HomeMy WebLinkAbout11-13-08A)
r~
~--~ ,_r7
-.,...,.
r~
(v)
'-~
_``~.__
I~t-i ..._. _ _-
r~ ~.d .
Y
..,~ -'~
r" ~ ;
+~
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF DONNA M. MITCHELL,
Deceased : No ;~ 1 ~' ~% ~ ~ ~~`
PETITION FOR SETTLEMENT OF SMALL ESTATE
Pursuant to section 3102 of the Probate, Estates and Fiduciaries Code, the undersigned
petitioner respectfully represents that:
1. The name and address of the petitioner is:
Edward A. Rickenbach
30 Logan Road
Enola, PA 17025
2. The relationship of the petitioner to the decedent is :Nephew.
3. The decedent died on: January 25, 2008.
4. The decedent was domiciled at time of death in Cumberland County,
Pennsylvania, with a last family or principal residence at:
335 Wesley Drive #205
Mechanicsburg, PA 17055
Lower Allen Township
5. The decedent's social security number is: 201-18-2206
6. The death certificate is attached hereto.
7. The decedent died testate. The will has not been probated and the original will is
attached hereto. The personal representative named there in is petitioner, Edward
A. Rickenbach.
i~
8. The names(s), relationship(s), and interest(s) of all parties beneficially interested
in the estate are:
Sui Juris
Name Relationship Interest es or no
Edward A. Rickenbach Nephew 100% yes
9. A spouse's elective share has not been claimed.
10. The decedent was not married or divorced after the date of execution of the will.
11. The decedent did not have a child or children born or adopted after the date of
execution of the will.
12. The decedent died owning property (exclusive of real property payable under
section 3101 of the Probate, Estates and Fiduciaries Code) of a gross value not
exceeding $25,000.00, which is itemized below.
Item Amount
Cash $600.00
Account# 6103556 with M&T Bank $1,947.70
Account# 98173103 with M&T Bank $903.63
Fresh Funds, LLC $30.68
(Refund from Harriet Carter Gifts)
Bethany Towers $51.83
(Refund)
TOTAL $3,533.84
13. An itemized statement of all claims against the estate is set forth below: NONE
14. The petitioner has paid or will cause to be paid all Pennsylvania inheritance tax
due on all property to be awarded under this petition.
15. There are no parties, beneficially interested in the estate, other than petitioner nor
are there any holders of claims who have not been paid in full
16. Your petitioner proposes that the balance be distributed to Edward A. Rickenbach
as follows:
Item Amount
Cash $600.00
Account# 6103556 with M&T Bank $ 1 , 9 4 7.7 0
Account# 98173103 with M&T Bank $ 9 0 3.6 3
Fresh Funds, LLC $30.68
(Refund from Harriet Carter Gifts)
Bethany Towers $51.83
(Refund)
TOTAL $ 3,533.84
~9
P
Edward A. Rickenbach, Petitioner
~2/
William C. singer, sq.
Supreme C urt ID# 27737
400 South State Road
Marysville, PA 17053
(717) 957-3474
VERIFICATION
The undersigned petitioner hereby verifies, subject to the penalties of 18 Pa.C.S.A § 4904
(relating to unsworn falsification to authorities), that the facts set forth in the foregoing petition
which are within his knowledge are true, and, as to the facts based on information received, after
diligent inquiry, he believes them to be true.
Date: / ,I J ~ ~~~e~~~''~/ f~c...-~~'%`L:r~~,C ~~
Edward A. Rickenbach, Petitioner
LAST WILL AND TESTAMENT
OF
DONNA M. MITCHELL
/ -..,--
~:~.-<-
c
~-:.
C"`
~..
~\=_
~,..
<s ~.
~~
_,
I, Donna M. Mitchell, of 335 Wesley Drive, Apartment 205,
Mechanicsburg, Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and
declar_n '=lli~ t~ ~;~. ~-,y - ~=~- ~~,; ~ 1 and. Testament, hereby revoking all
Jails and Codicils heretofore made by me.
ITEM I. I direct that all my debts and funeral expenses,
including my cemetery lot and gravemarker and all expenses of my
last illness, shall be paid from my residuary estate as soon as
practicable after my death as part of the expense of the
administration of my estate.
ITEM II. I devise and bequeath all of my estate of every
nature and wherever situate to my nephew, Edward A. Rickenbach if
he survives me by thirty days following my death.
ITEM III. If my nephew, Edward A. Rickenbach predeceases me or
dies on or before the thirtieth day following my death, then I ~
',,C
devise and bequeath all of my estate of every nature and wherever
,~~~:
situate to Douglas S. Rickenbach, of Est o, Florida. h
ITEM IV. I direct that any and aii Inheritance, Estate and
Transfer taxes imposed upon my estate passing under my Will or
otherwise, shall be paid out of the principal of my residual estate.
