HomeMy WebLinkAbout05-29-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of Fred R. Long
also known as
COUNTY, PENNSYLVANIA
File Number ~ I ~ ~~~ o
Deceased Social Security Number 203-10-6352
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 Executor
last Will of the Decedent dated 6/14/04 and codicil(s) dated NA
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 execution of Iheixy~rvme~s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: NA ' i_;~ -~`
,_ _
^ B. Grant of Letters of Administration __ _ y
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durante absentia; durante minoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (!f
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
(COMPLETE /NALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Messiah Village, 100 Mount Allen Drive Mechanicsbure Upper Allen Township PA
(T ist street address, town/ciry, township, county, state, zip code)
Decedent, then 93 years of age, died on May 14, 2008 at Messiah Village, 100 Mount Allen Dr., Mechanicsburg,
Upper Allen Township, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) 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
situated as follows: NA
1,200,000.00
e 0.00
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:
Karen Kapp, 561 Dogwood Dr., Mechanicsburg, PA 1 ~ 055
Form RW-01 rev. !0. /3.Oti Page 1 of 2
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA ryYi(}n ,r P, w .- ~ ~ ~<
SS ..._ i;i.. ~'~ iii"i ~~~ 05
COUNTY OF ~.~~~,~;~ _
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition arelj~e a~ttd ~COrrect t~t#te best of
~,; , ,
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petifibnrrr(s) will well iin+d, t~iily
administer the estate according to law.
Sworn to or affirmed d subscribed
before me the i:y! day of
0
C c l~
~ ~~
rthe Register
of Personal
Signature of Personal Representative
Signature of Personal Representative
File Number: C>L / " ~~~' U J ~..~
Estate of Fred R.
Deceased
Social Security Number: 203-10-^63))52 Date of Death:5/14/08
AND NOW, ~ ~[,~ ~.X (~ ~ UC~~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters
are hereby granted to Kazen Kapy
and that the instrument(s) dated 6/14/04
described in the Petition be admitted to probate and filed of record
FEES ~/~
Letters ............... $ ~/[,
Short Certificate(s) ........ $ ~ ~. ~
~ ~
Renunciation(s) , . ( J ~ ~
lti ~ ~ -
i $ ~ ,~~
,t~$ Gd
... $
... $
... $
... $
... $
... $ OJ
TOTAL .............. $ 0-~
in the above estate
Attorney Signature:
Supreme Court I.D. No.: 23887
Address: Laws, Staru~;h & Pisarcik
20 Erford Rd., Ste 305
Lemoyne, PA 17043
Telephone: (717) 975-Oti00
Form RW-02 rev. 10.13.06 Page 2 of 2
Attorney Name: W- Scott Staunch, Esq.
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or' photograph.
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CertificatiLm Number
I REV 11!2006
' PRINT IN
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%xr" '~;~ This i~ to rectify that the informagon here given is
p~TN OF pF =: correct!}' ru Ic d liom an Drat,
dlrljlA(.j /y ~ ~Inai CertlflCate Of Death
,xl ~, Otis =_
~~~ ~ ~l- dulu filed with me as Local Registrar. The original
o; ~ `;y certificate will he forwarded to the State Vital
~~ ; ~a~ Recorc'> Otfirc~ for permanent ailing.
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~9TN1fNT 0`~,;r~P~ ~~,, M Y
G~%[~~Nf~I~R g~.~tra Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) ~r~r< <„ ~ ~,,,•,p~o
I. Vame of Decedent (FrsL mid e, last, suffix) 2. Sex 3. Serial Security Number 4. Dale of Death (Month, day, year)
~
~~ 203 1 0 - 6352 Ma 1 4 2008
5. Age (Last einhtlay) Under t year Under 1 day 6. Dale of Birth ( ,day, year) 7. eidhplac¢ (City and state or foreign ounlry) Ba. Place of Death (Check only one)
uomhs Days rro~~s m~mnas Hospital. Other.
9 3 Yrs. Dec Inpalienl ^ ER / Out alien) ^ DOA Nursin Home
p g ^ Residence ^Olher SDecily
Bb County of Death Bc. Clly. Boro. Twp. of Death Bd. Facility Name (II not institution, give street and number) 9. Was Decedent of Hispmic Origin? ~ No ^ Yes 10. Race: American Indian, 81ack, While, etc.
