HomeMy WebLinkAbout10-24-05
Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
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Estate of ~y 11. )II c;/C5"
also known as
No. (). J . (J. DO ~- q 37
To:
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Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. J 7.5 20 1-9150
The petition of the undersigned respectfully represents that:
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Your petitioner(s), who is/Ie 18 years of age or older, and the executt1,L named in the last will of the
above decedent, dated J? / ~/. "7) ,20.
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in (Ji/'M b~yl(lnJ.
Pennsylvania, with h_ last family or principal residence at
1Y/~'j'J1) V ex V tI2--
(list street, number and municipality)
County,
9 +-/J Wa-/;:t~~~,., /!.i .
~~ $, 16t>V\ ,-~;>.
Decedent,then~earsofage,died tJc;r: Jg ,20Q,2,at NlAj{tJ}t. tf1(<'/ff /IIVt'GfM' )l.lJme.
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 incompetent:
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
(Unot domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
4;J97.)~
$
$
$
$ D. PO
5TOf
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and the grant of letters
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
thereon.
hdinature~etitioner( s)
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYLVANIA
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ss:
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affrrm(s) that the statements in the foregoing petition are true and
correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) of the above
decedent petitioner(s) will well and truly administer the estate according to law.
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Sworn to or affirmed al;:dlfbsc,ribed
Before me this d day of
OCT. ,20 ()5
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Estate of i0 /-;) f) b r; .. tl3 ) , Deceased
O,ry tl cfncJ:5
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW {) c fWu ,~ '111-- 20 iJi,' 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
~~r f Ih/ 171 , described therein be admitted to probate ~led of record ~s the last will of
c U ; and Letters are hereby granted to d.l!O/ Ie- /YI Ih dq ., / /Z
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Register of Wills .7
FEES
Probate, Letters, Etc. ............. $
Will ............................ ..... $
Renunciation... . . . . . . . . . . . . . . . . . . . . $
Short Certificates (J.-) ............ $
JCP.................................. $
Automation Fee................... $
Bond. .. . . . . ... . . . . . . .. . . .. . .. . .. . .... $
Total (; r iJi,) $
Filed Ocli- 'i 20~
86 DO
j'S 66
Attorney (Sup. Ct. LD. No.)
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Address
Phone
Register of Wills of Cumberland County
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OATH OF NON-SUBSCRIBING 'VITNESS
Estate of ;?;J /JX ,Y 1/, III c!~.s
No.
:J I - ') 0 0 f? -q 3 7
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Also known as
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, Deceased
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(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
4 . t.'iZve.familiar with the signature of IY/~~ It, IIJ~)t..-J , testat_ of (one of the
(
subscribing witnesses to) the codicil/will presented herewith and that ~believelbelieves the signature
on the codicil/will is in the handwriting of IIJ~ V /7, II Jc.~r to the best of
/
()tlJ- knowledge and belief.
Sworn to or affirmed ~d sllbscribed
Before me this L. I day of
OCT. ,20~
~4.JrJ..~
ame) "
zJ/~)vah une.- COJyA$l~);fJ J7P/3
(Address)
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Registe'vVYlr~
Deputy
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(Name)
;2/1 ~?(hVL ~/A.I/()/.3
(Address)
{I. /, J 0 tn- -'1 37
This is to certify that the information here given is correctly copied from an original certil cate III ( C lth till Y filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Offin for pLTllanellt Iililg.
WARNING: It is illegal to duplicate this copy by photostat or photo.graph.
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Local Registrar
Fee for this certificate. $6.00
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OCT 1 9 2005
Date
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H105.143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
STATE FilE NUMBER
TYPElPRJNT
IN
PERMANENT
BLACK INK
1.
AGE (lasl Birthday)
94
v"'.
SEX SOCIAL SECURITY NUMBER
2. Female 3. 175 - 20
BIRTHPLACE (City and PLA E OF DEA H Ch onl ne - see Instruction
Stale or Foreign Cou~try) HOSPITAL:
Pennsyvan1a '0""00'0
7. 8a.
FACILITY NAME (If not institution. give street and number)
DATE OF DEATH (Month. Day, Year)
4.10/18/2005
..
COUNTY OF DEATH
Re.ldence 0 ~:~) 0
RACE. American Indian. Black, White, et .
