HomeMy WebLinkAbout02-24-06
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of William F.S. Orner Jr.
also known as
No. 21-06- ~ \ ~ \.l,
, Deceased
Social Security No. 208-24-0058
Elaine M. Orner
Petitioner(s), who is/are 18 years of age or older, appl(ies) for:
(COMPLETE 'A' or 'B' BELOW)
[!] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
the Decedent, dated 07/01/2002 and codicils dated
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
D B. Grant of Letters of Administration
(c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs:
Name
elatlonship
eSldence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family
or principal residence at 704 North Front Street, Wormleysburg, PA
(list street, number, and mUnicipality)
Decedent, then
72
years of age, died
12/03/2005
at Lower Paxton Township, Dauphin County, Pennsylvania
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
78,000.00
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant
of letters in the appropriate form to the undersigned:
ignature
~~ {Y\ Q~
Elaine M. Orner
ype or printed name and residence
704 North Front Street
Wormleysburg, PA 17043
717/763-4646 ._
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Prepared by the Pennsylvania Bar Association
Copyright (c) 2004 form software only The Lackner Group. Inc
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
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 knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the ::tate aC('5d~ to law. tv) ~
Sworn to or affirmed and subscribed 7" ~
Elaine M. Orner
before me this ~~ ~
day of
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~~~~~!"'~ \
For the Registe~
~<=>\<.,~~\~~~ ~
No. 21-06- ~ \ ~ '-\
Estate of William F.S. Orner Jr. , Deceased
also known as
Social Security No: 208-24-0058
Date of Death:
12/03/2005
AND NOW,
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, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 00 Testamentary 0 of Administration
(c.I.a.; d.b.n.c.l.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Elaine M. Orner,
in the above estate and that the instrument(s) dated
7/1/2002
Short Certificate(s)....?..............$
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
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,^ A /} I/'/ Register OfWi!...~. ~. ~~ ~I:I.\'>.:~...
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Attorney: Michael L. Ban~
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FEES
Letters..............,........................ .$
~~~ .
I*el'ltmeiatiaFL..:~ \ \\-...,..........$
\S
Affidavits ( )...........................$
I.D. No: 41263
Extra Pages ( )....................$
Address: 429 South 18th Street
CodiciL.............. .........................$
JCP Fee....................... ..............$
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Camp Hill, PA 17011
Telephone3 717/730-7310
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Inventory.............................. n.... $
Other......~~~\~..:......_...........$
E-Mail:
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TOTAL............................ $
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Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Fqrm RW-1(1991)
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Thi~ is to certify that the information here given is correctly copied from an original ce:~ific~te oj deall, du1r filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records OffIce for permar1t'l1t fIling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Local Registrar
Fee for this certificate. $6.00
P 1193'iGD""
DEe 0 6 2005
Date
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(c')
143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
. 11.. Executive 11b. Medical
DECEDENTS MAILING ADDRESS (Street, CityfTown, State, Zip Code)
704 North Front Street
Wormleysburg, PA 17043
16.
FATHER'S NAME (First. Middle, Last)
18. William F. S. Orner, Sr.
INFORMANTS NAME (TypeIPrinl)
20a.
METHOD OF DISPOSITION
. Donation D Burial 0 Cremation ~emovar from State D
. 21a. Other (Specify)
SIGNATURE OF
. 22a.
Complete items 23 :-c
physici.an is not avai
certify cause of death.
5.
COUNTY OF DEATH
72
BIRTHPL~CE (Cily and
State or For6ign Country)
7Huskegga, MI
I
~~~M 0
RACE. American Indian, Slack, White, et
(Specify)
White
NAME OF DECEDENT (First. Middle, Lasl)
8b. Dauphin
DECEDENTS USUAL OCCUPATION
(~~V=;~i~~iW:Od;~eu:f1~~r:gtt
8e.
Commuuity General Osteopathic
KIND or BUSINESS' INDuSTRV
Assoc.
DECEDENTS
ACTUAL
RESIDENCE
(See instructions
on other side)
AS DFCEDENT EVER IN
u,s. AR.MED FORCES~t
Yes []I No D
MARITAL STATUS. Married,
Ne.....sr Married, Widowed
Divorced (Specify)
14.Married
SURVIVING SPOUSE
(If wife, give maiden name)
Elaine M.
Shade
17b. County
Did
decedent
live in a
~11mherl and township? 17d.XiI ~~h~e~~t~~7~i~i~Of Worml eYRhllri
MOTHER'S NAMEJ..First, Middle, Maiden Su~me)
19. Mary Elizabeth 0 Toole
INFORMANTS MAILING ADDRESS (Slreel. CilylTown, Slale. Zip Code)
20b
Hc. 0 Yes, decedent lived in
twp.
citylboro.
DATE OF DISPOSITION
(Month, Day. Year)
D 21bDecember 6, 2005
CENSEE OR PERSON ACTING AS SUCH LICENSE NUMBER
22b.
To the best of my knowledge, death occurred at the time, date and place stated.
(Signature and Title)
238.
TIME OF DEATH
24. 11 : 45
23b. 23c,
WAS CASE REFERRED TO A MEDICAL EXAMINER ICORONER?
