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HomeMy WebLinkAbout07-25-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUyY1b~2I_H-n/~ _ COUNTY, PENNSYLVANIA Estate of V k'-f5~/~~1~ ~~/NC'.L-~ ~~~~}/1~/~ File Nurnber ~~l ~ " also known as _ Deceased Social Security Number . ~. Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ,g ~ 1.11 A. Probate and Grant of etters Testamentary and aver that Petitioner{ej is Ls~e the (;~(~ ' I ~l~ G(-e.~ tffti~FT F named in the last Will of the Decedent dated eC . /'~- ~ ~® and codicil(s) dated (State relevant circwnslances, e.g., renunciation, death ojexecutor, etc.) ey Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution o~e instr-ument~offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person:- ~~'+' =r ~ ~ .I Ti ~ ^ B. Grant of Letters of Administration -' +~' N ~t-L_b'i (Ifnppticable, enter: c.t.a.; d.b.n.c.t.a.; pendente titer dura+rte n6se+uia; durance tyiriorit[ii~e) r - - - -, : ~ Petitioners after a ro er search has /have ascertained that Decedent left no Will and was survived b the followin sou an and~teirs: / () P P Y g P §~~ Y) (f Administration, c. t. a. or d. b. n. c.t.a., enter date of Will in Section A above and complete list of heirs.) ~i ~ _ , ,~ '" (COMPLETE LV ALL CASES:) Attach additional sheets if necessary. J in UK/ f~ County, Pennsylvania with his /her last principal residence at (List street address, town/city, township, county, stnte, zip code) / 20 (9cG-co(-en) ~ ~ U tiv~j ~ Decedent, then `~ ~- years of age, died on 7 1 ~ O g at t1-~ ~~ ~+/K~e~ (<1~.4d ' ~,~ r~¢/ 7~ ~~ l '~f / Decedent at death owned property with estimated values as follows: (If domiciled in PA) Al] personal property $ ~ ~> C~ ~ i { Personal property in Pennsylvania $ {-I-f= -A) Personal property in County $ Value of real estate in Pennsylvania $ ^'~ - situated as 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 foam to the undersigned: Signature Ty ed or tinted name and residence --'~'"LC i L ~'t` 1 ~~~ (G(- r'L ~ t !~ 5 _ ~L><PC f'rA,'/<'S J /1 /rY~t ~ P/7~ / ?~ .> Form R6V-OZ rev. 10.13.06 Pabe 1 Of 2 ti Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~~~~~Vil The Petitioner(s) above-named swear(s) or affirm(s) that the statements 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(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 ~ ~ ~~~~~ 4 Signature ojPersona! Representative ~-~ Signature ojPersonal Representative C7 r-a _~ C ~ or the Regtster Signature ojPersa~al Representative - `;L ~`J ~`- =~ GI; x~ c File umber: r7 --rte'. y~ f n Ts _ Estate of ' f 15~~~'~~- ~~~ _~~{ I ~'`(~ nI 1 ',. ,Deceased ~ Social Sec ' y Number:~~1 - ~~` ,~`1 ~~ U AND NOW, ~G~~, in having been presented b~ ore m IT IS ECRE~E/D~that Letters ` are hereby granted to / and that the instrument(s) dated ~/)L~y~_U~.1~Lr ,~[/(~C described iir the Petition be admitted to probate and filed of record as FEES L~ Letters ............... $ / Short Certificate(s) ...... .. $ ~ ~ Renunciation(s) ... . .. $ ~ 1 . $ d . .. $ 1G, 2 .. $ ,~ ~ . .. $ . .. $ . .. $ . .. $ . .. $ . TOTAL .. $ C~ $ ............ .. Date of Death:. c nsidera ~on of the fo egoi last W'll (and 7odicil(s)) of ~ ~ ~, Register of ilis- Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Telephone: Petition, satisfactory proof in the above estate dent ~~ ~ ~ ~ '`~ /~ Form RW-0_' rev. IO.I3.0( Page 2 Of 2 IIK.€t Ig RFC ~ninn, ~~ `~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $b.O0 P14541.6~~~ Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death du)y filed with me as Local Registrar. The original certificate will he forwarded to the State Vital Records Office for permanent filing. f!G~~ ~ „,,® ~JUL ?