HomeMy WebLinkAbout08-31-05
1/
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Albert Williams Johnson, III
also known as Albert W. Johnson, III ,Deceased
No. ~\ - D5 - D-l~ 2>
Social Security No. 189-30-3840
Petitioner(s), who is/are 18 years of age or older apply(ies) for:
COMPLETE "Au OR "B" BELOW:)
. A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executrix named in the Last Will of the
Decedent, dated 9/28/1965 and codicil(s) dated
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 Idocuments
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
o B. Grant of Letters of Administration
(c.I.a., d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the foltQjNing
souse if an and heirs: g~
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal re$idence
at 155 N 25th Street. BorouQh of Camp Hill ·
(list street, number and municipality)
Decedent, then 66 years of age, died 2/28/2005, at 155 N. 25th Street. Camp Hill. PA
(Location)
::0
r~r'l
(-;J
C)
--I"
-: :.-~~
i:::'J
"', ,''-'-)
, I -"'""I
. --")
.;;~;
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 ................................................................................................... $ 42:{l:
Total.................................................................................................................. ................... $ 4
Real Estate situated as follows: Y2 interest in Parcel No. 42+,386.0-01580.00-000+ Niooenose Two.. LvcominQ Countyl
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this P~tition and
the rant of letters in the a ro riate form to the undersi ned:
Si nature Typed or printed name and residence
Mary-Louise Johnson
155 N 25 Street
Camp Hill, PA 17011
Form RW-1 Page 1 of 2 (Cumberland County - Rev. 9/92)
'a>
i ....
II
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and 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 ~Cor~ing to law.
Sworn to and affirmed and subscribed ){~ ~ ~.17K
at5f (J
be ore me this"--/ day of
Estate of Albert Williams Johnson, III
also known as Albert W. Johnson, III
Social Security No.: 189-30-3840
DECREE OF REGISTER
, Deceased
No. ~\-()S.- OlC('3
Date of Death
2/28/2005
AND NOW, ,20llS-, in
consideration of the Petitio on the reverse side hereon, satisfactory proof having been presented before m~, _
IT IS DECREED that Letters . Testamentary 0 of Administration !
(c.t.a.; d.b.n.c.t.; pendente lite; durante absentia; durante minorillate)
are hereby granted to Mary-Louise Johnson
in the above estate and that the instrument(s), if any, dated 9/28/1965
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
~l n&.~l en '1~''t'f''t:~
Register of W '. ~~
FEES
Letters '" ...... ............... ..... .....
Short Certificate(s) ...............
Renunciation ........................
Affidavit ( ) .............:...........
~tr8 r~es ( ) LL~~.
Codicil..................................
JCP Fee ...............................
Inventory & Tax Forms ........
OtherC.;,;~..-l-,M~1Y.M~ :....'. .1~. ~
TOTAL....................
Form RW-1 Page 2 of 2 (Cumberland County - Rev. 9/92)
429461v1
.Ji}~ ,(tJ
$ ,00
$
$
$ . ('. "",""
L .> (JL.J
$
$10 . (~
$
$ 5- cC:
Attorney:
I.D. No.:
Vicky Ann Trimmer
49679
3401 North Front Street
Harrisburg, PA 1711 0-09~0
717-232-5000
$ , a4 tOO
Address:
Telephone:
DATE FILED:
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
JI-05'{)'R3
Howell C. Mette and Mary Louise Johnson, each a subscriber hereto, having been duly
qualified according to law, depose(s) and say(s) that they are familiar with the signature
of Albert Williams Johnson, III, Testator of the Will herewith and that they believe the
signature on the Will is in the handwriting of Albert Williams Johnson, III to the best of
their knowledge and belief.
Sworn to or affirmed~d subscribed
before me this,= 3/ I day of
r~ ,2005.
~M~~~U.N~-Jq~
For the Regi~~
429718vl
~~~r.~Jtr
Howell C. Mette (Name)
'7-0 ~ \0'? 1J~1. ~L,^-~
(Address)
~jjaU~t~
Mary L ~e John~ (Name)
/~!) ---/1- d 5~~"" (!a'/{ff'~
(Address)
11--.>
<tc:>
~:')
ii-r1
:1:",
$5
q...:>
-
'"io
~J;
C:i~)
cp
1..0
II
;~:1
C~
c-:-)
. J.":J
l--..)
,-'0'1
J (,-'J
., ,~'=:
--1
" (~s
rT1
) ("')
"'C-]
II
I [](J:'d\():'\ I<LV 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.
11334731
No.
thm- fJ(~
Local Registrar
Fee for this certificate. $6.00
p
t1AR 0 2 200~
Date
1--)
,..-'-)
'"
(')
.';:)
(.:..;",
I
N.
/"-
H105143 Rov. 2187
J. I - () ~ - (J79.:1
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
.-i
r:,?
.!::f
.r.:-
dNT
ENT
INK
1.
AGE (Lo.t Birthdoy)
NAME OF DECEDENT (First, Middlo, Lo.t)
Albert W, Johnson III
SEX
2. Male
STATE FILE NUMBER
SOCIAL SECURITY NUMBER
3.189 30 - 3840
(Month, Day, Year)
28 2005
T
I.
COUNTY OF DEATH
66
Yrs.
""""'-"" D
DOAD
::,,~,D
n Indian, Black. Wlite. at
ab, Cumber land
DECEDENT'S USUAL OCCUPATION
(c:r::=:'.K~d~.:::t=>t
lla. Lawyer llb. PUC
DECEDENT'S MAILING ADDRESS (Street. CitylTown, Slote, Zip Code)
155 North 25th Street
la, Carn Hi 11 , Pa 17011
FATHER'S NAME (Firat, Middlo. Lost)
la. Albert W, Johnson Jr
INFORMANT'S NAME (TypeiPrinl)
ZOa. Mar Louise Johnson
METHOD OF DISPOSITION
. Donation 0 Buriol 0 Cremation ~omovol from Stoto 0 0
. 21a. O1hor (Specify) 21b.
