HomeMy WebLinkAbout01-23-06
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ,.1 eIl;, ,--. ,J 0 r dCLrl No. d /- ~ (p . 0() (p)
also known as To:
Register of Wms for the
. JJ~I;eased. County of ('lAfYJWflar'ldin the
Social Security No. I&:J., - .7~- ,l...P.II'j( Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut fCl ^ named
iR tAG la3t .. ill of tl., aba .@ g~~~eeFtt, eatee 19
;n 't-he..ilfMl. codicil(s) dated ~r~f:E ~~~ iJp .;IDU" /0 'f h,p M< I- .Dtl/ cki<--rr-
(state relevant cirCllmstances, e.g. renunciation, death of executor, etc.)
. Decendent was d?miciled. at .death i~ Ctt. f'Y1 b-cv' IOL.~-s:. Coun?;, pen)~lv<Y;!ia, wj.tb
h ~ v- last famIly or prmclpal residence at ~ f<;( N. ,~ III r () v It ~ <t f~r-t /' YO 7 S
(list street, number and muncipality)
Decendent, then ~ years of age, died ()C ,(.0 he" /q
at
Except as follows, decedent did not marry, was not c;livorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim ofa killing and was never adjudicated
incompetent:
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Oecendent 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 ~state in Pennsylvania
situated as follows:
/. 10~
....;>\)0.
I (JCJ() , ( ..)
$
$
$
$
~o. (J()() . ('J cJ
,
WHEREFORE, petitioner(s) respectfully request(s) the prob<}te of the last will and codicil(s)
presented herewith and the grant of letters to... fYI en 'kA. r'-
t heron.
(testamentary; administratio .La.; administration d.b.n.c.t.a.)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 'I ,,.,
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COU NTY OF J
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The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true anti correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s)..klf the abov. ..e decedent pe'i,ione.*> will w~;inister ~state according to law.
Sworn to. or af~lr!TI. e,? ~t\d subscnbed { ./1 .. ~ ~
b~2'iS ,CSt ;.<1 day of' ~.
~~ ~
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~ . ~., ~ Reg"ter ~
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No. JI-D (p-6()/fy
Estate of J..eCcV) L. J O,rJuh
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
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AND NOW ~ (j n va ~ aJ, vi ct9_, in consideration of the petition on
the reverse side hereof, satisfactory proof having be~ prrented before me, .' J j
IT IS DECREED that the instrument(s) dated .5 3/ qt:' anti CdtbW! d/ikd ~ JIp OS
described therein be admitted to probate and filed of reco~d as the last will of 11':'6 il L ,} f),rla!..
~d Letters Tt6tp I1t1 ~^ltt~/
are hereby granted to JL (-M 'Pu Y If" P' y\.
~..~~ ;ft~f1-e--_~hsbUv'-L
" bf'A f'AYf~ ill ...;/jl17/AS ~
[r Register of Wills
F} :lIJI$
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ADDRESS
/"!J 5'.0'0
Probate, Letters, Etc. ......... $
Short Certificates(~ . . . . . . . . .. $ 31 ~ '.gg
RelWi1diUon W.I.(~. ~~p.Q.... $
J [(J.,ttJro $ ('SO/)
TOTAL _ $ Iff
Filed ........ ~;l"'~. '1; 0'3;. ~O~
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FEES
,-?/? (->;J-Y3 ~ ~:S73 ~
PHONE
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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.
No.
lii.... ~. ~~A~.~
Local Registrar
Fee for this certificate, $6.00
p
12044502
OCT 2 1 2005
Date
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H105.143 Rev. 2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FilE NUMBER
TYPElPRINT
IN
PERMANENT
BLACK INK
NAME OF DECEDENT (Firs~ MiOOIe. Lasl)
1. JEAN ,:J02.-DA..I~
AGE (Lost Birthday)
SEX
BIRTHPLACE (City and
State or Foreign Country)
o T
SOCIAL SECURITY NUMBER
3. IbL - 22...- 4-'-11 ~
ell In
DATE OF DEATH (Month. Day. Voar)
.. 1(', I "'j. 0.5'
~\ .