~ 200 Local Registrar Date Issued ~? ev ~ O _ c~ ~ ._ z c~ tom-- ' ,> r-- `-_' rn N -`~ s. C.~ -- - 1~• -- i_ r , ~ -- -U ~ 3EV tvz006 COMMONWEALTH OF PENNSYLYANIA • DEPARTMENT OF HEALTH • VITAL RECORDS PRINT IN "NENT CERTIFICATE OF DEATH ,K INK (See instructions and examples on reverse) STATE FILE NIIMRFR 1. Name of Decedent (Frsl, middle, last, suKx) 2. Sex 3 Social Security Numher 4. Dale of Death (Month, day, year) Px.usec.~a. ~~ Alann Fema.Le 224- 42 = 3452 Jw(:y 18, 2008 5. Age (Last &dhday} Under t year Under 7 tlay 6. Date of Binh (Month, tlay, year) 7, Birthplace (City and state or for eign country) 6a. Place of Oealh (Check only one) kmnau Days Hours rnmures Hospitaf~. er. O th 92 Yrs. p t Se 7, 1915 .... ~~JJ~~,,.. pp pp //++ ~ CrIA.C.V•(.[.Ce, IVI. ^Inpatient ^ERl0utpaliem ^DOA yy ~~ r ipl Nursing HOme ^Rasaence ^Other Spealy Bb. County of Deam &. City, Boro, Twp. of Death 8tl. Facifiry Name (1i not institution, give street and number) 9. Wes Decedent of Hispanic Origin? No ^Yes 10. Race gmencan Indian, Black, While. etc. CI1111bQJ[~fl/ld Eeus.t Pererusbo~eo T (u yes, s{redry ahan, (spec,M Go.P.den 1_.Lv " CeYLtQIC Mexican, Puerto Rican, etc.) (Vh~~Q 17. DecetlenYS Usuel Occu liar Kind of woM done Burin most of workin Ise. Do not slate retired) 12. Was Decedent ever in the 13. Decedent's Etlucation (Specify only highest grade completed) 14. Marital Status Married, Never ManieQ 75. Surviving Spouse (II wife, give maiden name) KiM of Work KirW of Business! Intlustry U.S. Armed Fo r ce s? Elementary /Secondary (0-72) College (1-4 or 5+) Widowed, Divorced (Speaty) SeChe#ivc De ~. 0 De~enee , rr yy ^ves t~Np 1 D~.voneed 16 Decedents Masing Address lSlreel, city l town. slate, Zip code) 606 Robent $#l eet Decedent's Penns pVQ/'~.(A Did DeCerlanl Actual Residence 17 Sl y Li in t t ve a. a e a 17c ^Yes. Decedent Lived In Twn C L Meehanieebwcg, PA 17077 -.-L g ~ ~~ ~ Township? rryy,, 17b. County Cumbeh.2and 17d. try No, Decedent Llvetl within µeCl_ _._ _ ~b~ / ' Aclual4im rls of _ IL(ll-(. Q Cily I Boro 18 Father's Name (First, belle, last. suffix} James L. Gainey 19 Mother's Name (First middle, maiden surname) Roee 8. Doug(~#iJ 20a. Inlonnant's Name (Type! Pnnt) 2W. Inlonnanl's Mailing Address (Street, sty 1 town. state, zip code) ~ • Hunte~t ~ 1i1 606 Robent S.t~ceet, IUechanic.abwcg, PA 17055 21 a. Memos of Disposition Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 2tc. Place m Disposition (Name of cemetery, cremeltNy or other place) 21 d. Location (City I town, slate, zip code) ^ Budai ^ Removal from Slate i Wes Cremetlon or Donation Authorized 1 ^ Otner~Specilr hyMetlicalExamtner/Caroner7 E/f ra5^Np ~ J 23a 2008 (Jcemat,~On SOCde. o PA cvut.idbult , PA 17109 22a. of uneral Serrrce ' nsee (or pesson acting as suchj ~ ~ ~~ 22b. License Number 22c. Name and Address of Facility ~ emOk 1io~ On PJtV.(.CEL1, n(r.. ' - " ` ~'"~ PD-138453 4100 Jones#own Road, Na~e.cabwt PA 17109 • Complete ems 23ac ony when certifying 23a. To the best of my knowledge, death occured at the lime, dale and place staled. (Signature and IMIe) 236 Lkanse Number 23c. Date Signed (Month day yea0 physldan is no! available al time of death to cenily cause of death. ', ^ 7 C..-~-~(J /`~(J~LLC~~"LLB-~2C~:C_.. /V V, rYZ-~/V~ _ /C-Y~S~II~J~~"7 , , ( ^ /, /~ (7 ~J ~~~~~y~-,y~l7li d~ kerns 2646 mull be completed try person who pronounces death. 