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HomeMy WebLinkAbout06-25-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Earl F ALPAUGH also known as COUNTY, PENNSYLVANIA File Number 21-- V~ - ~~ ,Deceased Social Security Number 202-20-1373 Susan A ALPAUGH Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or '8' BELOW.•) ~X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the ~ Qc.y'~ ~ ~ named in the last Will of the Decedent, dated 05/29/2008 and codicil(s) dated ~„Q State relevant circumstances, e. g., renunciation, death of executor, etc. Except as follows, 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: no ner B. Grant of Letters of Administration app rca e, enter: c..a.; .n. c. t. a.; pe en a de; uran[s a senha; uranfe mrnordate Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Relationship Residence c7 f•~: -::~, -~) `" -; , c_._ - c`~ ._. ;- r' f ,~. .- ~~, (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. `,'i ' ^ ' Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal reside_rsce at `^ 7_I - _~ 201 South Penn Street, Shippensburg Borough, Cumberland County, Pennsylvania 17757 ,~ (List street address, town/city, township, county, state, zip code) .~ Decedent, then 79 years of age, died on 06/06/2008 Decedent at death owned property with estimated values as follows: (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania at Menno Haven, Chambersburg, Pennsylvania All personal property $ Personal property in Pennsylvania $ Personal property in County $ 60,000.00 situated as follows: 201 South Penn Street, Shippensburg, Cumberland County, Pennsylvania Wherefore, Petitioner(s) respectfully request(s) the probate of the last Wilf 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 Susan A ALPAUGH 6802 Rice Road ~~ ~ /~ ~ ~ Shippensburg, PA 17257 10,000.00 Form KW-UL Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } 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 befor e this /~~ day of Susan A ALIPAUGH Signature olPersonal Representative -, ~ r-~ r..~. he a -~ Signature of Personal Representative _ _.,r a c.._ ~.. ~~, ~, .. _ - ;,~~ / - - ~; File Number: 21-- C~~ - ~~~ . Estate of Earl F ALPAUGH _ , Dece~ed' • .~- Social S cu ity Number: 202-20-1373 AND NOW, ~ ~ ~ having been presented efore me, IT IS DECREED that Letters are hereby granted to Susan A ALPAUGH in the above estate and that the instrument(s) dated 05129/2008 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............................................ Short Certificate(s) ....................... $ (~ Renunciation(s) ....................... ... ' ~~/~(, TOTAL .................................... S' ~. ~(~ C,c~ ~ ~~~ ~~~ ~ Date of Death: 06/06/2008 ;' ~ ~ , in consideration of the foregoing Petition, satisfactory proof Testamentary Attorney Name: Forest N Myers Supreme Court I.D. No.: 18064 ~ Address: $ Telephone $ ~ ~~; $ ~ Law Office Forest N Myers 137 Park Pllace West Shippensburg, PA 17257-9212 717/532-9046 Form RW-O2 Rev. 10-f3-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Attorney Signature: ~- ~-- OCAL REGISTRAR'S CERTIFICATION OF DEATH ~ ,~- ~ ~~ WARNING: It is illegal to duplicate this copy by photostat oir photograph. Fee for this ce~rtificute. $6.00 i~ ~~ !~2::~55~~ Certification Number This is to certify that the information here given is correc~ay copied from an original Certificate of Death duly Filed with me as Local Registrar. 