HomeMy WebLinkAbout03-07-06
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Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Clarence A. Gardner
also known as
No. 21-- :2-00~-Ollq
, Deceased
Social Security No. 197 -07 -8162
Thomas Larry Gardner
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 Administrator
the Decedent, dated 09/04/1984 and codicils dated
Nellie M. Gardner, executrix named in will, has renounced (Renunciation is attached).
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
Relationship
Residence
1'1IoJ1If'
SO\V
(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 22 Maple Avenue, Walnut Bottom" South Newton Township
(list street, number, and municipality)
c~..."
Decedent, then
85
years of age, died
04/23/2004
at Chambersburg Hospital, Chambersburg, PA
(Location)
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
80,509.00
$
$
$
$
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:
Signature
Typed or printed name and residence
Thomas Larry Gardner 10937 Morgan Drive
Shippensburg, PA 17257
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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 estate according to law.
Sworn to or affirmed and subscribed
~-;;t~~ J~ 4~
Thomas Larry Gardner //..
"7th
before me this ~ day of
F'ebrl1ary ! :2000
<~ '-4avvt1 AjIVL1~/?J/jAL .
'P^-~ ~ortheR~;T-
Ni:>.
21-- :Lf)Oh - tJ /'7 q
Estate of
also known as
Clarence A. Gardner
I Deceased
Social Security No: 197 -07 -8162
Date of Death:
04/23/2004
AND NOW,
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I in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters8Testamentary []{6f Administration e-rlt -
(c.ta.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Thomas Larry Gardner, Administrator
in the above estate and that the instrument(s) dated
9-4-1984
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
FEES
Letters................................ ........$
Short Certificate(s).. .P............... $
Renunciation...~.......................... $
12.00
5,00
-'
/
/
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C._.:.-
Attorney: J
..aA/u;{
2-10.00
Extra Pages ( )....................$
Will
eodieil.............................. __........$
1.0. No: 01624
Weigle & Associates, P .C.
Address: 126 East King Street
Affidavits ( )...........................$
JCP Fee...... .... ............... ............$
)5. DO
I Q. 00
Shippensburg, PA 17257
Telephone: 717/532-7388
Inventory.................................... $
E-Mail:
auto
Other.............................. __..........$
5: 00
TOTAL............................ $
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1(1991)
TYPEJPAINT
IN
PERMANENT
BLACK INK
l]S is to certify that the information here given is correctly copied frool an original certificate of death duly filed with me as
l,Cleal 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.
Fee for this certitlcate, $2.00
No.
~,,>>~
Date
2'~t/
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p
9914139
H105.143 Rev. 2187
COMMONWEALTH OF PENNSYLVANtA . DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT (ftrSl. Middle. Lastl
SEX
2.
STATE fILE NUM8ER
SOCIAL SECURITY NUMBER
3.
t. CLARENCE A. GARDNER
AGE (last 81nhdayl UNDER 1 YEAR UNOER 1 OW
Monllla DeVS Hour8 :.: MInut..
85 YIS.
:".,10
5.
COUNTY OF DEATH
Ib.
MAAITAl STATUS. M8med
~r MarTieCl. Wodowed.
0MIr<<*l (Speclly)
1.. Married
t7c.I2Q 'IW..dK...llMdin South
1Wp.
22 Maple Ave.
1~ Walnut Bottom, PA 17266
FATHER'S NAME (First Middle. Lasll
11. James C. Gardner
INFORMANT'S NAME {TypeIf>rintl
~. Nellie M. Gardner
METHOO OF DISPOSITION
8uM/ l&J Cr_ion 0 A4ImodI "om StaI.D
OCher
Cumberland 17d.D ~~..'::'of
MOTHER'S NAME (F.st. M1CldIe. M8Iden Surname)
1.. Martha V. Duffe . Ii'
INFORMANT'S MAll.lNG ADDRESS <<SIr... Ctlyfbom. SIaIe. Zip Code) (', .
