HomeMy WebLinkAbout04-17-08
Estate of (;fAcE-
also known as
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF (jo/lJ/!;<teLlrtvV
fh~~SLL
COUNTY, PENNSYLVANIA
"5
File Number
c2/- (jg~ LJ ttJr?
, Deceased
Social Security Number .I '1<{ ~3i?~'Y;1h
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
~. A. Probate and Grant of L
last Will of the Decedent dated
1: I
(State relevant circumstances, e.g., renunciation, death of executor, etc.) :,'~ ;? -.J ~ I :~~J
....')0 ,.....
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after executiof\ o( it;? tl;hlUme~) offexd . :':~
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: .: ~ N - ':~>
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o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante milloritate)
Petitioner(s) atier a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Administration, c.t.a. or d.b.ll.c.t.a., ellter dale of Will ill Sectioll A above alld complete list of heirs.)
~fn
Name
ll) ;7/1 $.) L<-.
Ii RelationshiD
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Residence I n 1.
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D(:cedent, then
JIo Plo/ )/#'fkf!ftJ !I:f~1~/-
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
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$ ,5OJO
$
$
$
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:
/7ci3
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
1n~a ~PR \ 1 PK 2: 56
COMMONWEALTH Of PENNSYLVANIA ' rn\.( "C
~ SS 0 \:,nl', \.01
II I"" I i :-: ',1:("\ (..(''''' J~01
COUNT'r' OF ~J1rll/.J:I/LO (It ": 0\S~f:tr'\I::IJ\f'!'r; \ 0/\
The Petitil;l;cni \ :lh\)\ '~"!L!l:led ~'\ e:!I(S) ur ,] :"f:rm(s) that the statements in the foregoing Petition ~re'true and con-ect to the best of
tile kil~)\\
Jnu be'lief of Petltionel\si anu that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
Jij;~
, day of
administer tb~ esrat.;; according to law,
Swom to or affirmed and subscribed
Signature of Persollal Representative
File Number:
c2/ ~ 08'- () Y3~
G ~OrL -3 I (C{f(eJ {
17li - 58-- ~T"jly
J'7! (JCVJS
, Deceased
Estate of
Social Security Number:
AND NOW, n pG.-1
having been presented before me, IT IS DECREED that Letters
are hereby granted to . \' haft') ('(II
Date of Death:
o ('M'~ 1 q, ~~
, in consideration of the foregoing Petition, satisfactory proof
in the above estate
and that the instrument(s) dated, G._p.{\ \ g , J(SJ~
described in the Petition be admitted to probate and filed ofrecord as the last Will (a d Codicil(s))
FEES
U100
$ \:/J.
$ 02J. 00
$
$
$
$
$
$
$
$
$
$
$ YJJ. ex)
Attomey Signature:
Leite rs
Short Certificate(s) " . . . . . . .
Renunciation(s) .",..".,.
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J.5,(JD
10,00
J:)t>D
Attomey Name:
Supreme Court I.D. No.:
Address:
Telephone:
TOTAL
Forlll RW-OJ rev 10.13,06
Page 2 of2
OS'- 43 (;
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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.
Fee for this certificate. $6.00
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P 14329122
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Certification Number
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
2. Sex 3. Social Seclority NlITlber
female 174 - 38 - 8716
COII"IIy 81. PIaco 01 Dealh Check one
Hospilal: Qthec
o Inpatlonl I&J ER 1 Ou1patlenl 0 DCA 0 Nlnilg Home 0 R_nee
9. Was Decedent ol Hisponic Orig;n? KI No 0 Yes
(II yes. spoclfy Cuben.
M.xican, PUOt1ORIcan. eIc.)
;.144 REV 1112006
lPE 1 PRIm- IN
PERMANENT
BlACK INK
I. Name olllecedor< (F.... _.Iest. sulfix)
Grace S.
5.""" (Lasl BiI1!lday)
STATE FILE NUMBER
4. Date 01 Death (Month, day, yea~
April 9, 2008
Farrell
7. BlllhPace ( and_or
, ~
6. Date 01 Birth(Morllh,
Somerset, PA
June 15, 1947
000.. . Spacity:
10. Race: American 1nc!an,IlIecI<, WNte, ole.
(Specif).\
60
!d. Foc:iIly Nome I" noI _, give street "'" number)
6b. County d Death
Dauphin
Harrisburg Hospital
white
14. Marital Status: Married, Never Married,
W_, 0lv0I0ed (SpecIM
Married
la Doc:edenf. E_ (SpaciIy only h9>&" !l'8d& c:ompletedJ
Elementary 1 Secondary (()'12) College (1" or 5+)
12 4
12. Was Oecedert ever In the
U.S. Armed Fortes?
Ov.. 0No
Decedent's
ActueI Resldence 178. Slate
most 01 ifI.DonotJta1er
KInd <I BuolnossllndUSlry
State Government
Joseph W. Farrell
Did Decedent
Live In a
Township?