24 Tme of Death ~ / fir ~ M 25. Date Pronounced Dead (Monet, day, year) O ~. ~ ~ - ~~` ~ ~ 26. Wax Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donations • . ^Yes No CAUSE Of DEATH (See Instructions and examples) r Approxlmale intorval: Item 27. Pan I Enter the chain olevents -diseases, injuries, or complicatbns - Ihal directly causetl the death. DO NOT enter terminal events such as cardiac arrest, Onset to Death Pan II: Enter other Sion ficnl Condit on o In lipg}o de Ih, 6ul not resulting in the underl in cause iven in Pen I 28. Did Toheccr Use ConMbule to Death? ^Yes Proh o respiratory arrest. or ven:ncufar tibrillafwn without snowing the etiobgy. Lial only one paUxe On each Ilea. g y g . ^ a ry IMMEDIATE CAUSE Fnal tlisease or ~ - ~ ~ corldihon resuairg in r f~ ._~. 8N) _' a %- ~ x J/TG ~^ T h'q~z V L, ~/ ~ , f Y / . 2g. II Female r ~ yj ~ .. x, ) , . Due to (or as a consequence of): ,ye -n 1... Se oantiell list conditbns if an ~ - ~ ~ ~ / ^ Not pregnam wimin past year ry y , y. ~~y.~,~.v leatlmg to are rouse hsled on Noe a. 6- ~ i - ~ ~ ~'y ~~ ~ D ~•„xv jEiygs~n] ^ Prognanl at Lime of tleath ue to for as a consequence ol): r Enter the UNDERLYING CAUSE ^ Nol pregnant, but pregnant within 42 tlays (disease a injury that initiated the /7 / ` ~ ~ / C~ ~1 , y7.t ~ r c 7 ° n' % r " pl d t ' L events resuflirlg m death) LAST. - ! D p ue to (or as a Consequence of): ~ r ^ Nol re hoot, but a hoot 43 da s Ip I 9 Pr 9 Y Year b f h d. r ore deat e ^ Unknown II pregnant within the pall year 30a. Was an Amopsy Pedormetl? 300. Were Autopsy Findings AvaAable Prior lp Completion 37. Manner of Deals 32a. Dale of Injury (Month, day, year) 32b. Describe How Injury Occuned 32c. Place of Inryry. Home, farm, Street, Factory, of Cause of Death ~, Natural ^ Homicitle Otlice Buildin ,etc. 5 9 (p~'iNl ^ Yes (~ No ^ ves ^ No ^ Acatlent ^ Pending Investigation 32d. Tme of Injury 32e. Injury at Work? 32f. If Transponation Injury (Specify) 32g. Location of Injury (Street sty; sown, slate) ^ Swcitle ^ DeuW Nol be Determineb ^ Ves ^ No ^ Diner / Operator ^ Passenger ^Petleslrian M ^Other~ Specify 33a. Cemfier IUeck only onal • Certltying physician (Physician certifying cause of tleath when another physician has pronounced tleath and completed Item 23) T b m t f k 33b. Slgnawre and Tnle of Cenifier ~ ~ r ~ o e es p my know tlge, tleath occurred due to the causes} and manner as staled_ _ _ _ _ _ _ _ _ _ _ ,. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ [~I • Pronouncin and ceUltyin h n Ph sici ici th b d h ,., - r,•,k,,s (,_ ~_,- ~-.vc..C~?s: g g p y ( a ys an o pronouxing eat and cenifying to cause of death) Te the best of my knowledge, death occurred at the lime, dale, and place, and due tp the cause(s) and manner as staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. license Nu r 33d. Date Signed IMOnIh, day. year) • Medical Examiner 1 Coroner V Z ~ ~ '~(, [, '_ '! , Gr C,~ On the basis of examination antl f or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as stated„ ^ < -- ~ -..~1 34. Name and Address of Person VVho Completed Cause of Death flle m 27) Type / Ptlnl j 35. Registry ~ na zure and Dl~~~/ry _ (-k / j ,. ,. ,. 36 Dale Fit (Month, ay, year) ~ ~'Z ~7-n C ,N`..~ <_ Gy T.