HomeMy WebLinkAbout05-14-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C V""'- ~ f I'l L '\"" j
COUNTY, PENNSYL VANIA
Estate of 00A,.0
h ~"i-v..J'1
File Number
uPl -c2lX1S' - 053;<
also known as
, Deceased
Social Security Number
[C)Z- 30 "i LLO
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 A v'--\.-L...; J' Sc",-B- PI'" nA l
last Will of the Decedent dated I M4\"1 '1-c:>O'Y and codicil(s) dated
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 execution6 the instrum~s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~~ g ~"')
) -0 ~ c; :>
~. TO -< (. .,:_.-~
o B. Grant of Letters of Administration '5: 5 J;"" ~;J ~~J
(If applicable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; dzm:ur0~/1!.I~ate) C)
'_J t....)):lIo -'q
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following ~~~ {FIany) aiIl1 heirs.:.jJf:~',,;
Admiflistratioll. c.t.a, or d.b.fl.c.t.a., enter date of Will in Section A above and complete list of heirs.) .,'- :0 o' o. ~i
-'0 -4... )
Name Relationship Resia'~~ce ~
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in CJ",^,~P r I !A..., J County, Pennsylvania with his / her last principal residence at
2> CvrtJ-~ A-~~ .v'i......,)(),c.JA.~ t-IOPiW-(LL. {,/./1^b71J..1../\-,v~ (/..I")N ,1,+- \?2..'-{O
(List street address. townleit)'. township, county. state. zip code) )
Decedent, then b 7
years of age, died on I \ Nt",! W~t
3 ~ 0 j ~ A--oIY'I
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 P A) Personal property in County
Value of real estate in Pennsylvania
$ '),)"0, tJ=o
$
$
$
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:
Ty ed or rinted name and residence
..... -rr f'i ,.) 1>",
12'1 /...H !OAN\{f- {)
.1-rlMTiL /ilL. l~~-' I
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
luna tiA Y I 4 AM II: 53
SS
COUNTY OF Cc)""\..~\A.L. +-0 tJ CLE(=;i< OF
- R""'H/'I'~ r'nl'RT
.. . . ..ni' \i\U',A,j I.
The PetltlOner(s) above-named swear(s) or affirm(s) that the statements 111 the foreg0111g Petltth~~:i1!Ieil.lndjC6~~~t~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
;1cfh
Signature of Personal Representative
Signature of Personal Representative
File Number:
~(-, e:JcJ.f6 - 053-;J
'-- P Lv ,v '-(
, Deceased
Estate of 00 t\,V
Social Security Number: ) t:)L 3 0 <it 2.... L D
AND NOW, '-hl ~ I <{ , ~ b , in consideration ofthe foregoing Petition, satisfactory proof
havmg been presented bewre m T IS DE~ED th~tters -ri.2Jti..J)\..(d~
are hereby granted to ~-thLL{ 0"...-0..4-- ~1..I()Y
Date of Death:
, I
rl"l I'Iy '2.. 0 0 '?'
o~
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will
Attomey Signature:
5t ~
Letters ............... ~__ (J r
Short Certificate(s) . . . . . . . . $ <6. OU
Renunciation(s) ..... .: '1'[ ~ I GtJ
i~J:~
. . $ 5,
FEES
Attomey Name:
Supreme Court 1.D. No.:
Address:
.. . $
... $
.. . $
. .. $
.. . $
TOTAL .............. $
5/t,61)
Telephone:
Form R W-02 rev. 10.13.06
Page 2 of2
HIOS.805 REV WI/07)
06- S-3A
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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.
P 14528640
~. ~b,.)...~~y 12/2008
Local Registrar Date Issued
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H105-143 REV 1112006
1YPE f PRINT IN
PERMANENT
BlACK INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
. 16. Decedent's MauingAddress (Street, city flown, stale, zip code)
67 Y<s.
152 -30 -9220 Ma
Ba. Place of Death (Check only one)
Hospila" 0tl1e<
o "patien' 0 EA I Outpatient 0 DOA 0 N"""" Home IX! Aesldence
9. Was Decadent of Hispanic Origin? txJ No D Yes
('yes,_Cuba',
Mexican, Puerto Rican, etc.)
