HomeMy WebLinkAbout08-07-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
Estate of Charlton M. Prowant
also known as
File Number
:AI -07 - 07.tj 7
, Deceased
Social Security Number 071-14-7647
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the Executor
last Will of the Decedent dated June 3, 1994 and codicil(s) dated
named in 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 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.) ::?:,
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Name
Relationship
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(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
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Decedent was domiciled at death in Cumberland
1685 Revere Drive. Mechanicsburg, PA 17050
(List street address, town/city, township, county, state, zip code)
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County, Pennsylvania with his / her last principal resiilince at
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Decedent, then 86
years of age, died on July 30, 2007; 2: 15 PM
at home
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 PA) Personal property in County
Value of real estate in Pennsylvania
300,000.00
$
$
$
$
0.00
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 appropriate form to
the undersigned:
nald Lee Prowant, 1685 Revere Drive, Mechanicsburg, P A 17050
FormRW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
SS
COUNTY OF Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correc:t 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.
Sworn to or affirmed and subscribed
before me the ,t1l
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Signature of Personal Representative
Signature of Personal Representative
Signature of Personal Representative
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File Number:
d I-07-()7</ 7
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Estate of Charlton M. Prowant
, Deceased
Social Security Number:
07/- ILl - It.PLj 7 .DateofDeath:
, ('l/)n 7 ~~onsideration of the foregoing Petition, satisfal:tory proof
that Letters
j-30-0/
having been presented before me, IT I
are hereby granted to
in th(~ above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Register of Wills
Letters
$
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
... $
$
$
.. . $
... $
... $
. .. $
... $
.. . $
TOTAL .. . . . . . . . . . . . . $
Attorney Signature:
Attorney Name:
Supreme Court J.D. No.:
Address:
Telephone:
0.00
Form RW-02 rev. /0./3.06
Page 2 of2
/).1-07-[;71/7
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
h.'c for thi" ccni ficatc. ')6.()(I
Ccrtificatiol1 ;\Julllhcl
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Thi, i, to certify that thc in 'crnLlt!On h'r,' ,: 'ell I'
corrl'ctly copied from an ori~l1a] ('l'1'Lficlk (I )L':lth
duly filed "ith me ;b Loca! RegiStrar 'ill' 'I ~i!l;t!
cl'nificate will hl' fon\ankd t\l tl!l' S ;rt.' V!i;t1
Rccor(b Office tor pcnnal1cl't filil1!!
P 13770957
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Local Registrar j C;rkl"wd
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REV 1112006
PRINT IN
'IIANENT
CK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FILE NUMBER
86
~ Residence 0 Other. Specify
DYes 10. Aace:American Indian. Black. While, ate
ISpecityj
White
Bb. County o! Death
Cumberland
11. Decedenrs Usual Occu hon Kind of wOfk done durin most of WOfkin file. Do not slate retired
Kind of Work Kind 01 Business I Industry
Service Technician Office
. 16, Decedent's Mailing Address (Street, city I town, slale, zip code)
1685 Revere Drive
Mechanicsburg, PA 17050
. :KJVe, DNo
Decedent's
Ac!uaIAesidence 17a. State
14. Marital Status: Married, Never Married,
Widowed, Divorced (Specify)
1
Pennsylvania
17b. County
f:t1mhprlRnn
17C.l9 Yes, Decedent Lived in
17d. 0 No, Decedent Lived within
Actual Umitsof
Hampden
Twp
18. Father's Name (First, mlddle, last, suffix) 19. Mother's Name (First, middle, maiden sumame)
Donald Prowant Pauline Mutchler
20a. Informant's Name (Type I Print) 2Ob. Informanfs Mailing Address (Street, city I town, slate, zip code)
City/Bola
DVe, DNo
o Accident 0 Pending Investigation
o Suicide 0 Could Not be Determined
Approximale interval: Part 11: Enter other sian~icant conditions conlribulino to death, 28. Did Totlacco Use Contribute to Dea!tl?
Onset to Death but not resulting in the underiying cause given in Pari I D YE!S 0 Probabty
o No 0 Unknown
29.lfFem~Je
o Nol pregnant wilhin past year
D Pregnant at time of death
D Not pregnant, bul pregnant wilhin 42 days
of death
o Not pregnant bul pregnant 43 days 10 1 year
before death
o Unknown If pregnant Within the past year
PA 19053
o Cremation D Donation
Sunset Memorial Park
22c. Name and Address of Facility
FH & CS Inc.