26. Yes I[] by FD, nr No D
: Approximate PART II: ~ther significant conditions contributing to death, but
. interval between not resulting in the underlying cause given in PART r.
: onset and death
Items 24-26 must be completed by
person who pronounces death.
DATE PRONOUNCED DEAD (Month, Day, Year)
A M. 25. December 3, 2005
27. PART I: Ent.r the dia....a. inJurl.. or compllelllona which caulld the death. Do not .nterth. mode of dyIng, Iuch I. cardIac or ruplralory arr..t, .hock er h.art faUur..
LI.t only on. cau.. en each line.
IMMEDIATE CAUSE (Final
disease or condition
resulting In death)--+
Sequentially list conditions
if any, leading to immediate
cause. Enter UNDERLYING
CAUSE (Disease or injury
that initiated events
resulting on death) LAST
! b.
c.
d.
DUE TO (OR AS A CONSEQUENCE OF):
WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH
PERFORMED? AVAILABLE PRIOR TO D D
COMPLETION OF CAUSE Natural Homicide
OF DEATH? D D
Accident Pending Inves(igation
VasD No 13 Vas D NoD Suicide D Could not be detennined D
DATE OF INJURY
(Month. Day, Year)
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED,
29.
30a. 30b. M.
PLACE OF INJURY. At home, fann, street, factory, office
building. etc. (Spec/f)')
30..
Yes D No D
30c,
28a. 28b.
CERTIFIER (Check only one)
*~~~~~F~~tGor:;t,~~I~~~~h:,s~~:~h C~~i'~%~~: t~ rhe.a~a~~:~(:r~~j~~X~i;:a~s ~t~fe~~?,~~.::.~. ~.~~~~. ~~~ .~.~,~~~~:.~. i.t~~ .~~).................. 0
31b.
LICENSE NUMBER
'PT~~~~~~.~I~fGm~Nk~;;I~~:'~:.~~':,~~~c;:.:~ ~~~K:ifl~".~d~tr.~~dU~~~~,d:~~h d':;'ed t~.;;:Z~';ul~.~(~)~~~ ~:~~.r asstatad. ................ D 31e. f)) 0 J.C 505.- L- 31d. ~ uS
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
31:~:E::::::'~~~~~~.~~~~~I~~I~~~~tlg.~ti~~: .1.~.~Y..~".I.~~~.~:.d~~.~ .~~~~:~.d.~t. ~~~.t1.~~:.~.~~.:.~.~~.~I~.~~..~n~.~.~~..I~ .~h~.~au"~,,.~~).~~d.. D I&f~9 ~:& .,\R~$~~ ~ ~ ~~~ MD
REGISTRAR'S SIGNATURE AND NUMBER /7 . t:/'t-: DATE FILED (Monlh. Day. Vaa,)
33. u-,2/n.....l~;7c.v. ~/I~/vl 34. I J Islbs ~
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rJ I, WILLIAM F.S. ORNER, JR., of the Borough ofWorrnleysburg, Cumberland
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~ County, Pennsylvania, declare this to be my last will and revoke any will previously made by~ ,
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ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my wife, ELAINE M. ORNER, provided she survives
my death by thirty (30) days. Should my said wife predecease me or be deceased on the thirty-
first day after my death, I give and bequeath all such items and insurance thereon in equal shares
to those of my issue, per stirpes, as survive my death by thirty (30) days.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to my wife, ELAINE M. ORNER,
provided she survives my death by thirty (30) days. Should my said wife predecease me or be
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deceased on the thirty-first day after my death, I give, devise, and bequeath all the rest, residue,
and remainder of my possessions and estate of every nature and wherever situate in equal shares
to those of my issue, per stirpes, as survive my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM V. I appoint my wife, ELAINE M. ORNER executrix of this my last will. Should
my said wife predecease me or otherwise fail to qualify or cease to serve as executrix of this my
last will, I appoint my son-in-law, BRIAN S. ROGERS, executor of this my last will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorIzed for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, 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
2
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and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this
Is?"'-
day of
0vl1
,2002.
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tv~r:J-~jl
WILLIAM F.S. ORNER, JR. 0
3
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The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testator was on the date thereof signed, published, and declared
by WILLIAM F.S. ORNER, JR., the testator therein named, as and for his last will, in the
presence of us, who at his request, in his presence, and in the presence of each other, have
subscribed our names as witnesses hereto.
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COMMONWEAL TH OF PENNSYL VANIA
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COUNTY OF CUMBERLAND
The undersigned, being the testator whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, does hereby acknowledge that I signed and executed the
foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
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WILLIAM F.S. ORNER, JR.
COMMONWEALTH OF PENNSYLVANIA
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WE, .'1 <-k. d L &^.~, -i and q YJ\J...~_f\\ ~ , the witnesses whose
names are signed to the attacheVd or foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw the testator sign and execute the instrument as his last will;
that he signed it willingly and that he executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the testator signed the wi II as witnesses; and that to
the best of our knowledge, the testator was at that time 18 or more years of age, of sound mind, and under
no constraint or undue influence.
COUNTY OF CUMBERLAND
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