HomeMy WebLinkAbout09-08-06
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Register of Wills of Cumberland County
PETITION FOR PROBATE and GRANT OF LETTERS
Estateof VVd!iu/'Y\ 6. It-rnp\e__ No. d)\ 6\0 tnC\,~
also known as To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Permsylvania
.. Deceased.
Social Security No. I Cj ,- 12. - C; ~ 2- '5
The petition of the tmdersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, and the execut(i(' named in the last will of the
above decedent, dated :=e b ['""Ii (i 0j I Li , .W- I q ~
and codicil(s) dated -
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in {I (,l I'll b ~ ,-.\ c.... nA
Pennsylvania, with h.t last family or principal residence at
laD l\i\t. AiIPI", Dr. Ili\e.L~'h'L.'.Jhu_r'1- PA i70'iS-
(list street, number an~ municipality)
Decedent, then.1L years of age, died I{ (.i.~k j l: ). I , 20~, at I ,J? q {7
Except as follows, decedent did not marry, as 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:
--
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
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: 0
<. I; G'. ()(.10
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$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and the grant of letters 125m I }f.k nt?u"ft/
estamentary; admlmstratlon c.t.a.; admmistration d.b.n.c.t.a.)
thereon.
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Register ofWnls of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
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SS:
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affmn(s) that the statements in the foregoing petition are true and
correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) of the above
decedent petitioner(s) will well and truly administer the estate according to law.
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Sworn to or affmned and stscribed
Before,.IJl~ ~ ~ day of
~ Y' , 20 fX..t,
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Registe~' .:(
No.
Estate of
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, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW g 's:'-i!: 2~, in consideration of the petition on the reverse side
herel?f}\satjlJf3ftory proof ha been presented before me, IT IS DECREED that the mstnunent(s), dated
V rt /b 0 ~ . ,described therein be admitted to pro te filed ofr~ M~llU
. rLA ; and Letters are hereby granted to fIne. cJ.
FEES
Probate, Letters, Etc. .............
Will ........................... ......
$
$
$
$
$
Automation Fee................... $
Bond........................... ...... $
q 1~1- 20tf!J; $
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Renunciation.................... ...
Short Certificates G:> ... ... ... . . .
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Thi~ h to certify that the information here given is correctly copied from an original certificate of death dul:, filed wilh me ~i'
Loc~d Regi'>lrar '1'1... ()riginal cerl1fiL'ate will be for\varded to the State Vital Records Office for pernl~llk'llt fi li1g.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATEI'ILE NUMBER
1 Rev,01/Q6
PRINT IN
AANENT
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, Name of Deceden\ (First, middle, last) I' Sex 13 Soo,,1 S""" Nu","" I' 0,,, 01 O,,'h (Moo'h, d,y, y,,')
\0: \\'<J...<<' ~ ~,"'-~\~ \~\ I q \ - 1.,1 - <;:S 4;01 \ 0'8 -9\ -.,2()O(.,
5 Age (Lasl birthday) 16 Under 1 '" Under 1 day 7 DaleolBir1hMonth,d~ar 8. Birtholace Citvand stale or forei ncountry) Sa. Place of Death Check anr. one
C\\ I Months Days HOUIS 1 Minutes \ 1\ -..)C) - \ C\ \ <4 IGreensburg, PA I Hosprtal I Other
YIS o Inna'tienl o ER/Oul alien! o DOA LJ/N~rsinn Home o Residence o ();h", Soeci~.
Bb. County 01 Dealh Be City. Bora, Twp of Death I ~. ~ :m~n;s:;,u,:gt~''''vd ;unmn ~ '1 ~ g. ~sN~ec~en~z~ ~1~s::;~~~~~n~Uban. 10. Race: American Indian, Black. Whrte, ale
~ (Specify)
Cumberland Upper Allen Twp. Me~ican, Puena Rican, etc.) Whi te
~
11 Oecedei1t's Usual Occuoation Kind of work done durinn rmst of workin life: do not state relired 12 Was Decedenl ever in the US 13 Decedent's Education Snecitvontvhi ties! radecormletedi 14 Marrtal SIalus: Married, Never married, 15 SUfVrving Spouse (lfwlle, g've maiden name)
~ School "1"~~~~er I Publt~ol~~t'1~~l'Y Armed Forces" I ElementaryfSecondary(O'12) 15+ eoltege(1-4 or 5+) Widowed, Divorced (Specif'/J
~ Yes o No Widowed
; 16 Decedent's Mailing Address (Stree!, crtyltown. state, zip code) Decedent's t'A Did Decedent Upper Allen Twp.
