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Home My WebLink About09-04-08PETITION FOR PROBATE & GRANT OF LETTERS Estate of Michael T. Green No. 21-08- r~b also known as To: Register of Wills for the deceased. County of Cumberland Social Security No. 196-48-4639 Commonwealth of Pennsy~nia c ~_ The Petition of the undersigned respectfully represents that: ~?~' ~~ ~ ': ,; Your Petitioners, who is/are 18 years of age or older and the Executrix named rn th~'L~lill o~the above decedent dated August 1, 2007 ,and dated December 15, 2007 "=ft~~cecu~r , ', ' named none died .Renunciations for none attached hereto. ~r~Q - " ' '_= ~ _`.~ Decedent was domiciled at death in Cumberland County, Pennsylvania, with his I~t~mily or~}-inci~t f.-_- residence at 4048 Seneca Avenue, Camp Hill, Lower Allen Township ~ Decedent, then 48 years of age, died August 21 , 2008, at M.S. Hershey Medical Center, Derry Township, Dauphin County, Pennsylvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA} All personal property $5,000.00 (If not domiciled in PA) Personal property in PA $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania, situated as follows: $180,000.00 4048 Seneca Avenue, Lower Allen Township, Cumberland Count 256 Yale Street, City of Harrisburg, Dauphin County WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signatur (s) and Residence(s) of Petitioner(s): ~ ~~~ Kelly D. Green ' 912 Gobin Drive, Carlisle, PA 17013 717-713-8966 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss 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 of the above decedent, petitioner(s) will well and truly administer the estate accordin to law. Sworn to or affirm nd subscribed before me this _~ day of t be , 2008. Regisfer Kelly D. Green No. 21-08- C~9C~ ~ Estate of MICHAEL T. GREEN ,deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, September ~ V , 2008, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated August 1 2007 and December 15. 2007 described therein be admitted to probate and filed of record as the Last Will of Michael T. Green ;and Letters Testamentary are hereby granted to Kelly D. Green FEES Probate, Letters, Etc..... ... $ 260.00 Short Certificates(-5- ~) . ... $ 20.00 Renunciation(s) ....... .... $ none JCP ................. ... $ 10.00 Automation Fee ..... ~. ~.. ... $ 5:00. Other Will . ... $ 15.00 TOTAL: . ... $ 310.00 Filed ................. ........... Register of Wills Q~~' SA ZM~ANNc HUGH,~S P~x~ Patricia R Brown Esq. (27474) ATTORNEY (Sup. Ct. I.D. No.) 354 Alexander Spring Road, Suite 1 Carlisle PA 17015 ADDRESS 717-249-6333 PHONE H105.805 REV (01yO7) Og-09G( LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.O0 P 14543~1~ Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with lne as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. LG~m ~ a`' ..A ~ 2 3~ 008 Local Registrar Date Issued I REV l1/loos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH + VITAL RECORDS PRIN7IN H"Er,kT CERTIFICATE OF DEATH (See instructions and ezamnlex nn r<srenenl C•) G ~ r~~ n n =??~r :_>~rn r. ,_ cJ~ ~ n' C ):~~ 0~ -~ r•J ea m rT1 '~ i •~ A r r_ , ~~'-- _. ° i:._i .:.1":1 ~_.~yi Yr~ :~ .'3 r ~ron~r, 1. Name of Decedent IFirst middle, last, suffix) 2. Sex 3. Soaal Security Number 4. Date of Death (Month, day, year) Michael T. Green Male 196 - 48'-4639 Au ust 21 2 08 5 A L Bi U . ge ( ast nhtlay) nder 1 year Untler 1 day 6. Date of Birth (Month, day, year) 7. Birthplace (City and slate or foreign coumry) 6a. Place of Death (Check only oneJ _ Mmms Days rwurs MinNes H o spiral: Otner . p T ~ - 48 Yrs. All us 2 r1,1 Inpatient ^ ER /Outpatient ^ DOA ^ Nursing Home ^ Residence ^Other - Speciry 8b. Cwnry of Deaih Bc. City, Born, Twp. of Deatn Bd. Facility Neme (II not inslitNion, give street and rWmherl 9. Was Decedent of Hispanic Origin? No ^Ves 10 Race A ri di . : me can In an, Black, White, etc. Dauphin Derry Twp. S. Hershey Medical Center ("yB5 sPecity Duban, (Speci/y) Mexican, Puerto Rican, etc) ~-p,• 1 to 11 ced fs U D l O b . a an sua ce t n Kind of work done dun rtwsl of world Ida. Do rtot stile rearetl 12. Was Decedent ever in the 13. Decedent's Education (Spedfy only Highest grade completed) 14. Marital Status: MameQ Never Manietl. 