HomeMy WebLinkAbout03-05-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
f i .
h' 'k', r 11') I, , j
COUNTY, PENNSYLVANIA
Estateof \ '" \;r 'I ~: I, 7f) hc'1 h
1'7
also known as , ),'. I'I "/
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File Number
, Deceased
Social Security Number
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Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW,')
o A. Probate and Grant of Letters Testall1entary and aver that Petitioner(s) is / are the
last Will of the Decedent dated 5l / ) 6 / U 7 and codicil(s) dated
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named in the
(State relevant circumstances. e.g., renuncialion, 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
(Ifapplicable. enter: c.t.a.; d.b.n.c.I.a.; pendente lite; durante absentia; duranle minoritate)
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Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following Spol,l,Se (ifanYkand heirs: (If
Administration, c.t.a. or db.n.c.l.a., enler date of Will in Section A above and complete lisl of heirs) . -, ~ ' C-,>
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Name
Relationship
Reside1le~ '
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(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary,
Decedent was domiciled atdeath in t: ':::; 1'1\ h .} , I}~ 1 lei County, Pennsylvania with hi~ / her last prin
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(List street address. town/city. township. county, state. zip code)
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Decedent, then <';' /
years of age, died on) / J i:, Vat
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Decedent at death owned property with estimated values as follows:
(If domiciled in P A)' All personal property'
(If not domiciled in PA) Personal property in Pennsylvania
(1 f not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
$ / 5 c;' " c: <-
$
$
$
situated as follows: C:- ()
5' /t- G. I ,... "',
I
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Wherefore, Peutioner(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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Signature
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Page 1 of2
Oath of Personal Representative
COJ\ilMONWEALTH OF PENNSYLVANIA
COUNTY OF
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SS
The Petitioner(s) above-named swear(s) or affim1(s) that the statements in the foregoing Petition are true 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 tmly
administer the estate according to law.
Sworn to or affirmed and subscribed
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Signature of Personal Representative
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5fgnature of Personal Representative
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betl)rc me the _-!) __ day of
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71("\~
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J ~ r, the Register
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Signature of Personal Representative
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File Number:
Estate of
fY7a 1Li LIt (~{, &"/ij
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Loy'e
, Deceased
1
Social Security Number:
Date of Death:
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AND NOW,
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having been presented before me, IT IS DECREED that Letters
are hereby granted to i3c-<. ( bed c\... k) (' '-'-.\ It' (')
,';X'X)e; , in consideration of the foregoing Petition, satisfactory proof
/7c'~ -feu t'f...'1 rlctn_1
C).-1'v\ (?t'- ~. \ C \ c~' L. Sch c, (T
in the above estate
and that the instrument(s) dated \':\:\'A C "'-<\ d. G ,';:itDl
described in the Petition be admitted to probate anc?filed of record as the last Will (and Codicil(s)) of Decedent
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~ Register of Wills . " \ ~'
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FEES
Letters ... (:iqCX)O, . . , $
Short Certificate(s) . .S. . . . $
Renunciation(s) .......... $
uJtll . . . $
'.J( P ... $
i--k, /-c.) $
$
$
$
$
$
$
TOTAL .............. $
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Attomey Signature:
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Attorney Name:
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Supreme Court LD. No.:
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Address:
Telephone:
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FU/'III R W-02 rev. 10.13.06
Page 2 of2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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C'ertd'i,',lliur! ,'\umher
'I hi, is 10 ,-crll \ !h,ll the Illtorm.itIon here i2i\ell i\
C()lTectl) cople.l i 'pm all oriilillal Ccrtificlle ut Death
dul:. tiled \\ nh !lIe a, Loe;.:l Reghlrar. The 01 iginai
ccni tical,' ,\ i! i Ill' i'urwanjed lc) the State ViLli
Relonh Ollie'c I"r permanent filini2
~~~_Jlj-1aL_
L IlL' a I Re"c;'irlli f {l Dale Issued
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H105-143 REV 11/2006
TYPE! PAINT IN
PERMANEN T
BLACK INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FilE NUMBER
1. Name ol Decl~nt (First middle, last, suffix)
Mary Elizabeth Lore
5 Arje (last Blrlhda~)
6. Dale 01 Birth (Month, day, year)
7. Birthplace(C
91 v"
8b. CO\Jntyof C<eath
Jan. 9, 1917
Alton, IL
ad. Facility Name (If not institutloo, give sltaet and number)
Golden Living Center
11. Decedent's Usual Ow atlan (Kind oj work done durin most 01 workin hie. Do not slate retired
Kind 01 Work Kind 01 BUSiness IlndlJstry
Hanemaker Home
12. Was Decedent ever in the
U.S. Armed Forces?
