HomeMy WebLinkAbout09-27-05
11
Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of !VIA-,(G.-rl,l eT 11. "To l.,JV~~ No. ~I - 05'OS1oS
also known as To:, -,
Register of Wills for the ,-')
County of Cumberland in the
Commonwealth of Pennsylvania
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Social Security No. ;231 .5- ~ t"" Db
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The petition of the undersigned respectfully represents that:
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Your petitioner( s), who is/are 18 years of age or older, and the execut.0- named in the laS~ will of ~
above decedent, dated I' 5- :n-/ tV e. ~ IF' ~.5 - , 20 0 :;'- ,': ..
and codicil(s) dated ~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in f /.{ n-l be " t ~ j)
Pennsylvania, with h.,l-last family or principal residence at
39Jl( B/Loc/c,t,])&t PIlIJ'i!- /I?/?CHIryv/C~6,,{It)
(list street, number and municipality)
County,
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Decedent, then k.L years of age, died ,;7;1.. 5c: f I , 200 .;- , at /7 cJ_ c-
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 incompetenit:
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:
20, OOd? , <0 0
/
$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presente~
herewith and the grant of letters t:?'r/l /11 t::>-7I+1C.
(t tamentary; administration c.t.a.; administration d.b.rj.c.t.a.)
Residence( s) of Petitioner( s)
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COUNTY OF CUMBERLAND
COMMONWEAL TH OF PENNSYLVANIA
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The petitioner(s) above-named swear(s) or affmn(s) that the statements in the foregoing petition are true and
correct to the best of the know ledge and belief of petitioner( s) and that as personal representative( s) of the above
decedent petitioner( s) will well and truly administer the estate according to law.
Sworn to or affrrme,Sl and svbscribed
BAore me this ~ ~ day of
~ ('1G:L""-',\ \0..: '- , 20 0 .5
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Register
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NO.4' - O.5-~~
Estate of \Y\c.U~~,;u..T ~ ')h..'Nl""", Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
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AND NOW ~Q ~\c:::u..,,- ~~ 20.1);5 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
~;.~ ~~ ' described therein be admitted to probate filed ofrecord aSr!he/ll~st will of
__;--_ _~~~(,"t-- ; and Letters are hereby granted to'-1/cvn f' ~ I-i r-IVJL~
FEES
Probate, Letters, Etc. .............
Will .................................
$
$
Renunciation....................... $
Short Certificates ( ).. . .. .. . .. .. $
J CP . . .. . . .. . .. . . . .. . . . .. . . .. . . . . . .. .. $
$
$
$
200S
Automation Fee...................
Bond.................................
Total
Filed q -.;l ,
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Attorney (Sup. Ct. LD. No.)
Address
Phone
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Thi~ is to certify that the information here given is correctly copied from an original ce:~.ific~te of death dul.r filed with me as
LOCil 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.()()
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Local egistrar (
62/-05 -Oi?loS
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CERTIFICATE OF DEATH
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3 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
8T A. TE FILE NUMBER
NAME OF DECEDE.NT (First, M'ddle, Last)
61
UND
Months
Days
DE 1
Hours Minutes
SEX SOCIAL SECURITY NUMBER
2.female 3. 231 -56 -6606
BIRTHPLACE (City and PLACE OF DEATH Check onl n
Gtate or Foreign Country) HOSPITAL:
.r: arm viIi e , V A ~;&!Jent 0 ERlOutpatlent 0 DOA 0
FACILITY NAMt:: (If not institution, give ~tree( a.ld r.umber)
Brookrldge Dr.
D
1.
AGE (Last Birthday;
5.
COUNTY OF DEATH
Cumberland
Vrs.
8..
8e.
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DECEDENTS USUAL OCCUPATION
l~r~:~I~~~j~~ (~~e,,~~~~:gISI
KIND OF BUSINESS IINOUSTRY
11.. aCCQun tan t 11b. boa t
DECEDENT'S MAiLING ADDRESS (8\",." Clty/Tow,', Stale, Zip Code)
sales
DECEDENT'S
ACTUAL
RESIDENCE
(See instructions
on other side)
AE DECEDENT EVER IN
I).G. .o\R\1E!J FC~RCES?
YesO No
12.
MARITAL STATUS. Marri<l<l,
Never Mamed, Widowed,
Divorced (Specifyi
1f.i dowed .
17c. ~es, decedent lived In
17d. 0 ~~~e=~~\j~i~ of
MOTHER'S NAME (First. Middle, Maiden Surname)
19. Estelle Parker
INFORMANT'S MAILING ADDRESS (Street, City/Town, Slate, Zip Code)
2Gb.315 Filmore Dr. ,Jacksonville,FL
PLACE OF DISPOSITION- Name of Cemetery, Crematory LOCATION - Cityrrown, State. p Code
or Other Place I
~erbours Chapel Ch.Cem.~2ur Oaks,NC
NAME AND ADDRESS OF FACILITY Leroo~ne PA.170
Musselman FH&CS,3L4 Hummer Av
LICENSE NUMBER DATE SIGN D
(Month, Day Year)
,612
twp.
