HomeMy WebLinkAbout07-16-08r
PETITION FOR I~RO~A'TE AND GF~ANT ®~' I1~TTE~~
REGISTER OF WILLS OF ('[j~V[RF.RT.ANn COUNTY, PENNSY"LV~ 1\ I ~.
Estate of DOriS M. Mosser File Number Z~'~ 6 ~~ 1
also Iaiown as
Deceased Social Security Number 2 01 -1 8-1 3 2 5
Petitioner), ;~ I~n: is. ~ 14 years of age or older, apply~ies) for:
(COrLIPLElZi '.-1'w~~'BEL06Y:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner is l~t~the _ Executor' named in the
last Will of the Decedent dated 1 and codicil(s) dated _ R„~h T +-L,..
Al~v 1 1-,._1-9..8-r IV~n~ ~-~ .-~~~~~-
wi~ngsses is daceased; i-t is unknown i~--~rm~13. n~,,,~,-~-,-~~r~ is i}ving;
trA a~~r°~s-oaf--Stephen T Damn is unknown
(Seale 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 insUvment~yl%offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:_
^ B. Grant of Letters of Administration
(IJappficnble, eater: c. t. a.; d. b. n. c. t. a.; pendetue fi[e; durance nbsentin; durmue ntinori[nte)
Petitioners; after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Admiuistretion, c. t. a. ord. b.n.c.t.a., enter date of Will in Sectior. A above and canplete list of heirs.)
(List street address, town/city, toivnslrip, coraig~, state, yip code)
Decedent, then 81- years of age, died on)~v 7 7nnR at _'~~, r~l f~rigyJ~7 r~~ ~}~~i ~~ 1781 1 -
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ ~ 7000_.OQ
([f not domiciled in PA) Personal property in Pennsylvania $
([f not domiciled in PA) Personal property in County $ __
Vahie of real estate in Pennsylvania $ 1 dn.~.Q.O~DQ
situated as follows:,'~(-6-KP1tC~Ll R~~d~ ~~-H111 p~ 17(111 ~~~a~~~~~_~+y~~_
Wherefore, Petitioner( respectfully request!;) tl;e probate of the last Will and Codicil(s) presented with this Petition and the ,rant of Letters in the appropriate form to
the undersigned:
Si;nahire Ty ed or printed namz ami residence _
r- ' Ray E. Mosser
~~~~~-~
35 Golfview Road
Camp Hill PA 17011
Form R6V'-U1 rer 10.13 JG PaQe 1 Of ~
(COttiIPLETEINALL CASES:) Attach additional sheets ifttecessary. ~ j =t ~ • i
_ J r- i _ r-`` )
Decedent was domiciled at death in C'_t]mherl and County, Pennsylvania with her last principal t~ydence at ~ rrt
3~ Golf~lP~~ Rc~ar7 Fact Pannchny'[) ThwnGhin_ C'amn Ni 11 AD 17(111 a .~ r
Oath of Personal Representative
Signature ojPersonal ~presentaf!ve Ray E . ~_ ~ser ~
_ ~ ~ Y~
Signature oJPersona: Representative - r"', ~-= - 1 ' ;
s`; ;;
Signature ojPersoeal Representative ~ 4;i'~ ~," r-~
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File Number: ZI ~ O~ ` ~ ~~
Estate of Doris M. Mosser
Social Security Number: 2 01 -1 8-1 3 2 5
COti1~ION'~~VEALTH OF PENIv'SYLVANIA
SS
COUNTY' OF CUMBERLAND
The Petitioner~¢) above-named swear(s) or affirm(s) that the stateilents in the foregoing Petition are true and con~ect to the best of
the knowledge and belief of Petitioner(s~and that, as personal representative~¢) of the Decedent, Petitionep~s) will well and truly
administer the estate according to law.
Sworn to or affirmed aiid subscribed
before me t!:e ~~?'~ day of
i
~~__, 2 0 0~8~, n/
`V(~
For the Register
Deceased
Date of Death: May 2, 2 0 0 8
AND NOW, 2008_, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Ray E. MOSSer
in the above estate
and that the instrument(~dated November 1 1 , 1 981 __
described in the Petition be admitted to probate and filed of record as the last Will ~~liilSi}~3~) of Decedent.