15. Surviving Spouse (It wife give maiden name) Kkd f W S , p Yk Kind of Busine I I ustry U. . Armed Forr~ces? Elementary I Secondary (D42) College (b4 or 5.) Widowed, Divorced (Specil» IT Specialist State o1~ ~a ^yea L.}No 12 Divorced 16. Decedents Mailing Address (Street, city 1 town, slate, zip code) Decedent's Did Decedent ~L., ~ Actual Resitlence 17a. Slate PA Live in e 17c.t' J Yes j$ c n ~ yp pecetlent Lived in LOwe.r Al ~ eTl ~~ Ca , _ Tw ~ r~ r~r ~x~ ( ~ } ry r 7y l aV~ l ~~1 17b. County Cumberland Township? 17d. ^ No, Oecedenl Lived within p """'r Lt~l i Actual LimXS of Clly / Born 18,F 'srNi (Flrst,glitldte,J;s1, suXix) t9. Mother's Name (First midrAe maiden surname) W~ ~ , 1 1< l.,reen Shirley Wetzel 20a. Informant's Name (Type /Print) 206. Informant's Mailing Address (Street city! town, state, zip cope) Shirley Hertzler 256 Redwood Lane Carlisle Pa 17015 21a. Method of Dlsposilbn Cremation ^ Donatbn 21 b. Date of Disposdron (Month, day, year) 21c. Place of Disposikon (Name of cemetery, crematory a other place) 21d. Location (City I town, stale, zip cotle) ^ Burial ^ Removal I St l ! rom a e Was Cremation or Donation Authorized ^ Othar~S - byMedlwlExaminerlCOrorkr? ^Yes^Nn August 25,2008 Ho11in er Cremator Mt Holl ignature of Fu tic fi ec ng as such) 22b. License Number 22c Name and Address of Facility • - 011654-L M ers-harrier funeral Home Inc 1903 Market St.Ca ' C plate I 5 23ae Doty when cenXying 23a. To the best of my knowledge, tlealh acurretl at the time, date and place staled. (Signature and line) 23b Li . cense Number physipan is not avaNable a1 time of death l0 23c. Dale Signed (Month, day, year) cavity cause of deem. Ilams 2426 muss be canpleled by person 24. Time of Death 25. Date Pronounced Dead (Hoorn, day, year) 26. Was Case Refered to Medical Examiner I Coroner for a Reason Other then Cremation or Doneti 7 who pronounces Beam. 1 ~ Z ~ A~ M. AU GuS`f Z L L 00 S on ^Ves ^ No CAUSE OF DEATH (See Instructions end examples) r Approximate interval: Item 21. Pan f. Enter the cha'n of events -diseases, injuries, or complications - that direly caused the death. DO NOT enter terminal events such as wrtliac arrest Pad II: Enter other.~ni sn~ondlions catlnhul'ng to tle-m, 28. Did Tobacco Use Contribute to Death , I Onset to Death resphalory arrest, or ventricular fibrillation without showing me etiology. List only one cause on each line. r but not resulting in the underlying cause given in Pan I. ^Ves ^ Probady IMMEDIATE CAUSE Final tlisease or ~ condebn resWUn m ~eath) ~ ~ No ^ Unknown g ~. a. ~ ~ R t- C~ LL CA{(Z (,.\NpaM1k Q r 29. If Female: Due to (or as a consequence op: ^ Nol pregnant wXnin past year Sequentlaky liar condlions, it any. b. lea6r to th li t d ^ Pre nant at lone of d th p e cause s e on line a. Enter the UNDERLYING CAUSE Due to (or as a consequerxxs ofg g ea (disease or injury mat initiated the r ^ Not pregnam, but pregnant within 42 days events resuking in death) LAST. c i of deem Due to (or as a consequence oQ: ^ Not p grant, but pregnant d3 days to 1 year d~ ~ before death 30a. Was an Aul opsy 30b. Were Autopsy Fintlkgs 31. Manner of Death 32a, Date of Injury (Month, day, year) 32h. Describe How Injury Occurted ^ Unknown it pregnant wdhin me past year Performed? Available Prior to Gompleuon ^ Natural ^ Homicide f C 32c. Place of Injury'. Home, Farm, Sreet Factory, OXice euiltling etc (Speci/y/ o ause of Death? . . ^ Yes ISC~ No ^ ^ yes ^ ryo ^ Accident ^ PeriOing InvesAgation 32d. Time of Injury 32e. Inlury al Work? 32f. If TranapofaHOn Inlury (Specity/ 32g. Location of Inryry (Street, cAy i town, stale) ( ^ Suiade ^ Could Nol be Delernined ^ Vas ^ No ^ Driver /Operator ^ Passenger ^Pedestnan M ^Other~ Specey 33a. Certifier (check Dory oriel 33h. Sgnalure entl of Candler • CsrlXying phyaiclan (Physician certityrng cause m learn when another physician ties pronounced deem and completed Item 23) Ta tlb best of my knowledge, death occurrotl due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pronouncing and cenXying phyaiclan (Physician both pronouncin death and ceni im t a f d ^ - g g ry o c use o eath) To the best of m knowled e d th d 33c. License Number 33tl Dale Si d h M y , g ea occurre al the lime, dale, and place, and due to the cause(s) and manner as statetl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ . gne ( ont , day, year) • Medlcel Examiner/Coroner On the beats of examination and I or )nveetigatlon, In my opinion, death occurretl at the time, sale, and place, antl due to the cause(s) and manner as slated- ^ 0'(-Ot2_00°l /4 U(,USj ZI y (,Ob &"' 34. Name and Atldress of Person Who Completed Cause of Dealn (Ite m 27) Type I Pnnl Regisbar' Dre and Die ~ / / I~ I I ~ I I 3s. D Filed (Mon day, year ~ ~/~~ ~~ $? Ek/En/ K!}D~ D O M. S. Hershey MediCdl Ctr. y Hershe PA 17033 ~ y, Oislxnition Permit No. _~ ~ ~~~ (, / LAST WILL AND TESTAMENT BE IT REMEMBERED THAT b8 ~ c~~c~( I, MICHAEL T. GREEN, a resident of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that I have two children, MITCHELL T. GREEN and KRISTEN D. GREEN. II I direct that all my just debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuaDy estate as a part of the expense of the administration of my estate. z r~ iiy ~,,~c ~~ days. ,m~~ remc~e 1 ~,eave ~~ec~-~.r~ ~~, Y1~ --~ V~``l r ~~7 r'-~ - 0) dais; I,gi~, devise._ax~d-1~~~~~~.th.^11 of mgr r-rnr~Pr1~~~ ~*,~ iii~i i~ai vi~crovz=iu~, of ~ t, to my children, MITCHELL T. GREEN and KRISTEN D. GREEN, in equal shares, per stirpes, pursuant to the terms of the hereinafter included ~t~ Trust -;_: ~' . ~-C7 (T1 r., ., , .~~ ~ 7c~1 . , CJ~-Tl ~~ - ~-~. ":'" y C.; '~. ~.. ~~ i '9 VI TRUST If either of my children who are under the age of twenty-five (25) years who survive me, I appoint my mother, SHIRLEY J. HERTZLER, as Trustee of the property that I have given to my children. A. The assets that are transferred to the Trust shall be divided into approximately equal shares for each of my children under the age of twenty-five (25) years of age. B. The Trust estate shall be administered until each child reaches the age of twenty-five (25) years. Until that time, the Trustee shall apply all net income and principal of the Trust estate as follows: 1) So long as my child is under the age of twenty-five (25) years of age, the net income of the Trust shall be paid to or applied for the benefit of my child at such times and in such amounts as the Trustee shall in his discretion deem necessary for his support, welfare, maintenance and education. Education shall be defined broadly to include not only that available in college, but also trade school and other similar training. In the event that the income shall be insufficient to provide my child with adequate maintenance, support, welfare or education, the Trustee may invade the principal of this Trust for this purpose. 2) The Trustee, in exercising her discretionary authority with respect to the payment of income or principal of the Trust estate to my beneficiary, shall take into consideration any income or other resources available to my child from sources outside of this Trust that may be known to the Trustee. The determination of the Trustee with respect to the necessity of making payments out of income or principal to my beneficiary shall be conclusive on all persons howsoever interested in the Trust. 3) The Trustee shall accumulate and add to principal any net income of the Trust not paid out in accordance with the discretion hereinabove conferred on the Trustee. 