100 Mt. Allen Dr. Actual Residence 17, Slate Lrveina 17c. Q{ Yes, Decedent Lrved in Twp
Mechanicsburg, PA 17055 I7b. Coun~ Cumber land Township?
17d.O No, Decedent Lived wrthin
AclualLimits of CityiBoro
18 Father'sName{Firsl,middle,lasl) 19 Mother's Name (Firs!, middle, maiden surname)
Alfred J. Temple Ella E. Shugar
20a.lnlormanl'sName(fypelprinl) 2Ob. Informant's Mailing Address (SIleel, cityltown, stale, zip code)
Lynne Mahood 303 W. Elmwood Ave. , Mechanicsburg, PA 17055
! 21a Melhod.ofDiS~ 21b. Date of Disposrtion (Monlh, day, year) "0 PO" ~' Ol<posrtrin {N,me 01 "me','Y. "'melo'Y 01 o!h" pl"'1 I"d L",,'rin (C"^,,,n, 5"", z. cod,)
o Burial rernation o Removal from State o Donation AUgust 24, 2006
'T. o Other. Specify: Holllnger Funeral Home & Cremat on Mt. Hollv SDrinQs PA
- '~;'.L.7;/~in:~ 1;~~o;~ ;u7 1220. Name,"dAdd'essolF"ili~ Myers-Harner Funeral Home
- 1903 Market St. Camp Hill PA 17011
Complele lIems 23a-<: only when certilying 23a. To the best of my knowledge, death occurred at the time, date and place stated. (Signature and title) 23b. Licensl~Number 23c. Date Signed (Month, day, year)
physician is not available at lime of death to
certily cause ofdealh
- 1\ems 24-26 must be completed by person 24 Time of Dealh 125 Date Pronounced Dead (Month, day, year) '6 Was Case Referred 10 a Medical Examiner/Coroner?
- w110 pronounces death 1'33 0 M g- d I - d. OD Co ~~Yes o No
CAUSE OF DEATH (See instructions and examples) : Approximate interval Pari II: Enterolher~ditionscontributinatodeath, 28 Did Tobacco Use Contribute 10 Death?
l1em 27 Part I Enter the chain of events - diseases, in/llries, or co~lications -thai direclly caused the death. DO NOT enter terminal events such as cardiac arrest, 'onsettodealh but nol resul1ing in the underlying cause given in Part I DYes o Probably
respiratory arrest, 01 ventrcular fibrillation without showing lhe etiok)gy. DO NOT abbreviate. Enter only one cause on a line Q"No o Unknown
IMMEDIATE CAUSE (Final disease or tJ ylJZ U ryl 011/ C1 :;? >i'PC I<s ..(;'iI /1)((' !n '-/1i i , vI' clL<o/' 29 If Female
cond~ion resulting in death) -7 ,. D"'f..lol pregnanl wrthin past year
Due lo~or as a consequence 00 fo cU. nU' YJI7 H 0/- o Plegnanl at time of death
Sequentially list condrtions. ii any, b --- o Not pregnant, but pregnatlt wrthin 42 days
leading 10 the cause lisled on Line a Due to (orasa consequence 00 A 1:c11t'11/II?r 5 +r.i /I.e of death
- Enter the UNDERLYING CAUSE
(diseaseorinjurylhatinrtiatedlhe 0 ,~--'- o Not pregnant, butpregnanl 43 days 10 1 year
. Due to (or as a consequence 00 (erCh,'otVtis'C&,!tU t1';("C/(C before death
events resutling in death) LAST : o Unknown if pregnant wrthin the past year
d.
30a. Was an Autopsy 30b. Were Autopsy Findings 31 Manner 01 Death 32a.Dateoflnjury(Monlh,day,year) l32b. Oesc,ibe how InIU'Y Qocu""" 320 Place of Injury: Home, Farm. Street. Factory, Office
Per1ormed? Available Prior to Completion t:Yffa.tural o Homicide Buik:ling, etc. (Specify)
of Cause of Death?
