HomeMy WebLinkAbout12-04-08PETITION FOR PROBATE AND GRANT OF LETTERS
{ZF.GIS"h~R OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
i~.~;<<~~c of Lavere A. Cook t~ileNumbcr ~ l U D ~~~G~
nl~o known as
___ ,Deceased Social Security Number
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Pc(itioncr(~). tvho is/arc 18 years of age or older, apply(ics) for: ~- j ~")
(CO,M1iP/.iiTli 'A' or '6' BELOW:) ~
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A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /arc the hixecutrix ~-~~~
, a
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n uncd n}~~e
I~i~t ~~ill of the Ucccdcnt dated ~u~y ~ ~ ~ ~~~~>~ and codicil(s) dated _ ~-- ~ ~=_
-.
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(,S7ate relevant ctrctunstance.r, e.g., renunciation, death n~executor, ete.J
I~:~cr~ri a, follows, Ucccdcnt did not marry,. was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
fin' prohatc. ~~as not the victim of a killing and was never adjudicated an incapacitated person:
B. Grant of Letters of Administration
(l~appGcable, enter: c. t. a.; d. b. n. e.t.a.; pendente tile: durance ab.ceutia,~ duruntc n~inorilate7
Pct i~ionrr(sj ahtrr a proper search has /have ascertained that Decedent Iett no Will and was survived by the following spouse (if any) and hcir~: t//
(~hnini.rn~ruinr~. r. 1. a. ur d. b. n.c.La., enter dale q/ W!l! in Section A above and complete list oJ~heirs.)
~ Name Relationship Residence
I
lC7)A1P/_F, %'F.' IN,~LL CASES:) Attnch additional sheets if necessary.
I )ra•d~:~~t way domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Alliar~cc I h i~_c. ~';uf slc, Cumberland County. PA. 17013
lli~t 'lrrP~ ~ni, lrc~.r,r. tuu~n~crly~. lau~nship. county..rlate. zfp code)
)cccdcnL then,.<`~ _ _ years of age, died on December 2, 2008 at Chapel Pointe, 3 Alliance Drive, Czu-lislc, 1'A 17(113
I h;erder;t ;~t death owned property with estimated values as follows:
(11 domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania `E;
(Ifnot domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania
tiituatcd as follo~~s:
12,000.00
Uh~~n•Ihrc. I'ctitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of I.ettcrs in the appropriate form to
the under,i2ncd:
Si mature f ed or rioted name and residence
,~~~ ~~ ~~ ~ 1j Llsie K. Cook, 3 Alliance Drive, Carlisle, PA 17013
/~ornt Xil'-0' rep'. /0.13./)6 Pa~C ~ O~ 7
Oath of Personal Representative
CC)MMUNWI'AL"fli OP PENNSYLVAN[A
COUNTY 0l= Ci1MHt;RLAN1~
SS
I~he Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
tine knowfed~~e and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will wel{ and truly
administer the estate according to law.
S~~~orn to ;;r affirmed and subscribed
heforc m~ the ~ day of
PC"~rr, ~c~t~ ~>~
__ ~~(C t
~, Por the Register
Si~natcn~e of Personal Representative
S'ignalure of Personal Representative p -;~ ,
c~c
5'ignaturc of Personal Representative
File Number: c~ ~ U g ~ ~ ~~
Estate of Lavere A. Cook ,Deceased
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Social Security Number:196-14-IOIR Date of Deathaeccmbcr 2. 200
RND NOW, ~ ~~~ U , in consideration of the foregoing Petition, satisfactory proof
having been presented befiore me, IT lS DECREED that Letters 't'estamentary
,jrc hereby p,ranted to Eisic K Cook
in the above estate
and ihai the. instrument(s) dated July 11,2002
described in the Petition be admitted to probate and fi{ed of
FFF,S
f.ctlcrs ..... ~~.,~... $ ~?~
Shori Certificate(s) ..a .... $ B
Kcnuncia[ion(s) .......... $
~jl $ I S
t
... $ v
... $
_~_ ... $
... ~
... $
... $
... $
~fO~rn1 . ... . .......... $ q8
Attorney Signature:
Decedent.
Supreme Court I.D. No.: ~'2`t6`J
Address: ~ 27 South Market Strcct
PO. 13ox 95
Mechanicsburg, PA 17055
Telephone: 717-697-7050
larn~ K11~-I1? rev. 1(LI3 QC Pa~C ? t)1 ~
Attorney Name: Andrew C. Shcely, 1'syuire _~
OCAL REGISTRAR'S CERTIFICATION O~ DEATI~i
WARNING: It is illegal to duplicate this copy by phatostat or phatograpl?.
