HomeMy WebLinkAbout01-05-06
Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Flore.i1('C E; UNC
also known as
No. "~ \ - '\J \, - "~"0 \ '--\
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No,2r1L/- oj - 5 ~ ~ ~
The petition of the undersigned respectfully represents that:
Your petitioner( s), who is/are 18 years of age or older, and the execute fS named in the last will of the
above decedent, dated l1laLf 3 , 20 0 '-/
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in ~ un be r/ a i'1 d
Pcnnsyl vania, with ~'last family or principal residence at
jOO ~ /,11 f $ tz:Jf'1e/ ]) Kd-€ _ Nt: /Iv'VI 11c-
(list street, number and municipality)
Decedent, then.2...i years of age, diedj}('" 1/ , 2ocL, at (J flK us LE liDs P j TI1 L
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,
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 ofreal estate in Pennsylvania
situated as follows:
$
$
$
$
.5 0 000
/
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and the grant ofletters
thereon.
~ature( s ~f Petiti~ner( s)
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(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYL VANIA
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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 Oi' affinned and subscribed
Before me this S ~......
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day of
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Register '\
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Estate of '\ \ ~'1 ~ '\.. ~ ~. \... \ '{\ ~ , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW -:S~~~'\'J\ S 20~1.." in consideration of the petition on the reverse side
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hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s), dated
~\;j. ~"3 ~ 'C ~v.. , described therein be admitted to probate filed of record as the last will of
, :. .
~\~w~,'\. ~ \...'\ ~ ; and Letters are hereby granted to
~"O.:'" ~. i.....\~~ '\~\'lJ~ ~ ~ \'(,' \t\' '1::. "'s",,~",,-~'
FEES
Probate, Letters, Etc. ............. $
Will................................. $
Renunciation.... . . . ..... . . . . ... . . . . $
Short Certificates (~;).) ............ $
JCP....................... .......... $
Automation Fee................... $
Bond. . .. . .. .. . . .. .. . . .. ... .. .. .. . .... $
Total $
Filed " - s 20'\:J\c
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Attorney (Sup. Ct. J.D. 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 certificate of death duly filed with me as
Loc,Li Hcgistrar. 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. S6.00
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""""NUIIIIIII""
P 11934418
No.
; Rev. 2JA7
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Local Registrar
DEe 2 2 2005
Date
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CERTIFICATE OF DEATH
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
STATE FILE NUMBER
MOTHER'S NAME (First, Middle, Maiden Surname)
19. Ruth Woods
INFORMANTS MAILING ADDRESS (Street. CltylTown, Stete, Zip Code)
lOb. 100 Flintstone Drive, Newv11le, PA 17241
PLACE OF DISPOSITION. Ni'me 01 CAtmetery, crematoryf LOCATION - CityfTown, State, Zip Code
orOtherPlaeeCremat10n ::;OC1ety 0
21c. PA Crematory 21d. Harrisburg, PA 17109
NAMEANDADDRESSOFFACILlTYAuer Memorial Home & Cremation
22c. Services, Inc. Harrisburg, PA 17109
LICENSE NUMBER DATE SIGNED
(Month, Day, Year)
NAME OF DECEDENT (First, Middle, Last)
SEX
2. Female
BIRTHPLACE (City and PLA 0 AT
State or Foreign Country) ttO$PITAl:
Monroe TwppA Inp.'a" []
7. 8a.
FACILITY NAME (If not institution, give street and number)
1.
AGE (Last Blrthdey)
Florence E. Line
84 Yrs.
5.
COUNTY OF DEATH
8b. Cumberland
DECEDENTS USUAL OCCUPATION
8c. Carlisle
KIND OF BUSINESS I INDUSTRY
Carlisl~ Regional Med Center
AS DECEDENT EVER IN
U.S. ARMED FORCES?
Yesm NoD
12.
17.. State P A
Old
decedent
live In a
township?
(~~::~~~~~~ d~~u~~rir~~,r~3)st Die kinson
110. Supervisor lIb. Colle e
DECEDENTS MAILING ADDRESS "Street, CltylTown, Stete, Zip Code) DECEDENTS
100 Flintstone Drive ~~~PD~NCE
Newville, PA 17241 (See instructions
on other side)
17b. County
Cumberland
John E. Leib
Harry E. Line
Items 24-26 must be completed by
person who pronounces death.
the best of my knowledge, death occurred at the time. date and place stated.
(Signature and Title)
23a.
TIME OF DEATH, ':)0
24.
DATE PRONOUNCED DEAD (Month, Dey, Year)
25. ~C~ ~I c2oo6
27. PART I: Enter the dl......, InJurle. or compUcatlon. which caused the death. Do not enler the mode of dying, IUch a. cardiac or respiratory arre,t, shock or heart failure.
List only ont cau.. on each 111'1..
IMMEDIATE CAUSE (Final
disease or condition
resulting in death)____
f~1\/1
/"
~V1.-It~1J
DUE TO (OR AS A CONSEQUENCE OF):
Sequentially list conditions [ b.
if any, leading to immediate
cause. Enter UNDERLYING
CAUSE (Disease or injury c.
that initiated events
resulting on death) LAST d.