11
2008
,. Name 01 Decedent (FIISt. middle, last, suffix)
4. Date of Death (Monlh, day, year)
5. Age (Last Birthday)
Bb. County of Death
DOthe,. Spoc""
10. Race: American lncian, Black, While, etc.
(Specif}1
white
~ I . Curnb
12. Was Decedent ever in the
U.S.ArrnedForce&?
Dyes XlNo
3 Curtis Ln
""""""',
Actual Resideoce 178. Sate
17b. County
17,.Dyes,~Uved;' Hopewell
17d.D No, ~Uved_
ActuaIUmitsof
TWO.
Cily/Boro
18. Falher's Name (FIrs~ middle, , suffix)
Horace Dowdin
20&. Infonnanfs Name (Type I Print)
19. Mother's Name (First, milXAe, maiden sumame)
Blanche Carn bell
2al. Informanfs MaiUng Address (Street, city Ilown, stale, ~ code)
P.O. Box 13, Atlantic,
21c. Place of Disposition (Name of cemetery, cremaIOIy or other place)
28511
~
';J,
'i
Springs ,1';1.
Funeral Home Inc
Items 24-26 must be cornpIeled by person
who pronounces death.
24. Time of Death
:3:oS'
26. Was Case Refemtd to MedIcal Examiner I COItlI'1ef lor a Reason Other than Cremation or Donation?
Dyes ONe
CAUSE OF DEATH (See Instructions and exa 88) I Approximate interval:
1lem27.PartI: Enterlhe~-digeases.injuries,orcompllcations-that(iredlycausedthedeath.OONOTanterterminaJeventssuchascardiacarresl, I Onset to Oeath
l'9Spiratory arrest. or ventricular libriIation withoLd showing Ihe etiology. Usl only one cause on each line. :
fNet/Y..~~;~t,L ~d/ (Qlj it,I"J Ghf2A-1
Part II: Enter other sionilicanl mndRions r.mlrihutino to dHlh
bulnotresultinginlheunder1yingcause~inParll.
==S~~)cI~
fJjo R y Q wI. G hW\.
28. Did Tobacco Use Contribute to Death?
o y" 0 "-bIy
ONo DUo"'"",,
29. " Female:
o Not_....puIyeaf
o P_a1time of cleath
o Not_,,,",,,,.,"a,"""n"'..,.
ol_
D ""'",","""-"",,,,,,",,,,"""10 'yes,
""""'daath
o """"""',_....lt1apulyaa,
32c. Place of ln~ry: Home, Fann, Street, FactOl'Y,
OlficeBui<l~'''''.(_1
r.:
~
",,\0
----
~~~=';~a.
Enter fhe UNDERLYING CAUSE
~~~~~~
b.
Due to (or 88 a consequence 01):
Due to (or as a consequence 01):
308. Wu an Aulopsy
Performed?
d.
3lI>.w.caAutclpoyFilldc1gll
Available Prior to Completion
of Cause of Death?
Dyes ONo
31. Marw'l8f of Death
~
z
i
~
w
~
lri-I\ I~ 1\ 1(') 1
32d. TlfTI8 01 Injury
32g. location of Injury (S1r991, city I town, stale)
-l
.;::
~
.j
--
/'
Dyes J2I No
~t"'" D-
o- OP'"""""""""'"
Ds,- DCa<dNolbeDele_
M.
338. CertIlIer (meek only one)
Cet1lfy;"g ph"~iall(I'l1yslcien_"",,,of_ _"""""physloien"'PfO'IOUlll'Oddea. ""'","",,","" 'am 23)
To the best of my knowtedge, duth occurred due to the cauae(a) and mamer as atatacL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
;:::m~:=:~=;==~~;.:r:.1o~== mannerasstatecL_ ___ _ _ __ __ __ __ _ _ _ 0
~:' ~::'srn::~ and / or invfttIgatfon, In my opinion, de8th occUf1'9d at the time, date, and pEe. end due to the cause(s) and manner as stated. 0
011
Disoosition Permit No.
68, 3 Sd.-
i ~-.
....j
LAST WILL AND TESTAMENT OF
JOAN LOUISE PENNY
zqns MAY 14 AM II: 54
CLERK OF
ORPHt,,~.rs COURT
I, Joan Louise Penny, a resident of Newburg, Pennsylvania, being of sound ~j'J,!d.iSP9'$ifig(:(}, Pt\
mind and memory and over the age of eighteen (18) years and not being actuated by any
duress, menace, fraud, mistake, or undue influence, do make, publish, and declare this to
be my last Will, hereby expressly revoking all Wills and Codicils previously made by me.
