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HomeMy WebLinkAbout06-10-08PETITION FOR PROBATE AND GRANT OF LETTERS i REGISTER OF WILLS OF (. ~:..m~~'~ c;q~~ COUNTY, PENNSYLVANIA _.._._ Estate of r /cf G'/Y/ f~~ ~~tv~ /c~K" File Number 1~.~ I also known as ~ ~ h~ _ ,Deceased Social Security Number ~ 7 7 ' ~ ~ ' ~55~ `7 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COtiIPLETE 'A' or 'B' BELOW.) ^ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~ ~ ~~ C i R.1 i_ ~~ ~~l~ained in the last 4I/ill of the Decedent dated ~~ - ~~~ 0 ~ and codicil(s) dated (State relevant circumstances, e.g., renunciation, death of executor, etc.) y ~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution ogitl~i~rsftumee) offend, A 7 for probate, was not the victim of a killing and was never adjudicated an incapacitated person: °' ~ ~' ' _ r ''-Z } ~ -art 7~ ^ lE. Grant of Letters of Administration ~ ~~ (If applicable, enter.• e.t.a.,' d.b.n.c.t.a., pendentelite; durante absentia, durnuTe r~ritate) G'a ` . Wit'-: _,~ .., Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) ar~ieirs: (If Administration, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) (COM.PLETE IN ALL CASES:) Attac/: adrtitional s/reefs if necessary. domiciled at death in (List street county, state, zip code) with his (, last principal residence at .d ~ i '7.~ I l- i ci ~ v r i ~j < `l Decedent, then /--~ years of age, died on ~ ~ . v '`~' at ~ ~ .,~~ /~ Decedent at death owned property with estimated values as follows: ~--7 (If domiciled in PA) All personal property $ v C% ~ ~ (If not domiciled in PA) Personas property in Pennsylvania $ e~G~ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the lase Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Fornr RW-0? r•e~~. to.t3.o6 Page I of 2 ~. ` ~ l C~ -r ~ _. ~.. ~ .-i ~.- . , __ Oath of Personal Representative COP/IMONWEALTH OF PENNSYLVANIA ~~Q~ ~~~ ~ ~ 1~M ~~' 3~ SS COUNTY OF ~~(~'(~1~'t-/G(:~ r~-~~~~~ ~F T 'Che Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Pe ~,ta'ue ~ra`tl~c~ec~t~~o the best of ~'~ the b:nowledge 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 befo ~ me the ~~ ~~ day of or the Register ~ ~`- Signature of Personal Representative Signature of Personal Representative File Number: dC ~ ~~ - o `rO~~ Estate of ~~~ ~~ phA ,Deceased --T. g Social Security Number: 1 l ~ "d b ~ S S 1 Date of Death: `1 A.ND NOW, 0 , ~~ , in consideration of the regoing Petition, satisfactory proof having been present before rite, IT IS DF~CREED that Letters are hereby granted to in the above estate and that the instrument(s) dated described in the Petition be admitted to p{obate and filed of record as the last Will and Codicil(s) o Decede t. A FEES ~// ~ Register of ills ~ /~ " J Letterer ............... $ ~ . 1 !\ lv,,~+llY/.' Short Certificate(s) ........ $ . ~' Attorney Signature: ~ gyp"-J~}~/ Renunciation(s) .......... $ " ~ . $ ~s. ... $ ... $ of Persona! Attorney Name: Supreme Court I.D. No.: Address: ... $ • • • $ Telephone: ... $ TC)TAL .............. $ ° Form R'6V-0' rev. IQ 13.0( Page 2 of 2 105.805 REV (01/071 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 1~663~77 Certification Number o~-~~/ 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. ~'.