HomeMy WebLinkAbout09-26-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
Estate of Harriet O. Fasick
also known as Harriet Oyler Fasick
CUMBERLAND
COUNTY, PENNSYLVANIA
File Number 21 - 07 <(81)
, Deceased
Social Security Number
172-01-4871
Kathryn F. Wert
Petitioner(s). who is/are 18 years of age or older, apply(ies) for:
(COMPLETE ~'or 'B' BELOW.)
I!I A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
last Will of the Decedent dated 09/17/1999 and codicil(s) dated
Executor
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
(It applIcable, enter: c.I.a.; d.b.n.C./.a.; pedente lite; durante absentIa; durante mmontate)
Petitioner(s} after a proper search has I 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.)
Name
Relationship
Residence
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ,,:~~)) ~
Decedent was domiciled at death in Cumberland County, Pennsylvania with his I her last principal residence-:~
- ~
ManorCare Health Services, 940 Walnut Bottom Road, South Middleton Township -:g.
(List street address, town/city, township, county, state, zip code) -
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Decedent, then ~years of age, died on 09/14/2007
at ManorCare Health Services, South Middleton Township
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) 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
situated as follows: nla
157,400.00
$
$
$
$
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:
Kathryn F. Wert
Typed or printed name and residence
4466 Valley Road
Shennans Dale, PA 17090
Signature
Form
Rev. 10-13-2006
Copyright (e) 2006 form software only The Lackner Group, Inc.
Page 1 of2
Oath of Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
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.
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. nature 0 ersonal sentative Kathryn F. Wert
Sworn to or affirmed and subscribed
Signature of Personal Representative
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before me this
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Signature of Personal Representative
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File Number:
21 - 07 ~
Estate of Harriet O. Fasick
, Deceased
Social Security Number:
172-01-4871
Date of Death: 0911412007
AND NOW,
,~~ as
~DD l , in consideration of the foregoing Petition, satisfactory proof
Testamentary
having been presented before me, IT IS DECREED that Letters
are hereby granted to Kathryn F. Wert
in the above estate
and that the instrument(s) dated 09/17/1999
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters..........J~..I~.....__... $
Short Certificate(S).......l~...... $
Renunciation(s).... ......................... $
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Attorney Signature:
LL)\\\ $ \'$"
Jc9 $ \0
~~ $ S
$
$
$
$
$
$
TOT Al... ................................. $ ~oo
Form RW-02 Rev. 10-13-2006
Attorney Name: Sean M. Shultz, Esquire
Supreme Court LD. No.: 90946
Knight & Associates, P .C.
Address: 11 Roadway Drive, Suite B
Carlisle, PA 17015
Telephone:
717/249-5373
Copyright (c) 2006 form software only The Lackner Group. Inc.
Page 2 of 2
H105.805 REV (011071
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
P 13858308
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Local Regi~
SEP/l 7 2'07
Date Issued
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REV 1112006
I PRINT IN
>AANENT
.CKINK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
8"9yrs.
OYJ.ER.
FfI:3 /c. (<
6. Date of Bil1h Manlh, , r)
7. Birthplace (C' and slate or f "n country)
.. It /1/2 ti?./"S e tJ """Go ..
j)/.iC~/YI8a 10) J q I PENl\J>SYJ,. i/19/\/J/'-i
lid. FacMltyNsmo IW no/ _, g.e..... and oomber)
I'I/I1A/ollen~E Jli7J;..nl S~I<'i.llC.e-$
3. Social Securtty Number
1'1,z- 01-44'-11
68. Place of Dealh (CtiecI< only onel
Hospilal:
D Inpatient D ER 1 0utpa1ien1 OOOA
9. Woo Decedent of H10panlc Origin1
(W yes. S!lOCify Cli>on,
Mexican, F'uertoRican, 8lc.~
1. Name of 0ec8dent (Frrst,_. 1a~,_I
NflIV<.iET
5.~(LastBir1hday)
6b. County of Dealll
ClJtn&"1U.IlA/l> $ou.:r;;. M IlJlJi..kiO,-.)
l1._.UouaJ K01dof__ most 01 DIe. Dono/_I.
K01d~_ Kindol_/""*""Y
HClmem/~KE:tZ #ClI11e.;n ~/ G-
. 16. Oecedenr. Maiing Address (Slreel. city 1Iown, _. ZiP ~
.i.j"-J 6&. iJA.LJ.Ey l<C!fi D
S'HJ>;XI/1I1IJ/S ,)f/J..J: Pt:+ ('7010
16. F.lher', Nome (F1IIl, _.last. .ufIJx)
r;:(,qtvK 0.. OY'I-EIG
12. Was Decedlnt ever In the
U.S. _ Foo:es?
DYes J,ill'No
Decodent'.
Actu8I Residence 17a.Slale
13. Decodent'. EclJcallon (SpocIfy oo~ hIg\1esl grade completed)
Sementary {Secondary (0-121 College 11-4 or 5+)
I;L
pr/llN'S YJ. i//}/l./I/J
Ct/mA.ck')../9/l/l.)
14. Marital Status: Mimed, Never Married,
W1_,~_18pociI)j
W i I)(li.~/Ja:l
17b. County
J);d Oecedenl
LiYeina
Townsh~'
l1c.00 Yas,_Ili'fad.