~. 22 Ma Ie Ave. Walnut Bottom PA 17266
PlACE OF DISPOSITION - Name of Cemetery, Cr......IOfy LOCATION. CilylTown, SIal., ZipCode
Of OIhef Place Southampton Township
2te. 21d. Cumberland Count PA
17b.Co
dIy/bclnl.
34.
. 28 2004
LICENSE NUMBER
PA 17257
Inc.
2D. 011776-L
lilthe ~.I of my knowledge, delllh occurred allhe I.me. dal. and plaee Slated.
lure and T~Ie)
2310.
IME OF DEATH J -
24. 12.. ~ f M. 25.
27. MAT I: Ent.r Ihe diM..... inJuries Of complications whic:hcaused!he c:lealh. Dc no! enl.. lhe mode o. dying, sucl1 as car iac or respiralory arresl, sfloCI< Of heart laiNr..
Lilli ontv one ca~ on .~ ~ne.
No~
21.
I IIpprozllllala
!==
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PART H:
OIher Signiflcanl c:ondiIiona COIlIribuIfng 10 daalh. but
IlOI rasuIUng in the undeftying __ ~ in w.AT I.
uIZ.J)$E /~
DUE 10 (OR (IS A CQNSEOUENCE Of):
lb.
c.
d.
DUE 10 (OR (IS A CONSEQUENCE Of):
DUE 10 (OR AS A CONSEQUENCE Of):
TIME OF INJURY
DATE OF INJURY
(Montll. Dey, \UJ)
WERE AUlOPSY FINDINGS MANNER OF DEATH
"""lABLE PRIOR 10
COMPlETION OF CAUSE ~ 0
OF OEI'lTH7 Nalutal Homicide
kcidenI 0 PenclinQ In_igalion 0
No 0 Suicide 0 Could no! ~ determIned 0
v.s 0 NoD
3011. 3OIl. M.
PlACE OF INJURY - No homa, larm, strHI, IllCIOIy. olfic.
buillIlng. eIC. ISpec~v\
.De. 21b. 21. 3011.
CERTIFIER (Check only one) \'
"CERTIFYING I'tiY$ICIAN (Physocoan ce<t.yrng cause 01 death when anoll.." p/lVSICo8n has pronounced de8ll\ an<) completed "em 23)
To the beel of no, _lectge, deelh occulTlld due... !he eause(sland manner.. sta'ed. . . .. . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
I-
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UJ
o
UJ
o
UJ
o
u..
o
w
~
of:
:z
. PRONOUNCING AND CERTIFYING PHYSICIAN (PhVSlCl3n both ptonouncrng death and cett.y"'ll to cause of dealt"
To lhe beel of my knowledg". dea.h occurred ., me ...... date. and p~a. and due 10 !he cauBe(sland manne'.. .'aled.. . . . . . . . . . . . . . . . . . . . . . . ..
.MEDICAl EXAMINER/CORONER
on the bIoaia 01 examination andlor investigation, in my opinion. death occurred at lhe time, date. and place. and due to the cauae(s) and
manner a. atated., , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,.... , . . . . . . . . . . . . . . . . . . . . . .
31a.
REGISTRAR'S SIGNATURE AND NUMBER
121/I~/,~
Register of Wills of
Cumberland
County, Pennsylvania
RENUNCIA TION
Estate of
Clarence A. Gardner
No.
also known as
I Deceased
The undersigned,
Nellie M. Gardner
spouse ~
(Relationship) (Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to
Thomas Larry Gardner
WITNESS my/our hand(s) this
2006
Sworn to or affirmed and subscribed
:2 ~h day
lotJ"
My Commission Expir
(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. Inc.
