HomeMy WebLinkAbout01-09-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
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Estate of Roy Harold Stone
also known as R. Harold Stone
File Number
. Deceased
Social Security Number 171-28-7007
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
IZl A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the Executrix
last Will of the Decedent dated November 2, 1999 and codicil(s) dated
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: ~:.~
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(lfapplicable. enter. c.t.a.; db.n.c,t.a.: pendente lite; durante absentia; dura~~!fiitinorit?N4i
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Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following s~ogi1 (if ah9J and heirs: (If
Administration, c.I.a. or d.b.nc.t.a., enter date of Will in Section A above and complete list of heirs) J:7'
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o B. Grant of Letters of Administration
Name
Relationship
Res~hce
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principal residence at
9 N. Railroad Avenue, Mechanicsburg, Borough of Mechanicsburg, Cumberland County, PA 17055
(List street address, town/city, township, county, state, zip code)
Decedent, then 93
years of age, died on November 18, 2007
at 9 N. Railroad Avenue, Mechanicsburg, P A 17055
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
$
$
$
$
50,000.00
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codieil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Sionature
T ed or rinted name and residence
Jean Elizabeth Stone, 9 N. Railroad Avenue, Mechanicsburg, P A 17055
Rickie 1. Cook
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Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representativ~
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COMMONWEAL TH OF PENNSYLVANIA
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COUNTY OF CUMBERLAND
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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 ofPetitioner(s) and that, as personal representative(s) ofure:jfjic~nt".,p-etitioner(s) will well and truly
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administer the estate according to law. ,..,. ill" . ': '.,..
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Signaf(;7 of~7fional Rep~sentativl
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Signature oj Persona Re resentative
Sworn to or affirmed and subscribed
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before me the
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Signature oj Personal Representative
File Number:
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Estate of Roy Harold Stone
Social Security Number:
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, Deceased
Date of Death: 1/ () G/,;/!cl.JL' { / J- y'[;{, / /
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6 , in c'?l1sidjeration of the foregoing Petition, satisfactory proof
AND NOW,
having been presented
are hereby granted to
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S_9~CRfED th~e;t~r~
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Attorney Signature:
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Letters ............... $
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......,. . $
1'01 '... $
I,
t(~/: $
~,~t l,C" \....../ $
. .. $
...$
$
$
$
$
TOTAL .. . . . . . . . . . . .. $
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Attorney Name:
THOMAS J. AHRENS
Supreme Court J.D. No.: 80143
Address:
52 Gettysburg Pike
Mechanicsburg, P A 17055
Telephone:
717-697-1800
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Form RW-02 rev. 10.13.06
Page 2 of2
Last Will
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of
ROY HAROLD STONE
I, ROY HAROLD STONE, of Mechanicsburg, Cumberland County, ,,",-,
Pennsylvania, make this Will and revoke all of my prior wills and cod~~~~) ~
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Article One
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My Family
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I am married and my spouse's name is JEAN ELIZABETH STONE.
All references to "my spouse" in my Will are to her.
The name and birth date of my child are:
RICKIE J. COOK, born April 18, 1945
All references to my children in my will are to this child, as well as any
children subsequently born to me, or legally adopted by me.
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Article Two
Distribution of My Property
Section 1. Pour-Over to My Living Trust
All of my property of whatever nature and kind, wherever situated, shall be
distributed to my revocable living trust. The name of my trust is:
ROY HAROLD STONE and JEAN ELIZABETH STONE,
Trustees, or their successors in trust, under the ROY HAROLD
STONE LIVING TRUST, dated November 2, 1999, and any
amendments thereto.
Section 2. Alternate Disposition
If my revocable living trust is not in effect at my death for any reason
whatsoever, then all of my property shall be disposed of under the terms of
my revocable living trust as if it were in full force and effect on the date of my
death.
Section 3. Testamentary Trust
If my spouse survives me, I authorize my personal representative to establish,
with the assets of my probate estate, if any, or with any property distributed
to my personal representative from my Trustee, a testamentary trust (or
trusts) for the benefit of my spouse and my other beneficiaries under the
same terms and conditions of my revocable living trust as it exists at the date
of my death. I appoint the Trustee and successor Trustee named in my
revocable living trust as the Trustee and successor Trustee of my
testamentary trust( s). The Trustee of my testamentary trust( s) shall have all
the administrative and investment powers given to my Trustee in my
revocable living trust and any other powers granted by law.
My Trustee shall be under no obligation to distribute property directly to my
personal representative, but rather may distribute such property directly to
the Trustee of the testamentary trust( s). Any property distributed to my
testamentary trust( s) by the Trustee of my revocable living trust shall be
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distributed by the Trustee of my testamentary trust( s) in accordance with the
terms and conditions of my revocable living trust as it exists on the date of my
death.
