HomeMy WebLinkAbout11-27-07
Register of Wills of Cumberland County, Pennsylvania
Estate of LUCY L. CSAJKA
PETITION FOR GRANT OF LETTERS
J../-{)7- /O~:u
No.
also known as
, Deceased
Social Security No. 174-20-5202
STEVEN M. CSAJKA (Peter A. Csaika died 7/23/2005)
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
GJ
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or
Decedent, dated 10/8/1996 and codicil(s) dated
named in the Last Will of the
State relevant circumstances, e.g., renunciation, death of executor, ete
Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
o
B. Grant of Letters of Administration
(c.I.a., d.b.n.e.l.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was surviv~ by the fOIl~ng spou8.fb
(if any) and heirs: Co .....:::D 1J:i
;:': :0 Z ~Tl :--
Name Relationship ~~en~
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at Golden Living Center, 770 Poplar Church Road, Camp Hill, PA 17011 (East Pennsboro Township)
(list street, number and municipality)
Decedent, then 83 years of age, died 3/17/2007 , _ . at Golden Living Center, Camp Hill. PA
(Location)
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 ........................................................................................ $
Total ..................................................................................................................... $
7,800.00
7 .800.00
Real Estate 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 approp" te form to the undersigned:
Signature
Typed or printed name and residence
Steven M. Csa'ka
416 Bucke e Lane East
Jacksonville FL 32259
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Peliti er( s) and th~pers:al represenla. tive( s) of t~ Dece.~e.nt,
Petitioner(s) will well and truly administer the estate a i g to la I (") g:o
/ <::: 0 -.J. f.g p~
Sworn to and affirmed and subscribed ,'-:0 :z.,
d +f~ Steven M. Csajka ..rr:cp <S~-
b f h. 7rrr d f '"-~m N r~lm
e ore me t IS ay 0 >':"<:"::12 -.I ':;0 0
~O ~ ~~_<f)^ C:-JQ
~VI,~?8"" 0 -v "'~:'~...1 ~
. '- ) C II :x :;2 -
~-) :0 N' i"-'" ~
--t .. r-
:0 ..- '"'r\
:::> w 'J~ ~
U
DECREE OF REGISTER
Estate of LUCY L. CSAJKA
also known as
!L1-/)7-J09~
,
Deceased
No.
IT IS DECREED that Letters lXI Testamentary 0 of Administration
(c_t.a., d.b.n_c.t.; pendente lite; durante absentia; durante rninoritate)
are hereby granted to John M. Smith, ESQ.
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ....................................
Short Certificate(s) ...............
$
$
$
$
$
$
Inventory & Tax FQrms............. $
~ Ac.d1Jrrattffk-:l....... $
Renunciation ..........................
l\ftiEf8~t (
) .W. U.I...........
Extra Pages (
)............ ..
Codicil .. ...............................
JCP Fee .................................
TOTAL...... ...... ...... ...........$
RW-7A
$}50V
rOD
w'
J1wa ,jaHm.ft ~p}ff
Register of Wills ~ i) a ~
J5,tX)
Attorney
10. (j)
Attorney: John M. Smith, ESQ.
I.D. No: #19520
Address: 222 S. Market Street, Suite 201. PO Box 267
-aD
.~.
q I.eo
Elizabethtown
PA 17022
Telephone: (717)367-1370
DATE FILED:
~( v(~?-
WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
L.
Middte
Social SecurityNd.
Jan.12t19.24
a~::;;hey, ."PE;!nna.
Birthplace
Golgen LivingCEmter
Cumberlahd Co.
Facility Name
County
City~__BO!:ough or Township
Occupation
Widowed Decedenfs
Mailing Address
Stevenesajka
. ""'" .
ArmedForces? (Yes or No)
770 Poplar ChurchlIDad,Camp Hill, Pa.
Informant
Name and Address of
Funeral Establishment
BuseF .H., 145 N.GrantSt., PalmYra, Pa~ 17078
Interval Between
Onset and Death
Immediate Cause
Sepsis
(a)
0;
~i
') .
