HomeMy WebLinkAbout05-30-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~ ~ m ~~ I~ n C~ COUNTY, PENNSYLVANIA
Estate of ~ ~ ~"~ ~ 'Trl U ~ I 1 ~ ~ Q ~1
also known as
Deceased
File Number Z~ ~ w ~~
Social Security Number ~ y `7 ~ ~~j ~ ~ T U ~~
Petitioner(s), who is/are l8 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver [hat Petitioner(s) is /are the ~ ~~~~'-t ,~'1`~f named in the
ast Witl of the Decedent dated ...~5 t,.~..t.~. I~l ~ ~ ~~ and codicil(s) dated
(State relevant circumstances, e.g., renunciation, depth of executor, etc.)
.Except as foFlews, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
fqr probate, not the xist(m of a killing and was never adjudicated an incapacitated person:
t-
(-
-^ . B. Grant of Lettersvf Administration
~ - Qjapplicable, enter: c. t. a., d. b. n. c. t. a.; pendente fire; durnnte nbsentin; durmue minoritnte)
- _-_
Pettioner(s~~fter a ~ropei• search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (!f
Admnistra'tfmt, c. t. a. orid.b.rt.c.t.a., enter date of Will in Section A above and complete list of heirs.)
a_ ` i -:
(COMPLETE IN ALL CASES:) Attach additional s/:eels if necessary.
Decedent was domiciled at death in L' ~,~ ~~ r ~, `n~ ~~ County, Pennsylvania with
(List sn~eet addr ss, town/city, township, counq+, store, zip code)
Decedent, lien ~ years of age, died on ~ ~ at
/ her last principal residence at ~'--~---
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ ~ - ~ ~~ CJ n
(lf not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ ~,
situated as follows:. ~ Ck_ ~l ~ ~=-- C _c.? t_ R t'1'~` `3
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:
n C
or printed name and residence
.t
Form RW-0? re+~. fa /3.06 Page 1 of 2
Oath of Personal Representative
COM;viONWEALTH OF PENNSYLVANIA
COUNTY OF
SS
~u. m ~e_~Z~~i1 ~-
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con~ect 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.
Swonr to or affirmed and subscribed
before tY;e the c~ _?~day of
( ~ ~/~t~~
For the Register
C_
oJPersorml Representntive
Signature of Personal Representntive
Sigtateu•e of Persona! Representative
File Number: `~ ~ O" ~ ~~
Estate of ~ l ,q~~--~a~~ U~1~ r/ ~~~ ~~ ~-_!~ ,Deceased
,Social Security Number: ~~~ " ~i-~ 7C__,~ _,`-~ Date of Death:, ~ ~~ ~. ~ ~~ c:~C~~
AND #1~QW, h-- ~~.~ , in consideration of the foregoing Petition, satisfactory proof
~.._ .._ ~
17aving be~preseiltecT~before me, IT IS DECREED that Letters
~. -
`~ are hereby granted-tn- -
~ in the above estate
acid that tk~instrur[elf(s) dated
described~rthe Petit~r,be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
c..-~ ~_~~ =-
c_:
~~ FEES •
• . a~ Register of Wills R-~/ ~~ '`rl~
Letters ...~J.,~~~ $ ~ {~~• ~.~~~~
Short Certificate(s) .. ~..... $ ~ a ._~1~ Attorney Signature: ~_
Renunciation(s) .......... $
~~- ... $ ~ ~. ~o
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ~~0 •QU
Attorney Name:
Supreme Court T.D. No.:
Address:
Telephone:
r-~,,n Rw-o? ,ev. 10.13.or Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
11NARNING: It is illegal to duplicate this copy by photostat or photograph.
I Fee fOr this certificate. 56.0(1
I d3 REV IIY2006
E !PRINT RJ
RMANENT
LACK INK
'This is u3 rertil'v that the information here given is
rorrect'v cOpicd from an Original Certificate of Death
duly fi"sad with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Record, OIfice fOr hermancnt tiling.
~!G~t.~ ,~ ~ °~) Y 1 2 1008
Local Regisu-~u~ Date issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILF_ NUMBER ~ 1' ~ ~„ 5 1 ,
1 Name of Decedent (First, miUUle, last, sulliz) 2. Sex 3. Social Security Number d. Date of Death (Month, day, yearl
Elizabeth M. Hose Female 189 - 05 - 1904 May 9,2008
5. Age (Last Binhday) Under 1 year Under 7 day 6. Dale of Binh (Month, day, year) 7. Bidhplace (City and slate or lor eign country) Ra. Place of Deelh (Check only one)
90 Y Monrlw Days H~hirs lAirxrl¢.s
October 1
1917
Forty Fort
Pa Hospil2l: Olller'
~
rs.
