HomeMy WebLinkAbout12-02-05
Register of Wills of Cumberland County
Estate of
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
Cll''' /1/ dt.rr../(fs' No. ~" - ~ S - '\'J'A, ~
/;~rYr I1f:' Ch,r()/II~ To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. J.?'1 - / ~ - 777 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 DK. ..< ~ , 20 O<.l
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in County,
Pennsylvania, with h_last family or principal ~sidence a;/
~tf ' .5'0(' n f'CA..- a ve CCi M /T/If /70 II
(list street, number and municipality)
Decedent, then~ years of age, died {kIT .1" ,20 oS, at (!qro/ylt CrCk~'I-- cikhQ /~JPICfU
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:
$ I~ ddO. D'
$
$
$
WHEREFORE, petitioner( s) respectfully request( s) the probate of the last will and codicil( s) presented
herewith and the grant of letters
thereon.
- Signature(s) OfPe~s)
''-1fc-(~ l) e aAA...:
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
. ~)
"-:~
I
1'-'
--:J
::';,)
C:::)
C)
/7tJ 5rJ
',0
,~I-j
:._~
-J ~J~~
',- .I
I ,'j'"1
_.J
: c )
"1
':1
~~~5
(1'1
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 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 ~w.
Sworn to or affIrmed and subscribed {-tf~ d, a ),~
Before me this "')... ~ ~ day of
~.~~ ~ '-9",< , 20 ~ ~ .
C/)
QQ'
::l
'"
2'
....
~
~
<::::s~~\;'~ S~~~,
Register
~~. ~~\ ~""" ~~
No. ~ '\ -'JS- \~~~
Estate of \~~lil-..~ "". ~ ~~~~\..\)! , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~"l..~~'\clL'( ~ 20~S, in consideration ofthe petition on the reverse side
hereof, satisfactory proof having been pre~ented before me, IT IS DECREED that the instrument(s), dated
~~ . ~ ~ 1 L ~~ , described therein be admitted to probate filed of record as the last will of
~"'~~~ V\. ~ ~~~~I....",s. ; and Letters are hereby granted to ~""~\~ ~~'J\\) '\::\\.~~\:)\...~
\;~~~ ~~ ~~"~~
Register ofWil~~~';>
'~-,~...
~'"
~~
FEES
Probate, Letters, Etc. .............
Will..... .., ... ... ..... . . .... . ... ....
~~
\S.
$
$
Renunciation... . . . . . . . . . . . . . . . . . . . . $
Short Certificates (~ ............ $
JCP.................................. $
Automation Fee................... $
$
$
20~
Attorney (Sup. Ct. LD. No.)
'e..
,~ .
S.
Address
Bond... .. .. . . .. . . . . .... . .., . . . . . . ....
Total
Filed '\~ -a..,
<;~ .~~
Phone
Hlfl5yn<RFV 1/1)< '"" \ ~ C'" ,,,'-\?
This is to certify that the information here given is correctly copied from an original cer~~'ic;e ()f9d~ath a~I!IY 'filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permancnl filing,
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No,
L ~11
~,~""'. 'i>Ud,../iJ. A?~
Local Registrar lJ
Fee for this cer1ificate, $6,00
p
12064810
C9 e Ix .lw-z~J. ~ d ()O S
Date
1"-'
(:;:::;)
C:;-,:;;I
cJl
::-1,-:)
r -,"1
o
"j
':'YJ
:-~~
'_-=:J
I
N
....;......
, c-")
-"~'I
-:1
~~
""'?
1'0
.,
U1
W
~~;
H105 143 Ru.... 2187
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
STATE FilE NUMBER
TYPE/PRINT
IN
PERMANENT
BLACK INK
NAME OF DECEDENT (First, Middle, La:;t)
SEX
:iJ
'"
::>
'"
.,
:0
.,
84
BIRTHPLACE (City and
Stale Of Foreign Coontry)
26 2005
.,
COUNTY OF DE,o.TH
y"
Itoona PA
, hOG" ce resi
Other
Res,dence (SpIUfy) E9
RACE. American Jndian. Black, White. at
(Specify)
.bDauphin
DECEDENrS USUAL OCCUPA liON
(~~V:~,~~t::~:o d~~"u~~~~,~)11
10,
white
SURVIVING SPOUSE
(ltw,fl.glV8 m.,dlnn.eme)
..,
17e. ria Yes. decedent live~ in T rJW~r A 11 ~n
17d. 0 ~~~e~~~~~I~i~: of
twp
city/bolO
PA
To the besl of my knowledge, dealt! oc.:curred at the lime, dalu ilnd place ::.latod
(Signalure and THle)
23.