~ ~ (~ a Local gistrar Date Issued rv ~ - - -- _._ _ _ CD c ca ,r _ _ __ . _ __ _ _._ _ ___ _ _. _ `-~ ~7 C._. F .. ~~~ G _, U) ~ . ~r ]~ < ` 7 t. - r ~ J ~ J -T'( ~ ... ~ ~ ` ,"- i Htos-1aaREV nnoofi COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~> W ~ -_ TYPE / PRINT IN PERMANENT CERTIFICATE OF DEATH -Q1 r BLACK INK (See instructions and examples on reverse) STATE FILE NUMBER 7. Name of Decedent (First, midtlle, lass, sullixl 2. Sex 3. Social Security Number 4. to f Death (Month, tla ,year) Thomas P. Kerr M 177 - 28 - 3559 5. Age (Last Birthday) Under 1 veer Untler 1 day 6. Dale of Binh (Month, tlay, year) 7. Birthplace (City antl slate or foreign country) 8a. Place of Death (Check ony one) spita: Other: M1Wnins Days Hwrs M,nutes H° ~ Yrs. ,~J Inpatient ^ ER /Outpatient ^ DOA ^ Nursing Home ^ Residence ^Other - Spedty: Bb. County of Death 6c. City, Boro, Twp. of Death Bd. acility Name (If not institution, give street and number) 9. Was Decedent of Hispanic Origin? ~ No ^Ves 10. Race: American Indian, Black, White, etc. (If yes, specify Cuban, (Specrykj Dau h:in Harrisbur Harrisbur Hos stet Mexkan, Puerto Rican, etc.) White 11. Decedent's Usual Occu atan (Kintl of work tl one tl urin most of world tile. Do not state retiretl( 12. Was Decedent ever in the t3. Decedent's Etlucation (SDecily only highest grade comp letetl) 14. Marital Status: Marred, Never Married, 15. Surviving Spo use (I(wile, give maitlen name) Kintl of Work Klnd of Business /Industry U. S. Armed Forces? ~ Elementary / Sec°ndary (0-12) College (1.4 or 5.) Widowetl, Divorced (Specil}g Accountant Bookkee in ^Yee "° 4 Married Caroline R. Jewett 16. Decedent's Mailing AUtlress (Street, city I town, state, zip code) Decedent's DId Decedent Slate P e nna . Live N a 17c Decedent Lured in Hampden T ^ Yes Act al Residence 17a 3803 Carriage House Dr. . u . , wn r°wnsD; D? 17011 Hill Pa Cam 17d. ^ No, Decedent Lived within nD. copnty Cumberland , . p Ac1val Limnam city/Bpr° 78. FaNer's Name (First, middle, last, suAix) 19. Mother's Name (First. mddle, maiden surname) Thomas A. Kerr Anna Morse 20a. Informant's Name (type! Print) 206. Informant's Mailing Address (Street, city I town, state, zip code) Caroline R. Kerr Carrie a House Rd. am Hill Pa. 11 21 a. Methotl of Disposition ^ Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 21 d. L°CdIIIXI (City I town, state, zip cotlel ^{Be~ ^ RemovallromState !Was Cremation or DonationAUthorized ^Np ^ Other- S ci ~ by Medical Examiner/CoronerP ^ Yes 6/7/08 St. John's Cemetery Mechanicsburg, Pa. 17055 22a. S' azure of Funeral Service Lkensee (or person acting as such) 22b. Lcense Number 22c. Name antl Atldress of Facility - 0-10098-L Matinchek &Dau hter F. Home, middletown, Pa. 17057 Cmnplele Items 23ac only when ceniying 23a. To the best of my knowledge, deem occurred at the time, date and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year) physician is not available al time of tleaN to cenity cause of tleath. Items 24-26 must be complete0 Dy person 24. Time of Deat~ i „ ~/ 25. e Pronouncetl Deatl (MOnn~day, ye ~~~ 26. Was Casa Referred to Medical Examiner / C°roner for a Reason Other than Cremation or Dowhon? who pronances tleath. ~ ~~ M. ~ ^ Yes ^ No CAUSE OE DEATH (See instructs sand examples) ~ Approximate interval: Part II: Enter other sionificam conditions mntnbuling to death, 26. Did Tobacco Use Contribute to Death? Item 27. Pan C Emer the chain of events -diseases, injuries, or cnmptications - roar tlirectty caused t death. W NOT enter terminal events such as cardac arrest, Onset to Death but not resulting in Ire underlying cause given in Part I. ^ Yes ^ Probably showing a etiobgy. List only one n each line, respiratory arrest, or