HomeMy WebLinkAbout08-27-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~~111$~ r ~Q'Y~ n COUNTY, PENNSYLVANIA
Estate of ~ \C~JI ~ LUG%1e ~~~~~ G File Number ~ ~ ~~ ~~~~
also known as ,, ff /I'' (,
,Deceased Social Security Number ~ ~ `~ " Q ~ ~ ~ T p
Petitioners}, who is/are 18 years of age or older, apply(ies) for:
(COt1~1PLETE 'A' or 'B' BELOW:)
~A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the '7'L named in the
last Will of the Decedent dated -- ~ ~ ~ 61 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 bom 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:
.0 B. Grant of Letters of Administration c`7
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia;xlu> it e n:irtorita~ _
~~ ~ -
Petitioner(s} after a proper search has /have ascertained that Decedent left no Will and was survived by the following~paC6~e (if a~ and lieits: (If
Administration, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ " =- ; r; ~
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in ~1~ (~ r ~~rl ~ County, Pennsylvania with his /her last principal residence at
(List sn•ee! address, town/city, township, count), state, zip code) ~j A
Decedent, then ~~-years of age, died on Ce(- ~` ~On at (1 (L ~~' L~ , ~/t
Decedent at death owned property with estimated values as follows
(If domiciled in PA) All personal property $ ~ 5~UC i0 ~ ~ O
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Forst R6V-OZ re,~. lo.t3.o6 Page 1 of 2
Wherefore, Petitioner(s) respectfully requests} the probate of the last Will and Codicil(s) presented with dtis Petition and the grant of Letters in the appropriate form to
the undersigned:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
//e~^ ~~^ // / SS
COUNTY OF l~t~/' 1R~(~/IQno1
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.
Swo;r, to or affirrr,ed and subscribed
before the the ~~_ day of
/- ~~~
For the Register
of
Signature of Personal Representntive
-t, ~- ,
r`?rr <:)
Signature ojPersaral Representative
'.-~ ~1
-_' _ _ .
._y .-..
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File Number: l ,, - //
Estate of 12rC' ~f'1 !t ~r ,Deceased
Social Security Number: 0~~-7 ~~ Date of Death: A1-~GT l,LCS ~ ~3 02~
AND NOW, ~ , in-c~-o~nsideration oft e foregoing Petition, satisfactory proof
having been presented before m IT IS J~ECRE}E~ that Letters 1 P-tS
are hereby granted to ~ ~U / Q- /l ~t,e.l (~,vu/~ ~
~ ~
in the above estate
and that the instrument(s) dated - ~~U
described in the Petition be admitted to probate and filed of record as the last W' (and Codic• (s)) of ecedent.
FEES ~~~
Register of Witls
Letters .... g5 ~ O~U .. $ a ~
Short Certificate(s) ...1..... $
Renunciation(s) .......... $
tall ... $
~c,~..~ ... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ca7~''"{'
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Form RW-0? rev. 10.!3.0( Page 2 of 2
105.805 REV (OI/p7)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 145431.1
Certification Number
REV nnoos
PRIM IN
AANENT
CK INK
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 he forwarded to the State Vital
Records Office for permanent filing.~~~ ~ ~ 2~~~
LGnrL ~ ~v~r,~" l l
Local Registrar Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH fn~ /~~Q ('~ +yQ
(See instructions and examples on reverse) STATE FILE NUMBER d ~ lJ GJ ~~ I 1
f. Name of Decedent (First, midtlle, last suXix) 2. Sex 3. Social Security Number 4. Dale of Death (Month, tlay, year)
Richard Eu aria Lenker Male 2O~r 03 X7148 August 23, 2008
5. Age (Last Binhtlayl Under t year Under 1 tlay 6. Date of Blnh (Month, day, year) 7. Birthplace (CAy and slate or forego country) ea. Place of Death (Check only one)
I4omha Days Havr: raimm~ Hospital: Omer.
84 vrs. Sep. 14, 1923 Millersburg, PA ^tnpauent ^ER/Outpatient ^DOA ®Nursmg HOme ^Resmence ^Other Specify
BD. County of Deam Bc. City, Boro, Twp. of Death 6d. Facility Name (lf npl instttulion, give street and number) 9. Was Decedent of Hispanic Origin? ®No ^ Yes 10. Race: American Indian, Black, White, etc.
pl yes, sDecily Cuban, (SDeciyy?
