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Home My WebLink About04-05-06 Cumu,erlandCounty Register of Wills PETITION FOR GRANT OF LETTERS Estate of David T. Shaffer No. 0( J - t (f),-II 2- "t ] also known as David Todd Shaffer , Deceased Social Security No. 173-38-6421 Jill Morrow Petitioner(s). who is/are 18 years of age or older. apply(ies) for: (COMPLETE "A" OR "B" BELOW:) o A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix Decedent, dated 5/2/1988 and codicil(s) dated named in the Last Will of the 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 incapacitated: o B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: f Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 320 Indian Creek Drive, Mechanicsburg, Hampden Township, Cumberland County (list street, number and municipality) Decedent, then 56 years of age, died February 20 ,2006, at Las Vegas, Nevada (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 ........................................................................................ $ Total ..................................................................................................................... $ 76,000.00 76,000.00 Real Estate 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 Jill Morrow 320 Indian Creek Drive Mechanicsbur PA 17050 RW-7 Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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 and affirmed and subscribed /) .., .---,{ before me this _ .7-. , /y I " day of rn LLf/ LL~ r (\0 I f) Y ,.,,- L--, /-/'" { ).2J!~1/! [{~, /r (1../1 ItU../J '(71S~Jwr iJi.i (;.hL'alJ ill f,' tt'/11ll/ ,,{A\ -' . '-' '-' .' .,! J /' . " Oath of Personal Representative ''1 '41 if /}Jt!~UUI- :Jl DECREE OF REGISTER Estate of David T. Shaffer also known as David Todd Shaffer Social Security No: 173-38-6421 Date of Death: 2/20/2006 . ~rL- AND NOW, () f1J/ti I v' I 2006 , in consideration of the Petition on the reverse side hereon, satfsfactory proof having been presented before me, Deceased No. ,~2 r (: C" 'C) ..2-<-17 IT IS DECREED that Letters IX) Testamentary 0 of Administration are hereby granted to Jill Morrow (c.I.a.. d.b.n.c.t; pendente lite; durante absentia; durante minoritate) in the above estate and that the instrument(s), if any, dated May 2, 1988 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. ~1tr It--<fi0111i~'.)t1c~)}?"U J C- pt< ~ /fr%~~. Pp FEES Letters. ........ ........................... $ $ $ $ $ $ Inventory & Tax Forms............. $ $ Short Certificate( s) ............... Relltll,ciation ......~; U............ Affidavit ( ) ....................... ).............. Extra Pages ( Codicil......... ......... ............... + H-j'rlJ JCP Fee ................................. Other ...................................... $ :2fV Register of Wills /).c)o / 5. l) j a~ / /: ~ ~ (/ <!#"L--- '-- Atlrney I 5" t/'V Attorney; David W. ReaQer I.D.No: 20868 Address; 2331 Market Street Camp Hill PA 17011 J5~ TOTAL ...... ................ .......$ RW-7A Telephone: 717-763-1383 DATE FILED () fit / :5:'';;'' 0 () & IFDEA JH OCCURRED IN INSTIIUTJON SEE HANIlBOOK REGARDING COMPLEtION OF RESIDENCE IIEMS L. . . . ~ONDITIONS IF ANY VHICH GAVE RISE TO IMMEDIATE CAUSE TATING THE INDERL YING ;AUSE LAST 4 :~'I~ .]~ I STATE OF NEVADA - DEPARTMENT OF HUMAN RESOURCES DIVISION OF HEALTH - SECTION OF VITAL STATISTICS I CERTIFICATE OF DEATH I LOCAL FILE NUMBER DECEASED NAME First Middle Last DATE OF DEATH (Month, Day, Year) 1. [j,wi If SHAFFER Tqdd CITY, TOWN on LOCATION OF DEATH 3b. Hell(!I:'lson SEX 4. Male DATE OF BIRTH (Mo., Day, Yr.) RACE r~JI;;,,~~~')' m~~~;f0merican 5. Wh i tf.? STATE OF BIR1H (II not U.S.A., nome colJntry) 98. 11ichioan SOCIAL SECURITY NUMBER 8. Dee 7, 1949 CITIZEN OF WHAT COUN- TRY 9b. U. S. A. Decedent's Education. grade com pie led. 10. 1 b ~ 12. Ji 11 MOrTOW 13 17]--JA -(i42J ,RESIDENCE-STA TE USUAL OCCUPATION (Give Kind of Work Done During Most of Working Life, Even if Retired) 14a Enoineer COUNTY CITY, TOWN, OR LOCATION INSIDE CITY LIMITS (Specify Yes or No) 15e. No Last M=>fospaCI? STREET AND NUMBER 15a. Pennsylv8nl.f. 15b. Cumberland FATHER NAME First Middle 15c Me(~h;:H).i.csburQ Last MOTHER-MAIDEN NAME 320 [ndlan Creek Dr. First Middle 16. WillJam INFORMAN I-NAME (Type or Print) (Street or R.F.D. No., City or Town, Slate, Zip) 17. Jane Yeauer 18" J J ]) Wife 18b. 320 Indian Creek Or., K~chanicgburq, Pennsylvania 17050 CEMETERY OR CREMATORY~NAME LOCATION City or Town State 19c. Las Veoas. Nevada Affordable Cre3lation And Buml 20c. 245'1 K. Decatur Blvd, lag Ve as, Nevada 89100 z ",:f nO .,,OJ ~~ 0."