. SI URE 0 NE EE OR PERSON ACTING AS SUCH
&c.
Carn
Hill
KIND OF BUSINESS 'INDUSTRY
DECEDENT'S
ACTUAL
RESIDENCE
(See instructions
on other stde)
17.. State
twp
17b. County
cityJboro
Oth&r significant conditi s contributing to death, but
not resulting in the unde iog cause given in PART I.
a.
~/;..;"wVJ' C()i..-IN 7iJ LJ"'~ r-J-V/l/b
TO (OR MA.CONSEQUE F);
Sequentially list condttions ! b.
if any, leading to irnmeQia1e
. cause. Enter UNDERLYING
CAUSE (Diseua Of injury C.
. that initiated events
reSUlting on daolh ) LAST d.
WAS AN AUTOPSY 'MORE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
TO (OR M C SEQUENCE ).
T (ORASAC
s aUENC
Natural
Accident
D
D
o
DATE OF INJURY
(MonCh, o.Y. Year)
TIME OF iNJURY
INJURY AT WORK? DESCRIBE HOW INJliIRY OCCURRED
MANNER OF DEATH
Yes 0 No
Yo. 0
NOD
Suicide
Homicide
Pending Investigatk>n
Could not be determined
o
o
30.. 3Gb. M.
o PLACE OF INJURY. At home, farm, street, factOfy. office
buildng, ele. (Specify)
300.
vo. D No D
300.
2a.. 28b.
CERTIFIER (Chock only one)
~~~~~~GJ~~~Z~~b71.S~~h~~~fc!::r:.:=(~3f.g:~~~.h:~~~~~~.~~~~.~.~~~~~~.i.t~~.~~~.. .............. 0 31b.
L1CEN:iIi.WMB~ ,n ~ DATE..2!.G~ (MOl)Ih,D.~Yoa~
.p~O~~:'~I:'Gm~~~;~:~:.~:.~t~~~~ l~:I~:,.~~..r;=~~.c:,~:rd~':t~Z~~~~~~~ ::~~.r as at.ted.......................g} 31c. /!/I{.J (/1 V7 P7 C; 31d. '/<< /'\oJ
NAME AND ADDRESS OF PERSON 'MiO COMP,!IETED 2AI.lSE OF DEATH
'MEDICAL EXAMINERlCORONER (It om 27) Typo or Print t9:tff () ",,/1':1 ~S /l?t:)
~~::,b::~::.:~~.~~~~.~~.~~~~.~~~~~~.~~:.I.~.~~.~~.~~~: .~~~.~~~~~. ~.t.~~. ~~:. ~~~:.~~.~~~~~..~~~.~.~.~~.~~.~~.~~~~~.~~~.. 0 ~ ~ I'f:'':4lu;" L I~ J,
31a. 32. '-/7"/, n'- ,"HI',v.)
REGISTRAR'S SIGNATURE AND NUMBER m t?J--: DATE FILED (Month, Day, Yeer)
/'t' /" I~/I~/I~ ~ ("
21.
r I
I
, "I
_.-- ~
- /
(-,)
LAST WILL AND TESTAMENT OF
ALBERT WILLIAMS JOHNSON TII
~:~,:-:ts
/.'....
-':1
] C__.,
J, Albert Williams Johnson TII, of the Borough oT'Roaribg
Cl
Spring, Blair County, Pennsylvania, being of sound mind and memory
~, ,
1
do make, publish and declare this to be my Last Will and TestamentJ
hereby revoking any and all Wills heretofore made by me.
FIRST. I direct that all my just debts, funeral expenses,
inheritance taxes and costs of administration of my estate be paid
as soon after my decease as may be found convenient.
SECOND. All the rest, residue and remainder of my estate, rea ,
personal and mixed, I give, devise and bequeath to my wife, Mary-
Louise Johnson, if living, and we do not die in a common disaster;
otherwise, I give, devise and bequeath said residue to my children,
share and share alike.
THIRD. Should my wife, Mary-Louise Johnson, predecease me or
should we die in a common disaster, I designate, constitute and
appoint my brother, Edward Lyon Johnson, guardian for my minor chi _
dren until they reach the age of twenty-one (21) years; said guard-
ian to use each child's share of my estate for his or her educatio
and support as he deems necessary and at his discretion, and I di-
rect that no bond be required of him requisite to handling said
funds.
FOURTH. I deslgnate, constitute and appolnt my wife, Nary-
Louise Johnson, as Executrix of this my Last Will and Testament, i
living; otherwlse, J deslgnate, constitute and appoint my brother.
Edward Lyon Johnson, Executor and direct that no bond shall be re-
quired of either of them.
/,<;
.
.
...
In Wi tness wnereof, I have on thi s '2 $ ..L day of September,
1965, signed, sealed, published and declared the foregoing instru-
ment as and for my Last Will and Testament, in the presence of eac
and all the subscribing wi. tnesses, each of whom I have requested i
the presence of each of the others to subscribe his name with his
address, as attesting witnesses, in my presence and in the presenc
of the others.
a~k* ~l,j_Q\.4__~_~I')
The foregoing instrument was subscribed, sealed, published an
declared by Albert Williams Johnson III, the Testator above named,
as and for hts Last Will and Testament, in our presence and in the
presence of each of us, and we at the same time, at his request, i
his presence and in the presence of eaeh other, hereunto subscribe
our names and residences as attesting witnesses. I
OF
OF
-2-