Cumberland Upper Allen Tw
Messiah Vi (II yes, specify Cuban, (Speciy)
lla e M¢xipan,Pua"pRipan alp.) White
11. Decedent's Usual Occ Don (Kind of work dome Burin mast of workln Ills. Do not slate retired 12. Was Decedent ever in the 1 3. Decedent's Education (Specify only highest grade completed) 14. Marital Status: Married, Never Married, 15. Surviving Spouse (II wife, give maiden name)
Kind of Work Kintl of Business I Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (SpecilN
Warehouseman Olmsted Air Ba e ~7Y¢a ^N° Widozaed
16. Decedent's Mailing Address (Street, city I sown, stale, zip coda) Decedent's Did Decedent
PA
561 Dogwood Drive Actual Residence 17a. Slate Gve in a 17c. ~ Yes, Oecedem Llvetl in ~T 2~ ~ } l e ~ Twp.
Township?
nacpunty Cumberland t7d C N°,DepadanlLivadwimin
Actual Llmils of qty / Boro
18. Father's Name IFirst, middle, last, su Ix) 19. Mother's Name (First, middle, maiden surname!
John Jose Nine Christenson
20a. Informant's Name (Type I Print) 200, Informant's Mailing Address (Street, city! town, slate, ziD code)
Karen J. Kapp 561 Dogwood Drive, IKechanicsburg,PA
21 a. Method of Disposition ~ Cremation ^ Donaton. 21 b. Dale of Disposition (Month, day, year) 21 c. Place of DISDOSIIIOn (Name of c¢melery, crematory or other p ace) 21tl. Lxalion Icily I town, state, zip code)
^ ~] Burial ^ Remnvaltrnmslal¢ waaaemabpnprOpnabpnAamorized
er ~ Speciry j by Medical Examiner! Coroner? ^ Yes ^ No May 1 9, 2008 Mt. Olivet Cemetery New Cumberland,PA1707
22a. Sjpppmre of Funeral Sgrvn Licensee (or persory~cting as such)
1
J 220, License Numner 22c. Name aM Address of Facility
`~'.
- ~ ~,~,~, FO 012342-L Stone & Murray F.H., 408 3rd. St.,New Cumberland,PA17070
to fleets 23ac onry when cenitying 23a. To the ye5'~Ynry ovAatlge, death occurred at the lime, date and place staled. (Signat ure and 1i11e) 230. License Numdar 23c. Date Signed (Month
day
year)
ysidan is not available al lime of tlealh to !~ ,
,
ceniq cause of deem.
kerns 2426 muss be completed by person 24. Time of Deam 25. Date Pronounced Dead (Month, day, year) 2fi. Was Case Referred to Medical Examiner /Coroner for a Reason Omer Than Cremation or Donation?
who prorwurrces death. ~: , 47 ~) t- . M.
/
y ~ h F` / y+ ..'~ r , ~..: 1
7 ^Ves ~] No
CAUSE OF DEATH (S
e
e Inatrudlons and examples) t Approximate intervah. Pan II: Enter other ~gr7jgrgnt conditions conlriburtna to death, 26, Did Tobacco Use Contribute to Death?
Item 27 Pan I: Enter dre r~hain of events -diseases, Injuries, or complications -that tliredty caused the tlealh. DO NOT enter terminal even ts such as cardiac arrest, Onset Ip Death Wt not resulting in the untlenying cause given in Pan I. ^ Yes ^ ProbaOty
respiratory anest. or venMcular fibnllelien without showing me etiomgy. Llsl only one cause on each Ilne.
IMMEDIATE CAUSE 'fFriel disease or r
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~ ii0 ^ Unknown
cordifion resulting in death) _' /) /J y y'~"d ~~ q~-~ ~ 1, ....~~ ~~
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Due to (or as a consequence
Se
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list condAi
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~'7 A Not pregnant within pas! year
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leading to the cause listed online a. ; .
-
i ^ Pregnant at time of deem
Due to (or as a copse
Enter the UNDERLYING CAUSE queries or)
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^ Not pregnant, but pregnant within 42 days
(disease or inj 9ry that-nMaled me
events r¢SUllin n death UST. c.
