HomeMy WebLinkAbout05-30-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
I?statc of f~dwC~<~ C • ~(~ ~t'%~
also known as
Deceased
Petitioner(s), v,-ho is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.•)
File Number ~~- ~~1~ ~ ~~~~"`
X03 3y - ~i ~ l
Social Security Number _
0 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 March 14, 2008 and codicil(s) dated ~ ~~
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(Stale relevant circwnstances, e.g., renunciation, death of executor, etc.) - ~a
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I~:~cept as follostis, Decedent did not marry.. was not divorced, and did not have a child born or adopted after execution of ~h~;im;trun-~nt(s) cfferc~c+--_=
f<~r probate. ~ti~as not the victim of a killing and was never adjudicated an incapacitated person: -- _~~,~
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® K. Grant of Letters of Administration ~'"~ 1
(/fapp[icab/e, enter: e.t.a.; d. b. n. c. t. a.: pendenle liter durante absentia; durunte rninorilaleJ
Petitioner(s) alter a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (l/
ldministration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.)
~ _ Name Relationship Residence ~
(COMPLETE /N ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
1918 Kcot Uri~~e. Camn Hill. Lower Alla~'hownshio Cumberland County PA 1701 I
(l.isl.en~eet ucldres.c. Rnrrrcitr, toirnship, county, state, zip code)
Decedent. then 61 years of age, died on Max 18.2008 at
Decedent at death owned property with estimated values as follows:
(Ifdomic~led in PA) All personal property $ ~d sh/G~i~~
(lf not domiciled in PA) Personal property in Pennsylvania
(Ifnot domi;~iled in Pn) Personal property in County
Value of real estate in Pennsylvania
situated .a follo~~ c
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 lorm to
the undersigned:
or printed name and residence
~~~~~~~~~ ~ ~~)~~%a~~ ~.lohn Baker, 1214 Rambo Road, Dyersburg, TN 38024
horrn RF1'-02 rev. 10.13.06 Pd~e ~ Of 2
Uath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition ar~;~ra~, end Lorrect to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent P~~Uioner(s)'wi~lX;yy~ji and U-uly
administer the estate according to law. ~ , ~ -
Sworn to or affirmed and subscribed
~~
before me the U day of
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~ or t!~e Register
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Bona! Kepresenlahve
Signature gfPera~avad Representalrve
Srgnatzrre of Personal Representative
File Number: ~~ -~ >~~~~>~,~~ ~ ~~ ~~
Estate of (~dwQ~d ~ • ~`~~ .Deceased
Social Security Number: ~U3 3 ~ ~~ ~ ~ Date of Death: May 18, 2008
AND NOW, ~ °~~ ~ , in consideration ofthe foregoing Petition, satisfactory proof
having been presented befo me, lT IS DECREED that Letters 1~estamcntary
are hereby granted to .tohn Baker
and that the instrument(s) dated March 14, 2008
described in the Petition be admitted to probate and filed of record as the
FEES
Letters ............... $ ~~ : ~
Short Certificate(s) ........ $ ~ ~~
Renunciation(s) .... $
l~ ~.. $ I s
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t,~ $ J ~=
... ~
... $
... $
... $
... $
... $
TOTAL . .............. $ ~ ~ ~
in the above estate
Will (and ~gdicil(s)) of Decedent.
/Re~rster of Wilds I,~ % /~~C
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Attorney Signature
Attorney Name:
Supreme Court I.D. No.: 62469 __
Address: ~ 27 South Market Street
I?U. Box 95
Mechanicsburg, PA 1705ti
Telephone: 717-697-700
Andrew C. Shccly, Hsquire
hbrm lZW-02 rev. 10.13.06 P2~e 2 Of 7
OCAL REGISTRAR'S CERTIFICATION OF DEATH ~~ ~~`~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fce fur this certificate. ti6.Ul)
Certification Numher
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~~jti1ENT OF`~~P//
This is to cattily that the information here given is
correctly copied Iron an original Certificate of Death
duly tiled ~~rith me as Local Registrar. The original
ccltifici-(te will he forwarded to the State Vital
1ZcLOrd, Office fur pern)anenl filing.