C mberland Cam Hill Manor Care Mexipan,PUenpRiwn.etc.) White
11. Decedent's Usual Oau Iron Kind of work done dun most of workin tile. Do not stale retired 12. Waz Decedent ever In the 13. Decedent's Education (Specify only highest grade completed) 14. Marital Status: Martied, Never Married, 15. Surviving Spouse III wile, give maiden name)
Kintl of Work Kind of Business /Industry U.S. Amletl Forces? Elementary /Secondary (0.12) Collage (1-4 or 5+) Widowed, Divorced (Speay)q
Truck Driver Truckin ®Vea ^Np 12 Widowed
16. Decedent's Mailing Address (Street, city I town, sate, zip code) DecedenYS Ditl Decedent
Pennsylvania Live ina 17c
Decedent lived in Hampden T
®Ves
n
l
l R
i
s
121 Hill Lane .
,
wp
Actua
es
dence
a.
ta
e
T°wnahi°' 17d
ithi
^N
D
d
t Li
d
Mechanicsbur PA 17050 w
n
.
O,
ece
en
ve
nD.counly Cumberland AdualLimilsol City/Bprp
18. Father 5 Name (First, midtlle, last, suffix) 19. Mother's Name (First, middle, maiden surname)
esker Florence C. Hoy
20a. Informant's Name (Type /Print) 20b. Inlom~en('s Mailing Address (Slree4 city /town, setts, zip code)
Mrs. Sheila Youn 121 Hill Lane, Mechanicsburg, PA 17050
21 a. Method of Disposition [~ Cremation ^ Donation 21b. Date of Disposition (Month, tlay, year) 21c. Place of Disposition (Name of cemetery, crematory or other pace) 21 d. Location ICIry /town, state, zip code)
^ Burial ^ Removal from State i Wes Cremation or Donation AuMorized
• ^ Other- ray: i byAletllcalExaminerlCoronef! ~7vea^NO
Au ust 27 2008
Cremation Society of PA
Harrisburg, PA 17109
~ 22a. Sgna , Fuser s ice arises (or person acting as such) 22b. License Number 22c. Name end Address of Facility At} r Memor ial Home and Cremation S e rvi e Inc .
PA 1~/1~~
b
. - FD-013376-L urg,
410 Jonestown Road, Harris
Complete tt 23a~c °nty when ceniryi 23a. To me best of my knowledge, dea oaurretl a the time, date entl place staled. (Signature and title) ~~^,~ ` r~ 23b. license Number 23c. Date Sign (Month, day, year)
pan is not aVakable el time of tleam o
cue ry cause of tleam. e +GKt)
~ "~> C~ ~~ D ~-~ E~YI !!k1 " tTl`~-f
G~ (~ ^~
~ +~..} Qr
_
Items 24-26 must be corpleted by person 2<_ Time of Death
' 26. Date P Deed (Monet, day, year) ~ ~
~
~ ~ 26. Was Case Referted to Medical Examiner / Coroner Mr a Reason Other than remation or Donation?
who pronounces death. ~~)~
~ M. •
'~
~ ~} C~ ^ Yes ^ No
CAUSE OF DEATH (See Instructions and examples) I Approximate interval: Pan IC Enter omer sipnkicant mndttrons contnbutino to tleam, 26. atl Tobacco Use rbme ro DealM
Item 27. Part I: Enter the chain of events - tliseases, injures, or complications -that directly caused the tleam. DO NOT enter terminal events such as cardiac arrest, 1 Onset to Death but not restating in the untlertying cause given in Pen L ^ Yes robaDly
respi2lory arrest, or ventricular fibnllakon widaut showing me etiology. List Dory one cause on each line.
^ No ^ Unknown
IMMEDIATE CAUSE (Final disease or r / L ~
~
~ 29. If Female:
contliYUn resulting in tleam) _' a.