I. EXECUTOR: I appoint Arthur Scott Penny as Executor of this my Last Will and
Testament and provide if this Executor is unable or unwilling to serve then I appoint
William John Penny as alternate Executor. My Executor shall be authorized to carry out
all provisions of this Will and pay my just debts, obligations and funeral expenses.
II. ACKNOWLEDGMENT OF CHILDREN
I have the following children, and all references to "children" in my Last Will and
Testament refer to the named following:
Name: William John Penny
Name: Arthur Scott Penny
Name: David Earle Penny
Date of Birth: 26 September 1962
Date of Birth: 3 January 1965
Date of Birth: 12 September 1967
III. SIMULTANEOUS DEATH OF BENEFICIARY: If any beneficiary of this Will,
including any beneficiary of any trust established by this Will shall die within 60 days of
my death or prior to the distribution of my estate, I hereby declare that I shall be deemed
to have survived such person.
IV. BEQUESTS:
I will, give, and bequeath unto the persons named below, if he or she survives me, the
Property described below:
Name: William John Penny
Address: Collegeville, Pennsylvania
Relationship: Son
Property: One third of the rest, residue and remainder of my estate of whatsoever nature
or kind, and wheresoever situate, which I now own or may have the right to dispose of at
that time of my decease.
Name: Arthur Scott Penny
Address: Atlantic, North Carolina
Relationship: Son
Property: One third of the rest, residue and remainder of my estate of whatsoever nature
or kind, and wheresoever situate, which I now own or may have the right to dispose of at
that time of my decease. y~
Name: David Earle Penny
Address: Westminster, Maryland
Relationship: Son
Property: One third of the rest, residue and remainder of my estate of whatsoever nature
or kind, and wheresoever situate, which I now own or may have the right to dispose of at
that time of my decease.
If a named beneficiary to this Will predeceases me, the bequest to such person shall
lapse, and the property shall pass under the other provisions of this Will. If I do not
possess or own any property listed above on the date of my death, the bequest of that
property shall lapse.
V. ALL REMAINING PROPERTY; RESIDUARY CLAUSE: I give, devise, and
bequeath all of the rest, residue, and remainder of my estate, of whatever kind and
character, and wherever located, to my children per share, but if any child predeceases
me, then his or her share will pass, per share, to his or her lineal descendants, natural or
adopted, if any, who survive me; but if there are none, then his or her share will lapse and
pass equally as part of the shares of my other named children.
VI. WAIVER OF BOND, INVENTORY, ACCOUNTING, REPORTING AND
APPROV AL: My Executor and alternate Executor shall serve without any bond, and I
hereby waive the necessity of preparing or filing any inventory, accounting, appraisal,
reporting, approvals or final appraisement of my estate. I direct that no expert appraisal
be made of my estate unless required by law.
VII. OPTIONAL PROVISIONS: I have placed my initials next to the provisions below
that I adopt as part of this Will. Any unmarked provision is not adopted by me and is not
a part of this Will.
# Any and all debts of my estate shall first be paid from my residuary estate. Any debts on any real
~ property bequeathed in this Will shall be assumed by the person to receive such real property
and not paid by my Executor.
se..- I direct that my remains be cremated and that the ashes be disposed of according to the wishes of
_ my Executor.
_ I direct that my remains be cremated and that the ashes be disposed of in the following manner:
I desire to be buried in the
County, Pennsylvania.
cemetery in
\(
CYJ
VIII. CONSTRUCTION: The term "testator" as used in this Will is deemed to include
me as Testator or Testatrix. The pronouns used in this Will shall include, where
appropriate, either gender or both, singular and plural.
IX. SEVERABILITY AND SURVIVAL: If any part of this Will is declared invalid,
illegal, or inoperative for any reason, it is my intent that the remaining parts shall be
effective and fully operative, and that any Court so interpreting this Will and any
provision in it construe in favor of survival.
IN WITNESS WHEREOF, I, Joan Louise Penny, hereby set my hand to this last Will,
on each page of which I have placed my initials, on this first day of May, 2008 at 3 Curtis
Avenue, Newburg, Cumberland County, Commonwealth of Pennsylvania.