't'he original certificate will be forwarded to the State Vital Re • rds Ofi~ice ~ parr anent filing. ®~g ~~' Loc Ret;ish~ar `,~= Date Issued C-~ :_) ~ . ~~t: ~ ~- - ~_. ,. I -..., _ _ ~- c.r: ,.r.: , ,. ~.: _ , _ .. _,, _. - c ,;~ -- _ -} ; ;,.7 H105-1a3 aEV nnoos COMMONWEALTH OF PENNSYLVANfA • DEPARTMENT OF HEALTH • VITAL RECORDS -'7 -"'~ PERMANIENTN CERTIFICATE OF DEATH - ~ 81ncK INK (See instructions and examples on reverse) s7ATE FILE NuMeER I' ~ 1. Nance d Decedent IF'nst, mgNe. Iasi, sNya) 2. Sex 3. Social Security Number 4. Dale of Death IMOMh, day, year) Male 202 - 20 - 1373 June 6, 2008 Earl F. Alpaugh 5. Age (last Binrdey) Under 1 year Under 1 day 6. Dale of BIM (Month, tlay, year) 7. Binhplace (Gdy and stale a loreign country) 6e. place a Death (Check only are) Moars - pan nags M,rurea Hospital: Other. 79 Ya 6/24/28 Shippensburg, PA ^mpelient ^ER /Outpaliem ^DOa ®NUrsing Home ^Reskknce ^Other Specify • 8h. Counry of Death &. Cay. Bao, Twp. a Death lrcan Intlian, Black. White, etc, tb. Facility Name (It not mslaulion, give street end numder) 9. Was Decetlenf of /lapanw Orrypn? No ^Yes 10. Race: Ayme f i b C (SOOay ~ yes, spec ty u an, (I te ~lhi Franklin Chambersburg . Menno haven Mexican, PUeno Rlzn, etc.) 11. Decedents Usual Occu Ipn Kintl of work done tl most d world I9e. Do not slate retired 12. Was Decedent ever in the 13. Decedent's Etluralion (Speedy holy highest gratle canpleted) 14. Marital Status: Married, Never Marrretl. 16. Surviving Spouse (II wile, give maiden name) Divaced SSPea1Vl W~~ Kind d Work Kir~dd Business l l ep ' U.S. Nmed Forces? Elementary /Secondary (0.12) Cdlege It-4 or bi) 12 ever Married Inventory clerk Letterkenny rmy ^Yes [~No ~ 16. Decedem's Maaag Address (Street cityllown. stale, zip code) nt'a Penns lvania DM Decetlem y Live in a 17c Decedem Livetl in TwP ^Yes 201 S . Penn $ t . . , Actual Residence 17a. SWIe ~wnanrp? 17e.I~No,Decedemuveewnntn Shippensburg Cumberland Shippensburg, PA 17257 nb. counry Actual limits of Cdyl Boro 18. Fathei s Name SFlrsl, rretltlle, last, suaix) 19. Mother's Neme (First, mM61e, maiden surname) Alice Dunbar Eratus Alpaugh 20a. IMOrmam's Name (Type / Pnnt) 20b. Inlamanl's MaiNrg Atltlress (SlreeL cdl' / bwn, state, zip code) ShipperLSburg, PA 17257 6802 Rice Road Sue A. Alpaugh , 21a. Mdihotl of Dsposition ~ ^ Cremation ^ Dorration 216. Date of D•ISposieon (Month, day, year) 21c. Place of Disposiion (Name of cemetery, crematory or mhur place) 21tl Location ICily i town, stale, zip code) ensburgg hipp Burial ^ Removal from Slate ;Was CremNiona Donation AUthorked • 6 10 08 I / S rin Hill Cemeter p g y p PA 17257 umberldnd Ct. ^ Other-Sa ; i byMedic Examiner/Cororrer7 ^Yes^NO , 22a uneralService ' nactin such) 226. licenseNUmber 22c.NamearAArNNessolfaciNty Fogelsanger-Bricker Funeral Home, Inc. ~ PA 17257 Shippensburg FD-011776-L P Box 336 O ~ ,. , . , . Corrplete Items 23ec only when cer(Xyhg etl at the time, dale end place staled. ISgmta and tAle) cun 23a. To the beat of my knawetlge, death oc 23b. License Nu nber 23c. Dale Slgnetl (Month, day, year) physidan is rrot available al time a death to ~ ^ ~2 {~- O~ .e-- ~n~ E Qy~ ~1 ~7~ ~~ ~3 ~~ L ~~_ 4 oL G7L7 cenay rouse of death. . . ~ erson t ce let 126 d M 24. Trme of Death nth, day, year) 25. Date Pronounced Deetl (Mo J 26. Was Case Referretl 1 edical Examiner I Coroner for a Reason Other than Cremation or Donation? e p Hems 2 mus cenp ~j 7 v ~ {~ / L x ~ ~ O~ ^Yes No who goncum:es death. • M. -- . - y O CAUSE OF DEATH Sao Instrue ons antl examples) , •lpptoxlmele irderval'. Pad II'. Eller other ~icant mrA0 ors cortnbNmglo tl~M, 26. Did Tobacco Use Conldbuie io Death? Item 