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Home My WebLink About11-07-05 , [ PETITION FOR PROBATE and GRANT OF LETTERS No. ~ 1- 05{}J~L.j- To: Register of Wills for the , Deceased. County of Cumberland in tie Social Security No. 200-22-5221 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: i Your petitioner(s), who t$/are 18 years of age or older an thcf~x~cutors in the last will of the above decedent, dated January 23 and codicil(s) dated n/ a Estate of Thelma L. Martin also known as (state relevant circumstances. e.g. renunciation, death of executor. etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, ith her last family or principal residence at 711 Brenton Street Borou h of Shi ensburg (list street, number and muncipality) Decendent, then 77 years of age, died ,:lJ' 2005 , at Shi ensburg Health Care Center Shi ensbur Penns lvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adop ed after execution of the will offered for probate; was not the victim of a killing and was never adjudica ed incompetent: no exce tions Decf!ndent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 17,200.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 200,000.00 situated as follows: Real estate located in the Borough of Shi ensburg, Cumberland County, Pennsylvania WHEREFORE, petitioner(s) respectfully request~) the probate of the last will aDlk pre~ented herewith and the grant of letters testamentar (testamentary; administration c.I.a.; administration d.b.n.c.t. .) theron. ~ OJ> i~ ~4/?/74~ ~ 'f Robin Ann Mitchell -g.g 455 East King Street :::,'ii Shippensburq, PA 17257 ~c.. '-''- ;:; 0 ;;; '" OQ r;5 r-',., ) ::'.J , ; I , f' :: \ I The petitiQner(s) above-named swear(~) or affirm(s) that the statements in the foregoing petition ar~ true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represeni tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to lawi SWN.n 10 01 aff~ and subscdbed { ;AiL <?A ~ ~ ~: tbis - ti;~oot 1&0/ ~ I ~~~OReg~ter ~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ') S8 COUNTY OF Cumberland J No. ~l- OS -OQ'?4 Estate of Thelma L. Martin , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW J(I()l~VY\~O^ r; Wl2005 ,in consideration of the petition on '- the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(s) dated January 23, 2001 described therein be admitted to probate and filed of record as the last will of Thelma L. Martin and Letters testamentary are hereby granted to Robin Ann Mitchell and Jay Lightfoot Will Fee Probate, Letters, Etc. ......... $ Short Certificates( 5) . . . . . . . . .. $ Renunciation ................ $ iSflmKfron Fee $ 19: 88 TOTAL _ $ 360.00 Filed .)\ ~ .~.-. Q$. . . . . . . . . . . . . . . . . . . . . . . . FEES 15.00 310.00 20.00 ,~ '4:unw., ~A()ft~k> Register of Wills ~~ .Q.u..J- ~.~ /) v1J-x- Robert C. Scholla~t #10196 ATTORNEY (Sup. Ct. LD. No.) 82 West Queen Street Chambersburq, FA 17201 ADDRESS 717-264-5194 PHONE l[ 1111''' <ill<; P':\ 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. 11338451 No. Fec for this certificate. $6.00 p &/..;; 74~~1 Date .", ) H105.143 Rev. 2187 ~ 1-05-98&/ COMMONWEALTH OF PENNSYLVANIA " DEP,ARTMENT OF HEALTH . VITAL RECORDS TYPEIPRINT IN PERMANENT BLACK INK CERTIFICATE OF DEATH , j ~\ 6. 77 Yrs. COUNTY OF DEATH SEX 2.Female BIRTHPLACE (City and P F A H State or Foreign Country) HOSPITAl 7. ShiJP!l1Sl:mg, PA :.-".. 0 FACILITY NAME (If nol institution, give street and number} STATE FII..E NUMBER SOCIAL SECURITY NUMBER .. 200 22 NAME OF DECEDENT (Firsl, Middle, Last) 1. Thelma L. Martin AGE (Last Birthday) :::~ty) 0 merican Indian, Black, Wlite, et Bb. Cumberland Shippensburg 'AS DECEDENT EVER IN u.s. ARMED FORCES? YesO NoI1D 12. hite PA MARITAL STATUS. Married, Naver Married, \Mdowed, Oi\lOrced (SpeCify) 14. Widowed 1.. '7e.1Xl Y.s. decede'" live.'" Shippensburg S RVIVING SPOUSE (I wif~,g/oIlIlltl,l.idet\I\'\TIIIl) " w '" '" ~ :; <( Did decedent 17b. County Cumber 1 and ~:~~h~P? 17d. 0 ~~hi~e~=mi~~~ of MOTHER'S NAME (First, Middle, Maiden Sumame) 1.. Mary E. Henry INFORMANT'S MAILING ADDRESS (Street. CitylTown, State, Zip COde) 2Db.691 Broad Street, O1anbersbJrg, PA 17201 PLACE OF DISPOSITION. Name of Cemetery, Crematory LOCATION. Cityrrown, State, or Other Place Township twp cily/boro ip COde 2'e.Spring Hill Canetery 21d. Shi~, PA 17257 NAME AND ADDRESS OF FACILITY 22e. -Bricker F.H. Inc. 17257 LICENSE NUMBER JOOS 2.. : Approximate , Interval between : onset and dea.th Other significant conditio contributing to death, but not resulting in the under! ing cause given in PART I Sequerttiahy list conditions . if any, leeding to immediate . cause. Enter UNDERLYING CAUSE (Disease or ir1ury . thaI initiated events resulting on death) lAST WAS AN AUTOPSY VVERE AUTOPSY FINDINGS PERFORMED'? AVA.ILABLE PRIOR 10 COMPLETION OF CAUSE OF DEATH? I: DUE TO (OR AS A CONSEQUENCE OF): DUE TO (OR AS A CONSEQUENCE OF) MANNER OF DEATH Nalural Accident G- O o Homlcicle DATE OF INJURY o (Monlh, Day, Year) o o 'De. 