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HomeMy WebLinkAbout11-08-07 PETITION FOR PROBATE AND GRANT OF LETTERS f!vl+l.~k.-A REGISTER OF WILLS OF COUNTY, PENNSYLVANIA Estate of ~ k+ also known as F. hdYlJ5A,'~ File Number ~ J - tJ1-IO/3 , Deceased Social Security Number I 7 if - 30 - 77 P D Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) 1>Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the last Will of the Decedent dated oM 4.....l.. l.. S"', /1 i6 and codicil(s) dated , G')(t:e.V t tZ., )( named in the (State relevallt 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 instlUment(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; durallte millaritate) 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 Administratioll. c.t.a, or d.b.ll.c.t.a., enter date of Will in Section A above and complete list of heirs.) ( ) :::~ " Residen~~~ . Name Relationship ~ --j I"J Decedent, then btr years of age, died on tol2-s/1J7 ( , at rkJfflE Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value ofreal estate in Pennsylvania $ $ $ $ 1'0 0, f) 00. . '/0 0., "J OtJ. - Sf-. ,I At ~ c- L I' (oJ '.>v ~, J 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: ql/ (cJc.KI.:" /'A situated as follows: T ed or rinted name and residence nc.ll S- Fom. RW-02 rev. 10./3.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYL VANIA COUNTY OF ~~(lMd SS The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tme and conect to the best of the knowledge and belief of Petitioner(s) anlthat, as personal representative(s) of the Decedent, Petitioner(s) will well and tmly administer the estate according to law. .~Ooo- dt(O~Q{tbtL Signature of Personal Representative Sworn to or affirmed and subscribed befm"e me the ~ ~+L day of NOl}.f(..I\\ ~\. . 02001 Signature of Personal Representative ~C~I:~tf ('JJkJ [1,..4., . . . . .... .: or the Registe~ ---rv- ~ 0 Signature of Personal Representative '.0.,1 '-.--: :1 :.::) --._l I C; File Number: f), 1- Dl- 1013 Estate of RtJ h t-v+ F. ~ ,Lv(j sk .rck... r-.:, , Deceased Social Security Number: lIe, - Sr1- 770 0 ANDNOW,~OV~\'YI6.r K ,J-ool Date of Death: 16-?.~-C)7 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to R ().. Y hlL Y c,... .4 . C h l '\ C " f--r.. in the above estate and that the instrument(s) dated M (.( vd 7 ~ ( I q r I. descrIbed in the Petition be admItted to probate and filed of record as the last WIll (and Codlcil(s)) of Decedent. () FEES , k!~Ylcf,. ~ J&dtrt~ /l~Jdj ~i,. Letters ............... $;ALoO 000 &;terOfWlllS f '-'1 Short Certificate( s) . . . . . . . . $$ \[. .00 Altom,y SigMI","' . ,). q- Renunciation(s) .......... I l r \ Attoll1ey Name: (....- S~ t\A V\-rt.1 E: I.... tJ~AI ,,; WI \ ... $15 .('() / -.J (.p . . . $ 10,CD Supreme Court I.D. No.: S ~ 7 ~ a r~ uYno..b~ ... $ ..s, ci) Address: "3 q () J N CJ.-.'I/,U \ I- . ... $ ...$ ~t? (1./1 fA Ilul'-42')7 .. . $ f . .. $ .. . $ .. . $ TOTAL.............. $ 3a.o ,(jJ Telephone: rrl - -, '"37-0 Lf (" "-t Form RW-{)2 rev. 10./3.06 Page 2 of2 H 1())~()'1 RLV IIIlilJfI LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. 