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