F
MARITAL STATUS. Married.
Never Married. Widowed.
DiYon;od (Specify)
1.. Divorced
R.Ild6nC8 0 =~) 0
RACE.. Americ8n Indian, B\ack. White. e .
(Specify)
10. Black
SURVIVING SPOUSE
{1{~,v\'WImUJu,.,."..)
twp.
17b. Countv
Cumberland
11d.KJ ~':t,~~~~~~i-::Of
Carlisle
citylboro.
LICENSE NUMBER
22b. FD 012633 L'
MOTHER'S NAME (Fir,t, Middle. Maiden Surname)
19. Ella Mae ers
INFORMANTS MAILING ADDRESS (S....,. cityrrown. Slo'e. Zip Code)
2Gb. 218 N. Pitt St., Carlisle, PA 17013
PLACE OF DISPOSITION. Name of Cemetery, Crematory LOCATION. CltyfTown, State, Zip Code
or Other Place
2QJmberland Valley Man. Grds 1d.Carlisle, PA 17013
NAME AND ADDRESS OF FACILITY
&rin Brothers Funeral Hare,
LICENSE NUMBER
PA
To the be y knowledge. death occurred at the time, date and place stated.
(Signature and Tltle)
23a.
TIME OF DEATH
2.. 7: 00 H>'l
DATE PRONOUNCED DEAD (Month. Day. Year)
M. 25. October 19, 2005
26.
. Approxima!e
: Interval betw$en
: onset and death
Other significant COnditions contributing to death, but
not resulting In the under1ylng cause given In PART I
27. PART I: Enter the dl......, Injun.. or compllclUOn. whIch e.uMd tM d..th. Do nOI.nter the mod. or dying, lueh .. c:ardlac. Of rI-~ratory Vrflil, ahock!), hIoan failure.
u.tonly OM ~ atll.b line.
Sequentially list conditions [ b.
if any, Idading to immediate
~ . cause. Enter UNDERl. YlNG
CAUSE (DiselJS8 or injury c.
. . that InttiBted events
resutUng on dath ) LAST d.
WAS AN AUTOPSV WERE AUTOPSV F'NDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
::'~:~ROF ~
Accident D
o
DATE OF INJURV
{Month, D"Y, v..r}
TIME OF INJURV
INJURV AT WORK? DESCRIBE HOW INJURV OCCURRED.
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Pending Investigation 0 Yes 0 No 0
Could not be detennlned 0 3D.. 30b. M. 30c.
PLACE OF INJURY - At home, farm. streel, factory. office
OulIding,ltC.(Specify)
2a.. 28b. 29. 30..
CERTIFIER (C""",, only one) SIGNATURE Al'ID TITL
.CERTIFYING PHYSICIAN (Physician certifying cause of death when anoth" physician has pronounced death and completed item 23) ~
TotM best of my knowleOg8, death occunitd due to the cluses(s) and manner as stated.-..............................................................p' 31b. "
LICENSE UMBER
*P~~~~~.;I~,Gm~tt~;;~'Z':e~t~~~~~~~~::~~:~~~~~.d;:d~ned~~~u~e~~)~~~~:~h~.ra8.t8ted.... ....0 31c.ll1. 0 31d. -:).. - O.j
NAME AND ADDRESS OF f~RSON WHO COMPLETED CAUSE OF DEATH MQ.\!:.I{...
*MeDICALEXAMINERlCORONER (Item 27) Type or Print 11' <?O~~ J4.,.0 "1.