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse- STATE FRE NuMeEH
I Nama of Decedan,,Firat midWe, Wal a°""' Lavere A. Cook 2 M le 3 S«ialS Ily Number A Dale of DeaO Monln day year)
a 196 _ 14 _018 becernber 2, 2008
5 4qe ILasI Brnhday) Under 1 year Under 1 day 6. Dale of BiM (Month, day, year) 7. aMplace (Chy aM dale or foreign counlryl fie. Place of Death (Check only one)
84 "'°""° °"' """' ""'""' December 31, 1923 Dilisburg, Pennsylvania "°spilar o'nar
Yrs. ^mpauent ^ERt Outpatw.rt ^DOA ~•Nursrng H°rtie ^Res~tlenca ^Omer~Specry
fib. County of Death 8c. Chy. Boro. Twp. of Death Bd. Facility Name (If not Instnulion give street aM number) 9. Was Decedent of Hispanic Origin? ~}.flo ^ Yes 10 Race. Amerman krtlran. Black. Wnlle, etc
Cumberland Carlisle Chapel Pointe (Ilyes,specllyCuoan, ISpoGrM Whlte
Mexican, Puede Wean, etc I
11 Decedents Usual Oc<u twit Krtb of work do ne B urin most of workin IAe Do not stale retired 12. Was Decedent ever in the 13. Decetlent'S Education (Spedly Doty hlghesl9tade compl eted) 14. Marital Status. Marneq Never Marnetl IS Survwiny Spo use Ill wde, give maiden name)
S~'P~'V~'~ Fed~'Paq~12~~~WW3'f'hent US Armed Forces? ElemenWry/,Sacondary10~12)
lLL Collage114or5.) WdOw orcgdlS rfN
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Elsie Reisinger
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16 De Q~nl'S Mail g A~a 55 (Street. aty /town, stale, zip cOdel
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A Ditl Decedent
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,6. tamers Name lFeat coddle last annul Park L. Cook Sr. Is.rmlharG Nama (FnGl. naaela. ma~an aLLmamal Blanche Anthony
zoa Inl°rmantsNamelTypelPrmn Elsie Kelly Cook 20b IWnrmanraMadirrgAtldeaalgtregtly~ance'b~ive Apt. 203 Carlisle, PA 17013
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21 a. MelnW of Drsposi,ion I ~Gramalron ^ Donation 210. Dale of Dispositpn IMonm, day, year) 21c. Place of Disposition (Name of
etery, crematory a other place]
cem 21d. L«ation (Cey ; rovrn, stale. zp cadet
^ Banal ^ Removal nomSlale ~
honzed
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m December a, 2008 Conolite Crematory Schaefferstown, Pa. 17088
E.aminer/Cororor4
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^ Omer - SPeuty' Y
22a $gnal Funeral SeN acting as such) 22b l¢ense Number
FD-012662-L 22c. Name aM Address Ol Fxdlly
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
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Complete hems 23at only when ceNrymg 3a To the best my knowledye, tleam «cuned al dre lime, Ie ane place sWleb. (Sgnalure and title) 23b. Cleanse Number 23c Dnle Signed (Month, day, year)
physician is rot avalabW al time W Deam 1° ~)
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24 Time d Death 25. Dale Pronowrce0 ad (Month, day, year) 26. Wa Case Rulened to Medical Examiner I Coroner for a Reason Olaer Iran Cremation a Daiaoon?
Items 24 26 must ba canpleted by person ~ yes ^No
wlw praroura:es deatn. ~ ~ O ~ M. ~ ~ , Q~1
CAUSE OF DEATH (Sea Inairuetlona and examples) I Approximate inlarval. Pan 11'. Enter otner Sf>861KmlLtf~l144115 LtiN(ddAN9Iti.-iulb. 2fi. Dd Tnbau.u use Ccntrdwle a Deam?
Ilam 27. Part 1. Enter the r;Dalf plyyy,,dti -diseases, Injuries. or omphcelions- Inat tlueWly caused the daalh. DO NDT enISr lamunal events su4h as caldk' c arrest, Onset w Deam bUl not rasa"irg in Iha ufrderlyrog cause given In Pan I. ^ Yes ^ Probably
respiratory awed, or vanlrkular li6rillalron wimoul showing the etiology Lisl only Orre cause on each line.
