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HomeMy WebLinkAbout07-08-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF L~u,~~sr.e't.Q•yt~ COUNTY, PENNSYLVANIA Estate of i///~'C-/~//fl ~- /=~ c yt~ also known as File Number Deceased Social Security Number Z~ ~ 3~ .~ y9~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) Ll A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the last Will of the Decedent dated ~~Tg^i U ~' and codicil(s) dated named in the (State relevant circwnstances, e.g., rersunciatiors, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after for probate, was not the victim of a killing and was never adjudicated an incapacitated person:- ^ B. Grant of Letters of Administration -t `. J co - `- i ~ instt tment(s)iof_~ere_d T1 t ~_: y~ flD C^ - G 7> ~~ ~ (lfappticable, enter: c.t.n.: d.b.n.c.t.a.; pertdente lire; durance absentia; durtt~lq minoritaie~j . -r 'u iV Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if anted' nd heirs: (!f Administration, c. r. a. or d.b.n.c.r.a., enter date of Will in Section A above and complete list of heirs.) Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in ~-UH/3cc`/Z G.5 N~ County, Pennsylvania with '.his /her last principal residence at GL ADZ(? Mr7>,i~% NuiZS:~G c'r?mss-/~}r~ iovc~ C~ARc.yc.vf FZD C•or2c~scC !~~ /7a1.3 -- (List sheet address, town/city, township, count), state, zip code) Decedent, then ~7 years of age, died on .529 ~OQ at CGA.2G HG+..!/' N/.~'S~.yG L' ~h/-,/i9/3 r Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal propecty $ ~~ ~ C7f~ ' ~ V (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in Count} $ Value of real estate in Pennsylvania $ situated as toll 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: ~ Si~nauire Tvped or printed name and residence ~ ~ ;'~ I ~jaaMeS H ~GO~//~ -7O"73 C.9.~Lisc.~; ~i/c'c: ~,j G/~RL/.SL.E ~/J l7~'%5 Form RW-OZ rev. !0.13.06 Pabe I Of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COLNTY OF L.U H.3G2L/d N/~ SS The Petitioner(s) above-named swear(s) or affirn~(s) that the statements in the foregoing Petition are tine and coned 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 ~~~y .~ _ For the Register S~a re ojPersonal Repres nt rive Signnture of Personal Representative __ 0 f r ' -~ ~3 ~ ~ ~~, ,. ~3 SiSnature of Personal Representative 7~C~ ~~ _3...1 File Number: ~ ~' ©~' ~~ Estate of /i~ZG/~/~ '-3 G~v~O Social Security Number: Z ~~ -3'2 ~ `~~`~ Deceased Date of Death: S~~ ~ /O S' ~ C . - .: ~ r; ~- ~ ~._:~+ ..- } N W AND NOW, \~~--~ ~ > ~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to in the above estate and that the instrument(s) dated ----- described in the Petition be admitted to probate and filed of record as the` last Will (and Codicil(s)) of Decedent. FEES ~.~~Qt,C~+~. ~1f_~,1( S.%~~~~1~1..~ ~~r L1~Q.`m Z ~~ .~ ~ Rego ter of Wilt; d Zs•~ Q~. Letters ..... .\, ...... $ ham" Short Certificate(s) ....~:.. $ • L~ Attorney Signature: Renunciation(s) ..... \~ ; 11 ..... $ $ ~~~ `~ Attorney Name: ~ ~ ... $ ~~• ~~~ Supreme Court LD. No.: ~l~C'~ ... $ S • tv~ $ Address: ... $ ... $ ... $ • • • $ Telephone: ... $_ L• ~ ~' TOTAL ........ L ...... $ x ~ m Form RW-0? rev. 10.13.0( Page 2 of 2 (In..n~.