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HomeMy WebLinkAbout06-18-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Esta4e of Seymour Cyrus Sorge also known as COUNTY, PENNSYLVANIA File Number C~' ~ r'X~,~11 l ~ ~ ~~ Deceased Social Security Number 089-03-7477 Robrrt F. Young, Esquire Petitioner(s), who isJare 18 years of age or older, apply(ies) for: (COIPLETE '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 January 15, 2007 and codicil(s) dated N/A named in the (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ j r~ _.. _ n t~ {ra Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of tlut instrument offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: No Exceptions _~_ - ~ - -i--r °~_ B. Grant of Letters of Administration '~~ `~ (tfapplicable, enter: c. t. a.; d.b.n.c.t.a.; pendente life; durante absentia; durante~r3inDritate~.,,• - __} ~• , Petitioners} after a proper search has !have ascertained that Decedent left no Will and was survived by the followin~~o~tse (if an~t~nd heirs: (/f. Administration, c. t. a. ord. b. n. c.t.a., enter date of Will in Section A above and complete list of heirs.) - , Q Name Relationshi Residence •`'' (COMPLETE lNALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at ] 102 Tiverton Road, Mechanicsbure, Hampden Township, Cumberland County Pennsylvania 17050 (List street address, town/city, township, county, state, zip code) Decedent, then 91 years of age, died on June 11, 2008 at Harrisburg Hospital, City of HamsburR, Dauphin County, Pennsylvania Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 300,000.00 (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 follows: Form RW=02 rev. 10.13.06 Page 1 of 2 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 apuropriate form to Oath of Personal Representative CO;YIMONWEALTH OF PENNSYLVANIA f ,, ,, SS ~;~~7.7 i9 i?,3 ~ ~i ~;~.~• Q ~ COI;JNTY OF "The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true~d`cptr~`r„~ ~ ;tih~st of _~ , the ]cnowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitionef(s~ will welt aired trtily~?.i administer the estate according to law. Sworn to or affirmed and subscribed be ore me the I ~~ day of ~~ F • the Register Signature of Personal Representative Signature of Personal Representative File Numbers= 7~ Estate of Seymour Cyrus Sorge ,Deceased Social Security Number: 089-03-7477 Date of Death: June 11, 2008 AND NOW, ~~ (;~ (,~ /'-~t~( )) ~_. , 01~ , in consideration of the foregoing Petition, satisfactory proof having been presented before , IT REED that Letters Testamentary are hE;reby granted to Robert F. Young, Esquire in the above estate and that the instrument(s) dated January 15, 2007 described in the Petition be admitted to probate and filed of FEES Letters ............... $ ~~ ~' ~ Short Certificate(s) ........ $ ~~~ Renunciation(s) .......... $ ~,~~... $ IS,by ... $ 1U t~ .. $ ~•~ ... $ ... $ ... $ ... $ ... $ _ ... $ TOTAL ...........:.. $ , ' . ~se- as the last Will (and Codicil(s)) of Register of Wills ' y "' Attorney Signature: ~ -/ Attorney Name: Elizabeth P. Mull gh, Esqutr Supreme Court LD. No.: 76397 Address: McNees Wallace & Nurick LLC 100 Pine Street, PO Box 1166 Harrisburg, PA 17108-1166 Telephone: (717) 232-8000 Form R6i! 02 rev, 10.13.06 Page 2 of 2 ~' ~~ S Ca LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. F'ee ftu- this cerlit-ic,ut_ 50.(10 REV 17/2006 PRINT IN 4ANENT ".K INK P 1~~ ~~ G X36 Certificiatios) tiLV»her This is to certify that the information here gi~~en i'. correctly copied t'rom an original Certificate of Dean duly filed ~~~ith me as Local Registrar. The origina certificate ~',~ill be forwarded to the State Vita Records Officc for permanent filing. LG~ ~ ~ J~U~ 1 1 008 Local Registrar Date Issued r.:, c~ !'1 ce J i~J `,i = ~ ~ - . -~-. { ~ '- ~~ •.~\ --{ } _- / - .-_ _~ .. 41.1 '. - ~ ~' COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ CERTIFICATE OF DEATH (See instructions and examples on reverse) „_.