HomeMy WebLinkAbout03-30-06
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of 'Jaceu.t!I,ne 7': #~"'/el( No. 2.DolP - 02-? 3
also known as J To:
Register of Wills for tht;
~ Deceased. County of (!'Lmbu-/a,n.d in the
Social Security No. 001-:/3 - ~7.::t1{ 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 executr; >c
in the last will of the above decedent, dated A/"V('.mk,r q
and codicil(s) dated NUl
named
, vi- ~at{
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ('am krlll/N.d County, Pennsy}vanja, with
last family or rincipal sidence at .S~.3:1 nrrll(;~ Rei.,. mt:rJIIlJ1ICSOte ,...,~
~ ~k/I1S.) .
(list street, number and muncipality)
Decendent, then '" years of age, d~d /)11rch ~ ,K-.:lelO'-,
at /-Io/v ,p'/r~r /t'A~11t/ Easr ./:i!itAsJe;HJ ~ _ ~J...~ lS~ .
Except'as follows, deceaent 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: N/A
Decendent 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
(I f not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
sit ted as follow. 52 J .x ~~,p~
~ ,SZJ". ~D
~ 4JD, t!Jbe:;. ~
~~ -
WHEREFORE, petitioner(s) respectfully reAuest(s) tht; probate of the last will and codicil(s)
presented herewith and the grant of letters tt':.5faA1el1 tl!:.r.J
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF Clth/~Q!.LA..AJ1J J
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, d truly administer the estate according to law.
affirmed and
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No. .2DOG --D2P3
EstateofJOC9llellTJc' T HUf'I{lj
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW '-11/lM-cl- 3D f VI 19: .2oCKt; in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated / / - q - 200 '-f
described therein be admitted to probate and filed of record as the last will of
Ja~ II T. J-IUr J f. .
and Letters -rei. h fall.
are hereby granted to bia.he t. W ej 1 z..tnan alf-Ia IJ/an (5' f,;Ufltz.mah
(00,00
Probate, Letters, Etc. ......... $ __
::LF". 0 0
Short Certificates(-7) . . . . . . . . .. $
WIll. . /5,00
RiRYRSlatlon ................ $
J"cP'faulo $ )5,00
TOTAL _ $ jlg.oo
Filed 7rJM (0. . 3.Q.r:'. .j. c9:~ (J.~. . . . . . . . .
~ '-idNu/i A#!~~
Register of Wi~~vlA/;
~!:'~ZlL ~
AITORNEY (Sup. Ct. J.D. No.) 35Si.3
eAarli!S E: ~Jeld.s IlL
~ {!/btiSUlPd~ ///ecJ/t-OiCSbU't! ;:;A /70s>
ADDRESS
FEES
7/7- ?b. -t!JZb'l
PHONE
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REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
the testat , sign the same and that signed as a witness at the
request of testat_ in h presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19_
(Name)
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF C lAIN /i8UA-IIfJ COUNTY ::~,:)
OATH OF NON-SUBSCRIBING WITNESS
J)IANE I/, /tJEI TZA1/M/ d,f;, :l>/;l/-AJE- 5, UJ€JTZh/n-d
(eae},t a subscriber hereto, ~ being duly qualified according to law, depose(s) and say(s) that
Ylc /S familiar with the signature of JACt;t/l:LIN~ 7:" #~.RL€y ,
-'€odieil
testatl::i.k- of ~B@ of tbe li1.lbgeribiflg nitI'l~3Sc3 -to) the will presented herewith and
codieil
that Sh'G believes the signature on the will is in the handwriting of
J,IC! ~1IlR.IAlE 7: #t(l2tGo/
to the best of fI~
knowledge and belief.
