HomeMy WebLinkAbout02-21-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of
also known as
ADELINE 5.
MUMMERT
File Number
all c2(XJrf- (5/ lf0
, Deceased
Social Security Number 189-07-8824
C, k( L
L.
b A-~TIZo d(
Petitioner(s), who is/are 18 years of age or older. apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
[] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the
last Will of the Decedent dated (( ;J...(, <( and codicil(s) dated
f< I e
)ctC
named in the
(State relevant Circumstances, e.g.,
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) offercd
for probate. \vas not the victim of a killing and \vas never adjudicated an incapacitated person: i '-..
C)
..-..'
o B. Grant of Letters of Administration
-'1
;--,",
(If applicable, enter. eta: d. b.n.c. t.a, pendente lite: durante absentia, durant<?'~inoriiR'd)
, . ,....)
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following sp~use (ifany) and heirs: '(/j
Administration, c.I.a. or db,n.c.t.a., enter date of Will in Section A above and complete /ist of he iI's.)
Relationship
-- -'.
~
Name
ReSidence
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death 111 CUMBERloAND County, PennsylvanIa with hiS / her last principal residence at
~kf2.,A>>-TUO.o M 8'Y! (}!tt A-L ~fYIf I Oil/) W S(J~~ Sf Co r-L ~'e.. f3 aVO
(List street address town/clty, township county, state, ;:IP code) J ~ _ '.
Decedent, then 9;l." years of age, died on FtJ r:;;( 00 g at 5if-A..A- if n () 0 l-fb f}1 C
1,0 (:7
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 PA) Personal property in County
Value of real estate in Pennsylvania
310.. OdD
.
$
$
$
$
o
o
~
(),cD
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 t()rm to
the underSigned
T
GAIL J..... GASTROCK
636 MALTESE DR.
PUNTA GaRDA
Flo
33950
Form R W.O] rev. I o.n 06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF
CUMBERJJAND
The Pe:titioner(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.
before me the
JCa
/
~~ ~~J:)llD~\c)
Signature oj Personal Representative
day of
GAIL L. GASTROCK
Signature oj Personal Representalive
Signature of Personal Representative
, /
... ',')
'--'-1
~.;::;
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Estate of
File Number:
ADELINE S,
~l cJ{J)g- ()/6{p
MUMMERT
'""l C0
,Deceased ..
ANON
having been presented before me, I
are hereby granted to
1 I r~)
189-07-8824 Date of Death: .2 ('-(oS--
0>2/ ,~(:) Y,' in consideration of the foregoing Petition, satisfactory proof
I DECREED that Letters TESTAMENTARY
IL L. GASTROCK
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of recorcl,as the last Will (a
Attorney Signature:
FEES
Letters............... $ J/;;O,w
Short Celiificate(s) . .'1, , , . $ ~()b
Renunciation(s) ., i. , . , , , ,$ 600
~ ftpll .. ,$ I$' oD
~ . , ,$ O. c..O
f n ...$ \..5(;6
.. , $
..,$
.. , $
.. . $
.. . $
TOTAL , . . , , , , , , . , : : : : l/r)J f!-~
Attorney Name:
DENNIS M. HARTRANFT, JR.
Supreme Court J.D, No.:
41076
Address:
151 E MAIN ST
EPHRATA PA 17522
Telephone:
717 738 2626
Form R W-02 rev 10.13,(16
Page 2 of2
H IO'i.R05 REV WI/(7)
() ~- / ~t;
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 14122084
Certification Number
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
~fr(~-
Local Registrar
FES/, B 2~
Date Issued
\~::..'
