HomeMy WebLinkAbout06-21-05
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Charles Parker No. 21-05- Ol....rJ \ 0
also known as
, Deceased
Social Security No. 418-14-6652
Cynthia L. Sims
Petitioner(s), who isfare 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) isfare the Executrix
the Decedent, dated OS/23/1984 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 at one time. His spouse died in the 1950's, prior to the birth of the Executrix
o B. Grant of Letters of Pdministration
(c.t.a; d.b.n.c.ta; 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:
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Atach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family
or principal residence at 11 Brookside Avenue Shippensburg Township,
(list street, number, and municipality)
Decedent, then
86
years of age, died
04/27/2005
at 11 Brookside Avenue, Shipp;lnsburg, PA 17257
(Location)
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 $ 2,000.00
situated as follows: Real estate with 50 ft. of frontage situate in Shippensburg Township, 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:
2,200.00
Signature
Cynthia L. Sims
Typed or printed name and residence
P.O. Box 1512
Louisa, VA 23093
YL:
Prepared by the Pennsylvania Bar Association
Copyrigrt (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 according to law. .A. A
Sworn to or affirmed and subscribed ....k" t'3~-#u.c.- d:--
~G ~a L. Sims
before me this L day of
J
No.
21-05- DLD 10
Estate of
also known as
Charles Parker
. Deceased
Social Security No: 418-14-6652
Date of Death:
04/27/2005
AND NOW. ~J.l'/
---'-tj ()
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [RJ Testamentary D of Administration
t
. c9-CD5
, in consideration
(c.I.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Cynthia L. Sims, Executrix
in the above estate and that the instrument(s) dated
5-23-1984
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
FEES
Letters..........................................$ 30. ro
~Ci. \!-<Lu1llA.l~~ba.u..o.\....~(l_1. ~ -~.'
Register of MIs ~~
~ (l<~~
Attorney: Richard L Webber, Jr., Esquire
Short Certificate(s)...................... $ 1<.0' au
Renunciation............................... $
Affidavits ( )...........................$
I.D.No:
49634
Weigle & Associates, P.C.
126 East King Street
Extra Pages ( )......................$
Address:
~.....~................$
\'5 . au
Shippensburg, PA 17257
JCP Fee.......................................$ \(), DC)
Telephone9 717-532-7388
Inventory........... ...........................$
E-Mail:
weigleattywebber@earthlink.net
Other~.......$ 500
TOTAL............................$ It. .(J()
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1(1991)
il
Thi ~ 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.
No.
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Fee for this certificate, $6.00
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TYPE/PRINT
IN
PERMANENT
BLACK INK
1129-485
...21 --OS-OVID
COMMONWEALTH OF PENNSYLVANIA 0 DEPARTMENT OF HEALTH 0 VITAL RECORDS
CERTIFICATE OF DEATH
(C~ro,,!er)
H105.144 Rev. 1/91
UNDER' DAY
Hours
SEX
STATE FILE NUMBER
SOCIAL SECURITY NUMBER
~\
2. Male
3. 418-14-6652
2005
BIRTHPLACE (City and PLACE QF DEATH (Check only one see InSlruchons on other side)
Slale or Foreign Country) HOSPITAL:
InpatienlD
7. ...
FACILITY NAME (It not inslilutiOl'l. give slreet and number)
~::ify)D
DECEDENT'S USUAL OCCUPATION
(~rJ:ok~~g'I~r~d~teu~f:~r~'t
110. Mechanic 11b.
DECEDENT'S MAIliNG ADDRESS (Slreet. CelylTown, Stale, Zip Code)
MARITAL STATUS. Married
Never Married, Widowed,
Divorced (Spec~y)
Widowed
RACE. American Indian, Black, While, etc.
(Speclly)
'0. Black
SURVIVING SPOUSE
(II w~e, give maiden name)
Cumberland
Be.
f7b. Coun
Cumberland
Did
_,f
Ilwtina
lownship? f7d.O ~~~:7:=Of
MOTHER'S NAME (Firs!, Middle. Maiden Surname)
unknown
17c,rn Yes, decedenllived if'
Twp,
twp.