xfik ,<<iJ~_ 1:Jn7av
me this 3D-Ih day of J)/iJ-NE H. t.JEJ7Z~)
'fVlLV.J'.ft. _ 1)f~ S-;:{$~ ~~I2JJ../d/E"~.M"/~I1I1~IPA /7lJSr
J.divlA", '-ItVJ1JA --A:I/1/~J"-:. I':) {'(Afjdtfss) I
,-~~u<.A.1 (-I}L).(~ Register X ~ ~; W~,lJ./Y)tLI/,---
'-'-r -- -, QK" .f)tA-NE S, I1Ifl/~,1fAjf
Sworn to or affirmed and subscribed before
(Address)
REGISTER OF WILLS OF e U 1Hk7eLA-Jui) COUNTY
OATH OF SUBSCRIBING WITNESS
(!g~IlLG:5 E. ..9I1EZ/.JS:ur
eod~(.a 1
--(cadI) a subscribing witness to the will presented herewith, ieadl)..{,eing duly qualified according to
law, depose(s) and say(s) that HE" It/~ present and saw
tlA{!.tp~€tt./A/E r: #qJe~EY
the testatrix , sign the same and that H~ signed as a witness at the
request of testat~ in h~ presence and (iA ta@ f)resetlee af e:ach otlKt} (in the presence of the
other subscribing witness(es)). / p:; ,.~ / .~
Sworn to or affirmed and subscribed before ~ g ~
me this Sf) th day of C!A4He.5 E:. ~'e~m~
~ . yI.:?a' c.Musu-R...." /JI~tY2,~.rJu~,,;, /7~sr
- c/t2A/leA. ~. (Address)
IJ.RA~I ~ Regis{?,.
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
c:::) ,
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of
codicil
testat_ of (one of the subscribing witnesses to) the will presented herewith and
codicil
that believes the signature on the will is in the handwriting of
to the best of
knowledge and belief.
Sworn to or affirmed and subscribed before
me this
day of
19_
f Name)
(A ddress)
Register
(Name)
(Address)
l 'jl: ~
!~ () certify that the infonnation here ~iven is correctly copied from an original certificate of death duly filed with me as
I I\cgistrar~ 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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l",'~~\\H OF PEi~-----__
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t2wn.. frl ~
Local Registrar
Fee for this certificate. $6.00
P 12409285
MAR 2 2 Z006
Date
c) ~"\
~.';-'
lRev.011Q6
PRINT IN
AANENl
CKINK
1 NamE 01 Decedent (Firs!. rr'iddlc, last)
;"';)
5 Age It ast birthday)
6:&: Yrs.
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORCS
CERTIFICATE OF DEATH STATE '=ILE NUMBEIi CO
JT s:~~sec:rlly Number ~; Date of Death (Mon.th, 'day, year)
J! !./ /r'). E Y ;- I' 006 - ,.( J' - '1-7..< LL ff\c~()h 2 \ ?.->-'JO ~~
7 Date 01 Birth (Month nay, Year~.L 8lrthe1ic~ (CiIy I ndSIE te Of forEIll~ coun.!!ii- Sa ~ (Check only ene
/l1 /l Y ..., "'..... J Q ;;2 (I I / 1 . I r ;:l 'II" Hospital . ~ Other
{7 -. '.1 I I .j , 4<", ;I (It,.5 t< I, tJ,: k /71 (.; I i/ lOin al ent ~R10U auenl 0 DOA 0 NurSll19 Home 0 Residence 0 0lher _ Soecify:
Be City Bora, Twp at Death ~- &1 FacIMjt-far,lp (II ~vll~l~l~'e slree! and number) 9 ":'a.s Deceden' of I-hspamc Origin? to. Race: America~ Indian, Black, Whrte, elc.
- \ \ \ \ \ \ ~ \ . [, ,LT No 0 Yes (If yes. spec Iff Cuban, (Sp3cify)
Ctll-r)j~1.J:,-,R)..fi/\/,) I ;;Jt:Jr f)J;:;:-A)/vS/,1ote.c) ~\~~,-l ~~r;-~-t ~O'3f'\.\'ax Mexx:an,PuertoRlCanetc) WI-1,'T{;'
II DC( edenl s Usual Occ allOn (K,nd 01 work done dunr,g !T(;sl 01 working i1fe, do nr,t stale ret,r~ -112 Was Decadcr I evpr 'n the tJS r+, De~edent's.~~lICallCn S ecl en h, hesl g:ade corrpleted) 14 Marr.a: Stalus Mamed, Never mamed. 15 Surviving Spouse (If wile, give maiden namc)
Kind of Work '''---r Kind of Bus'nesst.nousl'y ') ~ Armed Forces? ~ntary/Secollcary '0-12) Cc.llege (104 or 5+) Widowed, qivorced (Specifyj
(:,:..E/~"I'::--1-ct")I/n~':I/:A.I-e.(...-/,t-h...'f ,JIi 0 Yes ~_L_____ ___~ W/Dt).' 'E
i6 Decedent's Mailing Adnress (Street, clly~own, slale, Zip code) Decedent's 17a. State -..!.~Lt.J''; (1/.''- V). t' /J 1/"/ ) ,,1 Did Decede~1 17c,k Yes, Decedent Lived in
-j--?,q ,':::. 71:;1..:) /2/1 e 1: J2 0 l} ,) Actual Res;de'lCe ~~:~~~~?
