HomeMy WebLinkAbout04-24-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Eileen Amanda Clark
COUNTY, PENNSYLVANIA
File Number 21-08- ~ y~
also known as Eileen A. Clark
Deceased Social Security Number
James Clarence Clark
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or B' BELOW:)
QX A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the
last Will of the Decedent, dated 09/28/1988 and codicil(s) dated 08/11/1992
State relevant circumstances, e.g., renunciation, death or 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: c `;
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B. Grant of Letters of Administration `-~; ~ ' ' ~
.n.c..a.; en a e; uran e a sen re; uran a mmo a e - ~~ , - -,
ap ice e, en er c..a.; pe
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spous~~f~y) and'lleirs: (If '~
Administration, c.t.a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~-_' '~ _
4-A Adams Street, Enola, East Pennsboro, Cumberland, PA 17025
(List street address, town/city, township, county, state, zip code)
Decedent, then $9 years of age, died on 03/22/2008 at Golden Living Nursing Home, East Pennsboro Twp, Cumberland Co, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA)
(If not domiciled in PA)
(If not domiciled in PA)
Value of real estate in Pennsylvania
situated as follows:
All personal property
Personal property in Pennsylvania
Personal property in County
300,000.00
$ 0.00
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 1 of 2
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Oath of Personal Re resentative ~ ~ ~~ ~
p
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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
before me this __~_,~~,',;da~y of
v~ I Z(~%~
- I
~ For the Register
Representative James Clarence Clark
Signature of Personal Representative
of Personal Representative
File Number:
21-08-
Estate of Eileen Amanda Clark
A/K!A
Att
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Social S uriry Number: Date of Death: 03/22/2008
AND NOW, ll~ (~ ~~~ , in consideration of the foregoing Petition, satisfactory proof
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having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to James Clarence Clark
in the above estate
and that the instrument(s) dated 09/28/1988 08/11/1992
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............................................ $ 3 0.00
Short Certificate(s) ........................ $ 20.00
Renunciation(s) ............................. $
Will $ 15.00
Codicil $ 15.00
Fee $ 15.00
$
$
$
$
$
$
TOTAL .................................... $ 395.00
Att
Saidis, Flower & Lindsay
Address: 26 West High Street
Carlisle, PA 17013
Telephone: 717-243-6222
Form RW O2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
Supreme Court I.D. No.: 21458
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee fol~ this certificate, $6.00
~ ~.a124C~7u
Certification Number
o~-~r~s
This is to certify that the information here given is
correctly copied from an original Certificate of Death
drily filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
RecordyyO~ffice for permanent filing.
LGn~ ~ .C ~ ~ MAR~2 5 208
Local Registrar Date Issued
REV 11/21X16 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
I PRINT IN
MANENT CERTIFICATE OF DEATH
,cKINK (See Instructions and examples on reverse) ~,,,~ ~„ ~,,,,,,,,~„
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7 Name f Decedent (First, middle, Wsl, suXix) 2. Sex 3. Social Security Number 4. Date of Deem (Month, day, year)
'h ~~ C K 390 -14 - 0092 March 22, 2008
5. Age (Leal &dndeyl Under 1 year UMer 1 day fi. Dale of Rinh (Month, day, year) 7. &rthplace (City antl slate or Wrei n country) 0a. Place of Death (Check onry ogre)
MoMM Days Hours Mmulaa HoaplWl: Other:
gg yrs. Dec. 3, 1918 Milwaukee, WI ^lnpatiem ^ER/ompalWm ^DOA ®NUreing Home ^Resdence ^Other Specity
6b. County of Death Bc. City, Roro, Twp. of Death 6d Fedliry Name (II nM ingltulbn, give street and number) 9. Wes Decedent of Hispanic Origin? ~] No ^ Yes 1 D. RacefAmerican Indian, Black, While, etc.
