HomeMy WebLinkAbout04-02-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of
Elizabeth E. Machusak
File Number
~\ 0'6 O~-l")
also known as
, Deceased
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE ~' or 'B' BELOW:)
8 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the Executrix
last WiII of the Decedent dated October 22, 1998nd codicil(s) dated None
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 execution of the instrurnent(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: N I A
o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has / have ascertai~e? that Decedent left no Will and was survi:ed by the following spouse (if anY~d heirs: (1/
AdministratIOn, c.t.a. or d.b.n.c.t.a., enter date a/Will In SectIOn A above and complete lIst a/heirs.) ~
~
Name
Relationshi
,,--, ,~-
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in Cumber land County, Pennsylvania with his / her last princi~esidence at
1051 Allendale Road, A t. F Mechanicsbur U er Allen To n hi
(List street address, town/city, township, county, state, zip code)
-
-
...- f 't";'?~t
-~r I
o
[~'?
..G.u.unty, PA
Decedent, then
87
years of age, died on March 22, 200R
at
Carlisle, Pennsylvania
Dl:cedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$ 20,000.00
$
$
$ None
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:
c
~.
T ed or rinted name and residence
Susan I. Meadows
3807 Chi enham Road Mechanicsbur PA 17050
Form RW-02 rev. 10.13.06
Page 1 of2
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 ofPetitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or "Jfirmed and subscribed
~.. Q /1 ~~~
Signature of Personal'/i:presentative
Susan I. Meadows ~
Signature of Personal Representative
~
<<:::)
Clr:>
:r-.
.."
:::0
,
'"
- ,
('1"", ..-"'.~
before me the _4:!.d.-_ day of
~
F or the Register
Signature of Personal Representative
"'tJ
3:
'--"'~'.. .._-~
~!;.~.,' ~~,~:~~
ff ;~~;
S:r~
~'a
t.');,.....;
.,'. .,~
--
File Number:
dJ 0 ~ ?:,'l d
o
U1
Estate of Elizabeth E. Machusak
, Deceased
Social Security Number:
DmeofDemh: March 22, 2008
AND NOW, April 2, 2008 , in consideration ofthe foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Susan I. Meadows
in the above estate
and that the instrument(s) dated October 22, 1998
described in the Petition be admitted to probate and filed ofreco
FEES
Letters ... ./)/)/).W. . . . $ IdJ Register of Wills
~
Short Certificate(s) . . 6~ . . $ ~() Attorney Signature:
Renunciation( s) .......... $ Keith O. Brenneman
Lv, V .. . $ l~ Attorney Name:
.~~ . .. $ if..; Supreme Court I.D. No.: 47077
.. . $ -S- 44 W. Main Street
.. . $ Address:
.. . $ Mechanicsburg, PA 17055
.. . $
. .. $
...$ (717) 697-8528
Telephone:
.. . $
TOTAL ..............$ 110 e.~
Form RW-02 rev, 10.13.06
Page 2 of2
H I O~.X(1S ({LV I () I /()7)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to dupltcate this copy by photostat or photograph.
."
Fee for this certificate. $6.00
1",,11 '" /"",/"
1\\I,'~~\.1\\ OF PEl----_
\\\.,~~~,,,",,-
\\~ . =_. U..J.:'"
~\~-~. . ~\
l~t i _01~' \~~
~C::O\ ... '-'.
~c.J ---a.~l' I:l::.,~
~ 'j~ _ l '"
>'*'L~ .' ....'.... 'I*~
;. (;2'/" I~~'
"\.~ ~l
.", ;sf,? ------.\\.'<'l
""--.-.IMENi \)\ """'
"''''#/1/##111,,'1.11
P 142S2832
Certification Number
-
Hl05.143 REV 11/2006
TYPE I PRINT IN
PERMANENT
BlACK INK
This is to certify that the information here given i
correctly copied from an original Certificate of Deat
duly filed with me as Local Registrar. The S'riginc
certificate will be forw,arded to the State Vite
Records. Office for J!lermanent fIling. .
'i'R .?, ~~20 .8J
~:::~.,:",.....
