HomeMy WebLinkAbout11-16-05
Register of Wills of Cumberland County
Estate of m\-s V+"Y\'Ni1 \J, \~e\~
also known as ~ "'^ \'\r) > ~. ~~.
PETITION FOR PROBATE and GRANT OF LETTERS
~l:-D5 -looi
No.
To:
, Deceased.
Social Security No. \ '7J - '()..~.- ~((-,
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, and the execut.l.L named in the last will of the
above decedent, dated Q}"(-\\., S~--\..om\nPl- ,20 0 4
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in G~ 'y~ bP".....\a )\ d. County,
Pennsylvania, with heJiast family or :p~cipal residence at
\~ Sl\ \\n\~ t\v-. CaTh" ~'\\\ \ \)~, 'r(';\\ L()w~ ~\\.=>'t\ ~?
(list street, number and municipality)
\
Decedent, then.B:.9.. years of age, died,^~'An~ '"'b~ , 200S-, at 1')'\ e $:S \ p.'n 1 ~ t \\~~
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopte fier
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
(If not domiciled in Pa.) Personal property in County
Value of real e~t.e in Pennsylvania
situated as follows: ~ \ \ ()) 0 0 o. C'\ 0
$ \(')IOOO. CO
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil{s) presented
herewith and the grant ofletters
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
thereon.
, ' ~Ltur~urPetitioner(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 PENNSYL VANIA
}
SS:
COUNTY OF CUMBERLAND
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 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.
Sworn to or -= 1'/ subscribed
~efore me this (,p Od~ of
liD VelY\ ___, ZO ~
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Estate of
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW N'o v. 'LP iH- zeD.?, in consideration of the petition on the reverse side
hereof, satisfact9ry proof having been presented before me, IT IS DECREED that the instrument(s), dated
Q _ 2 .... 0' , described therein be admitted to probate filed ofrecord as the last will of
Po . ; and Letters are hereby granted to OAAkA N' PE:IE::RS At<-ft-
. BTT2 5 " ! .
FEES
Probate, Letters, Etc. ............. $
Will................................. $
Renunciation... . . . . .. . .. . . .. .. . . . . . $
Short Certificates (\~ ............ $
JCP.................................. $
Automation Fee................... $
Bond........... ... ...... ........ ..... $
Total~ $
Filed II. ILP zo05
~l90,OO
-15.DO
10.. DO
\D.oD
6.00
330.00
Attorney (Sup. Ct. I.D. No.)
Address
Phone
~~LV.).OVJ f\..CV lfU.1
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.
Fee for this certificate, $6.00
P 11932312
No.
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Ill.,,"~~\.111 OF Pli----......
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Local Registrar
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COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
NAME OF DECEOENT (Flfsr. Middle. LasI)
5.
COUNTY OF OE.IJ'H
89 v<s.
SEX
"
AGE (Last Bif1hday)
2.
;;~'7;fs-
BIRTHPLACE (City aPd
Slale 01 Foreign Counrry)
Cumberland
....
~"Ylo
Co.
Upper Allen
...
KIND OF BUSINESs/INDUSTRY
RACE. Ameriean Indian, BI8dr:, Whil.. etc.
IS""",,",)
white
DECEDENT'S USUAL OCCUOOION
(~=~:O~~r;~:r
II.. beautician lib. hair dressin
DECEDENT'S MAtLlNG ADDRESS (Slreet. CityfTown, State, Zip Code) DECEDENT'S
ACTUAL
RESIDENCE
(See .nstnJCrt0t\8
on other SIde)
".
FATHER'S NAMe (Firs!. Middle. Last)
17b. Cou
Old
doe.....
Mina
Cumberland ,_? 1?d.0 :"'~"v::of
MOTHEA'S NAME (Fl1'st. Middle. M8Iden Sum.ame)
~ Catherine Galame
INFOPMANT"S MAIUNG ADDRESS (Street. Citvl1bwn, State. ZiQ. Code.