/j 1 ;; c: it A r:./ ,<..' 'J ;,~ t {,,(i. (~ P A / ') () ,; S - 170. County ,; .:~' /1) 43 .E~r{! j.. II 1'/ ,)
j,C:) C 9L-1E.I../N'C
/,
Bb, County of Death
/-t Am ,.? ;)c!L__ Twp
17d 0 No, Decedent Lived wrthin
Actual Limrts of
CitylBoro
18 Father's Name (Firsl. middle, last)
Ai/ . C. i-i r~ ~ 1-
20a, Informant's Name (Type/prinl)
i);(~NI~ H
o Removal from State
o Donation
21b, Date of Disposrtion (Monlh, day, year)
lkl A I!O-l 2- 3. .2iJ (1 t,
22b. License Number
19, Mother's Name (Fi~st. middle, maiden surname)
DENI.SE DE/",oA:/y, E:
20b. Informant's Mailing Address (Street. city~own, stale, zip code)
S J... 3 ~ TE/J..k?.IIC!.E /2 (' I} D
Iv\ E Li4-A N i Q..S ~ (...( /!.. 6;' P A
21c. Plece of Disposrtion (Name of cemetery. cremafory or other place)
l 70 )'y-
ilf OM 0
Ct.) 2.. i Tz /).1 A 1"1./
oFH
C fr2. e;/'y I R T-O ,Q.. Y
21d. Location (City~own, slate, zip code)
(} RANT v I L u.=.. j':":J /I /1 (i .2 /i
F s (, " (f 1 9 3 L
23a. To l.he best of my knowledge, death occurred at the lime, date anc p!ace slaled. (Signature and trtlc)
22c. Name and AdOress of Facility
U) , t1 t-U IL.U:.
. ' ,2 0 (.~J /)7 f),t:...,iCUT<;;-/'z,ex,r /.J///.!..;!.,~/k,;,l~
((.'. I In In E:. '- f- c.{ N /i:7'_/i L. /'1 ,;. /'n &.r:: Ii," '- _ ':'Jl i'1'; "I
I 23b. Licer,se Number
23c. f1ate Signed (Month, day, year)
24. Time 01 Death .," --T25. Date Pronounced Deaj (Month, d1'f, ~ear)
\ 0 .. \l{ ~\~ MOJ'CNl
CAUSE OF DEATH (See Inst:lJctions and examples) : 'A;Jproximate interval: Part II: Enter other ~fi,~ant cundi;ions conlribulino 10 death.
Item n. Part I: Enler the ~ - di!.eases, injuries, or complicQtions.. !hal dllCC!1y caused !t,e dei;th. DO NOT enter terminal evan.s suc~ a~ caro~,,: aHe:;t, : onsat Ie deal~ bul not re5ulfi 1. in the unJerlyir.g caul.e given in Part I
reSPira. tory arrest, or ventricular fibri'lation wifhou! showing the e,liOlo9Y' DO NOT ahbrc'liII!e. Enter only nne caUSl! on a line,. . .: . (}. t \' , \
IMMEDIATE CAUSE (Flna, dlseasc or a '^. ~ (vt. ~&\,CJ :tA.? ~c...('~ \ O,.:~ e~ro.0...(.. ~'etl-\Jr-4-\ '~\ :{t
cor,dltlonresunlngmdeath) -7 . -D~q~~ ---~- - -_: __'_n__ '_'___
Sequentlallylistconditions,ifany, __...._.____.___ '____ _____________
: ~~~~~h~o ~~;:~~~:~~C~~~~e a Due to (or as a consequence ory'
. (disease or ini~ry thaI inrtialed the
events resulfing in death) LAST.