{h,~'~rf / I.2 T? www...aa5 ~~~ , ~ , L'. `• ' ~•-'._. ~ ~Q~~ "o -~r: i ~~ J J ~ ' ~ / °rJ/ . .z a y i ., ~ ( • i .S /`a~ S r ~G LI Diepasitlon Permit Nc. 0228477 Will and Testament of Priscilla G. Mann I, Priscilla G. Mann, a Pennsylvania domiciliary residing at 606 Robert Street, Mechanicsburg, Pennsylvania, being of sound and disposing mind and realizing the uncertainty of this life, do make, publish and declare this to be my will and testament. Article I. Family I was married but later divorced from Hunter Mann, Jr., now deceased. We had two children, Hunter Mann, III and James G. Mann. I have no other children. James G. Mann has two children, Victoria Register and James G. Mann, Jr. Victoria Register, the wife of Charles Register, has two children, Melissa Register and Rebecca Register. C? ~: ~ -~-, ;_ -~ ~? Article II. Executor -~ ~ _~ rv ~ _ A. I name my son, Hunter Mann, III to be my Executor. Should he fail`to~~uali~,or cease to serve, I name my son James G. Mann to be my Executor.. >> c ~ _ ., ~ i ~a , ~ r B. I request that no bond or security be required of any Executor. My Executorhall serve without compensation. C. My Executor shall have the powers specifically mentioned herein and additional powers as conferred by law or which are necessary or appropriate to achieve the purposes hereof. D. My Executor and Trustee may make distributions for minors to either of their parents or other persons with whom they reside and such person's receipt shall be a sufficient voucher in the accounts of my Executor and Trustee. Article III. Payment of Debts and Other Charges A. I direct my Executor to pay my debts existing at the time of my death and expenses associated with my death and cremation pursuant to arrangements made. B. Any estate, inheritance and similar taxes assessable on my death shall be paid as a cost of administering my estate and my Executor shall not request any beneficiary to pay any part of such tax. Article IV. Distribution of My Estate A. I give, devise, and bequeath my tangible personal property in as nearly equal shares as practicable to my children who survive me, provided that my Executor may sell or otherwise depose of any articles of my tangible personal property that my Executor deems inappropriate for distribution Page 2 in kind and add the proceeds, if any, to my residuary estate. I suggest that my Executor consider any memorandum I may leave regarding distribution of specific items of tangible personal property. Tangible personal property includes, without limitation, furniture, artifacts, silverware, china, utensils, pottery, plants, albums, clothing, memorabilia, household goods and appliances, but does not include money, securities, annuities, savings, checking, money market or other financial accounts or interests, pension benefits, the proceeds of insurance policies, contract, employment or retirement rights or other intangible rights or interests. All expenses incurred in delivering my tangible personal property and all expenses of storing and insuring such property pending distribution shall be paid as a cost of administering my estate. B. I give, devise and bequeath to each of my grandchildren that survive me and to their husbands and wives that survive me the sum often thousand dollars ($10,000) and to each of their children that survive me the sum of five thousand dollars ($5,000). C. I further give, devise and bequeath to my great granddaughters Melissa Register and Rebecca Register in equal shares all Series E and Series HH U. S. government bonds which I own at my death with accrued but unpaid interest. However, in the event that either or both of my said great granddaughters shall not have attained the age of twenty-five (25) years on my death, I give, devise and bequeath such bonds and interest intrust to my son Hunter Mann, III, who shall hold, administer and distribute the same as my Trustee for the following uses and purposes: (1) Until each such great granddaughter shall attain the age of twenty-five (25) years, my