o Yes 0'NO
Decedent's
Actual Residence t7a. State
Permsylvania
Cumber land
13. Decedent's Education (Specify only highest grade completed)
Elementary I Secondary (0-12) College 1104 or 5+)
Upper Allen
. 16. Decedent's Mailing Address ,Street, City ftown, slale, zip co:le)
11 Hellam Drive
Mechanicsburg, PA 17055
17b. County
19. Mother's Name (Firs!, middle, maiden surname)
Blanche Story
t8 Falher'sName(Fifst,middle laSI,suffix)
Allan Wright
20a. Intormant's Name (T~pe I Print)
Patricia Schaal
3. Social Security Number
142 - 09
5308
4. Dale of Deall1 (Month, da~, year)
March 2, 2008
14. Marital Stalus: Mamed, Never Married,
Widowed, Divorced (Specify!
Widowed
Did Decedent
liveina
Township?
17c 0 Yes, Decedent lived in
17d. 0 No, Decedefltllved withlO
Actual limits 01
Twp
CIty/Bora
20b Informant's Mailirlg Address (Street, city I town, stale, lip code)
11 Hellam Drive Mechanicsburg, PA 17055
21d.localion (City flown, state, zip code)
21c. Placti of Dispositioo (Name 01 cemetery. crematory or other place)
. ~
Fernwood Cemetery Bridgeton, NJ 08302
8 Mark~t Plaza Way
Hane Mechan1csburg, PA 17055
lIems 2~026 must be completed b~ person
who prooouoce:. death t.
24, Time of Death
CAUSE OF DEATH (See Instructions and examples)
Ilem 27. Pan I: Enlellhe klliilll ~ ~ dlseases, lOjUn.::s, Of complicalions- ll1at directly caused the death. 00 NOT enter lemrinal events such as cardiac arrest,
respiratory arlesl 01 ventricular hbnllation without showmg the elJOlogy. list only ane cause on each line
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Due to {or as a consequence of): / LJ
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Due 10 (o'as a consequence of); r ~ / /J
Ott7tJA/ I;; 0 h! n1., c rW'P ~ / HI U,-;ne; I/If $?<
Due to (or as a consequence 00'
~;:S~~~S~ ~~~!) dlse.:;
, Approximate inlelVaI: Part II: Enter other sionihcant conditions contributin9Io~,
Onset to Death but not resulting in the underlying cause given in Par1 t
SequenllaHy ksl cOndllioo:>, If any
~~~l~~ ~ltRLy,~b~~U~ a
idlse~seOf InlUry lhat initialed tht!
events ItlSulllfl9 III death) LAST.
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30a Was an Autopsy
Performed?
31 Mi:lnn8r of Death
30b Were Autopsy FinClings
A'ldllable Prior to Compl<:IIW'
of C,WMI 01 D"alh?
~.J1Ur<.l1 o Homicide
32d Timeot Injur~
OVo; ~!1!!.o
DYe:> DNa
[] ACCident D Pending Investigation
[J SUIcide 0 Could Nol be Determined
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33a C6-l11~er (check. 0Il1y 00&)
Certilying physician \Ph~SiClan cerlltylng cause (Jf ooillh I'olll,n aoolhi:J( physlcliln has prunOlJ/lCed death and completed flem 23)
To lhe best 01 my knowledge, death occurred due to the cause(s) and manner as slated.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
PronJuncing and certifying physician (Phy~ICIJn oolh pwnollncing deJth and certifYing to Ci!use of death)
To the bas-I 01 my knowledge, dealh occurred at the lime. dale, and place. and due to the cause(l) and manner as stateL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~~~:~::~sm~~:~~~~:t~:~ and I or imestigation, in my opinion. dt:alh oc;curred althe time, dale, and place, and due to lhe cause(s) and manner as slated_ 0
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DI:;i-'u;;llIun Perrrllt NoOl U_1.. t{ D
I~ / l'::<lf "':<1
bAuA:-
I Vt'r-K
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28. Did Tobacco Use ConIribWI \0 Dealil?