2\
'200 'to
26. Was Case Relerred \0 a Medical Enminer:Coroner?
J, I,! i:- i) ~
t>i Yes . 0 No
o Yes ~~
d
3Ob. Were Aulopsy Findings
Available Prior 10 Completion
of Cause of Death?
o Yes 0 No
31. Mannb' ofDealh
~UI'3.l 0 Homicide
o Accident 0 Pending In"esligalion
o Suicide 0 Could Nol Be Delermmed
-, 32a. Date of InjUry (;lonfh, da;'year)
-t32b Descrihe hOWIn!ury Occurred: -
28. Did T cbarco USE Conll ibute to Death?
o Yes 0 Probably
iXNo 0 Unknown
9 If Female:
V7 No! pregnant. wnhin past vear
lJ Pregnanl al. time of death
o Not pregnant, but pregnant within 42 days
of death
o Not pregnant, but pregnam 43 days 10 1 year
before death
o Unknown if pregna~l "Iilhir Ihc past year
:J2c. Place of Injury: Home. Farm, Street. Factory, Office
Building. etc. (Specily)
D~e 10 (or as a consequence oQ
. 3Oa. Was an Autopsy
Performed?
32d. Time oflnjury
33d. Dale Signed (Monlh. day, year)
32f.
32g. Location (Street. city~own. slate)
M.
338, Certlflef' (check only one)
Certifying physician (Physician certitying cause 01 death \lIben another physician has pronounced dealh and coll1lleled Item 23)
To the best of my knowledge, death occurred due 10 the cause(s) and manner as stated ......................n...................................._...................,.......................-..................X
Pronouncing and certifying physician (Physician both pronouncing dealh and certifying to cause of death)
To the best of my knowledge. death occurned allhe time, dall!, and place, and due 10 the cause(s) and manner as slaled......................................................................'O
Medical examiner/coronS(
On the basis of examination and/or Investigation. In my opinion, death occurred al the time, date, and place, and due to the cause(s) and manner as stated .........0
35. Regislrar's s~.e e i a,:istrict N 36. Dale Flied (Month, day, year)
L.bn"'- I ~I II ~I / I / j 1:9 /,;~/ d tJ CJ I..
(See instructions and exa~ples on reverse)
34. Name a~,Address at Person Who ~mpleteo Cause of Death (lIem 27) TypelPrint
H' ~ol+ftUl "L<..(}I Q.... 11.... .jJ e
~'JJ'> ~ .:-l~',,~~l~ 1.,...-.....u. t~e~, :A
ltar c. .
LAST WILL AND TESTAMENT OF JACQUELINE T.HURLEY
I, JACQUELINE T. HURLEY, an unremarried widow, currently of 5232 Terrace Road,
Mechanicsburg, Halnpden Township, Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this my Last Will and Testament,
hereby revoking and making void any and all prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, is to be distributed to my daughter DIANE H. WEITZMAN, also known as
DIANE S. WEITZMAN, currently of 5232 Terrace Road, Mechanicsburg, Hampden To\vnship,
Cumberland County, Pennsylvania.
In the event my daughter, DIANE H. WEITZMAN predeceases nle, then I direct that my
estate be divided into two equal shares and distributed as follows:
A.) One share to Iny sister, EVA SHEIL, Der stirDes.
B.) One share to my brother, MICHAEL TRJONO, Der stirDes.
3.
I nominate, constitute and appoint my daughter, DIANE H. WEITZMAN, also known
as DIANE S. WEITZMAN, to be the Executrix of this my Last Will and Testament. In the
event that she is unable or unwilling to act as Executrix, I appoint my sister, EVA SHEIL to be
the Executrix in her place and stead. In the event that she is unable or unwilling to act as
Executrix, I appoint my brother, MICHAEL E. TRONO, to serve as the Executor in her place
and stead. I further direct that they shall not be required to file bond or other security in the
Office of the Register of Wills for the purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7K day of
t1/~ , A.D. 2004.
,
~E~y
I~~~
~t:-cJi' .~~40~ -r ~
ACQELINE T. HURLEY
(SEAL)
Signed, sealed, published and declared by the above-named JACQUELINE T.HURLEY, as
and for her Last Will and Testament, in the presence of us, who at her request and in her
presence, and in the presence of each other, have her~unto subscribed our names as witnesses..
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