Article Three
Powers of My Personal Representative
My personal representative shall have the power to perform all acts
reasonably necessary to administer my estate, as well as any powers set forth
in the statutes in the State of Pennsylvania relating to the powers of
fiduciaries.
Article Four
Payment of Expenses and Taxes
and Tax Elections
Section 1. Cooperating with the Trustee of My Living Trust
I direct my personal representative to consult with the Trustee of my
revocable living trust to determine whether any expense or tax shall be paid
from my trust or from my probate estate.
Section 2. Tax Elections
My personal representative, in its sole and absolute discretion, may exercise
any available elections with regard to any state or federal tax laws.
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My personal representative, in its sole and absolute discretion, may elect to
have all, none, or part of the property comprising my estate for federal estate
tax purposes qualify for the federal estate tax marital deduction as qualified
terminable interest property under Section 2056(B)(7) of the Internal
Revenue Code.
My personal representative shall not be liable to any person for decisions
made in good faith under this Section.
Section 3. Apportionment
All expenses and claims and all estate, inheritance, and death taxes, excluding
any generation-skipping transfer tax, resulting from my death and which are
incurred as a result of property passing under the terms of my revocable
living trust or through my probate estate shall be paid without apportionment
and without reimbursement from any person. However, expenses and claims,
and all estate, inheritance, and death taxes assessed with regard to property
passing outside of my revocable living trust or outside of my probate estate,
but included in my gross estate for federal estate tax purposes, shall be
chargeable against the persons receiving such property.
Article Five
Appointment of My Personal Representative
I appoint the following to be my personal representatives:
JEAN ELIZABETH STONE and RICKIE J. COOK, or the survivor of
them.
I direct that my personal representatives not be required to furnish bond,
surety, or other security.
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I have initialed all of the pages of this Will, and have signed it on November
2, 1999.
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ROY HAROLD STONE
The foregoing Will was, on the day and year written above, published and
declared by ROY HAROLD STONE in our presence to be his Will. We, in
his presence and at his request, and in the presence of each other, have
attested the same and have signed our names as attesting witnesses and have
initialed each page.
We declare that at the time of our attestation of this Will, ROY HAROLD
STONE was, according to our best knowledge and belief, of sound mind and
memory and under no undue duress or constraint.
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Address:
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WITNESS
Address:
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STATE OF PENNSYLVANIA
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COUNTY OF CUMBERLAND
We, ROY HAROLD STONE, ''7/;",;v.", J. ;*",...1.:\ t and
7:;., (;:,1 /,1 /" s /, , the Testator and the witnesses, respectively,
whose names are signed to the foregoing Will, having been sworn, declared to
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the undersigned officer that the Testator, in the presence of the witnesses,
signed the instrument as his last Will, that he signed, and that each of the
witnesses, in the presence of the Testator and in the presence of each other,
signed the Will as a witness.
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ROY/HAROLD STONE
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WITNESS
Subscribed and sworn before me by ROY HAROLD STONE, the Testator,
and by Ihi;m/~r J. ithre'lf and Tci..-\d Ii. F~Lr\ ,the
witnesses, on November 2, 1999.
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NOTARY PUBLIC
My commission expires:
CHRlsnNE M. AHRENS, NOTARY PU8UC
CARUSlf BORO., aJMBfRlANO CO PA
MY COMMISSION EXPIRES AUG. 12 2002
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A,L RE'GISTRAR'S CERTIFICATION Q'F DEATH
V\fi\RNING It is illegal to dU!Jlicate this oPV bV photostat or photograph.
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Hl05.1~3 REV 11/2006 -
T'lPE ! PRiNT IN
PERMANENT
BlACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
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1 Name of Decedent (FI(st, middle. last, suffi..)
5 Age ILast BirlMay)
Roy Harold Stone
6 Date at Buth \Moolh, day, yea.)
93
June 22,1914
Hagerstown, Maryland
8b County l< Death
&1 Facility Name In nOl instilullOO, glve sl.eet and number)
7 Railroad Avenue
- 28 -7007
4 Dale 01 Oeath (Month, day. year)
November 18, 2007
Sa. Placo of Death (Check only one)
Hospital: Other
o Inpa~ent 0 ER I Oulpa~enl 0 DOA 0 Nurslllg Home ~Sidence
9 Was Oacedent 01 HIspanIC Ong'"? E. No 0 Ves
(If yes, speelly Cuban,
MeXJCaf\, Puerto RICat\. etel
OOther . SpeClty
10. Race: Amefican indian, BIacI<, Whoe, ete
(Spectlyl White
14, Manial Slalus: Mamed, Nevo. Married,
Widowed, DIvorced (spea/YJ
Married
Twp
most ot work ute 00 nol stile Tetired
KInd of Busoness I Industry
Barber
12. Was Decedent e\ler in the
U.S. Armed Forces?