_ _ _ __ , , ^ Inpatient ^ ER I Outpatient ^ DOA r
^ Nursing Home L'] Residence ^Other -Specily
gb. Cnumy of Death Bc. City, Born. Twp. nl Death 8U. Facility Dlame QI not inslilulien, give slreel and number) g Was Uecedent of Hispanic Origin? No ^ Ves 70. Rare: American Indian, Black, While, etc.
Cumberland Lemoyne (If yes, Specily Char, (Specily)
360 Walton
Street M¢xitan,PperlnRitan,el=) White
t I. Decaknl's Usual Occu alron (Kind of work Uone Uurin most of workinr Ille. Do not stile retired _
72. Was Decedent ever in the 13. Decedent's Eduralion (Specify only hiyhesl grade cmnplele<I) 14. Marital Rlalus: Marri tl, Nev¢r MarrieQ 15. Surviviny Spouse (II wile. give maiden mine)
Kind ul Work Klrxl of Rosiness / Indusvy U.S. Annod Fo
r
c
es? Elernenl r Secondary (0-12) College (1-4 or 5+) Witlowed, Divorc¢d (Specily)
Homemaker __ ~
x
T
^Y¢5 L}Np ~.~ Widowed
16. Decedents Mailirtg Adtlress (Slreel city /!own, s121e, ziV roJej Decedent's Did Uecedent
Pa
813 Bridge Street Atlual R¢aiderwe ,?a. slaw
Live in a ,7t ^ Yea D¢tadem Lived in Twp.
New Cumberland,Pa 17070 Township?
,7b.counly Cumberland t7d[~No,DetetlenlLivatlwid,in New Cumberland
__ .
Actual Litnils of bty I Boro
t0. Father's Name (First. mkklle. last, sully`) 19. Mother's Nanre (First, middle
maiden surname)
Peter McCabe _ ___ ,
Mary Brennan
20a. Inlamanl's Name (Type I Prtnl) 200. Inlormanl's Malllny AtlUress (slreel, city /town, stale, zip tale)
James Hose _ 360 Walton Street Lemoyne,Pa 17043
21 a. Method el Disposition ^ Creinallon ~ Donation 21 b. Dale of Disposition (Month, day, year) 21c. Place of Dlsposilion (Name of cemetery, clemalory or ollwr place) 21 d. Locetbn (City I town, sl¢le, zip tale)
~] Bunal ^ Removal Irom Stale: Was Cremation or Donation Aulhorized
^ oil 'i hYMedlcalExamineryD¢mner? ^Y¢a^NO
May 13 2008
Rollin Green cemeter
cam Hill, Pa
Siyrwture of rat Smvi e Li t e ~ g as such) 22b. License NumUer 22c. Name and AUUress of Facility
- ~w~ 011654-L ers-Harner Funeral Home Inc
1903 Market Street Cam Hill Pa 1.7011
Complete fleet 23a-c oMy when certifying 23a. To the b¢sl of my knmNetlye, death acurretl al the lime, Dale antl place slaletl. (Signature and tills) _
23b. License Number 23c
Dale Si
netl (Month
da
ear)
physician is rtol available al lime of tlealh to .
g
,
y, y
cedily cause ul tlealn.
Items 2426 mull be compleletl Uy person 24. Tme of Death 25. Dale Prorwunced Dead (Month, day, year) :?fi. Was Case RelerreU to Medical Examiner /Coroner for a Reason Other Than Cremation or Donation?
who Dronourrces death. ~ x /
/
- ~ _ ~ _ L) ~ ^ Yes ~~ft~
CAUSE
O
F DEATH (See Instructions and examples) r Approximate inletval:
Item 27. Pan C Enter the chain Ip 2v2nIS -diseases, injuries, or complications -Thal directly causeU the tlealh. DO NDT enter lertninal events such as caNiac arrest Part II: Enter other sianificanl condil ens conlribul~na to death, 2ft. Did Tobacco Use Contribute to Death?
, Oltset to Death
m5pralory arrest, or ventricular librillalion willwul showiny the elioloyy. List only one cause on each line. t but not resultiltg in the underlying cause given In Pzd I, ^ Yes ^ Probeby
~-`~ eTlo ^ Unknown
_
IMMEDIATE CA
SE /Final
disease or ~
/
'
-
"t`"' l
~
~ 1
/ -„
9
(
/,~
/
`-
~
~
~~~~
y~ U / { r
condillon rewllln death _~
a
l U' C7'L~~ I i "v / / I 2g. If Female:
.
