 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:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) 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
situated as follows:
$ /~~PCJ
$
$
$
WHEREFORE, petitioner(s) respectfulJ.y request(s the p o~ate of the last will and codicil(s) presented
herewith and the grant ofletters dWfJ,i1/~.
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
thereon.
0J~;~.r..e\,)OfPe:~o- _ r----tVfi R"ideoce(,)ofPeti~",,~,.J
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
}
SS:
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 beliefofpetitioner(s) and that as personal representative(s) of the above
d",dent potitinne",) will well ",d truly ,dmini"" the "1a~g tn law. I.
sworn. to or affirm~nd ~ribed {-;?/~f" {l,tJ 4' ~ '
B'f~ ~t.t+ day of '
,2005
C/.l
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No.~J -0 5 - 0 5S'G
Estate of EL 2t:\.?-'ET\.\ c ST un
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
hereof, satisfact
L1 -.,.21-<1 lP
~~ c...S-nm
;2. t) 2005, in consideration of the petition on the reverse side
proof having been presented before me, IT IS DECREED that the instrument(s), dated
, described therein be admitted to probate filed of record as the last will of
; and Letters are hereby granted to ~0.5 ~")~.:r\; --0 q, .
FEES
Probate, Letters, Etc. .............
Will............................. ....
Jjgu. J ~ lj.('" '^ .",.1 bJl!/1 b~' j;U
Register of Wills y..o..r Cf. u.. . .
v~
$ Va. 00
$ \5.00
Renunciation.................... ... $
Short Certificates ( )............ $
ICP..... . ............... ... .......... $
Automation Fee...... .. ....... .. .. $
$
$ 10d. CO
200S
Attorney (Sup. Ct. I.D. No.)
I;).. CO
1i).00
S .GO
Address
Bond... ......... ... ......... .........
Total
Filed r J"S
Phone
III(IS)'(I.'; 1<1:V 1/(1"
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.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
p
'~ "'Ii, -.? q ~~. ,) 3 -=:
,,;! _'" ~.,-,9 '1...,1' V ~'" C}
No.
H105.143 Re.... 2/87
~
(0
7- 05
Date
TYPEIPRINT
IN
PERMANENT
BLACK INK
CERTIFICATE OF DEATH
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
NAME OF DECEDENT (First, Middle, last)
Elizabeth C. Stott
SEX
lFemale
"
AGE (last Bil1hday)
srATE HlE NUMBER
SOCIAL SECURITY NUMBER
3.083 - 12 - 3540
DATE OF DEATH (Monlh, Day. Year)
4June 4, 2005
83 v"
BIRrHPlACE (City and PLACE OF DEATH Check onl one
.&tato Q( Foreign Country) HOSPITAL
~aratoga InpallenlD ERIOlllpalil.lrl,D
7.-2Rrin s NY fla.
FAClun' NAME <If not inSlitloltion, gi...e street amI number)
~/S ;>/:
RelKJtrlCl,! 0 ~I~:~ty) 0 ,{. v- . "~
RACE. American Indian, Black, While, et
(Specify)
..
COUNTY OF DEATH
B..
8e.
DECEDENrs USUAL OCCUPATION
AS DECEDENT EVER IN
U.S. ARMED FORCES?
VosO NolKI
12.
(~~:~i~ oll~~O d,:eu~nr~/;:gtl
. 11.. Homemaker 11..
DECEDENT'S MAILING ADDHESS (Street, CityfTown, Statl;!, ZIp Code)
355 South Sporting Hill
16. Mechanicsburg, PA 17055
17b. County
Pennsylvania
Cumberland
f.l
'"
:>
'"
'"
::;
'"
FATHER'S NAME (First, Middle, last)
18.
INFORMANT'S NAME (Type/Print)
20..
METHOD OF DISPOSlTtON
Burial 0 Cremation ~emo...al from State 0 0
0\ll0l (Spe<.~y) 2'0.
U l)5R:t'9E I,lC~NSEE..QR PEI\SON ACTING AS SUCH
. 22.. Ie CI--t/' :itepnen R. Hall
Complete items 23a-c only when certifying
physician is not a...ailable at lime of death 10
certify cause of death
10.
White
MARITAL STATUS. Married,
Ne...er Married, Widowed,
Di...orced (Specify)
14. Widowed
SURVIVING SPOUSE
(1Iw,r6.gl~6H1a,d6f'1 rlamll)
N/A
Did
de{;edenl
live in a
township?
He. 0 Yes, decedent lived in
Iwp
17d. ~ ~~hi~e~~t~~~~i~'~: of
Mechanicsburg
dty/bom
George W. Chamberlin
Douglas W. Scott, Jr.
MOTHER'S NAME (First, MIddle, Maiden Surname)
19. Alida Salisbur
INFOBMANT'S MAILING ADDRESS (Streel, CI!.r,Tllwn, StatealiP Code)
20b. l Heatherwood CirCle, Mi dletown, PA 17057
PLACE OF DISPOSITION- Nama 01 Cemetery, Crematory LOCATION. CityfTown, Stale, ZIp Code
or Other Place
24.
27. PART I: Ent.r th. dl"~"I,lnJurt.. or complicatlonl which cau..d th. aulll
Lilt onlWO on. Cilllll. on ...ch Ill\ft.