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~d~~A~~nf'~~~ ~~I) dise~
R~a..\ fu\ \V('~
Due to (or as a consequence of)'
Sequentially ijst conditions, if any,
~I~~~o J:~~~lm~ru~ a
(disease or injury ltIal initiated the
events resulting In death) LAST.
Due to (or as a consequence of):
Due to (or as a consequence o~:
l-\..~pu~IOI\
3Oa. Was an Autopsy
Performed?
DYes ~
3Ob. Were Autopsy Findings 31. M~Of Death
:~~~:s: :~~~:h~omPlelK)n ~ Natural 0 Homicide
32c. Place:>! Injury: Home, Farm, Streel, Factory,
Office Buik:ling, etc, (Specify)
32d. Time 01 In;ury
M,
321. If Transportation Injury (Specify)
D Driver IOperator D Passenger DPeOestrian
DOIh",specify.'
33b. Signature and Tille of Certifier
32g. Location of Injury (Streel. city/town, stalE!)
33a. Certffier (check ontyone}
~~~~g9~r:~I:~~~~:~:~~~~~e :~~t~hC:::~~:n~~~~:,h:: ~;~e<Lur:~ ~a~h ::d _co_m~I~~ ~~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 ...
~~~~ou~~~fa~~ ~~~:r~~::~~~a~c~~~~~ t~~,:~~nin~e;::c~~~~~rt~~~ot~cea~:~~i~~~ manner as stated.- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
Medical Examiner I Coroner
On the basis of examination and I or investigation, In my opinion, death OCCU"ed at the time, date, and place, and due to the causa(s) and manner as slated_ 0
33clicenseNumber
2001
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35 Regislrar'S~jlfln,.ture an.d D. istri~I'~. ~~-'-'.'; ".' ,..-,"", -,,'; "".
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34, Name and Address 01 Person Who Completed Cause of Death (Item 27) Type I Print
Stanley R. Goldman M.D.
4700 Union Deposit Rd. #120, Harrisburg, PA 17111
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Disposition Permit No. t"J /1 . '1' /i 7 3
REV-346 EX (8-92)
FOR REGISTER'S OFFICE USE ONLY
PA DEPARTMENT OF REVENUE
Coun9' Code
It,
Year
FUe Number
-7Lf 7
ESTATE INFORMATION SHEET
07
DECEDENT INFORMATION: Enter data as it wiD appear on aU documents submitted to the department.
Name (Last) (First)
10/13/1920
~;ddl,) ~
Prowant
Charlton
M
Decedent's Social Security Number
071-14-764 7
Date of Death
07/30/2007
Date of Birth
TYPE FILING: Enter check mark to indicate the nature ofthe return to be fIled with the d artment.
o Probate Return 0 Joint Assets Only 0 Estate Tax Only 0 Litigation Purposes (No Other Assets~
LETTERS GRANTED:
Enter check (.I) mark to indicate the nature of the proceedings at the Register of Wills Office.
Attach additional sheets if ex lanation is necessar .
o Testamentary
o Administration
o No Letters
o Other (Please Explain)
~
ATTORNEY/CORRESPONDENT: Enter aU data concerning the attorney or other individual to receive all tax information and
d
correspon ence.
Name (Last) (First) (Middle) Supreme Court 1.0. No.
Street Address
City State Zip Code Telephone Number
PERSONAL REPRESENTATIVE
INFORMATION:
Executor/Administrator
Enter aD data concerning the personal representative(s) of the estate authorized by the
Register of Wills
Name (Last) (First) (Middle) Social Security Number
Prowant Donald Lee 177-48-7330
Street Address
1685 Revere Drive ,,~..... '\
City Stat,; Zip Code Telephone Nu@1l:r ~
7174585890-: '~ --.J
Mechanicsburg, PA 17050 ~ ' I
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Co-Executor/ AdmlDlstrator
Name (Last)
(First)
(Middle)
r .1
Social Security NumbJ":.;
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City
State
Zip Code
Telephone Number
L')
Street Address
Co-Executorl Administrator
Name (Last)
(First)
(Middle)
Social Security Number
Street Address
City
State
Zip Code
Telephone Number
Prepared By
~~
rev. J O. I3. 06
LAST WILL AND TESTAMENT
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I, CHARLTON M. PROWANT, of Bucks County, Pennsylvani~~ h~~by
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declare this to be my Last Will and Testament and revoke.alJ
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wills and other testamentary writings by me at any tima!
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heretofore made.
ARTICLE I.
I direct my executor to pay, as soon as convenient after
my death, all of my legally enforceable debts, the expenses
of my last illness, my funeral and related expenses and the
expenses of administering my estate.