_. i852 Hall Dr. Carn Hill PA 17011
PLACE OF DiSPOSITION. Name ot Cerr.etery, Cl'8matof) LOCAllON. Cifyflbwn, Stale, ZIp Code
"''''he'PIa", 1 7 0 11
__I...?olling Green Cern. I42wer Allen Twp. ,PA
NAME AND ADDRESS OF FM;IUTY
Musselman FH&CS 324LR~g~Rr'A~k?043
LICENSE NUMBER DATE SIGNED
(Moo"'. Day, 'RIal)
MARitAL STATUS. Mam.o
Never Married, Widowed,
0_1Spec:dy)
...widowed
Lnwpr
SURVIVING SI'OUSE
(If WIfe. OM! maiden name)
1854 Holly Dr.
Camp Hill,PA 17011
"'P.
".
INFORMANT'S NAME (T ypatPrinl)
-. DarIa Peters
METHOD OF Olsl'OSrr~
O 1lutia1lS., C'ornal;on 0 RemoYlll'rom Slat. 0
Donot;on 01.... (Spoc;!yl
21..
Frank Barlow
c..,-...
23L
b..... 24-28 must" complotlld by TIME OF DfRH
____lit. 2...:)0 AM. 25.
27. PART I: Enter rhe diseasM, injuries Of' complications which caused the dIIath. Do not enler lhe mode of dying, such as cardiac or respiratory arrest, shoctc or heatt failure
List onty one cause on each IiM.
2311. 230.
"""S CASE REFERRED TO MEDICAl EXAMINEAlCOAONER?
v..o
~
'~llot_
if any, leading 10 immediale
-, E..... UNIlEIILYINO
CAUSE (Disease or Ifljufy
1hat initialed events
resAing in de8Ih) LAST
!:
WEREAU~RNOlNGS
-'lA8LE PRIOR TO
COMF'lETlON OF CAUSE
OF DEATH?
DUE TO lOR AS' CONSEOUENCE OF):
21-
f ApproximaJe
: in..... between
I OneIl and death
I
i
PART n:
Other sfgnjfteanc conditions conIributIng to death. bill
not resutting in tM undertying C8UH given in PART I.
_EOIATE CAUSE (Mnal
cfIseue, Or condition
resulting: in death)--..
. '-/ fl.A__tM . 6: dt4..P.&-<'U!,)
DUE TO (OR AS. CONSEOUENCE OF):
DUE TO lOA AS A CONSEQUENCE OF),
(IIM.N] tG
U.L1,
~
D;'l~' jat.L~/-c:
~ANAUTOPSY
PERFORMED?
,-0
No;i'
Y.. 0
MANNER OF DEATH
Nat..., ~. Homicidll 0
Accidenc Pending I",,"ligatlon 0
Suk:ide 0 Could not be determined 0
DATE OF INJURY
(Month. Day. Year)
TIME OF INJUAY
INJURY JJ WORK?
DESCRIBE HOW INJURY OCCURRED,
NoD
..... 0
NoD
fie. 21b.
::sn'IFIER (Check only one!
-CERTIFYING PHYSICIAN (PhVSICloin certifyIng cause of death when another phYSICian has pronounced deam anCl compte/ed Item 23)
To the bnto' my knowledge, d..thOCCUrreclduelOtheC8UH(S).ndmanne'..b1ted.,........ ..,..........
2..
3Ob.
PLACE OF IN.,;URY . AI home. farm, street. 'aaDly, offlce
building. ele. (Spec.fy)
300.
.~~~h~~.~:'~~';.,'Y':;'~:~:~:O' Inv..lIgollon. In my opinIon, duth O'.urred .tthe lime. date, .nd place. .nd cIIi:to tha c,use(.) .nd
manner.. stated.. . .. .. . . . . .. . . . . . . . . . '" . " .. . . " .. . .... . " . . .... . ..... ..... . . .. .. ... . . . '" . . . .. .
I..
