HomeMy WebLinkAbout12-30-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Frances G. Smith
also known as
File Number 21-08- ~a 0
Deceased Social Security Number
Laura J. Bartlett
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE A' or `B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) islare the Executrix named in the
last Will of the Decedent, dated 02/26/2007 and codicil(s) dated
Stale 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 instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
B. Grant of Letters of Administration
app Ica e, enter: c.t.a.; .n.c.t.a.; pe ente de; urante a senua; urante minontate
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) an~aeirs: (!f
Administratton, c.t.a. or d.b.n.c-t.a., enter date of Will in Section A above and complete list of heirs.) r-~ r==a
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54 Bullock Circle, Carlisle, Carlisle, Cumberland, PA 17015
(List street address, town/city, township, county, state, zip code)
Decedent, then $7 years of age, died on 12/01/2008 at Cumberland Crossin
Decedent at death owned property with estimated values as follows:
(If domiciled in PA)
(If not domiciled in PA)
(If not domiciled in PA)
Value of real estate in Pennsylvania
situated as follows:
All personal property
Personal property in Pennsylvania
Personal property in County
274,000.00
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:
Signature Typed or printed name and residence
Laura J. Bartlett 120 Wild Horse Court
Monroe, CT 06468
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Form RW-OT Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
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~/s_ubscribed
before me this <-,' O' Y' day of
D~Cern_ber , ~00~
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For a Register
S~ atur of Personal Represent a Laura J. Bartlett
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Signature of Personal Re resentative ' ~~"' -
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Signature of Personal Representative _ ,
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File Number: 21-08- ~ ~ 0 s
Estate of Frances G. Smith
,Deceased
Social Security Number: 168-14-081c~5 Date of Death: 12/01/2008
AND NOW, ~~ C. ~_ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, T I ECREED that Letters Testamentary
are hereby granted to Laura J. Bartlett
and that the instrument(s) dated 02/26/2007
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............................................ $ ~ ~.
Short Certificate(s) ........................ $ ' ~1,
Renunciation(s) ............................. $
$
$
$
$
$
TOTAL .................................... $ ~~ V!!J -
Attorney Signature:
of
Attorney Name: ~ Suzanne H. Griest
in the above estate
Supreme Court I.D. No.: 34362
Address: 129 East Market Street
York, PA 17401
Telephone: 717-846-8856
Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by phollostat or photograph.
Fee for this certificate. $6.00
This is to certify that the information here given is
c(>n~ertly copied from an original Certificate r,~f Death
duly filed with me as Local Registrar. "The original
certificate a-ill he forwarded to the Starte Vital
Records Office fur permanent filing.
P 1481039 _
Certification Number
LG~vn, ~ d`~ DES 0 3 X006
Loral Registrar Date-I-sued
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PRINT IN
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • ~., ~ ~ ,
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4ANENT VITAL RECORDS
CK INK CERTIFICATE OF DEATH ~
(See instructions and examples on reverse)
7. Name of Decetlenl (FmL middle, last, suffix) STATE FILE NUMBE R
Frances G. Smith 2. Sex 3. Social Security Number 4. Dale of Death (Month. tlay
year)
5. Age (Last Blnhtlay) Under 1 year Female 168 - 14 '= 0815
Under 1 tlay 6. Dale of Binh (Month
tlay
year) 7
Birth
l
C ,
December 1, 2008
Morons Oays ,
,
.
p
ace (
ity and slate or torsi n country) Ba. Place of Death (Check only one)
Hours Mtm,res
87 Yra. Hospital: Olhec
March 5, 1921 Dover 1trTp.
PA
8b. Court of Death
H Bc. Cit ,
^ Inpatient ^ E:R / Outpatient ^ DOA ®Nurstn
y, Bore, Twp. of Death 80
Facilit
Nam
II
t i g Home ^ Resitlence ^Other ~ Specity
Cumberland
.
y
e (
no
nstitution, give street antl number)
9. Was Jecedenl of Hispanic Origin? ®No
Carlisle
(Il .
