HomeMy WebLinkAbout09-05-06
Register of Wills of __ CUfl'lberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Sara B Stauffer
also known as
No. 21-06- I ~
, Deceased
Social Security No.
171-42-1130
David M Stauffer and Evan E Stauffer Jr
Petitioner(s), who is/are 18 years of age or older, appl(ies) for:
(COMPLETE 'A' or 'B' BELOW)
00 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
the Decedent, dated 02/25/1981 and codicils dated
Executors
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:
o 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:
I Name
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Residence
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(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 325 Wesley Drive, lower Allen Township
(list street, number, and municipality)
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Decedent, !tlen
90
years of age, died
07/29/2006
at Bethany Village, Mechanicsburg, Lower Allen Twp., PA
(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
74,550.00
$
$
$
$
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 appropnate form to the undersigned:
I Signature Typed or printed name and residence
,~ /~ c->. ~?/l David M Stauffer 4118 Overlook Drive
-/ 2J?'"t ItA -YfrT~--""'"-- Jarrettsville, MD 21084
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Evan E Stauffer Jr
2800 Larkin Road
Boothwyn, PA 19061
Prepared by th'9 Pennsylvanla Bar ASSOcIation
COPYright (c) 2D04 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
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befpre me thls..J day of
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David M Stauffer t' /
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21-06-
Estate of
Sara B Stauffer
also known as
Social Security No: 171-42-1130
Date of Death: 07/29/2006
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.t.a: pendente lite: durante absentia; durante minoritate)
are hereby granted to David M Stauffer and Evan E Stauffer Jr, Executors
in the above estate and that the instrument(s) dated
2/25/1981
,
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
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Short Certificate(s)....
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..$
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Letters............
FEES
.............$
$
Attorney:
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Affidavits ( ).. . ...$
I.D. No:
Extra Pages ).. ..............$
Address:
Codicil...... .
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JCP Fee...
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Telephone:
E-Mail:
Inventory....
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Other.......
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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.
Form RW-1 (1991)
No, 281879
Register of Wills of Cumberland County, Pennsylvania
OATH OF NON-SUBSCRIBING WITNESS
Estate of
SARA B. STAUFFER
No. ~I - O~'I~'(
Also Known as
DAVID M. STAUFFER and EVAN E. STAUFFER, JR
each a subscriber hereto, each being duly qualified according to law, deposes and says that
they were familiar with the signature of SARA B. STAUFFER
testatrix of the Will presented herewith, and that such subscribers believe the signature on the
Will is in the handwriting of SARA B. STAUFFER
to the best of such subscriber's
knowledge and belief.
Sworn to or affirmed and
subscribed befor~e this
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:2006. .
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DAVID M. STAUFFER (/
4118 Overlook Drive
Jarrettsville, MD 21084
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EVAN E. STAUFFE .JR:
2800 Larkin Road
Boothwyn, P A 1906:1:>
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'<EV. 0212006
PRINT 'N
~ANEN~
:KINK
1. Name of Decedent (t:jrst. middle, lasl, suffix)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
4. Date 01 Deatl1 (Month, day, year)
6. Date of Birth Month, da, ear
7. Birthplace Ci
1130
July 29, 2006
Sara
Stauffer
171 - 42
5. Age (Lasl Birthday)
Bethany Village
January 24, 1916
Harrisburg, PA
Other
Dlnpatierll OER/Oulpatient DooA ~NLJrsing Horne
9. WasDeced~ntofHispank:Origin? [gJ No Dyes
(If yes, Specify Cuban.
Mexican, Puerto Rican, elc.)
90
y~
8b County of Death
ad Facility Name (If not institution, give street and number)
Cumberland
Upper Allen Twp.
11 Decedent's Usual OccupaliOl'l (Klnd of work done during most of working life. Do not stale retired.)
Kind of Work Kind of Business I industry
Registered Nurse Healthcare
. 16, Decedenrs Mailirtg Address (Street, city I town, stale, zip code)
12. WasDecadenleverinlhe
U.S. Armed Forces?