.:::!:I!O
, J r--
...~~'m
· "'::: c.q :J:2
..., ^
jOo
:38.-"
;--:::0;
:oM..... .
?1i.' .
Describe how injury occurred:
(b)
ProbablePneUlOOhia
(d)
Other SignificanFConditions
Dysphagia, PJ;ofoundSDAT
Manner of Death
xx
o
o
o
o
o
Homicide
Pending Investigation
Could not be Determined
P.O. Box
I
I
I
I
I
I
"
State
ar:l.
<:;::)
-..
5
.:::0
Ii:
::r-'o ..
~~. ':IJ '.
~2~~
0')~
..,.,
:Jt
N
.-
.w'
c.t)
This is to certify that the information hef~ givenls.cQ~re~llycopied frolllan.origlnalcertificate
of deathdtlly Hied with me a.sLocal Regisfrar-The odginalc~rtificatevyHLbe fOI'VI/'a;rdedtoitne
State Vital.Records Officefot permanenfHlinW~~....~L.- ....38"...J57
L.0eB!_ Registrar:,{)f: VrtalAElCOr~ t>is(iicr:N*..
Date -Received by Local Registrar
City, Borough, Township
1 59 N. ~ilXoad$t..Pal.1'nvx'a, Pa. 17078
March .,' 20 , 2007
Street Address
"
j.
LAST WILL AND TESTAMENT
o
(--
---0
(-=) ::::0
-. --0
'IIO
_:~:~~g
-'U)^
00
C;O',
(-)C
: :::0
::-0-1
>
,....,
c:::s
c:::s
-.I
:z:::
o
<
N
-J
-0
::x
~
,",:.;: ~.
-..:....
;.:,;::: ~
(-
C/')
OF
LUCY L. CSAJKA
w
w
I, LUCY L. CSAJKA, of Dauphin County, Pennsylvania, being of
-iJ
sound and disposing mind, memory and understanding, do hereby
make, publish and declare this to be my Last Will and Testament,
hereby revoking and making void any and all prior Wills,
Codicils, writings thereto, by me at any time heretofore made.
ITEM I. I direct that the paYment of my debts and the
expenses of my last illness and funeral shall be paid from my
estate as an administrative expense as soon after my death as
conveniently may be done.
I direct that, if possible, I be interred in the Indiantown
Gap Military Cemetery, Indiantown Gap, Pennsylvania. Otherwise,
I authorize my Executor to make the decision to purchase a
cemetery plot in a suitable cemetery with a contract for
perpetual care, using therefor, funds from my estate in such
amount as my Executor shall consider necessary and desirable, and
I authorize my Executor to cause title to, or ownership of, such
plot so purchased to be vested in such person as my Executor
shall designate.
Further, in this connection, I authorize my Executor to
expend funds from my estate in such amount as my Executor shall
consider necessary and desirable for the purchase, erection and
inscription for a suitable marker for my grave.
ITEM II. I hereby give, devise and bequeath all the rest,
residue and remainder of my estate, realty, personalty and mixed,
~ )': (! ~ (SEAL)
LUCY CSAJKA .
Page 1 of 6 Pages.
II
"
wheresoever situate, to my husband, PETER A. CSA3KA, provided
that he is living on the thirtieth (30th) day after the date of
my death.
ITEM III. In the event that my husband, PETER A. CSA3KA,
does not survive me by said period of thirty (30) days, then I
specifically give, devise and bequeath all the rest, residue
and remainder of my estate to my son, STEVEN M. CSA3KA, provided
that he is living on the thirtieth (30th) day after the date of
my death.
ITEM IV. In the event that my son, STEVEN M. CSA3KA, does
not survive me by said period of thirty (30) days, then I
specifically give, devise and bequeath all the rest, residue and
remainder of my estate to my granddaughter, AMY MARIE WILLIAMS.