~l~ re~~. ,~~,; This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 195_3. Military Status ;;Z - H105-143 REV 11/2006 TYPE /PRINT IN PERMANENT BLACK INK I 0 WARNING: It is illegal to duplicate this copy by photostat or photograph. ~~~~ ~ enp~~~ Calvin B. Johnson, M.D., M.P.H. - Frank Yeropoli Secretary of Health State Registrar 141~~-~d No. JUN 1022008 Date COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (~ (~ {^~'7 (See instructions and examples on reverse) STATE FILE NUMBER ~ 1 . j 7 ]{ • / / 1. Name of Decedent IRrsL mitldle, bsl, suRix) 2. Sea 3. Social $ecurky Nambel 4. Date of Death (Month, day, year) Virginia B. Floyd F 265 - 32 - 24 5 29 2008 5. Age (Lass BrtMtlaY) UMer 1 year Under 1 day fi. Date o1 Berth {MOMn, da ,year) ], aAngxe (Cly and state a breign country) 6a. Place of Death (Check only one) name pays Han MIaRa Hospital: goer 87 vrs 3/31/1921 Clermont, FL ^Inpauern ^ER/outpd~m ^DOa ®NpramgHpme ^Reaidente ^omer-speedy: 60. County d Deafn tk. City, Boro. Twp. d Death 6d. Fatlary Name (II not institution, give street entl number) 9. Wes Decetlenl of HolBanic Odgin? [~ No ^ Vas 10. Pace: American Intlian, Beetle, While, ek. Ut yes, specify Cuban, (SpecH~ Gtiunberland Middlesex 'Itnm. Clar~nt Nursin & Rehab. Center Neaten, Puerto Rican. Btcl r. vviy1te 11. Decetlenl's Usual l]ccu apn Klntl of work d one tlu - moll of vrorkin life. Do nd slate retired 12. Was Decedent aver M the 13. Decetlenl's Etlut~lgn (SpedTy only highest gretle comp leted) 14. Mantel Status: Memetl, Never Maenad, 15. Surviving Spo use III wile, give maitlan name) KiM d Wo4c Nind of Busness /Industry U 5. Armed Fortes? Elementary /Secondary (412) College 11 ~4 or Sv) VAdowetl. Divorced (Speci!}d Registered Nurse Medical ®Yea ^Np 2 Widowed 16. Decedents Mai6rg Adtlress (Sheet, cM /town, sUte, zip cotla) Decedent's PA DIO Dacetlenl Decadent rived k, Middlesex yl~. Twp we 1]a state uee m a 1]t area Acual Reaitl 7073 Carlisle Pike #95 , . , er r wnahip? Carlisle PA 17015 ,]b Cpunry Cumberland vd.^ Np, Decoded Dvea wenb , Actual Lonils d City I lhro 16. Fadwi s Name (Post. mkldle, last, suXix) 19. Mdhei s Name (First, middle, maiden sumama) Richard - Bronson Reba KE>rn 20a. Inbtmad's Name (type 1 Print) 20b. InlomlanYs Mailing Address (SIreN, city /lows, slate, Lp wde) James M. Flo d 1' s P' PA 21 a. Memotl d Daposilon ~Cremalbn ^ Donalan 21 b. Dr»a of Disposition (MOntn, day, year) 21c. Race d Dispositon (Name d cemBlery, crematory or oMer place) 21 d. Lacatbn (City /town, slate, zip code) ^ Banal ^ Removal from Stele :,' Wtl Cremetlon a Donetlbn Atdhorized ^ q„ar.spBdy: bYMaMp.LExeminer,croon«? Yea^Np 5 31j2008 brans Cremation. Services Leola, PA 22a. Sgnature d F S 'ce Licensee (or per actin ass 22b. License Number 22c. Name entl AtltlresS of Fetillty f FD 012633 L Ekvin Brothers Funeral Htx~e Inc. Carlisle PA 17013 Camel pnty when rodilprg 23a. To the best of my know ,dean occurtetl at dre time, tlale aM pbce stated. (SigneNre erg Nle) 23b. Lcense Number 23c. Dale Signed (Month, day, year) Amy tatuse d deml~e at ama m dealn 10 1 IRms 2646 must be corrylete0 bV pers^n 2d. Time d Deelh 2 Date Pranwroatl Deatl (Mmlh, day, year) 26. Was Case Reterretl o ical Examiner /Coroner for a Reew ghat lha Cremation or Donation? who Pronarcaz death. L} ~ P, M. M ~ z C ZC C ^ Yas CAUSE OF DEATH (Sae inatraactiona entl examples) t Approx mate interval: Part I I: Enter other 5ipntl'rld wMNons contribuda to aaetn, 28. Db Tobacco Use ConMbule to Death? Item 2J. van I. Enter Me dta., e~ - tllwasBS, injuries, or complcaeons -that tlirectly causetl Vre dBaM. DO NOT mler tertnirtal evenLS such az prtliac artesl, Onset tp Deao Cut rot rewtting in ho Intlenybg Wusa given in Pen I. ^ Yes ^ Prabady rsspirslay anesl, a vadncular libdlaton without slowing dre etbbgy List only one cause an each line. ^ No ^ Unknown IMMEDIATE CAUSE Firel tlisazsa or wrreibonrewlnngin~eeth, --~ u9wat~~-tu-~ 14~eae,ri' Sa.,tun. a. 29.Lf~„a~e~. ^ Dua to (JJ a~;, a aqua t): r Not Pregnant wahin pall Year ^ pregnant e!