ITEM V. I appoint my nephew Edward A. Rickenbach, Executor
of this my Last Will and Testament. In the event of his
renunciation, death, resignation or inability to act for any reason
whatsoever, I appoint Douglas S. Rickenbach, Executor of this my
1
Last Will and Testament. I relieve my Executor from the necessity
of posting security in connection with their duties as such in any
jurisdiction in which they may be called upon to act.
IN WITNESS WHEREOF, I have hereunto set my hand to this my Last
Will and Testament, which consists of~ pages, to each of which
I have affixed my signature this ~ day of J two
thousand six (2006).
Donna M. Mitchell
2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to dlaplicate this copy by photostat or photograph.
F:'c' I~t)I~ tC1c• LL,Ii ~Ct ~F~.O!'
P 141~~~.~C~
REV 118006
PRINT IN
1ANENT
;K INK
~f~~-i~a7
'
~ xa
,al ,,; a
~,
~ .ice:: , _ ~ ~
~~~ `
P~ `x/
~
1~'£NT ~~~
~,~.
Th~~ i, r~i ret~fii~ `ha€ Eh.: s,tt~iTrniatiut; tiet~~ ~i~:~n i
ctln~e~tl~ cc;}?ie~l `rt,rn a), tlri<~in~tl C_k~rtClr_i-_e 11f I~eatP
IuIv- Ili I L>v l.I. I 1 ii4 L •1C;i~ ~c tai;-,)1 ~ -)c` x f,*1j?;1
ccttitic.,tt ~;!I tci~<<trLled ~ :'~, 1L.tla_ situ
~~ (,rc~; t )ttic; lit°sn..inL~nt tl~n~
r'% ~.~!~ JAN 3/0--20Q~ --
~.
I.t;cai R~_isirau I~ itr I>~(r_cl
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
,. Name d Decedent (First, mitltlle, last suffix) 2. Sex 3. Social Securtty Number 4. Date of Death (Month, day, year)
201
18
2206
_
_
Januar 25,2008
Donna M Mitchell Female
5. Age (Last Birthday) Under 7 year Under 7 day 6. Date of Binh (Month, day, year) 7. BiMplece (City and state or foreign country) Ba. Place of Death (Check only one)
Monttu pays Hain Miru,ea Hospital: Other.
1924 Altoona, PA ^I
ovember 7
83
i
i
t ^DOA ^N
H
^ER IO
i
R
id
^
,
Vf5
ent
en
ng
Ome
npat
uIDat
Urs
es
ence
Other Speciy
6b. Counry of Death Bc. Ciy, Boro Twp. Death Btl. Facility Name (If not institution, give street and number) 9. Was Decedent of Hispanic Origin? No ^ Yes 10. Race: American Indian, Black, White. etc.
Cumberland Lower Allen (If yes, specify Cuban, (Specifyt Whit e
335 Wesley Drive Mexican, Puerto Rican, etc.)
11. Decedent's Usual Occ atbn Kind of work done Burin most of wodein life. Do not slate retired 12. Was Decedent ever In the 13. Decetlent's Etlucation (Speciy only highest grade completed) 14. Marital Status: Marled, Never Marred. 15. Surviving Spouse (If wife. give maiden name)
Kintl of Work Kind of Business I Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5.) Widowed, Divorced (Specify)
Sample Maker Former AMP, In ®Yea ^Nn 12 Divorced
16. Decedent's Mailing Address (Street city /town, state, zip code) 2 0 5
3 3 5 W e s l e Drive ~
y Decedent's DId Decedent
Actual Residence ,7a. State P e n n S y l v a n l a Llva in a 17c. [~ Yes, Decedent Lived int. n w P r A l l e n Twp.
Townshi
?
chanicsbur PA 17055
M p
17b cnunry Cumberland ,7d ^ Np, oeceeenwved wihin
g ,
e Actual Umits of city /Boro
18. Father's Name (First, middle, last suffix) 19. Mother's Name (Rrst middle, maiden surname)
Luther J. Hill Lula M. Demoss
20a. Informant's Name (Ty,~e I Print) 20h. Informant's Mtiling Address (Street city I town, state, zip code)
Edward A. Rickenbach 30 Logans Run, Enola, PA 17025
21 a. Method of Disposition ^ Cremation ^ Donation 2t6. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or other place) 21 tl. Location (City /town, stale, zip cotle)
® Bpnal ^ Rertroval,rnmstale waaGrematlonoriMrtabonAaMpdzed
• 01/30/2008 Rolling Green Cemetery C
Hill PA 17011
^ Other ~ Specify' by Medical Examiner /Coroner? ^ Ye No am
P
ne21 Service Lit ee (9 arson acting as suc) 22b. License Number 22c. Narne antl Address of Fadlity
~-~`` FD013945L 1334 N. 2nd St.
