HomeMy WebLinkAbout06-21-06
Register of Wills of Cumberland County
Estateof ~ond E. WA/J
also known as "P~(nn,^d r;dwa.ra lAJ411
PETITION FOR PROBATE. and GRANT OF LETTERS
J 0 . c- C' .
No. I J - (jJ- 0 0.5
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. Olll- &1/- KK6, B
The petition of the undersigned respectfully represents that:
Your petitioner~, who is/Me 18 years of age or older, and the execut Y'i.x named in the last will of the
above decedent, dated m tl roe), 10 . ~ I 't 97
and codicil( s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in C u. WI bel'" )D..r1d
Pennsylvani~ wifil h.!,.l~t family or principal residence at # .
7f)~.J tlJl't.s1e fJ,")(e. Lift 322 . t:'4rhJ/~ (Slffer ~rl/}'S 0jP.)
, (list street, number and municipality)
Decedent, then e1 years of age, died ,J" C.u1~ 5 . 20~ at C4rl;~e R~iD1J4/ lhee/,(;Q,l
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:
AliA
County,
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
(linot domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: JJIA
DD
$ ~f)D~
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and the grant of letters ti:.sfllllenf..,."
..J (testamentary; administration c.t.a.; administration d.h.n.c.l.a)
thereon.
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Residence( s) of Petitioner( s)
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REGISTER OF WILLS OF CUIJI~/iX!L,/l-AJtJ 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)
t-
o
(Address)
Register
(Name)
(Address)
-- )
REGISTER OF WILLS OF c.llJ'JtSG7lUIJ.J/J COUNTY
OATH OF NON-SUBSCRIBING WITNESS
.JUbITH LEE J</EZ..
~ a subscriber hereto, (~ being duly qualified according to law, depose(s) and say(s) that
~e /$ familiar with the signature of ,0(}YI1J~N~ E. teJl'/-LL.
~gdi ~il...
testat~ of ~ge Qf the sHaseriaiHg "'itR~gb@t; ts) the will presented herewith and
that SIll?
r'QJ1kil
believes the signature on the will is in the handwriting of
/:tIWAI ~/I" E: ttJ Aa..
to the best of her knowledge and belief.
Sworn to or affirmed and subscribed before ~~ \<.J
me this (~ ~ LEM KIEt,.Name) ,
'A R04k/clfi,e t>t':J Nleehftl1ic~J,k~. PA 17tJSl)
(Address)
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(Name)
(Address)
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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 test at_ 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)
l"-
e)
Register
LLj
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(Name)
(Address)
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REGISTER OF WILLS OF Ct{At13e~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
L/AllJ/I It. K4t1 r F/JtA-#
ieae:h)J a subscriber hereto, f@a~~) being duly qualified according to law, depose(s) and say{s) that
.:5J1E"' /~ familiar with the signature of ~Y~H.d G: AlA-a
-€t)Jjdt
testat~ of {ofle sf t~@ f:;Ht3seribing nitfle33t:3 t8>1 the will presented herewith and
t:8eii Gil
that SHE
believes the signature on the will is in the handwriting of
;t'/IY/I!~/f'(} E, #kl.
to the best of kr knowledge and belief.
Sworn to or affirmed and subscribed before
~6~
)( 6~~~", ~, ~~~
'-'AIDA /l (Name). A I( FF/1UMI
7/2 A'~ Gnu RtI., /)''//.11111'1< 1111 17/)/'
(Address)
me this
l
(Name)
(Address)
H J()~ ~(), R FV I/()',
This is 10 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.
am-/(l1~
Fee for this certificate. $6.00
Local Registrar
p
12624165
JUN V 0 2lJlJ6
Date
3 Rev. 01106
'PRINT IN
~ANENT
,CKINK
1 Name of Decedent (First, middle, last)
y' -G([) '- ~s5
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. 11.