(ane of death Sequentially list condkons, if any, b. I"~ L~ ~r CL~-rl ' '~' kaangg to Ne cause IbtBd on hoe a. Due to or a `Jn r S EnterhW UNDERI.YINC CAUSE ( az equenceof. ^ Nd Pregnant, but pregnam witnin d2 eays la~sease a injury Ina! ineialed the 5 rewain in deem) LAST t of OeeN g . Due to (or az a consequence oF): ^ NBI pregnant, but pregnan143 days l0 1 year d. before tleeth ^ Unknown I1 pregnant wiNm gte peal year 30e. Was an Autopsy 3W. Were Adopsy RrgFgs 31. Mannar of Death 32a. Dale d Inpry (Month, day, year) 32b. Desmbe How bNry l]ccunetl 32c. Race W Injury: Home, Farm, SaeeL Factory, Pedortnetl? AvaAabo Prier to Completion d Cause of Death? r.f ~rbrUO Natural ^ Hdnlcide OAke Builditg, etc. (Spxity) ^ Yes ~ ^ Yes ^ No ^ Acaded ^ Pentling Investgatpn 320. Tme of Injury 32e. Injury at WoMn 32(. If Tmnspodadm Injury (Soedly) 32g. Laotian d Injury (Street, ciy /town, slate) ^ Sdx:itla ^ Ceuo Nat be DHerminetl ^ Yes ^ No ^ OMer! Operator ^ Passenger ^Petles4ian M ^gher- svaciy: 33a. Cedifier (check mly one) 7Jb. Signature end Idle of Cartitier • Csrtllying physlelan (Pnysirlan ceNtying cause 01 tleeth when another physician nos pronouncetl deaM entl wmpletetl Item 23) Ta the beat at mY krrowletlge, deaM occurred due loth eauadal end manrmr es sated_________________________________ r ~ •/ ~ L- • ProMUmMg ant ceM1Hying phyaklen {Physician both pronouncing tleeth arM cediying to cause of tleeth) ^ 33c. Licerae Number _ 33d. Dale Signed (Month, day, year) Te the beat of my krroWktlge, deem occuretl at the time, tlete, and place, entl tlua to the caufele) entl manner ae ala4ad_ _ _ _ _ _ . MetlbN Examiner, Carorev ------ /•~ V<;~~LJ7 !~'~ ~ ~l'`°' On the bests o1 examinatlon eM / or Investigation, In my opinion, tleeth apunetl at IhO lime, date, entl place, entl due to Ma cauaela) entl manner as afeted_ ^ y Name egg A~u~ o/ eersoo bhp Complrted Cawe o f dam Item 2]) Type /Print } ~ A p t 1 Re ignature anQrQlst. pludhe r (v y,~ ~ V \ F l L 36. Date Filed (Month, day, year) n ~ p : W t r•t J W .V ` r W C ' p e ~_ ~~ D ~~ ~ ~ ~ ~ ~ ~ ~ b ~ tIIr NN ` C l \ ~ k - Q rl rS Cs c ,hu. (-~r~~ _ Diappaapn Permit Np ©a ~ I I `Z ~ c o o - ~ t ~; ~ ~ ., x 1 ~ ~. ] -- ~ C _- )~ _ 7~. ~ , ~ "3 "~- _ 'j , l ~ G? LAST WILL AND TESTAMENT I, VIRGINIA B. FLOYD, of Osceola County, Florida, make this, my LAST WILL A~ c~ TESTAMENT, and revoke all prior Wills and Codicils. ` ~o ~ .. `'° -;-, c. , . -, ~_ r--- ARTICLE I-IDENTIFICATION-FAMILY MEMBERS '~ ~;~ _, r, c~ __ .-~ ,`~~~ 1.1 Child or Children. ~j=r-, ~ ;, _.:~ I have one (1) child, JAMES M. FLOYD. All references in this will to my "gild" " ar~o ` ~" r said named child. ARTICLE II-DEBTS AND EXPENSES 2.1 Debts and Expenses. I direct my Personal Representative to pay my funeral expenses, my medical expenses, the costs of administration, including ancillary, and such of my enforceable debts, other than those secured by property specifically devised under this Will or secured by property passing outside of this Will as my Personal Representative, with sole discretion, determines shall be paid. ARTICLE III-SPECIFIC GIFTS 3.1 Personal Effects. I devise all my clothing, jewelry, personal effects, furniture, furnishings, household effects, automobiles, boats and other tangible personal property (other than money), including insurance policies thereon, in accordance with a written