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HomeMy WebLinkAbout10-30-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland Estate of Raymond A. Smith also known as Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) COiINT~t', PENNSYLVANIA File Number __ ~ I _ ~}(~ ' ~ ~ 7 Deceased Social Security Number A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the last Will of the Decedent dated Febntary 1, 2007 and codicil(s) dated Executor E^-~ ..=° named in the c= (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 born or adopted after execution of the ;lrtsfrumettT~s,~ offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: - ~ '-" B. Grant of Letters of Administration -- (Ifapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durante absentia; durante minoritate) ~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by th.e following spouse (if any) and heirs: (If Administration, c. t. a. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Dauphin County, Pennsylvania with his /her last principal residence at Church of God Home 801 North Hanover Street Carlisle PA 17013 (List street address, town/city, township, county, state, zip code) Decedent, then 86 yeazs of age, died on October 26, 2008 at Carlolyn Croxton 'Slane Hospice, Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA $ 400,000.00 ) Personal property in Pennsylvania $ (If 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: Form RW-02 rev. 10.13.OC Page 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(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 c r~~ ~ day of '~`~ ~,~ ~1-- ,~ r For t ~ t;gister ,~= , ~~, - ~ : ~ C ~- Signature bfPe,~sonaJ Representative ~--" _ ~ ' ~~ Signature ofPersona! Representative - _ Signature of Personal Representative _, File Number:__ ~ ~ ' ~1 - ~ (Jl 7 Estate of Raymond A. Smith Deceased Social Security Number: Date of Death:October 26, 2008 AND NOW, ~,)N~ ~ ( ~ _>~~.~~~ having been presented before e, I IS DECREED that Letters ~ in consideration of the foregoing Petition, satisfactory proof are hereby granted to t°-Cl Cr~~u and that the instrument(s) dated ~~~ described in the Petition be admitted to probate FEES Letters ............... $ ~ ~,~~ Short Certificate(s) ....... . $ Renunciation(s) .......... $ 1 ... $ ~r ... $ ... $ ... $ ... $ ... $ ... TOTAL .............. $ $ ~ -9-6b Form RW-02 rev. 10.13.06 02. filed of record as the last Will (and Codicil(s)) c. Attorney Signature: Attorney Name: John M. Supreme Court I.D. No.: 6351 Address: Market Square Building Mechanicsburg, PA 17055 Telephone: 717-766-3172 ut the above estate Page 2 of 2 ~~ c~'I C~~~ I~77 LOCAL REGISTRAR'S CERTIFICATION IOF CJEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 148546E~5 Certification Number la7 P_rI _ G> u< rrpc aMlNrw PERMANEN! BUCK :NN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH ~$BB IDSISUCIIOnR anal aramnln¢ nn re...or oy r NUMtltN I Name w Dwecenl i;Frtsl. made Idsl. suHnl j. $ei ]. $ptlal $ecunly NUmoer < Dale 01 Dealn (Mpntn. tldy. year) Raymond A. Smith Male 183 - 12- 4006 