HomeMy WebLinkAbout05-14-07
Estate of
also known as
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF G #- i -l a-- d
f L '/ (!, J(c( ~ ','"
.
J - j)- & 7
COUNTY, PENNSYLVANIA
, Deceased
Social Security Number
a \ D 'l ()'-\~d
';) ~4 - 30-.;J 7JcO
File Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(C07TE 'A' or 'B' BELOW:)
~A. Probate and Grant of Lette~ Testamentary and aver that Petitioner(s) is / are the
last Will of the Decedent dated c., - r- () 0 and codici1(s) dated
&.e- (.... .)-vr 5
named in the
L..... 01' - r e.1\.().J'\.
(State relevant circumstances, e.g., renunciation, death oj 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 instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente 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: (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.)
r Name Relationshio Residence I
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c.)
Decedent, then
g3
years of age, died on
at
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/fo >/J / k I \c.)
I
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value ofreal estate in Pennsylvania
Q;.. C I
~~ O/oDD
$
$
$
$
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 appropriate form to
the undersigned:
f.l.cY'^o...
5eevr-J.'c.. 5
T ed or rinted name and residence
L {i1l.1t,.; I KIa..,
Forni RW-02 rev. 10.13,06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL V ANlA
COUNTY OF t1 ~ m.b ( (()J1cf
SS
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 personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law. a / .
Sworn to or affirmed and subscribed 6\ _ . ~ A ./
/ J I ~ature of Personal Rep t' -
before me the f day of
. /),()O 7 Signature of Personal Representative
Signature of Personal Representative
~\ Q\ '\)l\q;~
Ph IIIi <; rno. ftlo..vr-t /.{ !o,m
Social Security Number: cY1'-f 3 (P d. g/ Date of Death: ,~- B - 0 7
AND NOW, fYb.:d' /(0 , ~ in 'Omid;;;" Ofthe,h"gOing Petition, ,,"'''''tory proof
having been presented before IT IS DECREED that Lytters I fij nc:./J / V
are hereby granted to !\n.ll t~ / F. !CIO-J.- Y7
File Number:
Estate of
, Deceased
and that the instrument(s) dated 0 LA.Yle. 0, !)(;()()
described in the Petition be admitted to probate and filed ofrec~rdJ?1 the last Will (a
FEES ~
in the above estate
~~::rsce~i~~~~e~~; : L \:~. :
Renunciation(s) ... (~. . $
WII! .., $
.JeP ...$
,AA fo .., $
.., $
... $
.. . $
.. . $
.. . $
.. . $
TOTAL ............... $
<3\o.LP
YO.oo
/~
/ D .00
6-.6 0
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
Address:
Telephone:
Ib
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Page 2 of2
Form RW-02 rev 10./3.06
1105.805 REV 1105
This is to 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.
~I'l~
Fee for this certificate, $6.00
Local Registrar
p
13354847
MAY 1 4 2001
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REV llf2006
PRINT IN
AANENT
CKINK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
Yrs.
Klain
6. Date of Birth (lAonlh.
ar)
1. Name of Decedent (First, middle, Iasl, suffix)
5. AIJfJ (last Birthday}
83
oOlhar . Spacny,
10. Race: American indian, Black, While, ele
(Spec;(};) white
Cumberland
E. Pennsboro Twp.
17b. County
Pennsylvania
Cumberland
14. Marital Status: Married, Never Married,
_. 0N0rcad (Specil)!
widowed
17c.D9Yaa.~llJvedin Lower Allen
17d.0 No,~llivedwilhin
Actual Umlts of
Top.
11. Decedent's Usual lion Kind 01 woo. done du most of 1ft. Do not state
_01 WOO< Kindol_linduslJy
Re istered Nurse Healthcare
. 16. OacQnfs Mailing Adriaas (_I. clly IloWn. _, zip coda)
20 Grinnel Drive
Camp Hill, PA 17011
18. Falhar's Nama (Ars!, _.IasI. sulIb)
Eric Johnson
OacQnfs
Acl.uaI ResidenCe 17a. Sale
City 1 Boro
19. Mother's Name (First, mickle. maiden surname)
Margaret Newton
201>. _'s Malting Addraas (Slraal. city IloWn. s..... zip coda)
120 Cragmoor Road, York Haven, PA 17370
21c. Place of DispooilIon (Name of r:amaleIy, cromalOfy or oIhar plaCa)
Evans Crematory
21d. Locatlon (City I town, state, zip code)
Schaefferstown, PA 17088
22c, Nama and _ 01 Faciity
Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
231>. l.lco/lalI Numbar
230. Data S~nad (Month. day, yea~
26. Was Case Referred to Medk:aI Examiner I Coroner for a Reason Other than CremationOf' Donation?
oYos I25iNo
d.