FEES
Letters ............... $ LQ,'~. Q~
Short Certificate(s) ........ $ 2,0• Q~
Renunciation(s) .......... $
~r~l~ l 1 ... $ 15. DC)
~- ... $ ~~.~b
.. $ 5. Eao
... $
... $
.. $
... $
... $
... $
TOTAL .............. $ ~ ~ d• Ob
FurorRvV-0? rev. i0.13Oti
Attorney Signature:
Supreme Court LD. No.: 0 6 3 5 4 ___
Address: 39 West Main Street
Telephone:
Mechanicsburg, PA 17055
(717) 766-9622
Page 2 of 2
Attorney Name: Wi 1 1 i am_ T 4unr~~~
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LOCAL RECaISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~ Fee for this cl:rtificetc. `~(~.OO
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This, i. to certify that the information here given is
corrcctl}~ copied f5-om an ori~*inal Certificate of Death
duly, filed with me as Local Registrar. The original
certificate will he forwarded to the State Vital
Recryrd~ Oflic~.~ for permanent tiling.
,:; f,17„Z. ,~ ~ ~ MA 0 7 2008
r
Local Rr ~ i~trar Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
7. Name of Decedent (First. mitltlle, lass, suffix) 2. Sex 3. Social Security Number a. Oale of Death (Month, day, year)
female 201 --18 -1325 a 2 2008
5. Age (Last einhday) Under 1 year Untler 1 tlay 6. Dale of Binll (Month, day, year) 7. Birthplace (City and slate or lor ei n country) ea. Place of Death (Check only one)
xwmre Days r+ars Ni"alas Hospital: Other.
81 Sept. 15, 1926 Harrisburg, PA
Yrs ^ Inpatient ^ ER r OulDalienl ^ DOA ^ Nursing Home ^ Rasdance ^Other - Specity~.
60. County of Death 6c. City, eoro, Twp. of Death 60. Facility Name (II rat Institution, give street and number) 9. Was Det:edenl o(Hlspanic Origin? ^ No ^ Ves 10. Race: Pmerican Intlian, Black, White, etc.
Cumberland East Pennsboro 35 Golf View Rd. (lryea.apeclycaban,
Mexican PUenp Rican
etp
) (spap;M
,
. whit e
11. Decedent's Usual Occu tbn Kind of work d one d uri most of workin life. Do not stale retired 12. Was Decedent ever in the 13. Decetlent's Education (Specity Doty highest grade comp leted) 14. Manlal Status. Married, Never Marred, 15. Surviving Spo use (II wile, give maitlen name)
K'atl of Work
Kind of Business I IMustry U.S. Armed Forces?
Elamenlary / Secontlary (0-12)
College (1-4 or 5+) Widowed, Divorced lSpecrtyr
^Yes ^N
i
d R d E . Mo s s e r
y
~ q 12 marr
e
16. Decedent's Malting Atltlress (Street, city /sown, slate, zip code', Decedent's Did Decedent
3 5 G o l f V 12 w R d. A"uel Reaidenca na. sate P o n n c;/ 1 v a n i a town:n p? ' 7° ^ Yaa, Dacadam Lwad m F. a c f P a n n a h n r n Twp.
cpunty Cumberland nd ^No, Decadent Lived w9lhln
,7b
Cam Hill PA 17011 .
Actual limits of Ci I Boro
ty
16. Father's Name (First, mkltlle, last, suffix) 19. Mother's Name (First, miOBe, maiden surname)
Luther H. Zimmerman Mar aret May
20a. Informant's Name (Type /Prim) 20h. Inlortnant's Mailing Address (Street, rJty /town, shte, zip code)
Ray E. Mosser 35 Golf View Rd., Camp Hi 11, PA 17011
21 a. MethoO of Disposabn ^ Cremation ^ Donaton 21 b. Date of Disposition (Monts, day, year) 21c. Piece of Disposifion (Name of cemetery, crematory or omer place) 21tl. Location (City /town. state, lip code)
rpy~ Bpnal ^ Renxrval trwn solo ; waa cremation ar Donaton Aatharized
- May 7, 2 0 0 8 R o 11 i n g Green C' e m e t z r y P A 1 7 O 1 1
Camp H i 11
^ Ottler ~ Speciy: i by Medcal Examiner I Coroner? ^Yes ^ No ,
22 ra of Funeral Se Licensee (or person adi as such) 22b. License Number 22c. Name errd Address of Facility
- - FD-013163-L Musselman FHS~CS,324 Hummel AVe.,Lamoyno,PA 17043
C ~ e Items 23ac Doty when cenilying 23a. To the best of my knowl ,death occurred alJhe lime, dot eM place slatetl. (Signature end title) 23h. License Number 23c. Date Signed (Month. tlay, year)
pnysinan Is rat avasaNe al time of death to c
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tartly cause of tleam. ~
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Items 21-2b must be canpletetl by person 2 Time of Death ~ 25. Dale P ouncetl D (Month, day, year) 26. Was Case Referred to Medic Sminer /Coroner for a Reas n her than Cremation or Donation?