October 26 2008 5 A B , ge Ilasl r~Mayi UnWr I year Urger I Gay 6. Dale of Brnn (Hoorn, day. year) 7. &nlplxe (Coy anG 51aY w loraign reentry) Ba. Plxe dl Death (Dnxk only one) w ars Dar= teas sarwm Mospiul, 86 ys 10/21/1922 Marysville, PA °tMc ospice ^ Inpalwnl ^ ER I Oulpalgnl ^ DUA ^ Naarg Man! ^ ReaWKe ~Iner . Spec ry J I d Counry o Deam & Gry. Sao. Twp. d Dean fio Faa6ry Name (d rid narWlpn, give street arN rxaroerl 9, Wu Oaoedenl cl Mispanc Or,grnn ~ No ^ Vas t0 Rxe Atn¢rcan Irw~an Blaa wn.,e e¢ Dauphin Susquehanna Twp. Carolyn Croxton Slane Hospic (R yes, spenly Cuoa"' ISOlwYY1 YniCan, Pwno Rpan, ekl Whit e I, DKlWnI's JSWI 17tCU Iqn Kuq of wak 7or1! Gut ender d tile. DO rid sidle reoredl 12. Was Dxetlenl ever in Ilse ID. Dauderll's EGUCation ($pxily pNy nigMfl grade CdypYledl la Mental $latus. MameE. Never Married. I$. Sunning $pou58111 wile vlen Dame) grve rw Kok d W n S o . ArmeE For<es? ,,gbh. ~~~ KinO d Busirreis / plEUSI U. ry EYmeaary/SxmWry(O~t2) Cdlega (t_aw$.) lSpecJY) Owner Ins. Co Insurance }{$Y ^ 1 . .e Np 2 Widower _________ 16 Decedents Mying Adpress I$Irael. nry; town, sole. tp CoEe1 pep~nts ~ ~~ y- A R PA v~ wum •aWrc. IYa Stile 206 Ridgeview Drive lmha ,7<~ars,oxeWMLNeow Susquehanna i _ rp M a r y s v i 11 e, P A 1 7 0 5 3 Ito cp~nlY Dauphin '°"r"'"0p nG ^ Nd, Dxedenl hvx wnikn Actual Ludls d coy , ~.p I B Fdlner's Name (first. made Ida. sunnl 19 MdmN s Na(r1e (First, miEEle, maiEen SlMnirrl!) John W. Smith 29a. inlortnanl's Name I1ype; Prmp 2(Ib. Inlonnanl's MaYnq Adhey (SesY, WY / bwn, sole. .:q COW) Patricia S. Trawitz 204 Ridgeview DriT~e, Marysville, PA 17053 ~ 11 a MetnoG a D~Sp0a11XJn ^ Gyupon ^ DprNlipn 210. Dale of Psptaluan (Hmm, Wy, year) 21C. Plate d DiaposiUm (Name d cYnYry, wemakry a pmar Plea) 21 tl. Localgn (City I town, slate, tp Nde) ~ ^ Rlmdyaltiany l ~ ^ a e !~;,~ „„M°°n"~;;"°^a.,^Y.a^Nd 1 0/29/08 Chestnut Grove Cemetery Marysville, PA 1 7053 na s~gnatwe a Fa,wm teen (w as sod,) - - ~ nn lcense Nlanper ne. Name arN AGltey a Fadliry e 011825-L Shalonis FH, 206 Maple A~~e., Marysville, PA 17053 Gmpbl! Hems 2JaC only CBNIYv1g Myscun is MM av>,lad< al tune d Wdln to ~ 23a. Po Cre 6e31 d mY W'd"'Yd9e, Geam occuarBd Ins lints, Wle a s ($ignalw olYl ~a ".. ~ ~ / ,. 2Jp license Bumper 23C. Date lSgneG (HOnN. day. Ye ar ) aruh Huy a seen. ~ ~d ~1GC /` ja 1~ / ( ~ } ~ ~ / ~ f 7 _ . / / /! U® fi ,J J ~~ ,~ L' .~ve~ cl Hems N ~26 must a campa,eG W cersm .+so wwrwrces Warn N ti d Dedm $. Dale PrwqunCeG Deaf ( m. WY, Year) iJ 1 Z6. Was Caas Rllen k MaGrcal Examiner / Canner Iw easm Olner man Cremalron a DondlrOn~ ICJ ~~ti v~~ ~ C7 ^ Yn No CAUSE OF DEATH (SN Inelruclidns en •ampl ) I ApprocimaY inrarvW'. Pan II'. EMSr oY»r y ww •~+andl I ( I Ge L. 26 Dq iopa¢o Use Conmal! Ip Deamv tram Z 1 Pan I Enter the Cnaln d events - drays. mwnes a CwWicalains - mat dredly auseOlna Wam. DO NDT solar lermnal eveMS slxn as arax arreA . Onyl to Deam WI rid resuAi w me respualwy anesl. a venlnCWar lipnaarxn wrGgH 5lgrnrrg me ebobgy Usl oMy one cagy a eicn bM J aNaEying Cruse ryven n Pan I ^ Yes ^ Prdrady