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HomeMy WebLinkAbout10-08-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF ~'_~Am. ~~ lc~,~ _ COUNTY, PENNSYLVANIA Estate of ~~ t'YL t°rS ~ u) q ~ / ~7_~ / 6 /) ~ File Number ~ (~ ~d' - /Q~ O also known as ,Deceased Social Security Number ~ ~ ~ " ~ (~ '" ~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (~C,OM~PLETE 'A' or B' BELOW:) ~Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~_ ~ pC (,( `f ~ t ,~ named in the ]ast Will of the Decedent dated ~l - U / " D ~ and codicil(s) dated (State relevmi[ circumstances, e.g., renunciation, deatk 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 Administrati (Ifapp/icnble, eater: c.t.a.; d.b.n.c.t.a.; pendente liter durance absentia; durance minoritate) (COMPLETE IN ALL CASES:) Attach additional s/:eets if necessary. ~ ~_~ i. IJ 1 ~, W Decedent was domiciled at death in ~l, u,m Der,' a~ County, ennsylvania with his / t~}ier last principal residence at _~~ FS~n 11~i_,,,.n ~ns-i L.c•,,,._.~- ~~, „2,n Ni l~ ~ ~Gt [ 7D(i l~le .~vrr-lanTivn !t„.,., L,. (List street address, tdwn/city, townskip, county, state, zip code) Decedent, then ~_ years of age, died on d9 -at 8-/ s~ at s t DS Decedent at death owned property with estimated values as follows c,~-~~ (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ ('~ (lf not domiciled in PA) Personal property in County $ [~ Value of real estate in Pennsylvania $ ('' situated as follows: 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: or printed name and residence Fa~ui RW-0? rep,. !0.13.06 Page I of 2 Petitioner(s) after a pro search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) aucblleirs: (!f Adrnittistratiott, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~,_ -j ;=' Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA /~ f r SS COUNTY OF_( (,,t, YYI T~~ ~ ~G 'r1-C'~ Tire Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are ttue and con-ect to the best of thA knowlzdge and belief of Petitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and tnity administer the estate according to law. r~ _ -~ a ~ f::.. ~_ ,~ Sworn to or affirmed at:d subscribed ~ ~ ~- ~ (~ Signature of Persona! Representative ~ , ~ ~ ') before me the T>~h day of ~ ' i, ll ..!! F~ t/~-L- ~~~ ~ Signature of Persa~n! Representative ~ For the Register Signature of Persaml Representative ~' ~ ~~ _,7 ~ J CX7 File N,u~m/bet: ~l ~~- /~,~~J Estate of ~,~e ~L-Q~ ~i.LG(r/('/Gf ~~~~~5) ~ ,Deceased Social Security Number: ~7~-~U- fJ/7~ Date of Death:. '/ Z~/~~ AND NOW, C~~,i/ ~/Y. 6 in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters t~>~~ are hereby granted to Q d _ in the aL->ove estate and that the instrument(s) dated ~~ ' described in the Petition be admitted to probate and filed of record as the last Will (and dicil(s)) of cedert. ,~ FEES ~- //(~ _ O,e. S~> Letters . • . $ ~ ~ Register of Wi11s~~ '~ ~~~' r {^-'' Short Certificate(s) ........ $ ,`~ 0 U Renunciation(s) .......... $ -/-~ ... $~~ , v ~ ... $ ... $ ... $ ... $ ... $ _ ... $ TOTAL ~ 1 ............. $ <~i U Attorney Signature: Attoney Name: Supreme Court I.D. No.: Address: Telephone: Fornt RW-0? rev. l0.13.Ob Page 2 Of 2 Ils,lf•,=. rall~v 10'/~~ ~ ~ -I~r LOCAL REGISTRAR'S CERTIFICATION OF DEATH W,ARNlNG: it is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 14"l~?942J Certification Number This is to certify [hat the information here gi~ren is correctly copied from an original Certificate of Death dul~~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ^ •~ l.,ocal Registrar Date Issued t-.