^ Yes 10. Race.Amencan Intlmn. Black
White
etc
yes, speciry Cuban,
Cumberland Crossin 8
g M ,
,
.
ISOecI/yl
11. Decedent's Usual Occu
lion Kind of work done tlurin exican, Puerto Rican etc.) White
most of workin kle. Do trot stale reliretl 12. Was Decadent ever in the 13. Decedent's Education (S
ecif
l
hi
h
W
HOllSew~~f~ /vr an~St p
y on
y
g
est grade completed) 14. Marital Status. Marnetl, Never Ma
Kind of Business! Industry U.S. Armed Forces? El rried, 15. Surviving Spouse (If wile
give maitlen nam
Piano eache~
ementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Speci!}vj
Church ^ves ~No ,
e)
12 1 Widowed
I6. Decedents Meiling Atltlress (Street, city /town, slate, zip cede) Decedent's
54 Bullock Circle Actual Residence t7a slate Pennsylvania Did Deaadem
Carlisle, PA 17015 Live in a Ile. ^ Yes, Decedent Lrvad In
17b_Count Townahlp? Twp.
v Cumberland rid
®No
Deced
t L
18. Father's Name (First, mltltlle, last, suffix) .
,
en
ead wit
Actual Limits of
' hn
Carlisle Clly / Boro
Charles A. Grove 19. Mother
s Name (First, middle, maitlen samaras)
20a. Informant's Name (Type /Print) Ada S. Gross
Mrs. Laura J. Bartle 20b. Informant's Mailing Address (Street, city / Ipwn, stele, zip code)
tt
27 a. Method of Disposition 120 Wild Horse Court, Monroe , CT 06468
®Cremation ^ Donation 21b. Date of Di
^ Burial ^ Removal from Stale ;Was Cremation ar Donation Authorized sposition (Month, tlay, year) 21c. Place of Disposition (Name of cemetery, cremelory or other place) 21 d. Locaton (City !town, state, zip code)
^ Other-Speciyy ! byMedicalExaminerlCoroner? ($yes^NO DeC. 4, 2UU8 CIeIDat10II $OCiety of PA
22a. Signatur neml - Lkensee (ot.person acti such)
/
'
)
22b. License Number
22c. Name and Address of F
acilhy Harrisburg, PA 17109
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C FD-010694-L Auer Cremation Services of Pennsylvania
Inc
' Complete Items 23ac Dory when cerfifying
23a. To the best of my know ,Beam occurred
at me time, date and place slated
(Sgnat
ure and titl ,
.
4100 Jonestown Road Harrisbur PA 17109
physican is not available al lima of deem to
cerety cause of tleem .
e)
Renee Rnicos, RN, MS 236. License Numbe• 23c. Date Signed (Month, da
y'year)
ttems 24-26 must be com leletl 6
p Y Parson
24. Time of Death
25. Date Pronouncetl Dead (Month, tlay, year) RN353$16L
12-1-2008
who prwwurrpes deem
05:55 A N4.
12-1-2008 26. Was Case Referretl to Medical Examiner /Coroner for a Reason Other than Cremation or Donation
^ ves ®No
CAUSE OF DEATH (See Instructions and examples)
Item 27
P
I
E
.
an
:
nter the r•han of m - tliseases, injuries, or complications - trial tlirectly caused fire death, DO NOT enter terminal events such as cardiac arrest
respirato
arrest
l
k
l t Approximate interval Pan II : Enter other significant condAions cpnl'b~g to tleath, 20. Ditl Tobacco Use Contdbute to De
th?
,
ry
, or ven
r
u
ar li6rillation wehoul showing the etiobgy Dsl onty one cause on each line. i Onset to Death but not resulting in the urxledying cause given in Pan I. a
^ Yes ^ Probably
IMMEDIATE CAUSE (Final disease or __
rx,ntliticn resulting m death) rr^^~~ ~~ (( '-
-~ a. C(.-""iL~
S T' -~' ~
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t ^ No ^ Unknown
-
_
~(, l ~ ~ ~ 29
If Female:
D e to (o as a sequence oQ. t .
