HomeMy WebLinkAbout08-03-05
PETITION FOR PROBATE and GRANT OF LETTERS
cOl -OS- - ou,q I
Estate of Lois A. Harlin No.
also known as - . To:
Lois Borman Harlin Register of Wills for the
t Deceased. County of Cumberland in the
Social Security No. 111-16- 7 8 7 5 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut ors
in the last will of the above decedent, dated January 18. 2000
and codicil(s) dated
namec
, 19_
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h last family or principal residence at 71 Partridge Circle
C.~rl;~l~. PA 17011
(list street, number and muncipality)
Decendent, then 78
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 kming and was never adjudicated
incompetent:
Decendent at death own.ed property with estimated values as follows:
(If domiciled in Pa.) All peJsonal 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:
years of age. died May 6
,B' 700'i ,
tJ2. ~ . 606
(
$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
. presented herewith and the grant of letters Testamentary
(testamentary; administration c.La.; administration d.b.n.c.La.)
theron.
~
'"
b~~5~k~
3~ ~
.......
;0
(;j
~
00
Vi
X Gayle Harlin Kluz
- ;;. (-:J
I'~
.:::::~
C:,~,J
C'-"f
" 'I
()
, co)
:~-J
,-)
:!-,
':.:-:J
S:,:~
-'1
( '5
ITl
X James D. Harlin
, I,
,./, I
c -,
i
C)
. "' .......~,
j J j
J";::J
'..;.,'")
.l=""
rJ
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA "'1 ss
COUNTY OF Cumberland J
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 ~r affi~ and subscribed { ~~~ K~ ~
before t. thiS day of ~ ~
~ ~K )0: --
. IH)1o '-- . ~
~ ~4"ter :;;:
No. ...11 -OS- - <:noel'
Estate of ~~ Q _ l-k:lJ\i.u,-, ~~ ~ Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW 0. ^^--t}.i)-\ 3 0;00 S 1:9_, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 1-1'8' 'dCXV
described therein be admitted to probate and file of record as the last will of
. - 0--.K.a- ~ ~
and Letters \.Q...i~~~ tJ .
are hereby granted to , ~~ ~ ~ (~~ ~)('(\. 0/:'\ b -\-\c..,J...u..-
ftJ,Ja~~ .
~..~
FEES
Probate, Letters, Etc. ......... $ 4lDO .ei)
Short Certificates( ).......... $ L~o .00
R.1Y~~.~~ $1;30
j. ,') $ /O.<lU
TOTAL _ $55b .GO
Filed .. .5:. ~.... .9.$...................
John H. Brou;os, Esq. #06268
A TIORNEY (Sup. Ct. J.D. No.)
4 N.Hanover St, Carlisle,PA 17013
ADDRESS
717-243-4574
PHONE
Thi \ i\ 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
lL. ~~~~::;*~
"'lllf"~""'/'J',,,,
1IIIt,"~~\.1" OF P{f:---___
\I\~~'J'Z_..
~ ~ . ~-
~~-~. ~\
!:rEl ~: -:.' ~i
~=I _A--' 1_""
~.. '" Jr,.'-..,' I~;::
...- _ '11;j~ ,I ~
%.*~..,.....,I*~
\~ . '.' ~l
.,. ",. ~'" I'
-- "IP ~~",I
....--_flMEN1 \\\ ~ ,.""
""""";"",,,,111"""
p
1133
..~ l- -I ......~
_ltJfb
MAY 1 0 2005
No.
Date
C)
r-..>
(:.--.:>
C::::J
C...;"~}
=0
j"Y"l
C)
C::>
:;0
\...J
,'y',
C:=J
c:>
--."1
"'f'J
C)
iTl
I
c..0
~I
',::)
N
011/
H105.143 Flev. 2187
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
TYPE/PRINT
'N
PERMANENT
BLACK INK
o
w
.,
:>
..
~
~
1.
AGE(laIlBirthdav)
BIRTHPlACE (Coty a~
SWeOl' FCleognCounrrYl
78
V<s.
~)o
..
COUNTY OF DERH
~I ...
CUmberland
DECEDENT'S USUAl OCCUP,lllIQN
(~~~II~:O~~:zir:T
SURVIVING SPOUSE
(t! 'NIle. gwe maden namel
_.
Green Acres
_.
PA 17013
...11:50 am M.... 6, 2005
21. PART I: Enter the diMaMs. injuries or compicahons which caused the death 00 not ........ lhe mode 01 dying, such as cardiae or respiralory arrest. shc:Jdl: Of Matt failur..
li-' orIy one eeuu on each line.
NoD
Otfw signillcanl <:ondIIioN conIlibI.Clng 10 dutII. but
nul nNUIIlng in the undertying caa-. g;v.., in PART t
DATE OF INJURY
(Monm. Day. ~arl
TlWE OF INJURY
INJURY IJ 'NORK7 DESCRIBE HOW INJURY OCCURRED.
Nalura' ri HomicieM 0
! Accident 0 Pending Irwestlgation 0
NoG'l _0 No 0 Sulcido 0 Could not be d.termlned 0
_ 0 NoD
~
3
3OIt. 3Gb. t.II. 3Oc. 3011.
PLACE OF INJURY. Al home, larm, street, 'aclofy,olftce lOCRION (Snel. Cify(Town, SlaIIel
buildlog,.tc:.rSpecltvI
~ a ~
CERTIFIER ICheck only ()I"Ie)
.CER1'1FY1NG PHYSiCiAN (Phy5lC<arl cerllfylng caused dNlt1 wher> ,JnOll'1er phvSlCtan l'1as prot\Cll.lnced deall'1 anc] comOleled Item 231
To... beel 01 my knowledge, Meth occurrad due to ttMI caue.(..) and manne, _ staiN. . . . .. .............