' ^ No ~ Unhrruwn
IMMEDIATE CAUSE `lfinal disease a
V 29 II Female.
caWilion resuhngmdeam) ~. ~N7 I
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Due to (a as a wnsequence oll year
pregnant w
rti pal
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5 Quen11a11y Ilse ContldlonS, 11 any, b
the CduSe Ilsled on Ime a.
k ^ Not pregtanl. Dul Feynanl wdhm a2 Jays
Due t° (or as a consequence °II.
Enter h~ UNDEpLYING CAUSE
b W duals
IdSeasa of ibryry IMI Imuatad the
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events rasuinng ur dealhl EAST.
Due to for as a wnsoquence ot) ^ NW preyrwnt ouI p~eynaiv a3 U'sye 1° I year
belae deals
d ^ Unkrrdwn d pregnant wilfun the pall year
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30e Was an Autopsy 3W. Were Autopsy Findings 31- Manner W Death 32x. Dale of Injury (Month, day, year) 32b. Describe How Injury Occurred 32c Face of Injury twine Farm, Street. Factory
O"ice Ruddin9. eld lSPecrfy)
_ Pswurmad? Available Prror to Completwn
°r canna W Daatre
~Naterel ^ Han~aae
`] AcadaW ^ Pending mvestu}atwn 32d. Time of Injury 32e. Injury at Work? 32t If Transpod~ation Injury (SPeGityl 329. L«alion C lrgory I9reeL city 71own, state)
^ Yes ~e ^'iea ^ No
^ Yes ^ No ^ Dover; Operator ^ Passenyei ^Pedestrian
^ Su~cAe ~ ] Gauld Not be Delermined M ]01het-Specity-
73a Cenferlmeck only ) 33b.5gnaw and Title of Cendrenr n
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To tae best of mY know) d9 ~
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• Medical Examiner I Coroner
On the basis °t e[aminalion and (or Invnsligation in my opinion, death occurred al the lime, dale, and place, end due to the cause(s) and manner u ataled_ ^ 3d Name aril Aalress W Person Wno Completed Cause of Deam Iham 271 Type l Fim
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Disposition Permit No t/ V _~ ~ ~ `~ I -
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KNOW ALL MEN BY THESE PRESENTS: ~~~ ~,
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That I, LAVERE A. COOK, a resident of Brevard County, Floric]~-silo her~3y
W
make, publish and declare this my Last Will and Testament, hereby revoking and
rendering void any and all Wills and any Codicils thereto by me at any time heretofore
made.
FIRST: I direct that my Personal Representative, hereinafter named,
shall first pay and discharge all of my lawful debts and all expenses of my last illness
and funeral as soon as conveniently and properly may be done after my death.
SECOND: I direct that my funeral be conducted in a manner consistent
with my station in life and in accordance with the terms of certain inter vivos trust
agreement I have entered with the Myers Funeral Home of Mechanicsburg,
Pennsylvania, and that my remains be interred at the Indiantown Gap National Military
Cemetery.
THIRD: I give, devise, and bequeath unto my son, LARRY J. COOK,
or if he predeceases me, to his wife, AILEEN FIELDS COOK, all of my right, title, and
interest in and to a certain lot of ground to which I was awarded "Judgment of
Possession" by Order of the Twenty-Fourth Judicial District Court for the Parish of
Jefferson, State of Louisiana, Division "D", entered on June 10, 1993, at Docket No. 449-
827 In re: The Succession of Gloria Adams Cook (deceased), which lot is situated in the
Parish of St. Charles, State of Louisiana, being designated as Square 41, Iberville Section
of the Lakeland Gardens Subdivision, and being located in Section 80 T 12 S, R 9 E, of the
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Southeast District of Louisiana, East of the Mississippi River, and measuring
approximately 230 feet by 360 feet.
FOURTH: I give, devise, and bequeath all of my right, title, and interest,
including the right of sepulture, unto my son, LARRY J. COOK, or, if he predeceases me,
to his said wife, AILEEN FIELDS COOK, in and to two (2) certain single burial crypts,
each being situate in one of two (2) separate double burial crypts located at the Garden
of Memories Cemetery in Metairie, Louisiana, Number One Mausoleum, which two (2)
double crypts were originally acquired by my late wife, Gloria Adams Cook, in 1967 (one
of the single crypts in a double crypt having been used for the interment of the remains
of my late mother-in-law, Ella Hurley Adams, and the other single crypt in a separate
double crypt for interment of the remains of my said late wife Gloria Adams Cook, my
interest in said burial crypts having accrued to me as part of the distribution of the
assets of my late wife's estate by the aforesaid Court).