Cumberland East Pennsboro (If yes, specify Cuban, (SP~M
Golden Living Nursing Home Mexican, Puerto Rkan, etc) White
11. DecedenYS Usual tbn Hind d work done dun most of world Ise. Do net shale retired 12. Was Decedent ever in the 13. Decedent's Etlucebon (Spec6y only highest grade canpleted) 14. Madtal Status: Married, Never Married, 15. Surviving Spouse (II wile, give maiden name)
Kind of Work Kind of Business I IMustry U.S. Armed Forces? Elementary /Secondary (0.12) College (1-4 or 5.) Widowed, DNorced (Speafy~
Homemaker Her Own Home ^vea ®Nq 12 1 Widowed
16. Decedent's Mailing Adtlress (SIre91, city I town, state, zIP ~) Decedent's Do Decedent
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Pennsylvania Li
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4-A Adams Street ua
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na 17c. yea, Decedent LNed in Fas P nnsharo
, ® Twp.
Enola PA 17025 T~„~"p
, ro. c0any Cumberland nd. ^ "°, Decedent used within
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Aqual Umhs of
cry r Rom
16. Father's Neme (nrsl, mitldle, Wet. suaix) 19. MoMeYS Name (First, middle, maiden surname)
Clarence Schwister Norma Michi
20a Informant's Neme (Type / Pdnt) 20b. Informant's Meiling Atltlress (Street, cnV /town, state, zip code)
Mr. James C. Clatk 4-A Adams Street, Enola, PA 17025
21a. Method of Diapoailon ~ ®Cremation ^ Donatim 21 b. Date of DWposifion (Month, day, yeerl 21c. Place al Drs
Posaron (Name of cemetery, crematory or other pWce)
27d, Location (Ciry I town, stele. zip code)
^ Runal ^ Removal horn State Yles Cremetbn or Donation Authorized
^ OMer-Speciy: ~ byMsdlcslExemirl,r/Coroner? ®Yaa^Nq March 26, 2008 Cremation Society of PA Harrisburg, PA 17109
22a.signab Fune service LicensegyoLpersonactingaBl)uch)
) 22b.LkensaNumbar 22c.NemeandAddressotFacillry der Memorial Home and Cremation Services
Inc.
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Complete Hems 23a~ onty when caniying
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m 23a. Tot best of my k ,death acunetl at tM time, dale and pWce staled. (Signature and title) /'n : ~r,.,~ . / _ ..
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~V 236, license Number 23c. Date igned (Month, day, year)
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• Items 24.26 must be completed by person 24. Ti of Death 25. Dale Pm anted Dead (ManM, day, ar) 26. Was Case Retened to Medical Examiner I Coroner Ica a Reason Othe Than Cremation or Donation?
rota pronounces tleaN. ~ ~ M O ~ L L . !] ^ Yes ^ No
CA SE OF DEATH (See Instructions en exam lea) r Approximate interval:
IWm 27. Pan I. Enter the chain of events -diseases, injunes, or complicetbre -that dregly caused the deaM. DO NOT enter terminal evens such as caNWc onset, t Onset to DeaM
respkalory arrest, or venlncWar fibrillation widlaa slowing the etiobgy. list only one cause an each litre
r Pan II: Enter oNar stgni ant mvtdon. ontdb ~t'no to errs,
but ret reaWling in the untledying cause given In Pen L 28. Did Tobacco Use Conmbme to Death?