__ _.. _ ..... ___ 7. Name of Decedent (Frst middle, last, suRlx) 2 Sex 3. Social Security Number 4. pat of Death (MOnlh, tlay, ye r) Seymour Cyrus Sorge Male Ogg - 03 - 7477 /J ,'~ ~l' S. Age (Last Birthday) Untler 1 ear Under 1 day 6. Date of Binh (Month, day, year) 7. Birthplace (City antl stale or foreign coumry) Ba. Place of Death (Check only one) ~~ blooms Deus Iwvs Minmes Hospital. Other ~ 91 Yra February 25 ,1917 Tannersvi lie NY . , Inpatient ^ ER /Outpatient ^ DOA ^ Nursing Home ^ Residence ^Other specify. 8b. County of Death 6c. City, Boro, Twp. of Death 6tl. Facilk Name (If not instautan, give street and number) 9. Was Decadent of Hispanic Origins ~ No ^ Ves 10 Race Ame i I di Bl . . r n can an, ack, Whne, etc. (If yes, specify Cuban, IspeciM Dau his Harrisburgp Harrisbur Hos ital P b g P Me i P R x can, uerto MZn, etc.) White 1t. Decedents Usual Occu lion (Kind of work done tlurin most of workin tile. Do not slate retiretl 12. Was Decedent ever In the 13. Decedent's Education (Specity only highest grade completed) 14. Marital Status: Married Never Married, 76. Surviving spouse (11 wile give maiden name) , . A Kind of WOrk Kind ol8usiness! Industry U.S rmetl Foroes? Elementary! Secondary (0-12) College (1-4 or 5.) Widowed, Dlvorcetl (Specify r y 7 Automobile dealer Self LQ{ves ^Nn 12 Divorced 76. Decedent's Mailing Adtlress (Street city! sown, state, zip code) Decedent's Did Decedent Hampden Pa Live in Aquat Residence 77a Stal ~ 1102 Tiverton Road Mechanicsburg,Pa 17050 . e a ,7c [ Yea,DecedemLrvedin Twp Cumberland Taws ,hip? t7b c°unly "d ^ n~ °~mesoii"adwi'h'n a ary / Boro 16. Father's Name (Flrsl, middle. last suaixl 19. blather's Name (First mitltlle, maiden surname) Max Sore Rose Barban 20a. IntormanYs Neme (Type (Print) 206- Informant's Mailing Adtlress (Street, city /town, state, zip code) Robert Young 1102 Tiverton Road Mechanicsburg,Pa 17050 27 a. Method of Disposition ~ ^ Cremator ^ Donation 21 b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory a other place] 21d. Location (City I sown, stale. zip cone) [,~ Burial ^ Removal from Slate i, Was Crematbn or llonatbn Author{zed ^ Olher~ iry~ byMeaicalExamlrrer/Coroner? ^yes^NO June 13 2008 Mt Hebron cemeter Flushing,NY gnature of eras Service Licensee rson ing as such] 22b. License Number 22c. Name antl Address bl Facility • - 011654-L Myers-Horner Funeral Home Inc 1903 Market St.Camp Hill, Pa 17011 Complete ems 23a-c only when cenitying 23a. To the best of my knowled e, tleath , sate a pia tared. (Signature and 1i11e1 23b. License Numoer 23c. Date Signed (MOntn. day. year ) physician is not available al lime of death to - cen6y cause of death. ^-~ ~'-S / G~ .~~ ~- /~ ~vG~ Items 24.26 must be completed by person who pronounces Beam 2a. Time of Death ~ ..v ~ 26. Date Pronounce d (MOnlh, day, year] 7 / / ~ 2fi. Was Case Referred to Metlical Examiner /Coroner for a Reason Other than Cremation or Donation? . M, / r , v y ^Yes ~No CAUSE OF DEATH (See instructions and exa es) r Approximate interval: Item 27. Part I: Enter the chain of ev nE 1,5 -diseases, injuries, or complications -That directly caused the death DO star terminal events such as cardiac enact r Pad II: Enter other 5(gni6cant condifons contdbutino to death, ' 26. Did Tobago Use Contribute to Death? _ . , Onset to Death respiratory arrest, or ventrkular fibrillafion wkhoul showing the etidogy List only one cause on each I' r but n°t resulli n the u~a n9' Rymg cause given in Pad I. Y ^ es ^ Probably j t- t ',~ ~ ^ Unknown IMMEDIATE CAUSE (Foal disease or ~- ~ ~ ~ / cond6pn resulting in death) ~~ a J L, S/ ( t La ~ G/ /~ 29. If Female: / i , ~f , b ) ~ / / / Due to (or as a consequence of): r ^ Not pregnant withkl past year Sequentially list mnditions, A any, b ~ kadrg 1° the cause listed on line a. /f~' ~ ~/~~~a L ^ Pragnanl at time of tleam Due to or as a consequence o Enter the UNDERLYING CAUSE ( R ~ ' ^ N°I pregnant, out pregnant within 42 days (disease or injury Nat inbiafetl the c. ~ events resulting m death) LAST. r of tleath Due to or as a cons uence of P. ( ~ I Not a ant, but r ^ pr