27. Pan r. Enter the chain of events - eseases, injuries, or complicaliars - that &eMly roused the death. DO NOT enter lertninal events such as cardac artesl, Orrsel to Death but trot resuking in the untledymg rouse given in Pan I. ^Yes ^ Probaey respaatory anesl, or ventricular liaillation wahoul showing the etiology tat only orre cause on each Noe. ^ No ^ Unknown IMMEDIATE CAUSE 'fFinal daease or c ~ /y~~ w r cmdewn resulting in death) a ~ , I'YnA vy n r V i~ \~Yb ,5 I S _ (~ dTYI l C ~ ~ N (~NM r \~DYL l ~ O.1'iCll'C. 29. II Female: ^ N ast nt withi ea t ._~ , Due to (or as a consequence I / ~ ~ pregna n p y r o ^ Pregnant at time of tlealh Sequentially list cu dlrons, it any, b L17 c IU7l my y2t,~• . leatling to the cause listed on fine a. f ' '--~~- ^ Not pegnanl, but pregnant within 42 days Due to (or as a consequence o i . Enter the UNDERLYING CAUSE of deaRr (~iseese or injury That Initiated the ~ c ems resuAnrg in death) LAST r ^ Not pregnant, but pregnant 43 days l0 1 year Due m for as a consequence a): belore tleath d. ^ Unknown fI pregnant wllhln the past year 30a. Was an Autopsy 30b. Were AuloDsy Findings 61 Death 31 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occwred 32c. Place I Injury, Home, Farm, Street, Factory, Ofbce Building, etc. (Speedy) Pedormetl? Available Frror to Compalion of Cause nt Deelh? . Natural ^ Homalde ^Acddenl ^Pendirg lnvesligalron 32d. Time of lryury 32e. Injury el Work? 321. II Transponmbn Jury (Speedy) 37y. Location of lrrjury {Street, cilyllown, slate) ^Yes No ^Yes ^NO ^ Suicitle ^ Could Not be Determined ^Yes ^ No ^Driver/Operator ^Passerger ^Petleslilan M ^Other - Specily; 33a. Ceniller (check ary one) 33D. Sipnalure Tilk CRnllrer • Cenilying physician (Physician cenilying cause of death when another physician has prorwurlcetl death anU crompleled Item 23) death occurred tlue to the caUSe(s) end menrrer es slaletl_ _ _ _ _ ., _ _ _ _ _ _ _ _ _ _ ~ _ _ _ _ _ _ .. _ _ _ _ _ _ _ _ _ knowled e To the best or m , ~ ~ g . y ng physician (Phy.'~ an bah prmouncing demh and cedlfying to cause o1 death) eWr tl l 33c Llcerne Number 33tl. Date Sued {MOnlly day, year) ~ ye y dge, death occurte at the time, date, a1M phce, antl rlue to the cause(s) antl manner es slaletl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ To the best of m S~ ~ ~ Cj ! ,S ~ ~O Q l E i /C C:D ~ _ l0 "~ U oroner • Medica xam ner On the oasis of examinati rid / or investigation, i opi , n, Eeath accurretl at the time, sate, antl place, and due to the cause{s) and manner as staed_ ^ 34 Narrw. and Address of Persat Who Cornyleled Cause m Death (Item 77) Type /Print 35. Registrar's Slgnaturea Dislr her / ~~ f ~ ~!~1 3g. ale Filed( onlh, day, year) Dr. Antonia Chadwick Chambersburg, PA 17201 435 Phoenix Dr. ~ ! , { ~- ~ ~ Disposition Permit No. O~ / ~-6 L S F-....: ~_ ' ~ ( - ~_ , I, EARL F. ALPAUGH, of Shippensburg Borough, Cumberland County, Petifii~ylvara+~, revoke my prior wills and declare this to be my Last Will: , '~~~ Lti. _; .. iJ ~ .r FIRST: PAYMENT OF EXPENSES - I direct that the expense of my last illness and funeral be paid from my estate as soon as may conveniently be done. SECOND: BEQUEST - I give, devise and bequeath the following sums to the following named persons: 1. The sum of Two Thousand Dollars ($2,000.00) to ALICE ALPAUGH; 2. The sum of Two Thousand Dollars ($2,000.00) to TERRY Y~DUTZ; 3. The sum of Two Thousand Dollars ($2,000.00) to VANCE 1'OUTZ; 4. The sum of One Thousand Five Hundred Dollars ($1,500.00) to NANCY SWOPE; 5. The sum of One Thousand