~~~b:I:::~~~I.~~.t.I~~..~~.~~~~~~~~~~~.~~~:.I~.~~~~I~~::.~~~~.~~~~.~.~.~~.~.~~:.~~~~:.~~.~~.~~..~.~.~~~~.~:.~~~~~.t.~~.~~~.. 0 t.J, 1/? $~ ~ ;{. r-' ... ~J I /7 -. . t?~..~
318. 32. -,.. I "It ,..." It? I~ tJ~ v
REGISTRAR'S SIGNATURE AND NUMBER C' DATE FILED (Month. Day. Vear)
~. ~~~ ~I \ IalllOI 3..
Homicide
VesO
NoD
Suicide
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last Bill aub Q}tslanttnt
I, JEAN L. JORDAN, of the Borough of Carlisle, 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 executor 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 executor 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 if living.
3. I give, devise and bequeath all of my estate of every
nature and wherever situate as follows:
(a) Any car in the possession of a grandchild but
titled in my name is actually theirs and my executor is
directed to transfer said title to said grandchild
without any payment whatsoever, and
II
(b) All the rest, residue and remainder to my
c'
daughter,
Kimberly M.
Butler and my three
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grandchildren, Todd W. Hinton, Charles W. Hinton and
Michele D. Hinton, share and share alike.
4. I nominate and appoint Todd W. Hinton to be the executor
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of this my last will and testament, he is to serve as such
without bond.
Should he die before my death, renounce or refuse
to serve for any reason, or die leaving any of my estate
unadministered, I nominate and appoint Kimberly M. Butler, as
substitute executrix, also to serve as such without bond, with
the same powers as are given herein to my executor.
5. I hereby suggest that my personal representative retain
the services of Irwin, Irwin & McKnight, as attorneys in the
settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and
3~ day of May, 1988.
seal
this
_;1t:rl.~~EALl
Signed, sealed, published and declared by Jean L.
Jordan, 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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2
ACKNOWLEDGEMENT AND AEF.IDAVIT
WE, JEAN L. JORDAN, BETII A. MORRISON and KATHLEEN M.
KENNEY, 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 that she had signed willingly, and that she executed it as
her free and voluntary act for the purpose herein expressed, and
that each of the witnesses, in their 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.
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
SSe
Subscribed, sworn to and acknowledged before me by
JEAN L. JORDAN, the testatrix, and subscribed and sworn to
before me
by BEllI A. MORRISON and KATHLEEN M.
this 11~ day of May, 1988.
KENNEY,
witnesses,
--~.~.
R B. IRWIN. NOTARY PUBLIC
Il lE 8010. CUMBERLAND COUNll
MY COMMISSION EXPIRES OCT. 3, 1981
CODICIL TO THE WILL OF JEAN L. JORDAN
I, JEAN L. JORDAN, residing at 1406 Bradley Drive, Carlisle, Pa. 17013, Cumberland
County, Pennsylvania, being of sound mind, memory, and understanding, do hereby make,
publish, and declare the following as and for a Codicil to my Last Will and Testament, dated
May 31, 1988.
ITEM ONE: I hereby appoint KIM FURMAN as executor of my Last Will and
Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, a Codicil to my
16 -rf1 day of
last Will and Testament, consisting of one (1) typewritten page, this
Se.p 1-emb U ~(JL"~n the year of our Lord two-thousand and five.
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Register ofWiHs of Cumberland County
OATH OF NON-SUBSCRIBING 'VITNESS
Eslateof [fr/vJ!)c~
Also known as p /A Y?f\
No.
d 1- O&-{;tJ~)
, Deceased
)(;{4)bif Ii f\'>. ~r(r'>41\
-DoUUJlC\. ~. ~(cI7(he t (
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
tv( a rL.-. familiar with ~~ture of W.. ! ~0Gh I. ~r Ial'"Jtestat~ of (one of the
subscrib" . witnesses to) ~~~yIlfpresented her#8 and tbatSJ-t believe/believes the signature
on ~. I is in the handwriting of ~ ~ 10 {~ to the best of
-JJF- knowledge and belief.
~p~J1.1~
(Name)
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(Address)
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(Name)
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(Ad ess)
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