~Gwn~ ~~~~ MAY 1 2 8
Local f:egistru- Date Issued
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REV nnoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
PRIM IN
AANENT CERTIFICATE OF DEATH
CK INK
(See Instructions and examples on reverse)
STATE F ILE NUMBER
1. Name of Decedent (First, middle, last, wlfix) 2. Sex 3. Social Security Number 4. Date of Deam (Month, tlay, year)
Edward E. Baker male 203 - 34 - 0171 May 18, 2008
5. Age (Last einhtlay) Under t year Under 1 day 6. Date of Binh (Month, day, year) 7. Birthplace (City and stale or for eign country) 6a. Place of Death (Check only one)
Months Days Hwrs Minutes Hospital: ether:
61 Vrs September 18,1946 Corning, NY ^Inpatient ^ER IOutpelienl ^DOA Nursing Home ^Residence ^Other-Specify:
6b. Counry of Death Bc. Ciry, Boro, Twp. of Death 6d. Fadliry Name (II not institution, give sheet and number) 9. Wes Decedent of Hispa r¢ Origin? ®No ^ Yes 1 B. Race. American Intlian, Black, whsle, etc.
Cumberland Carlisle ManorCa re (Il yes, specify Cuban,
Mexican, Puerto Rican, eta) (SpecAy)
whit e
11. DecedenYS Usual Occu Ian Kintl of work d one Burin most of workin tile. Do not state retired 12. Was Decedent ever in the 13. Decedent's Etlucalion (Specify only highest grade comp leted) 14. Marital Slauu: Married, Neuer Married, 75. Surviving Spo use (II wile. give maitlen name)
Kind of Work Klnd of Business I Industry U.S. Armed Forces? Elementary /Secondary (0-12) Collage (1-4 or 5.) Widowed, Divorcetl (Specify)
roduction S ecialis Printing ^Yes pc]Nn 12 D::vorced
76. Decedents Mailing Atldress (Street city /town, state, zip code) Decedent's
Actual Residaxe 17a
Slate Dld Decedent
Pennsylvania Live ire 17c
ed In Lower Allen
®Ves
Decetlenl Li
1918 Kent Drive
Cam
Hill
PA 17011 .
nb.cnunry .
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T°wnsnip? 1,d.^Nn,Dan¢danluyedwitnm
Cumberland
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16. Father's Name (First, mitlde, last, sutla) 19, Mother's Name (First, middle, maiden surname)
Howard Ivan Baker Rose Isabelle Galusha
20a. Informant's Name (Type /Prints 2gb. Infomlant's Mailing Adtlress (Street, city /town, state, zip cods)
John Baker 1214 Rambo Road, Dyersburg, TN 38024
21 a. Method of Dispositon ~, ®Cr¢matlon ^ Donatbn 21 b. Date Of Oisposdion (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or other place) 21 d Location (Ciry /town, stele, zip codej
^ Buoal ^ Rertavaltrom5tate I, WasCrematlonorponatlonAutborbad Ma 21
Y ' 2008 Evans Cremator
Y
Schaefferstown
PA 17088
^ Omer-Speciy: ! byMedlcalExeminer/COronaR (~ve:^NO ,
22a. Signature. unerd Service Lic~gpsaelor person actlng as such) 22b. License Number 22c. Name antl Address of Facility
- l,. ~t,t//if; ~~,~--- FD 012 848 L Parthemore FH & CS, Inc. , P.O. i3ox 431, New Cumberland, PA 17070
Compete Items 23at only when ceRirying
ph
sician is not availaUe al time of death to 23a. To the best o y knowledge, death occuned at the li rid place staled. (Sgna lure antl ti(le) 230. License Number 23c. Date Signed (Month, tlay, year)
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hems 24-26 must Da completed b1 person 24. Time of Death 25. Date Pronounced Dead (Month, tlay, yea
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) 26. Was Case Referred to Medical Exami
ner
/Coroner for a Reas ~ Iher Ihan Cr motion or D
ooation?
who prawunces death. D ~ M. r~~
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t~ ^Ves `~ No
CAUSE OF DEATH (See Instrucdons end exa s) r Approximate interval: Pad II: Enter other S.igpj(I~CU conditions cnntdhutin° to death, 28. Did Tobaaro Use Contribute to Death?
Item 27. Pan I: Enter the chain Wevents - tliseases, Injures, or complications -that directly caused the death. DO NOT enter terminal events such as camiac arrest, Onset to Oeath but not resulting In the undertying cause given in Pad I. ^ Yes ^ Probably
respiratory anent, or venlrcular Ilbrllation without showing the etiobgy. List only one cause on each line.
