HomeMy WebLinkAbout12-18-06
Register of Wills of Dauphin County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Ruby L. Lineaweaver
also known as
No.
~ \ () U> \ \~O
, Deceased
Social Security No. 180389049
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
GJ
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix
Decedent, dated March 10, 1994, 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.I.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:
r Name Relationship Residence I
Sherry R. Porter dauahter 257 Three Sa. Hollow Rd.
Newbura, PA 17240
(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 265 Three Square Hollow Road, Newburg, PA 17240, Hopewell Township
(list street, number and municipality)
Decedent, then 58 years of age, died December 8 , 2006 ,at Chambersburg Hospital
(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 ........................................................................................ $
Total..... ................... ... .... .......................... ................ ........ .... ..................... ......... $
<~'J<O .
---
'?:;;.(?JO([,) . .~
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition an~'!re grant of l&tirs in
the appropriate form to the undersigned: '':::; ~
-. ~ ~-..' ,..
Typed or printed name and ~,idjnce ~
,~-.. r-
'> 2:7
0')
RW-7
Oath of Personal Representative
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) an}! a!)_~s personal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate - ing,!? laW: r).
before me this
Sworn to and affirmed and subscribed
\<:6
day of
DecemberL 2006
~~ ~\I1~~\ ~, l il
~l(/'-'
n
Co
.,~.~
:::to
.~~~:; h
"~ :-->') 5~
':,'~O.
r--;)
C.::>
~J
C7'
o
rq
c->
.~'J
fl ~~
."\ f .~;
ee
-0
-; ('''J
. -_.;~-~
-~
.,:~ S.~~
Estate of Ruby L Lineaweaver
DECREE OF REGISTER
No.
also known as
Deceased
c...j
::::'1 ,. """'"
.' J. \ ~ \ ,J:O"
Social Security No: 180389049
AND NOW, i 8' Oirru'nLlf/\
on the reverse side hereon, satisfactory proof having been presented before me,
Date of Death:
,~:t~
, in consideration of the Petition
IT IS DECREED that Letters ~ Testamentary 0 of Administration
(c.ta.. d.b.n.c.t; pendente lite; durante absentia; durante minoritate)
are hereby granted to Sherry R. Porter
in the above estate and that the instrument(s), if any, dated March 10, 1994,
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters.........,............,............ .
Short Certificate(s) ...............
Renunciation ..........................
~(
) ....\.~>....J\........
Extra Pages (
)............. .
Codicil.................................
.~ (~JD
JCP Fee .................................
$
Inventory & Tax Forms............. $
$
Other.......................,............. .
TOTAL .............................$
RW-7 A
$ 6b.OO
,)0 . dJ
$
$
$
$
$
IS' _ 00
\ . \ ()
\0~' '~.
Attorney
JS .00
Attorney: William P. Douglas
I.D. No: 37926
Address: 57 W. Pomfret St
Carlisle, PA 17013
Telephone: 717243-1790
DATE FILED:
~ .00
11 i1)5YI):" RE\'
WARNING: It is illegal to duplicate this copy by photostat or photograph.
IrClm an original certificate of death duly filed with me as
Stal: V 11a] Records Office for permanent filing.
~ \ D lo \ \00
This is to certify that the information here given is correctl:. u
Local Registrar. The original certificate will be forwarded \( th~'
~4!-
Fe!: for thiS certi ficat.:. S6.UO
'\) ().
f)k, I~ 7-08/;
Date
P 12996448
v~.
6/]6/48
Sa. Place of Death Ched:.onI one
Haspitlj
[]In.''',,' DER/OulpaIierrt DDOA DNursingHome
Q. Was_ofH"",,*,0rigH11 [ilNu DVes
(If yes. ."...;ty Cuban,
Chambersburg Hospital _.Puerto Riam.el:.)
12 WasDecod.rrt""".lhe 13. Decod.nlsEducaIoo(s"edfyonly 19hest~compIeIed) 14. MailaISlalus:ManIed,NewrMenied.
u.s Anned Fu"",,1 EOm.nlBry I Secood'"l' (~12) CofIeg. (1-4 '" S.) -. - (SpedIy)
Dves [ilN<> 12 Widowed
~""" 17..Stale Pennsylvania :~nl 17,. GlVes._lNoclin Hopewell
Township? 0
17b.Counly Cumberland 17d. ::-"'~ofUwd""n
7. BirIl ace
a'ldstateor
()
C-::;o
. '. :::0
..',~~
}!S~A
)C
.....,
c;:)
=
er-
a
P1
CI
:::I:J
:"
C')
<.-:J
.D
C~J
ri:~
'--'
CD
Hl05.143 REV. 02/2006
TYPE / PRINT IN
PERMANENT
BlACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
')('J
I -'-r-,
-'n
i:-=:l
iT'1
Ruby L.