wta pronounces death. ~~ !~~_ ~. M, ~ /1 I
EfJ(, ~ 7C % '~ ~~ ^Yes '
CAUSE OF DEATH (See Inatrudlons an exa les) I Approximate Interval: Pan II: Enlar other sionifiranl conditions conlridn ra to tleath, 26. atl Tobacco Use Contribute to Death?
Item 27. Pan I. Enter the chain of events -diseases, injuries, or complications - that direclry caused the death. DO NOT enter terminal events such as wNiac artesl, l Onset to Oealh but not resulting in the undenying cause given in Pan I. ^Yes ^ Probaoly
reslxratory artesL or ventricular libnllalan without showing the etldogy Lisl only one cause on each line. ~ ^ No ^ Unknown
IMMEDUTE CAUSE 1Final dsease or t ~I ~
condition resulting in tleath) ~ a (l~~a\ l ~ ~ C,~~ ~ V~ Z l .~ Jl~rv, I
29. II Female.
^
Due to (or as a cansequerae o ): Not pregnant within pall year
Sequentiesy 1st contlitans, if any, b, ~
li
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d ^ Pregnant al lime of beach
a
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e cause
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on
ne a. Due to o as a cnnse uence o
Enter fhe UNDERLYING CAUSE (r g 0~ ~
^ Npl pregrranl, but pregnant within 42 tlays
(disease or injury that lndialetl the ~
events resulting m death) LAST. of death
Due to (or as a co~sequerae Dry. ^ Nol pregnam, but pregnant 43 tlays b 1 year
d before tleath
^ Unkrrown II pregnant within the past year
30a. Was an Autopsy 300. Were Autopsy Flntlings 31. Manner of Death 32a. Dale of Injury (Month, tlay, year) 32b. Describe How Injury Occurred 32c. Place of Injury: Home, Farts, Street, Factory,
Panormetl? Available Pnor Ie Complelron
~Q.Natuml ^ Homicide Office Builtling, alt. (SpeciryJ
of Cause of Death? ~"
^Yes ~NO ^Yes ^ No ^ Acatlem ^ Pending Investigation 32d. Time pl Injury 32e. Injury al WorN? 32f. II Tranaponation Injury (SpectyJ 32g. Location of Injury (Street, city / bwn, stale)
^ Suictle ^ Could Nol be Determined ^Yes ^ No ^ Dmer I Operator ^ Passenger ^ Pedestrian
M ^Olher~ Specify
33a. Certifier (check only onel 33b. Signature antl Title of C,rrnilier _
%
• Cenaying physklan (Physician cenirying cause of death when arather physician nos proraunced death and wmpleled Item 23)
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To the best of my knowkdga, death occurred due to the cause(s) and manner ac slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ cJ
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• Aonwncing arts cenHying physician (Physk:ian both pronaxlcing death and cenitying to cause of death)
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^ 33c. License Number 33d. a Signed ( nth, day, year)
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manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Medical EXam11Mr I Coroner [~ (Y 1~
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On the bests of examination antl I or Investlgatlon, in my opinion, death occurred at the time, sate, and place, and due to the cause(s) end manrKr as steted_ ^ .
N \
~ Name antl Atltlress of Person Who Completed Cause of Death (Item 27) Type I Pri I
35 R t s awre and
egrs ~ I a1 l I ~ I ~ I~ I 3fi. Dale Fil Month, da ,year
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LAST WILL AND TESTAMENT -~ ,,...~
OF .: _:,
DORTS M. MOSSER
:,
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I, DORIS M. MOSSER, of 7007 Dolphin Road, Lanham, Prince
George's County, Maryland 20706, being of sound and disposing mind
and capable of executing a valid deed or contract, do make, pub-
lish and declare this to be my Last Will and Testament, hereby
~
~ revoking all other Wills and Codicils made heretofore by me. I!