- E(') 8~ 1l~ 0.... I-rr: W o 223. On the basis of examination and/or investigation, In my opinion death occurred at the time, date and place and due to the c3use(s) and manner stated. (Signature and Tir/e) ~ DATE SIGNED (Mo.. Day, Yr.) '" .0" ."" ~8 0." E'l.. 0" "" 1l~ 00 .... HOUR OF DEATH 22b. PRONOUNCED DEAD (Mo., Day, Yr.) 22c. PRONOUNCED DEAD (Hour) 21d. 22d. ON NAME AND ADDRESS OF CERTIFIER (PHYSICIAN, A nENDING PHYSICIAN, MEDICAL EXAMINER, OR CORONER). (Type or Print.) 22e. AT LICENSE NUMBER 23a.Far;rukah Imtiaz MD 4445 S. Eastern Ave. Las Vegas NV 89119 23b. (VV c1 5:2 3 REGIS1RAR \ DEATH DUE TO COMMUNICABLE DISEASE 24a. (Signature) 24c. YESO NO (a) Interval between pnset and death I J- J"A..A PART I Interval between onset and death (2. ~ Interval, between oqset and death I), >>vl./J (b) ~Me.~t-'l/l,'~' DUE TO, OR AS A CONSEQUENCE OF: .\~ .-, / C.O~ . fA-h~~ PART II (cJ '-'"}'\,A..<./ OTHEH SIGNI AUTOPSY (Specify WAS CASE REFERRED TO Yes or No) CORONER (Specify Yes or No) 27. No 26. Nu ACC., SUtCIDE, HOM., UNDET., OR PENDING INVEST. (Specify) 288. INJURY AT WORK (Specify YM or No) 28e. DAlE OF INJURY (Mo., Day, Yr.) HOUR OF INJURY DESCRIBE HOW INJURY OCCURRED 28h 28c. M 28d. LOCATION. STATE PLACE OF INJURY-At home, farm, street, faclory, office building, etc. (Specify) STREET OR R.F.D. No. CITY OR TOWN 281. 28g. STATE REGISTRAR No. 329491 "CERTIFIED TO BE A TRUE AND CORRECT COpy OF THE DOCUMENT ON FILE WITH THE REGISTRAR OF VITAL STATISTICS, STATE OF NEVADA." This copy was issued by the Clark County Health District from State certified documents as authorized by the State Board of Health pursuant to NRS 440. i 75. NOT VALID RAISED SEAL OF COUNTY HEALTH ) i'- WITHOUT THE THE CLARK DISTRICT DONALD S, KWALICK, MD, M.P.H. Registrar of Vital Statistics By: ~ Date Issued: FEB 2 4 2006 CLARK COUNTY HEALTH DISTRICT 625 Shadow Lane P.O. Box 3902 Las Vegas, Nevada 89127 702-383-1223 Tax ID# 88-0151573 r) I. -..... 'J -"'\ G I~ ~u j./ l LAST WILL AND TESTAMENT OF DAVID T. SHAFFER I, David T. Shaffer, of Lower Paxton Township, Dauphin County, Pennsylvania, make this my Last Will and Testament, thereby revoking all Wills and Codicils previously made by me. FIRST: All of my property, both real and personal, of whatever kind and wherever situated, I devise and bequeath to my wife, Jill Morrow if she survives me by sixty days. SECOND: If my wife should fail to survive me for sixty days I devise and bequeath all of the said property to her son, Brian David Morrow. THIRD: I appoint my wife, Jill Morrow as Executrix of my estate. IN WITNESS WHEREOF, I have hereunto placed my hand and seal to this my Last Will and Testament this 2nd day of May, 1988. c-_.. ~ '.... \.~ (. " '<~aWl:1 \_. /' David T. Sha e, I SIGNED, SEALED, PUBLISHED and DECLARED by the testator as and for his Last Will and Testament, in the presence of us: ~t:.?~ ~<A~ W2-12/WILLS2 \J Cumberland County, Pennsylvania Estate of David T. Shaffer OATH OF SUBSCRIBING WITNESS ~ \ - 0\0 -01L(l No. also known as David Todd Shaffer , Deceased (each) a subscribing witness to theO codicil(s) !XI wiIJ(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 an<W in the presence of each other 0 in the presence of~he ot r subscribing witness(es). ~f~ J,. I ~ Ie- Thomas1:"" Niesen (SIgnature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this 2 3 r d day of fVtorcKt , LOO~ ~~t~~ l~ ~ vn~ D/V My Commission Expires: COMMONWEALTH OF PENNSYLVANIA Notarial Seal . Rhonda Heffelfinger, Notary Public City Of Harrisburg, Dauphin County My Commission Expires Apr. 22, 2008 Member, PennsylVflnif' Association Of Notaries (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. r-, -.'i RW-2 (';...