^ l . ~ ~' - = O `~ C"3 > _r~ _ '.(} ~ } ,. 1-. _.. ~_-~t ~ - _ ^~ y.:~ { ~~ - ~ ~ S t~ y. W , CX~ Hm>us Nev n zwo COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE ~ PFINT IN PEw.lArlErlr CERTIFICATE OF DEATH BLACK mIR (See instructions and examples on reverse) srnrE FILE NurnsEH 1 Name of DecedaN IFrsl. nudge tas1. suffix) 2. Sex 3. SxY 1 Seuvrily Number 4. Daly of Death (MOnlfl, day. year) E Fitz ibbon Male 179- 40 -5176 Se tember 29 2008 5 Age Ilasl &ntday) Under t year Under 1 day 6 Data d Binh (Monin, day, year) 7. ar9lplace ICiry wd stale a forego aunlry) Ba. Place of DeaN (CMck ayy one) Mcnea Days Iwas Minutes Hospital. Olney. 60 Yrs October 3 1947 Ashland PA ~InpatieN ^ ER I Oulpauenl ^ DOA ^ Nursiny Nome ^ flesicence ^Otlrer SpBCOy Bo County ul Deam 6c. Gity, t7ao, Twp. of Death 90. FaWny Name pl not n,s1ilWlan give s9ce1 and mrmMrl 9. Was Deced¢N of Hispwxc Orgin? No ^Yes 10. Race: Artnrnan Irgian. Black WMe. Bk Df Yas, 51,¢city CuOaq fSpeaM Cumberland East Pennsboro Hol Spirit Hon ital ~x~n Pueno Pecan. ek) white I I. Decedonl's Usual Oct alron IKlyd d woe d are dui nnsl W wa ' INe Do noI slate rehretl 12. Was DBCedeM ever n 1M 13. 13ecBtleM's Eduralion (Spenly only hgnesl grade compl elntl) Id. Marital $lalus. Marrwd, Never Harriet 15. Bunning Spo use (II mla yise maden rwrel Knd d Woa Kad d Business 1 kduslry U.S Armed Farces? Elementary !Secondary IQ 12) Cdlege (I-d a 6~) Widowed. Divorced I Specryy) l~aa ^rw rigid Jud Messino td Dxadanl's Mailuq Address (Segel my I Wwn. stato, Tip vadel DecedenYS Dld Decedera Hamden lvania Ove ta a P nns 520 Lamp POSt Lar1e 17c. Yes, Decedent Lived in Actual Reatlerne 17a. Stale e v Twp. Township? 17d. ^ rro,l3xeaem used willyn Cumberland b c Hill PA 17011 oarny u rwwd UmisM ceY Boro IB FaIMr's Name (Frsl, mdae, last. sullul 19. Mother's Name lFttsi nudge. rrrei0en surname) James Fitz ibbon Joan Care 20a- Inidrtnanl's Name ITYPa / Pnnl I 20D. InlormaM's MaNirg Adtlress (SreB1, city !town, stale. zip code) Jud Messino 520 lam Post Lane Cam Hill PA 17011 21a IAethW of Dispositon i [ cremation ^ Donallm 210. Date d Disposition IMOnN, day, read 21 c. Place of Disposition (Name d cernelery, cremabry a dha place) 210 Location Icily / kwn. stale, iy code) ^ Banal ^ Removal bom Stale I Was Cremation or Donation AUllwr'¢ed r-~ ~ • l t PA Mt H lt S i ^ OtMI-Speniy OYMedicalEaamirertCororerT [ YaaLaNO October 4 2008 is er CrelTla o Hol Qr ngs, . o 22a Sgnalae d Funeral Senke Ln¢Asee for person ling as such . ~rY. } ¢ 22D. Lcense NariMr 22c. Name and Adtlress d FaciMy 8 Market Plaza Way ~ - .~~- ~i'' ~, .,. ,~ FD-13854$ Mal zz' r Complete hems 23ac aYY when cenilykg 23a. To en Mst of my knowledge. deem acared al the tune. dale and place staled. (Sgnanue and cant 23o Cleanse NumOar 23c. Dale Signed IMaaO, day, yew) pnysnun a nut availa0la al loin d tleal0lo ceNty ca a of death. Ilrnrs 24_Z6 must M cor,lpleled Dy person 24 Time a Deelh 25. Dale Prapunce0 Dead (Month, day, year) 26. Was Case Relenetl l0 hleacal Examiner / Corala Yw a Reason qMr Than Gematnn a Dordlan~ why ganalces death h ~~ M. /~' (n7 ~~ t~iM he(' a~' r~G ~D ^Yes ^Nu CAUSE OF DEATH (Sea Inslruellona and ex mplaa) t Approx nine nlerval: Pad N'. Enter