HomeMy WebLinkAbout06-12-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
Estate of Roland R Tesno
CUMBERLAND COUNTY, PENNSYLVANIA
File Number 21-- ~(JU0 ~ ~~~ j -
also known as
,Deceased Social Security Number 201-05-2227
John W Horn and Donald F Tesno
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or 'B' BELOW.•)
QX A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Co-Executors named in the
last Wil{ of the Decedent, dated 01/17/2007 and codicil(s) dated
rv
State relevant circumstances, e. g., renunciation, death of executor, etc. _
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution aT,t~ instrum@~s) off~r~d ::
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ C:J ~ " _
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B. Grant of Letters of Administration
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Petitioner(s~ after a proper search has/have ascertained that Decedent left no Will and was survived by the following sp~tase (if any) afS~heirs:~ (li
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) CJl
5225 Wilson Lane, Mechanicsburg, Lower Allen Twp., Cumberland, PA 17055
(List street address, town/city, township, county, state, zip code)
Decedent, then $5 years of age, died on 05/17/2008 at Bethany Village, Mechanicsburg, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 100,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA)
Value of real estate in Pennsylvania
situated as follows:
Personal property in County
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:
Signature Typed or printed name and residence
John W Horn 375 S Goodspring Rd.
f, /` ( Hegins, PA 17938
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~-- I Donald F Tesno 372 Lexington Way
!~ ~ /) ~( /~~~ Littlestown, PA 17340
F~ .n KW-UL Rev. 10-t3-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2
(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
COMMONWEALTH OF PENNSYLVANIA
CouNTY OF Cumberland
Oath of Personal Representative
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The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will welt and truly
administer the estate according to law. ~ j
Sworn to or affirmed and subscribed
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before me this /~ d.y of
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For the Register
~iJ'o~Jh n ~W%Horn..
l~~i~ l
Donald F Tesno
Signature of Personal Representative
File Number: 21-- p~~O' ~j
Estate of Roland R Tesno ,Deceased
A/K/A
Social Security Number: 201-05-2227 Date of Death: 05/17/2008
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AND NOW, ~ ~- ~~ 0 , in consideration of the foregoing Petition, satisfactory proof
having been presented be o e me, IT IS DECREED that Letters Testamentary
are hereby granted to John W Horn and Donald F Tesno
in the above estate
and that the instrument(s) dated 01117/2007 ,,_~
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent. rr-- ~ `~='
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FEES ` ' ~~ ~ ~ ,
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Letters ............................................ $ 210A0 -
Short Certificate(s) ................. ....... $ 12.00
Renunciation(s) ...................... ....... $
Automation Fee $ 5.00
JCP Fee $ 10.00
$
$
$
$
$
$
TOTAL ............................. ....... $ ~d~, ja. d' --290
Attorney Signature: `G-~'T~
Attorney Name: Marielle F Hazen
Supreme Court I.D. No.: 68003
Hazen Elder Law
Address: 2000 Linglestown Rd.
Suite 202
Harrisburg, PA 17110
Telephone: 717-540-4332
Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certiticate. $6.00
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Certification Number
This is to certif~,~ that the information here given i
correctly copied from an original Certificate of Deat
duly filed with me as Local Registrar. The origins
certificate will be forwarded to the State Vita
Records Office for pes-maneut filing.
MAk 1 ~/zpOA-
Local Registrar Date Issued
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!REV 17/200fi COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS 7'..._ - ?
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MANEN7 CERTIFICATE OF DEATH ~
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(See instructions and examples on reverse)
STATE FILE NUMBER C:+ [-l
1. Name of Decadent (First, middle, last, wfgz) 2. Sez 3. Social Security Numher 4. Dale of Death (Month, tlay, ye
Roland R. Tesno Male 201 - 05- 2227 Ma 17 2008
5. Age (Last Birthday) Under t r Under t da fi. Date of BiM (Month, day, ear) 7. Birthplace (City and state or faegn country) Ba. Place of Death (Check on" one)
Nonlhs bays Roars kanmaa Hospital: Other:
85 Yra. August 15 , 1922 Mowry , PA ^ Inpatient ^ ER /Outpatient ^ DOA Nursing Roma ^ Residence ^Other -Sped":
6b. Canty of Death 3c. Ci", 8oro, Twp. of Death 6tl. Fadldy Name (II not inslUNian, give slr9et and number) 9. Wes Decedent of Hispanic Origin? ®No ^Ves 10. Race American Indian, Black, White, etc.
