HomeMy WebLinkAbout11-08-05
Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
. ~. ~
Estate of ~upn 'b Whitt S-K
also known as
No.
To:
l;{ 1- 0 ~-O' C/~ t'>
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. (j 03 - Q.) - .J \ 3 ,
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, and the execut~ named in the last will of the
above decedent, dated roo.,\ 1.-\. ,20 or~ L-\
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in LtA ~ b.e.Y \ CLn d.
Pennsylvania, with h!.? last famil;: or principal residence at r. .
'7 D D UJtLi (\ tJ- l;)ti:fr;yy\. R...GtL ot LGLr II S-&-, PeL
(list street, number and municipality)
Decedent, then.:I2 years of age, died 0 d 3 , 20 0 S, at 5 : L~ J 0 YYI
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:
County,
JlM3
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pz..) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in. Pennsylvania
situated as follows:
1000 .r.'.>
$
$
$
$
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.ta.; administration d.b.n.c.ta.)
thereon.
Signature(s) ofPetitioner(s)
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Residence( s) of Petitioner( s)
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYLVANIA
}
SS:
COUNTY OF CUMBERLAND
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 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 affirmed and subscribed {
Befor) ~e this ~ ~ day-of
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No. 1/- () c;- 0 qir
Estate of I aLplt J L- tulv,e , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW IV (f'f( 4?1iJ--eA 0 20 05; 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
fYl cy '-I, J.. DO 'f ' described therein be admitted to proy,ate filed ofrecor"d a.s the last will of
; and Letters are hereby granted to t:!t'JM/ /J1. 6.-'f//I.5.
,
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/ Register of Wills / ;A
FEES
Probate, Letters, Etc. ............. $
Will................................. $
Renunciation... . . . . . . . . . . . . . . . . . . . . $
Short Certificates (3) ............ $
J CP . . . . . . . . . . . . . . . . . .. . .. . .. . .. . . . . .. $
Automation Fee................... $
Bond........... ......... ............. $
Total~ $
Filed NO\) ~l'" 20~<'
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Attorney (Sup. Ct. LD. No.)
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Address
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Phone
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Thi, is to certify that the information here given is correctly copied from an original cert iilt.:. Lode .Ill j II) filed with me as
Loed Registrar. The original certificate will be forwarded to the State Vital Records Off;c f.1J pennale It filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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No.
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Lucal Reg snll'
Fee for this certificate. $6.00
OCt~A 2005
[late
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ITEM l:l
SHOULDREAOAS FOLLOWS;
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2187
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
LJ
lAME OF DECEDENT (F;;:-sl. MicC1lo. laSl)
SEX
STATE FILE NUMBER
SOCIAL SECURITY NUMBER
~GE (Last Bir1hday)
UNDER 1 YEAR
Monlhs Days
Ralph L. White, Jr.
UNDER 1 DAY
Hours Minutes
2. Male
J. 003
42
3, 2005
73 y".
BIRTHPLACE (Cill' and PLACE OF DEATH (Cneck only one -;ee tn.slfuchoo.s on othel stdel
Stale or Foreign Country) HOSPITAL:
M t 1 . VT Inpolien, D ERlOutpa,ian,.O OOA D
1. on pe ler, ...
FACILITY NAME (II nollns!llUlIon. give Slreel and numberJ
gr:-lfyl 0
OUNTY OF DEJU'H
b.
Cumberland
...
Carlisle Boro.
c.a..I+J... t-.e.wf-U'"
RACE - American Indian. Black, White. 8tC.
(Specllyl
DECEDENT'S USUAL OCCUPATION
(~jv:O~~::i~~r~d~~eu~~r;~~r:ff
10.
White
14.
MARITAL STATUS. Married
Never Married, Widowed,
Divorced (SpecIfy'
Divorced
SURVIVING SPOUSE
(II Wile. gIVe maiden name)
700 Walnut Bottom Road
L Carlisle, PA 17013
~THER'S NAME (Firs!. Middle, last)
1711. Slale
PA
17b. County
Cumberland
No, decedent lived
17d. within actuallimils of
MOTHER'S NAME tFiJsl, Middle. Maiden Surname)
Did
decedenl
Iiveln.l!l
IOWnship?
17c.D Yes, decedenl lived In
lWp
Carlisle
Cityiboro.
..
'FORMANT'S NAME (TypaJPrint)
Ralph L. White, Sr.
Elizabeth Blair
I..
ETHOO OF DISPOSITION
Burial 0 Cremation ~ Removal/rom Slale 0
Other jSpecifyL
Pearl Gillis
17013
PA 17109
rematlon
me 24-26 must be compleled by
rson who prooounces dealh.
.J OOS-
MEDIATE CAUSE (Final
.ease or condilion
illlling in dealtl)_
/}~
2..