~ C' ~
! I(1j a:D~'X, \ R
_ oan Louise Penny ~
.., /' . 1\.
" L t//'+'~ nvc..l'l-Y<.
;V{..v8v-tU' tJ./t- (7 L yo
[Signature]
[Printed or typed name of Testator]
[Address of Testator, Line 1]
[Address of Testator, Line 2]
WITNESSES
The foregoing instrument, consisting oW- pages, including this page, was signed
in our presence by Joan Louise Penny and declared by her to be her last Will. We, at the
request and in the presence of her and in the presence of each other, have subscribed our
names below as witnesses. We declare that we are of sound mind and of the proper age to
witness a will, that to the best of our knowledge the testator is of the age of majority, or is
otherwise legally competent to make a will, and appears of sound mind and under no
undue influence or constraint. Under penalty of perjury, we declare these statements are
true and correct on this first day of May, 2008 at 3 Curtis Avenue, Newburg, Cumberland
Co ty, Commonwealth of Pennsylvania.
[Signature of Witness # 1 ]
[Printed or typed name of Witness # 1 ]
[Address of Witness # 1, Line 1]
[Address of Witness #1, Line 2]
[Signature of Witness #2]
[Printed or typed name of Witness #2]
[Address of Witness #2, Line 1]
[Address of Witness #2, Line 2]
~i: Z f.~~'1
i.j8J3 tlqfjtnt1Jd Lar1r ~
COLf-(j-lvd/r PA ,qte(p
/
[Signature of Witness #3]
[Printed or typed name of Witness #3]
[Address of Witness #3, Line 1]
[Address of Witness #3, Line 2]
SELF-PROVING AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
We,
, and
, the
testator and the witnesses respectively, whose names are signed to the attached
instrument in those capacities, personally appearing before the undersigned authority and
first being duly sworn, do hereby declare to the undersigned authority under penalty of
perjury that the testator declared, signed, and executed the instrument as hislher last will;
he/she signed it willingly or willingly directed another to sign for him/her; he/she
executed it as hislher free and voluntary act for the purposes therein expressed; and each
of the witnesses, at the request of the testator, in his or her hearing and presence, and in
the presence of each other, signed the will as witness and that to the best of his or her
knowledge the testator was at that time eighteen (18) years of age or older, of sound mind
and under no constraint or undue influence.
(~,*n.- ~~~.Q ~A'Li
Joan Louise Penny \
3 C U '"',l j Au'? -vu't..
IV i-""'; .1........- ~ ~ J> A-- (7 2.. ''C 0
[Signature of Testator]
[Printed or typed name of Testator]
[Address of Testator, Line 1]
[Address of Testator, Line 2]
~~
I ~ II "lill fl 1) r- .\1<-
_€-H-eulllL P ~ l, ~d-
[Signature of Witness #1]
[Printed or typed name of Witness # 1 ]
[Address of Witness # I, Line 1]
[Address of Witness #1, Line 2]
~;Af
/~S7nh2~ iY
l.4stL //0 IS-
[Signature of Witness #2]
[Printed or typed name of Witness #2]
[Address of Witness #2, Line 1]
[Address of Witness #2, Line 2]
rl" /;;}JJN:.
[Signature of Witness #3]
JU1tu'kv L 6i1huf [Printed or typed name of Witness #3]
'/t;t9~pe~r/'}k1.a IN; (L> l~=: ~i:~:::: :;t;: ~l
S~ribed, sworn, and. acknowledged before me, Slab o/IJ...,/~ d:v-rJ;
.{jb:.~ 1.1/,:]) f"- Q IJ--'ld ffl r fA ' a notary public, by
J /, A .'_ Ai _ ~ ~1JLLn LOL1ISe. ~lU7v , the testator and by
J.J..LCJ (lLLO.. (2 ~ . ~ {}Jzd ,
,
,and
the witnesses, this
,20
~
[NOTARIAL SEAL]
My Commission Expires:
":OMM . WE
Notarial Seal
Beverly 0, $andera, Notary PubIc
51. l'hornasiWp., FrankRn County
My ComlTilsslon'E.,. Jan. 7,2009
Member Pennsylvania As9OCiallon of Notarfe..