Pennsylvania
Cumberland
17c. 0 Yes, Dec9den1 lived "
17d.0 No,_LIved""""
AduaIINs 01
Twp
Lemoyne
17b. County
CIlyIBoro
19. Mother's Name (First. rnldIte, makien.lUmame)
Rose Nunnari
2Ob. Intonnanr. Maililg Add.... (SlreeL ~ llown, _, zlp code)
541 Third Street, Lewmoyne,
21c. Place <I DisposIlkln (Name 01 cemete<y. Cf9lI1ll1ory or other place)
Rolling Green Cemetery
208. ..-. Name (Type 1 Print)
Joseph W. Farrell
i OClomal;or, 0 Dona'kln 21b. Oal. of ~1lIon (Month, day, year)
!~==:=~OV..ONo
aclI"!i ..1UCh) 22b. License Ntrnbe,
FD 013 340 L
PA 17043
21d I.DcaI1on (CIty llown, ..... zlp Old.)
Lower Allen Twp., PA 17011
:
220. Name and Address of Fecilly
Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
. ~
23<. Date Signed (Month, day, year)
23b. Lk:onoe _.
~11emI23a..only"""'cortIlyiIg
phySic:ianlsnotavaillbleatlimeoldealhtD
c8IIlfycauoeof_.
n"", 24-26 """ be compIoIed by paroon
wt.o___.
26. Was -Case Referred to Medk:al Examll'lef J Coroner for a Reason Other than Cremation or Donation?
I&Jv" ONo
24. T..... 01 Death Pronounced: 2S.Ila" Pronouncod Ilaod 1- day, yea,)
10:40 A.... April 9, 2008
28. Old TobBcco Use Cc:lntrIMe 10 Death?
o Ves OProbably
o No 0 Unknown
29. " Female:
o Nolp<ogllWllwllNnpllltyea.
O~a1timeoldeal11
o Nolp<ogllWll.bUpregnanl""""42daYS
of_
o Nol~bulproglllnl43days101 YOO'
boforedoelh
o Unknown" pregnanlwllNn the past year
320. =::=:.r~ Street, FIdory,
Part II: EnterolherllloriflcantcmdlioMOOf'iI'bJIIKItodMth
bulnotresultingi'lthelRMl1yi'lgcauselJVen in Part I.
I Appmxlmele ,_:
t 0nse11O Oeatn
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CAUSE OF DEATH (See lnalructlonl Ind lump"")
Item 27. Part I: Enlerthe cblilUlt.i:dtlll- cisellSll, ir1111es, or compicItions -1hIt cIfecIIy caused the deaIh. 00 NOT enter termnal MI'IIS such aacardlac arrest,
resPratory arrest, 01' ventricular fbrilation wiIhW: showi'9 the etiology. list only one cause on eIICh fne.
=~~=)cll=
Hypothyroidism
.. Cardiac Dysrhythmia
Due to (or as a conseQlJ80C8 of):
b. Dilated Cardiomegaly
Duo 10 (or as. consequence 01):
_lBlcondilion~l,lIlY,
lledng to the cau&e listed on line a.
E.-Iho UIID1!RlYING CAUSE
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c.
Doe to (or as a consequence 01):
d.
n. Were Au10pIy Flndngl
A,valab6e Prior to Completion
01 Cauoe 01 DoaIh?
IZI v" 0 No
31. Manner of Death
fig _ 0 Hcmidde
0- OP-.glrw8l1lgalion
OSUcido OC~NolbeIlalem101ed
:lOa. Was en AuIopIy
P..-..r1
32d. TIme of 1r4lJ'Y
IZI V.. 0 No
M.
330. c..ntIo< ("*" only ""I
Certtfytng phystdnn (PhysIcian certifying cause 01 death when another physician has pronounced dea11l and comp/eteO Item 23)
To tho best 01 my u-ledge, _ occulTld due to tho Cluoo(.j.nd _" oIe1eII.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - -- - - - - - - 0
~=~:==~;~~"::'~':'~~'t.IO.::~t: mo...." as ,"Ied.. _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ 0
::~=":~= Ind I or Inve.tlgatlon, kt my opnlon, duth occuned at the time, date, and pWe. Ind dIM to tl'le caUH(.) It'Id INflntf lI.tatecL tKl
Patty J. Garber, Assistant Chief Depuly
33<1. Dale SIgned IMonth. day, yell)
April 10, 2008
34. Name "'" Address 01 Pe"", Who ~ eo"" oIllaeth (~27) Type 1 Pml
Patty J. Garber
1271 South 28th Street
Harrisbu ,PA 17111
I o2l- II 021 / II
35. Registrer.
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Olsposffion Pennit No.
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LAST
W ILL
AND
TESTAMEN
GRACE
S. FAR R ELL
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I, GRACE S. FARRELL, of Camp Hill, Cumberland
Pennsylvania, being of sound and disposing mind, memory, and
understanding, do hereby make, publish, and declare this to be my
.Last will and Testament and hereby revoke all other wills and
Codicils, if any, that I have made.