- `--
Due to (or s a cpnsequertce I , -- ^ Nol pregnant wilMn past year
~~~j~~
SequenlWOy list Contlil'mts, it any, b
~L. > L '['b/ y.5 !'•k"ti
' ^ Pregnant al time of deallt
. _
1¢adiny to the cause listed on line a
~
Due to or s a ertce of
Enter 10e UNDERLYING CAUSE
1 r
----`"
Nol
^ preynanL but preyltanl vnlhin a2 days
(¢tlisease or injury Owl Inilialetl the ~
vents resulting m tlealh) LAST.
r
--~ of tlealh
Drre b (or as a consequence ol). Nol
^ prat tl, Mil preynanl d3 tlays In 1 year
d. L`elore tlealh
- r ^ Unkrwwn II pregnant within the past year
30a. Was an 0.uloDSy
Perlametl~ 30b. Were Aulopry Firtdinys
A
il
bl
Pn 31. Manner of Death 32a. Dale of Injury (Month, tlay, year) 32b. Describe How Injury Occurred 32c. Place of Injury: Home, Fann. Slreel
Factory
va
a
e
or to ComlNelion
r-y~
Aural ^ Homxide ,
,
Office BuiMing, etc (Spec!/yl
of Cause of Dealn7
G1 Yes ~No ^ Yes Q-NO ^ Arcidenl ^ Pending Investigation 32d. time of Inlury - 32e. Inlury al Work?. 321. II Tmnsponnliar Inlury (Specil,~) ~ 32g. Location of Injury (Slreel, city I town, stale)
^ Suicine ^ Could Nol be Determined ^ Yes ^ No ^ Driver / Operala ^ Passenger ^Pedeslnan
_ M ^omer - spealy.
a. miller Check on
1 ty one)
• Certifying physician (Physician cenilyiny cause or deallt when artolher physician has pronouikad tlealh and completeU Item 23)
To the bell of my knowletlge, death occurred due to the cause(s) and manner as slaletl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
^ -. _ ~_ _-'
33h. B' Mure an Tide n rldier -
I"' ~~~
JLJ'
- - -
_ -- _ _ _
• Pronourwing and cerlilying physician (PhysKian Uolh pronoulxing dea!h and renilying to cause of tlealh) .
~~
To the hest of my Nnorvledge, death occurretl al the Time, dale. and place, and due 1¢ the cause(s) antl manner as slaletl_ _ _ _ _ _ _ _ _ _
_
_
• 33c. Lcense Number 33d. Dale Signed (Mlonlh, tlay, year)
_
.- _ _ _
_
Medical Examiner /Coroner
th
O
~ L'
)Z55 / i ~
~ _
~..- ~ - L, t-
~ / - '~
n
e basis of examination and / or Invesligal on. n ny opln on tlealh occurred al the ume, dale, a rJ place and di= l01he cause(s) ar d manner ae stalxl U '-' '--
--' -'-"' "- - ~ --- ---------------
34 Ua r e a td Atltlrass of Pers n WI Completed C e of Doalh (II 27) Type r P I
ID~aa ._.
"~5. Reg stmr r alurP, arc) D st I~"` V
~n ~-p / J 1 r ~ 3G. la Fle (Mn 11 daY Year)
_
~ 'S/- V1 //
~~yLt2f' ~ l_L_L_L_ J_..l r~.
~Q~ S
~GI~ rj~ `~ ~ 7! da
,
%'
~vC " LJ fJ [ ,r r ,YG J L h~':'," ( 9 / ~~ 7~.
~ Dlsposilien Pennil No
~,~SGD~-----
LAST WILL AND TESTAMENT
OF
ELIZABETH M. NOSEY
~_~:: =I, ELIZABETH M. NOSEY, of 813 Bridge Street, Apartment Number
2, New ~~mberland, Cumberland County, Pennsylvania, do make, publish
.:,
and,c~eclare this to be my Last Will and Testament, hereby revoking all
WiiJ.s and: Codicils by me at any time made.
C-J
ITEM I: I direct that all inheritance and
estate taxes becoming due by reason of my death, whether such taxes may
be payable by my estate or by any recipient of any property, shall be
paid by the Executor out of the property passing under ITEM III of this
Will, as an expense and cost of administration of my estate. The
Executor shall have no duty or obligation to obtain reimbursement for
any such tax so paid, even though on proceeds of insurance or other
property not passing under this Will.
ITEM II: I direct the Executor to pay the
expenses of my last illness and funeral expenses from the property
passing under this Will as an expense and cost of administration of my
estate.
