HomeMy WebLinkAbout01-31-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Margaret L. POIIOCk File Number ~I " ~ "`-' (f
also known as
,Deceased Social Security Number 181-32-3668
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW.)
^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EXeCUtOr named in the
last Will of the Decedent dated 1 /29/1993 and codicil(s) dated
(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 instrutt~Aynt(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~'
~-n ~-
B. Grant of Letters of Administration ~ ~' 'r '""
(If applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente life; durance absentia; durknte-vfiii~,oritat~
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spdtlse 1;if any) l 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.) `-
-- r-;
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at Manor Care
Health Services 100 Fairway Dr Camp Hill PA 17011 Cumberland County
(List street address, town city, township, county, state, :ip code)
Decedent, then 102 years of age, died on 7/19/2005 at 100 Fairwa~Drive. Camp Hill, PA 17011
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 3.811.53
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
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 appropriate form to
the undersigned:
Signature Typed or printed name and residence
17101
Robert L. Knu Es uire 407 North Front St. Harrisbur PA
Form RW-O2 rev. 10.13.06 Page 1 of 2
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
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 Decedent, Petitioner(s) will well and truly
administer the estate according to law.
4 ---.~ c---~
Sworn to or affirm~~ed~~ a$$n~~d--subscribed
b fore me the ~..1.L day of
I
of Personal
Signature of Personal Representative
cn
~, C7
.~
For the Register Signature of Personal Representative __ `
~, ;r ~
~( f t
File Number: ~ ~ , °~~"~ u ~ ~ I ~ ~-~.
-=+ ~
Estate of Margaret L. Pollock ,Deceased
Social Security Number: 181-32-3668 Date of Death: 7/19/2005
- ~ ~(~('~
AND NOW, ,~' +- man onsideration of the foregoing Petition, satisfactory proof
having been presented b ore , IT DECK ED that Letters
are hereby granted to ~ ~--~
in the above estate
and that the instrument(s) dated
described in the Petition be admitted probat a d filed of record as the last Will (a d Codicil(s) f Decedent.
FEES ~~ ~ ~'
~), Re inter of Wills
Letters ............................. $
Short Certificate(s) • • • • • • ; • • •• • $ ~ ~ Attorney Signature:
..
fb• ~ Attorney Name: Robert L. Knupp --
.... $
~•••• $ ~~=- Supreme Court LD. No.: 07083
.... $
.•.• $ Address: PO Box 630. 407 North Front St.
"•' $ Harrisburg. PA 17108
.... $
.... $
.... $
__-~~ Telephone: 717 238-7151
....
TOTAL ............................. $
Form RW-02 rev. 10.13.06 Page 2 of 2
ili~. i~, ?o certify that the information here given is correctly copied from an original certificate of death duly fined with me as
I_ur:.ll Registrar. The original certificate will be forwarded to the State Vial Records Office for permanent(f~iling.
WARNING: It is ille al to du licate this co b "~ ~ `~
g p py y photostat or photograph.
Fee for this certificate, X6.00
---- ~,~~
~~ ~ ~ ~ , ~~
Local Registrar
JUL 2 0 2005
Date
`. i
^ lev ve7
COMAhONWEALTH OF PEivI~SYIVC,NlA • DEPARTMENT Of HF-ACTH • VITAL RECORDS
CERTIFICATE OF DEATIi
,f
---~
I'-=
~:~
ca
C_
f.,7
y- f
~~
NAME OF DECEDENT (faR. Mld(ae. Lag) -
~ '
k
~' SEx
~ ,.OCTAL SECURITY NUMBER -. DATE OFD A~iMOmh. Dey. riser)
icorr_ ~,,.~} L
foe
r
_
+• / F
x.
3. l ~l - 3.? - ~3 ~; L d' ~•. J'L.I ~f~ I cl
a a ~s
AOE (Last BirmNy, UNDER 1 EM
M UNDER 1 DAY DATE OF BIRTH
1MMIn
Cay
'leer) BIRTHPLACE (Ury aatl
Stabarare
n C ,
PLACE OF DEAfH (ChxN a~ly one - xe instrua~als on rMner ade)
paha r Daya Hour . MykAas .
, g
oururyj
" HOSPITAL
OTHER:
/O~ Yn. ~~~~yy
4/~~/j(,(~C~ JQ IQq
' /f/!/C,2 r
S fl Ur2G
-
/DGNN'iL
/ (fl r^
Irtpatisrlt ^ ERIOulpuiant ^ DOA ^
~ms~~ Residsnp ^
d
S
^
I e. %I,LI A+1
7. ~. (
pllc
y)
COUNTY OF DEATH CTTY, BORO. TWP OF DEATH FAC1lfTY NAME pl r,a invmaion. ~ sheet and nlunoerl - WAS
D
ECEDENT OF HISPANIC ORIGIN? RACE ~ AmarbM IMlan, 84Ok
Whaa
Me
,
.
