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HomeMy WebLinkAbout06-19-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of CARL S. MC DERMOND File Number ~ ~ ~ ~ ~ lf~~~d also lrnown as Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or 'B' BELOW.) Social Security Number 204-03-9391 ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EXECUTOR last Will of the Decedent dated 08-13-2002 and codicil(s) dated named in the (State relevant circumstances, e.g., remotciation, death of executor, etc.) Except as foilows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ^ B. Grant of Letters of Adminstraiion (Ifapplicable, enter: c.t.ar db.n.c.t.a; pendente life; durante absentia; durance minoritate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Wilk and was survived by the following spouse (if any~and heirs: (If Administration, c.t.a. or db.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ ,.---'. c~ :..:_ ~ Name Relationshi R' ~ ~-- ' -,_ , _; r~ ._ ,... , ~ r -~J „i~ - (COMPLETE W ALL CASES.) Attach additional sheets if necessary. _ ~'' ;~ I}ecedent was domiciled at death in CUMBERLAND Coun Penns lvania with his /her last ~~ -~ ! ty, y princip~'residence at ~ 2189 NEWVILLE ROAD CARLISLE PA 17015 (List .street address, town/city, township, county, state, zip code) ~~~~ then 91 years of age, died on MAY 29, 2008 ~ CUMBERLAND COUNTY Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 6,000.00 (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 foilows: Wherefore, Petitioner(s) respectfully requests} 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: l f~ c___` ~!' ~ 1 I LYNNETTE C. LEWIS, 28 E. YELLOW BREECHES ROAD, CARLISLE, PA 17015 Form Rw-02 rev. IO.I3.06 Page 1 of 2 Oath of Fersonal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS 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 well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the /~ day of e r the Register ,~ ~~. " of Persona! Representative ~_~ Signature of Personal Represemative `_ ~) ~ c~ - =T7 ~ Signature of Personal Representative - r-~ o_, ~y ~. _~ ~-_ =~ 1 ~ ~ blQ ~ =~ c3 File Number: ~ ~> t7 Estate of CARL S. MC DERMOND ,Deceased z ,_ -, ~~ -i Social Security Number: 204-03-9391 Date of Death: AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented befo me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to LYNNETTE C. LEWIS in the above estate and that the instrument(s) dated 08-13-2002 described in the Petition be admitted to probate and filed of record FEES Letters ......~Q. c O() $ Short Certificate(s) .. ~.... $ a Renunciation) ....~...... $ ur- _ ~. ... $ a ... $ .~ _ ... $ ... $ ... $ ... $ _ ... $ _ ... $ 'TOTAL .............. $ e~ O:tld'--~ Supreme Court LD. No.: 22080 Address: i IItVINE ROW CARLISLE, PA 17013 Telephone: 717-249-7780 Fw~ Rw o2 rev. 10.13.06 Page 2 of 2 Attorney Name: WILLIAM A. DUNCAN 05.805 REV (01/0'7) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ee for this certificate, $6.00 P 14!28986 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death 3uly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Etecords Office for permanent filing. ~1. F'e~-~..c~.