I Approximale
: interval between
I onset and death
I
I
,
r/Le~ Ce.~
DUE TO (OR AS A CONSEOUENCE OF):
quentially list conditions
ny, leadIng 10 immediate
!.IM_ Enter UNDERLYING
,USE (Disease or in;ury
,I initiated evenls
ulling in dealtl) LAST
DUE TO (OR AS A Cm.JSEOUENCE OF):
DUE TO (OA AS A CONSEOUENCE OF):
\5 AN AUTOPSY
RFORMED?
d.
WERE AUlOPSY FINDINGS
AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
MANNER OF DEATH
DATE OF INJURY
(Month. Day, Yearl
TIME OF INJURY
INJURY AT WORK?
DESCRIBE HO'N INJURY OCCURRED.
Natural
c:r--
D
D
Homicide
D
D
o ~~'CE OF INJURY .AI home, 'ar~,O:;eel, factory, ottlce
building. elc. ,Specify)
JOe.
Yes 0
NoD
Accident
Pending Invesllgallon
Could not be delsnnined
M, JOe,
3Od.
LOCATION (Slreet. CifylTown. Stale)
.. D
No
Yes 0
No Er"
Suicide
.. 28b.
RTIFIER ,Check ooly ()(leI
.CERTIFYING PHYSICIAN (PhVslclan cenllYlng cause 01 death when anOlher physiCian has pronounced dealh ana compleled Hem 231
To lhe bell of my knowled!illl', dellth occurred ~ue to the caUse(s) IInd manner a:l staled. . . . . . . .
2..
3Of.
TtTlE OF CERTIFIER yJ ,
u< /~
UCENS UMBER DATE SIGNED (Month. Day. Year)
D J1c. 65 c) 0 7 / I 0 C J1d. "3 0 c:Jt CJ3
NAME AND ADDRESS OF PEASOf\WHO COMPLETED CAU$E OF DEATH
(lIem 27) Type or Prinl J . I J I ()...-v c i.>
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32.
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'PRONOUNCING AND CERTIFYING PHYSICIAN (PhysicJan bolh prDnOUllClf"IQ dealh and cerlifVlng 10 cause or dealh)
To the best of my knowledgl!', dealh occurred al the lime, date, and place, and due to the cause(s) and manner as .!Ilaled
.MEDICAL EXAMINER/CORONER
On the basis 0' examination andlor Investigation, In my opInion, death occurred althe lime, dale, and place. and due 10 lhe cause(s) and
manner as staled.. , , . . , . . . . . . . . .. . , . . . . . . , . . . . . . .
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IDnst lIill nun QIcsmm-eut
OF
RALPH WHITE
BE IT REMEMBERED, that I, RALPH WHITE, of 62 Aspen Road, Dillsburg,
York 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 and
making null and void any and all Wills and Testaments and writings in the nature thereof
by me at any time heretofore made.
ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after
my demise as may be convenient.
ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which
I have a power of appointment, I give, devise and bequeath unto my niece, RACHEL
ANDERSON.
ITEM 3: I direct my hereinafter named Executrix to pay all inheritance, estate,
succession and legacy taxes of whatsoever nature and kind, to which my estate or the
transfer of any property passing hereunder or otherwise passing by reason of my demise,
may be subject and to charge such taxes against my residuary estate, it being my intention
that none of the aforesaid taxes, either federal or state, on any property required to be
included in my gross estate, under the provisions of any state or federal law now in force
or hereafter enacted, shall be prorated among the persons interested in my estate to whom
such property is or may be transferred or to whom any benefit accrues.
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(SEAL)
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ITEM 4: I appoint my sister, PEARL M. GILLIS, as Executrix of this my Last
Will and Testament. In the event my sister, PEARL M. GILLIS, predeceases me, ceases
to act, or renounces probate, I then appoint my niece, RACHEL ANDERSON, as alternate
Executrix of this my Last Will and Testament.
ITEM 5: I direct that my Executrix shall not be required to give bond for the
faithful performance of her duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this t1-+.b day
of M(111-
u
,2004.
WIISS:
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COMMONWEAL TH OF PENNSYL VANIA
: SS
COUNTY OF YORK
We, RALPH WHITE, SHAWNA L. VARNER and LINDSAY M.
STRATHMEYER, the Testator 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 Testator signed and executed the instrument as his Last Will
and Testament and that he had signed willingly (or willingly directed another to sign for
him), and that he executed it as his free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and hearing of the Testator,
signed this Last Will and Testament as witness and that to the best of their knowledge the
Testator was at the time eighteen (18) years of age or older, of sound mind and under no
constraint or undue influence.
Sworn to and subscribed
before me this 4'f:!l day of
~ ,2004.
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NOTARY PUBLIC
MY COMMISSION EXPIRES:
Notarial Seal
S. D?wn Gladfelter, Notary Public
D"J~ur$1 Boro, York County
My CommIssIon Expires May 17, 2005
Member, Pennsylvania ASSOCiation of Notaries