1i.. StatA
17b. Cuuntv
city/bora.
David E. Hol,r.2S
IMMEDIATE CAUSE (Final
disease or condition
resulting in death)-+
:5 ~r~dR ~s k S-N7E~uLE OFI L~ j
C:a... .--eL,
26,
: Approximate
I interval between
: onset and death
PARTlI:
Items 24-26 must be completed by
person who pronounces death.
24.
27. PART I: Enter the dlse...., InJurle. or compile.tlons which caused the d.-th.
L1.t only on8 cau.. on each IIn..
,
Sequentially list conditions
jf any, leading to immediate
cause. Enter UNDERLYING
CAUSE (Disease or injury
thai initiated events
resulting on death) LAST
WAS AN AUTOPSY WERE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
E
DUE TO (OR AS A CONSEQUENCE OF)'
DUE :0 (OR AS A CONSEQUENCE OF);
Accident
MANNER OF DEATH
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DATE OF INJURY
(Month, Day, Year)
TIME OF INJURY
INJURY AT WORK?
DESCRIBE HOW INJUR I OCCURRED,
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Natural
Homicide
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30.. 30b. M.
PLACE OF INJURY. At home, farm, street, factory, office
bulldmg, etc. {Sptlt;lf)I)
30e.
Yes D No D
30c.
30d.
LOCATION (Street, CityfTown, State)
Yes 0 No
Yes D
NoD
Suicide
Pending Investigation
Could not be determined
28a. 28b.
CERTIFIER (Check only one)
*l~~~F:':~tGor~~1:~~~Jrg~S~~~hcg~~~~u~: t~ f~.a~a~:~(:r~~3ri;'~x~j~a~. h~r~~~~~~.~ .~~~~..~~.:?~~~~~~~.i.t~~.:~).... ...... ,.... ...
29.
.MEDICAL EXAMINER/CORONER
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31a.
REGISTRAR'S SIGNATURE AND NUMBER
33~ ~ L~ 11d.i /) /1
34.
~P:o~~~~s~l~fm~Nk~;;I~J~;~e~t~~~~c~:~ ~~~6:i~:~ne~d~t:,~~~;~~~.d:~~h d~n: t;::::Z~~u~ec:(~)~~~ ~:~h~.r as stated...................... 0
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LAST WILL AND TESTAMENT
OF
MARGARET A. JOHNSON
1, Margaret A. Johnson, of Mechanics burg, Cumberland County, Pennsylvani~l,
being of sound and disposing mind, hereby make, publish and declare this to be my Last Will
and Testament hereby revoking all former Wills and Codicils made by me.
ITEM I: I direct that all my legal debts and funeral expenses shall be paid fro~
the assets of my estate as soon as practicable after my decease.
ITEM II: I direct and bequeath all of my estate of every nature and wherever
situate, in equal shares, to my children, Paul E. Johnson and David L. Johnson, providing they
shall survive me by thirty days. In the event either of my children predeceases me or dies on lOr
before the thirtieth day following my death, I devise and bequeath his or her share to such
person's issue, per stirpes, who survive me.
ITEM III: I direct that all taxes that may be assessed in consequence of my de~th,
of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate
as a part of the expense of the administration of my estate.
ITEM IV: I appoint my sister, Nancy H. Hall, Executrix of this my Last Will.
Should she fail to survive me or is otherwise unwilling or unable to serve then I appoint my s<im,
Paul E. Johnson, as Executor, of this my Last Will.
ITEM V: I direct that my Executrix or her successor shall not be required to give
bond for the faithful performance of their duties in any jurisdiction, and should, notwithstanding:~;
this direction, a bond be required, I direct that a surety bond not be required.
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IN WITNESS WHEREOF, I have hereunto set my hand this J5+-~ day of
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,2005.
~dO 9t!~
- - -ARGARETA OHNSON
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The preceding instrument, consisting of this and two other typewritten pages
identified by the signature of the Testatrix, Margaret A. Johnson, was on the day and date tht+reof
signed, published and declared by Margaret A. Johnson, the Testatrix therein named, as and for
,
her Last Will, 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 hereto.
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COMMONWEALTH OF PENNSYLVANIA )
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COUNTY OF DAUPHIN )
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I ./ '" )-1, LJ (!! \'\,., s~hfestatrix 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 this instrument as her Last Will and
Testament and that she had signed willingly and that she executed it as her free and voluntar1 act
for the purposes therein expressed, in that each of the witnesses, in the presence and hearing <pf
the Testatrix, signed the Will as witnesses and to the best of their knowledge, the Testatrix was at
the time eighteen years of age or older, of sound mind and under no constraint or undue
influence.
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SWORN and Subscribed to and
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before me this.:> day of
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,jJIL.tk~ Wi '[rrJi,A.J
Notary Public
00' .,(,."IN(.~!\L:rH OF h._, ":" .__.
r NOTARIAL SEAL ,
\ LINDA WITMER, NOTARY PUBLIC I
CITV OF HARRISBURG, DAUPHIN COUNT:
MY COMMISSION EXPIRES MAR. 20, 2C03
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,2005.