HomeMy WebLinkAbout02-04-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cu.mbt( l6U'\d COUNTY, PENNSYLVANIA
Estate of \J Illl tA.yY) K Ko :., 1<<
also known as
File Number
~ \ () 9)
D\ 6. ),
, Deceased
Social Security Number
.J j, ...:,,~ (:, /-
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'll' BELOW:)
~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(sQ/ are the
last Will of the Decedent dated f;z~' -(.'3 and codicil(s) dated
d6t ~{;!Jl r
,J
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:
D B. Grant of Lettets of Administration
(Ifapplicable, enter: c.t.a.; db.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following sIlPusr (if any)juJp heirs: (If
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) "', .
, ;
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Name
Relationship
Residence "..'
;i
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. ,
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Decedent, then ~ D
years of age, died on Jt.u') lAw ~ 7.b I zu:/i at hI) rYtl_
Decedent at death owned property with estimated values as follows:
(lfdomiciled in PAl All personal property
(\fnot domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$ ;;, fl, ONI
$
$
$
situated as follows:
Wherefolre, 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:
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Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEAL TH OF PENNSYL v ANfA
C LA (It I. !' l (; (ld
SS
COUNTY OF
TIle 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 Decedent, Petitioner(s) will well and truly
administer the estate according to law.
'-/
.Ja.'?/?-t /) IJt( Un-
Sworn to or affirmed and subscribed
before me the
day of
.;)C/J f)
~L
For the Register
Signature of Personal Representative
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Signature of Personal Representative
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File Number: d.\ DCA D\(u)
W ,) I llVYj KDss.I'f c-
Estate of K. , Deceased
G ~ 2-4 Date of Death: t- 2.D - D 'h
, in consideration of the foregoing Petition, satisfactory proof
, Jl > I I~
in the above estate
and that the instrument(s) dated Pu:il.,0,-I d)q C).Ot:J3
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
I 1 _)1 ."'
FEES ') :C:1it - / "01 J.... ' . .1) c..-t/"U
Letters .. _ . 'i~()1 (..l(:q. . . $ 100
Short Certificate(s) . .lb. . . . $ '1u
Renunc:iation(s) ....!..... $ S
l-J d ( . . . $ ) S
-Jet) ...$)0
-.---JOu 10 . . . $
... $
.. . $
. . . $
. . . $
. . . $
.. . $
TOTAL .., . . . . . . . . . . . $ ()f; ,el o:mr
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
I-
v
Address:
Telephone:
Form R WoO 2 rev. lO.13JJ6
Page 2 of2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate thIs copy bV photostat or photosraph
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE filE NUMBER ~ \ C. ~ b \ ~'~
1. Name of OIlC8denI (F,sl. middle. last, s\lffi.l.)
William R. Kossler
5. Age(ll,5t8irthday}
6 D.leo(Birth Maolh,da 1. Bir',t\ lea
90
Yrs
September 4,1917 Pittsburgh, PA
8b CounlyofDealt1
ad Fao~ty Name (If not insblil1ion, give street and number)
Cumberland
Hampden
6110 Sommerton Drive
Com
13 Decedent's Educauon (Specify only highest !Jade completed)
Elemen~/SecondllY(Q-12J CoIl6ge(1-<torS+)
2
Hampden
11. DecedE,nt'sU~"Oa:u ilI11.00 KUlliol
Kind of Wirl.
Land Consultant
n\Ostol'H'.lr'J.lIl 'Ale Dono\!ola\.'elilvd
KiodotBu5iness/lnoosty
PA
Cumberland
19 Molher's Name (First, middle, maiden surname)
Minnie Roberts
6110 Sommerton Drive
Mec;hanicsburg, PA 17050
lhStata
17b.COllnlr
18 Father'!; Narr,e (F~st lIaddle, lasl, sl;ffi:x)
Joseph Kossler
4. Oall of Dealh (Month, dar, year)
190- 09 -5824
8. PlaclIolOeath Ch.,a,onl one
Hospital
o Inp,lienl 0 ER 1001pau&n1 0 DCA 0 N<lr5ing Homt
9 ~'~e~~u~:aruc~n1 .E9 ~
MeAican,PUIrtoRican,elc)
White
January 20, 2008
Top
OOll1ar.Speafy
lQ Raca. ~\ndian, Bladl., White .Ie
,-
14 Marll.1 Slatus M.-ried, N.~. M.ned.
WidolWKi, OivClald(Specify}
Widowed
Did Decedent
Uveina
TO'M'Iship?