\;) ("-) (-.J
::::0 (1;}lf t~:::Js sued
I .::.... C -I
nir'Tl
N =n '::>
~ ~~: ~~
:x ;g; F5
;:-:- rn
C'? C>
';'1
o
c.n
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Sse Instructions and examples on reverse)
,
I
I~~
"
~
~
::J
.,
11em82H6 nut bII ~ by penson
who prol'lOllOC8l dealh.
~
::)
:t:
\.I
~
0.03"0 ) /I M.
CAUSE OF DEATH (See lnalluctlon& and exampleol
1em27. PJrtI: Enlefthe~-disease6. ~,orcomplcalions-tbIItRcUy~ed"deaIh. OONOTenil,leminalevtOlssuchascardlCarresL
respltaloryauesl, Ol'venkicularfllflllatQlwMho\jlhowlnglhe ~ UsliDyOOlClllSlOl'l eachlile..
=~=~l.':ll\\~
..
S+ "" \L -<-
Dwto(or..a~of):
=~~I9~'~~a
Enlerlhll UNDERLYING CAUSE
=.s~1~~101~
b.
Due to (Of as I conuquenc:e 01):
c.
Du&totoruaCOJlllQU8fll:8of):
~
d.
3Ob.W."AllIcloGY_
A\lallablePriorto~
olCiI\lS8dDel\h'1
31. Manner 01 0eIIh
BNau" D-
O - 0 PondOlg InwttigUon
o s.- 0 CWd,.. he DeIamW1ed
32d Tmeol~
3Oa.W.sanAulopsy
Per!0l1lled1
I Apprminale il&emd:
I OnstttoDNlh
I
I
: 2'-\1-t.e.k S
I
,
I
I
I
I
I
.
.
I
,
Twp,
Ciy/Bcro
28.DIdTobIccoUseCoririlluleIoOlllh?
o Yu OP-
ONo ili!-
29.'"""""
~NoIpognarO_paslyear
o P......linaol_
o NoIpognarO,"'I'"lJl8"_'2"'"
ol_
D NoI_"'I'"lJl8"43daplo I year
btIora_
O-.I'"lJl8"-.......year
321:.==~~j-.F~,
~
lJ
~
~
is
~
32t.IIT"""f>CIl!aIio"'~(Sp<<IIy)
ODmw/"-'" 0_ 0-
M. OIher . $pIcly:
3!e> Cel,!!!,' \C\IeclI 00\'f ...\ 33b.
f.=t.r~====:",,::,"...wha~ano:r1lld~':~_~~~~~~! __ ____ __ ___ _ ____ _ m ~
Pro......'.. and ctr1llylng pI1y.lcIo. IP"'..... bolh """""""" <loa~ and ct"""'" lo ..... 01 """I 330. licon.. Numbor SOd. DaIo Slgnod (MorjlI. day, JUI)
:.::~~=~~=' <loalh occurr'" .tlh. .me,..... Ill' place, "",,,,10 the ct.08(.).ad....... .....le1l. ____n_ - ---- - -- nOM j) 0 ~ S'z. 'tt; E. 0 ~ - 2. 4. - "260 q
On the bula 01 ellMllnatlon.oo I OIlnYettlgallon, In my opinion. detth occurred It the Ume. dale, and pIIce, Ind due to the cause(t) and rnam..- It alated.. 0 34, Name 8nll.Mlhss at P,eISOR Wbo~ Cause t1 DeI\h _ 21) 1;t1)11 Pm.
3 Vo.,,~d. L. W.......fl.e-.r, M,p.
[:l111'i1 15 1:nS(.......h.tl~ c;.J, ~llvJ....~J ~ O)~t.{
I
DYes G No
Dyes ONo
D1spos1Uon Pard No.
~/ ...
..
","
...~
LAW OFFICES
SNELBAKER,
BRENNEMAN
& SPARE
LAST WILL AND TESTAMENT
(") '"
~O is
ffl ;0 Q:.)
