HomeMy WebLinkAbout05-22-05
PETITION FOR PROBATE and GRANT OF LETTERS TESTAMENTARY
Estateof Poin~~ /...'1fJN 1.....0,* No..:t-\-OS-BSO,
also known as IJ To:
Register of Wills for thl1 ( (\
County of C u w-I.o-O.<- V-6)
Commonwealth of Pennsylvania
. Deceased.
Social Security Number I fI::l - Lflf- ;) 6 fJ S
The petition of the undersigned respectfully represents that:
Your petitioner(s), is ( are 18 years of age or older and the Personal Representative(s) named in the will of above
decedent, dated F\f ",'/ I ~ I ;; 00,C; , and codicil(s) dated
'i\:) a N 5?
(state relevant circumstances, e.g. renunciation, death of executor, ete.)
County, Pennsylvania, with his (her last family or principal residence
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Except as follows, decedent did no arry; was no divorced; did not have a child born or ad d after execution
of the will offered for probate; was not the victim of a killing and was never adjudicated an incompetent;
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) Personal property
(Ifnot domiciled in PAY Personal prope~if Pennsylvania
Personal property in
Value of real estate in Pennsylvania
situate as foIlows:
at
at
County
$
$
$
$
If ()) DOO oC)
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WHEREFORE, petitioner(s respectfully request(s the probate of the last will and codicil(s) presented herewith and
the grant of letters ~ thereon.
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OATH OF PERSONAL REPRESENTATIVES
COMMONWEAtTH OF C:NNSYL V ~IA
COUNTY OF \ ~ \N-.. ~- , ( r-.r--
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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 Perl Repr sentativ s) of the ove decedent
petitioner(s) will well and truly administer thp p<tnte according to I
Sworn to or affirmed ann subscribed
before me this ;);l..j ,;;!:' day of
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f\JCtV it v"L.- Deputy Register
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Estate of
also known as
No.
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, Deceased
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DECREE OF PROBATE AND GRANT OF LETTERS TESTAMENTARY
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AND NOW, SE:'\l~~ ~ dDO.S., in consideration of the petition on the reverse side satisfactory
proof having been presented before me. IT IS DECREED that the instrument(s)
dated ~ ~ ...., \ \ ~) 6'>D 0 C,
described therein be admittesI to probate and filed of record as the last will and codicil(s) of the above named decedent
and Letters -\t.s, ~\: ~ ~
are hereby granted to C ~ s.. ~ La '-~
FEES
Probate ............................................................. $
Short Certificate(s)............................................ $
Renunciation(s) ................ ...... ..... ...... ..... ........... $
Inventory ......................................... .................. $
Judicial Computer Project................................. $
Inheritance Tax ....;............................................ $
Pleadings and Papers ........................................ $
Affidavit(s) ....................................................... $
Tax.................................................................... $
TOTAL ............ ......... $
~~~~
ATTORNEY (Sup. Ct. J.D. No.)
\fq \l.). Cx<:.. Nf{ sh<J.
~'~~.s.\o~ADDRESS ~ ,f7;)>7
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TELEPHONE NUMBER
Filed
A.D.
/0,21 (Reverse) (Rev, 3/93)
't AC' ^e;)C:'\
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This is to certify that thc information here given is correctly copicd fmm an original certificate of death duly filed with me a~,
I.ocal Registrar. The original certificate will be forwarded to the State Vilal Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
p
113382Q~
No.
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Hl05. 143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICAlE OF DEATH
S"AfE FOlE~Ut.l8ER
SOCIAL SeCUR'T'r' NUMBER
TVPL/PAINl
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PERMANENT
BLACItINI(
SE'
NAME OF oeCEDENT(F1fst. ModdIe. Last)
1, Robert L. Ley
AGE (LaS! Eloflhdayl UNDER 1 YEAR
Uonl"- o.p
2. Male
)
'.182 - 44
14 2005
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8lATHPLACf (C~V ir." PLACE CW oe.<<rH (CI>ec.. Of"". Qrll! -- "" 'f>5lruct~ on Olhe'!>del
Stale or Fereoon COUr\lryJ HOSPITAl
Carlisle PA lnpa,t_tlKJ
7. I ...
FACILITY NAME (I! r'oOl'I\SIi1ut,on. O'>'e scree! ana r'lUmtlel',
~)D
.. 52
COUNTY OF DeR'H
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Franklin
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Of:CEDENT'S USUAL OCCUPATION
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1tL U * S. Navy 1ftt. Senior
DECEDENT'S hlAtLING AOOFlESS (S1."". City/bofo. SU-. ZIP Code)
34 Shippensburg Mobile Esta~
17257
Chief
DECEDENT'S
ACTUAl
AfStDENCf
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onOlhef&lCle)
11'.51..
White
MARITAl STATUS. Matritd
Never 1Mrfwll. WidDwlKl.
DNorced~lyl
Divorced t5.
17c.lXI_,~llwdiro Shippensburg
SURVIVING SPOUSE
(nWlle.gMIlTl1ilodentlllm8)
Twp.
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Cumberland lDwnahip? 17d_0 :;':C':'nl=aI
UOTHER'S NAME (FIISI MfCl~_ MlIl6en Surname)
Bernice Glass
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INFORMANT'S MAIUNG ADDRESS ISlNllr!, C,rylTown, SJ.te, ZipCodeI
....3220 Michaux Drive Fa etteville PA 17222
PLACE OF DISPOSITION - Neme of Cemetery, Crem.llory lOC.lQ'1ON - City/Towfl. Slale, Zip Coo:>>
or Olhef f'lKe
~IrornSla'.O
2h;,Newville Cemetery :21... Newville, PA 17241
NAME AND ADDRESS OF FACILITY
u<. Fogelsanger-Bricker F .H.