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. Fee for this certificate. $6.00 P 13823520 ~ +.dv..~'7.l~ /07 ocal Registrar ;te Issued (-) C) .'J , ,.~) c<) N Hl~~~,~~'t.U~ -:.t PERMANENT IllACKINK 1/31-126 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See Instructions and axampl.s on reverse) II. Oecedenfl UIuaI Knd at Woc\ Program analyst . 16. OececJenI's Mailing AddresI (SIr_, city / 1OWfl, ~, zip code) 911 COcklin street Mechanicsburg, PA 17055 18. Falter', Name (Firs!. midcIe. Iut, suIfill Andrew Androshick 12. Was 0ec:edenI8V8l'1n1he U.S. AI'Jl'lId Forces? ClIv.. DNa _. Actual Rtiidenct 17. Stale . 00II01 Dulh 1_ cloy, v-l October 28. 2007 1.......01_.....,_...,....1 Robert s.......-vl F Androshick 6. Dale of Birth (Month, da , tod_'" 69 v<s. April 9. 1938 Pottsville, PA 00llwr. st>dI: 10. Roto:____"" l*"1tute eo County 0I1Jealh Cumberland ad. F_ Name 1"""-, !tie..... tod """""'l 911 Cocklin Street l1b.CounIy 17C.O v.., DecedenI UYed in 11d ~ ~o.::,\">"- Mechanicsburg Twp CiIy/- 2Oa. tnlonnlnh Name (Type I PrinI) 19. MolNr'I Name (FnI, midlIe, MIidIn~) Farenish 2llb.~_._-I_<iIlt'_._...._) 33 Teabe Drive Carlisle PA 17015 21c.PIocool_{Nomeol_._"'-~) 2Id.Ulcalion(Cily/-._...._1 Hollinger crematory t. Holly Springs, PA 22c.Namotod_oIF_ 8 Market Plaza Way MalpezZi Funeral Halle Mec ic 231>. Uconoo_ ~ ~ lems 2~'26 nut be ~ted by persoo .noprorlQlR:8Sdellh 25lla/l1 PlOIIOlI1CId OeacIIMonIh, day, ,..,1 October 28, 2007 301. Was an Ai*'Prf """"""'" d. 3llb.___ AvailabltPrior IOC'.ompWiion 01 Cause 01 Oed\? ov.. DNa 31. Manner 01 Oealh lR-'" D- O- oPondiogl<Nestigalion oSuicido OCooklNol..""""""'" 26. Was Cue Referred to ~ Ell8miner I Caoner for. Aeaion 0IIIr II\In CreMIIion or Oondoo? tJ(V8. 0 Na ApproQnIktinterv81 Part": Enlerolletsill'lilcanlcondiliM&c:ombdirlolDtMaIh, 28. DidTClbaccoUsaConlrtllillo0lalh1 Onset 10 Deall but not rediog in.... undertyWlg cause giMn in Par11. 0 VII 0 ProbIbIr o Na 0....... 281Fem111 0..._-.....,.., o P,_......oI_ o ...p'_.buIp'_..........,. ol_ D ""'~II.bul:pr.,..,.4341y11IoI.,.. ..... - 0..........--........,.., 32t:.==~_F_. CAUSE! OF DEATH (SM hwructJone and examp"') ttem 27. Ptrt I: En&er1he ~ - disN$eli, infuti8s, or comPk;aboAs -lhIt rlndycaused Ih8 !Math. 00 NOT emer terminal events such as cardiac arrest, rt$pirllory arrest, or ~ filriIaIion wiIhoul showing thI ellology. lisl frij one causa on eadlllnt ='~~=)~ Muscular Dystrophy Dot to (or as I consequence 01)' -...-....y. Itadino lOb cause NIed on line II E.... lie UNIllRlYfIG CAUSE ~..:::;:r. -:.o."'l'mr 0uI1o IOf 15 . COl'lMqUBllC8 of): DuttolDl'''.CXJr'lHCIUInctol) ov.. !llINa 32dTmeollnju<y 32V.locelionollnju<ylSO.... dly/_,_1 M. 33a ""'*'1_"""'1 . CenIIyIftg_I__causo 01"'''''''''''''''''''''''''' has pronouncod- ""__231 To"'''' or..,........,.... oc:c:urNd dut.... caulll(.)....tnIMIf.......... __.... ___ ____................ _____ __............... 0 . :=::.:=::hW:.=::=~ancld8a~.:=to=:a:..........w.d..________....___..___ 0 . ::: =--= ....,or ~ An., opWon, dNlh oc:currtd"1M tImt, .11, MMI p&Ice,lIKI duI to IhI CMlM(., Md 1UMIf........ Ja Coroner I l!5 I 1.;2 II 1;2. I { 1.::2 I _PemwlNa t.:J.9S4 33d. Dele 5ql8d _. day. .....1 October 29. 2007 34m.-c'Tl~"foll:':""m~c.-e8'r"tm1p Type 1 P"" 6375 Basehore Roadl Suite #1 Mechanicsburg. PA 7050 ~~_........ ~"", ~ ...~:~~_",.., .,.."'" _._"'!~',....-I_....;-"'!.I!I~."l~H!'!__..""jIJll!!lL._.._"_.,_.._ ..".~"~lfl''''''I.'lo~'''''._'_OUlj...'.,.1.!1!....."... """'''':'', "" '~~ H ::r:: \. CJ) "0 -t p:: t::l ~ . ~ t! ,'\ ~ , -', IX:l .~,~ ~ LAST WILL OF ROBERT F. ANDROSHICK I, ROBERT F. ANDROSHICK, of the Borough of Mechanicsburg, 1'0 Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. Item 111: I devise and bequeath all of my estate of every nature and wheresoever situate, together with the insurance thereon, to my wife, MARY J. ANDROSHICK, providing she shall survive me by thirty (30) days. Item 112: Should my wife, MARY J. ANDROSHICK, predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath all of my estate of every nature and wheresoever situate, together with the insurance thereon, to my daughter, BARBARA ANN ROBINSON. Item 113: I direct that all my just debts and funeral expenses shall be paid from the assets of my estate as soon as practicable after my decease. Item 1/4: I direct that I be buried in the National Cemetery Fort Indiantown Gap, Lebanon County, Pennsylvania. Item 1/5: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the administration of my estate. Item 1/6: I appoint my wife, MARY J. ANDROSHICK, Executrix of this my Last Will. Should my wife, MARY J. ANDROSHICK, fail to qualify or cease to act as Executrix, I appoint my daughter, BARBARA ANN ROBINSON, Executrix of this my Last Will. , . Item 1/7: I direct that my personal representative or their successors. shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF. I have heretmto set my hand this ..;( S- day of ~ . 19~. A/,.-r ~ ~t F. Androshick The preceding instrument. consisting of this and one (1) other typewritten page. each identified by the signature of the Testator. ROBERT F. ANDROSHICK. was on the day and date thereof signed. published and declared by ROBERT F. ANDROSHICK. the Testator named therein. as and for his Last Will, in the presence of us. who at his request. in his presence. in the presence of each other. have subscribed their names as witnesses hereto. ;j)LJ fJ /J 3q f) J ~ .It, g'(j)~~~~ _residing at ~ /-I-d)> {l1701( "~ 370 / }7u~Z<JLL ~...1u.r>.6. residing at ~ ~,;:?, . ~ I , , . , . COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF CUMBERLAND ) We, ROBERT __f'L .~ - , - "" r I 1::"_ ~ ('i\r) . F. ANDROSHICK, -.ll-eN'- ~ r=-, C oj IV e and C,~, j tv' '€.. ,the Testator 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 Testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~~/6<~. Subscribed, sworn to and acknowledged before me, He.Le.. N M. the Testator and G r'l f F i T.h , by ROBERT F. ANDROSHI CK, subscribed and sworn to before me by .l.lelV r ~ ~ itt. C ~1Q.. Notary Pu lic , HELEN M. GRiFFITH, Notary PubliQ (dmp Hill, Cumberland Co., Pa. (SEAL) ;/iY CSil'T,ission Expires AprillB, 1988