DYes Q" No DYes Mo o Accident o Pendinglnvesligalion 321 32g. Location (Street. Cityll.OWfl, slate)
32d. Time of Injury 13".,nIU'Y"WOI" If Transportation Injury (Spec#y)
o Suicide o Could Not Be Determined DYes 0 No o Driver/Operalor o Passenge'
M o Pedestrian o Other - Specify'
33a. Certifier (check only one) 33b. Signature and TiUe of Certifier
Certifying physician (Physician certilying cause of death when another physician has pronounced death and completed Item 23) c;f ~~;{~u11f}
To the best of my knowledge, death occurred due to the cause(s) and manner as stated ............. .......n...... ...................,........ ......... ........0
Pronouncing and certifying physician (Physic~n both pronouncing dealh and certilying \0 cause of death) m..m......~ 33c. LicenseNumber 33d. Date Signed (Month, day, year)
To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner as stated...... .. InOi/d~ rile;
Medical examlnerfcoroner
On the basis 01 examination and/or investigation, In my opinion, death occurred at the time, date, and place, and due 10 the cause(s) and manner as stated ........0 34 Name and Address 01 Person Who Completed Cause of Death (llem 27) Type/Prinl
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35~'~is~","..e" ..< I~I 11""<'1/ ( 136 ;7:/:;/;;~ /00 /)) T ,4LLG IV M /vc I 70 ",,;:
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(See Instrucllons and examples on reverse)
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WILLIAM G. TEMPLE
(:)
I, WILLIAM G. TEMPLE, a citizen of the United states,
and a resident of Pinellas county, Florida, being of sound and
disposing mind and memory, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking any other
Wills and Codicils by me at any time heretofore made.
FIRST:
I direct that all my legal debts and
liabilities, including funeral expenses, be paid out of my estate
as soon as practicable after my death, provided that such debts
and liabilities should first be paid out of the assets of my
Living Trust as described herein below, if such Trust is in
existence at the time of my death. Such debts and liabilities
shall be paid out of my estate only to the extent that the assets
of my Trust are insufficient to pay the same.
SECOND:
I devise certain personal property to my
beneficiaries in accordance with a list which I shall draft and
sign after the execution of this Will. Such separate instrument
is made in accordance with Florida Statute 732.515 and is
intended by me to be a complete andflnal disposition of the
property named in such separate instrument to my beneficiaries.
If no such list can be found as of thirty (30) days after the
PAGE ONE OF A SIX PAGE WILL
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date of my death, then all personal property which I own at the
time of my death shall become a part of the residue of my estate
and pass according to the residuary clause of this, my Last Will
and Testament.
THIRD:
All the rest, residue and remainder of my
estate, both real, personal and mixed property, of every kind and
nature and wheresoever situate, of which I may own or have the
right to dispose of at the time of my death or thereafter,
including the proceeds of any insurance on my life payable to my
estate or Personal Representative, and including any Powers of
Appointment in my favor, I give, devise and appoint to that
REVOCABLE LIVING TRUST, dated
\ '
___;t, [.
.......... . -~ "- . ..
/{
, 1993, of which
my wife and I are the Grantors, to be disposed of in accordance
wi th the terms of said Trust and any Amendments thl~reto executed
by me at any time prior to the execution of this Will.
FOURTH:
In the event that the aforesaid Trust is not
in existence, or is, for any reason, unable to receive any assets
passing under this, my Last Will and Testament, then I give,
devise and appoint all the rest, residue and remainder of my
estate, of whatever kind or nature and wheresoever situate, which
I may own or have the right to dispose of at the time of my death
or thereafter, including the proceeds of any insurance payable to
my Personal Representative and including any poweI:S of
appointment in my favor, I give, devise and appoint to the
beneficiaries of said Trust, in strict accordance with
PAGE TWO OF A SIX PAGE WILL
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dispositive provisions of such Trust, and any Amendments thereto
executed by me at any time prior to the execution of this Will.
FIFTH: If my wife, MILDRED M. TEMPLE, should die with
me in a common accident or under circumstances which make it
difficult to determine which of us survived the other, then it is
to be presumed that I survived my wife and the administration of
this estate is to be in accordance with that presumption.
If any beneficiary named herein, other than my wife, fails to
survive me for a period of ninety (90) days, then it shall be
presumed that for the purposes of this, my Last Will and
Testament, that such beneficiary predeceased me and the
disposition of the assets in my estate shall be made in
accordance with such presumption.
SIXTH:
If, at the time of my death, I own any
property jointly with any other person or persons, as tenants by
the entirety, as joint tenants with right of survivorship, or
which is payable to either co-owner or the survivor of them, then
it shall be conclusively presumed that such property was owned
jointly and such property shall pass to such person or persons as
a result of their survivorship, and shall not be considered a
portion of my probate estate.
