HomeMy WebLinkAbout05-03-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~ m bpl-[tLvut COUNTY, PENNSYLVANIA
-
Estate of
AVln{\
}-\-u Vl~ k
File Number
if! - 07 - Ol./3D
also known as
, Deceased
Social Security Number / 9 to - I~ ~ 677 P
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
~... Probate and Grant of Letters Tes~ame'ltary and aver that Petitioner(s) is / _ the E k ec: u..-t-V,'""'-I AtL.e-
last Will of the Decedent dated 9 / I q 1 <? ~ and codicil(s) dated
named in the
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted a
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
i"....,J,
(State relevant circumstances, e.g., renunciation, death of executor, etc.) C') ~S
, .........
r execution ~ ~ instrum~) offered
-T: (;] -<
"
D B. Grant of Letters of Administration
w
(lfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante:in#ior!t~te)
'~ N
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following Sp1J1J.s~1if any) a~eirs: (If
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) , " CO
~ :-: C_)
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Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
~~dent was.domiciled at death in C V- \1\.ll.a.dll:
(List street address, towlllcity, township, county, stale, zip code)
Decedent, then <i<'-X years of age, died on/O I ~ I~~ It> at
er last principal residence at J3 e. ~..'(, l:'--y
o 1I I
/3.e. ~ \--Lt....I Ca \(\(1_ ~A ~ \r
I..
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(!fnot domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
9.. ?() ()
$
$
$
$
situated as follows:
s +-0 cl' I Y\
~V\.S
~.
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:
S h '€...N'
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FO!?1l RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CAl riA ~Qtr lQ t1 c1
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 ofPetitioner(s) and that, as person rr=JJresentati~e(s) OfCthe De. cedent Petitioner(s) will well~d truly
administer the estate according to law.
- ~
SS
'.\-------
For the Register
Sworn to or affirmed and subscribed
before me the
3t-c:!
d-I -0'7-0480
Estate of A '/Il YltA !-/-U Vlc.--J~-a__ Y"; I<-
/9h- ~~OT?Y
, Deceased
File Number:
Date of Death:
10 ~- ~O (C"'
AND NOW,' f)(j)1 .in considmFaijeati n of the foregoing Petition, satisfactory proof
having been presented before e, I S DEC ED that Letters ~ .
are hereby granted to Shtr 1ft I Ann ttunr..hMi I( .
and that the instrument(s) dated~r 19, Iq~/.(
described in the Petition be admitted to probate and filed ofrecor as the last Will (and Codicil(s)) of Decedent.
lott,,, . q q q FEES $ L}5~ !li
Short Certificate(s) . . . . . . . . $ Q. ()() Attorney Signature:
~~ ..... ..::: :~:
~ ...$
~:::: '5.0)
... $
.. . $
.. . $
. .. $
...$ r; t7P
TOTAL .............. $ 3.
in the above estate
Attomey Name:
Supreme Court J.D. No.:
Address:
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Telephone:
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Form RW-02 rev. /0./3.06
Page 2 of2
H105805 REV 1/05 /'I_I . 07 -OY:30
This is to certify that the information here given is correctly copied from an original certificate of death 'auly 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.
~~Re;: Uf~
Fee for this certificate, $6.00
p
12910878
F.I 2 3 2806
Date
"'7
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/d - 2S- /~/ 7 .d~
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Hl05.143 Rev 01106
TYPElPRINT IN
PERMANENT
BLACK INK
, Name 01 Decedent (Fll'SI. middle. last)
ANN,if
5 Age (LaS1 birlhday)
Be
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIRCATE OF DEATH
/0 . Z 5 '.3 0
8 and SlallHlI
::T",.."",,;,.T,,,"","', P;'1
81:1. facllyName(lnolltsflulion.rjtiestreetanclM.VlDer)
STATE RLE NlJolBER
.. _..~-..,.-
//v/l/ C /1' -'f /Z. 1/<:
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7. Date 01 Birth
CV;'>?.Jt:,?<-4/V.cJ
C...,....,"'"
/:1/ <-<--
/0 - Z 0 .
z "'"' '"
8b County 01 Death
CoIeoe (1-4 or 5+'
0_ Do.....
10. RIca,Arnerartftliln.EIIict.'M*.*.
I~
/v.'7';"//:
,,--.-.-- 15 SummgSpouseIl....gioo-....1
-._(~
W;C)I<.../
A.- ".-v .e.
11 D&edent'sUsuaIQcc liOfl KindolwM:Oonedurin rroslolWOlk' lite:donotSUleteti'ed
~e:;;~;~ O~KnjOf~
16 Decedenl's Ma~ing Address (Slreet. ~1Iown. slale. z., code)
97 4/v6!..v /!ve' Ao'v.-e
C/V<ie.4, ?.-f / '7 J :l ",,-
c;.,/ZE
"" CounIy
:>"JefE./Z <-o4-;vO
:':.~ 17c.B V"._Uvedm C.