ITEM V. In addition to powers given to him by law, my
Executor and his successor shall have the following powers,
applicable to all property held by them, effective without court
Order and until actual distribution:
(a) To retain any property received by them, including the
stock of any corporate fiduciary acting hereunder;
(b) To sell real estate for any purpose, publicly or
privately, for such prices and on such terms as they deem proper
without liability on the purchasers to see to application of the
purchase moneys;
(c) To compromise controversies;
(d) To distribute in cash or kind or both at such
valuations as they may fix.
ITEM VI. All taxes, interest and penalties thereon payable
by reason of my death with respect to property comprising my
~~ X. L?~h.v (SEAL)
LUCY L1 CSA3KA c1
Page 2 of 6 Pages.
"
gross taxable estate, whether or not passing under this Will,
shall be paid from the principal of my residuary estate.
ITEM VII. I nominate, constitute and appoint my husband,
PETER A. CSAJKA, Executor of this my Last Will and Testament.
Should my husband, PETER A. CSAJKA, predecease me or, for any
reason fail to qualify as such Executor or, having qualified,
fail to serve as such Executor, I nominate, constitute and
appoint my son, STEVEN M. CSAJKA, as his alternate Executor.
Should my son, STEVEN M. CSAJKA, presecease me or, for any reason
fail to qualify as such Executor or, having qualified, fail to
serve as such Executor, I nominate, constitute and appoint my
granddaughter, AMY MARIE WILLIAMS, as his alternate Executrix.
No fiduciary acting hereunder shall be required to post bond or
enter security in any jurisdiction.
IN WITNESS WHEREOF, I have set my hand and seal to this my
Last Will and Testament, consisting of this and two (2) other
pages at the end of which I have also set my hand and affixed my
<;?A
seal for greater security and better identification this
Odr:b~R
day of
, A.D. 1996.
t:/1::jsz.-
.
C~ (SEAL)
Page 3 of 6 Pages.
11
Ii.
We, the undersigned, hereby certify that the foregoing Will
was signed, sealed, published and declared by the above-named
Testatrix as and for her Last Will and Testament, in the presence
of us who, at her request and in her presence, and in the presenc
of each other, have hereunto set our hands and seals the day and
year above written, and certify that at the time of execution
thereof, said Testatrix was of sound and disposing mind, memory
and understanding.
Page 4 of 6 Pages.
~
Residing at fk(?~PA
Residing at~wiSbJ 'A
,
"
IJ
"
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA)
) ss:
COUNTY OF DAUPHIN )
I, LUCY L. CSAJKA, Testatrix, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act
for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by
g-~ day of
LUCY L. CSAJKA, the Testatrix, this
od:o~\Q ~
, 1996.
II
~~ " eA1~J.,-d!___
LUCY L if CSAJ~A a
7j;;k~ of. fir.e/?S
NOTARY PUBLIC
NOTARIAL SEAL
VICKI L PETERS. Notary PublIc
Derry Twp.. Dauphin Coun\y
MY COmmisSiOn ExDire.s ...0,1114. 1997
Page 5 of 6 Pages.
"
. .
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA)
) ss:
COUNTY OF DAUPHIN )
We, R. ERIC PIERCE and -Mtb'NtM-M. ~.po.L .
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testatrix sign and execute the
instrument as her Last Will; that LUCY L. CSAJKA signed
willingly and that LUCY L. CSAJKA executed it as her free and
voluntary act for the purposes therein expressed; that each of us
in the hearing and sight of the Testatrix signed the Will as
witnesses; and that to the best of our knowledge, the Testatrix
was at that time eighteen (18) or more years of age, of sound min
and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before
PIERCE and -1J..d/Ndl- M. A\~4--Witnesses, this
() C*O~(J R \. , 1996.
me by R. ERIC
g~ day of
'7J:ek~ ~ &as
NOTARY PUBLIC
NOTARIAL SEAL
VICKI L PETERS. No1ary Public
Deny Twp., Dauphin County
Commission Ex' A '114.. 1997
Page 6 of 6 Pages.