REGIST~SIGNATUIfEf!9~
Gbn-,,'2... / ~/ ~4AbI'7?~ .
t'
o
s--s---
.PAONOUNCINO AND CERTIFYING PHYSICIAN (PhYsiCl8n borh P!'onOOtlClng dealh and cerlifyl/'lg 10 C8IJS6 01 deall1)
To the belli of my know'-dge, dealh OCCurred al Ihe lime, da.., and pface, and due to the eaUH(I) and Planne, ad staled.. /"
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LAST WILL AND TESTAMENT
BE IT REMEMBERED THAT
I, ANNA P. PETERS, a resident of Cumberland County, PelUlsylvania, being of sound and
disposing mind, memOlY and understanding, do make, publish and declare this to be my LAST
WILL and TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me.
I declare that I am not married, my beloved husband, GUY W. PETERS having predeceased
me, and that I had two (2) children, WILLIAM G. PETERS and ROBERT G. PETERS, both of
whom have predeceased me.
I have four (4) grandchildren, ROXANN ALBRIGHT, WILLIAM G. PETERS, ROBERT
G. PETERS and ANNMARJE PETERS. References in this Will to my grandchildren include all of
the grandchildren named above. '
II
I direct that all my just debts and funeral expenses shall be paid from my residuary estate as
soon as practicable after my decease.
III
I direct that all taxes that may be assessed in consequence of my death, of whatever nature
and by whatever jurisdiction imposed, shall be paid from my residumy estate as a part of the
expense of the administration of my estate.
IV
I hereby make the following specific bequests:
1. To my daughter-in-law DARLA N. PETERS I gIve, devise and bequest my
birthstone ring and diamond wedding band; and
2. r hereby direct my executor to sell my home at 1854 Holly Drive, Camp Hill,
Cumberland County, Pennsylvania, either at public or private sale, and the proceeds from
this sale I hereby give and bequeath to my grandson, WILLIAM G. PETERS.
V
All the rest, residue and remainder of my property, whether real or personal, wherever
situate, including any property over which I may have a power of appointment, I leave to my
daughter-in-law, DARLA N. PETERS and to my grandchildren, namely ROXANN ALBRIGHT,
WILLIAM G. PETERS, ROBERT G. PETERS and ANNMARIE PETERS, in equal shares, per
stirpes.
VI
I nominate, constitute and appoint my daughter-in-law, DARLA N. PETERS, Executrix of
this LAST WILL, to serve without bond. If DARLA N. PETERS is unwilling or unable to act in
that capacity, then I appoint my grandson, WILLIAM G. PETERS Executor of this LAST WILL,
to serve without, bond.
IN WITNESS WHEREOF, I, ANNA P. PETERS, have set my hand to this LAST WILL
this ~ -, day of :5ep+e rn hBl'- , 2004.
')z~. d~/J')A- E!;A!v'
ANNA P. ETERS
Signed, sealed, published and declared by the above-named ANNA P. PETERS, 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.
~~
~
2
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
I, ANNA P. PETERS, 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; that I signed it as my free and voluntary act for the
purposes therein expressed.
~~. (u;41~~d;~
A P. PETERS
Sworn or affirm:d 1f ~ acknowledged before me by ANNA P. PETERS, Testatrix,
thid7 day o~W/-, 2004.
~iC ~~~L..
\ i~:;~:::.;;a~ ,s.::[d
. Anne Carmody, Notary Public
i Mechanicsburg Boro, Cumberland County ~,
AFFID A VI T l "" Ccrlmiesion Expil'lils Expires M~r, 11, 20,,0
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
We, 'R. fYltl~Thof)JaS and j()h.~\.. 1) - G('~ 6 s ~,tj
the witnesses whose names are signed to the attached or fo,regoing instrument being duly qualified
according to law, do depose and say that we were present and saw Testatrix sign and execute the
instrument as her LAST WILL; that ANNA P. PETERS signed willingly and that she executed it as
her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight
of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix
was at the time 18 years of age or more, of sound mind and under no constraint or undue influence.
~~
Sworn or affin~1ed ~ ~l~acknowledge
thi~dayo~~2004.
~
No · Pub';;
(!cu~
3
.~ '~----..c..~k'__'_.~ .,
J\lc<::::ia! Ssal
Anne Carmody, Notary Public
M~chanicsburg Bora, Cumberland County
','j Ccmmission Expires Expires Mar. 11, 2006