I',:;
.-....,
REV 11/2006
PRINT IN
~ANENT
:K INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FilE NUMBER
1. Name 01 Decedent (FtrSl, mil:kIIe, last, suffIX)
t9f)ELlkE
.5:
/11 L.I M /11 EIi'T
5. Age (last Blrlt1day)
7. Birthplace (Ghy and state or lore~ coontry)
~A'TH tI/lJ~E:;e,l.t1N ,)
i-LNrvp,[I/N SYJ.V i
Sd. Facility Name (If not institution, give street and number)
.:;'/}-/2/-lfi /1 TtiN) Mt:.7I10f!-IM.. ;+olnE
6. Date of Birth (Month, day, year)
9;<. y"
Nl'tIE1J78;::.7? 1-) iq/S
8b. County of Death
C:t/ mt!; El2 L./f r/ ,)
11. Decedent's Usual lion Kind 01 work done duri mosl 01 WOl1d life. Do not stale retired
Kind of Work Kind of Busi!)ess I Industry
~J:~,ee r /J/.!f D./;'EX'tlRndt.lIIL ttflR .~ r
12. Was Decedent ever in lhe
U.S. Armed Forces?
Dyes .NNo
Decedent's
Actual Residence 17a. $tale
13. Decedent's Educalioo (Specify only highest grade completed)
Elementary / Secondary (0-12) College (1-4 Of' 5+)
/2
PENNS Yi. IJlhV:1I
{JIJ /J] ,gEe J. AIv'"
- 16. Oecedenfs Mailing Ali1ress (Streel, city I town, stale, zip code)
t."]~ MI-~j..77i:SC D,t2/,;;Jf
Pu~rn' ~O~n~ .
i'/..c .'1..; !) 11 3.3 'i',.,-o
18. Father's Name (Firsl, midde, Iets1. suffix)
J'ul/,v 51) G' 'iTS
208. lnformanfs Name (Type / Prkll)
(]IU~_ ,J... dASTlZoC-K
17b. County
i -'"
3 Sodal i; 9~mbeO 'l - cP y..z4
8a. Place 01 Death (Check on one)
Hospital:
D Inpab"'t 0 ER IOulpab"'l D DOA
9. Was Decedenl 01 Hispanic Origin?
(II yes, specify Cuban,
Mexican, Puerto Rican, etc.)
4. Dala or Death (Month, day, year)
FElJl?tlfl~Y /b
~oo8
Other:
Nursing Home 0 Residence DOlher. Specify:
No 0 Yes 10. Race:'American Indian, Black, White, ele.
(SpeaM
WhiTE.
Twp
14. MarttaJ Status: Married, Never Married,
W~ed. DNo=l (SpeaM
(~U,' ;.) ,'I ;~ z.;D
Did Decedent
Uvein a
Township?
He. 0 Yes, Decedent lived in
17d.l3! No, Decedent Uved within
Actual limits of
City/Born
~J..i.sl-E
19. Mother's Name (First, middle, maiden surname)
:!3.i./JIl/t!-/,iE COI2/lJ/ld
201:1. Infonnant's Mailing Address (Street city / town, state, zip code)
&'3~ ,+Jf1.L'7::l!Se l)12h).; IftNT71 (/Ol:/)/I FLt:;.e-/dA
35950
21c. Place of D~ition (Name of ce~ry, crematory or other place) 21d. Location (City / lown, state. zip codG)
;eeLl_IIVe. {/,~ MEh1.:.<Li n (. /'A.I2f( CJI/J7,<' h' I,-~ i?1 /70' /
1 Apprnl(imate interval: Part 11: Enter other simificanl condlIion!; contritlulina 10 death 28. Did Tobacco Use Conlribl1le 10 Deilh?
Onselto Death but not resulting in the undef1ying cause given In Part I 0 Yes 0 Probably
o No 0 Uokoown
29. tfFemale:
o Not pregnanl within past year
o Pregnant al Nme of death
o Not pregnant, but pregnant within 42 days
of death
o Not pregnant. but pregnant 43 days 10 1 year
beforeclealh
o Unknown if pregnant within the past year
32<:. Place of InjuIy: Home, Farm, Streel, Factory,
Offic9Building, etc. (Specify)
hems 24.26 muellie comp<eted by pe<SOn
who pronounces death. Cr' -) (';
CAUSE OF DEATH (See Instructions and examp )
Item 27. Part I: Enter the ~ - diseases, injuries, or complications -that directly caused the death. DO NOT enter terminal eyents such as cardiac arrest,
respiratory arrest, or ventricular fibrillation wilhool showing the etiology. Us! only one cause on each ~ne.