.
;~
I
e L /9m.~ ~, /~.~. M2nv~ ~'ca/• e N~'r~ L~`>t -S,E~c~ ~~~ No1~1 yw ^ N r«, speedy C1Aan, ($PeoMl
~Im/~~IP~
14nJD
M
l
P
R
.
~
ak
pn.
uss
ee ~
hin, N0. W ~ j ~ E
9. ,o
.
DECEDEM'S USI,AL OCCUPQK)N KIND OF BUSINESSnNDUSTRY WAS DECEDENT EVER IN DECEDENT'S EDUCATION MARITAL STATUS•MartNd Sl/RVIVING SPOUSE
Gi
Hard d
k
U
S
AAMED FOR
4
d
C
E^'/
'
ve
wd
tlrw
urrlg moat
.
.
1
(
~Sna. ~ o ~~oa r-,pm~,yelp Never Mardad. WWowad. In rule. qne ma,pan name)
r,
~
of workNlq Rte; N not ua~e`refired; l C'.<ll7) ffl '.. ,V w~ C/Q GTN~ yea ^ Nc NS.]
ElamentaN/SeconWry Cnlbge. OlvorcW (Spedfy)
~
~
_~ 11b. t!F ~~ r6121 (1J,yg5~1
11a. Orr F/eL
~^
DECEDENT'SMAWNG ADDRESS Street, City/town, Ya!e. t`~p Codel DECEDENT'S /,L/~iViYL
'---- --'-- -
tyA/
ACTUAL
^
/
t.
17a. Elele.-,-_-_______-.t~____. DM t'c
Yaa. NCedeM lNSOb -_
/Ur..l l-qi.e wAY ~~lL'E
1w
HESIUE
p.
N(.E n,,;~~m _
/~ I (AainatRY.1~wLL M T~
Lh/YI tT /7 %4L f"~sl//~~Jyh Lia"~.''L !'~ momer Seel a '+ a~
w h'P'7 No
NrsdoN fiyad
l
.
1e.
; , .~i/ ~ _
17b.tourl~_ ` 1"ri.[3~~L/~n1JI-- - 1Td.~SI .nnm.auallrna,o/_ C'~9JIli' ll/[1
'
_
_
_ony/boro.
FATHER'S NAME (F'e91. Mitld19 Last) - MMHEII ^ NAME (FV9I, aricUe. MaKfen Surname)
---i---~~--~-~-
INFCRMAM'S NAME (TypNP:nq ~ ~
-~-~ II:FORMAN'T'S MAILIfXI ADURc.S;i ($1'MY, Cilyrtown, Simla. Zip (,ode)
M /~f?
JAN
~
~
_
2W.
_ _
A/hn N/«
f~;~ i-~~' r (
2t:b. I ~,o l~9fGr.~la 1 1)Qr~E =
-
,
__
_
METHOD OF [NSPOSIT N _ _
TATE OF OISPC'STTIGN'~ - -~pLACE OF CISPOSI~I:`.N•Neme o'(:oma,iary, Cramaloy LOCATION •CirylTawn,SUta. Zn CON
Burial Crematan L) Removal Irom $1810 LJ Mcran• Dal'. Yesr) or 011ar Flare -•
Oonalion^ an
$
a
^
-
«(
I>K
vL----- ------
21h. J u L u 1 it .2 t) ~ ~
--~---- ~ ><f)~?/? i..s"'o3 ti'r2 4~ C~Il1aT~~ ~~/~.CIrE~ /s r~ci,:G ~i4 ' / :: '3
2u. 21d_ .
' SIGNATURE
JFF
R
T
UNE
ALSERV ENSEEORPERSUNACTINGASSUCH LK.F_NSEN~MBF.R NAN.EANUAOl7RESSCIFF.AC.il7TY cC Oct f ~e~~kt7 S'".~_E',F,r '11~G. ~q-~
F 5
~
~' ' "
?
~
~
[
%
'
_:_
12:0. _
c._-~~
~,
-c
z2<._
U
i.C.E .(/ei».a~£L fH ", - + /fG < C ..Z
c ~ ~! y__~
DOmpNw Gems 23ac when ceniying To e ~ hns~ 01 my knowlMye, tlrath occurrod et the line. date and plerzr stared. LICENSE NUMBER
--
DATE Sh3N
I
physician K rq1 avaaa al linty al Nath 10 (Signawra aro Tine)
' cartM halos W Nam. (MOnm. OmY. Isar)
't3a. _ ___ 23D. Y3c.
hems 2128 moat W mmPlated by TIME OF DEATH DdiE ?R(AlGUR'CED DEAD (Month. Cay. Ypar) VJA$ CASE REFERRED TO MEDICAL E%AMINER/CORONER7
• parson who pmrqulosa pwm.
pI
Jl.J.~ y / 9 1 c : ;
va. ^ No C1i
.~' 70 PM
a1
I as
.