17ca Vas,D~enIUvedill
17d 0 No, Dec&dant [j~ed W1lhlll
AClualUmlls01
Clly I BO'o
2CtI. Informant's Mailing Alitass (Street, city I town, stale, zip code)
6110 Sommerton Drive Mechanicsburg, PA 17050
21d. loc:alion(City/toWl'l.stale.lJPcode)
20. lntormanl'sName (Type/Printl
Kate Tannenbaum
2k Place 01 Dispo$ition (Name 01 c:emelNy, aematory cr- olher place)
Schaefferstown, Pa. 17088
Conolite Crematory
22c Name and A~ess 01 Facility
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
2k OatIS~(Mor,th,daY,YIilJI}
. lLillUs2426mu>.\boo~\e.Jbypel"WO
whOpo'OflU\lIlC8sJaath
24 Time of Death 25- Qa\8 PlOnC\lncad Dud (Mon\l'1, day, year)
7'. I c' .." /."} ,:' - L ( <) l"',
23b Licen>.eNumber
26 Was Case RBferred 10 ~CiII E;\aminer I Caon. fO' I Reawn OItIer than Crema~on iY Donalion?
o Yo> JjilNO
IMMEDIATE CAUSE (Final dl~",ase rx
coodilion ra>.IJtlingill death) ~
/Y}~lC ~l~
ApPfollimalll int8f~al Pari It Enler other SICllllficanl conditions contribullna 10 death 28. Old Tobacco USf Conlnwl.1o Dtllh1
Onsello Dealt1 but nol resl;IIin\l in lhlll;nderj~ln\l c.use il~8(\ ill Pert I 0 Yes 0 Plooably
.f!:J'1'l0 0 Unknown
29,lfFemale
o No! pr&gna~1 WlIl"ln pol>.t yew
o Pragnanl at Uml'l of death
DNOlpr8\ll1ant,butp'egnanIWllOID42da~s
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CAUSE OF DEATH (S.. in5truc::tiona and example$1
jli.m 27 PAin I: Enli;lf lha maio "I evellls' dlsea>.as. InJuria>., a comp~caliOlls . thaI diriictly caused the daath DO NOT enllOllarminal events Such as cardiac anasl
respjr alOfy arrest. a ventrlClllal flbo:~latio(\ IHIU\Cl'l1 s.tIowi(lglhllo ello\cgf lj$1 only (:/'lEi ta\l!.8 on each ~ntl
O",,,,,,...,,,,,.q",","o~l Y~L t({J " kJ!
Sequ..o~ally 1>.1 condlllOIlS. If ar,y
leading 10 ca'lse ~sled OIl ~nll a
En\et the UNDERLYING CAUSE
(disllase or inj;Jl') thallf1l~al..d the
. e~8I1lS r..>.ultmg in j,;<rm ) lAST.
Due to (Of as a consequence Ill)
Due 10 (llr as ICllnsequence Ill)
30. WasanAlJlops~
PerfO'med?