vemniculan Ilbrillatiol~sajtht I II 1 ^ No ^ Unknown ~ ~ ~ YY IMMEDIATE CAUSE IFinal disease or 29. If Female: condition resulting In death) -~ a ^ Due to (o segue ce o : - r Not pregnant within past year ^ Pregnant et time d death Sequentiafiy list cpnditbn;, if any. b. leading to the cause listed on line a. Due to or as a cron uence of Enter the UNDERLYING CAUSE ( ~ )~ r ^ Not pregnant bW pregnant within 42 days (disease a injury that initiated the c ST of death events resulting m tleath) LA . Due to (or as a consequence oQ. Nol hertz. but ^ preq pregnant 43 tlays to 1 year tl. ~ before tleath ^ Unknown if pregnant within the past year 30a. Was an Autopsy 3W. Were Autopsy Findings 31. Atanner of Death 32a. Date of Injury (Month, day, year) 325. Describe How Injury Occurred 32c. Place of Injury: Home, Fartn. Street Factory, Pedometl? Available Prior to Canpletion of Cause of Death? ^ Natural ^ Homicide OAice Building, etc. (Specifyf ^ Accident ^ Pending Investigalien 32d. Time of Injury 32e. Injury al Work? 321. If transportation Injury (Specify) 32g. Location of Injury (Street city /town, state) Yes No ^ Ves `r.Q No r"• ^ Suicide ^ Could Not be Detennine0 ^ Yes ^ No ^ Oriverl Operator ^ Passenger ^Pedestrian M ^Other ~ Specify: 33a. Certifier (cmech only one) ronounced OeaN and completed Item 23) sician has rtif in se of death when another h Ph i i ca ni i h i i c 336. Signature antl Titi of ni r ~ r~ ' \ l y g p y p ys c an ce u ty ng p ys c an ( • e To the best of my knowledge, death occurred tloe to the cause(s) and manner as 5tated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ - J V v v ~ • Pronouncing and cenitying physician (Physician both pronouncing death and cenitying to cause of dealhl ~ To the best of my knawletlge, tleath occurretl at the time, sate, and place, and tlae to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33c. Lic rise t~ bar 33tl. Dat@S'g ~ ,pay,. yeN{-~ lFJ, (/ dical Examiner t Coroner • M e Dn the basis of examination and / or investigation, in my opinion, death occurred at the time, dale, and place, and due to the cause(s) and manner as stated_ ^ , and ddr~-s of Person Who Completed C a us e n ri 34 Nam~y l 'Death (Item 27 Type i P ntt ~y I ~ ~ ~~ 1 (' 35. Registrar's Si -are and Dist cl N ~ '` `1 / t 36. Date ~iled (Alonth, day, ye ) C ^ ' ~ l , ~ ~ / 1 _ ~ ~ ~ ~e~' ~I,/((~r.~ ~Q y' Iv~L /~ r 111^^^ CCC../// 'y V V~ ~^ ~ O C - J ~ v ,r rr D~~~l~ I"- V Dispo~,.. __, ~. id N°. .i _ .. +_ .~:_ ~. ,~; , ; ,_.. , ._, , ., t __ .; ~j[~~~ ~~~~ (Q~= T VUr q"~.f .r ,r•i. ~h. V~ ~i o~-c~~y ~- LAST WILL AND TESTAMENT OF THOMAS PAUL KERB I, THOMAS PAUL KERB, of Hampden Township, Cumberland County, Pennsylvania, being of sound and disposing mind, hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all prior Wills and other testamentary writings at any time heretofore made by me. 1. I direct that the expenses of my burial and all my just debts be paid as soon as possible after my death. 