(J:!;P (") $
f"';:!$r- -v
>::<:93 ,
C5 (r.j:x I'\)
00
I, ELIZABETH E. MACHUSAK, of 1051 F Allend~~oa<il'
:a~ -
Mechanicsburg, Cumberland County, Pennsylvania, being ~
<n
and disposing mind, memory and understanding, do hereby make,
OF
ELIZABETH E. MACHUSAK
.~_.., J
, --'j>
~r'J td
~~~ j,::
::_:,:_~:::;\i'
s@wiq
publish and declare this as and for my Last will and Testament,
hereby revoking and making void any and all wills by me at any
time heretofore made.
1. I direct that all my debts and funeral expenses be paid
as soon as practical after my death by my Executrix or Executor,
whichever the case may be, hereinafter named.
I direct that all taxes that may be assessed as a
consequence of my death shall be paid from my residuary estate
as part of the expenses of the administration of my estate.
2. I give my white bedroom set to my daughter, SUSAN I.
MEADOWS, and all of my Longaberger baskets to my son, PATRICK S.
MACHUSAK.
3. All the rest, residue and remainder of my estate, real,
personal and mixed, and wheresoever the same may be situate,
I give, devise and bequeath in equal shares to my following
children: MIKE MACHUSAK, II, PATRICK S. MACHUSAK, SUSAN I.
MEADOWS and JEFFREY L. MACHUSAK.
If any of my children identified above shall fail to
survive me, I direct that the property and/or share of my estate
to which said deceased child would otherwise been entitled shall
be divided equally between or among my surviving children as
specifically identified hereinabove in this Paragraph.
3. Although I am not unmindful of my daughter, CHARLOTTE
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY
OF
CUMBERLAND)
We, ELIZABETH E. MACHUSAK, KEITH O. BRENNEMAN, ESQUIRE and
SUSAN L. ZYCH, the Testatrix and the witnesses, respectively,
whose names are signed to the attached or foregoing instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument
as her Last will and Testament and that she had signed willingly,
and that she executed it as her free and voluntary act for the
p~rposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the will as
witness and that to the best of his or her knowledge the
Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
12!o~1C );zc:rL'Jt~
p;;;;::;:.
t4 .
Wltness
,CAd fl-
v
-/!. '~~
Wit~s
Subscribed, sworn to and acknowledged before me by ELISABETH E.
MACHUSAK, Testatrix, and subscribed and sworn to before me by
KEITH O. BRENNEMAN, ESQUIRE and SUSAN L. ZYCH, witnesses, this
22nd day of October, 1998.
LAW OFFICES
SNELBAKER,
BRENNEMAN
& SPARE
.
~IV\,~
Notary Public
Notanal Seal
Chnstlne M White Nota P .
Mechanlcsburg Bora c' be ry ublrc
My Commission EXPlr~s~~a~d7C~ggt
Member. Pennsylvania AsSOCiation of Notaries
N. STETLER, it is my intention that she not be a beneficiary of
any property of mine, real, personal or mixed under this my Last
will and Testament or that she in any way share in my estate.
4. I hereby nominate, constitute and appoint my daughter,
SUSAN I. MEADOWS, as Executrix of this my Last will and
Testament, but should she predecease me or fail to qualify, then
in such event, I nominate, constitute and appoint my son, MIKE
MACHUSAK, II, as Executor of this my Last Will and Testament.
I further direct that no person serving as Executrix
or Executor hereunder shall be required to post any bond to
secure the faithful performance of her or his duties in the
Commonwealth of Pennsylvania or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to I
this my Last will and Testament written on Two (2) pages this
22nd day of october, 1998.
(J.~ ~ )J?i(d.--I(SEALl
Eli beth E. Machusak
Signed, sealed, published and declared by ELIZABETH E.
MACHUSAK, the Testatrix above named, as and for her Last Will
and Testament, in our presence, who, in her presence, at her
request, and in the presence of each other, have hereunto
subscribed our names as attesting witnesses.
*'
( SEAL)
LAW OFFIC.ES
.~L",-'70.- y( . :,,J (SEAL)
SNELBAKER.
BRENNEMAN
& SPAI~E
-2-