Dyes IJ!]No
Decedent's
Actual Residence 17a Stale
Pennsylvania
Cumberland
17e. III Yes, Decedent Uved in
17d. 0 No,D~entUvedwilt1in
Actual Umfls of
13. Decedent's Education (Specify only highest grade completed)
Elementary I Secondary (0-12) CoHege (1-4 or 5+)
12 4
14 Marital Status: Married, Never Married.
Widowed, Divorced (Specify)
widowed
325 Wesley Drive
Mechanicsburg, PA 17055
18. Father's Name (First, middle, lasl. suffix)
Chester C. Byler
17bCounty
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o Residence 0 Other - Specify
10. Race American Indian, Black. White ete
(Specify)
white
Lower Allen
Two
City/Bom
200 Informal'!'s Name (Type I Print)
19. Mother's Name (Rrst, middle, maiden surname)
Myra Jackson
20b, lnformanrs Mailing Address (Siree!, ctty ftown, state, zip code)
2800 Larkin Road, Boothwyn, PA 19061
21b. Date of Disposilion (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 21d Location (City I town, stale, zip rode)
Evan E.
21a. Method ofDlsposilion
o Burial 0 Removal frocn State
D Other Specify:
22a. Signature ofFLlneral Service U
Stauffer, Jr.
: [.;l Crnmatlon D Don"'on
. Was Cremation or Donation Authorized
: by Medical Examiner I Coroner'?
nact1n such)
Schaefferstown, PA 17088
Evans Crematory
22e. Name and Address of j:."acillty
FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
. ~
23b. license Number
Comp!ete Items 23a-c 0fI1y when cert 9
physician is 'lot availab!e attirl''8 ofdealh
certify cause otdeath
Items 24-26 must be comp~te:l by person
. who prnnouncesdeati'1.
25. Date Pronounced Dead (Monlt1, day, year)
4~;{) PM J-u./'I 2'"",,2u'Lp
CAUSE OF DEATH (See Instructions and examples)
Ilem'lT. PART I: Enter the d:~- diseases, inJw;es, or complications - that direcUy caused the death. DO NOT enter terminal eV€llls such as cardiac arresL
respiratory arrest, or ventriculaf fibrillation wilI1oLJ! showing the etiology. List only one cause on each line
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23c. Date Signed (Mol'lt'1, day, yeer)
Approxlma(einlerval
Onset to Dealt1
Part II: Enter other sianifir.ant conditions conlribuliflQ llld..e.atI1
bulnot reslJl~ng in the underiying cause given in Part i
26. Was Case Referred 10 Medical Examil'ler I Coroner for a Reason Ql/'ler than Cremation or Donation~
Dves ~No
24. Time of Death
</~
SequBntiaily ~sl Cf?rlditions, ;f al1Y,
~~'1~ ~~~~~~ ~~U:5E
(disease cr injury thalinilialed the
events resultmg lrl death) LAST
Due to (or as a consequertce of)'
E~d - \-7:Ap
Due to (or as a oonseqllence of)
r.- (7 /I.<..v.-"'''' /,Ji, 7
DlIe to (or as a conseqllence of)
t WereAutopsyFindings
AvailableprlOr~Compl , n
01 Cause of Death?
DVes No
31 Manner eath
Nalurai 0 Homicide
o Accident 0 Pending Inves~gation
o Suicide D COLlld Not be Determined
32d. Time of Injury
32g Location of Injury (Slreel,cityltown, stnte)
Dyes
M
338. Certifier (check only Ofll~)
Certifying physician ~Physician certifying cause of death when another physician has pronounced death and completEd Item 23]
lothe best 0' my knowledge, death occutTlld due to thoC8use(s) and manner BB stato9_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~~Ot~:u~~~~,a: ~1~:~:~~,hJ:~~~a~~~~~~~ ::ti%~~=,;n~e~~c:~da~~;t~t:u:uo~e~:)~~d manner as stat~(t _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -D
~~~:~~~ism~f:~~~f~~~:~ and lor investigation, In my opinion, death occurred at thl'l timl'l, data, and place, and due ~o the cause(s} and manner as stllt!Q. _ -D
Not pregnant within past year
o orcgnantatbmeofdeat~
o Nolpregnant, butpregni'lnt within 42 days
ofdealh
o Not pregnant, but oregnant 43 days 10 1 year
aldeath
o Unknown if pregnant within the Dast year
32c. Place of Injury: Home, Farm, Street, J:actory
Office Building, etc. (Specify)
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Signed (Month, day, year)
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34. Name and Addresp 01 Pernon Who Completed C8I}se of Dea~ (Item 27) Type iJ;jint
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foJl,ST WILL AND TEsrrAG1E~N'I
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and disposing mind, memory and understanding and capable of ~e-eghnp: ~
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df'ed or contract, do heret)y make, publish and declare this i~55lJment:1,()
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my Last i~jill and Testc:ment, hereby revoking and cancel1ing all rcrmer~ills
SARA B. STAUFFER
, SiIRA B. STAUPPER of Baltimore County,
and coc:Jjcils by me at any time made.