I Approximate_,
I Onset to Death
I
I
I
I
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I
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I
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I
I
I
I
I
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Part II: Enter other si!J1111cBnt r.ordIIons tlMtrlbubla to dI8th 28. Did Tobacco Use Contribute to Death?
b~noIraaulllnginlhaurdlflyingcau..tt-an"Par11. 0 Yaa oProbabIy
oNo oUnIrnown
29. "F.mal"
o NoI p!Og18I11 wIIhIn paslyaar
o PragnanI alllme ol_
D NoI_nl. but P..... wIIhIn.2 days
ol_
D NoI_nt. but p_l43 days 10 1 yaar
-.-
o Unknown" plepn\ _lha past yaar
32c. Pleca 01 Injury: Home. Fertn. SIraal. Faclofy.
0II'<a 1luiIcIng. ale- (SpecIy)
=~=)clsaaaa-:
a.
_islcondillons.lany.
teacinatothtcauselillldonlnea.
Enlarh lNlEALYlNG CAUBE
="~"u:.~
b.
c.
3Oa.Wasan_ 311>.W8l8_FIn<Ings
P_ A_PrIorIoCon'4>lal\oll
01 Cauea 01 Oaalh?
oYaa ~No 0 Yaa 0 No
31. _ 01 Oaalh
~ Natural 0 HomicIda
0- oPardnglnvaatiga!ion
o Sulc:Ida 0 Cc<Ad NoI ba Qalermilad
32d. Time oIlriuY
32g. Location oIlriuY (Slraal. city IloWn. ...1.)
M.
338. Ca<1IIIar (_ on~ ana)
~..r.r~===:"~lha"'=''':=':~-~-~~~~~----------------- 0 ~
~:=~oc'.u~::"~:"~~tolo=::_..etalelL_________________ 0
::' ":.":::':''= and 1 or Inveatlgatlon, in my fltlInlon. -. occurred at lha lima. dills, and piKe, and due to Ilia cauaa(.) end m.nnar.. etalelL 0
J"VV'
33c. Licens8 Number
YylO () J3 it "3 L
:Ra0a\f8r's~N~ ~
I,;(I/I~I/I""'I
34. Name and Address of Person Who ~ted Cause of Deattl (Item 27) Type I Print
8'10 Poplcur O\urrh'1<(.(I((, SlLI k s::.e.
Dlsoosi\ionParmINo.. OIIl"pgq2
a \ tJ t \)~'(rfi
LAST WILL AND TEST AMENT
OF
PHYLLIS M. KLAIN
I, PHYLLIS M. KLAIN, of the Township of Lower Allen, County of Cumberland,
Commonwealth of Pennsylvania, being of sound and disposing mind, memory and
understanding do make, publish and declare this to be my Last Will and Testament, hereby
revoking all prior Wills and Codicils made by me.
ITEM I:
I direct that the expenses of my last illness and funeral shall be paid out of
my Estate as soon after my decease as may be convenient.
ITEM II:
All the rest, residue and remainder of my Estate, real, personal and mixed,
I give, devise and bequeath unto my beloved husband, AMBROSE. KLAIN.
ITEM III:
In the event that my husband, AMBROSE KLAIN, should predecease me
(For the purposes of this, my Last Will and Testament the word "predecease" shall be construed
to include simultaneous deaths, deaths within sixty days after the death of the "predeceased"
individual, or deaths under circumstances in which it cannot be determined whether I or the
"predeceasing" individual died first.) then and in that event I give, devise and bequeath the rest,
residue and remainder of my Estate, real, personal and mixed, unto my beloved sons,
MATTHEW NEWTON KLAIN and DANIEL FRASER KLAIN, according to the following
terms:
~;7,. : . ~ \1 \ },' It
1
(A) Share and share alike; except that, in the event that both sons are able to
agree as to which should take any particular item or items, then the subject
or subjects of such agreement shall pass specifically to the agreed upon
individual.
(B) In the event that one of my sons shall predecease me then the portion of
my Estate that would otherwise have passed to that son shall pass to his
issue per stix:pes, or in the event of a failure of his issue, to the other.