^ Yes ^ Probe
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IMMEDIATE CAUSE IFinel daease or
e
^ No nkn
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condition fesuMng in eathl _~ a_ AGi4,t/1.~ ~ S"~ . F G~ l / rJ ~'C. i 29. II Female
Due to (or as a consequence o~ / C /~ ~
Se
eMW xst cadaons
if an 01 pregnant within past year
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lead~rp to the cause tided on line a ^ Pregnant el time of death
pus In o as e ~
Enter the UNDERLYING CAUSE (r correequence of):
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Not a nant, but
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evan~ re3UMinfig n dBetn)
LAST 01 death
Due to (or es a consequence oft: ^ Nol pregnenl, but pregnen143 days to t year
d. ~ celore death
^ Unknown if pregnenl witMn the pall year
30a. Was an Autopsy
Penonred? 306. Were Autopsy Firstlings
Avasable Pnor to CanDletion 31~r of Deelh 32a. Date q I ' Month, day, year
nNry ( ) 32b, Describe How In u Occurretl
I ry 32c. Place q Injury: Havre, Farm, Slreel, Factory,
d Cause of Death? Natural ^ Haniade Office Building, etc. /SpecityJ
^ Yea to ^ Yes Jo ^ AcciOe^t ^ Pendng Invesligadon 32d. Time of Injury 32e. Inlury at Work? 32f. If Trensponation InN7 lSPadh') 32g. Lawtion of Injury (Street, qty I lawn, slate)
^ SuiciOe ^ CoNd Not be Determined ^ Ves ^ No ^ Drivarl Operetor ^ Passenger ^Petlestdan
M' Other - Spen'ry:
33e. Cedifer (drecN only ore) 33b ignature aM 7ihe of Certifier
• CerNlying physician (Physxcian ceNyng cause el deaM when arwMer physicWn has pronounced tleath and completed hem 23)
To the best of my knowedge, tleath occunetl due to the cause(s) antl manner as etated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• P ~ +~
ronouncing and ceneying physickn (Physician both pronouncing death antl caddying to cause of tleam)
To the best of my knowledge, death occunatl et the time, rWte, aM place, and due to the cause(s) end manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
• Medical Examiner /Coroner 33c. Lkense Number
~~ ~ ~ ~ ~ 33tl. Dale netl (MOn~M1, day, year)
~7+ - ~-7
i G
Y
On the beets of ezaminatfon end I a investigation, In my opinion, tleath occurred at the time, date, and place, and due to the cause(s) end manner as staled.. ^ t/
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3a Name an4
re of Persm Who Camplelgd~Cause 1 Dea (Da
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Disposaion Parma No. 0195827
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STATE OF NORTH CA~,RIF;TAT~~ ~''~ 2; ~ ~
COUNTY OF WAKE tt~ L
LAST WILL
OF
EILEEN AMANDA CLARK
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I, EILEEN AMANDA CLARK, being of sound mind and body do
hereby revoke all prior wills heretofore made by me and
declare this to be my Last Will and Testament.
ARTICLE I
PAYMENT OF EXPENSES AND DEBTS. I direct that my
funeral expenses, including the cost of a suitable grave
marker, the cost of_ administering my estate and all legal
debts allowable as claims against my estate be paid out of
the general funds of my estate.
ARTICLE II
PAYMENT OF TAXES. I direct that all the estate,
inheritance or other taxes imposed by reason of my death
upon property passing under or outside this Will and made
payable by the laws of the United States, this state or any
other state or country by reason of my death shall be paid
out of my residuary estate, except that this provision shall
not be construed as a waiver of any right which my Executor
may have to claim reimbursement for any such taxes due
because of property over which I have a power of appointment
or which I have given away but which, for whatever reason,
is included in my taxable estate; or because of any
insurance policies payable to beneficiaries other than my
Executor which are included in my taxable estate; or because
other property is included in my taxable estate which is not
a part of the probate estate.
ARTICLE III
BRA DY, SCHILAWSKI
and EARLS
ATTORNEYS AT LAW
P O. BOX 5529
CARY, NORTH CAROLINA 27511
EXECUTOR. I hereby appoint my son, THOMAS JOHN CLARK,
to be the Executor of this my Last Will; and I vest my said
Executor with full power and authority to sell, transfer and
convey any property, real or personal, which I may own at
the time of my death at such time and price and upon such
terms and conditions as may be determined appropriate and to
do every other act and thing necessary or appropriate for
the complete administration of my estate. 6Vithout in any
way limiting the generality of the foregoing provision, I
hereby grant my Executor all of the powers set forth in
North Carolina General Statues, Section 32-37, subject to
Section 32-26, and these powers are incorporated by
reference. Should an Alternate Executor be required, I
1
nominate my son, JAMES CLARENCE CLARK. I direct that no
bond be required of my Executor.
ARTICLE IV
ELIMINATION OF GUARDIANSHIP. During the administration
of my estate, it shall not be necessary for my Executor at
any time to have a guardian appointed for any beneficiary
with respect to the disbursement of income or principal or
other property to or for such beneficiary. My Executor may
pay any part or all of the payments directly to a
beneficiary or to some other person, firm or corporation for
the benefit of such beneficiary.
