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HomeMy WebLinkAbout08-15-07 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA File Number 21-- 0'7 - () l' oct Estate of Donald A. Gray also known as , Deceased Social Security Number 202-20-2721 Terri L. Kaptain , formerly Terri Lee Berkey and Steven D. Gray Pelitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) [!] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) islare the Co-Executors named in the last Will of the Decedent, dated 09/23/1981 and codicil(s) dated Marguerite C. Gray, named Executrix, predeceased Decedent having died on November 7,1998. 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 (It applicable, enter: c.I.a.; d.b.n.c.l.a.; pedente lite; durante absentia; durante mmontate) Petitioner(s) after a proper search haslhave 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.) Name Relationship Residence (.-., (.;..;;~ -.I .;;0 ., -., :l:h (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. . j::O Decedent was domiciled at death in Cumberland County, Pennsylvania with his I her last principal reSIden2e at ,;.-,,, 903 Allendale Road, Mechanicsburg, Upper Allen Township, Cumberland, PA 17055 (Ust street address, town/city, township, county, state, zip code) co ...... .:::- Decedent, then 78 years of age, died on 07/25/2007 at Hershey Medical Center, Hershey, Derry Twp., PA 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 $ situated as follows: 903 Allendale Road, Mechanicsburg, Cumberland County, PA 17055 37,500.00 111,400.00 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: Signature , Typed or printed name and residence Terri L. Kaptain , formerly Terri Lee 122 Forest Hills Road Berkey Red Lion, PA 17356 {/} Steven D. Gray 6479 Wheatley Road Federalsburg, MD 21632 Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative } S8 } COMMONWEALTH OF PENNSYL VANIA COUNTY OF Cumberland 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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Swom to or affirmed and subscribed before me this I sfL day of Signature of Person aiR s nta ve Terri L. Kaptai , formerly Terri Lee Berkey _ap,--R_~ven'!:~ Signature of Personal Representative F,ile Number; 21-- 0'1- ,1CbQ Estate of Donald A. Gray , Deceased Social Security Number; 202-20-2721 Date of Death; 07/25/2007 AND NOW, 5 ,c!tx>? , in consideration of the foregoing Petition, satisfactory proof Testamentary are hereby granted to Terri L. Kaptain . formerly Terri Lee Berkey and Steven D. Gray and that the instrument(s) dated 09/23/1981 described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent. l'-.') C") ~:2;.,l.. .c;; ~ in th~bove !'l5tp.te' J '=-;~ C) z:; , "J -->>I.--r-1 ~'-f~ /'- c..n ,-. ..; ',;) , ) )L. -" =0 .---j ~-!It :Jr= a:J Renunciation(s)............................. $ Attorney Signature; FEES Letters............ ........ ........... _.. ......... $ ().( 00 . (X) a4-.to Short Certificate(s)........................ $ w"\ \\ ~~ IT__ Attorney Name; Supreme Court I.D. No.: 19475 Bogar & Hipp Law Offices One West Main Street Address: Shiremanstown, PA 17011 Telephone: 717-737-8761 Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 H105.~05 REV (01/07) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P13770708 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. t2nm-1'l ~.~ JUL) 0 2~ Local Registrar Date Issued (") Co '::::::0 ';:'>:J ;'TO )~:ig _(,')7':: :'C)O "'iO~T' )C. -~ -n :J> r--;l = = --I :po. c:::. G? (.11 :P' ::.It C? ~ ~ COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See Instructions snd exsmples on reveres) 3.SocIalSocurilyNumber 202 - 20 -2721 ea. PIece of Oealh Checl< one) HospIlaI: Lower Allen Twp. V 1112006 ~INT IN _ENT INK 6. Dale of Sinh (Monlh, de , 7.BIr1h (CIIy and slllte or I '"78 VIS. Ma r.. 1 2 , 1 929 Btl. County of Oealh Dauphin Sd.Fac:ifllyNlme(ltnoflnsliMlort.giw_and_J .S. Hershey Medical Center 13. _rs EOJcallon (Spodly only highest grade completed) Etem"ftl_rv{D-f2} College (H or 5>) Pennsylvania Cumberland moslof life. 00 not_1Ofl Ki1d oI8us1nesS IlndlJsIf/ parts supr. heavy equlpme f6~nrrei~1ri~~lf.corleJ Mechanicsburg, PA17055 fUafht<'sNome(FifSl,_,lut,sulffxJ Charles Carrol Gray f7b. County 19. Mo1har's Nome (FifSI, _, maiden SlImama) Emma Shearer 2Oo.1_'a ""me (7ypo I PtfnfJ STATE FILE NUMBER 4. Oata of Daalh {Uon1h, Oay, yo.,} Jul 25,2007 14. Martial Status: Mamed. Never Married, WIdowed. DMllted (Specify) widowed OkIO_nt U.elna 17C.