IMMEDIATE CAUSE (IFi
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^ Unknown
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sease or 5 ~
crondrTion resuairg in Beam) -~ a. _ . ((' 1~l~1 ~ ~- 1 1 "- -"Cf ^~~~ i c ^~~, (i'
V / / v -~ r 29. II Female:
^
Due to (or as a consequence of): ~ Not pregnant within past year
Sequentially list corgaions, if any, b_
leadag to the cause listed on line a
^ Pregnant at lime of death
. pue to o as a tonne
Ent r the UNDERLYING CAUSE (r quer~ce oQ: ^ Not pregnant, but pregnant within 42 days
(disease or injury that inaiatetl the c
events resuting m death) LAST. of tleath
Due to (or as a consequence oQ'. ^ Not Pregnant, but pregnant 43 days l0 1 year
e before death
_ ^ Unknown II pregnant within the past year
30a. Was an Autopsy 30b. Were Autopsy Firstlings 31. Manner of Death 32a. Dale of Injury (Month, day, year) 320. Describe How Injury Occurretl 32c. Place of Inryry: Home, Fann, Street Factory,
Performed? Availa0le Prior to Completion
^ Natural ^ Homicide Offke Building, etc. (Speciy)
of Cause of Death?
^ Yes ~ No ^ Yes ^ No ^ Accident ^ Pending Investigation 32d. Tme of Injury 32e. Injury al Work? 32f. II Transportation Injury (SpeciyJ 32g. Location of Injury (Street city l town. slate)
^ Suicitle ^ Could Nol be Determinetl ^Ves ^ No ^ Dover I Operator ^ Passenger ^Petlesman
M ^ Other ~ Sper'ry: r
33a. Certifier (tlteck Doty one) 33b. Sgnalure and Tnle o
• Certftying physician (Physktian certirying cause of death when another physician has pronounced death and canpleteO Item 23)
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To the best or my knowledge, tleath occurred due to the cause(s) and manner as slalerL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ - ~ ~ \ ~.`~
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• Pronourcing and cenitying physician (Physician both pronoundng death and cedifying to cause of death)
To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) antl manner as staled_
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. License Number 33a. Dale Signed (Month, day, yea
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Medical Fxaminerl Coroner C[ ~
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On the basis of examinatlon antl I or Investigation, in my opinion, tleath occurred at the thne, date, and place, and due to the cause(s) and manner as staled_ ^
34 Name and Address of Person Whe Comploled Cause of Death (hem 27) Type I Print
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LAST WILL AND '~'~~.'~ l',~~MENT r~r~~ .~~,.~ 3`J ~~~ l~. 33
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EDWARD E. ~~AKER ''
I, EDWARD E. BAKER, of 1918 Kent Drive, Camp Hill, (Lower
Allen Township), Cumberland County, Pennsylvania, make, publish and declare
this as and for my Last Will and Testament, 1-~ereby revoking all other Wills and
Codicils heretofore made b~~ me.
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FIRST: I direct that all inheritance, estate, transfer, succession and
death taxes, as well as my just debts and tian~:;•~.~i expenses, of any kind
whatsoever, which may be payable by reason ;,~f r-~y death, shall be paid out of the
principal of my estate as the same can conve~~i;:ntly be done.
SECOND: I give, devise and bec~af~ath all the rest, residue and
remainder of my estate of whatever nature and wherever situate, including any
property over which I hold power of appointment and together with any insurance
policies thereon, unto my brother, JOHN BA~;FR, of 1214 Rambo Road,
Dyersburg, Tennessee, provided he survives ~~~~~ by thirty (30) days.
THIRD: I acknowledge that I ar;~ the father of TOODD E. BAKER, and
further state that TODD E. BAKER is not a r_~.~~~~~e~~ beneficiary of this, my Last Will
and "hestament, as appropriate distribution4 a~~: ' ~;:l s have been made to hire during any
lifetime.