Due to for as a poneepuence °~:
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W/~.I~TU G,~ Se
of death
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~ `F'IN! Not pregnant, but pregnant 63 days to t year
before death
^ Unknown if pregnant within the past year
30a. Was an Autopsy
Penomred? 30b. Were Autopsy Findings
Available Prior to Completion 31 Manner of Deelh
~ 32a. Date of Injury (Mon th, day, year) 320. Oescnbe How Injury Occuned 32c. Place of Injury: Home, Farm, $Ireel, Factory,
of Cause of Death? r~,
aNral
IS" ^ Hgnicide Office Building, etc. (Speciy)
^ Yes [v] No ^Ves ~ ^ Accident ^ Pending Investigelion 32tl. Time of Injury 32e. Injury at Work? 321. If Transponalion Injury (Specity) 32g. Location °I Injury (Street, city l lawn, state)
^ Suicide ^ Caltl Not be Determined ^Ves ^ No ^ Driver I Operator ^ Passenger ^Pedeslrian
M ^Other- Specity~
33a. Certifier (check only oriel 33b. Signature and Title al Csnilier
• Cenlrymg phyalclen (Physician cenitying cause of death when another physician has pronounc¢tl tlealh and crompl¢Ied Item 23) ///~~y
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To the best of my knowledge, death occurred due to the cause(s) and manner as akted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• P
i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,
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ronounc
ng and cenilying physician (Physician both pronoundng death and cenitying lp cause of deem)
Ta the best of my knowledge, death occurred al the time, date, and place
end due to the cause(s) and manner es sfated
^ 33c. license Number 33d. Date Signed (Month, day, year)
,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Medical Examinerl Coroner ,~~x ,x ~~ 5, ~ ~~
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V _ / . / _ ~oa D
On the basis of examination end I or investigation, in my opinion, death occurred at the lime, date, end place, and due to th e cause(s) and manner es sseted_ ^ , `f O
34 Name and Address~of Pa
rso
n Who Com sled Cause of Death (Ite
~ m 27) type I Pnnl
Re
35
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~ h ~ ~I ! I ~I ~I ~I 36. Date Fie (Month,
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Disposition Permit No. y / l ~j Q rf /
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LAST WILL AND TESTAMENT ;~,;~,,s ~;~ ~ ~, ~;.~
,.;
._..~ ~~.,. ~~r~ '.'~. ?I' f S
OF
,- ~- , ` -
FRED R. LONG ~ `~
I, FRED R. LONG, of 214 Eutaw Street, New 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, hereby revoking all otherwills and codicils previously made by
me.
ITEM I: I direct that payment of all my just debts, expenses of my last illness,
funeral expenses and the costs of administering my estate be made fronn my estate as soon after
my death as conveniently may be done.
ITEM II: I give, devise and bequeath all of the rest, residue and remainder of my
estate, of every nature and wherever situate, together with all insurance policies thereon, as
follows:
A. I bequeath thirty percent (30%) of the said residue to NCAREN KAF~P, my niece,
of 506 Mount Allen Drive, Mechanicsburg, Pennsylvania 17055;
B.1 bequeath thirty percent (30%) of the said residue to WAYNE LONG, my brother,
of 927 Sixteenth Street, New Cumberland, Pennsylvania 17070;
C. I bequeath ten percent (10%) of the said residue to AMBER LEIBIG, of 524 Third
Street, New Cumberland, Pennsylvania 17070;
D. I bequeath ten percent (10%) of the said residue to TRINITY UNITED
METHODIST CHURCH, New Cumberland, Pennsylvania 17070;
E. I bequeath ten percent (10%) of the said residue to the SALVATION ARMY;
Page 1 of 5
F. I bequeath ten percent (10)% of the said residue to BETHESDA MISSION,
Harrisburg, Pennsylvania.
ITEM III: I direct that any and all taxes that may be assessed in consequence of
my death, including all inheritance, estate and transfer taxes imposed upon my estate passing
under my Will or otherwise, shall be paid out of the principal of my residuary estate as a part of
the expense of the administration of my estate.
ITEM IV: I authorize and empower my personal representative to compromise,
adjust, release and discharge in such manner as my personal representative may deem proper,
all debts and claims owed by or to me or my Estate; to sell, lease or exchange at public or private
sale or in such manner, at such prices, and upon such terms of credit or otherwise, as my personal
representative may deem proper, all or any part of my property, real or personal; to execute,
acknowledge and deliver instruments of conveyance, including deeds in fee simple; to borrow
money for the purpose of paying estate, inheritance or other taxes which are required to be paid
and to secure any such loans by pledge or mortgage of all or any part of my property and to
execute the necessary instruments to carry out such powers; to distribute my estate in kind or
partly in money or partly in kind, and to determine the fair value at which any property so
distributed in kind shall be received by the distributees; to conduct any lousiness in which I have
an interest at the time of my death, for such period as my personal representative may deem
proper, power to borrow money and pledge assets of the business and the power to do all other
acts that I, in my lifetime, could have done, to delegate such power to any partner, manager or
employee without liability for any loss occurring therein and to organize <~ corporation to carry on
said business as capital to such corporation and accept stock in the corporation in lieu thereof and
hold such stock for the uses of this, my Will, and to vote said stock or sell the same as to my
personal representative may seem best; to retain all stocks, assets, bonds and investments owned
Page 2 of 5
by me without being confined to what is known as legal investments; t~~ execute any options to
purchase, to apply for stocks, bonds or other investments, to purchase or otherwise acquire real
estate and to execute the same powers thereover as hereinbefore provided, to retain indefinitely
any part of my assets, real or personal, which is or may become unpnoductive or to make sale
thereof; to pay carrying charges and expenses of the property out of other principal or income of
my estate; to invest and reinvest in all forms of property without reastriction to investments
authorized for Pennsylvania fiduciaries, as my personal representative deems proper, without
regard to the principle of diversification or risk; to exercise any laity-given option to treat
administrative expenses either as income tax or as estate deductions, vvithout regard to whether
the expenses were paid from principal or income. The powers herein conferred shall be to my
named personal representative and all successors thereto and shall b~e in addition and not in
limitation of other powers conferred on said fiduciary.