I direct my Personal Representative to
or caU:3e to [)e
and satisfied all of my legal dellts and the expenses of my 1:1St j Ilncsc;,
funeral and interment in such amounts as he may deem to t)e oY'oper, a,=; soon
my death as may be practicable. MY said Personal
tive i:=; authorLzEd,
ancl din?cted to incur such bills and expenses for my funeral ('md
interment as in tlis di,3cretion are proper, without reg,'ITd tr) any Jimitatton
imposed
law or rule of Court in force at my
domici LEe; at the time
my death. Further, I d:lrect that my Personal Representative pay Ot:t of DW
re:3icluary (?~;tate, 'vvithout apport;ionment, all estate ,inheri Lance and J :Lkc
taxes iffi[)osed by the government of the United States or any sta.te or tccrri
thereof in respect of all property required to be included in my [TOSS esta
for estate or like tax purposes by ('my such government~) v!heiher tIle
Dasses under this Will or othenvise, without any contribution any
of any such property.
SECOND: I
, devise emd
(111 the rest, residue and
of my estate, property and effects, real,
and mixed, whatsoever and
vvherever situate unto rry children, EVAN E. ~)TjlJ]}'F'ER, Jri. and CNile ::;rI'J\IT'FL':Fl,
in equal pelctS, shan? and share alike, absolutely, cmd in fee ie providec]
that they shall sLlrvi ve me by ninety (90) days, in the event that t'i thET' chi lel
shaH not survive me by ninety (90) days but shall leave a cni lel or children
dho do sur-vi ve me by ni:1ety (90) days then sa:i d chi ld or chi lc:lren ,"haJ 1 take
the deceased parent's srlare, otherwise, if there be no
child or
,,:hildren, my surviving child shall take the whole.
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'rHIRD: In the event my chHdren shall not survive me bV ninety (90)
days, and my children leave no ch:Ud or children who ;3urvi'Je me
ninety (C1O)
days, emel I would otlJEcrwise die w:L thout a direct decendent, I then mak{? tlle
following charitable bequeath, by giving, devis
, mid
all t'ne:
rest, residue and remainder of my property and effect;:;, real, persona! and
mixed, whatsoever Cli1d wheresoever situate unto the BE'IHAJ.JY VILL/\CE RETIREME:rJT
CENTER, .vlechEmicstJUrg, Pennsylvania and the LERA.NON Vi\LLEY C:OLLEGE:, Annvillc?,
Pennsylvania, their Sl:ccessor or successors, in
, ::shan" and sr,arc'
alike, absolute ly, and in fee simp Ie.
FCJlJR'I'H: r hereby nominate, constitute and
'[LY som;, mr}\!! I':.
STAUPFER, JR. and Dt\VID M. STAIJFFER, to act as Personal
s Crt' this,
my LAST 1:JTLL M.JD 'l'ES'l',Lt\0F:i\JT, and expressly request that
be
from tl1e
of giving bond. I hereby give my Personal
sentatives flll r!c)ipjer
Cli1d di sccetion in the management and control of my e;3t;ltco, , rerscna 1, mld
mixed, with the rirpt and power to sell all, cw any thereuf, \~hich they
or he may deem advisable or necessary for the payment debts or the
advantageous settlement of my estate, without thE'
of' [nak
C3ppli -
cat ion tc, or of obtaining the approval of any Court; and nc) purchaser f'rom
my said Pecsonal Hepre;:;entatives s.ha.ll be under any obl
to seec
the
application of purchase money.
'rES'TIIV[ONY WHEREOF, I have lxcreunto set my hCli1d axd ~)eaJ to 'JJ1
my Li\2'l' WILL tWD TE<:STlUvlEN'T,in Westminster, fV'aryland, this---,__~___ elf
_._--~-----=.---~-_.-
, 1981.
-.
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( SE~r~LI)
SJ\RP, B. STAUFFER
'TIle foregoing instrument, consisting of this Cli1d tWJ other
pages was siisl1ed, sealed, published and declared by SARA B. 5TAUFFm, the
nerein narred Testator as for her Last \11'111 and Testament, in our preserce
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and :in the presence oC' each other, we have hereunto suhscrtbed ()l;r nclJYJe,3 a:c;
attest
witnesses.
Address ,
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