HomeMy WebLinkAbout02-12-08
PETITION FOR PROBATE AND GRANT OF LETTERS
Register of Wills of Cumberland County, Pennsylvania
Deceased
File No. ~ I
Social Security No.
o ~ () J yq
170-16-6171
Estate of
STEPHEN STRUMLOK
MARILYN S. McCOY
Petitioner, who is 18 years of age or older, applies for:
(COMPLETE "A" OR "B" BELOW:)
0' A. Probate and Grant of Letters Testamentary and aver that Petitioner is the
named in the Last Will of the Decedent, dated May 1 ih , 1995
Executrix
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:
o
B.
Grant of Letters of Administration
(if applicable, enter: c.I.a.; d.b.n.c.l.a.; pendent elite; durante absentia; durante minoritate
Name
Relationshi
Residence:
(COMPLETE IN ALL CASES): Attach additional sheets if necessary.
Decedent was domiciled at death in
Cumberland
I _
County, Pennsylvania, with his last family or pri/llcipal re~ence at
Messiah Villaqe, 100 Mount Allen Drive, Mechanicsburq, Upper Allen Township, PA 17055--
(list street, address, town/city, county, state, zip code)
Decedent, then
88
years of age, died on
January 20, 2008
at
Messiah Village, Mechanicsburg, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property.....................................................................$ 225,000.00
(If not domiciled in PA) Personal property in Pennsylvania.....................................$
(If not domiciled in PA) Personal property in County....................................................$
Value of real estate in Pennsylvania ......................................................................................................................$
T otal......................................................................................................... $ 225 , 000.00
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 appropriate form to the undersigned:
Sionature Typed or printed name and residence
/!rd+ ;/ ?/Ie &r MARILYN S. McCOY
24 South 27th Street
Camp Hill, PA 17011
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The Petitioner above-named swears or affirms that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the estate according to law.
Before me this
I;;;}
day of
,-.-.._,
Sworn to and affirmed and subscribed
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FileNo.
d I 08 6;r+(
Estate of
STEPHEN STRUMLOK
, Deceased.
Social Security No: 170-16-6171
Date of Death:
JANUARY 20, 2008
AND NOW, Ve)XJ),LlfZj 1,1 ,2008, in consideration of the foregoing Petition, satisfactory
proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby
granted to MARILYN S. McCOY in the above estate and that the instrument dated
Mav 17.1995 described in the Petition be admitted to probate and filed of record as the Last
Will and Testament of the Decedent.
FEES
Letters...~aS,"D.tQ $ 311:)
Short Certificate(s).3 $ l d.
RcnunciotiorW.\.\\... $ \ 'S
Affidavit ().................. $
Extra Pages ()....... $
CodiciL......................... $
JCP Fee....~..~k>. $ , S
Inventory...................... $
Other.............................. $
TOTAL......... $ 3~~
~ ::J~JLUJ~:J ,
Register of Wills ~at./0
Attorney Signature: ~ b ~
Attorney: EDMUND G. MYERS
1.0. No: 20558
Address: Johnson. Duffie. Stewart & Weidner,
301 Market Street. P.O. Box 109. Lemovne. PA 17043-
Telephone: 717-761-4540
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
(\'ri :'i\..' ;U,\r\ ,< 'U';i~l
",.,;<I"'H'ii,(//",:;;" This is to certity fhat the 111formali(\11 her,' gi\\'1i i
i~\.~\.\-' - !(lIl".;::;" curreetly copied tn'J)] an original Certificate \,f Deall,
,./~/". ~~\ duly filed with tn, as Local Regi:--trar. The orit:!I1a1
f~~...~~%\ . certificate \\dl b\ forwarded to the State \11.,1
'~ 5 ,'E, .hg) Records Office fOI permanent filing.
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\~f!4injTti{~J~~/ '.~. ~~t. ~t~'~~~/JAU_~i2QQl
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P 13889311
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H105-143 REV 1112006
TYPE! 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
c:ll 0 6- cJlfCj
v"
6171
4. Date 01 Death (Monm. day, year)
Januar 20 2008
1. Name of Decedent (First, middle, last, suffix)
Ste hen
5. Age (last Birthday)
88yrs.
6. Date of Birlh {Month,day, yearl
I .