Dollars ($1,000.00) to KAY FLOWERS; 6. The sum of One Thousand Dollars ($1,000.00) to JOANNE FLOWERS. THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and remainder of my estate unto SUSAN ALPAUGH, to dispose of as she wishes. FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be (i) assignable to a beneficiary or (ii) available to anyone having a claim against a beneficiary. FIFTH: DEATH TAXES -All federal, estate and other death taxes payak~le on the property forming my gross estate, whether or not it passes under this will, shall Ise paid out of the principal of my probate estate just as if they were my debts, and none ~~f those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment of federal estate tax purposes. SIXTH: MANAGEMENT PROVISIONS - I authorize my Executrix, as fi~llows: A. Retain/Invest: To retain and to invest in all forms of real est~ite and personal property, including common trust funds, mutual funds and money market deposit accounts and certificates of deposit, regardless of any limitations imposed by law on investments by executors or any principle of law concerning imrestment diversification; B. Compromise: To compromise claims and to abandon any property which, in my Executrix's opinion, is of little or no value; C. Borrow: To borrow from and to sell property to others, and to pledge property as security for repayment of any funds borrowed; D. Sell/Lease: To sell at pubic or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales of leases; E. Capital Changes: To join in any merger, reorganization, voi:ing-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; F. Distribute: To distribute in kind and to allocate specific assE~ts among the beneficiaries (including any custodian hereunder) in such proportions as my Trustee may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all property at any time held by my Executrix or my Trustee and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be in addition to those granted by law and shall be exercisable without court authorization. SEVENTH: EXECUTOR - I appoint SUSAN ALPAUGH, Executor of my Will. Neither my Executrix, nor any successor shall be required to give bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 29`h day of MAY, 2008. ~'-l/ (SEAL) ARL LPAU H Te r In our pr sence, the above-named Testator signed this and declared it to be his will, and now, at hi r uest nd in his esence and in the presence of each other, we sign as witnesses: 2 STATE OE PENNSYLVANIA COUNTY OF CUMBERLAND . SS I, EARL F. ALPAUGH, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Will, and that I signed it as my freE~d voluntary act for the purposes therein expressed. ,%, ~~ ~~~~ We, EARL F. ALPAUGH, the Testator in and the undersigned witnesses to the Will, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that I, the Testator, do hereby acknowledge that I signed the instrument as my Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the Testator sign and execute the instrument as his Wil{, that he signed it willingly and 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 knowled ,the Testator was at that time eighteen or more years of age, of sound mind and under n c nstraint or undue influence. i~ /i ~ / / / F. Hess Witness Subscribed, sworn to or affirmed, and acknowledged before me by the above-named Testator and by the witnesses whose names appear on this 29`"day of MAY, 2008. .~ Note Public CUi ~ E P Notarial5ea~ public Forest N. MYB a• F°~kltn County Shl burg Bo 19,2009 My pny~i~lon E~cPires Dec•