(Spec",,)
10. Whi te
SURVIVING SPOUSE
(II wife. lli1/a maiden nama)
;{\
Cumberland
8b.
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17.. Slate PClo''"lnC'~Tll:T?n; iiI ~~~enl
17b. County rl11.nhprl ;::jnn ~~:~~~p? 17d,D ~~hi~~~~I)i~~Of
MOTHER'S NAME (Firsl, Middle,'Maiden Surname)
19. Fannie L He
INFORMANrs MAILING ADDRESS (SIreet, CityfTown, Stale, ZIp Code)
20b,
PLACE OF DISPOSrTION- Name of Cemetery, Crematory
or Other Place
21cForest Lawn cern.
NAME AND ADDRESS OF FACILITY
FH&Cremat
LICENSE NUMBER
23b. 1<.. tv S-
WAS CASE REFERRED TO A MEDICAL E
26. Ve, 0
, Approximate PART II:
: interval between
: onset and death
!wp.
city/bora.
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Sequentially lisl conditions b.
if any. leading to immediate { c.
cause. Enter UNDERLYING
CAUSE {Disease or injury
thal initialed events
resulting on death ) LAST d.
WAS AN AUTOPSY WERE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEA TH7
DUE TO (OR AS A CONSeQUENCE OF):
DUE TO (OR AS A CONSEQUENCE OF)
Ve,O NO~
Ve,O
::~:~R OF &TH
Accident 0
o
Homicide
DATE OF INJURY
(Morlth. Day. Year)
o
o
o
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
NoD
Suicide
Pending Investigation
Could not be delennlned
30a. 30b.
PLACE OF INJURY - At home, fann, slreet, factory, office
bulldi"ll,llc. (Specily)
30..
30d,
LOCATION (Street. CilyfTown. Stale)
f.
OF
p-o
288. 28b.
CERTIFIER (Check only one)
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n'n.nn 0 31b.
*PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both prOllooncing death and certifying 10 cause ofdeelh) ~ lICENSO 0 t- ~ z. (5" _ L DATE S'l~~_~M~(Oa~r)
To the best of my knowiedge, death occurred at the time, date. and place, and due to the cause.(a) and manner.s stat.d..........".,......" 31c, \ 31d. f ~
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
*MEDICAL EXAMINER/CORONER (Item 27) Type Of Print
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318.
REGISTRAR'S SIGNATURE AND N~ .
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LAST WILL AND TESTAMENT
I, MARY A. HICKS, of Lorain Borough, Cambria County,
Pennsylvania, being of sound mind, memory and understanding, do
make, publish and declare this as and for my Last Will and
Testament, hereby revoking all former Wills by me at any time
heretofore made.
FIRST: It is my will that all my just debts and funeral
expenses be first fully paid as soon as may be after my decease.
SECOND: All the rest, residue and remainder of my estate,
I
It real and personal, I give, devise and bequeath unto my beloved
I
husband, Leslie M. Hicks, and I appoint him Executor hereof,
provided, however, that if he predeceases me, or dies within sixty
(60) days of my death, then I give, devise and bequeath the rest
of my estate as follows:
I give and bequeath the sum of Five Hundred ($500.00) Dollars
unto the Moxham Lutheran Church of Johnstown, Pennsylvania.
I give and bequeath my books, my electric organ and all of my
stock in the Penn Traffic Company unto my granddaughter, Cheryl
Lynn Hicks.
All the rest of my estate, I give, devise and bequeath unto
my son, Leslie M. Hicks, Jr., and I appoint him Executor hereof.
If my son predeceases me, I give, devise and bequeath the rest of
my estate unto my granddaughter, Cheryl Lynn Hicks and any other
grandchildren I may have, share and share alike, and I appoint my
granddaughter, Cheryl Lynn Hicks, Executrix hereof. If my grand-
daughter, in such event, is a minor or unable to so serve, I
appoint the united States National Bank in Johnstown Executor
I
II hereof.
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IN WITNESS WHEREOF, I have hereunto set my hand and seal this
-3/~
- day of August, 1971.
-?71~ II- ~
(SEAL)
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Signed, sealed, published and declared by the above named
Testatrix, MARY A. HICKS, as and for her Last Will and Testament,
in the presence of us who at her request and in her presence and
in the presence of each other, have hereunto subscribed our names
as witnesses thereto.
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