Harrisburg
Neumyer Funeral Home
Inc.
~ ,
,
,
Complete Items 23a<only when cenitying 23a. To the has' I my knowledge, death oaured al the lime, date and place stated. (Signature antl title) 236. License Number 23c. Date Signed (Month, day, year)
physican is rat available al time of tleam to
cerdly cause of death.
Items 2x26 must be completed by person 24. Time d Death 25. Data Pronounced Dead (Monet, day, year) 26. Was Case Refened to Medical Examiner /Coroner for a Reason Other Iran Cremation or Donation?
whopronounceadeam. Aprx. 11:00 PM. January 26, 2008 (Yea ^"°
CAUSE OP DEATH (See Instructions and examples) ~ Approximate interval: Part II: Enter other sienificant conditions crontnhuline to death, 26. Did Tobacco Use Contribute to Death?
Item 27. Pan I: Enter the Uta n of events -diseases, injuries, or wmplicatlons -that directly caused the death. DO NOT enter terminal events such as caNiac artesl, Onset to Death but not resulting in the untledying cause given In Pan I. ^ Yes ^ Probably
respiratory crest, or ventricular fibrillation wimout showing the etidogy. List only one cause on each line.
^ No B•lfnknown
IMMEDIATE CAUSE (Final disease or t
conenion resulting in death) -~ a Hypertensive Cardiovascular Disease t
DM 29. If Female.
^ N
Due to (or as a consequence op: ~ ot pregnant within past year
^ P
t ti
t
f tl
th
Sequentially list conditions, if any, h regnan
a
me o
ea
leatling to the cause listed on line a.
Due 10 (or as a consequence ofj: ^ Not pregnant. but pregnant wilhln 42 tlays
Enter the UNDERLYING C/1DSE
(disease or injury that initiated the of death
events resulting in death) L4ST.
Due to (or as a consequence of)-. ^ Not a nanl. but a rant 43 da s to 7
pr g pr g y year
d. before death
^ Unknown II pregnant within the pass year
30a. Was an Autopsy 30h. Were Autopsy Findings 31. Manner of Death 32a. Date d Injury (Month, day, year) 32b, Describe How Injury Occurted 32c. Place of Injury. Home, Farm. Street, Fadmry,
PeAomred? Available Prior to Completion Okice BuiMing,etc.fSpeciry)
of Cause of Death? ~NaWral ^ Homkide
^ Accident ^ Pentling Investigation 32d. Time of Injury 32e. Injury al Work? 32f. If Transportation Injury (Specityl 32g. Location of Injury (Street, city I town, state)
Yes Na
^ Yes No
^ ^
^ Suicide ^ Could Not be Determined
^ Yes ^ No
^ Dnverl Operator ^ Passenger ^Pedestnan
M ^Other~ Specify
33a. Cenifer (check only one) 33h Si natuTA.yid Tole of CeAifier //~ Chief Deputy
• Certitylnq physician (Physidan cenitying cause of deem when another physician has pronouncetl death and wmpleted Item 23)
dmtn occurred due to the cauae(e)and manner es statee---------------------------------^
Ta the best of my Knowledge , ~ . ~ / (~ f„ _ _L
OLEY~ i!!r-~~-- Coroner
,
• Pronouncing end cediying physkien (Physician born pronouncing death and cenitying to cause of death)
^ 33c. License Number 330. Date Signetl (Month, day, year)
To the best of my knowledge, death occurred at the time, date, and place, aM due to Me cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ January 28
2008
• MedkalEsamimulCoroner
On the beats of examinatlon and / or Investigation, in my oplnlon, death occurretl at the time, date, and place, and due to the cause( s) one manner as stated_ ~ ,
34 e dtl s of P so Who Compl t Cause yh (It 2 Type I Prnt
~o~c~ ~. ~'c~cenro~e, ~~iie~ ~eputy Coroner
35. Regiabar'a s I e[uW Diamd ~
~ ~
~
~ 3s. Data Filed (Norm, day, year) 6375 Basehore Road, Suite lit
I
I
I
~ %P2,.• '^~ I ~ / ~,~, ~p~ Mechanicsburg, PA 17050
P~
Disposition Permit No. t:,' v L ,~ ~ /'r/