Cumberland Lower Allen T~.7fl
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" ~ Bethan Vi11aoe of yea, apepi"coda",
Y ISpectiM
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~ b Mexican, Pueno Rican, etc.) ~
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11. Decedent's Uwal Occu lion Kintl of work done duri most d wadd IHe. Do not state retired 12. Was Decedem ever in the 13. Decedent's Educatron (Specify oMy highest grade completed) 14. Marital Status: Martied, Never Married, 15. Surviving Spouse (If wife, give maiden name)
pod of Work KirN of Business / IrMustry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specd)7
Electrical En ineer Curtis-Mathes ,,Yea ^NO 4 Widowed
16. DecetlenYs Mailing Address (Street, dry /town, state, zip code) Decedent's Did Decedent Lower Allen Twp
PA Live Ina
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5225 Wilson Ln.
Actua
ence
7a. state
es
17c. $] tea, Decadent lived In
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Twp.
PA 17055
Mechanicsbur owns
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17d.^Na, Decedent Lived within
,7b. COUn" Cumberland
g, Atlual LlmAS Oi Ci"/Boro
16. Father3 Name (First, middle, last, sugiz) 19. Mother's Name (First, mltltlle, maitlen surname)
Luther Tesno Estella Welker
20a. InlormanYS Name (Type /Print) 20b. Inlormanl's Mailing Adtlrew (Street, dly /town, slate, zip code)
Donald Tesno 72 Lexington-.Way, Littlestbwn PA 1732+0
21 a. Method of DisposiUOn remotion ^ Donator 216. Data of Disposition (Monts, day, year) 21c. PI a al Disposition NName of tamer crematory a omer place)
ol~in
er Funeral Home & 21d. Location (Ci" /town, stale, zip code)
^ Banal ^ RemovalfromState WasCrematlontxDonatlonAUtMrized~I May 21, 2008 g Mt. Holly Springs PA
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^ Other - Specrry: i by Madlgl Exemlrter /Coroner? L.J'Yes ^ No
22a. ~ dFuneral Service ~ nose rson ass 226. License Number 22c. Name and Address of Fadliry Myers-Hamer Funeral Home
014819 L 90 a e h' 1 P 17 11
Complete Items 23ac ony when aerkM"B 23a. To me bast of my knowledge, death occured al the time, date and place slated. (Signature and title) 23b. Lcense Number 23c. Dale Signed (Month, tlay, year)
physcan is not evadable al time of death to
cerlUy cause of deem. ~ r- -'\
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Uems 2446 must be completed by person me of Death
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24. 25. Data Prorrowlced (MOmh, day, y 26. Was Case Relerr to Metlical Examiner / Corwrer for a Reason Oche an Cremation a Donation?
wtw pronounces tleath. ~ (~ ~? ~~M. .~~ ^ Yes No
CAUSE OF DEATN (See Inetructiona and exa ) r Approximate interval: Pan II: Enter odrer ' 28. Did Tobacco Use CoMrNute Io Death?
Nam 27, Pan I: Enter me chain of events -diseases, injures, or comDUCaUOns - that directly caused the death. DO NOT terminal aVlmla such as cardiac artesi r Onset to Death but rxx rosultmg in the uMedying cause given in Pen I. ^ Yes ^ Pmba6ly
respiratory artesi, or ventricular fibnlWtian wUhoul strowing the erowgy. Usl oMy one cause an each line.
^ Pb [] Unknown
IMMEDIATE CAUSE (Fkul6sease or
in death)
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Due b (ar as a consequence o : NOt pregnant within past year
SequenUalh/ list conditions, it any, b, ('' 4/J I ~ ~ ~~ ~~ 1 ~ ~
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he cause
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ne a. Due b or as a can uence r
Enter lne UNDERLYING CAUSE ( ~ ~~ r Not
^ pregnenh but pregnant wimin 42 days
(rFsease or irqury met mitlaled me c i
events resulting m death) LAST. r of tleaM
Due m (or as a consequence otp. l ^ Not Dregnanl. but pregnant 43 days to 1 year
d ~ before death
^ Unknown if pregnant within the past year
30a. Was an Autopsy 30b. Ware Autopsy Findings 31. Manner of Death 32a. Data of Injury (Norm, day, year) 326. Describe How Inlury Oceurted 32c. Place of Injury: Home, Farm, Street, Factory,
Pedormed7 Available Prior to Campletbn n •~~ ^ ~miade Office Builtling, etc (Speaty)
of Cause of Deam? Wes'°'"'"'
^ Yes o ^Ves ^ No ^ ACCWenI ^ Pending Investigation 32d. 7me of Inlury 32e. Injury el Work? 321. If Transponalion Injury (Speciy) 32g. Locator of Injury lSlreel, dry I town, stale!
