HomeMy WebLinkAbout01-30-06
Estate of MIRIAM D. KALEY
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
~J - oLD - DO<ib'
No.
To:
Register of Wills for the
, Deceased. County of CUMBERLAND in the
Social Security No. 159249225 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 rix named
in the last will of the above decedent, dated JUNE 28. 1967
and codicil(s) dated NONE
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with
h er last family or principal residence at 324 W. ALLEN STREET. MECHANICSBURG. PA 17055
MECHANICSBURG BOROUGH
(list street, number and municipality)
Decedent, then 79 years of age, died 1/11/2006
at HOLY SPIRIT HOSPITAL. CAMP HILL. E. PENNSBORO TOWNSHIP. PA 17011
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
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
NONE
$
$
$
$
66.000.00
0.00
0.00
0.00
WHEREFORE, petitioner(~) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters TESTAMENTARY
thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
'7- /~~- 4- ~?j.J
MABEL K. HOUGH
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324 W. ALLEN STREET
MECHANICSBURG
PA 17055
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF CUMBERLAND
Sworn to or affirmed ~d subscribed
before me this ~<::J -'I' . day of
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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 knowledge and belief of petitioner( s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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1[ MABEL K. HOUGH
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No. J..I-D~-Ob ~ g
Estate of MIRIAM D. KALEY , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW Wt/Al (j'l ..31J r-- , in considemtion ofllie petition on
the reverse side hieof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 6/28/1967
described therein be admitted to probate and filed of record as the last will of MIRIAM D. KALEY
and Letters TESTAMENTARY
are hereby granted to
MABEL K. HOUGH
FEES
Probate, Letters, Etc.. . . . . . . . $
Short Certificates ( ~). . . . . . . $
R " II f,11 $
~~elat18rr. .~ . . . . . . . . .
V { p+ A-v'1l.> $
TOTAL _ $
9 /, itJ.:4n "1: L .j 0 }.-
Filed. . . ......lA {,; . (j ../.6117 Y. . .
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MURREL
24849
54 EAST MAIN STREET
MECHANICSBURG
ADDRESS
PA 17055
717-697-4650
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.
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Fee for this certificate. $6.00
p
122692~29
JAN 1 3 2006
Date
J J ,,0 & - 0 () 1 ~
Hl05.143 ReY. 011Q6
TVPElPRINT IN
PERMANENT
BLACK INK
1 Name 01 Decedent (First, middle, last)
Miriam D. Kaley
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBEA
a.\ . Cumberland
3, Social Security NurrtJer
159 24
E. Pennsboro Twp.
most of workin We' do not state retired
Kind of Businessllnduslry
Insurance Co.
16 Decedent's Mailing,ADdress (Street. cityltown. slale. zip code)
324 W. Allen st.
Mechanicsburg, PA 17055
on hi 51 adeco led 14 MarrtaISlatus:Married,Nevermarried,
College (H Of 5+) WIdowed, Divorced (Specif}1
DYes
Decedent's
Ac1ualAesiclence
17a.Slate P~nnc:yl'\T::.ni.::ll
Did Decedent
LMi in a 17c. 0 Yes, Decedent Lived In
Townsh,,?
Twp
17b, CountjC'nm hE'> r 1 rl n n
17d.D No,Decedenllivedwithill
ktualLirritsof
CilylBoro
16. Father's Name (First. mOdis, last)
Robert Kaley
19. Mother's Name (First, middle, maiden surname)
208. Inlormanrs Narre (Typelprint)
Mabel Ro ers
2Otl. Informant's MaiUng Address (Streel, cltyllown, stale, zip code)
Mabel K. Hough
324 W. Allen st. Mechanicsburg,PA17055
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2tb. Dale 01 Ois.pos~ioo (Mooth, day. year)
21c. Place 01 DisposKion (Name of cemetery, crefTlll.lOry Of other place)
2td. location (Cilyllown, slale, zip code)
o RernovalfromSlale
o Donat>>n
1/13/2006
22b. License Number
Hollinger crematory
22c. Name arK! Address 01 Facility
Mt.Holly Springs,PA170 5
011589L
2 . To Ihe best of my knoWledge. death occurred at the lime, dale and place staled. (Signature and t~le)
HollingerFH&CrematoryMt.HollySprings,P~17065
23b. License Nurrbar 23c. Dati Signed (Month. day, yaar)
'I
. Items 24.26 roost be corT1)leled by person
who pronounces death
24. TIITlEl 01 Dealh
7:5D
PM
: Approxifflllleinlerval:
: onsello death
26. Was Case Referred to a Medical Exarr'lnerlCoroner?
at;
~ Yes 0 No
Part II: enter other !Iinnilicant r.nndilin~ conlmu~na 10 dMlh, 28
but not resulting I1lhe underlying cause given in Part I.
f,
CAUSE OF DEATH (See Instructions and eumpJes)
Kern 27. Pan t: Enterth. ~ - diseases, injtM"ies. or co~tions -that directly caused the death. 00 NOT enter 1emW\a1 events such as cankc alresl,
respiratory aITesl. or ventrCular fbri/lalion wilhoul showf1g the etiology. DO NOT aDbreviate. Enter only one cause on a line
:~~:;~~~US;J~U:~dUa~r a. rl'v"~
Sequenlially list condKioos, ilany, Due 10 (o~a.)co;L~L:n~ t \""t..
_ ::,n: ~~o~~~~:C':u~~e a Due 10 {or as a conseg(ieoc:e oQ
. =~~iin~~la~hitr~e Due to {or 8S 8 consequence oQ
308. Was an Autopsy
Pertormed?