FIFTH: All the rest, residue and remainder of my net estate, whether
the same be real, personal and mixed, including homestead property, and wheresoever
the same may be situate, including specifically the proceeds of any insurance policy that
is payable to my estate or Personal Representative, Igive, devise a.nd bequeath to my
wife, ELSIE K. COOK.
SIXTH: I name, nominate, constitute and appoint my wife, ELSIE K.
COOK, as Personal Representative of this, my Last Will and Testament, and direct that
she shall serve without giving Bond, hereby giving and granting unto my said Personal
Representative full power and authority to sell and dispose of any property of which I
may die possessed, whether the same be real, personal or mixed, and wheresoever the
same maybe situate, and upon such price, terms and conditions as she in her sole and
unrestricted discretion may see fit, and without Order of Court.
-2-
SEVENTH: I may leave a written statement or list disposing of certain
items of my tangible personal property not otherwise disposed of above. Any such
statement or list in existence at the time of my death shall be determinative with
respect to all items devised therein. If no written statement or list is found and properly
identified by my Personal Representative within 30 days after the Personal
Representative's qualification, it shall be presumed that there is no such statement or
list and subsequently discovered statement or list shall be ignored.
EIGHTH: Any person who seeks to set aside or invalidate this Will, or
any provision thereof, shall by such action be deemed to have forfeited any and all claim
or interest in my estate, and shall take nothing by reason of my death.
IN WITNESS WHEREOF, I have hereu}~to set my hand and affixed my seal
at Titusville, Brevard County, Florida, on the ~ day of ~~ ~ ~ ~-~ =, 2002.
LA ~ L A. , O /K ~ ~~ '
Signed, sealed, published and declared as and for his Last Will and Testament
by LAVERE A. COOK, the above-named Testator, in the presence of us who have seen
the Testator sign, and who have hereunto affixed our names as attesting witnesses
hereto, in his presence, at his request, and in the presence of each other.
. , - -_ Titusville, Florida
;~:
,~~ ,~~:.~ „- :.' ' Rt.1.~,t_<_,1 ~ ~, Titusville, Florida
-3-
STATE OF FLORIDA
COUNTY OF BREVARD
ss:
d~~~ ~ ~ ~ ~ ~ ~ P !, ~ ,
We, LAVERS A. COOK, }~'~ (''~~A,~ } ~ .~' ~ ~ ~~u' ,and ~~+, _`,f{~ ~ ~- - ~' t~.~.4 ~~ Wit, the
Testator and the witnesses, respectively, whose names are s ed to the attached or
foregoing instrument, having been sworn, declare to the undersigned officer that the
Testator, in the presence of witnesses, signed the instrument as the Testator's last Will,
that the Testator signed, and that each of the witnesses, in the presence of the Testator
and in the presence of each other, signed the Will as a witness.
4 .1" ~
3 (,~~ b i~~ J, ~
Testator
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Wi~n.ess ~~, r
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~it~ess
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Subscribed and sworn to before me by LAVERS A. COOK, the Testator, who ^ is
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personally known to me~or- „has produced ;~ ~:` z_.~.:=_t. r~_: _ as identification,
and by l~~r. ~~,d~:w~ ~ C.. 1-~~~t ti-~~ . , a witness who ~ is personally known to me -or- ^
has produced as identification, and by ~ i,, .~,~ -~.,._, 1`. ,~._ ~,x <>~ ;~_ i
a witness who is personally known to me -or- ^ has produced
as identification, on this 1 ~'~`', day of ~ 4.~~ ~_~ ,_, 2002.
> ry..~
~~
Signature of Notary
{Seal)
~pY P
,~, i~: Pameka 0. Brookes
+. +r MY COMMISSION # DD016170 EXPIRES
'%'~as April i a, 2005
%~;oF~ F;,~~ BONDEDTtIRU1R0Y falN INSURANCE, iNG
-~-
I have executed a Last Will and Testament that refers to a separate writing
under which I am privileged to give certain of my tangible personal property. It is my
wish and direction that the persons listed below shall receive the items so designated:
ITEM
DATED AT
DEVISEE
this day of
CITY STATE
LAVERS A. COOK
-~-