.
.
xs.
1____---
27. PART I: Enter tM disssnas, Inryrbn or CompliCetbns which caused the Nam. Ib rot emer IM mode al Oylnq, such as cartliac or rxapiramry anent, shock or omen !ailura. i Approximate PART 11: Other signillOUa OondGiora mnuiplairp ro deem, Dul
LiN only one uuae on seen line
.
1 Interval Wtween rrot rsaultalq b tlw uMertyinq mlma given b PART I.
l orlaal errd a..m
IMMEDIATE CAUSE (Foul _ (" 1
tlwaaa ar corWeion / " ~ ? ' L-t r ~ 11, ~
resuasq in tleam)-• a
~-Y'1 7"G'{Y ~
1
,~ b /~
.
. ~-
_-
.
UE m
OF A$ A %ONSEOUEN
(
CE OFT:
sapwmlaly IM mnealona b.
~
__ _
---~-
N arty, leadlnq b binlearo DUE TO (OF4 A$ A CONSEQUENCE OFT: 1
_ u1ns. Einar UNDERLYMG l
CAUSE (Disease a irlpny c. _
_
-mat innatetl events DUE TO lOR AS S CONSEQUENCE C17: -- ~-- .~
resumrq in deem) LAlT
C
. _ _-_- _-_________ ________..--_ _ _-__ _-._.__._.i_
WAS AN AUTOP$V WERE AUTOPSY FINDINGS MANNER JF DEATH 'PATE Of :WLRY TIME CFIWURY IWURYQyyORK7 DESCRIBE t10WIWURV OCCURRED.
PERFORMED9 AWULABLE PRIOR TO ~ i(Mnnm, pa.t Pearl
~---_-- ~__~~
~ -'-----
COMPLETION OF CAUSE
OF DE.vN7 Natural ~ Homicide U
T~
Yea ^ No LJ
^
ACCiNm
Pendlrrg lnvaalkjalbn Ll
~
~_
-.- M. ~• 30d.
Yea ^ No~ YM ^ NO ^ $UILIN ^ Coub nor Ds NlsnnlneG L~ PUCE OF I W l1Fl V - Al home, hrm. street. IaClpy, p111Ce LOCATION ($aeel Qily/TdM
Sestet
,
buiken9, etc. ISpxnvl
2M. 2b
29
. __-
. .-. I~•~ 30f.
-_------_____. -
_.___-__-_
CERTIFIER :Check only unel
'CERTIFYING PHYSIgAN a q SIGNATURE AND TITLE OF CERTIFIER
( yar+an cerlMin Cause nl tleatn .vnan anMhm Mysiven has prOnouneo rlo9m ert7 CanlnMatl i;nn 23' ~~Il ll // /f (~ ~ yJ ~
To Ilia twat el mY anoreNd9e, deem eeturred dw to tM CaeN(s) and rnanMr n stated
^ (
~
~
~ 1
~
4 ~1
..........
y(/
.
.~
.
~
................. .
. ........................ 21 b.
~_
-_ -
LICENSE NUMBrrE:^R DATE SIGNED;Mxm, Da~y1, yearf
'PNON(1UNCING AND CERTIFYING PHYSICIAN(Physs;an hOln picna~ncinq tleam antlcwWy'nq ncav,e of tlead+l ~ A.Y C} y+. ]tli ~~ ~- L%~
' Te the Wet o4 my krowNdga, Nam xcumW et ma uma, date, arW place, a rid dw to IM causa(a(and manner sa hated .......................... ^ a f O. ~ V
_
NAME AND ADDRESS OF PERSnN HO COMPLETED CAUSE OF DEATH
. (Item 27) Type a Pr7M '
• 'MEDICAL DCAMINER/QORONER ~ t 174.2 ~ L . S~arryy'j
O~ C"±.
r
On the Uaata of eammination and.'or Inyestiyallon, in my opinion, death ,000rrea al the Ilea, dmt•, and place, srM due Yo the onuse(s) an0 ^ ~ 5 C~ y fV p! 4;L~ y-~j S /71J'G
...
mMnlf as ate4ad .............. .... ... ...... ...................
...
.
.. ...... .
3,a.
_ _
32. c.,~ r ~ S lwur ~ ~~ 7 ~l /4
'
_ ~~
_ _
REGISTRAR
4 NATURE AN B -~~,
DATE FILED (MOnm. Day, lber)
33. _ ---~ ~ --- 3.. ~ o as a ~-
v
~bg-~i~
LAST WILL AND TESTAMENT ~.