~ Vas,Oaceda,nivodin Upoer Allen TownshJp? '7d. 0 No. Decadent Lived wl1hIn Aclual~of 7W1>. CIIy I Boro 2fI>.lnformenf',Malfng_(_,~I_,_.~corle) 122 Forest Hllls Rd., Red Lion, PA17357 2fd.Locetion(CllyI_,state,zitlcorle17011 Camp Hill,PA 2'c.P\acoof[l;opoe;tlon(Narnaof_,_orotharplace) ROlling Green Cemetery Itam$ 24.26 _ ba CllfIIIIlaIad by persor 24. T1meofOea1h 25.llate_llead (Uon1h. dey, yaar) 0110__. t: ( M. VIAl 'tf': UJl}-:f- CAUS~ OF llEATH (See lnotr_ ~ 100) namV. Part, "ntorftte~-_. injuri<6,or03lnplclrlion$-1haldreClly_IhI_. OONOTonlar_inalevenIs such ascardlocenast, raspilatory enast. or _, _ wifhout st'oowIn91he atioIl>gy. Usf only one ceusa on _Ilna. =~~=\--.; a. ~~t"t:..j.'.1tJ ~I- pM:,,~kd-- ( "J DUO to (;;;;ra_ofJ: b. Duato{orasa_ofJ' I. Approximateinlefv8l: I Onset to Dealh I I I I I I I I I I I I I I I I ~Iist...-., il any. =~~r~a ="~n~~ c. Due 10 (or as a consequence of): d. lOa. was en Aulopay - 3UAlnnar of Dae1h ~Natural 0 Homiclda 0- 0 Pendng Invasti_ 0- OCouldNolba~ M. 3Ob. wara Aufopey Ffn<ings A_PrioIIoCon\llafioo of Causa of 0ea1h' Dvas ~No DVM ONo 32<1. lime of Injury 330. Carfffiar ("*" only onaJ . ====:U':;:"~I1e~~':=::::::~~_~~~~~._.______._______ 0 ~ . :.~~~~~~:n~dee~":,:=~~=_asstated.._________________ 0 =~~~;= and f or InvuttgetIon, In my opinfon, duth occurred at the ume. date. and place, and due 10 U. catlM(.) and manne, .. silted- 0 35. R ~ I ~ II 10,1 1/ V . . ni!l.l"oI'Wtinn Permit No. ("}6 SO~q I Hummel Ave.,Lemoyne,PA17043 23b. Ucanaa Number 230. Data Signed (!.Ionlh. day, yaer) 26. Woos Case Rafarrad to UedICIIIExamlnarI Coroner lor a _ 01h0r _ Ctamalioo or Oonallon? OYaa ONo Part 11: En othir I6mificanI oordIims eonlribulinI'I: to dMIh, 28. Old Tobacco Use Contribllte to Dea.lh7 bufnofrasullingin1haunclalfyingceusagfYanmPartI. 0 Yea OP!llballly o No Unknown ~I'~( V.f~...r Di..... 2W_ o NoIprapnlwifhinpastyaar eJ rh.~ R......( lJ,i~.." 0 "'->latfimeofdeafh o NoI pregnant, but pragnent wifhjn 42 days ofdee1h o NoI pregnant, but pragnant 43 days 10 1 yaer batore_ o Unknown i1pragnant wl1hIn fila pes' yaer 32c. Pfaca 01 Injury: Homo, FIlmt, 51raat. Facto<y. OtIicaBuildn9,atc.(Sp<<:i/y) 32g. Locafioo 01 Injury (51...., clfy 1_, Bfata) 1East Jlill anb Wtslauttnt OF 00NAlD A. GRAY I, lX.NALD A. GRAY, of 903 Allendale Road, Mechanicsburg, Cumberland Cotmty, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I direct the payrrent of all my just debts and the expenses of IIJ:Y last illness and funeral from my estate, as soon after my death as conveniently may be done. SECOOD: I devise and bequeath all the rest, residue and remainder of my es:tate of -whatever nature and wherever situate tmto my wife, MARGUERITE C. GRAY, provided she survives rne by sixty (60) days. THIRD: Should IIJ:Y wife, Marguerite C. Gray, predecease rne or die on or before the sixtieth (60th) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto my children, TERRI LEE BEP.J<EY and STEVEN f~) o ~.~~ Co -.. D. GRAY, in equal shares .