30tl Were A<llop~~ Findings
A~ailabIeP~ toCom?\.ltioo
01 Cause of Dtlalh?
31 Manner 01 Death
~NaMal
o ACClden\ 0 Pendll1\1 \meslIgallOll
o S\llode 0 CClJId Nul be Dtltllfll1ined
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~:O::U:.~~:ta;~ ~~~~:~:,I1::~~I:c(:::/::~ :ethu~~~~~:,n:n~;~~:,d.:lI~~:gl~O ~:u:~;:i~~d manner II i,.tleL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D
~~~~:~~:~m~~:~;~~=t:~ ~d liar lnvutillltioll, ill fIl)' llpinion, d.uth o~c\med. ilt tho time, d.lte, J,(Id.pll..... &rid dill \c the cWlllt) and m~n" II "I\.d. _ _.P
J~R1r
I"^ Ii II- I.l. 0,
Disposition Permit No
o Notpregnafll,bulpl<09nanI43clayslo 1 yell{
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DUni<noWl1ltprll9nat11WlthinthtlpaslYlar
12c Plao& of lf1jUfy. HooIe,F.m,SI1M\. Factrxy.
OfficeoBuildingalc (SpfI<:ify)
32g loc:allono/lnJII'f(Slreel,crlyltown, >.tlte)
---
-,
lAST Will AND TESTAMENT
OF
WilliAM R. KaSSLER
'~.--
KNOW All MEN BY THESE PRESENTS, That I, WilLIAM R. KOSSlER, of the
township of Hampden, County of Cumberland, and Commonwealth of Pennsylvania, do
make, publish, and declare this instrument to be my Last Will and Testament, hereby
revoking and making void any and all former Wills by me at any time heretofore made.
FIRST: I direct the Executor hereof to pay all my just debts, funeral expenses and
costs of administration as soon as conveniently may be done after my death. I further direct
the Executor hereof to pay all inheritance, estate, transfer and succession taxes which may
be levied or assessed upon any property which is included as part of my gross estate for the
purpose of any such tax.
SECOND: I give and bequeath unto the following individuals and corporations as
follows:
A. ST. THERESA CHURCH of Chesapeake, Virginia, the sum of $1,000.00.
B. OUR LADY OF GRACE CHURCH of Greensburg, Pennsylvania, the sum of
$1,000.00.
C. ALEX TANNENBAUM, the sum of $1,000.00.
D. LAURA TANNENBAUM, the sum of $1,000.00.
j4/~/-<
- 1 -
THIRD: I divide the rest, residue and remainder of my estate, realty and
personalty, howsoever designated whosesoever situate into equal shares and I then
give, devise and bequeath one equal share unto each of my children, my daughter
KATHLEEN J. TANNENBAUM, and my son THOMAS R. KOSSLER as follows:
a.) In the event my daughter, KATHLEEN J. TANNENBAUM, does not survive
me by thirty (30) days, then in that event I give, devise and bequeath her share
of my estate that she would have received to my son-in-law, HARVE A.
TANNENBAUM, per stirpes.
b.) In the event my son, THOMAS R. KOSSlER, does not survive me by thirty
(30) days, then in that event I give, devise and bequeath the share of my estate
that l11e would have received to my daughter, KATHLEEN J. TANNENBAUM,
and in the event that my daughter KATHLEEN J. TANNENBAUM does not
surviVe me by thirty (30) days, then in that event I give, devise and bequeath her
share of my estate set forth in this subparagraph that she would have received to
my spn-in-Iaw, HARVE A. TANNENBAUM, per stirpes.
FOURTH: I appoint my son, THOMAS R. KOSSlER, to be Executor of this my
Last Will and Testament. I do hereby give to the Executor hereof full power, discretion and
authority at any time or times to sell, at private or public sale, mortgage, lease, pledge,
exchange or otherwise deal with or dispose of the property comprising my estate as deemed
bE!st, to settle and compound any and all claims in favor of or against my estate as deemed
best and, for any of the foregoing purposes, to make, execute and deliver any and all deeds,
mortgages, contracts, leases, bills of sale or other instruments necessary or desirable
therefor.
j?J:~ J\
- 2 -
FIFllH: In the event my son, THOMAS R. KaSSLER, fails or refuses for any
reason to serve as Executor of this my Last Will and Testament, then in that event I appoint
KATHlEENI J. TANNENBAUM, as Executrix of this my Last Will and Testament.