SEVENTH: I make, nominate and appoint m~ wife, MILDRED
M. TEMPLE, as Personal Representative of this my Last Will and
Testament. I request that my Personal Representative serve
without bond and I expressly give and grant unto my Personal
PAGE THREE OF A SIX PAGE WILL
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Representative full power and authority to sell any or all of the
assets of my estate without notice and without order of any
Court. In the event she does not survive me, or in the event for
any reason she does not qualify as Personal Representative of
this Will, or having qualified shall fail for any reason to act,
then and in such event, r hereby appoint my daughter, LYNNE T.
MAHOOD, as Alternate Personal Representative of this my Last Will
and Testament.
EIGHTH: Without limitation of the powers bestowed on
my Personal Representative by statute, common or general rules of
law, I authorize and empower my Personal Representative in the
administration of my estate at any time and in my Personal
Representative's sole discretion to sell, mortgage, or otherwise
encumber without notice and without order of court any assets of
the estate including any real or personal property belonging to
my estate and to settle any claims, either in favor of or against
my estate, as to which my Personal Representative shall deem best
to retain any stocks, bonds, notes, other securities and other
property, real and personal, without liability for any decrease
in value thereof, and to execute any and all proper and necessary
deeds, conveyances and receipts. All powers bestowed on my
Personal Representative shall be applicable to any successor
Personal Representative, acting hereunder to the same extent as
though expressly named herein.
IN WITNESS WHEREOF, I, WILLIAM G. TEMPLE, have hereunto
PAGE FOUR OF A SIX PAGE WILL
II L1/-
set my hand and seal in Pinellas County, Florida, this day
of
February
A.D., 1993.
A. / .. ~. . . / / l. .
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WILLIAM G. TEMPLE / ~
( SEAL)
The foregoing instrument was on this JL) day
of
February
A.D., 1993, signed, published and
declared by WILLIAM G. TEMPLE to be his Last Will and Testament
in the presence of each of us, who thereupon at his request and
in his presence and in the presence of each other have hereunto
subscribed our names as witnesses this day and year last above
written.
/J11M
residing in
Palm Harbor, Florida
(Y'Le~I..Jfl..L~c_reSiding in
Safety Harbor, Florida
STATE OF FLORIDA
COUNTY OF PINELLAS
We, WILLIAM G. TEMPLE, the testator and
Mark W. Brandt
and
Melissa H. Nelson
,
witnesses respectively, whose names are signed to the attached or
foregoing instrument, having been sworn, declared to the
undersigned officer that the testator, in the presence of
witnesses, signed the instrument as his Last Will, and that each
of the witnesses, in the presence of the testator and in the
PAGE FIVE OF A SIX PAGE WILL
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presence of each other, signed the Will as a witness.
WILLIAM G. TEMPLE
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Testator
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Witness
rJ~D~
Witness
STATE OF FLORIDA
COUNTY OF PINELLAS
The foregoing acknowledgment was acknowledged before me this
ID-+hday of Februarv , 1993 by WILLIAM G. TEMPLE, the
Testator and by
Mark W. Brandt
and
Melissa H.Nelson
, the witnesses, who are
personally known to me or have produced d Yl vef (5 _I. e.en~e
as identification and who did/did not take an oath.
'-Cl~ '-(y\ .~~
Notary Public
My Commission Expires:
OfFiCiAL NOTARY SEAL
DAW~.J M ;vlM:VIN
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO, cco,m26
MY COM MIS310;-'; EX!', OCT. 20,1994.
PAGE SIX OF A SIX PAGE WILL
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Frazer
Hubbard
randt
Trask
L.L.P
Attorneys At Law
JOHN G. HUBBARD
MARK W BRANDT
, THOMAS].TRASK
*RICHARD A. ALEXANDER
LYNN A. BRAUER
June 11, 2001
1\1r. & Mrs. William G. Temple
4833 E. Trundle Road #512
Mechanicsburg, PA 17050
Dear Mr. & Mrs. Temple:
Enclosed please find the original Wills which you requested. If I can be of any further
assistance, please advise.
Sincerely,
FRA~~~~& TRASK, L.L.P.
MARK W. BRANDT
MWB/dp
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Post Office Box 1178
595 Main Street
Dunedin, Florida 34698
Telephone 727-733-0494
Fax 727-734-9581
'Fax 727-733-2991
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