~Jisu1~Si d:~~)~;
{" '-' j9 ~i ~ ~ ~.v -\ .-&;. ~ ( U J ~
Due 10 (or as a consequence of):
8equenIOJ~ list conditlons. d any.
=8:DC:~~~~~~~ s,.
(disease or ~ry thai initialed the
events resUtiilg In death) LAST.
b.
Due 10 (or as a consequence of):
Due 10 (or as a consequence of):
d.
308. Was an Autopsy
Performed?
3Ob. Wele Autopsy Findings
Available Prior 10 Completion
of Cause or Death?
31. Mamer of Death
.!lrNatura! 0 Homicide
o Acddent D P,""ng Irwesbgebon
D Su<kle 0 Could Not lie DetOfmined
M.
Dyes ~No
[Jy" ONe
32<1. Time of I~ry
338. Certifier (check only one)
Certifying physlcllll (Physician certifying cause of d9a1h when another physician has pronounced death and compIeIed item 23)
To the best of my knowledge, death occurred due to the cauH(l) and manneral stated.... _...... _........ _.... _............ _.... _.... _...... _.. 0
~=:~a~:=:=~~=~I='::n:::a:rn:1ol~::~~~a~ manner 81 stated.................................... D
~= ~a;~~~~;~r:.= and I or investigation. in my opinion, death occurred a1 the time, date, and place, and due to the cause(s) and manner as stated.. D
I ...::.I. / I' 36~ga'e~~on~",~
I~I I <-''I I I or//p/P1L/C/
O;,oosilioo Pennn No. 00 91,f 7 Cl
Fu NE72AL f.-+on1C<
23b. Ucense Number
32g. location 01 Injury (Street, city / town. slate)
o
33d Dat~~7 ("g(O 6
34. Name and Address 01 Pe~ ~ ~led Ca~ 01 o,~~ 1em 2~1.y / Print ,
iJA RJUL K. {,./t.;;:;1 W.le: , l).(.
-:J :< .1 S . P / IT. S 7:eJ::ET "/1
C!. /i't./ 'E: rrT 17<:.'; ..3
O~-J~
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"'"fl
LAST WILL AND TEST AMENT
OF
ADELINE S. MUMMERT
f'.)
c.)
r,..:,:,
I, ADELINE S. MUMMERT, of Mechanicsburg, County of Cumberland and
Commonwealth of Pennsylvania, declare this to be my Last Will and Testament, hereby
revoking any wills or codicils heretofore made by me.
ITEM I. I direct that all my legally collectible debts and funeral expenses, including
reimbursement to any individuals for any expense of my last illness paid by them, shall be paid
from my residuary estate as soon as practicable after my decease as a part of the expense of the
administration of my estate.
ITEM II. I bequeath my household and personal effects and other tangible personalty of
like nature (not including cash and securities), to my beloved husband, RUSSELL E..
MUMMERT, PROVIDED he survives me by thirty (30) days.
ITEM III. I bequeath all of the shares of stock, common and preferred, and all of my
interest in any notes, mutual funds, and bonds of any kind, which I own as of the date of my
death, provided, that this bequest shall be of an amount which shall not exceed the Federal
Estate Tax exemption equivalent, to the Trustee hereinafter named, IN TRUST, for the
following uses and purposes. For example, if the current exemption equivalent is $600,000.00
and the sum of my such securities at the time of my death is $400,000.00, the entire
$400,000.00 shall be placed into this Trust. However, if the current exemption equivalent is
$600,000.00 and the sum of my such securities at the time of my death is $700,000.00, only
$600,000.00 shall be placed into this Trust. The remaining balance of $100,000.00 shall be
given to my husband as part of the marital gift described in ITEM IV herein.