5 Age(LaslB01hday)
'1
6. Date of Birth Mont1. d
58
Newburg, PA
DResidence DOlher.Sj>eci\y:
10. Ra:;e: ArnericrI'llncli~, Block, White, etc
(SpedIy)
White
ao. Coon~ of Dea\tl
Bet Fac:ilityName (If 001 ilstilution, give sieelar'ld nurnber1
o
~
~
Franklin Chambersburg
11. Decedenfs Usual Occu lion nd of work OOne durin rrut of life. 00 not stale retired.
Kind of Work Kind of Busiooss f Industry
H th Benifits Adv. Carlisle Barrick
. 16. Decedenfs Mailing Address (Street. city I town, state, zip code)
265 Three Square Hollow Road
Newburg, PA 17240
18. Father's Ncrne{First,middle,last,sufflx)
Cyril R. Cassner, Sr.
208, Inlorm.,rsName (TypefPrint)
Sherry R. Porter
218. Method of DisposKion
D Burial 0 RemoveI from Stale
o Other . Spodlf .
22a. Funeral
Twp.
~
CilyiBoro
19. Mofhel's""", (F0"St, _. ma;den suman-e)
Violet D. Franklin
2Ob. lmml.....MelIngAdd,..,(S1l8eI,clly/_._.,.,_1
257 Three Square Hollow Road,
21,. Place of Dispositilll (N8IIlOof....-y. aemmy"'_plecel
Newburg, PA 17240
21d.looation(Cily/_._,zipcodel
~r:::~~~~=dBecme~
M.
CAUSE OF DEA T1i (SM lnatructtona and .)lampl..)
ltemll. PART I: En1efthe~.digeases,iljtJlas,orCOfT1llicalions-thatdir9ctlycaJSedthedealt1. DONOTenferlBrminaleventssucl1asClllliaclWT8Sl.,
RlSpiratory arres~ or ventricula" fibriDation wiIhoul showing the etiology. List only one caJSe on each line.
{r)(J~t.> TN6 flC('<l f 'fA /L 1JV:6
ft-rJ { {or ~1f1~
-..."":
Onsello Dea\tl
Smithsburg, MD
Home, Inc.
17257
ir(rl~ JjJbl
26.._;;- _Ill - 'T"""" lC'J"'?"fllr. ReesonOlhe,1lJ"lCremeOOn ",Don_?
~ves DNa (np"f)~f .c2'-1jw$.
PartlJ:Enlerolher~mncitilm;aDrb.JtiootJdelih 28. DidTobao::oUseContrlbuteIoDeath?
bulnof_tingillheundeltyilg"""giwlnilPa11. 0 v" DProl>al;y
ON<> ~n
29. W Female:
o Not pregnllll. within pest year
o Pregnantel lime ofOeelh
o Nell pmgnan~ but preglUllt wlthln 42 days
ofOeelh
o No1pmg""'lbutpnlgOen143daysIo1yea<
ofdaath
o Unknown d pregnarrt within the past year
32c. Place of 1njlJf)': Home. Farm, Street, Factory,
0IIce!ll;~"<l..< (SpecIIy)
fftA L rNLI/{?&
cSf1&tlftGo fiI,)>lt.."'1fOrl
Comp"" 1_ 230< only when cen;ry;eg
physDiIIl is not available at timed death to
certify cause of death.
11ems24.26_be~by"""""
who pronounces death.
~
:\lJllnlially istoondilons, if lilY,
Ent~"i:~ERl~':~~
(disease or injury IIlat initialed the
events resulting m death ) LAST,
Due to (or 81 & consequence af):
b corp ( Ptv<'V~
Duet:o(orllS8CXl1l5flqLJElnce .
Due to (or as II consequence 01'1'
d.
321. nr.............,..,(SI""M
Dl>Ne</o"emto< Dp....nge<
M. DOlher.SpecKy
33<0. Certifier (check ooly onel 331>. S91
CerIlfyIng phyoi~on (PhYS"'"'" certiIying "'"'" of death when 181_ physicien has pronoonoed deel11 end com~eted 110m 231 ~" I
Totttt t.t of my knowltdgt,dHth oceumddlHltottl'~Ule('l.ndmlnlttr..~_ ___ __ _____ __ _ __ _ __ ___ _ ___ _ _ _ ____..D 0", /
Pronouncing ,Ad c;erUfytng phylk:lan (Physician tJoItl pronouncing deaIh and certifying to cause of death) r# 33c;, f1j Num 33d Dale Sla,ood ~!'J.7' 1
T.'" be.. of my Imowledge, _h..............ti.... -. .nd pIece,ond duolo...ceuM(olondmonnero..1eIa<\. - n nn___ -- C ----..IQ ", r7 (/2 3 S"'2 S- . {P((O () :1='6
MedIc.1 Eumlnerl Coroner ----'/ '1
On the _is of ex.mlnatIon .nd/ or InY8ltig.tlon. in my C)9lnk)n, deet ITId .1 the t1mt, dJte,ancI place,.nd due to th. cauN{l} and manner -at8tfcL_..D 34. N~Addres5 of PeISOl1 Who CompIet8d Cause of Death (Item 27) lype I PriIll
35. Regislno's Sig"alu~ and O.1ncI Number , <'7 I "7. ( s-; 36.. ,." (Month, day. yo,", H.f? rJ j:" oj I,) ,(<" 1. J,4JJ!l J t' tZ.