list or memorandum, which I may have executed and which is in existence at the time of my death. In the event of any conflict between such memorandum and any subsequent such memorandum, this Will, or any Codicil to this Will, then as to such conflict the provisions of the last executed document shall prevail. My Personal Representative shall conclude no written memorandum or list exists if none is found within 60 days after admission of this Will to probate. ARTICLE IV-RESIDUE 4.1 Residue. All the residue of my estate shall be distributed to my son, JAMES M. FLOYD, presently residing in Carlisle, Pennsylvania, or to his issue in equal shares, per stirpes. ARTICLE V-FIDUCIARY APPOINTMENTS 5.1 Fiduciary Appointments. I appoint my son, JAMES M. FLOYD, to be Personal Representative under this my Will. No Personal Representative shall be required to furnish bond or other security in any jurisdiction. Page 1 of my Last Will and Testament '~ ~ ~~ ~ ARTICLE VI-ADMINISTRATIVE PROVISIONS 6. L Taxes. I direct that all estate, inheritance or other death taxes (including interest and penalties, if any) payable under the laws of any jurisdiction by reason of my death, whether or not the property generating such taxes passes under this Will or any Codicil (other than any generation- skipping transfer tax, tax on property over which I have a power of appointment, or tax imposed on qualified terminable interest property, which taxes are to be paid according to applicable law or from said property), shall be paid out of my residuary estate, without contribution, reimbursement or apportionment. 6.2 Beneficiaries Under Age 21. (a) If a beneficiary under age twenty-one (21) becomes absolutely entitled to any property, such property shall immediately vest in such beneficiary. The fiduciary in its discretion may distribute the property directly to the beneficiary, directly in payment of the debts or expenses of such beneficiary, to the Guardian of the person or property of such beneficiary, the parent or parents of such beneficiary, to a custodian for such beneficiary under a Uniform Transfers to Minors Act, to any other person who shall have the care and custody of the person of such beneficiary, or to the Personal Representative named in this Will. If property is distributed to the Personal Representative, the Personal Representative shall hold the property as a separate trust for the benefit of the beneficiary and shall pay to or apply for his or her benefit all the net income and so much of the principal at any time and from time to time. as the Personal Representative with sole discretion believes advisable to provide adequately for the beneficiary's health, maintenance, education and support in reasonable comfort. (b) All funds not paid to or applied for the beneficiary in accordance with Section 6.2(a) shall be paid to the beneficiary at age twenty-one (21) or to the beneficiary's Personal Representative in the event of the beneficiary's death prior to age twenty-one (21). Upon obtaining a receipt from the person to whom distribution is made, the Personal Representative shall be relieved of any further obligations with respect to the property distributed. ARTICLE VII-FIDUCIARY POWERS 7.1 Fiduciary Powers. My Personal Representative (including any substitute or successor Personal Representative) shall have the following powers, in addition to, and not in limitation of, those powers under F.S. § 733.612, or similar provision of subsequent law: to (a) invest, reinvest and retain, abandon