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HomeMy WebLinkAbout06-12-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Mary G WALTERS also known as COUNTY, PENNSYLVANIA _ File Number 01 ~ - ~~ ' ~~~ 3 ,Deceased Social Security Number 175-03-1413 Stacy Lee Lynch Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or B' BELOW.) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executrix named in the last Will of the Decedent, dated 06/30/1997 and codicil(s) dated 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: B. Grant of Letters of Administration r`' 0 app rca e, enter: c.t.a.; .n.c..a.; pe ente rte; urante a sentra; urante mrnorrtate ~~ ; ~ pp Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spoTj~j(if any) a~helrs ('ff Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) , .-~ -o C ? f ~+7 ~ <_~~ _? ~ r"- .; rn ,: ~. Name Relationship Residence .= ; ~ N -- ' --t -~ U ~ ~ ~-~~-7 _} ~- ~ '.Jc t:~.J _. ,-, .+'} -"'t (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 45 Carla Drive, Shippensburg (List street address, town/city, township, county, state, zip code) Decedent, then $9 years of age, died on 04/23/2008 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 Manorcare Health Services All personal property Personal property in Pennsylvania Personal property in County situated as follows: 40,000.00 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 Lee Lynch 43 Peach Orchard Road Newville, PA 17241 -491-4299 Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 IOi.B(IS HC-,~~ t01/07i a' _oY ~ ~~ ~,/~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ~ 14235327 Certification Number H105~143 REV 11/2006 TYPE / PRIM IN PERMANENT BLACK INN ,0 l~ 3 S ri 0 This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Record, Office for permanent filing. Q` K ~~ ~ v al Registrar „ Date Issued C'7 t ~ ~ - C ~ 4~ --; w~ ~ ' ) r ~ ~-~ _ ~ _ ~. ~. -: Si N _J`1 r~ 7 _ .,~~ ., ~ '~z . COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~-~ ~~ JY' c- ~ r' ~ CERTIFICATE OF DEATH -p _•'i '• See instructions and exam lee on reverse P 1 STATE FILE NUI~ER .Z' - 1, Name M Decedent (First, middle, last, suffix) 2. Sex 3. Sadal Security Number 4. Date of Death (Month, ,year) Mary G. Walters Female 175 - 03 - 1413 April 23, 2008 5. Age (Last Sintday) Under 1 year Under 1 day 6. Dale of Binh (Month, my, er) 7. Bklhplece (Chy ant slate or loreign ceunlry) Sa. Place M Death (Chede only one) "~^~ an '~"' "1108 etterkenny Twp. Hoapitar. aner 89 Yrs. Jll 1 7 19 1 $ ^ Inpatient ^ ER / Oulpelient ^ DOA Nursing Fbme ^ Residence ^aher -Specify: Bb. Canty M Death &. Chy, 6oro, Twp. m Death !ro. Facilhy Neme (h ml hnthulion, give street ant mmiber) 9. Was Decedent of Fiepank Origin? ®No ^ Yes 10. Race: Arrpricar~ Indian, Slack, Whne, ero. - (If yes, specity Cuban, Franklin Chambersbur Manorcare Health Services MexiCen,PUertoRicen,etc.) ite 11. Decedent's Usual Goo Kind M wok done most of wo ' 0e. lb nd slate retired 12. Was Decedent ever in the 13. Decedent's Education (Speedy only highest grade completed) 74. Marital Status: Monied, Never ManleQ 15. SurvNing Spouse (II wile, give maiden name) ~d (~M Kind of Work Kind of Susiwss / IMUStrY U.S. Armed FaInces? Elementary ! 1Se 2 dory (0.12) College (1-4 or 5+) WldOwed Payroll Cleric Shbg. School Dist. ^vea y_I No Is.De~eaenraMauMgafdress~sreat.ary/wwn,xata.ziP~de) DeceaenYa Penns lvania W °~~M ~Cj Southampton y 17c Decetleltl Lived in Tw Yes 45 Carla Dr1Ve p. . , Actual Resitlerce 17e. sate T01V0SNp? Shippensburg, PA 17257 t7d.^NO, Decedent LNed waNn Cumberland 1n. conMr Adual Lirri15 o1 ciry/Sorn 18. falheis Name (First, midge, lest, suAivt Mme q rcpt mM~tnaMe 19. ghrONOa (Fl . J OhnSOR) Clarence J. Gayman 20a. IMormanYs Name (Type /Prim) 20b. /Moment's Mailig Address (Street, city I town, state, zip code) Stacy L. Lynch 45 Carla Drive, Shippensburg, PA 17257 21a. Method d Deposition ^ Crematim ^ Doneaon 21b. Dale M Dispceitlon (Month, daY. Year) 21c. Place M aspcehbn (Name d cemHery, crematory a other place) 21d L pigcMbnpleay /SO vy n. =u gzq wde) Settle 11 D ~] Bartel ^ Removal from Stale Wes Cremation or Donation ANlwrced • ^ ~,. Y. ; by