FOURTH: In addition to all powti~rs granted to tl gem by law and by other
provisions of this Will, I give the fiduciaries ~r.:~ring Hereunder the following powers,
applicable to all property, exercisable without court approval and effective until actual
M
`` distribution of all property:
~~
~ (A) To sell at public or private s~~:;l~~, o~~ to lease, for any period of time,
~~ any real or personal property and to give optir~n:~ fc~r sales, exchanges or leases, for
such prices and upon such terms (including c-F,dit, with or without security) or
conditions as are deemed proper. This incluc~;~s the power to give legally sufficient
instruments for transfer of the property and t,~ r;~ceive the proceeds of any disposition.
(B) To partition, subdivide, or ir:rpro~~ real estate and to enter into
agreements concerning the partition, subdivis~~~n, improvement, zoning or management
of real estate and to impose or extinguish rests-ibtiUris on real estate.
(C j To compromise any claim ~ ~r controversy and to abandon any
property which is of little or no value:.
(D) "To invest in all forms of prr,,~,~~t-~~.. including stocks, common trust
funds and mortgage investment funds, withor?t ~e~>7riction to investments authorized for
Pennsylvania fiduciaries, as are deemed propc~~-, ~~~ithout regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, rigb~. or privilege granted in insurance policies
or in other- investments.
(F) To exercise any election or ~~r;~~°ilege given by the Federal and other
tax laws, including, but not necessarily being ~l:rit°_'d to, personal income, gift and
estate or inheritance tax laws.
(G) 'To make distributions to m~~ .,~~rt~n named beneficiaries in cash or in
kind or partly in each.
(H) To borrow money frorr7 thek~~,~.ei~~:s or others in order to pay debts,
taxes, or estate or trust administration expe~~s~:~:; to protect or improve any property
held under- my will, and for investment purpo:d~,.
(I) To select a mode ofpayme~~~. ~.~r.der- any qualified retirement plan
`~ (pension plan, profit sharing plan, employee s'~~:;k. «wnership plan, or any other type of
t~ qualified plan) to the extent pro~~ided for by t-.~ ~_~!.~~~ or the law.
FIFTH: I nominate and appoint .fit )~A'+~ BAKER, Executor, of this, my
Last Will and "Testament. I direct that my Ext~:,st~,~~ and his successor shall not be
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required to post security or a band for the pe ~~;_,-;~ance of their duties in any
jurisdiction.
IN WITNESS WHEREGF, I have herc.~~~~o «.et my hand and seal to this, my
Last Will and Testament; this ) C/' day of~ a~i~~rc~~. ?008.
~~-u--~-~-~ ~ 7~~ _. ~'; -,._-_.,, (SEAL, )
EDVVAIZ® ~;.~}%efK.~.1~
Signed, sealed, published and dec~ared ~-~~~~ t?,~; above-named Testator as and for
his Last Will and Testament in our presence, t.~~"~:o at his request, in his presence and in
the presence of each other, have hereunto sts~s.~.s:ribed our names as attesting witnesses.
Address ~'" ~~/ ~~ i `amr_ `-__ -_.__.~s.=~
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OATH OF SUBSCRIBING WITNESS(ES),r,~~='=~
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
l~.statc of EDWARD E. BAKER
Deceased
Andrew C. Sheely and Becky M. Knisely , (each) a subscribing witness to
(Prfn! Names)
the ®Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that s~-/ire /they ~a /were present and saw the above Testator / Tom, sign the same
and that she / he /they signed the same and that she-l-~e /they signed as a witness at the reduest of
the Testator /-=F~s~z~h~ in l~ /his presence and in the presence of each other.
(.Sr~nahu~r)
7pl .;enna Court
r.S7rc-~ ~. i~r~n~~~.~.v
Mechanicsburg, PA 17055
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Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
Deputy (or Register of Wills
(.Signalu e
927 Knepper Drive
(.Slreel /Iddressj
Mechanicsburg, PA. 17055
(City. Stale. ZrpJ
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this ~~ day
of , 000
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Notary Public
My Commission Expires:
(Signature and Seal of Nolary or other official yuali5al to
administer oaths. show date of expiration of Nolar~'s Commission.)
~O'fl[: Tu be taken h ~ Officer authori-r,ed to administer oaths. Please ~ ~~ Y ~
y - ~. s) at time of notarization.
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Kan,ieen a snsey, Nomry Publk:
~~ ~,~~„~ R i i ~'-0 3 re,t ~ n. i 3. na Med~b~rp eoro, Q~and Cotr~Fy
My ODrtNnieeion E~ires Sept 17, 2011
P~nMyivania Aosoc~8tion of NotarNis
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