ARTICLE II.
I give all my automobiles, and all other articles of personal
or household use, together with all insurance relating thereto,
to my wife, JOSEPHINE M. PROWANT, if she survives me by thirty
days.
If she does not so survive me, I give all such property and
insurance to my son, DONALD LEE PROWANT.
ARTICLE III.
I give all the rest, residue and remainder of my estate,
real, personal and mixed, of whatsoever nature and wheresoever
situate, including any property in which I may have an interest:
A. To my wife, JOSEPHINE M. PROWANT, if she survives me
by thirty days; or if she does not so survive me,
B.
To my son, DONALD LEE PROWANT.
In the event that DONALD
LEE does not survive me, I direct that my estate shall
pass to his issue.
ARTICLE IV.
No interest in income or principal shall be assignable by,
or available to anyone having a claim against, a beneficiary
before actual payment to the beneficiary.
ARTICLE V.
All federal, state, and other death taxes payable because
of my death on the property forming my gross estate for tax
purposes shall be paid out of the principal of my probate
estate just as if they were my debts, and none of those taxes
shall be charged against any beneficiary.
ARTICLE VI.
I appoint my son, DONALD LEE PROWANT, executor of this
will, but if he for any reason fails to qualify or ceases to
act, I appoint KAREN OLEJARZ, ESQUIRE, executrix in his place.
I direct that no executor shall be required to give bond in
this or any jurisdiction.
ARTICLE VII.
I authorize my executor to exercise the following powers,
in addition to those given by law, to be exercised in his sole
discretion:
A. To retain any property which may at any time form part
of my estate as long as may be deemed advisable;
B. To sell at public or private sale, for cash or credit,
with or without security, any real or personal property;
C. To exchange, lease or partition prperty and give options
for sales or exchanges;
D. To make distributions in cash or kind, or partly in each;
E. To borrow from anyone, even if the lender is a fiduciary
2
hereunder, and to mortgage or pledge real or personal
property as security therefor for repayment of the funds
borrowed;
F. To compromise claims and to abandon any property which
is of little or no value;
G. To invest and reinvest at discretion without restriction
as to so-called "legal investments," with the specific
right to invest in common and preferred stocks;
H. To register securities in the name of a nominee, or to
hold the same unregistered and in such form that they
will pass by delivery;
I. To retain and pay agents, accountants and counsel
(including but not limited to legal and investment
counsel) for advice and other professional services; and
J. To exercise any election or privilege given by the
federal and other tax laws including, without limiting
the foregoing, the election of the alternate valuation
for federal estate tax purposes and the election to claim
deductions for death tax or for income tax purposes,
and to make or not make equitable adjustment for the
exercise or nonexercise of any such election or privilege.
ARTICLE VIII.
If any provision of this Will shall be invalid or ineffective
either wholly or in part, then to the extent of such invalidtty
or ineffectiveness, this Will shall be inoperative without in
any manner impairing its valid or effective provisions, or the
valid or effective remainder of any provision which is partially
invalid or ineffective.
3
ARTICLE IX.
The term "fiduciary" shall refer to all those from time to
time acting as Executor. The term "Executor" shall include the
plural and/or feminine thereof if such are the facts when the
terms of this will are put into effect.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this my Last Will and Testament the day of
One thousand nine hundred and ninety-four.
(SEAL)
CHARLTON M. PROWANT
Signed, sealed, published and declared by Charlton M. Prowant
the above-named testator, as and for his Last Will and Testament,
in the presence of us, who, at his request, in his presence and
in the presence of each other, all being present at the same
time, have hereunto subscribed our names as witnesses.
of
of
of
4
Acknowledgment by Testator
and
Affidavit of Witnesses
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF
A?Juff
he witnesses, respectively, whose ames are duly
signed to the t ached or foregoing will, being first duly sworn,
do hereby swear to the undersigned authority that the Testator
signed and executed the instrument as his last will in the presence
of the witnesses named and that he signed willingly, and that he
executed it as his free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and
hearing of the Testator, signed the will as witnesses and that
to the best of their knowledge the Testator was at the time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.-
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and
Testator
~y-
Witness
Witness
Witness
Subscribed, sworn to and acknowledged before me by
, the Testator, and subscribed and
sworn to me before me by
, and
JUN ;"'3 1994 day of
One thousand nine hundred and
the witnesses, this
NOt,
My
NOTt,RiAL SEAL :J"
LARRY PLATOWSK'l. NOlary' Public
Le'Jitt~\~~. ;~.~l~~f~~i~ ~(.~.~';!:r/., 7
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