Sequentially list contlitrons, i1 any, b
leadingg to (fie rouse listed online a
r ^ Nol
pregnant within pall year
.
Enter fhe UNDERLYING CAUSE Due to (or as a consequence oq:
^ Pregnant at lime of tleath
Idsease or Inryry (hat indialed the ~
events resubing m death) LAST.
r ^ Nol pregnant, but pregnant wiMn 42 days
Due to for as a consequence o1J:
t
__ of death
d.
r ^ Not pregnant, but pregnant 43 days to 1 year
bef
d
70a. Was an Autopsy
30b
Were Aut
Fl
i ore
eath
Performed' .
opsy
ntl
ngs
A
il 31 Manner of Death 32a. Date of Injury (Month
day
year) 32b
Des
ib
H ^ Unknown it pregnam within the pass year
va
able Prior to Completion ,~, ~ ,
,
.
cr
e
ow Injury Occurretl 32c
Place of In
H
el Cause o1 Death?
L/~eWral ^ Homicitle .
jury:
ome Farm, Street, Factory,
OXice Builtling, eta (speciry)
^ Yes ~ ^ ryas ^ No ^ Accident ^ Pentling Invesugalian 32d. Time of Injury 32e. Injury at Work? 321. If Transportation Injury (SpecilyJ 32g
Location of I
S
^ Suicide []Could Nol be Determined
M
^ Yes ^ No
^ Driver I Operator ^ assenger ^Pedeslnan .
njury (
treet, city /town, stale)
33a. Cenilier (check only one) ^Other - Specity:
'
Certifying physician (Phyvtian certifying cause of deem when another phystaan has pronounced tleath antl completed Item 23)
To the best 01 my knowledge, tleath occurred due to the cause(s) and manner as atated_ _ _ _ _ _ _ _ _ _ _
•
g
33b Sin
, ~ a ertifier
lam,}~.
1
~ ~ ~
• ..,- /-7
V-.r_. . ~.
`'
_ _ _ _ _ _
Pronouncinq and cenNying physician (Physician both pronouncing death antl certifying to cause of tleath) _ _ _ _ _
- -- ^ t "'~'~ ~
`
To the hest of my knowledge, death occurred at the Ilme, date, and place, and due to the cause(s) and manner as stated_ _
• Medical Examiner/Coroner _ ^
-------------- 33c. Lie s
n' bet
/ Q ,~ r ~•-- -
! 33tl. Dale Sig etl (Month, dayi~
~
On the basis o/examination and / or investigation, in my opinion, death occurred at the Limo
date
and
l ,
l ~ L
7 r
~
2
,
,
p
ace, antl due to th e cause(s) and manner as statetl_ ^ 3d
Nam tl Add ~
35 Registra' azure antl Dis{~,ry~~~) .
e an ress of Person Who Complete0 Cause of Dealn (teem 27) Tyoe 7 Pnnl
Dlaposi,fan Permit Na. 0309126 ~~ ~ ~ ~ I f
LAST WILL AND TESTAMENT
OF
FRANCES G. SMITH
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I, FRANCES G. SMITH, as resident of Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this as and for my Last Will and Testament, hereby revoking,
annulling and making void any and all Wills by me at ;any time heretofore made.
ITEM 1. I direct the payment of the expenses of my last illness and funeral
from my estate as soon after my death as conveniently maybe done.
ITEM 2. I give, devise and bequeath all the rest, residue and remainder of my
estate, real, personal and mixed, of whatever kind and wheresoever situate, which I may
own. or have the right to dispose of at the time of my death, as follows:
a. I give, devise and bequeath five (S%) percent of this my residuary
l~Nll_lT. HIMF_\, FIFRNI)FD. tiCH.if~\IA\V FI,P
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Yuk K, R\~-.sl'I,\, r. I X301
Cn rrlai~vt 17171 Ri6.y85(,
estate unto ST. PAUL'S `BRED RUN" UNITED CHURCH OF CHRIST, absolutely.
