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Home My WebLink About02-28-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cum but Q nd COUNTY, PENNSYL VANIA \.ld\f\ E. ~()lermD File Number c2-J - O~ -OJ:~(o Estate of also known as Fe J.0 . 1<6 @CCf3 I Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COil,/PLETE 'A' or 'B' BELOW:) ~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the AA.... _. . ~ r: '" ", } In. last Will of the Decedent dated ~ - ~ -c9C>03 and codicil(s) dated ~ , Deceased Social Security Number 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 executi6fr~e instlU~(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: {, (~~ g D B. Grant of Letters ilf Administration ,,) Q:) (If applicable. enter: c.t,a.; d.b.n.c.t.a.; pendente lite; durante absentia, durante.,iI"In.r1'itate)-:::;' Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spOilse (if anyj)j\d heirs: (If ; Administration. c.t.a, or d.bn.c.t.a., enter dale of Will in Section A above and complete /ist of heirs.) en Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. County, Pennsylvania with his / her last principal residence at c;> \ (List street address. towl1!city. township. county. state, zip code) Decedent, then 3lo years of age, died on F-e.1l\ 1'6, (gt~ ~1(ltJJ~itQ.1 Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania $ 15 QO $- ~~ ax> 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: \. FOJ'/I1RW-Ol rev. 10.13.06 Page 10f2 - Oath of Personal Representative COMMONWEAL TH OF PENNSYLVANIA COUNTY OF ell yY\ Dev-- \QI\ d SS The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tlUe and conect 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 tlUly administer the estate according to law. Sworn to or affirmed and subscribed Q - :-:: "~-_.) before me the r" -;~l t ~ C:J ,,) CO -::1 Signature of Personal Representative U r~.'.."'" .J Slgnaltlre of Personal Representative -:::J N C.'! JI-Og- (Jl~LP ,jClhn t. Palermr) Social Security Number: 071- Llf - 1 '7L1l . Date of Death:kbr Ii Q ~ ~: ~ AND NOW, ;;( q/fl ~~ ~Jrbrlla8' c)tiJl, , io ooo,idm"onofthdo"goiog Pe""oo, "",f",o<)' pmof hmog beno p,,,,,,"d bMa7 ' IT DECREED LCrr 1<"5+0 ry~n1l1I (j are hereby granted to ~. lO..-..1X1nc: Q File Number: Estate of , Deceased in the above estate and that the instrument(s) dated descnbed 111 the Petition be admItted to probate and filed of record as the last Will (and Codlcil(s)) of Decedent. FEES IJ./VltR. /11lJtJWu JiM A QntfrJ. ~' , ^ $ Or'...)! "^. 0" Register of Ills 1 f C< ct'JJ. Lettels .,. ....... ... ..YjAk ~ J (J "if $ i/O.OO $ ~~,~:{S8 ,(j.OO Short Certi ficate( s) . . . . . . . . Renunciation(s) .......... Illlill \~ftormhOY\ Attomey Signature: Attomey Name: Supreme Court l.D. No.: $ $ $ ...$ $ .. . $ .. . $ ..............$ Address: Telephone: TOTAL ?52D. ro Page2of2 Form RW.01 rev 10.13.06 - II ,:.1 ./"'7 /\''''~I ,'_/ (' -- (.-/ ,,/. e( {.j; LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Certification Number This is to certit\ hat Lll' information here given is correctly copied-fI"ll11 an miginJl Certificate of Death duly filed with m~ as L()cal Registrar. The original certificate will be tor\varded to the State Vital Records GUice fw perrnanent filing. Fee for this certificate, $6.00 P 14288615 ~~~Jv~ ~/ II /~ Date Issued co !'-) Hl05-143 REV 11/2006 TYPE I PRJNT IN PERMANENT BlACK INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FilE NUMBER 86y" 8b CouoryolOeath June 17, 1921 Geneseo, NY /)/ ;) (JoB" 1 Name at Decedef\l (FirSt. middle. last, sutbl John E. Palenro 5. Age (last Bir1hdaVI 6 Date 01 Birth (Month, day, ear) 7 .".'1"'" I ed. Facility Name (II not ~stiMion, give street and nuntlerl HOL 6fJ1M-r HOSiJ,r.Ri-. 11, Decedent's Usual lion Kind ol work dooe durifl IOOSlof life. 00 no! slate refired Kind 01 Work Kind of Busiooss Ilodusby Assistant VP Pharmaceuticals 12. Was Decedent ever in !he U.S. Armed fQ(ces? u1ves ONo Oecedeor, AcIuaIResid90ce 17a,Sale 14. Marital Stalus: Married, Never Married, Widowed, Divofced (Specif)1 widowed . 16 Decadeot's MaiIi1gAddress (Street, city floWn, state, zip code) 21 Glendale Drive Mechanicsburg, PA 17055 18 Falher's Name (First middle,lasl. suffix) James Palenro 17b, County Pennsylvania CUmber land 17c. E1' Yes. Oecedenl Uved in 17d. 0 No, Decedent lived wahin Aduall..inil$of Upper Allen Tw, City I Boro 19~~ttJ~r:;V~J " l!l ~ 2Ob. Intormanrs Maiing Address (~eet, city Ilown, Slate, ~ code) 907 Bonny Lane Mechanicsburg, PA 17055 21c,P\aceofDisposiIion (Name of C8me1ery,tremalOry or OCher place) C\ '-.J Items 24-26 lTJUsl be ~Ied by person who pronounces death t. 