~~.s~lce•~~y 2/ 2ooa Local Registrar Date Issued H10S113 REV 1121108 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPEI PRINT IN PERMANENT CERTIFICATE OF DEATH t~^ BLACK INK See instructions and exam lee on reverse ~ ~ ~~ ~ 6 11J~!!~ t p ~ STATE FILE NUMBER 1. Name d Decedent (FesL naadk, last sufixl 2. Sex 3. Social Sewdy Number 4. Date d Deem (Hoorn, deY. Year) Carl S. McDermond male 204 _ 03 - 9391 May 29, 2008 s. Age Ilam BiMaay) under t year u«kr f day s. Dare d ann (Hama, day, year) ?. r~rtnaaa (coy and meta «loreign mow) ea. Plata of Deem (cneok Dory one) 91 """"w °"` "w"' """" tlospilal: omen Yrs. October 23, 1916 Cumberland Co., PA ^/ ^ER/OUWatlenl ^DOA ^NUrdrg Home [Residence ^om«-Spadty: _ Bb. Ccunly d Death 8c. Gy, B«o, Twp. d Deem Bd. FadNy Name (11 ml nstilutbn, give sheet aM lam6er) 9. Was Decedent of Hispanic Origin? ~] No ^ Vas 10. Race: Amenran Indian, Bkd. Whke, ek. Cumberland W Pennsboro Tw tlryea,apenhycwan, Ispa«M White 2189 Newville Rd . p • . Mexican, Puerto Rkan, etc.) 11. Decedents Usum goo ICmd d w«k done duri most d life. 0o rat slate re' 12. Was Decetlenl ever in th 13. Decedent's EMralion (Spacity any highest grade mmpieled) 14. Madml Scotus: Marred, Never Married, 75. SurvNing Spouse Ilf wde, 9Na maiden name) Div«cetl (Specify) ~~ Widowed Kira d Ku,d d Buekwas / Telephone"~"~o. AssignmentMept. , V.S. Amad Forces? Elamemary 7 Secantlery (0.12) Cotlege (1d or 5+) ^y~ ~g~ 12 Married Helen Foster rB.De~a~ M~gApte.st y k,zlpaadel V i '~ Decetlenre DaDerredem W. Pennsboro PA Uva in a 17c ®ras Derseem uvatl m Twp S J.le 1CQ . i5Y 1V ew G Carlisle PA 17013 . , . AcWal Residence na. late Liveawana , Cumberland T°"'"e"'p' nd.^ ~De~d „b ~, d . Y city/~ 18. FamergName (Fxm, mitlQ@ Iqg, su6n) Ose C ermOnd 1g. Homers Name (RmL middle, maiden wrreme) Pearl Kennedy 20a. Iniomanr's Name (Type! Pnnll bg /~1re~ ($neet, alyjmwn. code z4 cotlel 20b. Irdogryyr a ~ Carlisle PA 17015 ow 1Sreaches Rd. LL2L5S Telll I,ynnette Lewis . , . _ 21 a. Mmhp1 d Dkposilbn i ^ CremaBOn ^ Donation 21b, Date of DispasMron (Marini, deY. Yom) 27c Place d DLspositian (Name d cemdery, aremm«y «om« place) Big Spring Presbyterian Cemetery 21d. Location (City / town, dde zip code) Newv>_lle pA [Band ^ Renaud lmm sale ~wr cremdkn«D«rdan ANhorised ^ June 2, 2008 ^ gher. MHedkd Exerdrl«yCoroner7 ^vas No 27a. FunemlSe i« aangaewch) 224.LiceneeNamber 22c.NemeandAtldressolFadhty Hoffman-Roth Funeral Home & Crematory 138504 Carlisle PA 17013 Hanover St 219 N • ~ ., . Manic 23a<any 23a. Tome bed of my kmaMtlpe, tleem oa coed d au time, date aM place coaled. (SigreWre eM title) 23b. Liceree Number 23c. Date Signed (Month, Oay, year) ptryskkn k not avdldae d d tleem ro txNly c«we d tle9tll. • Memo 2428 must be conpleted M parson 24, Time d Deem 25. Date Pi«aurcwd Oesd (Momh, day, year) 28. Was Case Relanetl ro Metlkel Examiner / Comrler hx a Reason Omer then Cremation or Donation? wnapr«xxxaeseeeth 12:15 pm M. May 29, 2008 ^Y~ ®~ CAUSE OF DEATH (Sae Instructions anal ezamples) r Approx'vnare nlervd: Pan 11: Enr« dh« ' 2& Did Tobacco Use Comnhde ro Deem? Item ZY. Pan I: Erser me dun d events- 6seasea, injuries, «compfazti«u -met dkectly reused me deem. DO NOT em« terminal evade such as