.~•,41 S" V•7,t
(~ ~ ~, /•G ~(~ ( T,~
^ N
Due to (or as a conseq rice op: I
~-. I ot pregnant within past year
^ Pregnant al time pl death
Sequentially list condhbns, if any, b. ~ ~ ^~
~d /I /I ~ f/.- ~) ~ G7 1 t,
_
leadirp to the cause listed on line a. ~ i
UNDERLYING CAUSE Due to (or as a consequence ot):
t
m
E ^ Nol pregnant, but pregnant within 42 days
n
er
e
(disease or injury that initiated me c of tleath
events resulting in tleam) LAST
Due to (or as a consequence oQ: ^ Not pregnant, but pregnant 43 tlays to 1 year
d. before death
^ Unknown it Dregnanl within the past year
30a. Was an Auopsy 30b. Were Autopsy Findings 31. Manna aM 32a. Date of Injury (Monet, day. Year) 32b. Descrba How Injury Occurted 32c. Place of Injury: Home, Farts, SIreaL Factory,
Penormed? Available Pror to Completlon OXroe Building, etc. (SpeciyJ
of Cause of DeaM? NaN21 ^ Hanicide
~ ^ Acpden( ^ Pestling Inveshgetion 32d. Time of Injury 32e. Injury at Work? 321. If Tmnsportaaon Injury (Spedry) 32g. Lowtlon of Injury (Street, pry I town, slate)
^ Yes No ^ Vas
^ Suiptle ^ Could Not ba Detemened
^ Ves ^ No ^ Diver l Opexbr ^ Passenger ^ Pedestdan
M omer - Speciy:
33a. Cenilier (check only one) 33b. lure aM Tttle of Cen' r
• CertNying physician (Physician cenirying cause of death when another phyapan has prorwuncetl death and completed Item 23)
To the beat of my knowledge, tleeth occurred due to the cause(s) entl manner es atated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
-
• Pronouncing and wrtilyirg physician (Physician Doth pronouncing tleath entl cen4ying (o cause of tleam)
^
e to tM cause(s) end manner as atated
d d
d
t
d
l
i 33c. License Number 3d. Dale Sign onth, day, year)
~
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
u
a
e, an
p
ace, en
me,
To the best of my knowledge, Beam occurred al the t
C ~ ..1 [
- , ~~~
oroner
• Medical Examiner /
On tM heels of examination and / or investigation, in my opinion, death xcurced at me time, date, end plow, end due to fhs cause(s) end manner as amted_ ^ 27) Type I Print
34 Name and Atldress of Person Whp Canpleted Cause of Death (Item
A
~
/ I ~ I / I ~ I
35. Registrar's Sgnatu a Distract Numb / 36 Dpate~ (Monet y, Year) J~'~~ + '2 ~~~~' ~ ~ J
I
I
Disposition Permit NO. 022$615 _.
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RICHARD E . LENKER - - J ~->
- `~' ~_
~,
I, RICHARD E. LENKER, of the Township of Hampden, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this my Last Will and
Testament, hereby revoking and making void any and all prior Wills by me at any
time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after
my decease as the same can conveniently be done.
2.
I direct that there shall be paid out of my residuary estate all estate,
inheritance and like taxes together with any interest or penalty thereon imposed by
the Government of the United States, or any state or territory thereof, or by any
foreign government or political subdivision thereof, in respect to all property
required to be included in my gross estate for estate, inheritance or like tax purposes
by any of such governments, whether the property passes under this will or
otherwise.
3.
I give, devise and bequeath my entire estate, real, personal and mixed of
whatsoever nature and wheresoever situate to my wife, EVA G. LENKER,
absolutely and in fee simple.
-1-
4.
In the event my wife EVA G. LENKER predeceases me I give, devise and
bequeath my estate as follows:
(a) I give and bequeath One Thousand ($1,000.00) Dollars to my
son TEDDY RICHARD LENKER.
(b) All the rest, residue and remainder of my estate, of whatsoever
nature and wheresoever situate, I give, devise and bequeath to my wife's
niece, SHEILA YOUNG and her husband CHARLES YOUNG.
5.
Lastly, I nominate, constitute and appoint my wife's niece, SHEILA
YOUNG, to be Executrix of this my Last Will and Testament and I further direct
that no bond or other security be required of my personal representative to
guarantee faithful performance of her duties.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this / yl
day of September, 2007.
~~
~~~~ ~~, (SEAL)
c ar a er
COMMONWEALTH OF PENNSYLVANIA )
SS
COUNTY OF CUMBERLAND )
I, RICHARD E. LENKER, the testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according to law, do
hereby acknowledge that I signed and executed the same instrument as my Last
Will and Testament; that I signed it willingly, and that I signed it as my free and
voluntary act and deed, for the purposes therein expresse ~ ~ j
`.
t (SEAL)
c ar en er
Sworn and bscribed to before
me his (~~ day of September, 2007.
` ~ .~ "~
t.d~f 7/ ~,
otary is
COMMONWEALTH OF PENNSYLVAN~~ , ,
SS
COUNTY OF CUMBERLAND )
We, the undersigned, J. Robert Stauffer and John M. Eakin, the witnesses
whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw the
testator, RICHARD E. LENKER, sign and execute the instrument as his Last Will
and Testament; that the said testator 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 knowledge, the testator
was, at the time, eighteen (18) or more years of age, of sound mind, and under no
or undue influence.
Sworn and subscribed to before
me this /yh--t day of September, 2007.
~~i'I
otary u is
Nowwit ~t
MMMr Ihr
~ ~ ~ ~