't CAUSE OF DEATH (See Inatructlona and examples) Item 27. Pal'll: Enter the ~~ - OISllases, IIljOlies, or complicatlOf1S -Ihallirectly caused f\e death. DO NOT eoIer terminal events sudl as cardiac arresl, respiratory arres!, or ventricular fibnllalion withoul showing lhe eliology Usl only one cause on ead! ine ApproKimaleinterval Part II: Enlerother Onsello Death but not resulting in the uodertying calJse given in Part ~ ,~ . , ~J=S:~~~I)~se:; Due 10 (or as a consequence 01) Lp \A~ Pt.-I 0. OYe~ 0 No [JYe> ONo 31 MannerotDealh ~Ndlura! L]Horniclde o AC<:ld.;r,1 0 P<:lldIng Inve~IIQdIlOn 32d, Time of Injury D Suimlt: [J Coold Nut be Dell!rOlined 29 II Female: o Nol pregflilnt W~t~1I past 'r'ear o Pregmlnl allime at death o Not pregnant, but pregnant Wllhir1 42 Ci<lys of dealh o Not pregnant. but pregnant 43 days 10 1 )til ........"" o Unknown II pregnant wtU'WI Che pasl yaIr 32c, Place of Injury, Home, hnn. Sltael, Factory OIfiooBulldlog,elc(SpeciIyJ SequeoliaMy liit coru:lltl\)f\S, if any. leading to tleCdllse hladon line a Entellhe UNDERlYING CAUSE (diseilseor IfIjury Ihal initialed the events rllSlJltiOg 111 dedth) LAST. Due 10 (or as a consequence of) Due 10 (Of as a consequence of) JOa Was an Autopsy Perlorm&d? n Were Aulopsy FlrIdulgs A~..~able Prior 10 CompI"IIOf\ 01 Caus.e 01 lkalh) .~ \~ M 32111 Tran~pof1alion Injury (Spocify) [J ()fiver I Operalor 0 Passerlgel rJPedeslrliln ~loo"". """'''' J3a. Ceroller (check ooly one) 33b S'9flalufll and Tille ol Certifi61 ~::V~~~;~=.::n ~~~fy:~:~~ ~:::~:c~~:~~~r~)~:~:rh: ~~~~ ~d~ _~ _~~~ :e~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ fir .. ~~o:u=~n~ -.:~ =~:~~~:~:~~ :hti::l~~r;n~~~,~~:r:~~ol~~~~~~a: mlnner I. Slaled.- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 331; lunse Numbel Ir'-I:> D 7 D ~::~:~$mo7::~;::: ~nd I or investigation. in ffi1 opinIon. death DCcwred althe time, date, and place, '00 due to the cause(s} and nUlnner ISSlatecL 0 ~ ~ :5 -(;~ ~ I ,:2..11 I,~ I / L2 I C.4vn Disposition Permil No () leU 210 LAST WILL AND TESTAMENT r-j (~1 OF -'-1 r''l '-::1 0) 0,) JOHN E. PALERMO .") 1"-.) ('"' I, John E. Palermo, residng at Upper All Township in the Borough of Mechanicsburg, County of Cumberland, and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish, and declare this as and for my Last Will and Testament, and I do hereby revoke all Wills and Codicils heretofore made by me. FIRST I direct that all my just debts and funeral expenses be paid as soon as conveniently practicable after my death, escept that any debt secured by a mortgage, pledge, or similar encumbrance on property owned by me at my death shall be paid by estate at the sole discretion of my executrix. SECOND All the rest, residue, and remainder of my estate, real, personal, and mixed of whatsoever the same may consist and wheresoever the same may be situate, including the lapsed legacies and any property over which I may now or hereafter have the power of appointment or other disposition, I give, devise and bequeath to my daughter, Mary Jo Danella if she survives me for a period of thirty (30) days. If she shall predecease me then to my grandchildren, David Danella and Lindsay Danella in equal shares. THIRD Anything in this, my Last Will and Testament, to the contrary notwithstanding, in the event a legatee or devisee herein named or designated is a minor at the time distribution is directed to be made, then and in that event the share to which such minor is entitled hereunder shall be held in trust for his benefit during his minority, and my trustees shall payor apply for the benefit of such minor so much of the income and principal of his trust as may be deemed necessary and proper by my trustees, in their sole discretion, for such minor's support, maintenance, education, and health, and shall distribute, absolutely and outright, the full balance of principal and undistributed income of the trust to such minor upon his attaining the age of twenty-one (21). In the event minor shall die prior to attaining the age of twenty-one (21), the balance of the trust created for such minor shall be distributed, absolutely and outright, to his then