Gs.mlrter/Cororer? ^ras^Na 4/29/08 Spring Hill Cemetery , Cumberland Ct. ,PA 17257 22x. MFUnerel Se (or rson as such) 22b. Lirense Number 22c. Name and AdbessMFerdlily Fogel Sanger-Br1C er Funeral Home, Inc. _ ~ 4~ FD-011776-L P.O. Box 336, Shippensburg, PA 17257 Cortplele Items 23a<oNy when cenilying 23a. To are best of my , death aauned al the line, date ant p6are slated. (SgnaWre and alley 23b. License Number 23c. Dale Signed (Month, day, year) plgsician a nM availede at time of bead, to p, ~N 2 L Z Q ceMly cause d deaN. (} , • hems 2446 must be cernPletetl by person 24. Time M Death 25. Dale P Dee/d~(Month, day, year) ~2 ~f p 26. Was Case Refer~re~d/t dial Examhrer / Coroner fa a Reason r Nan remalbn or Donatbn? ,' who Draauwes death. f~• ~ ~I'Yl M. ,/-~ 1`1 I ~ 72 L~CJ ^Y~ ltd'"v CAUSE OF DEATH (See instructions end eaemples) ~ Approximate interval: Pan IC Eller oNer sim~ I cend'dions contnbMiw to death, 28. Did Tabeoco Use Cemnbule to DeaN? Item 27. Pan I: Eller Ure Ma'n M events- dseases, iyunes, w cernplirations - that diredN caused Ve deaN. DO NO7 emer IennFal evems such es ceMec anesL r Oreel ro Death but nd resuheg wt the urderyeg cause given n Pen I. ^ Yes ^ Prdebly respirelory arrest, or venldwlar tixihMion wilhoN showing Sw etiobgy. lal only one cause on each Ina. ~ ^ No ^ lh4mown r I dsease ar ' Q ~ U$E IF~ a A ~ u A~ ' 29.11 Female: h ,, . l i on r es rg de ) -~ a Y1'lQ~~ . fNLX~ ^ . Due b a e consequence oQ~ ~~ '"`~ i j c ~~ }~ L[/ SequeMiaNy list ceriddabra, it any, b ~ G ~ No, pragraM within past year ^ PmpeM M ame of tleaN . le b the cause listed on hoe a. d): t con¢equ Due lofpr as a r ^ NM pregianl, M Pregnant wi1Nn 42 days ~ ~ ~ i Eller Ne UNDEflLYING CAUSE (disease or injury Thal Miliated the c. 1/11~1Y/lJ'K~l ' M deaN events resulting m demh) LAST. d ^ NM pregmM, bM pregnant 43 days b 1 year ): Duero (or as a consequexe belae death d. ~ r ^ Unknovm A pregnant whNn Ne past year 30a. Was an ANapsy 30b. Were Autopsy Findings 31. Ma JM Dee1h 32x. DMe of Iryury (Month, day, year) 32b. Descrbe How Injury Occurtetl 32c. Place of I :Home, Fartn, Sreel, Fedory, OXic S o'/ ~ ~ Perbrmed? Aveilade Prbr to Conpletim d Cause of Death? Natural ^ Homidtle e M Y) ~ ( . ^ Accident ^ Pendeg Inveslgation 32tl. Tine M Injury 32e. Inyury at Work? 321. II Trarnponagon Injury ISPr. rYl 32g. Lucalbn d Inlury (Sleet, dly I bwn, stale) ^ Yes No ^ Yes ^ No ^ Suicide ^ CauM NM be Detemined ^ Yes ^ No ^ Ddver /Operator ^ Passenger ^Pedeslnan M ^aher spealy: 33x, Certifier (check oMy one) 33b. Sgrelure end TA M e Tiler ~ ('~ l I • Certifylrg physklan (Physiian certilYdg cause M death when another physitlen has pronounced deaN ant completed hem 23) death oaurtetl due to Ne cause(s) and manner as atalecL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _I~ To fire best M my knowledge ~ , , • PronnunNng erM eenKying pirysklen (PKYsician both praawcirg tleaN aiM cenhyeg b cause M death) To the heal of my knowledge, death occuned sl the lime, date, and plece, and due to the oeuse(s) end manner es etated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ i /C 33c. License Nwnber ,,,, ~ D s9 3 a 9 - L 33d. Dale Signed (Month day year) y ~-~/o ~ oroner • Medical Exam ner On the basis M examine a loves( bn, In my nbn, o r al the time, date, and plere, end due to the cause(s) end manner as itNed_ ^ 34 Name and Address of Person Who Complel Cause of Death (Ile 2 T / Prrl~~, C f1 ~ O ~ A G r~~ I'r'~~ v~ Registrar's Signature ell slncl Number ' ~ I ~ I ~ I ~ ~ I - , y~) 3E F4ed (Month, tlay . . Y Grr r ~ ~ ~ - yC~~' 1Pf Al%e- e Nff/h ACS ~ aQ~ - P A ~ / ~ ~ / z ~..:.~ V - Depositon Permit No. ~~~ ~L `~ r~-a c.~ Law Office of FOREST N. MYERS **a 10000 Molly Pitcher Highway Shippensburg, PA 17257 (717) 532-9046 * * LAST WILL AND TESTAMENT r; ~ ~ ~ -~ , _~ ~ _,~ F ,,~ ; ; . ~ .