A. To pay the net income therefrom to my said husband for and during his lifetime;
B. As much of the principal of this Trust as Trustee shall, in its sole discretion,
determine is needed for medical, educational, support and health expenses in the event my
spouse's other assets are depleted;
C. Trustee may apply the net income of this Trust for the support of my husband,
should he by reason of age, illness or any other cause, in the opinion of the Trustee, be
incapable of disbursing it;
D. No property ineligible for the marital deduction or any similar benefit shall be
distributed to this gift for my husband pursuant to this Article;
E. Upon the death of my husband, the Trustee shall first deduct and pay to the
personal representative of my husband's estate an amount equal to the increase in federal estate
tax or state death taxes which his estate will have to pay because of the inclusion of the assets
under this Item of my will in his gross estate (unless he directs otherwise in his will) and all
then-remaining principal shall be distributed as follows:
1. The balance of the then-remaining principal shall be distributed as follows:
i. I give one (1) equal share to my son, JACK MUMMERT, if he
survIVes me. If he does not survive me, and he has children, I direct that such share be
divided equally between or among his children; and
ii. I give one (1) equal share to my daughter, GAIL A. GASTROCK,
if she survives me. If she does not survive me, and she has children, I direct that such share
be divided equally between or among her children.
F. This Item of my will is intended to empower my Executor to qualify this gift or as
much thereof as they deem advantageous for the qualified terminable interest property
provision set forth in Section 2056(b )(7) of the Internal Revenue Code as amended by Section
403 of the Economic Recovery Act of 1981 and my Executor is hereby authorized to make the
election to qualify or not to qualify. As such I direct that (1) if any provision of my will shall
result in depriving this Item of the benefits of IRC Section 2056(b)(7), if elected, such
provision is hereby revoked and my will shall be read as if any portion thereof which would
result in such disqualification is null and void; (2) my Executors are hereby excused from
liability to any person for the decision to elect to have this Item qualify for the marital
deduction or for the decision to elect not to so qualify it; and (3) no reimbursement or other
adjustment shall be made as among beneficiaries by reason of the consequences of such
election or failure to elect.
ITEM IV. I devise and bequeath the rest, residue and remainder of my estate of whatever
nature and wherever located to my beloved husband, RUSSELL E. MUMMERT, PROVIDED
he survives me by thirty (30) days. In the event I am not survived by my husband, or if he
fails to survive me by thirty (30) days, I direct that my estate be distributed to my children,
JACK MUMMERT and GAIL A. GASTROCK, in equal shares, per stirpes.
ITEM V. I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate
as a part of the expense of the administration of my estate.
ITEM VI. I appoint JACK MUMMERT and GAIL A. GASTROCK, as Co-Trustees of
any trust created under this will, and I direct that they shall serve without bond, and further, I
direct that they shall be able to give good title to any real estate without order of court.
ITEM VII. The interests of the beneficiaries herein under shall not be subject to
anticipation or to voluntary or involuntary alienation.
ITEM VIII. My Executor and Trustee shall have the following powers in addition to those
vested in them by law and by other provisions of my will applicable to all property, whether
principal or income, including property held for minors, exercisable without court approval,
and effective until actual distribution of all property:
A. To retain any or all of the assets of my estate, real or personal, including any
shares of stock or other securities I may own, without restriction to investments authorized for
Pennsylvania fiduciaries, but to invest as a prudent man of intelligence and not for
speculation, giving due regard to the safety of the principal and the adequacy of the income;
B. To invest in all forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, but to invest as a prudent man of intelligence and discretion would
buy for himself, for investment and not for speculation, giving due regard to the safety of the
principal and the adequacy of the income;
C. To sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges or leases, for such prices
and upon such terms or conditions as they may deem proper;
D. To allocate receipts and expenses to principal or income or partly to each as they
from time to time think proper; and
E. To borrow from, or to sell to, my Trustee even though such Trustee may be my
Executors.
ITEM IX. I appoint my husband, RUSSELL E. MUMMERT, Executor, of this my last
will. Should my said husband fail to qualify or cease to act as Executor, I appoint my
children, JACK MUMMERT and GAIL A. GASTROCK, or the survivor of them, to serve as
my alternate Co-Executors. I further direct that my Executor or his successors shall not be
required to give bond for the faithful performance of their duties in any jurisdiction, and shall
give title to real estate without order of court.
;26
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of
.Jctl/\U~1 ,1996.
j~ X Jr.~ (Seal)
ADELINE S. MUMMERT
Signed, sealed, published and declared by the above-named Testatrix, ADELINE S.
MUMMERT, as and for her last Will and Testament, in the presence of us, who at her
request, and in her presence, and in the presence of each other, have subscribed our names as
witnesses hereunto.