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(Signature) NIl. M G. d ,J
e le . ar ner
Forest Park Nursing Home
700 Walnut Bottom Road
Carlisle, PA 17013
February
(Address)
(Signature)
(Address)
(Signature)
c.,;'
(Address)
GOIv1MONWEALTH OF PENNSYLVANIA
! Notarial Seal
i ~Iora M. Vogt, Notary Public
I North Middleton Twp., Cumbel1and County
! 1'1.,\' C(1'"Tlmission Expires May 21, 2009
'_"~,"".^...-_r",......_
f'f'l"'rjP.r, L ~nr'.sV!VaJila ,Gr,sociatiol"'! of Notaries
NOTE: Renunciations executed outside the Office of Register of Wills
in some counties are required to be notarized.
Form #RW-4 (1991)
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I lard County, Pennsylvania, being of sound mind, IllE!IDry and understanding, do
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IAST WILL AND TESTAMENT
I, CIARENCE A. GARDNER, of Walnut Botton, South Newton Township, CUmber-
make and publish this my last Will and Testament, hereby revoking and making
void any and all fanner wills and ccrlicils by me at any time heretofore made.
FIRST.
I direct my hereinafter named Executrix, or Executor as the case
nay be, to pay all my just debts and funeral expenses as soon as conveniently
may be after my decease;
I further direct that all taxes that may be assessed
in oonsequence of my death, of whatever nature and by whatever jurisdiction
imposed, shall be paid as part of the expense of the administration of my
Estate.
I SOCaID. I give, devise and bequeath all my property, real, personal and
. J
II mixed, whatsoever and If.heresoever situate, to my beloved wife, NELLIE M.
II GARDNER, absolutely.
n
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1 GARINER, the sole Executrix of this my Iast Will and Testament.
I
, FCXJRrH. Provided, however, that in the event my said wife, NELLIE M.
Ii GARINER, should predecease me, or if \Ne should die in a carmon disaster, then
THIRD .
I hereby naninate, constitute and appoint my said wife, NELLIE M.
in either of said events, I give, devise am bequeath all my property, real,
personal and mixed, whatsoever and wheresoever situate, to my son, THG1AS
lARRY GARrNER, absolutely; provided further, that in the event my said son,
THCMAS IARRY GARrnER, should predecease ne, then in that event, I give, devise
and bequeath all my property, real, personal and mixed, whatsoever and where-
soever situate, in three (3) equal shares, share and share alike, one (1)
equal share to my granddaughter, L. CHRISTINE BIlGER, one (1) equal share to
my granddaughter, C, SUSANNE GARDNER, and one (1) equal share to my grandson,
TlmAS L. GARDNER, JR., absolutely; provided further, that in the event any
of my aforenamed three grandchildren should predecease me, then in that event,
I give, devise and bequeath the share of the said deceased granichild to the
child or children, in equal shares, share and share alike, of my said deceased
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grandchild, then living at the tine of my decease; provided, however, that in
the event my said deceased grandchild leaves no child or children living at
the tine of my decease, then in that event, I give, devise and bequeath the
share of my said grandchild to my surviving grandchild or grandchildren, to
wit, either L. CHRISTINE BIlGER, C. SUSANNE GARDNER, or, TIn1AS L. GARDNER, JR.
in equal shares, share and share alike, then living at the time of my decease.
FIFI'H. Provided further, that in the event any of my aforementioned
Legatees are not at least eighteen (18) years of age at the tine of my decease,
then in that event, I hereby naninate, constitute and app:>int DAUPHIN DEroSIT
BANK AND TRUST CCMPANY, Harrisburg, Permsylvania, as the Guardian of the
estate of the said minor child or children, the said Guardian to take arrl
receive the share of the said minor child or children and invest arrl re-
invest the same in legal or non-legal investments, whichever in its discretion
it deems proper, and the said Guardian to have full power and authority, in
its discretion, to pay such aroounts of inoome and principal as are necessary
for the support, maintenance and education of the said minor child or children,
and upon the said minor child or children reaching the age of eighteen (18)
years, to pay the said share to the said child.
SDcr'H. Provided further, that in the event my said wife, NRT.T.TR M.