IYYEDIATE CAUSE IFinal assess a // 1 ^ No ^ Unkrrown casdrron resWUng m deem; "{ ~ ~ n ~ ~ / / 1 -r t _ O Q V / C ~ f~~ y s / n~ / ~-~ ~ ~ . f Gs ^~ 29. a Flmak -~ a D/ue~10 Iw as a conseguerce d). seaen airy I~sl cmWans. n any. D ! ~ io nr, C, O ~J S ~~ C v L~ , r / ^ Na aegnaw w~lwl pea Dear baoe~0 to me ca Ca (C' ~ / S e <~ -{ u w r ^ Pr rl nl l G I I C l •` p l ~ n ~ S ,~ u . o, r v / C s e on ns a w ag a a ,d Ilene d Watn E 1 UNDERLYING CAUSE D e IO a as a ConypMrrte d): ~ ~ ~ ^ Nq pregrNM. old pregnant mlrwr 12 Wy5 I lauds! a in,ury Indl iNedleG Ins t NH,ts rlsurong in aalnl LA$i. ~`~ Due to la as a conseguerke oil. ~ ' ~~! ~ J l~ O ~ /' a ~ 01 dam d ^ Nol pregMnl. an aegnarn. t3 days k I year -- , ~ + C f t. (~ alas oearn tipsy 700 were Aulapsy F~ndnge JI. M Dram ^ Unknown it pregnant wlNn ;ne pea year l0a was an Aal 72a. Dale a Iryury (MMN. Wy. year) 720. Des<ri6e Mow Iryury Occurred P ~ enameG ArarlddP Pow to Complllain J2c PIaKe Ol Iryury Bane F 2Y dClay Nawd ^ Npm W ox a ld s it e i ng It r pltr,; a cause a Deam, r`) ~Q, ~ s ~ ^ A¢gern ^ Penang Iovesligdlgn 72G tens a o-yury 72e InWry al wod+ 721. n rransponaem Iryu ^ 7 (sPetihl 72g LOtalgn a Injury 1$Ireel. nn town. s;alel ^ SuiaW ^ Could NoI De 0llermvw,d ^ yes ^ No ^ Dover r Operate ^ Passenger ^Peaseon Aa . olner . $pICV/Y: lJa Cen~I~Q. ~ICna~r. Orin doer 7JD a Cemner • CMilying pnysiCiin IPnys~c:dn :emlying cause of oldln wMn dnaner pnys,odn Has wonounCeO Oedln anG CompleleG Item 271 n. to Ins Desl of my knowledge. Eeam occurreG sue to Ins eau d~ ~ . ~-~ r sNsl and manner as stalld_'_-___' - --'---'--'-----"---'--'- • Pronouncing and cenirying pnysician IPnysl:an own praxwncey Warn and cemtv.n, to cause of dealnl 33C Lv:eny Numper is :n! asl or my knowk4ge. seam OCturreE al Ins time, Eire. anE place, and due Ip Ins causes sl and manner as sl]lea_ _ _ _ _ _ _ _ - ^ 7JC Dale $ ed IM In Gav year) YeG^ilEaimmer,~Pr --------- n~ /~ - e 3 I o ~ s" -E ~~~ ~ ~ , ~;3 on I e msrs of eaamrnaoon ins r or inresegadon..n my opinion Eeam «cu,rea al me lim a , e, an. and pence. anE Due to Ins ausgsl ,nE manrw as snleE_ ^ ' 3/ Name q AWr d P w _ y sss erSyC w y+mweln'1 cause a OeaP. IIIem dil ryp!' P•inl lie , - m ~ L / f .. ,, 11 rr M nee r ' ! .. . ,, M n. N ?'~tyc: U' <_< ,, u v, ,r' o ¢ 76 Dale led m Gay. year, r F 1 r `j? S C ~~o i f I I 116 I /d~l~ /~r (~ ~ ,ie ~ ,. , (. , /fi A )-, ~~ This i~ to cert,ty that the information here given is correctly copie;l fl-om an original Certificate of Death duly filed wilt, me a, 1_.ocal Registrar. The original certificate will be forwarded to the State Vita] Records Office felt permanent filing. ~~c~ GC r~~ ~ P~ o ~ Local R gistrar ~~ Q ~ Date Issued l o _ l -`~- ~, - {-, ._ -s7 -J -~ - ., epds,n"n Plrm,~ Nn (/id' b J J -. ] ~ ~_ '1 ~T /1 ~....~i 1 -±- LAST WILL AND TESTAMENT ''~ <.,7 =i ,,, -~ :. ~~ RAYMOND A. SMITH I, RAYMOND A. SMITH, of the Borough of Marysville„ Perry 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 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 ibe 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 and bequeath the sum of TWO HUNDRED THOUSAND ($200,000.00) DOLLARS to my sister, PATRICIA S. TRAWITZ. 