This bequest is unrestricted and the Board of Trustees or other governing body may use
and expend the same for the benefit of such organization in any manner it deems
appropriate.
~L'i:G2~/LCQ~L ~J
FRANCES G. SMITH
1
b. I give, devise and bequeath five (5%) percent of this my residuary
estate unto REVEREND SIMON W. KAHUNYA of Nakuru, Kenya, East Africa, to be
his absolutely.
I give, devise and bequeath the remaining ninety (90%) percent of
this my residuary estate unto my daughters, ANITA K. SMITH and LAURA J.
BARTLETT, or the survivor of them, in equal shares.
ITEM 4: I direct that no Trustee, Executor or other fiduciary named,
nominated or appointed in this, my Last Will and Testament, shall be required to post
bond or give any security of any type for any purpose whatsoever, any law or rule of
Court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary
notwithstanding.
ITEM 5: I direct that any and all inheritance, estate and transfer taxes
imposed upon my estate, passing under my Will or otherwise, shall be paid out of the
principal of my residuary estate.
ITEM 6: I hereby nominate, constitute and appoint my daughter, LAURA J.
Guu_tir, Hntr..~, Hecxo~x. &'xat'nu~v t.i,r
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TFI.EPxII\t_1771 R-06-8RSh
BARTLETT, Executrix of this my Last Will and Testament. In the even of renunciation,
death, resignation or inability to act for any reason whatsoever of my said daughter, I
nominate ANITA K. SMITH Alternate Executrix of this, my Last Will and Testament.
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FRANCES G. SMITH
2
IN WITNESS WHEREOF, I, FRANCES G. SMITH, the above-named, have to
this, my Last Will and Testament, signed my name at the bottom of pages one through
hand and seal this ~~ ~ day of ~ 2007.
two for the purposes of identification and at the end hereof, on page three, have set my
c~~tC~(J /IC~~C~+n-v~c~ (SEAL)
FRANCES G. SMITH
Signed, sealed, published and declared by FRANCES G. SMITH, the above-
named Testatrix, as and for her Last Will and Testament, in the presence of we who, in
her presence and in the presence of each other, have at her request subscribed our names
of a~s~~.c~l~~~l.G `4
GRIF'_1T, HINF\. HFRRfll.ll, Sl'N \LMA V\ LLP
A'rr0u~[:i't >T Ln~~
129 F,~s'r 41 ~RKer STRPFT
7i~aK. Pon'vsvLV'>~'in 17101
T[I.FPH(1\-[r717i N16%RSG
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as witnesses hereto.
COMMONWELATH OF PENNSYLVANIA
COUNTY OF YORK SS:
We, FRANCES G. SMITH, s~~and
r~'l'Y/i'' Z. ~yilose~, the Testatrix and witnesses, respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and Testament, that she signed willingly or willingly directed another to sign
for her, that she executed it as her free and voluntary act for the purposes therein
expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed
the Will as witnesses, and that, to the best of their knowledge, the Testatrix was at that
time eighteen (18) years of age, of sound mind, and under no constraint or undue
influence.
Subscribed, sworn to, and acknowledged before me by FRANCES G. SMITH, the
Testatrix, and subscribed and sworn to before me by the aforenamed witnesses, this ~i~'~
~r NIF)T, H1~1e5. HFNNOI.H, $t'H.1111aM1ti LI.P day of )' 200 /
Arrors~-Ei's ,Ir L nw
I?9 FAST M,~NKeT $TkFFT
1'oxx, Pt~'n'Sl't von-in 17401
TFI r.PHONF 171 ]~ riJ6-2iN56
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N ARY UBLIC
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
4 KELLY A. LAUER, Notary Public
City of York, York County
My Commission Expires February 2, 2010
FRANCES G. SMITH, Testatrix