,1~~ 1. I direct that the expenses of my last illness and
~~
~
`;~,'~ funeral shall be paid out of my estate by my Personal Representa-
`~''` ,~ ;,~ I
~~~
tive, hereinafter named.
{
i Primary Bequest
1 - .~
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~~~ 2. Provided that he survives me by thirty (30) days,
,
,
?~~~ I hereby give, devise and bequeath, absolutely and forever, all
~~
~:~- of m ro ert real and personal, of whatever nature and where-
Y P P Y
1~-11 ~~
soever situated, owned by me or over wY.iich I have the power of
appointment at the time of my death, to my husband, RAY E. MOSSER.
Secondary Bequest of the Residual Estate
3. Should my husband, RAY E. MOSSER, fail to survive me
by thirty (30) days, I hereby give, devise and bequeath, absolutely
and forever, all of my property, both real and personal, whatso-
ever and wheresoever situated, to which I may be entitled or which
I may have power to dispose of at my death, absolutely and in fee
simple, unto my daughter, MELINDA R. STiJMPF. However, should
MELINDA not survive me by thirty (30) days, then this bequest
shall pass to her issue, such issue taking by representation the
LAW OFFICES
CROSS. ROZNER
& EDWARDS
share MELINDA would have taken if livinci,
SUITE 300
LANDOVER MALL WEST
Personal Representative
LANDOVER MD. 20783
~3°I~ "Z-'°'° 4 . I hereby appoint my beloved husband, RAY E . MOSSER,
- 2 -
as the Personal Representative of my Estate. Should he pre-
decease me or be unwilling or incapab}_e of so functioning, then
I appoint my daughter, MELINDA R. STUMPF, as my alternate Per-
sonal Representative. Both of the aforesaid Personal Representa-
tives shall serve without the requirement of bond and shall not
be held accountable for losses incurred by my estate during its
administration.
5. I hereby give to my said Personal Representative
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full power and discretion in the management and control of my
estate, with the right and power to sell all, or any portion
thereof, which he may deem necessary, :in the absolute exercise
of his discretion for the payment of my just debts or any lega-
cies herein bequeathed, or the advantageous settlement or dis-
tribution of my estate, or for any othE~r reason which my Personal
Representative may deem proper or advisable, and without the
necessity of making application to or of securing any previous ~
Order of Court therefor, and no person paying any money to my
said Personal Representative shall be under any obligation to
see to the application of any money paid.
IN WITNESS WHEREOF, I now subscribe my name to this
my Last Wi11 and Testament, this ~_ day of .~kra~~l ,
1981.
D S M. MOSSER
WE, THE UNDERSIGNED, being over the age of eighteen
(18) years and being residents of the State of Maryland, and at
- 3 -
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the request of DORIS M. MOSSER, do attest that DORIS M. MOSSER
has, on this day and in our presence, SIGNED, SEALED, DECLARED
and PUBLISHED this writing as her Last Will and Testament, and
that to the best of our knowledge, she is on this day of sound
and disposing mind; in attestation thereto, we subscribe our
names as witnesses in her presence and in the presence of each
other.
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+DA~'~~ ®~' i°TOi®1-SUB~~£~~3I"'~T~ ~'~IT1~I;S~(~~)
REGISTER OF WILLS
CUMBERLAND COUNTY, PEi~1NSYLVANIA
Estate of nc,r; G M Mosser ,Deceased
--Peel}uda ~ St-i~mi f and Matthew A. Stumpf ,
(each) being duly qualified according to law, deposeO and say( that x~I~r~~cthey /were well-
acquainted with Doris M. Mosser
and xi~/are familiar
with the handwriting and signature of the decedent, and that the signature of Doris M. Mosser
to the foregoing instrument purporting to be the Last Will and Testament/mil of Doris M.
Mosser
is in~is/her own proper handwriting.
~s`'""""'`~ Melinda R. Stt~ipf
e
~stree rrr,e.~s~
Camp Hill PA 17011
(C~r~:, Srore, Zq~)
(s<<~ attire) Matthew A~ Stumpf
~s ~ t r res abler Place,.-A~-4
Camp Hill PA 17011
(Crt~-, Stule,Li~~)
t •J
Executed izz Re~ister's Office
Sworn to or affirmed and subscribed
before me this `L.Q^r'_ day
o f _yLl,~ 2 0 0 8
~~~
Deputy for Register of `vb'ills
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For in2hV'-0l rev. 10.1;.0(