T~1
G',A.',~..a CrL &:
T"II
18 Father's Name (First. 1TiddIe. lasl)
JIZ.C 6- OR
20a. Inlotmanl's Name (Typelprinl)
lTd. 0 No.~lifedMlin
AcolIIlftsol
COy-
/7;7 .: ~ ~ ~"'...;..-v
19. ......s Name (Fist 1tidlIe. mailJen Stmimel
hct:-€,,-, 0", T<~ )
2011. _.MIing-(SIr....<iy-._...._J
/J.:?., <: C~~4,v
-SH€,2 ~4,
/~'" C'~-"'f"e./1I::
97 4',,{EN 4c." C~.'~ //?-? ,; 7oz";;-
2'c. Aoce"DisposIjon(Name"~,_or__
57 VL/~O/""/oL "5,7'&/
22<. ........-.....FacIIy
Coll1llete Items 23a-c only When eerlilyi1g
physr;ian is I'IOl availabfe allirne 01 death to
Cer1ify cause of dhlh
. Items 2.4.26 must be COll1lleled by person
who pronounces death.
/';)d~/C::R~ ,e""",U?' /--
o
w
en
~
~ :-
:::;
<(
2'
-E( ;9 M
CAUSE Of DEATH (Soe_.............l
Ilem27. Pan f: EnI8llhe~-diseases.~ies.0l'~ -1hatdirecllycausedlM!de8Ih.DONOTenIer~evenI5.sucbascardi;r;1fleSl.
respiralOty arres!. orventri;:ular Ib-illation wIhouI showi'lg the ~ioIooY. 00 NOT abbr~le. EnIer.OtVfOM taU5801l'-', )
IMllEDIATECAUSEIF...ld....." <t r,) 1"-. I.....~ .. J ""''' L . "'"' t) ,../1-- "' .
cond.lOn resllRrng rn death} --;.. a. ~ r.. ( r I _ t:
SequentiallylolcondOons.',"Y. b. DU<!~I"''''''''''_o~: p~,.!''''''1; v" 1....1'-- "'/;J ~"j l
_ :~:U":D~:~tdC~u~a. Dueto(orasaCOttSeQUenCeof)'
. (disease or irlfury lhat ingled lhe
evenls resullng in death) lAST.
D V. ,il No
:~leirlletval PattIl:Erwolhersicl*anl:eondhJM~"dMIl.
: onseIlodealh tMnotr8SlUgirllhe~causegiwtfti'lPanI
3Oa. Was Irl Autopsy
per1ormed?
3211. -...."""'Oa:unod
211- 0I:f- Tobaa:o Use CoIetIM lo DedI?
o Yes 0 PrabIbtr
ONo .bc,.-
29. ._:
31-1IoI......_...._
o "'-.....01_
D "'"_"'''''''_<2''''
ol_
0"'"_"'''''''''''''''''_
--
D ~I~__"_~
30c .-..q.y:_......__.<*>>
~*-(~
".1 "'1 J
!~
Due to (Of as a consequeoce of)
D Yes AtJ No
d
3(1). Were Autopsy Fincmgs
Ava__IoCon,;elioo
01 Cause 01 Death?
OYesONo
31. MaMefofDealh
.>- Nalural 0 Horrici:Ie
0_ O-.g_
o _ 0 CoutlNolBe~
32ll _01"""'_."'._1
32frT_""",(~
o 0riweI~ 0 Passonger
o '-'an 0 ~-Sooaiy
3311. _.........Cdior
71A'
329. LocaIIon___1
32l;t. Trnt of q.,
I-
Z
W
o
w
U
w
o
u..
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33a. Certiner (check only one)
Certifying physician (Phvsiciarl ~g cause 01 death "'*' anocher physiciIn has ptof'lOUrad deltI... COfI1IIeIId _23)
To thebesl of my knowtedge, deattla<<WNd due to thtcause(s)and""" as.....
Pfonounc:lng and certtfying phr$ieian (PftysQan boll prooouncingdealhand~loc:ause ofdellh)
To lhe ~t of my knowtIdge, death occurred at the time. dale, and pIKe,... due 10 U. Ci1UM(s).. __.-.cI
Mtdlcale~
basis ol..uminalion and/or
M
..1-
o
I'" II.
n
n. li:enseNLI1tJer
M /) ~ '1 J> -I:lj}. L
33d ___..,._
(j '-- f .l;..- l..-~ l ".s "
~p
(See inslructions and examples on reverse)
34. Name WId Address of Paon Who Carr1*Ied c.ae of OeaII{IIIn 21) Ttpe'Prft
,J.-.o,..,.....{ (>>0... 'l'''' ",,/') .''',,,/
,. '1 ~ I~ .. 1"'1 .. - cJ\.-.... -.,Joo. "--'\
'v.,- '-b/l ,AOr"',
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11
LAST WILL AND TESTAMENT
OF
(- ~,
--.J
ANN M. HUNCHARIK
391 Piney Place
Johnstown, Penna.