TIME OF DEATH
2. 6: 30 PM
PA 17(155
27. PART I: I!n..r Ih. .:11....... InJ"rI., or (ompllt'llon. whl~o ,a"..d tn. .:IlIth. Ou nOI.nt.r the mo.:l. uf dying. '\olCO a. cardl., Ur ...plrllory ..r.... .ho,'" or h..rt f.llur.
U.tonly 0'" ,a".. un.aCh IIn.
DATE PRONOUNCED DEAD (Month. Day, Year)
.... 2. October 26, 2005
26,
: Appre>>cimate
. interval betwuen
: onset and death
'?
~
c:)
,..".
r;;
":t::
,,)
OUE TO (OR AS A CONSEQUENCE 0 )
SeqIJentii:llly list conditions
if any. leadmg 10 immedIate
. cause Enler UNDERLYING
CAUSE (Disease or injUlY
. that inill<:lted events
resulllng on dealh l LAST
r
WERE AUTOPSY FINDINGS
AVAILABLE PRiOR TO
COMPLETION OF CAUSE
OF DEATH?
OUE TO (OR AS A CONSEQUENCE OF)
DUE TO (OR AS A CONSEQUENCE OF)
MANNER OF DEATH
;j
~
Ndlural
%
o
o
DATE OF INJURY
(Monlh. Oa~, Vear)
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED
Humicide
o
o Ya, 0 No 0
30a 30b. M 30'c.
o PLACE OF INJURY. At home. farm, streel. factory. offtCe
bUlldinu. etc. (Speclf~)
30.
o
")...'//
ALCldt:nt
Pending Investigation
Could 1101 be uelurmined
Ye~ D No)!l
Ya,O
NoD
Suidde
28a. 2ab.
CERTIFIER (Checll unly one)
.l~~~:F~~tGor~;~;~~~er~~~~~:1h C~~~'ti~~a':rus: t~ fhed~ha~~I:~(~I~~~'rX~x~~~a~~ h:t~f~~~'~~:~.~ .~~~~~l. ~~1~ .:~.I~~~~~~.~ .i.I~'~~ ?~).
2.
I-
Z
w
Cl
w
U
<"
Cl
"-
o
w
::;
'"
Z
"PRONOUNCING AND CERTIFYING PHYSICIAN (Physician bolh pronouncing Otlath .mu Lertlfying to CdUSO of dCcidh)
To the ba,t of my knowledge, death occurrltd at th.llme, dute, and place, and due to the cau...(a) and manner aa atated.
"MEDICAL EXAMINERJCORONER
On the baal. of eumlnaUon and/or invuU"'iltlon, In my opinion, death occuHl;ld ,II the Ume, delhr, and place, ilnd due toJ lhe cau..a(.) and
manoeraa.liIted ... ............ .... ..., ....... .......... ...... ........... ........ ....,............. ..,........,.......... ...................................
31.
Rf;GIST~ 's SIGNATURE AND NU~BE/.
33
I (I . j
~?'U :y
/ ,/. -......
Ult 1.2 II III
H]()').80') REV 9/R6 ~, l:"I. S ,C"'"'\\ \ ?,
T'1is IS (() certift' thar the information here given is correcrly copied from an original certificare c-: de~~ri~ d l!l;~ fil~I~;'11
I.oeal R~gistraL The original certificate will be forwarded (() the Srate Vital Records Office for pcrnan<:rlr i'iling,
me as
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No,
...--:liiiIHHi;;;;;;;
Aiii(~\.1~iJ!fil~----___
,\ .:..~,.~ "It./'. --,.
,\' ~/ '\:..t:':.
It~~( ~[i;\~\
i~:el . ~ . \~%
\~ ~i\ ..f/t.. )i:'~
\~ *\:{ ."_.~ ':">--~J *~
\. a.\\, -"-., ., - //~l
,,"A.. . /~"
-,.----~,flME-N-l- - ~\ ~~ ",\..,
---""""""""'''/11111'' ~/
~ ~P~..
iI.A~-'l~.L ~
Local Reglslnr -
Fee f(lr this certificate, $2.00
P 7120758
Ii) ,~ ft 9
--- 1..l.....-rA~LI r _ _ Po'
/ ' )at!
.;2 CJ () !
r....:>
~:~
,'.:.:;.7
c_n
c-;,
:J:J
I-'n
CJ
rj
::or)
c:c)
'-'"
(::J
~) C"")
. ")
--Tl
" (~=s
rTl
.~
,
i"0
-eJ
\"'0
Hl0!l.r4JAev 2187
COMMONWEALTH Of PENNSYLVANIA' DEPARTMENT Of HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
en
\.0
TYPE/PAINT
IN
PERMANENT
BLACK INK
NAME OF DECEDENT iFJrSl. M~~- -..--------
----_._~----_._---- ---------.--- --_.~-_.