~ ILlI I ~ I I 2C(;J Chambersburg, PA 172Cfj
(See instructions and examples on reverse)
Dv" DNo
31. ~7ofDeath
izI Netuflll 0 Hu_
0_1 0 PendlnglnveellgeOOo 32d. Trne of 'iury
DSUIoIde DCouIdNofbeDelermined
32g. Incation of injuy (Sbeel. cIIy 1 town. stalel
Dves \iN<>
3Ob, WflffJAutopsyFindings
AveleljePria.CorrI>letioo
of Cause of Death?
3Qa, Wf!J5MAutopsy
Perlonned1
1U? cl!t t ~lll i.f I clttu &Q} t JJt cutttttt
OF
""
~~~~
,,:::,;}..,
RUBY L. LINEAWEAVER
co
I, RUBY L. LINEA WEAVER of Hopewell Township, count~;sgf J?
Cumberland and state of pennsylvania, being of sounq:":and (;'1
disposing mind, memory and understanding,
1"-'
0"
do hereby make,
publish and declare this my Last Will and Testament.
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, of
whatsoever nature and wheresoever situate, I give, devise
and bequeath to my husband, JOHN N. LINEAWEAVER, absolutely
and in fee simple.
3.
In the event my husband should predecease me or die
within thirty (30) days from the date of my death," I give,
devise and bequeath my entire estate, of whatsoever nature
and wheresoever situate, to my children in equal shares.
- 1 -
4.
I nominate, constitute and appoint ORRSTOWN BANK, to be
the guardian of the estate of any of my children who are not
of age on the date of my death, and direct that said
guardian in its sole discretion apply principal as well as
interest for the maintenance, education and support of such
child or children when the same is in his or her best
interest without the necessity of petitioning the Orphans'
Court for permission to make such expenditures; I direct
said guardian to take possession of all insurance or annuity
contracts on my life to which said minor or minors are
entitled and any and all pensions or death benefits from my
employer or from any society or organization of which I am a
member, said proceeds to be added to the share of each child
under this will.
5.
Lastly, I nominate, constitute and appoint my husband,
JOHN N. LINEAWEAVER, to be the Executor of this my Last Will
and Testament, and in the event he is unwilling or unable
for any reason to act as such, I nominate, constitute and
appoint my daughter, SHERRY R. LINEAWEAVER, to be the
Executrix of this my Last will and Testament in his place
and stead. I further direct that no bond or other security
be required of my personal representative to guarantee
faithful performance of his duties.
- 2 -
IN WITNESS WHEREOF, I have hereunto set my hand and
seal this 10th day of March, 1994.
)
,j .'
hi' It I / }'/~;' I ( I , > ',_-,( SEAL)
. ~U:; L..Li~~aWea~er
Signed, sealed, published and declared by the above-named
RUBY L. LINEAWEAVER as and for her Last Will and Testament, in
the presence of us who have subscribed our names hereto as
witnesses, at her request, in her presence and in the presence of
each other.
:.. h,,-
- 2 -
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
C-'V~\...A~\ COUNTY, PENNSYLVANIA
Q.. ,,\, '~ L. L; '\-'< C_""Q,^~
~U"''' L:, . L;"..,^-\...~ and ~~~ Q...l \M!1>~~Qo~
(each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well-
acquainted with ~~'\,.... L . L \' ^~ tr...~r and am/are familiar
with the handwriting and signa~e of the decedent, and that the signature of ~~____ l. l~ C\.Q",~~
~
Estate of
, Deceased
to the foregoing instrument purporting to be the Last Will and Testament/8uJ~La of
~ v~ \.-, ~ w. ~""",....r is in..../her own proper handwriting.
#~.~~
(. ure)
'3,3l~t.J 2-'"-:.: N
(Street Address)
7
C if >'? '.,..~ .1
(City, State, Zip)
UT
8 70 IS
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this \ g day
of ~~ ,~
,--,
c:::;o
->>
-~~
~j)~
.CJC)
<:;:2-n
'~S
t"->
=
=
<:T'
C':l
rq
(""'")
-."
...;:--
, ,
., r~ :=1
'!-"! ~~,.~$
'.,~l
~;~3
) c>
1 "--T"1
, "r)
"., ;:~~
~j-) I..~)
0:>
~~
Deputy for egister fWllls
-0
':-?
N
0'
Form RW,04 rev. 10.13,06