~V" D'''''''bly
o No 0 Unknown
29 1\ Female
~ Not pregnafll WlthlO post ~E:ar
o Pregnanl at lime 01 dealh
o Notpreyrkint.bul?rsgllantwlltlln42 dd/;;
01 death
o Not pregnant. bul pregnant 43 da~s 10 1 year
before death
o Unkno\A.n II pregnant 1Ifllhlll the paSl year
32c.PtaceOllnjury:Home. Farm,Sreet Factory
OffICe BUilding, elc. (Specify)
v70
LAST WILL AND TEST AMENT
OF
<.-
MARY ELIZABETH LORE
, ~,~
I, MARY ELIZABETH LORE, now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may
have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I gIve, devise and bequeath my tangible personal property 111 accordance with any
memorandum I have handwritten or signed, located with my will or with my valuable papers and
found within 30 days of the probate of my will. Gifts may only be to persons who survive me or
to organizations which exist at my death, and if there is a conflict, the memorandum having the
latest date shall govern. To the extent no such memorandum is found, or all of my tangible
personal property is not disposed of pursuant thereto, my tangible personal property shall be
added to my residuary estate and pass under Article IV hereof.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath IN EQUAL SHARES to my children, PATRICIA L.
SCHAAL, of Cumberland County, Pennsylvania, per stirpes and BARBARA CULLEN, of
Dunedin, Florida, per stirpes. If a beneficiary fails to survive me by thirty (30) days, but leaves
descendants who survive me by thirty (30) days. those descendants shall receive, per stirpes, the
share the beneficiary would have received had he or she survived me by thirty (30) days. The
share of any deceased child who does not have living issue shall be divided and distributed to my
remaining child, per stirpes.
Article V
I nominate, constitute and appoint my children, PATRICIA L. SCHAAL and
BARBARA CULLEN, as Co-Executors of my Last Will and Testament. I direct that my Co-
Executors be permitted to serve without bond. In addition to those powers granted by law, I grant
them power to distribute in cash or in kind, in like or in unlike shares, and to file any qualified
disclaimer I could have filed if living. My Co-Executors shall receive reasonable compensation
for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Co-Executors, in her absolute
discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
2
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any
beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Co-Executors; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
G) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF, I, MARY ELIZABETH LORE, hereby set my hand to this
my Last Will and Testament, on ~~ 0
,2007, at Harrisburg, p~
'" ~., cJ.'.,- . / ~/
MAR ~... IZAB~ORE
In our presence, the above-named MARY ELIZAB H LORE signed this and declared
this to be her Last Will and Testament and now at her request, in her presence, and in the
presence of each other, we sign as witnesses.
Name
Address
~rt)~
~ YlJtL )
2000 Linglestown Rd., Suite 202, Harrisburg, P A 17110
2000 Linglestown Rd., Suite 202, Harrisburg, PA 17110
3
I, MARY ELIZABETH LORE, Testatrix, who signed the foregoing instrument, having
been duly qualified according to law, acknowledge that I signed and executed this instrument as
my Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
MARaELIZABETH LORE, the Testatrix
on (I 1/4 ~ ,2007.
~v1~
Nota Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Marlelle F. Hazen, No~ Public
Susquehanna Twp., Dauphm County
My Commission Expires Sept. 23, 2010
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute
this instrument as her Will; that she signed and executed it willingly as her free and voluntary act
for the purposes therein expressed; that each of us in her sight and hearing signed the Will as
witnesses, and that to the best of our knowledge. that she was at that time eighteen (18) years or
more of age, of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to before me
by Cor;,,"~ Grrf5. ~~D~SI?
and fY\{}t<C ( .s - m J L LE K..
witnesses, on r / ;;2.0
I
.2007.
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Witness ~
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,COMMONWEALTH OF PENNSYLV:ANIA
. Notarial Soal 1
s!:!,~le F. Huen, NotaIy Public
M -= II1na 1Wb. o.uphln Countv
Y Comml..lon l!l(plrel Sept, 23, 2010
4