WAS AN AUTOPSY WERE AUTOPSY FINDiNGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
DUE TO (OR AS A CONSEQUENCE OF):
DUE TO (OR AS A CONSEQUENCE OF):
MANNER OF DEATH
DATE OF INJURY
(Monlt1. Day. Year)
g
D
o
Homicide
Pending Investigation
Could not be determined
D
o
D
30a. 30b. M.
PLACE OF INJURY. At home, farm, street, factory, office
bUIlding, etc. (SpeCify)
30e.
Yes 0 No D
30c.
Natural
Accident
Yes D No W
Yas D
NoEa
S....icide
28.. 28b.
CERTIFIER (Check only one)
.l~~J~F~~?or~~11~~~~e~hl.S~~:rhc~c~i~%J~U~: t~ Pheea~a';j~:~(:)'~~3rJ~x~~~a~s h:t~f:~~~~.~~.~. ~~~~~. ~~~ .~~~~~.l~ .i.t~~ .:~).........
29.
.proo~~~:.~'~?m~Nk~;;,:J'::~':e~~Ho~~~~:~ ~~~~:i~:~ne~d~t:,r~~~u;I~~~.d:~~h d~n: t:~Z~:u~e~(~)~~~ d~:~~er as stated...................... 0
"MEDICAL EXAMINER/CORONER
~:~~:rb::I:t::e~~~~.I.~~.t.I~~. ~~.~~~~ ~~~~~~~~.~~~~.~: .I~ .~~ .~~I~~~.~~ .~~~~~ .~~~~~~.~. ~.t. ~~~. ~.~~.'. ~.~~:. ~.~~ .~~~.~~'. ~~.~ .~.~~. ~~ .~~~ .~~.~~.~~.(.~~ .~~~.. 0
31a.
REGISTRAR'S SIGNATURE AND NUMB~ /7 111 ~
33. LbJvn.... "' '( l' a.-
I~ J I ~ ) III
SOCIAL SECURITY NUMBER
3. 204 - 03 - 5222
'Ch ck nl ne-s elnst
DATE OF DEATH (Month, Dey, Year)
4December 21, 2005
ERlGutpat.ient 0
DOA D
~~:~fy) 0
RACE - American Indian. Black, While, et .
(Specify)
10. White
Residence 0
MARITAL STATUS. Married,
Never Married, Widowed.
Divorced (Specify)
14.Widowed
SURVIVING SPOUSE
(If wife, give maiden name)
15.
17e. ~ Yes,decedenliivedln Upper Frankford
twp.
17d. 0 ~~h~e;~t~~~~i~~~ of
city/bora
23b. 23c.
WAS CASE REFERRED TO to MEDICAL EXAMINER ICORONER?
26. Yes E;:l No D
. Approximate PART II: Other significant conditions contributing to death, but
: interval between nct resulting in the underlying cause given in PART r.
: onset end death
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
32.rz r VVtJf/,vIJ
DATE FILED (Month. Day. Year)
34. ])
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LAST WILL AND TESTAMENT
I, FLORENCE E. LINE, of 129 Walnut Bottom Road, Shippensburg, Cumberland
County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby
expressly revoking all Wills and Codicils heretofore made by me.
1. I direct my Executors to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my Executors to sell any realty owned by me at my death,
and not specifically devised herein, at either public or private sale, and to give good and
sufficient deeds therefor, in fee simple, as I could do ifliving.
3. I give, devise and bequeath all of my estate of every nature and wherever situate to my
five (5) children, share and share alike, the child or children of any deceased child taking the
share their parent would have taken if living.
4. I nominate and appoint HARRY E. LINE and F. VIRGINIA HOCKENBERRY to be
the Executors of this my Last Will and Testament; they are to serve as such without bond.
5. I hereby suggest that my personal representatives retain the services of Irwin &
McKnight as attorneys in the settlement of my estate.
" I
IN WITNESS WHEREOF, I have hereunto set my hand and seal this J'V:' day of
May, 2004.
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FLORtN<:E E. uf' ~ ~
Signed, sealed, published and declared by FLORENCE E. LINE, the above-named
Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request, in
her presence and in the presence of each other have subscribed our names as witnesses hereto.
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ACKNOWLEDGMENT AND AFFIDA VIT
WE, FLORENCE E. LINE, MARTHA L. NOEL and SHARON L. SCHWALM, the
Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will and Testament, that she had signed willingly, that she
executed it as her free and voluntary act for the purpose herein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to
the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of
sound mind and under no constraint or undue influence.
~~ ~ o(~
FLORENCE E. LINE
~,~~fitY'
THA L. NOEL
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~~.;!~P':/t' ,Jr.' ", . ~
. SHARONL.SCHWALM
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by FLORENCE E. LINE, the
Testatrix herein, and subscribed and sworn to before me by MARTHA L. NOEL and
SHARON L. SCHWALM, witnesses, this 3~ day of May, 2004.
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Notarial Seal
Roger B. Irwin, Notary Public
Carlisle Boro. Cumberland County
My Commission Expires Oct 3. 2004
Member, PennsylvamaAssociation 01 Notaries
3