LICENSE NUMBfR
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DUE Td'IORAS "CONSEOUENCE Of)
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OUElO(Ofl AS ACONSEOUENCE OF')
DUE m{OR ASA CONSEQUENCE Or)
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WERE AUTOPSY FINDINGS
1MtJLABLE PRIOR 10
COMPLETION OF C"'USE
OF 0EnH?
MANNER OF DEATH
DATE OF I/lLJUAV
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IlOll9SUltin; in ."" uncieflying ,*,";iwn in PII.RT I
TIME or INJURY
INJURY!J WORK?
DESCRIBE HOW INJURY OCCUAflED
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CERTifiER ICIlecl< onl~ one) ~
'C1;ATlFYlNG PHYStClAN (Physocoan Cf!J1"Y'''9 cause '" death wnen anolher Oflvs.IC.an liaS prOrlQUr\C4!'d <leam an<l comPJeted"em <.'3)
TO the bot.. Of my knowle(tQe. dellln OCCU....-d __10 me c.uM'II,allod m....ner.. ".leeI. . .
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'''FlONOUNCING AND CERTIFYING ftHYSICIAN (f'tlygoan DQlh ;>lonOUrI(;1I19 ooalh and"Ceflltyong 10 cause 01 deillh\
TolM~of my kroowlfilg.., d..lhO<:l;urr~.tthelt...., dille, and placlI, and due to thIlCIIU..t_) and manna,.. 'Iatftl..
"MEDtCAl. EXAMINER/CORONER
On the b..i. Of ...minllllon ,lind/Of' 1"'...",aUgalion, in my opinibn, de.tn occurred III,!he lime, dllle. ':and pIece, and dul!' 10 th", clluae(..) and
manner...I.'"__ . .. ..... _ ... , . ........,...... ....... ......_ . ...
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REGISTRAR"S SIGNATURE AND NUMBER
SION..-rURE
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LICENSE MBER ~ L
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NAME AND ADDRESS Of PERSON WHO COMPLETED CAUSE OF DEATH I. ,
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LAST WILL AND TESTAMENT
KNOW ALL MEN BY THESE PRESENTS, that I, ROBERT LYNN LOY of
Pennsylvania being of sound and disposing mind, memory and understanding, do
make, publish and declare this my Last Will and Testament hereby revoking all
prior wills and codicils by me at any time heretofore made.
FIRST: I direct the payment of all my legal debts, funeral expenses
including my grave marker and all expenses of my last illness, state, federal
estate and inheritance taxes and administration costs shall be paid as soon as
may be conveniently done following my decease leaving all specific bequests free
of tax to the legatee.
SECOND: I give, devise and bequeath all my property be it real, mixed or
personal, to my sons, Charles A. Loy and Stephen Z. Loy, in equal shares, share
and share alike, per stirpes.
THIRD: If any of the beneficiaries under this my Last Will and
Testament are minors, then in that event, I give, devise and bequeath said
minor's share to Charles A. Loy, as Trustee of my estate, to invest and reinvest
the same during the minority of the said minor with the following powers' in,
addition to those currently given under law:
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a. The power to use the income from the said minor's share for
the support, health, maintenance and education (including
undergraduate, graduate or technical schools) of the said minor.
b. The power to use the principal if the income should prove
insufficient for the support, health, maintenance and education
(including undergraduate, graduate or technical schools) of the
said minor
c. The power to distribute to the said minor the remaining
principal and income when she attains the age of Twenty Five
(25) years, upon a good and valid releases without the
necessity of adjudication by the Orphan's Court.
d. No trustee named herein shall be required to post bond in this
or any other jurisdiction.
FORTH: I nominate and appoint Charles A. Loy, as Executor to serve in
this or any other jurisdiction without the requirement of bond of any nature or
kind.
IN WITNESS WHEREOF, I, ROBERT LYNN LOY to this my Last Will and
Testament set my hand and official seal, this (j*' day of ~2005.
~1:~nJ&f
Robert Lynn Lo
(SEAL)
Sworn to and subscribed, declared and
Published by Robert Lynn Loy, as
his Last Will and Testament, and so
Done in the presence of we the
Witnesses, who sign at his request,
And in his presence, and in the presence
Of each other.
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COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
I, Robert Lynn Loy, whose name is signed to the foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I
signed it willingly; and that I signed it as my free and voluntary act for the
purpose therein expressed.
fJlmrI ~~ ~
Robert Lynn Lo
Sworn to and acknowledged, before me,
By Robert Lynn Loy, the Testator,
This 13 daYOf~ 2005.
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l'\J6tary Public
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COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
WE, Darlene M. Bigler and Sharon Coleman Adams, the witnesses whose
names are signed to the foregoing instrument, being duly qualified according to
law, do depose and say that we saw the Testator sign and execute the
instrument as his Last Will and Testament; that he 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,
and that to the best of our knowledge and belief the Testator was at the time at
least eighteen (18) or more years of age and of sound mind and under no
constraint or undue influence.
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Sworn to and subscribed before me by,
Darlene M. Bigler and Sharon COle~~
The witnesses, this (iit- day of 2005.
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Notary Public
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Sjl1PJl~1~~bl!I.~ ,:13\-)1':); C:Jmhtil:md Counly
M~:.::~~"'Jfl ';:'plI"" May 15, 20(~
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