-' Cumberland County, Pennsylvania Estate of David T. Shaffer OATH OF SUBSCRIBING WITNESS ':2 (- (j ~- O}~'l No. also known as David Todd Shaffer , Deceased (each) a subscribing witness to the 0 codicil(s) IX) 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 an~ in the presence of each other 0 in the presence of the other subscribing witness(es). /-, (.~~ ~ 'f~\ (Signature) Carroll F. Purdy (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this ..:? 7 t$} day of /~ A-,k! c// ,2~j' I '---?;?~~"'UO'- ,L/. Crv / ~~t~om~~~~on Expires: / Notarial Seal . Margaret H. Y oh, Notary Public City Of Ha~sburg, Dauphin County My CommisSIon Expires Sept 28. 2006 Member. PennsYlvania Association Of Notaries 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 r. ~') . ;"';.' . ~'-.J REAGER & ADLER, PC ATTORNEYS AND COUNSELORS AT LAW 2331 MARKET STREET CAMP HILL, PENNSYLVANIA 17011-4642 717-763-1383 TELEFAX 717-730-7366 WEBSITE: ReagerAdlerPC.com THEODORE A. ADLER + DAVID W. REAGER CHARLES E. ZALESKI LINUS E. FENICLE THOMAS O. WILLIAMS SUSAN J. SMITH SUSAN H. CONFAIR TIFFANY M. CARTWRIGHT PETER R. WILSON JOHN H. PIETRZAK + Certified Civil Trial Specialist Writer's E-Mail Address:MZercher@ReagerAdlerPC.com March 31, 2006 Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of David T. Shaffer Our file number: 06-140 Dear Register: Enclosed please find two fully executed and notarzied Oaths of Subscribing Witness for the above- referenced estate. Please proceed with the issuance of the Letters Testamentary and forward the original Letters and Short Certificates to me at your earliest convenience. In the event you have any questions, please feel free to contact me. Very truly yours, , '" ,'-7 ..} ; :. ~ ~ ----. \-' ~?, V" Monica D. Zercher Legal Assistant Enclosures ? (- 0(;- 0)"-( J REAGER & ADLER, PC ATTORNEYS AND COUNSELORS AT LAW 2331 MARKET STREET CAMP HILL, PENNSYLVANIA 17011-4642 717-763-1383 TELEFAX 717-730-7366 WEBSITE: ReagerAdlerPC.com THEODORE A. ADLER + DAVID W. REAGER CHARLES E. ZALESKI LINUS E. FENICLE THOMAS O. WILLIAMS SUSAN J. SMITH SUSAN H. CONFAIR TIFFANY M. CARTWRIGHT PETER R. WILSON JOHN H. PIETRZAK + Certified Civil Trial Specialist Writer's E-Mail Address:MZercher@ReagerAdlerPC.com March 20, 2006 Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 RE: Estate of David T. Shaffer Our file number: 06-140 Dear Sir or Madam: Enclosed please the Petition for Grant of Letters, Estate Information Sheet, Original Will and Death Certificate for the above-referenced estate. Please kindly hold the issuance of the Letters in your office until you receive the Oaths of Subscribing Witnesses. They are in the process of being signed and return to me. Please issue three (3) short certificates and mail the Letters Testamentary and Short Certificates to our office once the Letters are issued. Thank you for your attention to this matter. v lry l"'. ly yours, I~\/) 'bL-- \ , Monica D. Zercher Legal Assistant Enclosures 1 -"..:. -' . (3 G : I Ci ~..1 """ {, ~' (/2-'-( ;' /) ! ' v . (~~ REAGER & ADLER, PC ATTORNEYS AND COUNSELORS AT LAW 2331 MARKET STREET CAMP Hill, PENNSYLVANIA 17011-4642 717-763-1383 TElEFAX 717-730-7366 WEBSITE: ReagerAdlerPC.com THEODORE A. ADLER + DAVID W. REAGER CHARLES E. ZALESKI LINUS E. FENICLE THOMAS O. WILLIAMS SUSAN J. SMITH SUSAN H. CONFAIR TIFFANY M. CARTWRIGHT PETER R. WilSON JOHN H. PIETRZAK Writer's E-Mail Address:MZercher@ReagerAdlerPC.com + Certified Civil Trial Specialist March 20, 2006 Via hand delivery Jill Morrow Morrow Diamonds & Farrar Jewelers 3750 Market Street Camp Hill, P A 17011 RE: Estate of David T. Shaffer Our file number: 06-140 Dear Jill: Enclosed please find David's original Last Will and Testament along with the Petition for Grant of Letters and Estate Information Sheet which must all be presented to the Cumberland County Register of Wills along with an original death certificate in order to probate the Will. Please do not sign any of the documents until such time as you appear before the Register. Please provide the Register with the enclosed letter of instruction. There will be a probate fee in the amount of $252.00 based on requesting three Short Certificates. This fee will need to be paid at the time of probate. In the event you have any questions, please contact me. v el~~~y yours, 1) 1Jl v Monica D. Zercher Legal Assistant Enclosures ss : \ (.....' ) G'~ t..;; ,,,'.,l-