4) In the event my child predeceases me or dies prior to the termination of this Trust, the interest of my child in the Trust shall cease, except that if he or she is survived by any children, then the Trustee shall pay net income of the Trust to or apply the same for the benefits of such children of my deceased child, in such amount or amounts as the Trustee in her sole discretion may determine for support, welfare and maintenance. C. When my child reaches the age of twenty-one (21) years, a calculation of the property remaining in the Trust shall be made and ten percent (10%) of the total thereof shall be distributed to him or her. D. When my child reaches the age of twenty-three (23) years, a calculation of the property remaining in the Trust shall be made and twenty percent (20%) of the total thereof shall be distributed to him or her. E. when my child reaches the age of twenty-five (25) years, a calculation of the property remaining in the Trust shall be made and the total thereof shall be distributed to him or her. F. My child, as beneficiary of this Trust, shall not have any right to alienate, encumber, or hypothecate his interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his creditors or liable to attachment, execution or other process of law. G. In order to carry out the purposes of this Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitation specified elsewhere in this Will: 1) To retain any property received by the Trustee estate for as long as the Trustee considers it advisable. 2) To spend funds for the maintenance and repair of real property. 3) To sell at public or private sale, exchange or lease for a period of time any real or personal property and give options for sale of the lease. 4) To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of this Trust. 5) To borrow money and to mortgage or pledge any real or personal property. 6) The Trustee shall maintain accurate records and accounts and shall render statements to my beneficiary hereunder showing receipts and disbursements of principal and income no less frequently than annually. The Trustee shall serve without bond and shall receive fair and reasonable compensation for administration of this Trust, not to exceed five (5%) percent of annual income. 7) To distribute property in kind. 8) To do all other acts that are in his judgment necessary or desirable for the proper management, investment and distribution of the Trust estate. VII I nominate, constitute and appoint KELLY D. GREEN, as Executrix of this LAST WILL, to serve without bond. If KELLY D. GREEN is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my mother, SHIRLEY J. HERTZLER, as Executrix of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, MICHAEL T. GREEN, have set my hand to this LAST WILL this ~ day of ~v4~~' , 2007. MICHAEL T. GRE Signed, sealed, published and declared by the above-named MICHAEL T. GREEN, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ,~~ !' , ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, MICHAEL T. GREEN, 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 instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. MICHAEL T. GR Sworn or affirmed to and acknowled ed before me by MICHAEL T. GREEN, Testator, this ~ S-'` day of , 2007. i` t ~~~ Notary Public Gamrv~~nweaith ~f Pennsw~lvania f~fOTARiAL ~cE-.I_ C?E.s'~tis~=rAFf l._. F?"~'AC4l, ~f~t~rj Public ~~echani;;s;i,~+~;~ ~~sro., Goer?~y of i;urnberland Niy'`e.`'ii;;~i'tisi+~n F•X~7iPe:~ J~urta t j 2010 ,~~i C'-~ ~~~ Sworn or affirmed to and acknowledged before me this ~ ~` day of , 2007. Notary Public ~,nen°nar5~vdaifh of Penns Ivania i`~UTA~s`A~- SEAS G"~~ti~~r"oF~ L. ~`~'ftRa, i~~tat•~,~ F'UbIIC Mech:t~'li z~t<rt Barn„ CaGnf~~ of ~umberiand }, ~:'a•-,,,--~; ~i~°t ir>.~aires June 1 i , 20i 0 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. We, ~`'~; r~~l l (~ ~~~ `i ~~ ~~' Gf°< and , j~~rJ g~~ ~, ~ ~/~~ , the witnesses whose names are signe~`fo the attached or foregoing in~rument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his LAST WILL, that MICHALE T. GREEN signed willingly and that he 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 y~f~our knowledge, the Testator was at the time 18 years o age or mo , of sound mind and under no constraint or undue influence. ~% ~,J ~~! ~..-