ARTICLE V
DISPOSITION OF ALL PROPERTY-RESIDUE. I hereby devise
and bequeath all of the property which I may own at the time
of my death, real or personal, tangible or intangible, of
whatsoever kind and wheresoever situated to my husband, JOHN
RUSKELL CLARK, if he survives me. I direct that my spouse
be permitted to claim the maximum marital deduction as
allowed by law. If my husband does not survive me, I give,
devise and bequeath the rest, residue and remainder to my
children: THOMAS JOHN CLARK of Bowie, Maryland; CARY MICHI
CLARK, Marysville, Pennsylvania; JOANNE KAY KEANE, Elkton,
Maryland; JAMES CLARENCE CLARK, Harrisburg, Pennsylvania;
JON WILLIAM CLARK, Enola, Pennsylvania; and SCOTT ALAN
CLARK, Boone, North Carolina, in equal shares, per stirpes
and not per capita.
IN WITNESS WHpEREOF, I have signed my name and set my
seal, this the ~+O day of_ ~„ 1988.
(~~~O~_r, (iGyY~Cliy~~Q_ ~~~~2~~~ SEAL )
EILEEN 11MANDA CLARK
~RADY, SCHILAWSKI
end SARIS 2
a tuner rs a uw
PO BOX 5529
/, NORTH CAROLINA 27511
u•
Signed, sealed, published and declared by said EILEEN
AMANDA CLARK to be her request and in her presence and in
the presence of each do hereby subscribe our names as
witnesses.
a-sty,-~ o f ~.~, lUC
~. o f CC~.t.~ , /l.7 C
STATE OF NORTH CAROLINA
WAKE COUNTY
for the purposes expressed therein.
The witnesses stated before me that the foregoing Will
was executed and acknowledged by the Testatrix as her last
Will and Testament in the presence of the witnesses who, in
her presence witnesses and that the Testatrix, at the time
of the execution of the Will, was over the age of eighteen
(18) years and of sound and disposing mind and memory.
Before me, the undersigned authority, on this day
personally appeared EILEEN AMANDA .CLARK, and
~c?~ n F. M c~. and ~.-c_.le~ ~~ ~ A~ ,
known to me t be the Testatrix and the witnesses,
respectively, whose names are signed to the attached or
foregoing instrument, and all these persons by me first
being duly sworn.
The Testatrix declared to me and to the witnesses in my
presence; that said instrument is her Last Will and
Testament; that she had willfully signed and executed it in
the presence of the witnesses as her free and voluntary act
L~~~~ L~~Qir~ G~Q~ ~L:G%~
EILEEN AMANDA CLARK, TESTATRIX
G7ITNESS
~~ ~-w~
WITNESS
BRADY, SCHILAWSKI
and EARLS 3
AT TOR NE VS AT LAW
eo. Rox ss2e
CARV, NORTH CAROLINA 27511
Subscribed, sworn and acknowledged before me by EILEEN
AMANDA CLARK, the Testatrix, subscribed and sworn before me
by ~~ar~ ~ !'~ u r-,olua___~__ • and ~.c~~2..~ ~-~--t,~,~e~
the witnesses, this ~~'^ day of , 1988.
N TAR PUBLI
MY COMMISSION EXPIRES: _~IQ--~
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rFajFill F::EG~i
BRADY, SCHILAWSKI
and EARLS [~
ATTORNEYS AT LAW
P.o eox ssze
CARV, NORTH CAROLINA 27511
~~" `~~~
STATE OF NORTH CAROLINA
COUNTY OF WAKE
FIRST CODICIL
TO THE LAST WILL AND TESTAMENT OF ~-~ `~=r~ ~ `;'~
^T
~y
,, nC,
EILEEN AMANDA CLARK Ci_~':`,` , .