4. I give and bequeath the sum of FIFTY THOUSAND ($SO,C100.00) DOLLARS and my real estate known as 206 Ridgeview Drive, Marysville, Perry -1- County, Pennsylvania, with the furniture and fixtures contained therein, to my niece, CONSTANCE KING. 5. I give and bequeath the sum of TWENTY THOUSAND ($20,000.00) DOLLARS to DONNA HOFFMASTER, wife of TIMOTHY HOFFMASTER. 6. I give and bequeath the sum of TWENTY THOUSAND ($20,000.00) DOLLARS to my friend, DOROTHY TAYLOR. 7. All the rest, residue and remainder my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my sister, PATRICIA S. TRAWITZ. 8. In the event my sister, PATRICIA S. TRAWITZ, should predecease me, the gift to her shall not lapse, but pass to her daughter, CONSTANCE KING, if she survives her mother otherwise the gift shall lapse and fall into the residue of my estate. 9. In the event my niece, CONSTANCE KING, should predecease me, the gift to her shall not lapse, but pass to her mother, PATRICIA S. TRAWITZ, if she survives her daughter otherwise the gift shall lapse and fall into the residue, of my estate. 10. In the event both my sister and my niece, PATRICIA S. TRAWITZ AND CONSTANCE KING, should predecease me, the gift to them shall not lapse, but pass to THE MARYSVILLE CHURCH OF GOD. 11. Lastly, I nominate, constitute and appoint, JOHN M. EAKIN, to be Executor of -2- this my Last Will and Testament and if for any reason he is unwilling or unable to act, then I nominate my sister, PATRICIA S. TRAWITZ, to be Executrix in his place and stead, and I further direct that no bond or other security be required of my personal representative to guarantee faithful performance of his or her duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this (,~' day of February, 2007 -~ -~ ~ (SEAL) aymon mi ~ ~`~~ ~~~ -3- COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL ) SS ROtsj/LL~ry VA~DERLYKE COUNTY OF CUMBERLAND) cA'ItatE ~oROIwN, ~ My ComfnlNton Expl~~i Oci 24, 2010 I, RAYMOND A. SMITH, 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 expressed. ~ purposes therein Sworn an s bscribed to before met ' day of ~ 2 . ~~ is ~ COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERI=,AND~ SS NOTARIAL SEAL ROaBALVN M VANOERtri(E Notary Public E bROUGII. ClM4,ER(,ylp C.vurrn My Comm pion Explr~s ~- pt; 2010' We, the undersigned, ;~~~-T%~~1~ ~ ~E l-~-L 1 ~ and . c~ N ~v witnesses whose names are signed to the attached or foregoing instrument, bein dulyy ,the according to law, depose and say that we were present and saw the testator, RAYMOND Afied SMITH, sign and execute the instrument as his Last Will and Testament; executed it as his free and voluntary act for the ppu oses therein expressed that ach of usain the hearing and sight of the testator, signed the Wi~ 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 constraint, duress or undue influence. ~ ~~ ~~~ c-~ `~_ Sworn anc~ s bscribed to before \ t~ ~ .day of/, 2 Lj of u is ~,. . r !, y (SEAL) ~G~ -4-