8b.Counlyof~ath
Cumberland
Other:
KJ Nursing Home 0 Residence OOther. Specify
9. Was Decedent of HispaniC Origin? 00 No 0 Yes ~O. Race: AmeMcan Indian, Black. White. e'!c.
~e~~~;:~~~~:~, elc.) (SpeciM whi te
11. Decedenl's Usual Occ
KindofWQfk
Colonel
14. Marital S1atus: Married. Never Married.
Widowed, Divorced (SpeciM
Widowed
. 16. Decedent's Mailing Address (Streel, city f town, state, zip code)
4833 E. Trindle Rd. Suite 574
Mechanicsburg PA 17050
=~~Ideote nfl.Slate Pennsylvania
llb. C'""~ Cumber land
17c.UYeS,DecedentUVedi~ Upper Allen
17d.tJ No. Decedent Uv9d withm
AcI1JaI Limits of
Twp.
City/Boro
18. Father's Name (First, middle, Iast,suffix)
Michael Strumlok
19. Mother's Name (First, middle, maiden surname)
Alice Java
20a.lnlormant's Name (Type f Print)
Maril n McCoy
21 a. Method of Disposition
2Ob. Informant's Mailing Address (S1reet, city Ilown, stale, zip code)
24 S. 27th St. Camp:,fiUn,-"PA:. HOll
21c. Place of Disposition. (Name ol eemetel'/, crematOl'j 0\" oIh&l' place} 21d. location (City flown, stale, zip code)
Indiantown Gap National Cemetery Annville, PA
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Spedfy
22a.signatu.re re~oiF~ Service
~~~-;;::;;:::.,
Complete Items 23a-<: only when certifying
phy8icianisnot availllble al time of death to
cerlilycause 01 dealtl
22c. Name and Address 01 Facility
ottman Roth Funeral Home and Crematory Inc. 219 N. Hanover St.
OQ30 A M.
)..otJ~
2fi. Was Case Re1erred to Medical Examiner! Coroner lor a Reason Other than Cremation or Donation'
Dves No
238. To the best of my knowledge, death occurred althe Ilme, dale and place stated. (Sigl'lalure and title}
23b. Ucanse Number
Items 24-26musi be compieled by person
. who pronounces cleath.
24. T1me of Death
Dves ~
3Qb. Were Autopsy Findings
Available Prior to Completion
of CallS9 of Dealh?
DVes ~
31. M8~r of D6ath
r::r- Natural 0 Homicide
o Acddent 0 Pending Inves~gation
o Suicide 0 Could Not be Determined
I ApproximateinteIVai:
: OnsettoDeath
,
,
: ,C:;m 111ldCJ
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l oJ YI'I) Is
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Mj,iX'I/CJiSloAJ
T)1(il.x..,U1 yYJ! {iilu.~ ::r'ir 11
lII?:hL,'Y}Ilt5.hl~/JjJ liMit. )hi:;
m1/J.-'U (:d/JI>{..R-f.
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28. DId Tobacco Use Contribute 10 Daath?
D Ves Dp""'ab~
IiJ-1fo DUIlk_
29. If Female:
~Notpregnanlwithinpaslyear
o Pregl'Iant at time cl death
o Not pregnant, but pregnant within 42 days
ol_
D Not pregnant, but pregnanl43 clays to 1 year
beloredeath
o Unknown if pregnant wiItlin the past year
32c. Placa of Injury: Home, Farm, Street, Factory,
Office Building, etc. (Specify)
CAUSE Of DEATH (see InstrUctions Bnd examples)
Item 27. Part I: Enter !he ~- diseases, injuries, orcompflcations -that directly causecllhe death. DO NOT enlerterminal events such as cardiac arrest,
respiratoryarreSI,OI"ventricularllbriMationwilllool showing the eliology. Ust only one cause on each line.
=~t~~~~)d~~
5eQLMlnl:~~~='~~a.
~ UNDERLYING CAUSE
(ciseaseorirljury!tlalinitiatedlt1e
events resultiilg In death) LAST.
b.
Due to (or as a consequenca of):
d.
304. Was an Autopsy
Performed?
32d.1imeotlnjUl)'
32.g. Locatioo IJllni'drf \SI.<<lei., c~ I town, state)
".