gn p egnanl 43 days to 1 year d. ~ t i ^ Uo known If pregnanl within the pall year 30a. Was an AWOpsy P n d 306. Were Putopsy Findings P il A C 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Deuribe How Injury Occurted 32c. Place of Injury. Home. Farts Street Facto ry orme e va able rior to ompletion ~ Natural ^ Homicide , . Office Building, etc. (Specify) of Cause of Death? ^ Yea ®'klo ^ 'les ~ No ^ Acddent ^ Pending Investigation 32tl. Time of Injury 32e. Injury at Work? 321. If Tmnsponatgn Inlury (SpecityJ 32g. Location of Injury (Street, city /sown, stale) 3uiciUe ^ ^ Gouts Not De Determined ^ Ves ^ No ^ Dmer l Operator ^ Passenger ^ PedesMan M ^Other ~ Speply: 33a. CertAier (check Dory one) 33b. Sgnature antl T e of Ce ~' • Certitying physician (Physician cemlying cause of death when arwther physician has prorauncad death and completed Item 23) To the best of my knowletlde, tleath occurred due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ „ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ P i d - <'a~ e • rorwunc ng an cenitying physician (Physician both pronouncing deaM and cenifyirg to cause of death) To the hest of my knowled death occurred at the time e date and lace and d e to M d d ^ 33c. Livens ber 33d. to Signed (Month, day, year) 4~ g , , p , , e cause(s) an u manner as state _ _ ., _ _ _ _ _ _ _ _ _ _ _ _ _ .. _ • Medical Examiner I Coroner ~ `/riC ~ ~ .- ~ /y/,1 ~ n ~ On the basis of examination antl / or investigation, in my opinion, death occurred at the time, tlete, and place, and due to the cause(s) and manner as statetl_ ^ . , (, 4 VV 3n Name and 0.dtl ss of Person Who Compteled Cause of Death (Item 7/3 i Print Registrar's Si- ~/Dis { I ~ I ! I ~ I , ~ I 36 Date f letl ( nth, day, year) ~ S' ,~ A'i1'1 /~~~~~~ ) / //~ .~,~j/~ Disposlion Pernul No. ~~/ /~j _._. _~ ,_ LAST WILL AND TESTAMENT OF ~r~j ~~";' f ~ ~; r ~. ~~ Seymour Cyrus Sorge I, Seymour Cyrus Sorge, a resident of Las Vegas, Clark County, Ne4'~d~ being oi: sounc~.,4 and disposing mind and memory and over the age of eighteen (18) years or having been lawfully married or a member of the armed forces of the United States or a member of an auxiliary of the armed forces of the United States or a member of the maritime service of the United States, and not being actuated by any duress, menace, fraud, mistake, or undue influence, do make, publish, and declare this to be my last Will, hereby expressly revoking all Wills and Codicils previously made by me. I. EXECUTOR: I appoint Robert F. Young, Esquire, of Harrisburg, Pennsylvania, to serve as Executor of this my Last Will and Testament and provide if this Executor is unable or unwilling to serve then I appoint Richard S. Young of Middletown, Delaware as alternate Executor. My Executor shall be authorized to carry out all provisions of this Will and pay my just debts, obligations and funeral expenses. II. SIMULTANEOUS DEATH OF BENEFICIARY: If any beneficiary of this Will, including any beneficiary of any trust established by this Will shall die within 60 days of my death or prior to the distribution of my estate, I hereby declare that I shall be deemed to have survived such person. III. BEQUESTS: I will, give, and bequeath unto the persons named below, if he or she survives me, the Property described below: Name: Cornell University, School of Veterinary Medicine Address: Ithaca, NY Relationship: none (My poodle Ruby was treated by them many years ago) Property: One Thousand Dollars ($1,000.00) Name: Benjamin "Barney" Barton Address: Darien, Connecticut Relationship: Son Property: Twenty-five Thousand Dollars ($25,000.00) If a named beneficiary to this Will predeceases me, the bequest to such person shall lapse, and the property shall pass under the other provisions of this Will. If I do not possess or own any property listed above on the date of my death, the bequest of that property shall lapse. IV. ALL REMAINING PROPERTY; RESIDUARY CLAUSE: I give, devise, and bequeath all of the rest, residue, and remainder of my estate, of