J)~~~. ~~
residing at
f-fll a-, ~
PI)
residing at
q~ 16&
OA TH OF SUBSCRIBING WITNESS(ES)': 1':3 2 i
'~: , ,
REGISTER OF WILLS
CUMBERLAND COUNTY PENNSYL VANIA
,
c:2/ -c2Wf?- O/fir'
Estate of
ADELINE 1
MUMMERT
, Deceased
DENNIS M. HARTRANFT, JR.
, (each) a subscribing witness to
(Print Name/s)
the CI Will D Codicil( s) presented herewith, (each) being duly qualified according to law, depose( s) and
say(s) that she / he / they was / were present and saw the above Testator / Testatrix sign the same
and that she! he / they signed the same and that she! he ! they signed as a witness at the request of
the Testator / Testatrix in her / his
~,Ik:5f
(Signature)
DENNIS M. HARTRAN T, JR.
120 ROYER RD., EPHRATA PA
presence and in the presence of each other.
(Signature)
17
522
(Street Address)
(Street Address)
(City. State. Zip)
(City. State. Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before mJ't~is c:,,2!Vf . day
of ~;JciYUjj)./L :v(jO~
~
Deputy f,
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other ofllcial qualified to
administer oaths. Show date of expiration ofNotary's Commission)
NOTE To be taken by Officer authorized to administer oaths. Please have present the original or copy ofinstrument(s) at time of notarization
Form RW-03 rev /0./3.06
6~ <f 2si
OATH OF NON-SUBSCRIBING WITN-tSS(ESr;'; 3: ! ~
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
0>2/ - ~c)06' - 0 f r~
Estate of
ADELINE )
MUMMERT
, Deceased
GAIL L. GASTROCK
and
(eacfl) being duly qualified accordiy- to law, depose(s) and say(s) that
acquainted with ADELINE MUMMERT
she / he / they was / were well-
and am/are familiar
with the handwriting and signature of the decedent, and that the signature of ADELINE
MUMMERT
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
ADELINE 5 MUMMERT
is in his/her own proper handwriting.
~\ ~
~\ .~\ ~~
'. \' -,k\V . ~ ro~\'
. "'"'"~ ~" n -.N ~
G.A.IL L. GASTROCK
----6-1 n MJ'I T,'T'F,SF. Dr?, PTT!:iIT~ GORDA. FL
(Street Address)
(Signature)
33950
(Street Address)
(City. State, Zip)
(City, State, Lip)
Executed in Register's Office
1
Form R W-04 rev 10.13. 06
02/19/2008 10:42
71 773321 76
WEAVER FINANlCAL
PAGE 02
--r~'-
RENUNCIATION
, i
c.!
r,)
REGISTER OF WILLS
aMERU\N) COUNTY, PENNSYLVANIA
~ ( - :200'6~ 61 o(p
CJ
r.,,)
Estate of
ADELINE
MUMMERT
, Deceased
I.
JACK
MUMMERT
. in my capacity/relationship as
of the above Decedent, hereby renounce the right to
(Print Name)
EXECUTOR
administer the Estate of the Decedent and respectfully request that Letters be issued to
GAIL
GASTROCK
~JI
'" ~4J~
($~)
JACK MUMMERT
(St"'~1 ,4dd,e.;8,J
(Ci/y, Stat" Zip)
Executed in lh,ist~r's OffICe
Sworn to or affirmed and subscribed
before me this day
of
Ex~c_d oul of Rquter's Offic~
Before the undersigned personally appeared the
party executing this renunciation and certified
that he 0 she executed the renunc;iappn for the
purpq ted within on this cJOtt"\ day
of
Deputy for Register of Wills
lie
mission Expires: ~ ()D {:;LOO?
(5 ignalurc an:! Se.1 ofNolafy at other olTlcial qualific41D
IIdmini5/I:T (llllh.~. Show date of cllpiralion or Notary's COlllmi,lrion.)
F",.", RW-06 ,.... 10.13.06
COMMONWEALTH Of PENNSYLVANIA
NOTARIAl SEAL
SUZANNE M. DEDERER, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires AUK. 20, 2009