~- .. I, Mary G. Walters, of 110 East Orange Street, Borough of Shippensburg, C~imberland County, Shippensburg, Pennsylvania, revoke my prior wills and declare this to be my Last Will: FIRST: PAYMENT OF EXPENSES - I direct that the expenses of my last illness and funeral be paid from my estate as soon as may conveniently be done. E N :BEQUEST - I request that the property of Lee F. Walters in my home set forth in the attached memorandum shall be returned to him. THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all my property, whether real or personal, tangible or intangible, together with all insurance policies thereon, unto my grandchildren, NICOLE D. LYNCH and TASHA R. LYNCH, provided they shall survive me by thirty (30) days, per stirpes. FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be Ii1 assignable to a beneficiary or Iii) available to anyone having a claim against a beneficiary. FIFTH: DEATH TAXES -All federal, estate and other death taxes payable on the property forming my gross estate, whether or not it passes under this will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of 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 for federal estate tax purposes. SIXTH: MANAGEMENT PROVISIONS - I authorize my Executrix, as follows: A. Retainllnvest: To retain and to invest in all forms of real estate 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 investment 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 my granddaughter or others, and to pledge property as security for repayment of any funds borrowed; D. SeIIILease: To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales or leases; E. Capital Changes: To join in any merger, reorganization, voting-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 assets 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 wil(shall be in addition to those granted by law and shall be exercisable without court authorization. EVENTH :TRUSTEE- I hereby direct that any share or shares of my estate which passes to a minor, to be held in trust on the following terms and conditions: A. So long as any child or children are minors, the net income of the trust shall be paid to or applied for the maintenance, education or support of any or all of the children at such time and in such proportions, as my Trustees shall in their sole discretion determine. In the event that the income would be insufficient to provide any of the minor children with adequate maintenance, education and support, the Trustees shall invade the principal for this purpose and such invasions shall be according to the needs of the children, rather than according to any pro rata scheme of distribution. B. The Trustees shall create a separate Trust for each child upon his or her attaining the age of twenty-one (21) years. The principal of such separate Trust shall be the pro rata share of the principal Trust, according to the number of children entitled to receive income from the Trust; and the share of such child in the income from the original Trust shall thereafter cease. The terms of the separate trust shall be as follows: 1. The Trustees shall immediately pay to such child one-third of the principal of said trust. 2. The entire net income shall be distributed quarterly to such child. 3. The Trustee shall pay the remainder of the principal and income upon her attaining the age of twenty-five years, at which time the Trust shall terminate. 4. If said child shall die prior to attaining the age of twenty-five (25) years, the separate trust for his or her benefits shall terminate and the principal of any undistributed income shall be paid to the estate of such child. 5. In the event any of the children dies prior to becoming entitled to share in the principal of the original Trust, the interest of such child in said Trust shall cease. I appoint Stacy Lee Lynch and C. Lee Gayman, or the survivor, Trustees of the trust created in this, my Last Will and Testament. I hereby relieve said Trustee from the necessity of posting security in connection with the duties as such in any jurisdiction in which he or she may be called upon to act, insofar as I am able by law to do so. EIGHTH: EXECUTOR - I appoint my Granddaughter, Stacy tee Lynch, Executor of my Will. In the event of the death, resignation, renunciation or inability of my granddaughter to act as Executor, I appoint C. Lee Gayman, Esther Brandy and Ruth Millhouse, Co-Executors of this, my Will. Neither my Executor, nor any successor shall be required to give bond.