HomeMy WebLinkAbout01-10-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C \.) N\.o~lA~ COUNTY, PENNSYL V ANL\
Estate of
also known as
MAG?-"1 J E~ \A:I\.IV..A..C~ER.
File Number
a, D~ ()6~1
::
, Deceased
Social Security Number
Petitioner(s), who lshre [8 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) is I are the
last Will of the Decedent dated h- (-a -9" and codicil(s) dated
~~ ICe. Q ToR
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:
f..........)
Q .-'-
o B. Grant of Letters of Administration .~ 0 ~
(Ifapplicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; dUrallff3 ~iilf!Jrilate) (._
~r C"1 ~:
Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following sPous~ift;~ny) ar1d11eirs:
Admillistratioll. c.t.a. or d.b.ll.c.t.a.. enter date of Will ill Sectioll A above and complete list o/heirs.} ,;: ;}~ a
, I
(If
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R~i:~~ C" ~
U1
Fi
Name
Relationship
(CO/IIPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
55
Decedent, then I <1 years of age, died on J \ -1 q - 07 at
M ts,<;.{AJ-+ \) i LL&\~E
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in P A) Personal property in County / cJc ~ $
Value of real estate in Pennsylvania :oe.pu;;;.l T $
40,DOO.C:D
situated as follows:
Wherefore, Petitioner(s) respecttully request(s) the probate orthe last Will and Codicil(s) presented with this Petition and the grant of Letters in the rm to
the undersigned:
Ty ed or rinted name and residence
j AA ES :J:DOSCA S t-lJ1MA cH ~
FormRW,02 reI'. 10.1306 Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
COUNTY OF
CLJV.hYW
SS
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 ecedent, Petitioner(s '11 well and truly
administer the estate according to law,
before me the
10
Sworn to or affirmed and subscribed
Signature of Personal Representative
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Signature of Personal Representative
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';A \ ao (JDb'
Estate of /frlJL{ ~(]n l-!a/Y10J!her
Social Security Number: ~ ,~ Date of Death: \ \ - \ 9 -(2:)-"1
AND NOW, ......~~ 16 ,d6cB, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters \~~~-\o....IY
are hereby granted to ~~e..<;; ~\o..s ~ I
I
u
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o
File Number:
w
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, Deceased
and that the instrument(s) dated ~\J..x\e.. \. d \ ~~ '-l
described in the Petition be admitted to probate and filed of record as the last Will
in the above estate
Letters
FEES
.. ,~9L~.,.
$
$
$
$
$
$
$
$
$
$
$
$
.............. $
~o
\do
Short Certificate(s) . . . . . . . .
Renunciation(s) ..........
1/)'11.\
'- \c r
~-b
Attomey Signature:
\'5
10
to:;
Attomey Name:
Supreme Court I.D. No.:
Address:
Telephone:
TOTAL
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Form RW02 rev 10.1306
Page 2 of2
HI05.805 REV (01107)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 13989550
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
!2wn-1?~. NO~ 2 0 ?fj07
Local Registrar Date Issued
Certification Number
MESSIAI-\
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REV 1112006
PRINT IN
AANENT
CKINK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
~
:1:
6. Dale of Birth (Month, clay, year)
Bel. Facillly Name (If I'IOt institution, give street and number)
\J~LL(4,G>f
9. Was Decedent of Hispanic Origin?
(II yes. speclfyCuban,
Mexican, Puerto Rican, elc.)
10. Race:,American Il'Idian, Black, While, ale.
(Spec;fyj
white
12. Was Decedent ever in the
U$. Armed Forces?
DYes DCINo
Decedent's
Actual Residence 17a. State
13. Decedent's Education (Specify only highest grade completed)
Elementary I Secondary (D-12) College (1-4 or 5+)
12
14. Marilal Stalus: Married, Never Married,
Widowed, Divorced (Specify)
widowed
17b. County
Pennsylvania
Cumberland
Did Decedent
Live;n a
Township?
17C~YeS,DecedentLiVedjn TTrrpr
17d. 0 No, Deceden1 Uwd wi1hin
Actual Umitsof
All pn
Twp.