whatever kind and character, and wherever located, equally to my nephews Robert Frank Young of Harrisburg, Pennsylvania and Richard Sorge Young of Middletown, Delaware, provided that one or both survives me. If neither survives me, then I give, devise, and bequeath all of the rest, residue, and remainder of my estate, of whatever kind and character, and wherever located, equally to the estates of Robert Frank Young and Richard Sorge Young as alternate. V. ADDITIONAL POWERS OF THE EXECUTOR: My Executor shall have the following additional powers with respect to my estate, to be exercised from time to time at my Executor's discretion without further license or order of any court. ___o -~ ~,, VI. WAIVER OF BOND, INVENTORY, ACCOUNTING, REPORTING AND APPROVAL: My Executor and alternate Executor shall serve without any bond, and I hereby waive the necessity of preparing or filing any inventory, accounting, appraisal, reporting, approvals or final appraisement of my estate. I direct that no expert appraisal be made of my estate unless required by law. VII. OPTIONAL PROVISIONS: I have placed my initials next to the provisions below that I adopt as part of this Will. Any unmarked provision is not adopted by me and is not a part of this Will. beneficiary to this Will is indebted to me at the time of my death, and the ~ beneficiary evidences this debt by a valid Promissory Note payable to me, then such person's portion of my estate shall be diminished by the amount of such debt. ~~=~~ny and all debts of my estate shall first be paid from my residuary estate. Any debts on any real property bequeathed in this Will shall be assumed by the person to receive ch real property and not paid by my Executor. ~f I desire to be buried in the Mount Hebron cemetery in Flushing, New York. VIII. CONSTRUCTION: The term "testator" as used in this Will is deemed to include me as Testator or Testatrix. The pronouns used in this Wi!! shall include, where appropriate, either gender or both, singular and plural. IX. SEVERABILITY AND SURVIVAL: If any part of this Will is declared invalid, illegal, or inoperative for any reason, it is my intent that the remaining parts shall be effective and fully operative, and that any Court so interpreting this Will and any provision in it construe in favor of survival. IN WITNESS WHEREOF, !, Seymour Cyrus Sorg h eby set my hand to this last Will, on each page of which I have placed my initials, on this day of January, 2007 at 2121 East Charlestown Rd. Las Ve as Clark Coun State o Nevada. 9 tY, Seymour Cyrus Sorge , ' .~ %_- 2121 East Charlestown Rd Las Vegas, Nevada i' rl /~/ V [Signature of Testator] [Printed or typed name of Testator] [Address of Testator, Line 1] [Address of Testator, Line 2] [Signature of Witness #1] [Printed or typed name of Witness #1 ] [Address of Witness #1, Line 1] [Address of Witness #1, Line 2] 1~ the testator and the witnesses respectively, whose names are signed to the attached instrument in those capacities, personally appearing before the undersigned authority and first being duly sworn, do hereby declare to the undersigned authority under penalty of perjury that the testator declared, signed, and executed the instrument as his/her last will; he/she signed it willingly or willingly directed another to sign for him/her; he/she executed it as his/her free and voluntary act for the purposes therein expressed; and each of the witnesses, at the request of the testator, in his or her hearing and presence, and in the presence of each other, signed the will as witness and that to the est of his or her knowledge the testator was at that time eighteen (18) years of age or older, /~~und mind,and under no constraint or undue influence. ~~ ~~ °~ f ;z,~c~t-~-~ ice'---J [Signature of Witness #2] ..,v - ,F,~'G~ [Printed or typed name of Witness #2] C' Nf °/ - ~ ~ ~,~ ' _ w~ [Address of Witness #2, Line 1 ] Lr)S P~-~- s itl/" ~~~ ~ ~~-- [Address of Witness #2, Line 2] ~ ~ a r ,i ~~ .X [Signature of Witness #3] t'~ r c ,ter - ~~,.