GARDNER, srould predecease me, or if we should die in a carmon disaster, then
in either of said events, I hereby naninate, constitute and appoint my said
son, TIn1AS LARRY G?-\Rl::NER, the sole Executor of this my Last Will and Testa-
ment; provided further, that in the event my said son, TIn1AS IARRY GARDNER,
should prErlecease me, then in that event, I hereby naninate, constitute and
appoint my said granddaughter, L. CHRISTINE BIlGER, my said granddaughter,
C. SUSANNE GlUIDNER, and my said grandson, TIDMAS L. GARDNER, JR., or the
survivor or survivors of than, to wit, either J... CHRISTINE BIIGER, C. SUSANNE
GARI:t\JER, or, THO.MAS L. ~, JR., then Ii ving at the time of my decease,
as Executors of this my last Will and Testament, my said Executor or Executors,
. as the case may be, to have full power and authori ty to do any and all things
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(SEAL)
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necessary for the canplete administration of my estate, including the power
to sell any and all real and personal profe[ty of which I may die seiza:l, at
public or private sale, in his, or their, discretion, without any Order of
any Court; and I further direct that my said Executor I or Executors as the
case may be, not be requirErl to file any Bond in connection with the settlanen
of my said Estate.
IN WI'INESS WHEREOF, I, ~ A. GAROOER, have hereto set my hand and
seal to this my Last Will and Testament, written on four (4) sheets of paper,
this 4th day of September, 1984.
! !
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(SEAL)
Signed, sealed, published and
declared by ClARENCE A. GARDNER,
the Testator, as and for his
last Will and Testament, written
on four ( 4) sheets of paper, in
the presence of us who have 1 at
his request, signed our names as
wi tnesses hereto in the presence
of the said Testator and of each
other .
II (-'J~Jj~~\U(Mw~
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CCMrvmWFALTH OF PENNSYLVANIA
S8
COUNrY OF ctf.mERIAND
* .
I, CIARENCE A. GARmER, Testator, whose name is signed to the attached
or foregoing instrunent, having l:een duly qualified according to law, do
hereby acknowledge that I signed a11d executed the instrunent as my last Will
and Testament; that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
~~ A. ~dA-'--<.f~./
Clarence A. Gardner
I SWam or affinned to am. acknowledged before me by CIARENCE A. GARDNER,
I the Testator, this 4th day of September, 1984.
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CCJ.M:>NWEALTH OF PENNSYLVANIA
SS
<DUNTY OF ctMBER!AND
No+- ic
ELIZABETH 8. fETlER. NOTARY P BlIC
WEST PENN9BORO lWP.. CUMBE D COUNTY
IY COMMISSION EXPIRES Sf . 12. 1987
Memlaer, '.nns,tvania Associ.tion of Not,ne.
We, ROBR..-qr J. YCXlJM and TERESA J. BURKHOLDER, the witnesses whose names
are signed to the attached or foregoing inst....-rument, being duly qualified
aCXX)rding to law, do depose and say that we were present and saw the Testator
sign am execute the inst.runent as his Last. Will and Testament; that the
Testator signed willingly; and that the Testator executed it as his free
a11d voluntary act for the purposes therein expressed; that each of us in
the hearing and sight of the Testator, signed the Will as witnesses; and
that to the best of our knCMledge, the Testator was at that time 18 or more
years of age, of sound mind, arrl under no oonstraint or undue :influence.
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PA
'-r- ~~~u..d~.k.\.~
a J. Burkholder
ewburg,. PA
Sw:>:m or affinned to and subscribed before me this 4th day of Septes:nrer,
1984.
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Notary Pub
ELIZABETH B. FUZER. NOTAR sue
WEST PENN980ftO lWP.. CUMBERLAND COUNTY
MY COMMISSION EXPIRES SEPT. 12. 1987
".mb". PtMl1tvania ASSOCiation of Notarittt.
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