338. Certifier (check only onel
Certifying physician (Physician carti!ying cause of death when anolher physician has pronounced death and completed Item 23)
To the best of my knowledge, death ocCUlT6d due to the cause(s) and manner as staled., _ _ _.. _ _ _ _ _ _ _ _ _ _ _ - - _ - - - _ - - - - - - -.. --
=~~~,a~ :W~hJ.:a:::=~ :htt~~~n::~~~~~~~=~~~~ manoo as stated- _ _ _ _ _ _ _ _ _ _ _ _ _ _.. _ _ 0
~:~:~m~~~=: and I or Investigation, in my opinion, death ()Ccurred allhe time, dale, and place, and due to the cause{s) and manner as sblted.. 0
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35. Regis
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igo'''""",j(t~~&t'"~'U.J
Id-. I I Id- I \ I D I
Di_moo p,,,,,1t No 0 () ~ 75-..s> '1
34. Name and Address 01 PefSOFl Who Completed Cause of Dealh (Item 27) Type '..P.li/11
pA-IVI1I ,N'OO/-C,,:J/t:.Sij /h0 1Vi!'
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c:\wp51\wills\strumlok.stv file # 10069-01
1lI&st .ill &ttb Qftst&uttttt~~
OF
1--
"'",-)
.~-l
STEPHEN STRUMLOK
^ 1
J
".)
I, STEPHEN STRUMLOK, of Silver Springs Township, Cumberland County,
Pennsylvania, do hereby make, publish and declare this to be my Last Will and
Testament, hereby revoking all former Wills by me at any time heretofore made.
FIRST:
I direct the payment of my just debts and funeral expenses as soon
after my death as will be convenient to my Executrix hereinafter named.
SECOND: I give, devise and bequeath all of my property, whether real, personal
or mixed, and wheresoever situate at the time of my death in equal shares, share and
share alike, to my children, MARILYN S. McCOY, STEPHEN R. STRUMLOK and
NANCY C. VARDARO, or to the issue of any deceased child, per stirpes.
THIRD:
I nominate, constitute and appoint my daughter, MARILYN S.
McCOY, to be the Executrix of this my Last Will and Testament. Should my daughter,
MARILYN S. McCOY, fail to survive me, I appoint my daughter, NANCY C. VARDARO,
...--;L
c:\wp51\wills\strumlok.stv file /I 10069-01
to act as such Executrix in her place and stead. No Executrix shall be required to file a
bond.
IN WITNESS WHEREOF, I hereunto set my hand and seal this
i?r5-
day of /11 t-:J
,1995.
/~IuJ7 ~-'7ft47[
( Stephen Str1Jmlok
SIGNED, SEALED, PUBLISHED and
DECLARED in the presence of:
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initials-f12-
c:\wp51\wills\strumlok.stv file 1110069-01
COMMONWEALTH OF PENNSYLVANIA
: ss.
COUNTY OF CUMBERLAND
I, STEPHEN STRUMLOK, Testator, 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 STEPHEN STRUMLOK, Testator,
this / 7 '!!' day of I J1-.-~t;} , 1995.
#
~A-7f;7JU0,/'?>t
( Steph n S~rumlok, Testator
/
NOTARIAL SEAL---l
TERESA J. BURKHOLDER, Notary Public II
Carlisle, Cumberland County, Pa.
M C .. Ex .'es Fob ." 1"~""<:: ;
y ommlSSlon P!' ~~'-':'~_.;
3
c:\wp51 \wilIs\strurn!ok.stv file 1/ 10069-01
COMMONWEALTH OF PENNSYLVANIA
: 55.
COUNTY OF CUMBERLAND
We, JAMES D. FLOWER and CAROL J. LINDSAY , 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 Testator,
STEPHEN STRUMLOK, sign and execute the instrument as his Last Will; that he signed
willingly and that he executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the sight of the Testator signed the Will as witnesses; 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.
and
Sworn or affirmed to and subscribed to before me by JA..Tv1F.S D. FLOWER
('A ROT..1 T.TNn~1'.Y , witnesses, this II/ill day of,--;r7 /'tli r-' , 1995.
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C ~ NOTARIAL SEAL \
TERESA J. BURKHOLDER, Notary Public
Carlisle, Cumberland County, Pa.
~ommissio~~"'s Feb. 12, 1m I
4