City/Boro
19. MOlher's Name (First, mlddIe, maiden surname)
Mary Fulmer
2Qb. Informanrs Ma"ing Address (Street, city I town, stale, zip code)
871 Mandy Lane, Camp Hill, PA 17011
21c. Place 01 DislXl5ition (Name of cemetery, crematory or other place)
Rolling Green Cemetery
Hummel Ave.,Lemoyne,PA17043
23b. License Number
23c. Date Signed (Month, day, year)
24_ TITTlt of Death
OIY~
M.
Dead (Man1h, day, yearl
1<r107
26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation or Donation?
DYes ~o
CAUSE OF DEATH (see Instructions and examples)
Item 27. Part I: Enter the ~ - diseases, injuries, or compIlcatIons -that directly caused the death. 00 NOT enter terminal events such as caniac arrest,
respiratory arrest, or ventricular fibrlHation without shovting the etiology. Ust only one cause on each gne.
==~~~~~)dl~
Approximate interval:
Onset to Death
Part II: Enter other siontficanl conditions contributina to dAalh,
but not resulting in !he underlying cause given in Part l.
DYes ~o
3Ob. Were Autopsy Findings
Available Prior to Completion
of Cause 01 Death?
DYes ~
31. Ma~ of Death
[2(NaluroJ 0 Homicide
o -. 0 Pending fnveetigetion
o Suidde 0 Cou~ Not be Determined
u~
iAtaJW
w-edUJ
~
&tt,~tlJ1.. ~ W~
advtbU-UcI etlll!l-J
~;U
1...U01...Mo.(.,J
28. Did Tobacco Use Contribute 10 Death?
O~OProbab~
l!:I No 0 Unknown
29.~:
[3" Not pregnant within past year
o Pregnan." time ol dea1h
o Not Pf9Qn8nt. but pregnant within 42 days
ol dea.h
o Not pregnant, but pregnant 43 days to 1 year
belol1ldeeth
o Unlmown H pregnan1 wi1hin 'he pes' year
32c. Place of Injury: Home, Farm, Street, FactOly,
Office B~king, etc. (Spec;(y)
a.
;{)OS
~~~'~~i~a,
Enter 1M UNDERLYING CAUSE
=,"~ry.~~t.'
b.
c.
d.
308. Was an Autopsy
Perl0nned7
32d. Time of Injury
M.
321. "Transportation Injury (Specify)
o Driver f Operator 0 Passenger 0 Pedestrian
Other - SpecIfy,
:s.,M;;;;;:;O~~0- /11f)
33c UCMmOr <I a 5 if::; )" 33d. Dati ,9 I q1h;~rl
32g. Location olln;ury (Street, city Ilown, stale)
33e ee_ (check only one)
Certlfytng physician (Physician certifying cause or death when another physician has pronouncec:l cle8th and completed Item 23)
To the best of my knowledge, death occurred due to theeault(l) and manner al stated..... _........ _.... _...... _...... _...... _.... _ _..........._
~;:U~":f~ ~~~~la~~; =hu=:~~::::~.:rnc:iot~:~~:~~ manMf as stated.. .. _.. _ .... .... .... .... _.. .... _ 0
~:I=~":,~= and I or Investigation, In my opinion, death occurred at the time, date, and place, and due 10 the cause(s) and manner as stated.. 0
35. Registra~
~
~) I 36. Date Fi (Monl} day, year)
I oa II ~ / I 1 I /1 ',;jI() I~OC, 7
DisposJUon Parm;' No. 0 () 7 () 5 :J. S
34.Na~~rit'1O~)ntJath(ltem27) TypefPrint
I () tJ ~/)1-r fJ/.-l-e jJ J.>:;e vI!! ,-./
/J1 -i-/-P7IIIC-S8Jllc- 1'04 170.5<:'
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SAIDIS, GUIDO,
SHUFF &
MASLAND
26 W, High Street
Carlisle, PA
II
LAST WILL AND TESTAMENT
OF
MARY JEAN HAMACHER
I, MARY JEAN HAMACHER, of New Cumberland, York County,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby 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 payment of my just debts and expenses of my
last illness and funeral from my estate as soon after my death
as conveniently may be done. I desire that my body be interred
at the Rolling Green Cemetery.
Further, I authorize my personal representative to expend
funds from my estate, in such amount as my personal
representative shall consider necessary
and desirable for the
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sui table ~E:ifker ~ormy
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purchase, erection and inscription of a
grave.