~- ~~
. ~.,- -
+~~, , ti=`~ ' ~ ~ ~~~
MARGARET L. POLLOCK
I, MARGARET L. POLLOCK, of Camp Hill, Cumberland County,
Pennsylvania, being of sound and disposing mind, hereby make,
publish and declare this my Last will and Testament, hereby
revoking and making void all prior Wills and other testamentary
writings at any time heretofore made by me.
FIRST: I direct my Executor, hereinafter named, to pay all of
my just debts, funeral and testamentary expenses as soon as
conveniently can be done after my demise.
SECOND: All of my personal clothing and household goods and
furniture I give, devise and bequeath to MRS. R. D. (ELSIE)
BABBITT, JR. Any inheritance taxes payable as a result of the
bequest in this Paragraph are to be paid out of the residue of my
estate.
THIRD: All the rest, residue and remainder of my estate of
whatsoever kind and wheresoever situate I give, devise and bequeath
after the payment of all taxes and expenses of my estate to:
1
a) Thirty Percent (30~) to MRS. R. D. (ELSIE) BABBITT,
JR.;
b) Thirty-five Percent (35~) to CAMP HILL UNITED
METHODIST CHURCH, Camp Hill, Pennsylvania;
c) Thirty-five Percent (35$) to FIFTH STREET UNITED
METHODIST CHURCH, Harrisburg, Pennsylvania.
FOURTH: Should there be any property of whatsoever kind and
wheresoever situate which I have the right to dispose of at the
time of my death, including but not limited to any special or
general power of appointment or both, I hereby appoint the same to
my legatees set forth in Paragraph SECOND and THIRD hereof.
FIFTH: I nominate, constitute and appoint Robert L. Knupp as
Executor of this my Last Will and Testament and further direct that
he shall serve without. bond. If he should fail to survive me or be
unable or unwilling to serve, I name Dauphin Deposit Bank & Trust
Company as my alternate Executor. Said Executor or alternate
Executor shall have the power to discharge all the debts, liens and
encumbrances upon my estate, as well as any taxes thereon, to pay
for the cost of the final disposition of my remains and final
illness, if any, to receive any and all commissions and other
compensation for services rendered by me during my lifetime and to
perform any and all fiduciary duties authorized by statute.
2
y
l
Further, I direct my Executor or alternate Executor to preserve my
estate and any instructions pertaining to the distribution of the
same from any attachment or anticipation while in the hands of my
said personal representative, it being my express intent that all
legacies shall be free from any attachment or anticipation while in
the hands of the accountant for my estate.
SIXTH: It is my Will and I so desire that Robert L. Knupp of
the law firm of KNUPP & KODAK, P.C. of Harrisburg, Pennsylvania,
shall act as attorneys for my Executor in the settlement of my
estate, they being acquainted with my affairs.
IN WITNESS WHEREOF, I have to this my Last Will and Testament,
typewritten on ~ pages of paper, set my hand and seal at the end
thereof this ~~ day of ..,.~~ , 1993.
Margar t L. Pollock
SIGNED, SEALED, PUBLISHED and DECLARED by the above-named
Testatrix, MARGARET L. POLLOCK, as and for her Last Will and
Testament in the presence of us who, at her request, in her
presence and in the presence of each other, all being present at
the same time, have hereunto set ~~zands as witnesses.
Name
3
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, MARGARET L. POLLOCK, 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 and Testament; that I signed it
willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed.
a1~ rgare L. Pollock
Sworn and subscribed to before me by MARGARET L. POLLOCK, the
Testatrix, this ~~(`1 day of ~ 1993.
M~ --
C-Lc ~~~~-~ ~ ~' `%-T
Notary Public
My Commission Expires: -
(SEAL } ~~+a' Seel
Cz-c'I F. F :^ 3~~ .pry F'ubNC
G2r,- c,:
COMMONWEALTH OF PENNSYLVANIA - ~~^/ ~c ~
Pe. ~.,;.t i~ s t. r, c ,~r ~. GU i3 i;;a.5
SS.
COUNTY OF CUMBERLAND
We, ~~-~-, cG 1/~ ~7. / " 7w, ~-e -~ ~~jl G-~ ~~
the witn sses whose names are signed to the attac e or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw MARGARET L. POLLOCK, Testatrix,
sign and execute the instrument as her Last Will and Testament;
that she signed willingly and that she 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 mind and
under no constraint or unc
Sworn to and subscribed b~
this ~ day of ~ -u~,
1993.
Notary Public
My Commission Expires:
( SEAL } ~ c ~,. ~ ~t: ~,,
~t-*~