15906
- ~- ;:, )
--,',1
, I
C.."::.
-.'r
i
\ Place,
r',)
KNOW ALL MEN BY THESE PRESNETS, that I, ANN M. HUNCHARIX, of 39+) Piney
c'
City of Johnstown, County of Cambria and State of Pennsy1 vania,being of
sound mind , memory and understanding, do make, publish and declare this as and
for my Last Will and Testament, hereby revoking and making void any and all will
which I may have made prior to this date.
FmST: It is my will that all my just debts and funeral expenses and the
expenses of proving my Last Will and Testament be in the first place fully paid
and satisfied.
SECOND: I hereby give, devise and bequeath all of my property, personal,
real, or mixed of whatsoever kind and wheresoever situate to my beloved son,
JAMES HUNCHARIK of P.O. Box 92101, Santa Barbara, California, 93190-2101. Sho d
my son predecease me or should we die at the same time or as a result of the sam
accident or disastor then I hereby give, devise and bequeath all of my property,
real, personal or mixed of whatsoever kind and wheresoever situate to my beloved
daughter-in-law, SBERIAL HUNCHARIK.
THIRD: I hereby nominate, constitute and appoint my beloved son, JAMES
HUNCHARIK as Executor of this my Last Will and Testament; and in the event that e
predeceases me or cannot serve, I then nominate, constitute and appoint my belov d
daughter-in-law, SBERIAL HUNCHARIK, as Alternate Executrix.
II
FOURTH: All estate, inheritance, legacy, succession or transfer taxes
(including any interest and penalties thereon) imposed by any domestic or forei
Ilaws now or hereater in force with respect to all property taxable under such
ilaws by reason of my death, shall be paid by my Executors out of my general es-
itate as part of the expenses of the Administrators thereof with no right of rei
bursement from any receipien~ of any such property, I authorize my Executors to
pay all such taxes at such time or times as they deem advisable.
FIFl'H: No Executor or Executrix hereunder shall be required to give bond
or furnish sureties in any jurisdictions.
IN WITNESS WHEREOF, I have hereunto set my band. and seal this
fq~
day of September, 1986, A.D.
Ib/tt; ~ "'.vHLil~l
;'M. Huncbarik
Signed, sealed, published and declared by the foregoing Ann M. Huncharik
as and for her Last Will and Testament in the presence of us who have hereunto
subscribed our names at her request and as witnesses thereto in the presence of
the Testatrix and of each other.
......
ek h. '. fJG'--/
Address ,
<::. .. ... '.
l jC}~~.~o/t~_.~
Witness
/) ,
~J."'r.)..~ b ~-~
Address
// v_/
REGISTER OF WILLS CAMBRIA COUNTY
OATH OF SUBSCRIBING WITNESS
Estate of Ann M. Huncharik
, Deceased.
File No.
[;)/- 07-DL/2f)
Please Print
I, Vasil Fisanick
--
(uoh) a subscribing witness to thel will_xx:Jdi.Iril~ presented herewith, (JeA&R) being duly qualified
according to law depose(s) and say(s) that ~lhe/_ was/~Jt<Kpresent and saw the above TestaWi{(rix)
sign the same and that she/ltdk~ signed the same and that~Hlhe/they signed as a witness at the request
of Testatm-(rix) in her/Wsi<lheir presence andJLin the presence of each other _in the presence of the
other Subscribing witness( es).
co
C)
c:.;
~~/~-
, (Signature)
L1_
IIIJ Ph~/LJ~lph;o.... A.\J"e. tVl'lr1-hur\ e(lWlb..r~~I~.A
(Address) )
,::"")
(Signature)
:--~
;;::"'" .
(Address)
Executed in Register's Office
Executed out of Register's Office
Sworn to or affirmed and subscribed
Sworn to or affirmed and subscribed
before me this 15th
day
before me this
day
of March 2007. .
S1~,~~
Register 0 il
of
Notary Public
My Commission Expires:
(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.
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
Cambria COUNTY, PENNSYLVANIA
:J-1-07-QC/30
Estate of
Ann M. Huncharik
, Deceased
and
(each) being duly qualified according to law,depose(s) and say(s) that she /~ was / WEJleC well-
acquainted with
Ann M. HnnC'h.<lrik
and a~Jiamiliar
with the handwriting and signature of the decedent, and that the signature of Ann M. Huncharik
to the foregoing instrument purporting to be the Last Will and Testament/Ci~ of
Ann M. Huncharik
is iruhi&lher own proper handwriting.
C"lti/h-
(Signature)
(Street Address)
(City. State, Zip)
before me this
of April
25th
day
2007
I
c_
Executed in Register's Office
Sworn to or affirmed and subscribed
N
Q~.-Uu.~
Deputy for egi r of Wills
o
Cl
Form RW-04 rev. 10.13.06