/I7<I","v-lo./~ /J",.J J;i'<<// <..c.I/ (c:
DUf:. ro (OR AS A OlN51::0UtONCE Of)
01" ~.<"vl?,
..-/
[ :
DUE TO (OR ASACON~E.QtJENZE OFI
~
~
'-Q
~
.1\1
~
\
DUE TO lOR AS A COH',t:OUENr::r OF)
WERE AUTOPSY FINDINGS
AVAILAOLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
MANNER or I1F~
Nalural Cj'
DATE OF INJURY
(Month. Ddy. YII;;.r)
Homicide
o
o
o :~~CE OF INJURY
bu.ldlrlg.ElIC. (Spflc,ry)
308,
D
D
Accidtlnl
Pending In...estig::ttion
Yes D No 0'
Yo, 0
NoD
Suicide
Could not be delenninmj
I-
Z
W
o
W
()
W
o
lL
o
W
::;
'"
Z
2841. 28b.
CERTIFIER (Clleck only one)
.l~~~:FJ~~tGor~~~I;~~~e~g~S~~:rhcg~~~i~~~':1U~: Ie:: ~~:~~~~~~{;)~~~J'J~x~;~a:!i h~~r:~~~~~.:~~ .~~~~~. ~~~ .~.~.~~:~~.~ .i.t~I~~ .:~~
29.
.PRONOUNCING AND CERTIFYING PHYSICIAN (Physician bCllh pronouncing death and certifying to cause ot death)
To the be.t of my knowledge, death occurred al the lime, date, and place, and due 10 the caus8lio(1) and manner as stated...
"MFrJICAL EXAMINERlCORONER
On the bashl of examination and/or In...estlgatlon, In my opinion, death occurred at the time. dale, and place, and due to the causes(s) and
manner as stated ......................
31a.
REGISTRAR'S SIGNATURE AND NUMBER
131~lo-l.).I'd
26.
, Approjl(imate
: inlt:!rval between
: onset and dealh
Olher significant conditions contribu(ing 10 dealh, bul
not resulting in the undenying cause given In PART I
TIME or INJURY
IN,IURY AT WORK? Dl::SCHIBE HOW INJURY OCCURHED
30b.
M
y" 0 No D
30e.
d.~
.J"fi .c
J1b.
LICENSE NUMBER DATE SIGNED (Monlh, Day, Year)
31c.,,?,7.[)c>/S-:-..,/ t: 31d. 0"-. ~(. ",:'(1"
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
(Ilem 27) Type or Prinl \In''';?L.:J C':~:f #/1. .?1p
~.../<7t. /~. _"<;'~.L.I'k
n1. .k.-/'!.........~... ,r?1../:7C'.'j'
dO
o
32.
DATE FILED (Month, Day, Year)
34.
(.:,- 7 - 65
B:WILLS7\SlOTI.ELI
,
Ia$t .ill ano Q[egtamettt
OF
ELIZABETH C. STOTT
BE IT REMEMBERED, that I, ELIZABETH C. STOTT, of 406 Orchard Lane,
Mechanicsburg, Upper Allen Township, Cumberiand County, Pennsyivania, being of sound
mind, memory and understanding, do make, publish and declare this as and for my Last
Will and Testament, hereby revoking and making null and void any and all Wills and
Testaments and writings in the nature thereof by me at any time heretofore made.
ITEM 1: I direct that my hereinafter named Executor pay all my just debts, my
funeral expenses, and the expenses of the administration of my estate. With this direction,
I authorize and empower my Executor to expend for my funeral expenses and interment
such amounts as he may consider necessary and proper, without regard to any limit that
may be prescribed by a court of law.
ITEM 2: I direct my Executor to pay all inheritance, estate, succession, and legacy
taxes of whatsoever nature and kind, to which my estate, or the transfer of any property
passing hereunder or otherwise passing by reason of my demise, may be subject, and to
charge such taxes against my residuary estate, it being my intention that none of the
aforesaid taxes, either federal or state, on any property required to be included in my gross
estate, under the provisions of any state or federal law now in force or hereafter enacted,
shall be prorated among the persons interested in my estate to whom such property is or
may be transferred or to whom any benefit accrues.
ITEM 3: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which
I have a power of appointment, I give, devise and bequeath unto my children, DOUGLAS
W. STOTT, JR., LINDA E. GROVE, and CAROL E. GULICK, in equal shares, per capita.
ITEM 4: In the event that any of my enumerated children should predecease me,
I direct that the share of such deceased child lapse, and that my estate be divided between
my surviving children, in equal shares.
ITEM 5: I nominate, constitute and appoint my son, DOUGLAS W. STOTT, JR.,
as Executor of this my Last Will and Testament.
ITEM 6: I direct that my hereinbefore named Executor shall not be required to give
bond for the faithful performance of his duties in this or any jurisdiction.
IN wnNESS WHEREOF, have hereunto set my hand and seal this c::r /..J; day
//~
:
\------
of
1996.
Lfu_.i'dL C ~
/ELI ETH C. STOTT
The preceding instrument, consisting of this and one (1) other typewritten pages, was
on the day and date thereof signed, sealed, published, and declared by the Testatrix herein
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
h~OO
(~",Nt. &~
OF
~--rf'z~?J ?~
6J J&-k~ .f~
OF
2
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF YORK
keJL~C:
STOTT,
flm/~/
and
the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument
as her Last Will and Testament, and that she signed willingly, and that she executed it as
her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix signed the Will as witnesses, and
that to the best of their knowledge, the Testatrix was at the time eighteen (18) years of age
or older, of sound mind, and under no constraint or undue influence.
%L.'#:e~' c U-~
ELIZA TH C. STOTT
_[~o P
----
~~~
SWORN TO AND SUBSCRIBED
BEFORE ME THIS ,<f.../h DAY
OF
,1996.
Notarial Seal
Janet S. Gore, Notary Public
Dillsburg Bora, York County
Mv Commission Expires Oct. 25, 1998
'?r, Pennsylvania Association of Notaries