cardiac arrest, ~ ored ro Deem but rat resdmg n the uMadymig cause given In Pan I. ^ Yes ^ Probably mspiretory erred. «venekukr IiMitletbn wawN showing the eadogy. List oNy aru cause an each 6ne. ~'(go ^ Unknown ,,! /}~ IMMEDIATE CAUSE (Fxrd tlisease « ~~t,,N~n~ ,~~-~r-F~- 7 ,~ r/S ~ / " ' ~ mndtan msdtirq n deem) -~ a 29. M Female: ^ Nd snn ) l Duero (« as a consequence oQ: ~ ; Sequentldty lid con9lians, g any. b pas year pregren w ^ Pregnant at lima d seam _ Iea~q ro me uuee riled an irre e. 1 Due to (« as a conseQuence oq: r ^ N« pregnant, bd pregrwm wbhn 42 days Ed« me UNDERLYNIG CAUSE r (finesse or iMury tlut eatleted du c d deem , wrenk reaukng n deem) UST. Due 10 (« ae a C«ISegUerlae On: ^ Not plep'wnt, but pregnanl43 tlaYS to 1 year Oel«e de0m d w ^ Unknaam M lxagrwnl wimm me Pea Year . 30a. Wee an Adapsy 3JJ. Were Aukpey F'krdrgs 31. Manner d Deem 32a Date d In'ryry (Marini, day, year) 32b, Dasaae Haw Injury Occurred 32c. Place d Irlyay: Homo, Falco, Shed, Factory. OMke Butldng, ero. (Sp«wy) Perkvnud7 Aveikbb Prior to CoroPkticn d Cause d Deam7 ~~~ ^ Fronkdtle ^ ACidenl ^ Penang Irnestigetkn 32d.'f d hryury 32e. In)ury at Work? 321. M Trensporktion Injury (Spedly) 32g Lacafion d Injury (Sired, dry I town, sbta) ^ Vim, [!.~NO [] Yes [~ No ^ Sukide ^ ColAO Nd be Detertnnatl ^ Yes ^ ~ ^ Odver I Operaror ^ Passe«3er ^P H Om« ~ Spenry: 33a. CwMfier lahedc ooh' anal 33b. SigrwWre and TAIe o ,(/~ • CMNYing phyekkn (Physawn cedMykp cause d deem when arrotAer physkkn has pmra«aed deem and conpleted Item 231 _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ death occurred tlw to the cause(s) and manner es sktetl knowl d e fl t d b - /,/ \ ~•0 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g , u my e 7o ea • Pnaouneing end ceAHying phyaklan (Physkien hom Waauncin9 deem and ceralpng to cause d dedh) _ _ _ _ _ _ _ To tlw bed d my krawtetlge, deem escorted d the Ume, tote, and plare, and due to the cause(s) aM manner ac date4. _ _ _ _ _. _ _ _ _ ^ ~. Cleanse Num r ~~/~V ~ /(i> 1i fj 33d. Date Sign (Marini, deY, year) y ~/ ? fF Z~~ 'r'O ((/JJJ ./ • Aletlksl Examiner/C«ormt ro the cause(s) and manner as afafed_ ^ e On the bask d examination antl I «Inveetigation, in my opinion, aem occurred et the time, dde, entl place, eM tlu s~ Pevsc WM o syyyuuu~271Jyge,/ Prat 34. Name and A / rr/aI/Ie/k~d7Cau ~~gs ~ C ?-C% f ~ ;Rag aWre era 4llQcl / ~ ~ ~t ia~ ` ~ ~ ` ~ ~ Dare Fiktl (Monet. deY.Y~r1 H / ~ Y / /X !7'~'j f' ~,..p ~ ~(,. '(L C•;N f~/" (~j+~~,gL ( e.A1: lJ p , Okpositicn Perme No. \ 1 c~~`~ L L I ~ ` 6~$ b~lS?~ ~..~ C7 -, Q ~,~ c_. _ ,~ ~~ ,_., , ---, ~ ` J ,- -. LAST WILL AND TESTAMENT _t{ _, I, CARL S. McDERMOND, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as maybe done conveniently after my decease. 