^ Suidde ^ Could Nol he Delertnined ^ Yes ^ No ^ Driver /Operator ^ Passenger ^ Pedestrian
M other ~ Speo'":
33a. Center (Neck Doty onej 336. Sg
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• Cerlltylnq physlgan (Physician ceni"ing cause of deem when another physidan has pronounced deem aM completed Item 23}
To me beat of my knowledge, death occumed due to the cause(s) end manner as slated_ _ _ _ _ ._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~' ~
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• PronounNng aM certltying phyalcian (Physican both pronaundng death and ceNtying to cause of death)
^ 33c. License Number
33d. 0 Sgned IMonIR day, year)
To the txat of my knowledge, death occurred at the time, date, end place, and due to the cause(s) and manner es stated., _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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On Nre bests of axaminatian and / or inveatlgadon, in my opinbn, death occured M the little, date, aM place, aM due to the cause(s) and manner as stated_ ^ 34 Name antl~q}d-d~ress of P~arson Who Completed Cause I Deelh Item 27) T / Pn
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35. Registrar
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Disposition Permit No. 0196065
O ~ -~3`f
LAST WILL AND TESTAMENT
OF
ROLAND R. TESNO
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I, ROLAND R. TESNO, now domiciled in Cumberland County, Pennsylvania, glare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum I have handwritten or signed, located with my will or with my valuable papers and
found within 30 days of the probate of my will. Gifts may only be to persons who survive me or
to organizations which exist at my death, and if there is a conflict, the memorandum having the
latest date shall govern. To the extent no such memorandum is found, or all of my tangible
personal property is not disposed of pursuant thereto, my tangible personal property shall be
added to my residuary estate and pass under Article IV hereof.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath as follows:
1. ONE-HALF (1/2) thereof unto my brother-in-law, CHARLES A. HORN, JR.,
of Higins, Pennsylvania. In the event that CHARLES A. HORN, JR. predeceases me or
fails to survive me by thirty (30) days, I give, devise, and bequeath his share to his wife,
SIDONIA LERCH HORN, of Higins, Pennsylvania, per stirpes.
2. ONE-HALF (1/2) thereof to be equally divided and distributed to my brothers
and sisters as follows:
1. ONE SHARE to DONALD F. TESNO, per stirpes;
2. THREE SHARES to EDITH M. TESNO, per capita;
3. ONE SHARE to JOANN TESNO MILLER, per stirpes; and
4. ONE SHARE to my nephew HAROLD W. TESNO, JR., per stirpes.
Article V
I nominate, constitute and appoint my nephew, COL. JOHN HORN, of Hegins,
Schuylkill County, Pennsylvania and my brother, DONALD F. TESNO, of Littlestown,
Pennsylvania, as Co-Executors of my Last Will and Testament. I direct that my Co-Executors be
permitted to serve without bond. In addition to those powers granted by law, I grant them power
2
to distribute in cash or in kind, in like or in unlike shares, and to file any qualified disclaimer I
could have filed if living. My Co-Executors shall receive reasonable compensation for services
rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Co-Executors, in their
absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any
beneficiary,
(fJ to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Co-Executors; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
3
(j) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF, I, ROLAND R. TESNO, hereby set my hand to this my Last
Will and Testament, on 1 ~a , 2007, at Harrisburg, Pennsylvania.
~~
ROLA D R. TESNO
In our presence, the above-named ROLAND R. TESNO signed this and declared this to
be his Last Will and Testament and now at his request, in his presence, and in the presence of
each other, we sign as witnesses.
Name
Address
2000 Linglestown Rd., Suite 202, Harrisburg PA 17110
2000 Linglestown Rd., Suite 202, Harrisburg PA 17110
I, ROLAND R. TESNO, Testator, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my
Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
ROLAND R. TESNO, the Testator
on S n~ R l 7 , 2007.
`~~ ~/~,
Notary Public f ~
CONMAONWEALTH OF PEI~13YlvAtaW
se~~
M~ea M. Kain, Nofa~y Pubic
6u~quN~erris Two., O~aupNin CauxY
My CannfiMion Expbes Atg.11,2010
~~~
ROLAND R. TESNO
4
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testator sign and execute this
instrument as his Will; that he signed and executed it willingly as his free and voluntary act for
the purposes therein expressed; that each of us in his sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or
more of age, of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to efore me
by t ~ e ~ ~(GLZrc l ;
and {Yly~ Ft„ti_ Q. Or.P~,~.nnn.
witnesses, on Fl~ u ! 7 , 2007.
c_ ~~j / ~ Gc..-
Notary Public .' //--
Witn ss
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COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Melissa M. ICain, Notaty P~lic
Susquehanna Twp., Dauphin County
My Commission Expires Aug.11,2010
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