'PRONOUNCING AND CERTIFYING PHYSICIAN (Ptlvsoan boll'1 ilfooouncll"lO deall'1olnd ceroll'lnQ to cause or ~lh\
To..... bett of myknowltdQfl, dealhoccurred at IN time. dale, and place, and due tet "'aeauu(s) and mannera. staled..
...
z
~
(,)
w
o
~
o
w
~
~
Z
'MEDICAl EXAMINER/CORONER
On Ihe b.als 01 e.aminatlon and/or Invesllgallon,ln my opinion, death occurred al ttw! tll1\f), date, and place. and due to the c.use(s) and
m.nn.....slated.....,.......... . .............. ... ............ .... ...... ............ .... ............ ... .._..
:l1a.
FlEG1STFlAR'SSIGNATUREANONUMBEA ~.. ~
33. ao.;....~. ~b.)...~
1;)..1 \ 1rl..1 I. to I
,...
~
~
~
.~
11lttst .ill an~ westnment
of
OJ
-,
JlXois 1\. 1h1arlin
'1
..... "
I, LOIS A. HARLIN, a resident of and domiciled in the State of Florida, Social.Sect\rity No?
111-16-7875, declare this to be my last Will and revoke all earlier Wills and Codicils. - ~
ITEM I
Direction to Pay Claims
I direct that all valid claims against my estate be paid as soon as practicable after my death.
ITEM II
Estate Taxes
My Personal Representative shall not pay expenses of my last illness, funeral, claims, costs
of administration and taxes assessed by reason of my death as I have directed for their payment
under the Trust Agreement hereafter mentioned, and I hereby confirm that direction.
ITEM ill
Separate Writing Clause
I give those items of tangible personal property to those persons described in a separate writing
dated subsequent to this Will as allowed by the Florida Statutes. If no such separate writing is
discovered within thirty (30) days after my death it shall be conclusively presumed that no such
separate writing exists.
ITEM IV
Residuary Estate
I give my residuary estate to the Trustee of THE LOIS A. HARLIN TRUST dated the same
date as this Will to be administered as part of this Trust. If this bequest and devise is ineffective, I
hereby incorporate said Trust by reference and make it a part hereof
I......'
:"":'~~..J
(,
C.-'I
'U
-, ,;-1
, ()
('~)
:,5
, (__.J
"r--,
1::7
,--)
'~:J
..)
. 11
'-,)
I
GJ
:-,:"~
ITEM V
Appointment of Personal Representative
I appoint my daughter, GAYLE KLUZ and my son, JAMES D. HARLIN to be the Co-
Personal Representatives under this Will and I direct that they shall serve without bond.
ITEM VII
Powers
By way of illustration and not of limitation, and in addition to any powers granted to personal
representatives generally, my personal representative is specifically authorized and empowered with
respect to any property, real or personal, at any time held under any provision of this will: to allot,
allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims,
contract with respect to, continue any business of mine, convey, convert, deal with, dispose of, enter
into, exchange, hold, improve, incorporate any business of mine, invest, lease, manage, mortgage, grant
and exercise options with respect to, take possession of, pledge, receive, release, repair, sell, sue for,
make distributions in cash or in kind or partly in each without regard to the income tax basis of such
asset and, in general, to exercise all of the powers in the management of my estate which any individual
could exercise in the management of similar property owned in its own right, upon such terms and
conditions as to my personal representative may deem best, and to execute and deliver any and all
instruments and to do all acts which my personal representative may deem proper or necessary to carry
out the purposes of this my Will, without being limited in any way by the specific grants of power
made, and without the necessity of a court order.
('iN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this /cf day of
/'=1 .P~--- , 2000.
f'-....>
~ )I -j~~
LOIS A. HARLIN
2
.~
'~
j
The foregoing Will was signed and declared by the said Testatrix as her Will in our presence,
and we, at her request, in her presence, and in the presence of each other, have subscribed our names
as witnesses on the above date.
Wi~2J :?a(O~
I ) P S" if Si/ -.M SI- /1..W.1 .Ai C 1e:-fA
Witness Address
~=
Witness Signature
RO,?lil Jb I.". g~d. "Fe ~3L111
5'0 ? illtld ICJL~ /Lei.
Witness Address
UL'~~~ j)eaoL, FL
Prepared by:
Kirk Grantham, Esq.
1860 Forest Hill Blvd.
Suite 105
West Palm Beach, FL 33406
(561) 966-6211
3
PROOF OF WILL
STATE OF FLORIDA )
) SS:
COUNTY OF PALM BEACH )
WE, LOISA. HARLIN, cf(~ It ~ ron+h(tt'l1 and Cy,OSS
J. KC.~ ~-o.. , the Testatrix and the witnesses respectively, whose names are signed to the
attached 0 foregomg mstrument, havmg been sworn, declared to the undersIgned officer that the
Testatrix signed the instrument as her Will, that she signed, and that each of the witnesses, in the
presence of the Testatrix and in the presence of each other, signed the Will as a wit~e,..
L~ A !;~
LOIS A. HARLIN
c9~~ -F ~~(C
Witn Signatu,., ,
/1lfl~ 0
Witness Signature
"'~'" '(/4
.~ .n ~<.
. TERRY R.~\J.E~
.. * My Co~"".~n ~
..... ~~ Expires May. 19,2000
"~i OF f\.O~
Subscribed and sworn to before me this -1 ~ day of ~ 2000.
~ .---;-::>~
:=J..L\~ 1'-. 4.A
Notary c, State ofFlonda
Print or stamp name of notary public, commission
number and date of expiration
Personally known o~u~ification X
Type ofldentification Produced: 0 . ' v-t\O t-::I-U~
4