SEX
STATE F'LE :\IUM8ER
SOCIAL SECURITY NUMBER
....GE (la~ B>r1hOayt UNDER 1 YEAR
Monlhl Days
..
Female 3.
196 -
..
COUNT'( OF DEATH
75 v"
8IRTHPlJ.CE ,Cry M1d PlACE OF DEATH lO,<<k OPly OPe -- '>eft 'nSlIUCr<Of1S on utt>e. '>>IJei
5tale 01 tCleogn COllnUyl HO~TAl
Altoona, Pa. Inpa..enl ~ ERlOuIp.allllnt 0
1 ...
FACllfTY NAME III flQl ,nSN\JIoOll, give SlIeel and I'IUmbet,
....
Cumberland
oeCEDEN1'S USUAL OCCUPRION
lG.ve kJtl(j 01 WOIk 00ne dulH"l9 mosl
at --kS~I:SAU;s(;,Ci~te
...
White
MARITAL Sr....1\)5. Mamed
Nev., M.,-ned. Widowed.
Orvou:ed (Spec,."
Married
SURVIVING SPOuSE
(11 """e, ~... m.den namel
Harry M. Carrolus
1..
FR'HER'S NAME (First MoOdIe, laSl)
4067 Seneca Ave
Camp Hill, Pa. 17011
l1b. Coun
Did
-
Mll'lIe
Cumberland -....;p? l1d.oX::i..."':'::'..'.;:'OI
MOTHER'S NAME .FoISl Moddle. Malden Surname)
-
Camp Hill
C"Y-'
,.,
INFORMANTS NAME (T ypelPtlnl1
Unknown
1.. Margaret Boyles
INFORMANT'S MAtLIHGAOORE5S (SIt.... ClI'yfTown, State. ZipCodel
2Gb 4067 Seneca Ave Cam Hill, Pa. 17011
PlACE OF DISPOSITK)H. Name 01 Cemelary, CI.matory lOCRKlH. CifyITown, SI.., rip Code
Of Or:h81 P~e
....
METHOD OF rnSPOSITION
Bunal 0 C(emalion [}( Removal 110m SIal. 0
Or:hef(Sp<<-lfyl
Harry M. Carrolus
5)
"'
:>
"'
.
~
<
Jan 9, 2001
ale.
Conolite Crematory
ald.
SChaefferstown, Pa. 17088
NAME AND ADDRESS OF FACILITY
FD-014318-L
a2e.
M ers Funeral Home Inc. 37 East Main Street Mechanicsbur
LICENSE NUMBER ORE SIGNED
(MonIh, Day, \'8al"l
23b. 2k,
Wl\S CASE REFERRED TO UEDlCAl EXAMINERlCORONER1
Yo.6(l fD, ...0
t?J
H.
I Apprc.lmal.
: inlerwal betwHn
: CJnMI and de.1ft
i
PART II: au. signtficanl 0DndiIi0ne ccl"\lnbut6nl; Ie ".lh. Dul
not rewlingin the ~ C&uM QiYen in PART I
IIOfNlatllailule
( , )
Re~j);f(d()fl~ A.\I<'S;i- ____
buE 1O(OA AS ONSEOUENCE Of):,
NCi( \ - Sma \ I r f \ I ('(1 H\ 1lQrrl2_Lill:'i1\_
OUE lO(OA AS A CONSEOUENCE Of): ~
C'Oiomll.\ o..dhHO'{'kru.1 s
I
I
DUE lO(OA AS A CONSEQUENCE Of)
d
WERE AU'TOPSY FINDINGS
A""'LABlE PRIOR TO
COMPlETION OF C....USE
OF DERH1
"'ANNER Of DEATH
DATE OF INJURY
(Moo", Day, Year)
TIME OF INJURY
INJURY AT 'NaRK?
DESCRIBE HOW INJURY OCCURRED
v.. 0
...g
IQ,IUfel g
Aceldflnt 0
s..c... 0
n.
HcmlCide
[J
[J
o ~E -OF INJURY. AI Ilame. talm~~"l, lactory, office
building. Me ISpec'M
3...
v.. 0 ...0
P.,1d>ng In"'.Sl.g.allOll
z
w
5)
:.l
o
::,
w
~
z
o
Hill Pa.17011
Could IlOI bI del.rm,ned
M. JOe.
lkju l~,
Lz, (~211IJJ
30
Reg ister of Wills of
Cumberland
County, Pennsylvania
OATH OF SUBSCRIBING WITNESS
Estate of
Harry Carrolus
also known as
No.