Trustee shall pay to them or expend an her behalf from their respective shares so much of the income or proceeds of sale of such bonds for their education and welfare as he may deem advisable in his discretion and shall accumulate any surplus income. Upon each great granddaughter attaining the age of twenty-five (25) years, my Trustee shall distribute to them the balance of their shares and the trust shall then terminate. (2) If either such great granddaughters shall die before distribution to her of her full share of the bonds, proceeds of any sale or disposition thereof, interest anal accumulated income, then the remainder of her share shall be paid to the survivor or, in the event the survivor is less than twenty-five (25) years old, held pursuant to this trust and distributed upon her attaining the age of twenty-five (25) years. Should Hunter Mann, III cease to serve as my Trustee, I appoint James G. Mann to that position. Page 3 D. I hereby give, devise and bequeath all of the rest, residue and remainder of the property which I own at the time of my death in equal parts to my sons Hunter Mann, III and James G. Mann, if they survive me. If either of my children do not survive me, then I give the portion due that child to his estate. The rest, residue and remainder of my property includes all assets not otherwise effectively disposed of herein, property or interests of whatever nature and wherever situated in which I have any interest at the time of my death, including accounts, annuities, policies and securities held in the names of either my sons or other persons or in joint names for convenience. Article V. Miscellaneous Provisions A. The underlined headings are for convenience and shall not affect interpretation. B. The term Executor shall refer to any executor or executors serving hereunder. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 15~.~ day of ~°t'e~~ , aova , in the presence of each and all of the subscribing witnesses, each of whom I have requested in the presence of each of the others to subscribe their names and addresses as attesting witnesses in my presence and in the presence of all the others. ,'- ~~~ ~~ l Priscilla (J. Mann The foregoing instrument was on the date last above written duly signed, sealed, published and declared by the said Priscilla G. Mann as and for her will and testament , in the presence of us, who at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto ~~~i~`~%(~ L2,~ residing at .5~~do ~or~is~ y.~ . fUl,o~~.~w~~-s 6~~r1g ~~ /74s~,S`. L~~ ~ ;,yt_J~. o-~I~j/Yt,~~~ residing at -.~'o~~o ~OVr.rP I~t-, Acknowledgment Commonwealth of Pennsylvania } ss. County of Cumberland } I, Priscilla G. Mann, the testator whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will and testament; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to and acknowledged before me by Priscilla G. Mann, the testator, this /~f~, day of ~P~~ax~N.(~ TODD , ':~h~ c--~C~_~ ~^ ~'~-- ~c.~ Priscilla G. Mann ~~~ ~~ Notary: ~ _ ,, w ;~ ~ , ,,, My Commission expire ~~'~ fi'~ ~~~' ~c~3a Affidavit ~, ,~ , . _, ... e.r;•.cizs Commonwealth of Pennsylvania } ss. County of Cumberland ) We, -.~P~~.•P ~~c~~~~~ and ~ ~t~y'e~y ~ cS~dn~P~ the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as her last will and testament; that the testator signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ~P66i~ _~Pc~i-~-~ Q/ and ~-r~e~v ~ ~~Unr~,~ ,witnesses, this day of ~Prerndr~ , .~?caoa Witness W t ss ~~ ~~ Notary My Commissio ~`Pn~"..._.---•-- _1 ~,.., ~ .: ~-~,., ~~~~~c R r -:~ : ;; .,aunty ,, . ., :'7, 2004 ...