2. I authorize and empower my executrix to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature situate to my wife, HELEN F. McDERMOND, providing she shall survive me by sixty days. 4. Should the gift in Paragraph No. 3 not take effect, I devise and bequeath all of my estate of every nature and wherever situate as follows: (a) I give certain items of personal property according to a list left with my substitute executrix. (b) 50% of the residue is to be divided equally between LYNNETTE C. LEWIS, LAURI ANN SHERIFF and JAMIE L. KELLY, share and share alike. If LYNETTE predeceases me, her share shall go to LAURI ANN and JAMIE. If either LAURI ANN or JAMIE predecease me, their share shall go to their children, share and share alike. (c) 25% of the residue is to be divided equally between CARLEE HAHN and CORY HAHN, share and share alike, but to beheld in Trust by MANUFACTURERS AND TRADERS TRUST COMPANY, of Carlisle, Pennsylvania. (d) 25% of the residue is to be divided equally between SHAUNA KELLY, BRADY KELLY, SIDNEY ERIN KELLY and KYLIE KELLY, share and share alike, but to be held in Trust by MANUFACTURERS AND TRADERS TRUST COMPANY of Carlisle, Pennsylvania, until they reach the age of eighteen (18) years and then the funds are to be used for their education, and any remainder is to be distributed to them upon completion of their education. 5. I nominate and appoint HELEN F. McDERMOND to be the executrix of this my Last Will and Testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for an reason, or die leaving any of my estate unadministered, I 2 nominate and appoint LYNETTE C. LEWIS as substitute executrix, also to serve as such without bond, with the same powers as are given herein to my executrix. 6. I hereby suggest that my personal representative retain the services of Irwin, McKnight &: Hughes as attorneys in the settlement of my estate IN WITNESS WHEREOF, I have hereunto set my hand and seal this i3 / day of August, 2002. ~ SEAL) CARL S. McDERMOND Signed, sealed, published and declared by CARL S. McDERMOND, the testator above- named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. 3 ACg1VOWLEDGEMENTRND AFFIDAVIT WE, CARL S. McDERMOND, MARTHA L. NOEL and JACQUELINE L. D:RAWBAUGH, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by CARL S. McDERMOND, the testator, and subscribed and sworn to before me by MARTHA L. NOEL and JACQUELINE L. DRAWBAUGH, witnesses, this ~ 3 ~ day of August, 2002. ~. Notary Public Notarial Seal Roger B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Oct. 3, 2004 M~111b9r, R91MIbyA W NOf J ~L r, ~/~ CARL S. McDERMOND a 1 0~0~01~2 RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of CARL S. MC DERMOND Deceased I, HELEN F. MC DERMOND , in my capacity/relationship as (Print Name) EXECUTRIX of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to LYNNETTE C. LEWIS D to ~l ~''®~ (~te~ Executed in Register's Office Sworn to or affirmed and subscribed before me this day of. o ~, ignatnre) ~ 2189 NEWVILLE ROAD (Street Address) CARLISLE, PA 17013 (city, State. ztp) Executed out of Register's Office Before the undersigned personally appeazed the party executing this renunciation and certified that he or she executed the renuncia~yon for the purposes stated wi in on this l "6 ~ day of t,~~~6 , Deputy for Register of Wills 1 ~~` it 1 ~'LI ~Q ~~r ~ ~ ! ~~~~ ~17i~~" Form RW-06 rev. 10.13.06 ~ : °.. ., 1'~otazy Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Nota~' Commission.} OigWEALTH Q~ PENNSY<_VA ~~ NOTARIAL SEAL ,LOAN D. ADAMS, PJotary Publir, Carlisle Boro., Cumberland County Commission Expires March 7, 2J11