11 Brookside Ave.
Shippensburg, PA
,..
FATHER'S NAME (First Middle, Last)
'B. Ar+-.hur Parker
INFORMANT'S NAME (TypelPrint)
~. Cynthia L, Sims
METHOD OF DISPO~ITI~
Bunal ~ Cremation 0
Donation 0 Olher (Spec~y\
. 21..
SIGNATURE OF FUNERAL SERV
17257
DECEDENT'S
ACTUAL
RESIDENCE
(See instluclions
on other side)
citylboro.
'B_
INFORMANT'S MAIliNG ADDRESS (S1reet, CrlyfTown. State, ZiP Code)
20b. P.O. Box 1 51 2 Louisa, VA
PLACE OF DISPOSITION. Name of Cemetery, Crematory
or Other Placa
23093
LOCATION. CityfTown, Stale, Zip Code
LICENSE NUMBER
22b_ FD-O 12984 L
o the besl of my knowledge, dealh occurred at the time, date and p1aC9 stated.
(SIgnature and Title)
21d. Hanover 'IWp., Lebanon Co., PA
Occlusive Coronar
DUE TO (OR I>S A CONSEQUENCE OF)'
Disease
Inc. Shi PA 17257
DATE SIGNED
{Month. Day, )ear}
23b. 23c.
WAS CASE REFERRED 10 MEDICAL EXAMINER/CORONER?
26. Yes J8' No 0
:~roximate PART II: Other Significanl conditions contributing to death, bul
,lnlerval between not resulting in the underlying cause given in PART I
10'''''''''''01'
23a.
TIMEOFDEATH Aprx.
24. 7: 00 P M 25.
27. PART I: Enter the diseases, injuries or complications which caused lhe dealh. Do nol enter the mode of dying, such 8S cardiac or respiratory arrest, shock or heart failure
Ust only one cause on each line.
b.
DUE TO (OR AS ACONSEQUENCE OF)'
DUE 10 (OR AS A CONSEQUENCE OF)
d.
WERE AUIOPSY FINDINGS MANNER OF DEATH
AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH? Nalural
DATE OF INJURY
(Month. Day, Year)
TIME OF INJURY
INJURY AT WORK?
Yes D
No D
Accident
% Homicide D
D Pending In\l9Stigalion D
D Could nol be determined D
Ve'
288. 28b.
CERTIFIER (Check only one)
"CERTIFYING PHYSICIAN (Ptlysician cerlifying C<!lI(;e 01 dealh when uflothel physiciallllH(; prnllouncl;l(l dealll and completed Uem 23)
To the best of my knowledge, death occurred due to lhe ceuae(sl eritl manneres.leled.. .................
Suicide
29.
30a. 3Gb.
PLACE OF INJURY. At home, farm, street, factory, office
building, etc_ (Specily)
300.
SIGN
"MEDICAL EXAMINER/CORONER
On the baels 01 examination and/or Investigation, In my opinion, death occurred at the lime, date
mannera.slated....... ............
318.
REGISTRAR'S SIGNATURE AND NUMBER
D Chief Deputy
~~ Coroner
UCENS DATE SIGNED(Month, Day. Year)
D ~~ ~& A ril 29, 2005
NAME AND ADDRESS Of PERSON WHO COMPLETED CAUSE OF DEATH
("em 27) Type 0' p,;", Todd C. Eckenrode, Chf . Dep. Coroner
6375 Basehore Rd., Suite #1
_ Mechanicsburg, Pa. 17050
DATE FILED(Monll1, Day, Yea9
>-
z
w
fii
hl
o
LL
o
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.PRONOUNCING AND CERTIFYING PHYSICIAN (PhysIGiall boll I prclrlolJnGing cicattl81ld cerlilyin{J locau~ 01 deatll)
To the best 01 my knowledge, death occurred at the time, date, Bnd piece, and due to the cause(5) and menner as stated.,.