'Db. M. P~ACE OF INJURY. At home, farm, street, factory, office bUildin",etc.(Speclty) 30e. TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJU Y OCCURRED Y.sO NO~ Y.sO 28a. 28b. CERTIFIER (Check only one) ~~~~F~~tGor~~~'~JA.Jef:l.~~:rh ~~~~~d~~ teg 8ae:~~~~(:~W3~~x~~~a&. ~~f:8~~~~, ?~~~~.~~.~,~~~~~.~.j.t~~ .~~),.. NOD Suicide Could not Qe detecmtned y.sO NOD 3Dc. Pending Investigation f-- Z uJ o uJ U uJ " u- o uJ :; <( Z 29. .PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death) To the best of my knowledge, death occurred at the time, date, and place, and due to the caU$ea(a) and manner as stated... 'MEDICAl EXAMINER/CORONER ~~:::':rb::i:t::e~~~mlnatlon .nd/or kwestlglt'llon, In my opinkon, death occurred It the time, date, and place, and due to the causes(s) and 0 31a. REGiS1RAR'S SIGNATURE AND NUMBER Ii ~ ~ ?1 3.. .' LAST WILL AND TESTAMENT I, Thelma L. Martin, of 711 Brenton Street, Shippensburg, CumberHmd County, Pennsylvania, revoke all my prior wills and declare this to be my Last Will and Testament. 1. I direct the expenses of my last illness, funeral and burial shall be paid from my estate as soon as practicable after my death. 2. I give the residue of my estate to my daughter, Robin Ann Mitchell, provided 'she survives me by thirty (30) days. 3. In the event my daughter, Robin Ann Mitchell should predecease me or if we should die in a common disaster, then in either ofthose said events, I give, devise and bequeath all of my property to my sister, Violet Helm, my brother, Jay Lightfoot and my sister, Jane Cline, in equ'll shares. In the event that my brother or either of my sisters shall predecease me, I direct that their share shall lapse and be added to the shares of my surviving brother and sisters. 4. I nominate, constitute and appoint my daughter, Robin Ann Mitchell and my brother Jay r..j Lightfoot, as Co-Executors of this my Last Will and Testament. I direct that no~xecutor or Executrix named, nominated or appointed hereunder shall be required to post bor:~! or give any security of any type for any purpose whatsoever, any law or rule of court of the Com!ri,dmwealth-pf Pennsylvania or any other jurisdiction to the contrary notwithstanding. [, ) " . II \ \ " ~ IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal the d3'raay of ~,rv...a. ry, 200l. . -:..--I4-L ~ AI ~ Thelma L. Martin Signed, sealed, published and declared as and for her Last Will and Testament by Thelma L. Martin, the above-named Testatrix, in the sight and presence of us, who at her request and in the sight and presence of her and each other, have hereunto subscribed our names as witnesses on the day and year last above written. ~~~~~ ~ j ~c4~' / ' -2- 11 I' .. COMMONWEALTH OF PENNSYLVANIA COUNTY OF FRANKLIN SS I, Thelma L. Martin, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; and that I signed it willingly and as ~y free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Thelma L. Martin, the Testatrix, this r-J ~ day of Ja.,vC,LCJ.ry ,2001. _1j~ vY ~ I/L ~, , Testatrix ~A.~ ~ary Notarial Seal Lynann M. Funk, Notary Public Chambersburg Bora, Franklin County My Commission Expires Feb. 29, 2004 M8mber, P"nrWfi'.'omlJ Association of Notaries -3- I .. ~ COMMONWEALTH OF PENNSYL VANIA ss COUNTY OF FRANKLIN We, -:70)' c-€. (f'. fhJ~/ anddc.6t'r t- C S-,A'.,h.,..rl,thewitnesseswhose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instl1i1ment as her Last Will and Testament; and that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight ofthe Testatrix signed the will as a witness; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ~Y- ce (( ~;J bY and , ~ / ((() b f'r t- ( Jclv//u.rf, witnesses, this ~ day of Uu~" ~ r;/ , 2001. ~~)\\ ~~b~ ?bL Ll /.4.~ ~ ~~- ,4.~, Notary I . Notarial Seal I __ Lynann M. Funk, Notary Public i .I.,hambersburg Bora, Franklin County L.1~Y Commission Expires Feb. 29, 2004 i,/jt_;:~jl;el, ;./(.,_:(j~'s:i!I'</E"l{~!a i'\,sSOct~t!on ot Notaries -4-