-~ =~3. Q ~'~ FOURTH: My Executor and personal representative shall hav~fr-r1 (/) ~/< (./1 the following powers in addition to those vested in them by law and~lC~; T~ other provisions of this Will, applicable to all property, exercis~l~ without court approval and effective until actual distribution of all C'J .1="'" r property: (A) To sell at public or private sale, or to lease, for any period of tine, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such tenns or conditions as are deemed proper. (B) To invest in all fonns of property, including stocks, coomm trust funds and lIDrtgage investments funds, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification, risk or productivity. (C) To canpromise any claim or controversy. (D) To exercise any option, right or privilege granted in insurance policies or in other investments. (E) To make dis tributions to my herein n.arred beneficiaries in kind. FIFlli: All taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be considered a part of the expense of the administration of my estate, and my personal representative shall have the absolute power in his or her discretion to pay the sane at once whether or not the law \IDder which they are imposed permits the postponerIalt of all or part of them to a later time. SlXlll: I nominate and appoint MARGUERI'lE C. GRAY, Executrix of this, my last Will and TestaIIalt. In the event of the death, resignation or inability to serve for any reason whatsoever of the said Marguerite C. Gray, I nominate and appoint TERRI LEE BERKEY and STEVEN D. GRAY, Co-Executors of this, my last Will and Testament. I hereby relieve my Executrix from the necessity of posting security in connection with her duties as such in any jurisdiction in which she may be called upon to act insofar as I am able by law to do so. IN WI'INESS WHEREOF, I have hereunto set my hand and seal to this, my last Will and TestaIIalt, this ~ ~ day of ~'-' 1981. ~ (SEAL) Signed, sealed, published and declared by the above naned Testator as and for his last Will and Testament in our presence, who at his request, in his presence and in the presence of each other, have heretmto subscribed our nanes as attesting witnesses. Address /lA u.~ ('" .. , .... ... t,(.({ .. ~'L/ I \\\()Jc~ C'.d~ Address -2- OATH OF NON-SUBSCRIBING WITNESS(ES) Zl-()l~ ftt;q REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Donald A. Gray Terri L. Kaptain, formerly Terri Lee Berkey (Print Name) and Steven D. Gray (Print Name) I Deceased acquainted with Donald A. Gray and Un/are familiar (each) being duly qualified according to law, depose(s) and say(s) that ~/ they w.D / were well- with the handwriting and signature of the decedent, and that the signatureQWlald A. Gray to the foregoing instrument purporting to be the Last Will and TestamenVCodicil of Donald A. Gray I . / ~' ~ /LA<- L.' (/) ~ture) Terri L. Kaptain, f rmerly Terri Lee Berkey is in his/her own proper handwriting. ~~!.v.lbr 122 Forest Hills Road 6479 Wheatley Road (Street Address) (Street Address) Red Lion, PA 17356 (City, State, Zip) Federalsburg, MD 21632 (City, State, Zip) (") So ~"C;:U 'v -l:0 , 'i_~r- ~:~~ Cj ,J'"') ~~~; .:J:J )';~ --; Form RW-04 Rev, 10-13-2006 Coovrioht Ic) 2006 form software only The Lackner Group, Inc, ......."'J c.---:> = --.; :;:... c: G) <..n :r;.. ::;1: CO .c- .r- OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Donald A. Gray James D. Bogar (each) a subscribing witness to (Print Name/s) the [!] Will 0 Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and , Deceased say(s) that ID / he / lImY was / ~ present and saw the above Testator / ~ sign the same and that Ui / he / ~ signed the same and that ID / he / lImY signed as a witness at the request of the Testator / "H~'( in his / Dr presence and in the presence of each other. (Signature) One West Main Street NWEAlTH OF PENNSYlVANIA NOTARIAL SEAL IONNIE L W1WAMS, NOTARY PUBlIC ItIIREMANSTOWN BORD., CUM8ER~D co. (Signature and seal of Notary or other offi aI qualifietlfCOMMIS ON WI ES APRIL 18. 2009 administer oaths. Show date of expiration . (Street Address) (Street Address) Shiremanstown, PA 17011 (City, State, Zip) o :-y '~=g '".T:eJ -(~~ (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed )i~5~ Executed out of Register's 'dfNce Sworn to or affirmed and subscr~ije<f before me thi!': q+1-- day'- of ~uot ,'ZOOI., -:BoY) n i.t2 rI G.1JL0 Notary Public My Commission Expires: before me thi!': of day Deputy for Register of Wills r--.) c.:> =s :;> c: (7) U1 I " :r::- 3: C) .::- .::- Form RW-03 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.