32b, Describe how Injory Occurred'
29 If Fe
Nor pregnam willWl pasl y&ar
o Pregnanl al t~ 01 death
o Not praqnant, but preonanl withil 42 days
ofdealh
o Not pregnanl, bul pregnanl43 days to 1 year
belore death
o Unknown if pregnant within Ihe past year
32c_ Place 01 Injury: Homo, Farm, Slreet, Faclory. Office
Building, ele. (5p6ciM
o Yes "'fA No
d,
3Ob. Were Autopsy Findings
Available Prior kl Completion
of Cause 01 Dealh?
o Yes 0 No
31. Manner ofOealh
i! Nal~ral 0 Homicide
o Accident 0 Pending Invesllgation
o Suicide 0 Couk:l Not Be Dalermed
328. Dale 01 Injury (MOnlh. day, year)
32g. localion (Slteet, cifyltown. slate)
a2d_ Time 01 Injury
M,
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63
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330. Certiflef (check on~ 0118)
Cenltylng physiclan (Physician certifying cause 01 death when another physician tlas pronounced dealh and cofTllleled nem 23)
To the best ot my knowledge, death octurred due to the cause{s) and manner as stated ....__......_n"..............."...,......".".H......._..._..._ ......_..............................
Pronounclng.nc1 clrtltylOi physician (Physician bolh pronoulci1g death and certifying 10 cause of death)
To the besl of my knowledge, death occurred It the lime, dale, and place, and due to the cause(s) and manner as staled.."..........,,,...,,...............,,............
Medle;1I eumlnerlcoroner
On the basis 01 examination and/or Invesligatlon, In my opinion. death occurred II the time, date, and place, and due to the cause(s) and manner as stated
35. . r:s~oal:~~~:: ~ 101.11 I.;) I \ I 0 I
33d. Dale Signed (Monlh, day, year)
111'J/cG
34.AN~me.a~ ~r_~c.of ~~; ~ ~~~~cause of Dealh (lIam 27) TypelPrinl
~~l ~'- ")01. .'\_--'l_t._f.4;""o1.('lol 1L::J~/')
L'V"V" ,l,-<U,!'~ {.., d ( ,
(See instructions and examples on reverse)
LAST WILL AND TESTAMENT OF MIRIAM D. KALEY
I, MIRIAJI1 D. KALEY, of the Borough of' Mechanicsburg, County
of Cumberland and State of Pennsylvania, being of' sound and disposing
mind, memory and understanding, do make, publish and declare this
my last Will and Testament.
1.
I direct the payment of' all my just debts and f'uneral ex-
penses as soon af'ter my decease as the same can be conveniently
done.
2.
I give, devise and bequeath all the rest, residue and re-
mainder of my estate, of' whatsoever nature and wheresoever situate,
to my sister, Mabel K. Hough, her heirs and assigns.
3.
LASTLY, I nominate, constitute and appoint my sister, Mabel
K. Hough, Executrix of' this my last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this;:<.PC.,l,day of' June, A. D. 1967.
~~~-(4~u 1) MA.::i::= ( SEAL)
Ivliriarn D. K~ley f/ ' ,
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Signed, sealed, published and declared by the above named,
l-1iriam D. Kaley, as and for her last Hill and Testament, in the
presence of us, "'Tho have subscribed our names hereto as wi tnesses,
at the request of said testatrix, in her presence and in the
presence of each other.
/
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-2-
OATH OF SUBSCRIBING WITNESS
Estate of MIRIAM D. KALEY No. d 1- () to - () 0 b f
also known as
, Deceased
.I. ROBERT STAUFFER
(each) a subscribing witness to the 0 codicil(s) ~ will(s) presented herewith, (each) duly qualified according to
law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and
that she/he/they signed as a witness at the request of the Testator(rix) in her/his/their presence ancQ in the
presence of each other ~ in the presence of the o!!le?Subscribing witness(es).
C;~4IL~hA
~ JV/(Signature)
.(. .I. ROBERT STAUFFER R / MAIN & MARKET STREETS
MECHANICSBURG PA 17055
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Sworn to or affirmed and subscribed
before me this ()") iL-. day of
, dOO to
NOTARIAL SEAL
DEBORAH L. RYAN, NOTARY PUBLIC
CITY OF MECHANICSBURG, CUMBERLAND COUNTY
MY COMMISSION EXPIRES JUNE 11, 2006
/lA..../'
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.)
NOTE: To be taken by officer authorized to administer oaths. Please have
present the original or copy of instrument(s) at time of notarization.
RW-2
Register of'\ViHs of Cumberland County
OATH OF NON-SUBSCRIBING 'VITNESS
Estate of fill'?I/I.;I1 'J) 1<' A l... L- 'f
No. 0( 1- O/P - DO bO
Also known as
, Deceased
---
-J t./ (J rTt i Ie' C I-- /( 12 l(
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
S It': (5 familiar with the signature of ill t 'A At "J t< /l L '- - ( , testati!L4. of (one of the
subscribing witnesses to) the codiciVwiII presented herewith and that <(< I L :-beHevelbelieves the signature
on the codiciVwill is in the handwriting of ,Jt I .~ , It...t/f 'D K" l (.. - V to the best of
,
t -It -/! knowledge and belief.
Sworn to or affirmed and subscribed
Before me this J... ~-"<~ day of
~ <::I<~'~,5~1,"'( 1~ ,20 'Jl..",.
2~k~
f ,:) 13,,1 J (; '7 j
(Address) .J ,4 C Ie ~ It AI 11 A ';v t..:- () ~ 7' ~ <j
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Register
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Deputy ,~ \
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(Name)
(Address)
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