olMr L9BIIxBN {~4pgflir&pIrlDJlypgyL ~YilIO, 2B. Db TeOxco Use CYnbibWe to Deals? Item 2l Pan 1 Eaer IW GBadLVLY,YElllS - asaases. nlune5 or complealnns - IIWI alealy caused Ne main- D(y NOT enter teii,arwl Bverns such as caraac arrant, q~sel to DeaNr ON dd resWling in NJ adenyal9 dada gven n Pan I ^Yes ^ Prubagy respaatory arrest a venbniaar Iloritlallon wiOroW showuig Ilse elnbgy Lrsl oNy one cause un each fine. ii ^ rb ~MlYrww WMEDIATE CAU6E 1Final a>rase or (/11 (~y1 I/ ~ r cuMrtnn cesunnyhbeaMl --~ 1 ~] I Y ~ L (,a1Y xraeu - ~ a 29. It Female. N l ^ N Due to la as a consequence op- a praylaM w wi p^s yua, ^ Preyrunl al Woe W death Se auztlNaxy Ns1 ¢onaaa~s 11 airy. b leadrg to dye cause Ysled al Yre a. Enter B~0 UNDERLYWG CAUSE Due to Ia as a consequence op'. ^ Nil Preyrwnl but g0y+raN wiltun 42 days d death (as¢ase ur urWry Nut nuxalal lna N d LAS events rosu ing in ealnl T. Due w for a:; a consequence op: NW I, WI n147 dd s 10 1 ^ pregnan pregla y year Celore deals d. ^ Unkrnwn a pregwnt wrlan me pass year 30a Was an Autopsy 300. Were Autopsy Finangs 31 Man of Deam 32a. Dale d UN'aY 4MOnlh. day YBwI 320. Describe !taw Newy Occurred 32c. P4¢e of Iryury. Hare Farm Street Fxlay, P¢dwmed? Availaae Pnor to Compleuen Otlne BaWng. ek ISpecrry/ oI Gause of Deals? alural ^ Hwnu:de ~~ ^ Y / ^Y ~'IJo ^ Acudenl ^ Penang Investigation 320- Ono a Iryury 320. Injury al Work? 321. II iransportalien xjury (SpecilyJ 32y- Lacalion of NINry Istraa, Lily! bwn, stale) es IYn° es ^ SukN¢ ^ Could Nol be Deternunetl ^Yes ^ Na ^ Onver /Operator ^ Passer~gUr ^Petleslnan M Omer ~ SpaclY 33., CemMt IcMCx oNy and 33b Siynalure and Td • CaNlyntg pnyskun iPl,ysxiw cenHying cause M dealli wnun anoliier ptrysiaan teas prurxwnceJ Oaaih and Completed Item 23) To IM Wsl of my knowledge, dun occurred due to IM cause(s) and manner as sliled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pronounnry and cMifying ppysklan iPhysician Ouln prcnouncuig death and caddying to cause of dealni To Ise Mst dl mY Ynowladge, death xcurred at Ise nine, dale, and place, and tlee to IM teasels) and maser as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • Medical Examiner I Curernr 73c License Nur r G I ~ ~ ., 330. Dale iyne~ M11ugP~, year) ~ Z ~ (/ On lM haste W Yxaminalion arW I of investigation, In my apinion death otturred al Ise lime, date, and place, and due to tM causel9) and manner as sated_ L] ~ Name and A ass W Person WM Cmiplelea Cause cl DEaN Illem 27 T I Prvll n 75 R - raiure and Di In NJmy9 ~ I 1 I ~ I I ~ I ( I ~ %. Dan Iled IMunlh day, year) ~ ' ~ ~' GI `^'C •V _ • t ~ q , `c f, . ~ / . . vcX.i.,, - ° ~ J ~ r ( 3~w , 7 . C J/VO Z 2 1 Disposition Pennil Na ~ ~ / O ~~ LAST WILL AND TESTAMENT c ~ ~ ; , _ ~, - - c~ o ,:- - -~; ~ ~ _ c~ JAMES E. FITZGIBBON _ ~- --~ -,; - - c.., , , _~ .. ,:,_ ~ I, JAMES E. FITZGIBBON, of Camp Hill, Hampden Township, Cumberland Couty, Pennsylvania, declare this to be my Last Will and revoke any Will or Codicil previously made by me. ITEM I: I direct that all taxes, penalties and interest that may be assessed on property passing under this Will, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of administration of my estate, without apportionment. Any such taxes, penalties and interest imposed on other property passing as a result of my death but passing outside of my probate estate shall be apportioned among and allocated to