living lawful issue, if any, per stirpes, and if there be none, then to his brothers and sisters equally, if any and if there be none, to his heirs at law and next of kin as provided by the intestacy laws of the state of my residence in force at the date of my death. FOURTH In the event of the minority or incompetency of any of the beneficiaries herein named, my executors and trustees, in their discretion, are hereby authorized and empowered to make whatever income, principal, or other distribution of property of whatever character, to which such beneficiary may be entitled, directly to such beneficiary, or to the person or persons having the care or custody of such beneficiary, or to such beneficiary's lawful or natural guardian, or may apply said distributions in behalf of such beneficiary and in such cases my executors and trustees shall not be required to see to the application of any distribution made by virtue of the authority herein contained and the evidences of such payments or a receipt for such payment or distribution, signed by the legal guardian, or either parent of the minor, or a person standing in loco parentis to the minor, shall be full and sufficient release and acquittance to my executors and trustees of all property and money or other person to whom such distribution is made be required to furnish bond or other security. FIFTH I direct that all transfer, inheritance, legacy, succession and other taxes, including State and Federal, which may be assessed or imposed upon the transfer or any property under this Will, or upon property which may be part of my residuary estate; and no devisee, legatee, donee, transferee, or insurance beneficiary, shall be required to payor contribute to the payment of the same. SIXTH In the administration and distribution of my estate, my executors or trustees, shall have all the powers and authority granted to them by common law or statute. SEVENTH Wherever the words "executrix", "executor", "executors", "trustee", or "trustees" are used herein, they shall be construed to mean executors, executor, executrix, trustee, trustees, and the survivor or survivors of them, and their successor or successors in office. EIGHTH As used herein, each of the masculine, feminine or neuter genders shall include the other genders, the singular shall include the plural, and the plural shall include the singular, wherever appropriate to the context. NINTH I hereby nominate, constitute and appoint my daughter Mary Jo Danella as executrix and trustee of this my Last Will and Testament. In the event that my daughter predeceases me or shall not survive me for a period of 30 days I then appoint Stephen Palermo, Jr. Upon death, resignation, incapacity, or failure to qualify of either of my children, I hereby nominate, constitute, and appoint the other child, executrix and trustee in her place and stead, with the same powers as executrix and trustee, as are herein conferred upon my original executors and trustee. I direct that none of my executrixes or my trustees appointed under this Will, nor any successor, executor, or my trustees howsoever appointed, shall be required to furnish any bond or security in any jurisdiction in which hem she, or they may be called upon to act. IN WITNESS WHEREOF, I have hereunto set my hand and seal this i~ day of ~, 2003, in the year Two Thousand and Three. (Witness) --~ 0 -~ IAft;! Jr.! ~f IlLfrrk. /dl '?tJ ~-S- (Address) (Address) - COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND ss.: ACKNOWLEDGMENT & AFFIDAVIT I, JOHN E. PALERMO, the testator in and the undersigned witnesses to the will, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that 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) that we, the witnesses, were present and saw the testator sign and execute the instrument as his will, that he signed it willingly and executed it as his free and voluntary act for the 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. ,e--, d~ S 11101/ U sl '*h. }I11/' / /ltSY AddreS~ () ..... 90b fA ~rJiS Address Sworn to and subscribed before me this J R + h. day ofYJ tptJ tniJ1A.J 2 m~ , H)lli +h 1 /lJ . _)j~t;?^P,UbliC. My commission expires: ~ . Jlft^/U ~ClfU)(t1Lj Lo.~OOl Notarial Seal l Heather Rothermel. Notary Public I Halifax Twp.. Dauphin County My Commission EJcPres Jan. 6. 2007 ! Member. Pen/l6ytvaoia As&ocial\on Of "lota~~" ' -