LASTLY: I direct that no fiduciary appointed by this, my Last Will and Testament,
shall be required to give bond and that if, notwithstanding this direction, any bond is required
by any law, statute or rule of court, no surety shall be required thereon.
IN WIITNESS WHEREOF, I have set my hand and seal to this, my Last Will and
Testament, consisting of Four (4) typewritten pages on the margin of which (except this
page) I have affixed my initials this 29th day of August, A.D. 2003.
~~~~~ K. t7(YJ-~~1--/
WilLIAM R. KaSSLER
Signed, sealed, published and declared by WilLIAM R. KaSSLER, the above-
named Testator, as and for his Last Will and Testament, in the presence of us and each of
us, who at his request, and in his presence, and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
.~ " . //","?
//, ~::/~
A~~~~~
H^~~t~'L IJ
Amy Knauer /,) _>)
- 3 -
County of Cumberland
ss.
Commonwe~lth of Pennsylvania
ACKNOWLEDGMENT AND AFFIDAVIT
We, WilLIAM R. KOSSlER, the testator, and the undersigned witnesses to the Will,
the attache~ or foregoing instrument, having been qualified according to law do depose and
say:
(a)th~t I, the testator, do hereby acknowledge that I signed the instrument as my Will,
that I signed it willingly and as my free and voluntary act for the purposes
therein expressed; and
(b)thiat we, the witnesses, were present and saw the testator sign the instrument as
his last Will, that he signed it willingly and as his free and voluntary act for
purposes therein expressed; that each of us in the hearing and sight of the
testator signed the Will as a witness and that to the best of our knowledge the
testator was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn to or affirmed before me by WilLIAM R. KOSSlER, testator, and Beth Myers
and Amy Krtlauer, witnesses, this 29th day of August, 2003.
L"zJ~/~a) ~ j)
7rA~(.J.p~~;K - O---;l/J...-LR /\./"
WilLIAM R. K SSlER
~ //,7
..?'-
~eth Myers
-4-
ACKNOWLEDGMENT
On this, the 29th day of August, 2003, before me the undersigned officer,
personally ~ppeared WilLIAM R. KOSSlER, known to me, (or satisfactorily proven) to
be the per~on whose name subscribed to the within instrument and acknowledged that
he executeq the same for the purpose herein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
--- h1A/':,
NOTARY PUBLLIC\
, I
( I
/
/
My commi$sion expires:
NOTARIAL SEAL
Amy Knauer, Notary Public
M~chanicsburg Borough, County of Cumberland
. y Commission Expires Jan. 25, 2005
- 5 -
RENUNCIATION
~;.""\
V_'
I' REGISTER OF WILLS
( I LA.. I)') f2>[-l~L Ii rd D COUNTY, PENNSYLVANIA
'<!.='
Estate of
WILL i A/'Y\.
(2.-
k'o~s LGr2-.
, Deceased
I,-r~'\I\ M
(Prinl Nam'iL
'?7- ~c- y'TO ,2... 0 \~T~
\2-D ~ ,=,'YL.:J
< 0 S So LtI2-
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
<?; )Y1--10
administer the Estate of the Decedent and respectfully request that Letters be issued to
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~.s L..-t-..s ~.4.. V -""'-
JA~v('"Yl1
3(.)
Z-o 0 2>
~
I :3 S t.1 L 41Z.,lL
(Slreet Address)
Q
(Dale)
Del"l:
4PT
I~
CAt-e.K..- .5 PU fL
(City, Slale, Zip) I
C'i1
9'1 '13 9
EXt?cuted in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this .:~ 0 n.. day
of w_-::s tt-Y'..A,.-\" '" L-' ,.:... (,.. _?
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Notary Public
My Commission Expires:
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D~~puty for Rttgister of Wills
Form R W-06 rev.: 10.13. 06
(Signature and Seal of Notary or other official qualified to
oaths. Show date of expiration of Notary's Commission.)