FIRST: It is my wish, and I direct, that after my death any
part of my body may be used to replace diseased or worn out parts
of other humans or to rehabilitate human parts or organs. Any
part of my body which can be preserved for subsequent restorative
purposes in living humans may be stored for this purpose. I
further direct that the remainder of my body be buried.
SECOND:
All of my Estate, of whatever nature and wherever
situate, I give, devise, and bequeath to my husband, JOSEPH W.
FARRELL, so long as he shall survive me by thirty (30) days.
THIRD:
Should my husband fail to survive me by thirty
(30) days, then I give, devise, and bequeath all of my Estate, of
whatever nature and wherever situate, to my son, MARC JOSEPH
FARRELL, of Pittsburgh, Pennsylvania; and to my daughter, JULIE
BARKER FARRELL, of Camp Hill, Pennsylvania, in equal shares, so
long as each shall survive me by thirty (30) days. Should either
of my children fail to survive me by thirty (30) days, but be
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represented by children then living, these children shall take,
per stirpes, the share to which my child would have been entitled
if then living.
FOURTH: All interests of any beneficiary in the income or
principal of this Estate, while undistributed and in the
possession of my Executor, even though vested and distributable,
shall not be subject to attachment, execution or sequestration
for any debt, contract, obligation or liability of any
beneficiary and, furthermore, shall not be subject to pledge,
assignment, conveyance, or anticipation.
FIFTH: All inheritance, estate, and succession taxes
(including interest and any penalties thereon) 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.
SIXTH: I nominate, constitute, and appoint my husband,
JOSEPH W. FARRELL, as Executor of this, my Last will and
Testament. In the event of the renunciation, death, resignation,
or inability of my husband to act for whatever reason in this
capacity, then I nominate, constitute, and appoint my children,
MARC JOSEPH FARRELL and JULIE BARKER FARRELL, as Co-Executors of
this, my Last will and Testament.
I direct that no representative named above shall be
required to post security for the faithful performance of his/her
J
~
~ duties in any jurisdiction insofar as I am able by law to relieve
~~
, him/her of such obligation. Any of my representatives shall be
entitled to reasonable compensation for the performance of the
duties set forth here.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this qrl day of April, 1992, on this, the third of three
typewritten pages. I have also signed the left-hand margin of
the first two of these pages for purposes of identification only.
/&zd-d:(/ xl {J1(}.AA.-t.1.(
GRACE S. FARRELL
SIGNED, PUBLISHED, and DECLARED by the Testatrix,
GRACE S. FARRELL, as her Last will and Testament, in the presence
of us, who at her request, in her presence, and in the presence
of each other, have hereunto subscribed our names as witnesses.
OYho~u) j~J J3 F ~ :Jf~L
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fu~,y,~, ~A 11-~S-
ACKNOWLEDGMENT
Commonwealth of Pennsylvania
County of Cumberland
I, GRACE S. FARRELL, Testatrix, whose name is signed to
the attached instrument, having been duly qualified according to
law, do hereby acknowledge that I signed and executed the
instrument as my Last will and Testament; that I signed it
willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed.
h,CD -l/ Jtc:UI/Lt{{
Sworn or affirmed to and subscribed before me by
q' +1_" day of
GRACE S. FARRELL, the Testatrix, this _
r'
CfyJ/\A j , 1992.
, f
V~i'l (1/1
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NOTftRL\L SEAL (~
SHARMAN 9TUZ, iJOTi,RY PUBLIC
CAI;P HILL bORO. CLr1BERLAND CO.
MY COMMISSION EXP IRES OCT. 1. 1995
AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
We, bt,'~'H'1L It. WM.lv+-
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and O':tnDAA~r2LJ Ji.~,
the witnesses whose names are signed to the attached instrument,
being duly qualified according to law, depose and say that we
were present and saw the Testatrix sign and execute the
instrument as her Last will and Testament; that GRACE S. FARRELL
executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight of
the Testatrix signed the will as witnesses; and that, to the best
of our knowledge, the Testatrix was at that time 18 years of age
or older, of sound mind, and under no constraint or undue
influence.
\-1) ~"- 1t. W~
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Ci. \rh Wl-:-'n._d ;;~~Lv-r/
f" Sworn or affirmed to and subscribed to ,pefore me
u,' "tir'" r>" " (] \ /'.' · ,i, "
by _Q YAA u . ~,If (:I yi/ji:t ~nd ,7 / (t lit )( CYJflQCf--!;Lu'
witnesses, this 9th day of Q flA } I./ , 1992. l, L
NOTARTAL ''EAl
SHARMAN sr,TELTZ. nOTARY PI;SLlC
CAf'iP HILL GOf,O. CV"JERLNiD CO.
MY COMMISSION EXPIIiES OCT. 1. 1995