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HomeMy WebLinkAbout02-05-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of PATRICIA G KEEFAUVER A/K/A PATRICIA KEEFAUVER also known as PATRICIA KEEFAUVER Deceased Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) COUNTY, PENNSYLVANIA File Number_~~ ~~ ~} ~a`] Social Security Number 066-32-4568 ®/ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EXECUTOR last Will of the Decedent dated 6/25/2007 and codicil(s) dated N/A named in the (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 instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: NO EXCEPTIONS B. Grant of Letters of Administration Petitioner(s) after a proper search has /have ascertained that Decedent left no Wil] and was survived by the following Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) (IJapplicable, enter: c. [. a.; d. b. n. c. t. a.; pendenle cite; durance absentia; durance minoritate) ~,,~ ionshi (COMPLETE lNALL CASES:) Attach additional sheets if necessary. '7 ~~any) an 0 _1 ~trs (ff_: ~'L3 -n W - - ~' i'n 1 F-;- t. ~ ~. ~_. ~ C.l .=-~=; . v r'-z ~ ~r IV Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at 107 WOODVIEW DRIVE MT HOLLY SPRINGS PA 17065 (List street address, toam/city, township, coanry, state, =ip code) Decedent, then 67 years of age, died on 8/17/2008 Decedent at death owned property with estimated values as follows at CAROLYN CROXTON SLANE RESIDENCE (If domiciled in PA) All personal property $_ ~/ ~ ~ GT~ (If not domiciled in PA) Personal property in Pennsylvania g (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania ,~ situated as foil 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: DENNIS D KEEFAUVER 107 WOODVIEW DRIVE, MT HOLLY SPRINGS, PA 17065 Form RW-02 rev. /0.13.06 Page I of 2 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 subscribed before r^.e the ~~ ~ ~da~y of 2 ;y ~~ _,~ ~Vt '! x~ ~~ ~. For the Register Signature of Signanrre of Personal Represen[ative Signature oJPersonal Representative File Number: ~~ ~~ ~,aS Estate of PATRICIA G KEEFAUVER A/K/A PATRICIA KEEFAUVER w~ Q w _ ""'i '+~ i C~ ~~. 4 fem... ~ ~ ~~ ~ ~: _ ,~ ~ c. r a ¢ ~ <:=~ „ ~ ~ ~°• i r c N , Deceased Date of Death: 08/17/2008 Social Security Number: 066-32-4568 h ~~ AND NOW, ~ C`x'1 ~ ~ ~ "~~ ~''~i > ~~~ ~ > in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS ECREED that Letters 1~S `~~~ ~Z~ are hereby granted to ~ hIS ~ ~ ~ ~~ in the above estate ~~ and that the instrument(s) dated .~ l~'1 C '~~ ~ -~- described in the Petition be admitted to probate and filed of re ~ ~d as the ;ast Will end Codicil(s) of Dec ~ ent. T\ FEES c,o ~"~ " ~" Letters .... ~~~ • • • • • $ b Short Certificate(s) ..<,j .. .. $ ~o~y Attorney Signature: Renuncia\tion(s) ........ / l ~ . IJ~ .. $ .. $ - ~~ ~ Attorney Name: . • $ / (~ Supreme Court I.D. No.: . $ . . Address: ... $ ... $ ... $ ... $ ... $ Telephone: ... $ TOTAL ........... o .~.~,~ ... $ ' ~~ Register aj IVills Page 2 of 2 Form RW-02 rev. 10.13.06 I05.R(15 Rf:~" fi) I/C17 i LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, ~6.Op ~%"'°~----.. "Phis is to certify that the inform itum hcac 1~iven is ,,n"'p~SN OF pE""- correctl co icd from an original Ce)tificate of Death ~. N,y _ > P ~x,~°p~~~ ~`~~; duly filed with n~~e as Local Re~lstrar. "I he oii~inal ~' _ ~ \y certificate will he fol~•arded to khe State Vital ~~ - a~ kea)rds Office for permanent filin~~. ~ '° ~LasrC3n~~a,n`LY+-•~ U~b 1 8~ 200$ P 14805905 ~q9j~.-~~~P~t''' A• MEN Certification Number """'r/ Local Registrar Date Issued __ __ _ _ _ __ n ~ C ° ` ° '; • ~ ~ ~ ~. ` ` ~ -V ~ -:J~ . J `~ ,. ~. V J ~' d ~ • t 0.w' ~ ~~ / ^ ~ ~© ~ ~;~,. ~-may , ~ -- {'..r ~ H10S743 REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS N TYPE/PRINT IN PERMANENT CERTIFICATE OF DEATH ' BLACK INK (See instructions and examples on reverse) STATE FILE NUMBER (~ ~ ( ~ ^l~ <_ ~"\ ~, rY. `I ~I t. Name a Decedent (Firs, mdtlle, lest, sa5x) 2. Sex 3. Social Sepunry Number 4. Data of Death (Manm, day, year) Patricia G. Keefauver F 066 - 32 - 4568 August 17, 2008 5. Age (Lest Binhtlay) Under 1 year UMer 1 day 6. Date a Birm (Month, tley, year) 7. Binhpuce (City and state w Iwagn country) Ba. Place of Deam (Check oMy one) MoMM Days Hours Nxx4m Hospital: Other: HOSp1Ce Home 67 yra_ 10/8/1940 RBI ~ ^Inpelienl ^ER/Outpatient ^DOA ^NursingHOme ^Resitlence ®Omer speary: Bb. County of Deam &. City, Bom, Twp. of Deem tb. Fetllgy Neme (N rat insNugan, give sheet antl nwnber) 9. Was Decedent a Hispank Origin? ®No ^ Yes 10. Race: American Iriden, Black, While, arc. (If yes, speaN Cuban. (spery'M Dau kin usquehanna 'Itap. Carolyn Croxton Slane Residence Mexican, Puerto Rican, etc.l White 71. Decetlea's Usual Lion Kintl a vrork d ww du' most a Ige. Do not stale rem 12. Wes Decedent ever In gro 13. DecetlenYS Etlucetion (Speary Doty hghest grade mmpl eled) t4. Madul Sams: Martied, Never Mameq 15. Sumving Spo use Qf wtte, give maitlen name) Kind of Work Kind a Buainau / IMudry U.S. Amred ForcesT Elementary /Secondary (0-12) College (1< w 5F) Wi~ad• DNOa~ IspeaM istered Nurse Healthcare ^Yea ~C1Na 5+ Married Dennis D. Keefauver - 18. DecedenYS MaiMg Address (Street, cgY I town, state, dP tale) Decedent's Did Decedent Aaual Residence 17e. sure PA LFre Ina t7c{i~CYes, Decedere Wed In South Middleton Twp. 107 Woodvlew Dr ~ Township? 17tl. ^ No, Decedent Lived rdNn Cumberland 17b C m Mt. Holt S Tin s PA 1 065 . OU y Aaaal umgaa Ciryleao 13. Famels Name (Flrst, mdtlle, lest, sugix) 1g. Mamer's Name (Rrst, middle, maiden surname) E. Justin Lyman Velma - Clancy 20e. InlcmMnYS Name (Type / Print) 200. Inlomlem's Mailing Address (Street, city /town, sate, zip ode) Dennis D. Keefauver 107 Woodview Drive, Mt. Holt S rings, PA 17065 21 e. Method a Disposgion ]~}Crematbn ^ Duration 21 b. Dare a Disposition (Mann, day, year) 21 c. Puce a Disposition (Name of cemetery, aemetory or aura pace) 21 d. Lacatbn (City / usm, sure, rip code) _ ^ Banal ^ Rertaval Irom Sere i Wee Cremation a Donstim Authalzed 2008 21 Ebans Cranation Services PA Leola ^ omer-speaN: . hyk4edkalExamlrwycarpnaR ~Vea^Np / 8/ , _ 22a. Sigrurure a F Liceraee (ape acg Such 22h. LJCeree NaMer 22c. Name sal Atltlress a Fadh"ry - - t FD 012633 L Ekain Brothers FunLxal Home, Inc., Carlisle, PA 17013 Compete gems 23e<aay when certifying pryaiaan a not aveirede d time d deem to To the~~~¢¢¢sssttt my rc~~, rtetl ar tlxs lane, tlau aria place sated. (SignaNre antl Igle) ~ ~ p ~ ~ . 23b. Licerme Number 23c. Date Sigrretl (MOnm, daY, Year) cemN cease d deem. R ~d`Y•'L/(„v /y )J a. ~ 7 i ~ - -~ ~ ~ 00 - gams 2426 mwl be cempleted by person 24. Time a Deam 25. Dale Promunced Oeatl (MOnm, tlay year) 28. Wee Cece Refened to Metlkxl Examiner / Coroner tw a R ason Omer than Crematan w Dentition? wlp pmicencas deem. ` M. ~ ~ ' ~ ^ Vas No CAUSE OF DEATH (See InstnseHons and exam lea) r Appmximete interval: Pad II: Enter other sgn_ihmnt conNldrss amtnhutina u deem, 28. Ditl TobecW Use Cmtnbee ro Deem? Item 27. Pan C Enter dce Meld a evens - diwasea, Iryuries, a canplMagons -that dreclly ceusetl the tleam. DO NOT timer tennirW evens such as cardiac anesL Onset m Deem bd not resulting kl me undelrying cause given in Pan I. ^ Yes ^ Pmbaby respretay erred, w venhkular fibdlution vddaul showing the egokgy lid Dory one cause on each line. /~ /f ^ No ^ Unkrawn IMMEDIATE CAUSE Fmd disease a a~ ~ ~y L / ~ 1 / r mnd'nun resulting m ~th) -~ a. I r r L ~ S f (n ~ ~i[ l.~ V~ f ~~/t 1~ `(/1 h ~ Q/~ i 3 y •,~.,n 29. g Femere: ^ Oue to (a as a consequence op: r r Na pregnant wmin past year ^ Pregnant at time of tleam Sepen6atly let cendd'ans, g arty, b. leadag u the cwse listed on M1ce a. ~ Due to (or as a consequence oQ: ^ Na Pregnant. but pregnant wimin 42 days 1 Faster the UNDERLYING CAUSE (disease or injury mat inigated me c of deem events resugirg In deem) LAST. Due to (or as a consequence Dry: ^ Not pregnan, but pregrwit d3 mys to t year before tleam tl. r ^ Unknown d pregnant within the past year 30a. Was an Autopsy 306. Were Autopsy Flrltllrgs 31. Maurer a Deem 32a. Date a Injury IManh, day, year) 32b. Deacnbe How Injury Oceuned 32c. Puce a Injury: Home, Farm, Sred, Fedory, Perlortced? Avaieae Pnar to Compdion al Cause a Deem? ~ NaWnI ^ Homidtle OFCa Ba~9• dc~ (~Nl ,,,yyy ^ Vas ~NO ^ Vas ~o ^ Acdtlent ^ Pendrp Invesbgetion 32tl. Tme of Injury 32e. Injury al Woa? 321. tt Trensponation Inlury (Speak) 32g. Laatim of Injury (SreeL MY I