ITEM III: I devise and bequeath all of my estate
whatsoever nature and wherever situate as follows:
a. One-seventh (1/7) to my son, LAWRENCE F. N`O'S/EY, JR.,
or in the event he predeceases me, to his surviving spouse;
b. One-seventh (1/7) to my son, JAMES M. NOSEY, or in the
event he predeceases me, to his surviving spouse;
c. One-seventh (1/7) to my son, EUGENE W. NOSEY, or in the
event he predeceases me, to his surviving spouse;
d . One-seventh (1 / 7 ) to my son, MARK P . NOSEY, or in the
event he predeceases me, to his surviving spouse;
e. One-seventh (1/7) to my daughter, MARY KATHRYN NOSEY, or
in the event she predeceases me, to her surviving spouse;
f. One-seventh (1/7) to my daughter, ELIZABETH ANNE HOSEY-
SHULL, or in the event she predeceases me, to her surviving spouse;
g. One-seventh {1/7) to my son, PATRICK J. NOSEY, or in the
event he predeceases me, to his surviving spouse.
In the event any of the aforementioned beneficiaries are not
survived by a spouse, said share shall be payable to his or her
issue,per stirpes. In the event that said beneficiary is not survived
by either a spouse or issue, said share shall be added to the residual
estate and divided equally between the hereinbefore mentioned
beneficiaries.
ITEM IV: In the settlement of my estate, My
Executor shall possess, among others, the following powers:
a. To retain any investments I may have at my death, as long
as the Executor may deem it advisable to my estate to do so;
b. To sell either at private or public sale and upon such
terms and conditions as the Executor may deem advantageous to
the estate, any and all real or personal property or interest therein
a .~ ~ ~r ~r`-~
owned by the estate;
c. To pay all costs, taxes, expenses and charges in
connection with the administration of my estate;
d. To compromise controversies; and
e. To do all other acts in the Executors judgment deemed
necessary or desirable for the proper and advantageous management,
investment and distribution of the estate.
ITEM V: Any person who shall have died at the
same time as I shall have, or in a common disaster with me, or under
circumstances that the order of deaths cannot be established by proof,
or within thirty (30) days of my death, shall be deemed to have
predeceased me.
ITEM VI: I appoint my son, LAWRENCE F. HOSEY,
JR., to be the Executor of my Estate. In the event my son cannot act
or refuses to act as Executor for any reason, I nominate, constitute
and appoint my daughter, ELIZABETH ANNE HOSEY-SHULL, as alternate
Executrix. The Executor is specifically relieved from the duty or
cbligation of filing any bond or other security.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my last Will and Testament, consisting of this and the preceding
2 pages, at the end of each page of which I have also set my initials
for greater security and better identification this 6th day of July,
1995.
~~~`~ z ~"~ ..~ (SEAL)
E IZABETH M. HOSEY
3
We, the undersigned, hereby certify that the foregoing Will was
signed, sealed, published and declared by the above-named Testatrix as
and for her Last Will and Testament, in the presence of each other,
have hereunto set our hand and seals the day and year first above
written, and we certify that at the time of the execution thereof, the
said Testatrix was of sound mind and memory.
" Re i d i r~g a t : ~~{ ~ S~~F ~~
Thomas ,~ merick ~~,c~,~ ~~~,~~f~n.~..,(, ~~ ~ ;7c~ 7~
~~~'~) Residing at: ii~;~ ,~~u-~~-,~~-
Ann Molsky ~ .r7~s s~
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND .
I, ELIZABETH M. HOSEY, Testatrix, whose name is signed to the
attached or foregoing 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 Isigned it willingly, and that I
signed it as my free and voluntary act for the purposes therein
expressed.
Swor o nd subscribed
befesre t t day
o Ju 1 5
~ NO ARY P LIC
( My Commission Expires
;~ ~~f-~~ ~', '~~~dc-.x~~ (SEAL )
LI BETH M. HOSEY ;;/
(SEAL)
tirL:a~ ~a~
Barbera Sur*~e-:~~ uiva~ , tVC~tary a~ ~~
My fomiri:~u~ri _~:<rxrP~ ~,~, y ~y5 ~
ber, , vrirayw~N ,:7auii, ~ ~t tiut~nes
4
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
We, Thomas G. Emerick and Ann Molsky, the Witnesses whose names
are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and
saw Testatrix, ELIZABETH M. NOSEY, sign and execute the instrument as
her Last Will and Testament; that Testatrix signed willingly and she
executed said Will 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 eighteen (18) or more years of
age, of sound mind and under no constraint or undue influence.
W e s --
./
Sworn to. d subscribed
before m this 6th da,y
of Jul 1 ~ 5
y~~~~~._
,~' N TARY BLIC
My Commission Expires:
(SEAL)
~~ 6
Witness
Notana~ ~~i
~~y~~~qB~~/a(r~bara{.,S~~uf!ryr~}ydep-Sullt~/are, Notary p,~Vlic
"'~"`• llZimUCllcu 1~ Gl~Jrr4'. 4/1~i ~1~?l i~lfKj i. ~(%U r~fi~
~Y Commisswn Exn~res Q;:. 9, :~.f5
fiber, ennsyPvarna. - _._.
~:x;c,~r1Uo~~ of ;vU~~f;i3S
5