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICA TE OF DEATH STATE FILE NUMBER
3. Social Security Numbtll
5. Age (Last birthday)
87 Yrs.
8b. Counly of Death
o Residence 0 Other. S ci.-
10. Race: American Indian, Black, White, elc.
( Specilyj
14. Mar~al Slatus: Married. Never married,
Widowed. Divorced (Specilyj
Widowed
White
15. Surviving Spouse (If wife, give maiden name)
Lot 322
17a. Slate
PA
Cumberland
Did Decedent
~~=~~~? 17c,J(J Yes, DecedenlLivedin Si 1 upor ~rt'i n.gs
17d. 0 No. Decedent Lived w~hin
Actual limits of
Twp
17b. Counly
18. Father's Name (First, middle, last)
Ra ond E. Wall
20a. Informant's Name (Typelprint)
19. Mother's Name (First, middle, maiden surname)
CitylBoro
Vir inia O. Andere
2Ob. Informant's Mailing Address (Streel. cityllown, slate, zp code)
Cremation Societ of PA 17109
22c. NameandAddressolFacilityAuer Memorial Home & Cremation Services, Inc
4100 Jonestown Road, Harrisbur , PA 17109
23b. License Nurrber 23c. Date Signed (Month, day, year)
M Dy i7700 JI.A;Ne 5 '200 (;
,JUNE
26. Was Case Relerred to a Medical Examiner/Coroner?
'Yes 'l:iI"No
CAUSE OF DEATH (See Instructions and examples)
hem 27. Part I: Enter the ~ - diseases. mjuries, or CO"1llications - thai directly caused the death. DO NOT enter terminal events such as cardiac arrest,
respiratory arrest. or ventricular libr~lation w~hout showing the etiology. DO NOT abbreviate. Enter only one cause on a fine.
I..MEDIA TE CAUse (Fmal disease or
cond~ion resulting in death) -7 a.
Approximate interval:
onset 10 death
Part II: Enter other sionificant cond~ions contributina to death.
but not resuhing in the underlying cause given in Part I.
Sequentially Iisl condiOOns, if any,
. leading to the cause lisled on Line a.
- Enter the UNDERL YlNG CAUse
.. (disease or injury lhat initiated the
events resuhing in death) LAST.
CD N &e SI' I 'V ~
Due to (or as a consequence o~.
l<;CHt:; (Y) I c..
Due to (or as a consequence o~:
C Ol!..oNAR. 'f
Due to (or as a consequence o~:
H a AeT
FAI'-'" tt.E:.
R-e-NAL
iNSuffic.:I~N C'(
28. Did Tobacco Use Contribute 10 Death?
o Yes r<r"Probably
o No 0 Unknown
29. If Female:
o Nol pregnant ~hin past year
o Pregnant at time of death
o Not pregnant. but pregnanl within 42 days
of death
o Nol pregnant. but pregnant 43 days to 1 year
before death
o Unknown if pregnant w~hin Ihe past year
32c. Place 01 Injury: Home. Farm. Street. Faclory, Office
Building. etc. (Specilyj
c.
Cf.\~L)IOfYh'cPA, H Y
A {2.. n R. Y D IS-a;\S.:e:
o Yes ~
d.
3Ob. Were Autopsy Findings
Ave liable Prior to Co"1lletion
of Cause 01 Death?
o Yes Q"'No
31. Manner of Death
~atural 0 Homicide
o Accident 0 Pending Investigation
o Suicide 0 Could Not Be Determined
32a. Date 01 Injury (Month, day. year)
32b. Describe how Injury Occurred:
3Oa. Was an Autopsy
Performed?
32d. lime 01 Injury
32e. Injury at Work?
o Yes 0 No
321. If Transporlation Injury (Specilyj
o Driver/Operator 0 Passenger
o Pedestrian 0 Other - Specify:
33b. Signature~rtifier R ~
33c. License NUmber
YlC> Y 177CD
32g. Location (Street. cityllown. slate)
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33a. Certifier (check only one)
. Certifying physician (Physician certilying cause of deatll.when anolher physician has pronounced death and CO"1lleted hem 23)
To the best 01 my knowledge. death occurred due to the cause(s) and manner as sl<lted ................................................................................................................................0
~~Ot:u:~~~,a::: ~:~~~hJ:a~~~c~~~:~~ t~~i:~~~~::~e;I~C~~~~~~~n~t~~~=~:~~~~t~ manner as Sl<lted..........................................,...,........................~
Medical examIner/coroner
On the basis 01 examination and/or Investlgalion. In my opinion. death occurred at the lime. dale, and place, and due to the cause(s) and manner as sl<lted .........0
Registrar' Signa lure and Dislrict Number
t?r'.
M.