17d.O No, _ll.Ne<IwI\hin
Adua1 UmIII 01
.sOUtH ()71 iL'>.i.l:roN' T""
City/80m
208. Informant's Name (Type I Prim)
k ntH j( r/V'
$;HiJ(!/J1HN-S lJJj)..E /9; 17(' 90
33a Ce'lfIer(c_onIyonel
. CortIfylng physlcl.n IPhysician ~..... of dea~ when enoJher ~n hes P'Ofl(lllr<ed doelh end completed Item 23)
T."" Ileotofmy~, _ occunedduot."" ClUM('I onclmonnor II elated... _ _ _ _ _ _. _ _ _ _ _ _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
~~:=~Ja~=:~~oncl~~':':l.,l~~=""",,",-,,_ ____ ____________ 0
=' =.= and ("!m-tlgalioll, In my opinion, deoIh occurred ,,\he Ume. clala, end place, and due to the ClUse(.) and manner II sJated.. 0
loQ II~ /1/1
Pe'lI: EnlarOlher_oondiIions_to_. 28. Old ToIlecco Use Contribute to Dealh?
butnol resuttmg.lheundOr\yingceue. g\Yen. Pe'l. 0 Y.. DprobebIy
o No 0 Unknown
29. II Fomate,
o Not_ntwilhinpaalyaer
D ?regno"'" lime of deal"
o NoI pregnanI. but prsgnant VIiIh. 4:! day.
ofdealh
o Not _nt. but pregnant 43 days 10 1 yoar
batoIo_
o _" pregnanl wiIh1n lhe paaI yaar
320. PIeco of 1n;Kr Horne. Famt. S/,"" F~.
Offic. &ildlng. etc. (SpecHy)
~9~~=)~
Sequentito"~'~~lt
=.: UNOEAlY1llG CAUSE
~aa:e~~~~
Oueto(Ofasa~of);
c.
Due 10 lor 00 a_oI):
:lOa. Wu an Autopsy
Perlom1ed'
d.
~. Wer. "'-Y Frrdngs
AvaJIable_to~
01 Cause of Oealh?
DYe< DNa
31. Mamet 01 Oealh
I8lNaturel D-
O Accidant 0 P-.g In...ugellon
o Suicide 0 c_ No! be OetennJned
32d. T... 01 Injury
32g. LocalIon of Injury (S/reeI. city Ilown. ....)
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LAST WILL AND TESTAMENT
OF
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I, Harriet o. Fasick, of 398 Kings Hig~~~, 6tot:.. ~~,'
Marysville, Perry County, pennsylvania, being,,~~,~~ s~nd an~
disposing mind, memory and understanding, do mak~;j pub.hishand
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declare this to be my Last will and Testament, hereby rev~ing all
wills and Codicils heretofore made by me.
HARRIET o. FASICK
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ITEM I. I direct that all my debts and funeral expenses,
including my cemetery lot and gravemarker and all expenses of my
last illness, shall be paid from my residuary estate as soon as
practicable after my death as part of the expense of the
administration of my estate.
ITEM II. I make the following specific devise and bequest:
A. My two (2) cemetery lots at Rolling Green Cemetery to my
daughter, Kathryn F. Wert.
ITEM. III. I devise and bequeath all of the rest, residue
and remainder of my estate of every nature and wherever situate as
follows:
A. One-third (1/3) of my net estate equally to my two (2)
grandsons, Eric Wert and Jeffrey Wert, or the survivor
of them.
B. The rema1n1ng two-thirds (2/3) of my net estate to my
daughter, Kathryn F. Wert. In the event she predeceases
me or dies on or before the thirtieth (30th) day
following my death, then one-third (1/3) to craig Wert
1
and the other one-third (1/3) to be di vided equally
between my grandsons, Eric Wert and Jeffrey Wert, or the
survivor of them.
ITEM IV. I direct that any and all Inheritance, Estate and
Transfer taxes imposed upon my estate passing under my Will or
otherwise, shall be paid out of the principal of my residual
estate.
ITEM V. I appoint Kathryn F. Wert, Executrix of this my
Last will and Testament. In the event of her renunciation, death,
resignation or inabili ty to act for any reason whatsoever, I
appoint Eric Wert, Executor of this my Last will and Testament. I
relieve my Executrix or Executor from the necessity of posting
security in connection with her or her duties as such in any
jurisdiction in which she or he may be called upon to act.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last will and Testament, which consists of,ctl ~ pages, to each of
which I have affixed my signature this )"7 day Of~""{A-'
one thousand nine hundred and ninety-nine (1999). ~
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Harr1et o. Fasick
2
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
PerVj
ss
. .
. .
.
.
, and rn Ct~ Ii, Etter b ISS (~e r ,
and , the testat'rix 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 for the
purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the testatrix, signed the Will as witness
and that to the best of their knowledge the testatrix was at that
time eighteen years of age or older, of sound mind and under no
constraint or undue influence.
f4Y-v~t{9. ~
Testatrl.X
and acknowledged
Fasick, Testatrix and
and acknowledged
'J r , and
, Wl.tnes es this
1999.
NOTARIAl SEAl
JODI A. McNEELY, Notary Pu&!ic
MatyavilIe Boro, Perry County
My ComlMdon Expires April 7, 2003