(C) In the event that both of my sons should predecease me leaving issue, then
the shares otherwise going to each individual son shall go to that son's
issue per stix:pes.
ITEM IV:
I direct that all legacies and shares, while in the hands of my Executor or
Substitute Executors, shall not be subject to attachment, execution or sequestration for any debt,
contract, obligation or liability of any legatee or beneficiary, and shall not be subject to pledge,
assignment, conveyance or anticipation.
ITEM V:
I direct that all estate, inheritance and succession taxes shall be paid out of
my residuary estate to the same effect as if said taxes were expenses of administration, and that
all life insurance proceeds, property held with my said husband as tenants by the entireties,
legacies, devises and other gifts made by this, my Will, or by any Codicil hereto, shall be free
and clear thereof; in the absolute discretion of my Executor or Substitute Executors, he/they may
pay such taxes immediately, or may postpone the time of payment of taxes on future or
remainder interests until possession thereof accrues to the beneficiaries.
2
ITEM VI: I direct that my Executor or Substitute Executors shall have the power:
A. F or the payment of debts or for any purpose of administration or
distribution, to sell, mortgage, lese, alter, improve, partition and exchange all or any of my real
estate, and to sell the same public or private sale, for such prices and upon such terms as to cash
and credit as he may deem best or upon the reservation of ground rents and the said ground rents
in turn to extinguish or assign, and to grant and convey good and sufficient title, without liability
on the part of the purchasers, to see to the application of the purchase or consideration monies.
This power shall not be construed to work a conversion of the real estate unless and until the
power is actually exercised.
B. To sell and transfer, either in person or by attorney, all stocks, bonds,
investments and other personal property owned by me without liability on the part of the
purchasers to see to the application of the purchase or consideration monies.
C. To borrow such sums of money as may be required for the purpose of the
Estate, and to secure the loan by a pledge of all or any part of my Estate property, or mortgage,
and to execute an accompanying bond authorizing or other evidence of indebtedness. Persons or
corporations advancing money to the Executor or Substitute Executors need not inquire into the
necessity.
ITEM VII: I hereby nominate, constitute and appoint AMBROSE KLAIN, my
husband, as Executor of this, my Last Will and Testament. In the event that AMBROSE KLAIN
3
shall predecease me or die prior to the settlement of my Estate, I then nominate, constitute and
appoint my sons, MATTHEW NEWTON KLAIN and DANIEL FRASER KLAIN as Substitute
Co-Executors of this, my Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this S4- day of
~_/
,2000.
~k) M""c'f~f ki"".__:
PHYLLIS M. KLAIN
The preceding instrument, consisting of this and three (3) other pages, was on the date
thereof signed, published and declared by PHYLLIS M. KLAIN, the Testatrix therein named, as
and for her Last Will and Testament in the presence of us, who at her request, in her presence and
in the presence of each other, have hereunto subscribed our names as witnesses hereto.
~I-~ If rf-,<-tlu.~~,J
JrLJ.~ j:) luALt('
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Residing 6 001 J J-cA-.LJ fi . J
,04
I
'/ 7 tJ \J ~:.r
Residing.J13~ W. 4~~, f'~/jJ, /70 z.,r
COUNTY OF (!.u ,1.?16 €. d-L-A /1.13
)
) SS:
)
COMMONWEALTH OF PENNSYLVANIA
WE, PHYLLIS M. KLAIN, and ~,;f c.~~, and
tfI
/k't'"~/ A {).~~ ' the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will, and that she had signed willingly and that she executed it as her free and voluntary act
4
for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of
the Testatrix, signed the Will as witnesses and that to the best oftheir knowledge the Testatrix
was that time eighteen (18) years of age or older, of sound mind and under no constraint or
undue influence.
~f(': M<><1~f 0=<~
PHYLLIS M. KLAIN
Subscribed, sworn to and acknowledged before me by PHY1,.LIS M. KLAIN, the Testatrix~ and
subscribed and sw<?rn to before ~e ~y j1t- ___~ >f (L-~LtA4-~ , and
/~F- .;2 w ~L7/' ' witnesses, this S:,rl-. day of
. _ ,2000.
~.."\ ---)
~;e~ AJ.-i~
Notary Public
Notarial Seal P bile
8athe~~r do~~~~;;b~~~~~ C~U~6b3
My ~J:nmission Expires Sept. 22,
\ nia Association 01 Notallel
Member, pennsy va
5