2. I give and bequeath all the remainder of my ~~~ property, real, personal, and mixed to my wife, Caroline J. Kerr, providing she survives me by thirty (30) days. 3. In the event my wife, Caroline J. Kerr, does not survive me by thirty (30) days, then I give, devise and bequeath the remainder of my property, real, personal, and mixed to be divided among my three daughters, DEBORAH K. HOLT, CATHERINE K. CYPHER, and MARTHA K. SMITH, as shall survive me for thirty (30) days. If a child of mine does not survive me, such deceased child's share shall be distributed in equal shares to her respective children. Page l: Will of Thomas P. Kerr 4. All loans due from my children to Caroline and me must be paid off prior to the distribution of anything in this will. 5. It is my desire that none of the stocks and bonds be sold. Each stock is to be divided equally among my three daughters and any fractional shares are to be sold. The bonds will be divided with each daughter receiving one/third of the bonds. My personal representative may make the decision as to the sale of my homes. All cash will be divided equally among my three daughters. 6. I nominate, constitute and appoint ~1L CAROLINE J. KERR, Executrix of this my Last Will and Testament and further direct that she shall serve without bond. In the event that she is unable or unwilling to serve as Executrix, I nominate, constitute and appoint DEBORAH K. HOLT, as Alternate Executrix of this my Last Will and Testament and further direct that she shall serve without bond. Said Executrix shall have the power to discharge all the debts, liens and encumbrances upon my estate, as well as any taxes thereon, to pay for the cost of the final disposition of my remains and final illness, if any, to receive any and all commissions and other compensation for services rendered by me during my lifetime and to perform any and all fiduciary duties authorized by Page 2: Will of Thomas P. Kerr statute. Further, I direct my personal representative to preserve my estate and any instructions pertaining to the distribution of the same from any attachment or anticipation while in the hands of my said personal representative, it being my express intent that all legacies shall be free from any attachment or anticipation while in the hands of the personal representative for my estate. T~~-- IN WITNESS WHEREOF, I have, to this my Last will and Testament, typewritten on five (5) pages of paper, set my hand and seal at the end thereof this ZS~' day of Sep ~ 2006. r----- `y--~~"~-""~--' ~ - ~ ~-.~~.~ ( SEAL ) THOMAS PAUL KERR Page 3: Will of Thomas P. Kerr COMMONWEALTH OF PENNSYLVANIA :SS COUNTY OF CUMBERLAND I, THOMAS PAUL KERR, Testator 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 this 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. ~ P~....1, 1~.~.. THOMAS PAUL KERR `Cl~-., Sworn and subscribed to before me by THOMAS PAUL KERR, the Testator, this ~~ day of ~~~~'J 6 . N ary Public My Commission Expires : 7/~G'1O~~Q COMMONWEALTH OF PENNSYLVANIA Noharial Seal M~chege G. Quaca, Notary Pubic Camp Hdl Bono, Ctxnbedand County My Commission Expires July 30, 2010 Member, Pennsylvania Association of Notaries Page 4: Will of Thomas P. Kerr COMMONWEALTH OF PENNSYLVANIA: :SS ~l~ COUNTY OF CUMBERLAND: We, 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 THOMAS PAUL KERR, Testator sign and execute this instrument as his Last Will and Testament; that THOMAS PAUL KERR signed willingly 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 the time 18 or more years of age, of sound m;nr~ and unc-;Pr no constraint or undue influence. <~~~~~ G~ ~~ o o C?~~~1~'~~ ~~ ~l c~1~~~~~a~r Sworn to and subs ribed before me i s d a ~~,~~°~ 2 0 0 6. otary Pu lc /~/~f~ My Commission Expires (SEAL) Page 5: Will of Thomas P. Kerr COMMONWEALTH OF PENNSYLVANIA Notarial Seal Mx~eBe C. tluaca, Notary Pubfic Came hNN Bono, Currtberiand Courtly My Camrrttssbrt Expires .luly 30,2010 Member, Pennsylvania Association of Notaries