!iJ Ves 0 No
Decedent's
Actual ReSIdence 17a Slate
PA
Cumberland
13. Decedent's Education (SpeClly only highest grade completed)
Elementary I Secondary (0-12) College (1.4 Of 5.)
12
Jean Elizabeth
- 16 Decedent's MaJllIlQ Addeess (SIleo!, CIty I lown, siate, ZIIl cooe)
7 Railroad Avenue
Mechanicsburg, PA 17055
17b, County
17c. 0 Ves, Decede<t\ lived in
17d. 'l)( ~i=~I(jUved withul
Mechanicsburg
O.y I Bow
19. Mother's Name (First, middte, maiden surname)
18 fattrer's ~Jame (Filsl. middle. last su/ful
Roy Baker Stone
Jean Elizabeth Stone
2{)b. Inlormant's Maoltng Address (Slreel, ciIy 110W11. Slale, 'Ill code)
7 Railroad Avenue Mechanicsburg, PA 17055
21d. LocallOO (Clly Ilown, slale, zip code)
Mount Holly Springs, PA 17065
zoa Inlonront's Name (Type I Pnnt)
Mamie Estella Cole
21c Place of [loSPOSllion (Name 01 cemetery, crematllfY or oltler place)
Hollinger Creamatory
Mems 24-26 must btl compleled by person
who prooouf~es iJeath t.
CAUSE OF DEATH (See Instructions Bnd examples)
l1em 27. PMl, Enter the ~~ - diseases, to/unes. or complw;aIIOl1S -that dlreclly caused the death. DO NOT enter terminal events such as cardiac arre~t,
fesptlalory anest, Of venlilCular tibrillauoo WIthout shoWing lhe ehulugy. list only one cause on each ~ne
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Due.o {or as a consequence o~ V ~
S<quentwlly ~Sl condtt\Of\S, d any,
~~,~ S,;o't.m~)i'1:ru~ a
(d1Soectse 0( InJu,\, that IniliClled the
e....ents reSl../ttlOg Ifl ded.Ul) lAST.
Due to (or as a consequence of)
Due to (or as a consequence of)
3()a Was an Autopsy
Ptlr1urmed?
3lll> We<e Autopsy Flndulgs
Avadable POOf to CompJtilion
01 Cause of Death?
31 Manner 01 Oeath
~Ial n homICide
o Acadenl [J Pendmg In'esligalron
o SUICrde 0 Could Nol be Deterrruned
32a Dale oIlnlWY (Month, day, year)
DYes yr'
o ~es 0 No
32d. Tune of Inlury
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33a Certltiet (CM'" ooly one)
Certifying physician \PhYSIQilfl certifYing cause 01 death when dnolt16r phYSjGlafl has pronounced death and wmpltMd Ilem 23)
To the best of my knowledge, death occurred due to the cause(s) and marmer .s stated-. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Pronollncing and certifying physician \PhY::iIClJn Oolh prOflUU/lClog deiJItI and CtHlIfYlOg to cause 01 <leatll)
To the best of my knowledge, death occurred iillhe time, date, and ptace, an4 due to the caus.e(&) and manne, as i\a\8\L _ _ _ _ _ _ - - - - - - - - - - -
~~~::~:~~;':"ll~~~:~: and I or In\/estigalion, in my opinion, de.ath occuHed at tile time, ddte, Bnd plate, and d~e to the c.aUH\a) ,md manllel' al ltatu(L []
') ; .., 1" 36 ale F~d (Monlh, day, yearl
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O,spu>>llonPeln",No OOq~q'ol
OVes
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Approximate interval
Onset 10 Death
Pan II: Enle. other SlOIldtcanl cnnditlOflS ~JQ.lluJb,
b<ll no1 resulttn9 in the underlyrng cause goven in pan I
28 DId Tobacco Use ContnIxAelo Death?
DYes 0 ProbaUy
No 0 Uni<nov.n
29 II Female'
o Not pregnant WIUIIIl pas! year
o Pn:gnanl a' \Kne of d&ath
o Not pregnant, bul pregnant Wllhm 42 days
o'death
o Not p.egnant, but pregnant 43 <lavs 10 t year
before death
o Unknown iI preQMnI wilhifllhe past year
32c Piace of Injury: Home, farm, Slreet, FactllfY
Oltice BuildIng. ole (Speclly)
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329. Location of Injury lSUeet, <rty 1 town, Slate)
34')me and Add~~~s;J- !tjrson Who fomP"ed Cause ~\ Death (hem 27) Type I Plint
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