the beneficiaries of such property and shall be paid by each such beneficiary. ITEM II: I devise and bequeath all of my estate, of every nature and wherever situate, to my companion, JUDITH M. MESSING, now of Camp Hill, Pennsylvania, providing that she survives me by thirty (30) days. ITEM III: In the event that my companion, JUDITH M. MESSING, dies on or before the thirtieth (30th) day following my death, I devise and bequeath all of my estate, of every nature and wherever situate, in equal shares to such of her children, TRACEL L. HAWKINS WILT, now of Charlotte, North Carolina, and JAMES R. HAWKINS, III, now of Harrisburg, Pennsylvania, as are living on the thirty-first (31St) day following my death. ITEM IV: I hereby authorize and empower my Executrix, hereinafter named, to sell any or all of the real property and personal property which I may own or to which I am entitled at the time of my death and which is not otherwise specifically bequeathed herein, in the sole discretion of my Executrix, at private or public sale, without an Order of Court, at such time or times and upon such terms as the said Executrix shall deem appropriate for the best interests of my estate (or my beneficiaries) thereby converting the same into cash. I further authorize and empower my said Executrix to execute, acknowledge and deliver all proper writings and deeds of conveyance and transfer thereof. ITEM VI: I appoint my companion, JUDITH M. MESSING, now of Camp Hill, Pennsylvania as Executrix of this, my Last Will. Should my said companion fail to qualify or cease to act as Executrix, I appoint my friend, WILLIAM KNITCHMAN, now of Carlisle, Pennsylvania, Executor of this, my Last Will. ITEM VII: I direct that my Executrix, or her successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 2 IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of , 2008. t C~ (Seal) A ES E. FITZ I B ,Testator The preceding instrument, consisting of this and three (3) other typewritten pages, identified by the signature of the Testator, JAMES E. FITZGIBBON, was on the day and date thereof signed, published and declared by JAMES E. FITZGIBBON, the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. ~Q,~'tG~ ,~// 2~/l,C~ of 17 Dorchester Road, Hummelstown, PA 17036 r of 345 Maple Lane, Carlisle, PA 17015 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN ss ~ , We, Liana M. Z~rilli~ and ~ ~ "~ witnesses whose names are signed to the attached or 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 his 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 the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. SWORN TO OR AFFIRMED BEFORE ME BY THE ABOVE-NAMED WITNESSES THIS ~ DAY OF ~~~ , 2008. Notary Public CLvLQ ITNESS WITNESS COMMONWEALTH OF PENNSYLVANIA Notarial Seal Constance P. Brunt, Notary Publlc Susquehanna Twp., Dauphin County My Commission Expirss Oct. 20, 2009 COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN ss I, JAMES E. FITZGIBBON, 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 instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. f ES E. FITZG1~bN, Testator SWORN TO OR AFFIRMED AND ACKNOWLEDGED BEFORE ME BY THE ABOVE-NAMED TESTATOR THIS i~~ DAY OF -~ , 2008. 1~--.-~~~~i Notary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Constance P. Brunt, Notary Public Susquehanna Twp., Dauphin County My Commission Expires Oct. 20, 2009