assets as long as shall seem prudent, without restriction to investments authorized by law; (b) sell, convey, exchange, mortgage, lease or otherwise dispose of all or any part of my property, real or personal, at public or private sale, for such prices and upon such terms and in such manner as such fiduciary may deem advisable (c) receive the proceeds, rents, issues, incomes and profits Page 2 of my Last Will and Testament there from; (d) borrow money from themselves or others; (e) employ and compensate custodians, accountants, attorneys and other agents; (f) register securities or other property, real or personal in nominee or bearer form; (g) liquidate or compromise any and all claims due to or by my estate; (h) make distributions of such property in cash or kind or partly in each, in divided or undivided interests; (i) exercise federal tax elections under the Internal Revenue Code, with or without making compensation among beneficiaries; (j) retain and manage any business; (k) account to adults; (1) pay Personal Representative's commissions and attorney's fees on account; and (m) execute and deliver necessary instruments and give full receipts and discharges. ARTICLE VIII-DEFINITIONS 8.1 Definitions. References in this Will to "descendant" or "descendants" shall mean child, children, and issue, whether born or adopted before or after execution of this Will, provided that any adoptee is under the age of eighteen (18) years at the time of adoption. The singular shall be deemed to include the plural, the masculine the feminine, and vice versa. Headings and captions are for reference only. IN WITNESS WHEREOF, I have subscribed my name and atlixed my seal to this my Will at New Smyrna Beach, Florida, thiss~ay of January 2006. al) IR NIA B. FLOYD We certify that the above instrument was on the date thereof signed and declared by VIRGINIA B. FLOYD, as her Will in our presence, and that we, in her presence and in the presence of each other, have signed our names as witnesses thereto, believing VIRGINIA B. FLOYD to be of sound mind at the time of signing. ~~ Of 610 N. Peninsula Avenue W. M. Gillespie New Smyrna Beach, Florida 32169 G~ of ~p ~~~.~ w ~~ 3~-i~ ~ STATE OF FLORIDA ) COUNTY OF VOLUSIA) We, the undersigned, being the Testatrix and witnesses, respectively, whose names are signed to the foregoing instrument, and having been sworn, do hereby declare to the undersigned officer Page 3 of my Last Will and Testament ~_~~ that the Testatrix, in the presence of witnesses, signed the instrument as the Testatrix's Will, that the Testatrix signed willingly; and that each of the witnesses, in the presence of the Testatrix and in the presence of each other, signed the Will as a witness. ' ~ •! VIRGI IA B. FLOYD ~~~~~ WITNESS Q' WITNESS Subscribed and sworn. to before me by VIRGINIA B. FLOYD, the Testatrix, and by W. M. Gilles ie, and /~~i¢. ~ C~.4~d~ the witnesses, on thi ~#~ p~ ~ s~ day of January 2006, all of who personally appea ed before me. VIRGINIA B. FLOYD, the Testatrix, ~ is personally known to me or has produced identification. I personally know W. M. Gillespie, a witness, and Q ~ ~ f~-~ t~~~Z/ , a witness. N tart' Public, State of Florida Identification produced: _ Drivers License Other: THIS INSTRUMENT PREPARED BY: William M. Gillespie, Attorney at I,aw 233 North Causeways P.O. Box 580 New Smyrna Beach, FL 32170 17 ,,.p. ~~~ ~'t MYCOMI~ da F. Plett~e r. ~ ~ ~1~2~ w~RCD ~~P~`• eoN~o October 1~ 2007 TNRU TROY FAM RVSURANCE, LNG Page 4 of my Last Will and Testament ~ (,~