I, EILEEN AMANDA CLARK , domiciled of Wake County, North
Carolina, do hereby make, publish and declare this to be the
First Codicil to the Last Will and Testament heretofore
executed by me on September 28, 1988. This Codicil being as
follows:
Article III, of my Last Will and Testament executed by me
on September 28, 1988, shall be stricken and voided in its
entirety and Article III shall be amended as follows:
Article III
BRADY, SCHILAWSKI,
EXECUTOR. I hereby appoint my son, JAMES CLARENCE CLARK, to
be the Executor of this my Last Will; and I vest my said
Executor with full power and authority to sell, transfer and
convey and property, real or personal, which I may own at the
time of my death at such time and price and upon such terms
and conditions as may be determined appropriate and to do
every other act and thing necessary or appropriate for the
complete administration of my estate. Without in any way
limiting the generality of the foregoing provisions, I hereby
grant my Executor all of the powers set forth in North
Carolina General Statues, Section 32-27, subject to Section
32-36, and these powers are incorporated by reference. Should
an alternate Executor be required, I nominate my son, JON
WILLIAM CLARK to be Executor without bond of this my Last
Will.
And except in so far as said Last Will and Testament is
expressly or by necessary implication changed by this First
Codicil and is in conflict therewith, I do hereby ratify,
republish and reaffirm my said Last Will and Testament
executed by me on September 28, 1988, and each and every part
thereof.
EARLS and INGRAM
ATTORNEYS AT LAW
P.O. BOX 5529
CARY, NORTH CAROLINA 27512
IN WITNESS WHEREOF, I sign, seal, publish and declare
this instrument to be the First Codicil to my Last Will and
Testament hgretofore executed b me on September 28, 1988,
this the 1~ day of ~, 1992.
',, ~ u ,.X ~ Y1,-. [L-„~ ~~ c ~_ r' ..~ ~ .c .-1'~- ( SEAL )
EILEEN AMANDA CLARK
The foregoing instrument was signed, sealed, published
BRADY, SCHILAWSKI,
EARLS and INGRAM
ATTORNEYS AT LAW
P.O. BOX 5529
CARY, NORTH CAROLINA 27512
and declared by EILEEN AMANDA CLARK to be the First Codicil to
her Last Will and Testament executed by her on September 28,
1988, in our presence, and we, at request and in the presence
of each other, have subscribed hereunto as witnesses our names
this ( l°~` day of A U CsUS1` 1992 .
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Address l d ~ ~l'lYL~~ m ~~.C_,l~.~
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Address ~.
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STATE OF NORTH CAROLINA
COUNTY OF WAKE
Before me, the undersigned authority, on this day
pe onally ap$~~eared EILEEN AMANDA CLARK,
~iL~ic,Qi ,~~,( n (~C~7Z.:~ and Ar1G f t,A -M• ~~! ,
known to me to be the Testatrix and the witnesses,
respectively, whose names are signed to the attached or
foregoing instrument, and all of these persons being by me
first duly sworn. The Testatrix declared to me and to the
witnesses in my presence: that said instrument is the First
Codicil to EILEEN AMANDA CLARK's Last Will and Testament
executed by her on September 28, 1988, that she had willfully
signed and executed it in the presence of the witnesses as her
free and voluntary act for the purposes therein expressed; or,
that the she signified that the instrument was her instrument
by acknowledging to them her signature previously affixed
thereto.
The witnesses stated before me that the foregoing First
Codicil was executed and acknowledged by the Testatrix as her
First Codicil to her Last Will and Testament executed by her
on September 28, 1988, in the presence of the witnesses who,
in her presence and at her request, subscribed their names
thereto as attesting witnesses and that the Testatrix, at the
time of the execution of this First Codicil was over the age
of eighteen (18) years and of sound and disposing mind and
memory.
~'-~ E.[%~''i-.I . ,~'. fY)/~~~-c.~~- CJC ~ t~~. (SEAL)
EILEEN AMANDA CLARK
Witness
Witness
Subscribed, sworn and acknowledged before me by the
Testatrix; subscribed and sworn before me by
~~ i~~ M~i~~ ~ and AN6f LR ry~. I~-+f ,
witnesses, this (f i~.. day of ~~ ~S-r' 1992 .
My commission expires:
~tc~vtian G. ~~---
Notary Public
~ TN£~'~4~5 A. F.~,FCLS
z' ""y ^onl~ ~r.:siorz Ezuill:s 8 , ;a
BRADY, SCHILAWSKI,
EARLS and INGRAM
ATTORNEYS AT LAW
P.O. BOX 5529
CARY, NORTH CAROLINA 27512