Any and all payment or payments of any sum or sums, whether in cash or in kind
and whether for principal or income payable to any beneficiary shall be made upon the sole receipt
of the respective beneficiary to whom the payment is made and free from anticipation, alienation,
assignment, attachment, and pledge and free from control by the creditors of any such beneficiary.
ITEM V: All shares of principal and income hereby given shall be free from
anticipation, assignment, pledge or obligation of the beneficiaries and any of them and shall not
be subject to any execution or attachment, levy or sequestration or other claims of the creditors
of said beneficiaries or any of them.
ITEM VI: I nominate, constitute and appoint KENNETH E.. BANKERT as the sole
Executor of this, my Last Will and Testament, to serve without bona. In the event of the
renunciation, death, resignation, refusal or inability to act for any reason whatsoever of the said
Page 3 of 5
KENNETH E. BANKERT, I nominate, constitute and appoint KAREN IKAPP, my niece, as the
Executrix of this, my Last Will and Testament, to serve without bond.
IN WITNESS WHEREOF, I, FRED R. LONG, have, to this, my Last Will and
Testament, set my hand this ~ day of ~UN~ , 2004.
~~ '• ti '~~ (SEAL)
FRED R. LONG, Te ator ~c
k
On this `'~1~~` day of ~ t~+Y~ , 2004, Fred R. Long declared to us that this instrument
was his Last Will and Testament, and we were requested to act as witnesses to that declaration
and to his signature. This will was then signed in our presence, all of us being present
simultaneously. We now declare that he is, to the best of our knowledge, of sound mind and we
subscribe our names as witnesses.
Signatures:
~e of
Addresses:
~r JH /7D13
of
IoY6 w flid~. i~<<~
ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
State Of ~' ~ : Gxistine M. Chubb, Notary Public
SS Hampden Twp., Cumtx~land County
tt My Commissbn Expires Oct. 2.2007
County of ~, Yh~PSZlot>~ ~ Member, Pennsylvania Association Of Notaries
I, Fred R. Long, Testator, whose name is signed to the 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 I signed it willingly, and that I signed it as my free
and voluntary act for the purposes therein expressed.
~~ ~~~~
Fred R. Long f:
Page 4 of 5
Sworn to or affirmed to and acknowledged before me by Fred R. Long, the
Testator, this )~ ~ day of `=Cuu'- , 2004.
~-.
~~ Cam. ~~_
Notary Public
AFFIDAVIT COMMONWEALTH OF PENtVSYLVANIA
Notarial Seal
c girisdne M. Chubb, Notary Public
State Of ~c~lenS~~~`j~~sca Hampden Twp., Cumberland County
SS ~' ~~~ Expires Oct 2, 2007
COUnty Of \~' Q.~,~ Member, Penneylvanln Aoo®ClStion Of Notaries
.1~A aE3
We, ~ l~ ~a~ and ~nl,~z ~_ ~Q ,the
witnesses whose names are signed to the foregoing instrument, being my qualified according
to law, do depose and say that we were present and saw the Testator sign and execute the
instrument as his Last Will and Testament; that Fred R. Long signed willinigly and that he executed
it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing
and sight of the Testator, signed the Will as witnesses; and that, to the best of our knowledge, the
Testator was at that time 18 or more years of age, of sound mind and under no constraint or
undue influence.
_ ~~
it s Witn s
Sworn or affirmed to and subscribed to before me by ~,,~ and
mod,.: ~1.C'~, ,witnesses, this -4'~day of "~~„~ _, 20 4.
~,~.
Notary Public
Page 5 of 5
RENUNCIATION
-,rY'~ _ ~ ,~-~
Sri
REGISTER OF WILLS ~~, '" ~` '~r~'
Cumberland COUNTY, PENNSYLVANIA
~2l -o2~U~ - ~~~.5
Estate of Fred R. Long
Deceased
I, Kenneth E. Bankert , in my capacity/relationship as
(Print Name)
Executor
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Karen
~"-a~-~o8
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
FormRW-06 rev. 10./3.06
~--os ~
(Si tore)
(Street Address)
1yef~ Cu,~ fit- la.td a ~,~ / ~ a 7 D
(city, state, zip)
Executed out of Re~~ister's Office
Before the undersigned personally appeared the
party executing this :renunciation and certified
that he or she executed the renunciation for the
purposes stated withiin on this ~~~'`' day
of aa6
` ,
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other otticial qualified to
administer oaths. Show date of'expiration of Notary's Commission.)
NOTARIA~I. SEAL
Mariann L Stiely, Notary Public
Lemoyne Boro., Cumberland County
My commission expin;s January 02, 2009