~ - [Printed or typed name of Witness #3] ~' ,. `. ~ [Address of Witness #3, Line 1 ] a a t ~ , ~ !~; ; ~.'~, ! ' [Address of Witness #3, Line 2] Subscribed, sworn, and acknowledge before me, 32~~~ ~" p0/ ~~ , a notary public, by ~ier,~ ~J'p,Cy e ,the testator, and by and the witnesses, this ~~ ~ day of [NOTARIAL SEAL] ~~,~u,•; ~ = ti,,.: , Mate o! ;v.~~_.. " ~ `,,~~anty of Clark .~ , `~~3a~CE E. ALLEN JR. ;! holy Appoinhroent ~7r::W a'v^n~~/ a ,-:.:ter:-,..-®-:i~r~_-.. rr .~ ~f' ~ ~~ County of r L- My Commission Expires: ~~~s ` l81 ~ OG 7' _.~ ~~~ ~~ .~' WITNESSES The foregoing instrument, consisting of ~ pages, including this page, was signed in our presence by Seymour Cyrus Sorge and declared by him to be his last Will. We, at the request and in the presence of him and in the presence of each other, have subscribed our names below as witnesses. We declare that we are of sound mind and of the proper age to witness a will, that to the best of our knowledge the testator is of the age of majority, or is otherwise legally competent to make a will, and appears of sound mind and under no undue influence or con Int. Under penalty of perjury, we declare these statements are true and correct on this r day of January, 2007 at 2121 East Charleston, Las Vegas, Clark County, State of Nevada. [Signature of Witness #1] [Printed or typed name of Witness #1] [Address of Witness #1, Line 1] [Address of Witness #1, Line 2] . r,. °~ >- f ~c. ,~ {. ~J„i~_-!,C ~ f t?r,~ ,, [Signature of Witness #2] "~„,,~,~,~ / ,lc-,~'Lr [Printed or typed name of Witness #2] =.~i3~ 6~. C'y,-l~l/~Si~.~ %~w:~ [Address of Witness #2, Line 1] L_.~ ~ ~~~~% / ~~ ~ ° ~ [Address of Witness #2, Line 2] r, .n . ,~ ~! ( ~ ~~ [Signature of Witness #3] l~~ G N irl'~ ~ S ~''+'~ [Printed or typed name of Witness #3] l - 1 j~rfr~ ~ ~ ~( //)) [Address of Witness #3, Line 1] j; ~4 ~ ~ jJ ~ ~: ~~ ~' ~U~) ~ ~ "t ~ ~~ [Address of W fitness #3, Line 2] - - - -Optional Self-Proving Affidavit Form - - - - (Note: The grey box below is not a part of the Affidavit and is included for informational purposes only. You should not include it as part of the Affidavit.) About this Self-Proving Affidavit Form: Although aSelf-Proving Affidavit is not a requirement in the State of Nevada, it is an excellent idea to sign one when executing a Will. It can greatly reduce the difficulty associated with probating the Will when the time comes. The testator, along with three witnesses, must sign the Affidavit together in the presence of a notary public. The Affidavit is then attached to the Will. Its basic purpose is to affirm that the Will is that of the testator and that the will was signed and witnessed in accordance with all applicable state requirements. To make aself-proving Will, a testator should follow this procedure: (1) The testator should sign the Will in the presence of the witnesses and have the witnesses sign as well; (2) A notary public should be present at the time the Will is signed by the testator, together with all the • ~-~ ---••~~+~ tho hlank Salf-Prnvinn Affir~avit fnrm hPlnw to tha L _ _ r __ Estate of OATH OF SUBSCRIBING WITNES r J ~^ r±I _ ~':, _ , ~ . REGISTER OF WILLS COUNTY, PENNSYLVANIA rr~ ~. 4- (Print Name/s) the~Will ^ Codicil(s) presented herewith, (each) Deceased (each) a subscribing witness to qualified according to law, depose(s) and say(s) that she /they was were present and saw the above estator /Testatrix sign the same ,and that she / he / hey ~~ signed the same and that she / e / hey signed as a witness at the request of in ~r / is presence and in the presence of each other. (Signature) 1(~ v ~ ~ ~ y~er-f~ /dry .-, (S reef Address) ~~~~ ~ l ~ ~~ ~ ~ ~~ (City, State, Zip) /~©~~ Executed in Register's Office Sworn to or affirmed and subscribed before me- his ~~~ day of , ~~~ (Street Address) (City, State, Zip) Executed ot~t of Register's Office Sworn to or affirmed and subscribed before me this of day Deputy-#~or Re ist~r of Wills // Notary Public E/ My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Fonn RW-03 rev. 10.13.06