.~
loll/I~I/I/ I
34. Name and Address of Person Who Completed Cause of Death (Item 27) Type/Print
W/I-"'I,""\,," VOfo/Arl, fYI D.
;J. "Z 0 W ; L. _~ CW ~,. fl.~T
C. AILe.. i:::, \..G F'A J 7013
33d. Dale Signed (Month, day, year)
J iANiJ 5 I 200G
(See instructions and examples on reverse)
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Last Will and Testament
I,RIJ'/I1CiIJb t:.. lUALL of the City of C/l/?t.lfl.~-
County of (' v H ~ E /{ L IJ-^" b , State of 1--::> Eiv 41 "....
,
being of sound mind, and not acting under duress, menace, fraud, or undue influence of
any person do hereby make, publish and declare this instrument my last Will and
Testament and do hereby revoke any and all other Wills and Codicils heretofore made
by me.
FIRST: I order and direct that my just debts and funeral expenses, expenses for
administration of my estate and any inheritance, State or Federal taxes upon said estate,
except those, if any, which are secured by mortgage or deed of trust, shall be paid as
soon after my death as may be practical.
SECOND: I am a Wi /:)tI ~v' IS R person. My spouse is
~ , () tJ i., I/- /.., e- J: h '11: L I 1, Iv P ;.df IIi: lOt / ) j::,: H #-;1, y, R tJ I.4h". I)/i/ It! IE -r-r'i n' <';' 1=
" . ,
and
are all my children either natural or adopted.
THIRD: I nominate my spouse as Guardian of my minor children. In the event that my
spouse shall predecease me or fails to serve as such Guardian, then I nominate
and appoint Nt. fL' Guardian of the person and property
of my minor children. I further direct tha t no bond shall be required.
FOURTH: I hereby make the following specific bequests: ,,' .J; /cf?/
I' '7. /u V7" PJiKIJI?O,K 11/
f1 Y 12-- t iA.I AJI ~~ ~\j n' /1) .5 /Y /11( IS e> 1= . / /'" (, <'/7r \ t
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t1cl~IJ..5- f)CHc ~"'Tl-/F #-3~~ If}f/lf' 7P Hy /... Iv6 /~
, :),.1 J'. C r. e w7"/.,t i.I W (? f1/ JJ ~I /~ ~ /I E t-. /jjY
CC/pt P /fJ Iv Ie IV ./. /'(. I
FIFTH: I hereby give, devise and bequeath all of the rest and residue of my estate, aA
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property over which I have power to dispose to If y YIII?t:~ [/lIt. M?~4,' ~04/)/ft.t. .11
SIXTH: I nominate and appoint J tJ b I -r' fI L 5 t:= k f /!E l-
as Executor of this will. In the event that the Executor named above shall predecease me
or fails to serve as such Executor of this will, I nominate and appoint
L !,fl/)/IRJ1-E II 17&' rp/of AN as Executor. I further direct that no appointee hereunder
shall be required to give any bond for the faithful performance of their duties.
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m SEVENTH: I hereby authorize my Executor to exercise all power, rights, discretion and :
.: duties deemed necessary for the proper administration and disposition of my estate. :
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~ I b 'b hi W"ll h' 1'00 (1-Day of ~/ AfZ ell., 19 9) -7 ~
~ su scrI e my name to t SIt IS I ~ at....-
.: ;if 13 ( If If/V I c. S t~ U /(. G Pt= Iv tJ S 'j J.-- VI1- /U I/}-:
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-tc On the day written below, R It 11-( /J vb F W 1/ /. L *"
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-tc declared to us, the undersigned that this instrument, consisting of 2 pages, was *"
: illS Will and If E requested us to act as witness to it. thereupon signed :
-tc this Will in our presence, all of us being present at the same time. We now in If Ie; *"
-tc presence and in the presence of each other subscribe our names as witnesses. *"
~ 0 .t/1 V 1"'/ ) A e, 1A/ 1'11-. '- *
-tc It is our belief that I\n / n tJ J, ;) is of sound mind and under no *"
~ constraint or undue influence whatsoever. *'
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~ We declare under penalty of perjury that the foregoing is true and correct and that *'
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-tc this declaration was executed on f1 if I< ell /0 , 19 9 7 *"
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1'f WItness ' Address I /070 ~
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