town, state) ^ Sudtle ^ Could Na ba Detarminetl ^ Ves ^ No ^ Driver / Operetar ^ Passenger loan M ^Omer ~ SpeciN: 33a. Cenifa (Mack only one) roneuncetl death and com leted Item 23) h n has m 1 d ln n m aid l Ph ld nil 330. signature antl Ttre d my [~ y- ,i"- yJ `~ ~G' /t y p p g WUea o ea w en ena or p e Nan ( ys an ce y • CeHgying phys Tothe hest of my knowledge, death otturtatl due to the cease(s) and manner as sated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - I • pronouncing and certlNing physklen (Phydaan hour praaaving deem and cenirying to cause o1 death) ^ 33c. License Number 33tl. Date Signed (MOnm, day, year) To the heat of my knowledge, death occurred d dre time, date, and place, antl due to the cease(s) ant mmner as sated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ l E i /Co oner • M tlk ~s /' r60~1 ~~ ~L ~k .q.1 Q O~ ~ I ~vt/ sa xam ner r e a On the basis or examinadon and / or Invastlgalbn, in my opinion, deem occurretl at the time, date, antl place, and tlue to the cause(s) and manner es sated_ ^ 34. sme antl Adtlress f Pars Wh'o_CO/mpeted Cause a Deem gram 27) Type I Ptinl /t / }) N~e ~ ~~~ r , ~ ~ ~ (' s kt N d I ' Dale Filed (Monm Year) daY ' ~ t C / /L V4 I {/~ ~ ' V r J ( _" ~~~~( VV ~ + r s a re ai 35. Regk c~~~ Id I I I ~, I- I O I ~ , . . l6 l~(4- 1~1 I g o Id i s - •cr~.- a rr f Dispositbn Permit No. o ~ ~ t4,, LAST WILL AND TESTAMENT OF ~ a - 6~ PATRICIA G. KEEFAUVER ~ ~ -rs ~ _~: + = ~> ~~ L ( rT1 ~ t ~. ~ ~ ~ 7'rJ7 ~ ~.r '~ ~ f ~"a I, PATRICIA G. KEEFAUVER, now domiciled in Cumberland County, sylv~a, _ ~ r . ~ L. ' 1,~,.: declare this to be my Last Will. I revoke all other Wills and Codicils that I may have previo&~ly ~'' made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be apportioned pro rata to the beneficiaries, such that each beneficiary shall be responsible for payment of inheritance tax on the property received by him or her. Article III I give, devise and bequeath my tangible personal property to my husband, DENNIS D. KEEFAUVER. In the event DENNIS D. KEEFAUVER predeceases me or fails to survive me by thirty (30) days, then I give, devise and bequeath my tangible personal property in accordance with any memorandum I have handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal property shall be added to my residuary estate and pass under Article IV hereof. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my husband, DENNIS D. KEEFAUVER, of Cumberland County, Pennsylvania. In the event that DENNIS D. KEEFAUVER predeceases me or does not survive me by thirty (30) days, I give, devise, and bequeath the remainder of my estate, of whatsoever nature and wheresoever situate as follows: A. EIGHTY PERCENT (80%) EQUALLY to my daughters SHIREEN S. BOWER, of Del Ray Beach, Florida, per stirpes, DANA M. MAUD, of North Bay Village, Florida, per stirpes, and MICHELLE R. DRAGON, of Mt. Holly Springs, Pennsylvania, per stirpes. The share of any deceased child who does not have living issue shall be divided and distributed to my remaining children, per stirpes; and B. TWENTY PERCENT (20%) EQUALLY to my two granddaughters, ALEXIA DRAGON and TAYLOR DRAGON, of Mt. Holly Springs, Pennsylvania, per stirpes. Artirla V If a beneficiary under this Will has not attained the age oftwenty-five (25) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the terms in Article VI. 2 Artirla VT In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support, health, care and education of the child until the child attains the age of twenty-five (25) years. B. Upon attaining the age of twenty-five (25), the remaining principal and accumulated income of the child's share shall be distributed outright to the child. C. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. Article VII In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: (a) to retain in the form received and/or to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, 3 (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to the extent any trust hereunder is the beneficiary of a Retirement Account (as hereinafter defined) my Trustee shall draw the benefits from the Retirement Account in amounts sufficient to meet the minimum distribution requirements of IRC Section 401(a)(9) and the regulations thereunder (the "Required Minimum Distribution"). Notwithstanding any provision of the trust to the contrary, the Required Minimum Distribution shall be paid to or applied for the benefit of the income from such trust, or if there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. "Retirement Account" means a plan qualified under IRC Section 401, or an individual retirement arrangement under IRC Section 408, or a Roth IRA under IRC Section 408A, or atax-sheltered annuity under IRC Section 403 or any other benefit subject to the distribution rules of the IRC Section 401(a)(9), or the corresponding provisions of any subsequent federal tax law. It is my intention that this trust qualify as a "conduit trust" under IRC Section 401(a)(9) so that the trust beneficiaries shall be considered designated beneficiaries for purposes of the minimum distribution rules, and that distributions may therefore be taken over the trust beneficiary's life expectancy (or the life expectancy of the oldest trust beneficiary). The Retirement 4 Accounts shall not be subject to the claims of any creditor of my estate and they shall not be applied to the payment of my debts, taxes or other claims or charges against my estate unless and until all other assets available for such purposes have been exhausted, and even then only to the minimum extent that would be required under applicable law in the absence of any specific provision on this subject in this my Will, (i) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; to pay from my estate reasonable compensation for all their services, (j) to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death, and (k) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. Article VIII I hereby appoint my daughter, MICHELLE R. DRAGON, as Trustee of any Trust(s) created in this Will. In the event of the renunciation, death, or inability to act, for any reason whatsoever of MICHELLE R. DRAGON, I nominate, constitute and appoint my son-in-law, CHRISTOPHER J. DRAGON, successor Trustee of any Trust(s) created in this Will. Article IX I nominate, constitute, and appoint my husband, DENNIS D. KEEFAUVER, Executor of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executor, I nominate, constitute and appoint my daughter, MICHELLE R. DRAGON, successor Executrix of my Last Will and Testament. I direct that my Executor or 5 successor Executrix be permitted to serve without bond. In addition to those powers granted by law, I grant them power to distribute in cash or in kind, in like or in unlike shares, and to file any qualified disclaimer I could have filed if living. My Executor or successor Executrix shall receive reasonable compensation for services rendered to my estate. Article X In addition to the powers conferred by law, I authorize my Executor or successor Executrix in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor or successor Executrix; and to pay from my estate reasonable compensation for all their services, 6 (i) to conduct alone or with others, any business in which I am engaged, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with the standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, PATRICIA G. KEEFAUVER, hereby set my hand to this my Last Will and Testament, on ~~5 , 2007, at Harrisburg, Pennsylvania. .. XJ PATRICIA G. KEEFAUV In our presence, the above-named PATRICIA G. KEEFAUVER signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address 2000 Lint?lestown Rd Suite 202 Harrisburg PA 17110 Sui PA 17110 I, PATRICIA G. KEEFAUVER, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by PATRICIA G. KEEFAUVER, the Testatrix, on ~~~~ ~lS~ , 2007. ~ ~- ~'~.~.2 ~. ~ ~., Notary Public COMMONWEALTi-i OF PENNSYLVANIA Notarial Seal Melissa M. Kain, Notary Public Susquehanna Twp., Dauphin County My Commission E~ires Aug.11,2010 7 a ..X~ PATRICIA G. KEEFA ER ~~ We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by m ~(',I S. rn 11~~-~- and ~a~~'~ V, F' ~ ~ g,(~~ witnesses, on y~ ~ X1,5 , 2007 Notary Public v Witness Witness COMMONWEALTH OF PENNSYLVANIA Notarial Seal Melissa M. Kain, Notary Public Susquehanna Twp., Dauphin Courriy My Commission Expires Aug.11, 2010 8