<.=}
SECOND
I give, devise and bequeath any and all valu~bie je~lry
C:J
that I have in my possession at the time of my death to(~
daughter, DO~TNA LEE BERGONZI.
THIRD
I give, devise and bequeath all the rest, residue of my
estate in equal shares to my children, JAMES DOUGLAS HAMACHER,
LAWRENCE WILLIAM HAMACHER, DAVID BYRON HAMACHER AND DONNA LEE
BERGONZI, per stirpes.
1
)
1
F
~
SAIDIS, GUIDO,
SHUFF &
MASLAND
26 W. High Street
Carlisle, PA
II
FOURTH
I direct that any and all inheritance, estate, and transfer
taxes imposed upon my estate passing under this Will or
otherwise shall be paid out of the principal of my residuary
estate.
FIFTH
In addition to the powers conferred by law, I authorize any
personal representative acting under this instrument, in his/her
absolute descretion:
(a) To retain in the form received, or to sell
either at public or private sale any real or personal
property;
(b) To exercise any options to subscribe for
stocks, bonds, or other investments.
(c) To join in any plan of lease, mortgage,
consolidation, exchange, reorganization or foreclosure
of any corporation in which my estate or any trust may
hold stocks, bonds or other securities;
(d) To sell, transfer, convey, mortgage, pledge,
lease or exchange any property, real or personal, which
at any time may form part of my estate, for the paYment
of debts or taxes, or for any purpose of administration
or distribution, for such prices and upon such terms
as my personal representative, in his/her sole discretion,
may deem wise, and to execute and deliver deeds of
conveyance or transfer thereof;
(e) To make settlements and compromises on such
SAIDIS, GUIDO,
SHUFF &
MASLAND
26 w. High Street
Carlisle, PA
terms as my personal representative in his/her sole
discretion may deem wise without the necessity of
obtaining any court approval thereof;
(f) To make distribution hereunder either in cash
or kind, as my personal representative in his/her
discretion
may deem wise.
SIXTH
I do hereby nominate, constitute and appoint JAMES DOUGLAS
HAMACHER to act as Executor of this my Last will and Testament.
Provided, however, that if he is unwilling or unable to act as
Executor, I direct the duties of Alternate Executor, be
performed by LAWRENCE WILLIAM HAMACHER.
SEVENTH
I direct that no personal representative, guardian, trustee
or other fiduciary appointed under this instrument shall be
required to give bond for the faithful performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I, MARY JEAN HAMACHER, have hereunto
set my hand and seal to this my Last Will and Testament,
consisting of four (4) typewritten pages, the first three (3) of
which bear my signature in the margin for identification, this
/~day of ~
1996.
rn=a ~'"" lb>~~
MARY JEAN HAMACHER
SAIDIS, GUIDO,
SHUFF &
MASLAND
26 w. High Street
Carlisle, PA
Signed, sealed, published and declared by the above-named
Testatrix, MARY JEAN HAMACHER, as and for her Last will and
Testament in the presence of us, who have hereunto subscribed
our names at her request as witnesses thereto, In the presence
of said Testatrix and of each other.
\.0 Ole
ADDRESS ,.;} 10 9 177a~ >l1-
(f~ )fJJ f7A /~) / I
SAIDIS, GUIDO,
SHUFF &
MASLAND
26 w. High Street
Carlisle, PA
II
COMMONWEALTH OF PENNSYLVANIA:
SS
COUNTY OF CUMBERLAND
WE, MARY JEAN HAMACHER,
Jo Smith
and
Johnna Deily, the Testatrix and witnesses, respectively whose
names are signed to the foregoing or attached 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 Testament and that she signed willingly and that
she executed 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
the time 18 or more years of age, of sound mind and under no
constraint or undue influence.
~
i,. '"
Subscribed, sworn to and acknowledged before me by MARY
JEAN HAMACHER, the Testatrix, and subscribed to and sworn or
affirmed to before ~ by Jo Smith
witnesses, this /.;? /- day of
and Johnna J. ei
~J1;2~
Notap Public
f ._.~- ._-
NOTARIAL SEAL
THELMA S. McCAUSLIN, Notary Public
Camp Hill, Cumberland County
My Commission Expires July 3, 1996