~ '\ - 'JS - \~\l. ~)
, Deceased
James D. Bogar
(each) a subscribing witness to the 0 codicil(s) [!] will(s) presented herewith, (each) being duly qualified according to law
depose(s) and say(s) that she/he/they waslwere present and saw the above Testator(rix) sign the same and that she/he/they signed as
a witness at the request of Testator(rix) in his/herltheir presence and [!] in the presence of each other 0 in the presence of the
other subscribing wiitness(es).
Sworn to or affirmed and subscribed
before me this J nd
of ~ CQI)')1lJ.€;L ~005
:B{JlI f\ u of LJ -^ 00 f1Jyn/)
day
Notary Public
My Commission Expires:
(Signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Notary's commission.)
Prepared by the Pennsylvania Bar Association
Copyright (c) 2004 form software only The Lackner Group, I
{:l~fJ~-
James D. Bogar
One West Main Street
Shiremanstown, PA 17011
(Address)
(Signature)
c.~)'
(Address)
(Signature)
(Address)
NOTE: To be taken by officer authorized to administer oaths.
Please have present the original or copy of instrument(s)
at time of notarization.
COMMONWEALllI Of PEf'lNSYlVA"'A
NOTARIAL SEAL
BONNIE L. WILLIAMS, NOTARY PUBLIC
SHIREMANSTOWN BORO., CUMBERLANO co.
MY COMMISSION EXPIRES APRIL 18 2009
I
,'".)
~:-~
en
...0
Form #RW-2 (1991)
iI'C
, .
; .
. ?
e .
,
Register of Wills of Cumberland County
OATH OF NON-SUBSCRIBING WITNESS
Estate of Harry Carrolus
No. ~\.~ s- \~'^'~
Also known as
, Deceased
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
he familiar with the signature of Harry Carrolus , testat or of (one of the
subscribing witnesses to) the codicil/will presented herewith and that he believelbelieves the signature
on the ~/will is in the handwriting of Harry Carrolus to the best of
his knowledge and belief.
~~b~
Sworn to or affirmed and subscribed
Before me this ~ ,,~ day of
~'l..~~"-o,,,< , 20 ~
(Name)
Robin D. Carrolus
4 Perms Way Hoaa
Mechanicsburg. PA 17050
(Address)
~~, ~~,
~\
~~
Register
~.~~ ~...
~ ' ,~,
Deputy
(Name)
(Address)
I
1"'0
:>)
,::::::>
c::>
LASTVVILLANDTESTAMENT
OF
HARRY CARROLUS
I, HARRY CARROLUS, of Lower Allen Township, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, unto my wife,
COLLEEN J. CARROLUS, provided she survives me by sixty (60) days.
SECOND: Should my wife, COLLEEN J. CARROLUS, prede-
cease me or die on or before the sixty-first (6Ist) day following
my death, I devise and bequeath all the rest, residue and remain-
der of my estate of whatever nature and wherever situate, includ-
ing any property over which I hold power of appointment and
together with any insurance policies thereon, in equal shares, to
my children, ROBIN D. CARROLUS and JEFFREY L. CARROLUS, provided
that should any of my children predecease me, I give and bequeath
such child's share unto his issue per stirpes by representation,
and if there be a failure of same, then I give and bequeath such
deceased child's share to my surviving child as provided herein.
THIRD: In addition to all powers granted to them by
law and by other provisions of this will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
2
FOURTH: I direct that all inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
FIFTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SIXTH: I nominate and appoint my wife, COLLEEN J.
CARROLUS, Executrix of this, my Last will and Testament. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said COLLEEN J. CARROLUS, I nominate and
appoint ROBIN D. CARROLUS, Executor of this, my Last Will and
Testament. In the further event of the death, resignation or
inability to serve for any reason whatsoever of COLLEEN J.
CARROLUS and ROBIN D. CARROLUS, I nominate and appoint JEFFREY L.
CARROLUS, Executor of this, my Last Will and Testament. I direct
that my Executrix or Executor, as the case may be, and their
successors, shall not be required to post security or a bond for
the performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this J~t~day of
~c.e~ ' 2000.
~~~ (SEAL)
HARRY CA~LUS
3
Signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament in our
presence, who, at his request, in his
presence of each other, have hereunto
attesting witnesses.
presence and in the
subscribed our names as
"
"
Address
Jif~
{ {..{,u.. I. _" _ /
I I
~~fh-~
Address
4