34.
{ '2--~r
.
L, .-.
LAST WILL AND TESTAMENT
I, CHARLES PARKER, of R. D. 1, Shippensburg, Shippensburg Township,
Cumberland County, Pennsylvania, being of sound mind, memory and understanding
do make and publish this my Last Will and Testament, hereby revoking and
making void any and all former wills and codicils by me at any time heretofore
made.
FIRST. I direct my hereinafter named Executrix, or Executor as the case
may be, to pay all my just debts and funeral expenses as soon as conveniently
may be after my decease; I further direct that all taxes that may be assessed
in consequence of my death, of whatever nature and by whatever jurisdiQtion
imposed, shall be paid as part of the expense of the administration of my
estate.
SECOND. I give, devise and bequeath all my property, real, personal and
mixed, whatsoever and wheresoever situate, to my beloved daughter, CYNTHIA L.
ZELLARS SIMS, absolutely. Provided, however, that in the event my said
daughter, CYNTHIA L. ZELLARS SIMS, should predecease me, then in that event
I give, devise and bequeath all my property, real, personal and mixed, what-
soever and wheresoever situate, to my granddaughter, SHAKANA ZELLARS SIMS,
absolutely. Provided further, that in the event my said granddaughter,
SJ-IAKANA ZELLARS SIMS, lS not at least eighteen (18) years of age, at the
time of my decease, then in that event, I hereby nominate, constitute and
appoint VALLEY BANK AND TRUST COMPANY, of Chambersburg, Pennsylvania, as
the Guardian of the said minor's estate, my said Guardian to take and recelve
the share of the said minor child and invest and reinvest the same ln legal
or nonlegal investments, whichever in its discretion it deems proper, and
the said Guardian to have full power and authority, in its sole discretion,
to pay such amounts of income and principal as are necessary for the support,
maintenance and education of the said minor child, and upon the said minor
child reaching the age of eighteen (18) years, to pay the said share to the
said child.
THIRD. I hereby nominate, constitute and appoint my said daughter,
CYNTHIA L. ZELLARS SIMS, the sole Executrix of this my Last Will and Testament;
provided ,however, that in the event my said daughter, CYNTHIA L. ZELLARS SIMS,
should predecease me, then in that event, I hereby nominate, constitute and
4
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(SEAL)
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appoint VALLEY BANK AND TRUST COMPANY, of Chambersburg, Pennsylvania, as the
Executor of this my Last Will and Testament, my said Executrix, or Executor
as the case may be, to have full power and authority to do any and all things
necessary for the complete admin~stration of my estate, including the power to
sell any and all real and personal property of which I may die seized, at public
or its,
or private sale, in her/discretion, and without any Order of any Court; and
I further direct that my said Executrix, or Executor as the case may be, not
be required to file any Bond in connection with the settlement of my said
Estate.
IN WITNESS WHEREOF, I, CHARLES PARKER, have hereto set my hand and seal
to this my Last Will and Testament, written on three (3) sheets of paper, this
23rd day of May, 1984.
~"A-/ ~<~
(SEAL)
Signed, sealed, published and
declared by CHARLES PARKER,
the Testator, as and for his
Last Will and Testament written
on three (3) sheets of paper in
the presence of us who have, at
his request, signed our names
as witnesses hereto in the presence
of the said Testator and of each
other.
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COMMONWEALTH OF PENNS~LVANIA
SS
COUNTY OF CUMBERLAND
I, CHARLES PARKER, 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 the instrument as my Last Will and
Testament; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
~
C arle~
Sworn or affirmed to and acknowledged before me by CHARLES PARKER, the
Testator, this 23rd day of May, 1984.
Notary ublic
EUlAafTH 8. FETZER. ~OlAflY Fit/Bll
S1 PfNrl~'ilOJl1) TWP.. CUMOfll1.AND N11
IIY CO.UUSSION EXPIRES SfrT. 11. 1.~~7
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