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Home My WebLink About02-18-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of William J. Otstot also known as File Number 21-09- C7~LC~.n ,Deceased Social Security Number 174-05-3820 Janie R. Baker Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or '8' BELOW:) ~X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the last Will of the Decedent, dated 07/03/2002 and codicil(s) dated 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: B. Grant of Letters of Administration apptca e, enter: c.t.a.; .n.c..a.; pe ente ite; urante a senha; urante mtnontate Petitioner(s) after a proper search haslhave ascertained that Decedent left no Will and was survived by the 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.) :~ ~ Name Relationship Residence `; , ~ ' a ~ ~ -- - ~ .i --. ~ _ f, _-;= ~, ,7 ~ ~ ' (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 Country Meadows, Mechanicsburg, Hampden, Cumberland, PA 17050 (List street address, town/city, township, county, state, zip code) Decedent, then 96 years of age, died on 01/20/2009 at Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 138,601.00 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 Janie R. Baker 883 Siddonsburg Road ~ ~ '° ~ Lewisberry, PA 17339 Form KW-UL Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 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 er affirmed and subscribed t""'~~'~-~-~''~-- '+ ~ ~ ~ ~~~- ~j Signature fPersonalRepresentative Janie R. Baker ''"~ before me this ' ° day of ~? ~ _ - ',y ~ -rt r Si nature of Personal Re resentative X. -For the Register Signature of Personal Representative .;j._~ ~sv:. _~: - ~ tV - File Number: 21-09- G~~I,V Estate of William J. OtStOt ,Deceased Social Security Number: 174-05-3820 cc"vv~~vv~~ Date of Death: 01/20/2009 AND NOW, i" C ~~ ~( ~ ~-~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT I ECREED that Letters Testamentary are hereby granted to Janie R. Baker in the above estate and that the instrument(s) dated 07/03/2002 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. t ~ ~ - - FEES; ~r~...J~._- ~ ~ 1 Register ~Ils Short Certificate(s)........>..~~........... $ ~Q ` ~ , ~ ` Attorne Si nature: r ~ +. Renunciation(s) ............................. $ Y 9 ~~~~~ L.. / ~~/ i~ .l ~ $ ! ~ Attorney Name: Michael L. Bangs j , i7 $ ~, ~\\ \` ~' U Supreme Court LD. No.: 41263 ~`~j $ J $ Address: 429 South 18th Street $ Camp Hill, PA 17011 $ Telephone: 717/730-7310 ~c~ TOTAL .................................... $ ~~~ ~--7 Form RW-OZ Rev. 10-13-2006 Copyright (c) 2006 forth software only The Lackner Group, Inc. Page 2 of 2 il,le vrF hid ~. ~ -, LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Pee for this certificate. `~f~.UO P 1500253 Certification IV(nnber 1 REV 11/2006 /PRINT IN MANENT 9CK INK This is Lo cerlif~~ f1-iat the inlotulation barn t>iven i~ correctl~r copied fi~orI an urivinal Certificate of Death duly tiled with nu• a~. Local R~~~isu~ar. The ori~ri)~al cerCificatc will he fo(~e<(rd~d to tine State V'itai Records Office fin peruuYnent i'ilin;'~~~ ~ ~ ~~~~ L2-~ ~ D/ Local Registrar Date ]slued ('~ n.J ra - ~ Q c~ _ r_a ~ - ; . _C C7 C7J r zT r-n ,- ,__ t_-. - -r : ~ r ~., 1 ~ ~ ~ ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ N ~ ~ 3 CERTIFICATE OF DEATH '~ (See instructions and examples on reverse) STATE FILE NUMBER ~ 1 n ~~ n ` ( n ~ ~ 1. Name of Decedent (First, middle, lass, suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, tlay, year) William J. Otstot Male 174 - 054- 3820 Januar 20 5. Age (Last Birthday) Under 1 year Under 1 day 6. Dale of Birth (Month, day, year) 7. BiMplace (City and state or fore n country) 6a. Place of Death (Check only one) Momhs Days eaurs Mlrwiae Hospital: Other: 96 yrs. Nov. 27, 1912 Harrisburg, PA ®In bent ^ER/Out tienl ^DOA ^Nursin Home pa pe g ^Residence ^Olner-Specify. 66. County of Deem 6c. City, Boro, Twp. of Death 6d. Fadliry Neme Qf not instttution, give street and number) 9. Was Decedent of Hispank Origin? ®No ^Ves 10. Race. American Indian, Black, While, etc. ~.'Wp . hf Yes, specity Cuban. ISpeciq( Cumberland East Pennsboro Holy Spirit Hospital Mexican,PUenoRican,etc.) White 11. DecedenYS Usual Occu Nan Kind of work d are duA most of wnMi file. Do not state rehred 12. Was Decetlent ever in me 13. Decedent's Education (Speciy onry highest gratle compl eted) 14. Mamal Status: Married, Never Married. 15. Surirving Spo use (II wife, give maiden name) KiM of Wak Kind of Business I Industry Carpenter Custom Builder U.S. Armetl Fomes7 [3~Vea ^Np Elementary /Secondary (0-12) College f t-4 or 5+) Lf Wbowad, Divorced (Specil~ Widowed 18. Decedent's Mailing Address (Street city /sown, state, zip code) Decedent's Did Decedent P A Live in a 17c Decedent Lived in Hampden T ~ Yes 17 A R id S 883 Siddonsburg Road . , wp ctual es ence a. tate Townahip? Cumberland 17tl.^No, Decetlenl Lived within rib co Lewisberry, PA 17339 . pnry Actual Limits of CI / Boro N 16. Earner's Name (First, mitldle, last, suNlx) 19. Momer's Name (First, mitltlle, maitlen surname) Eva Miller 20a. InfomlanYs Name (Type I Pdnt) 20h. Inlormanl's Mailing Address (Slreel, city I town, stale, zip cotle) Janie R. Baker 883 Siddonsburg Road, Lewisberry, PA 21 a. Melhotl of Disposition [~ Cremation ^ Donallop 21 h. Date of Disposition (Mpnm, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or other Dlace) 21 tl. Location (City f town. slate. zip code) ^ Banal ^ Removal from Slate i WaeCremationaDonationAuMOrixed Jan 21 2009 BFH Crematory Grantville PA 1 7028 ^ 0 r -Specify: i by Medical Examiner / Droner? Ves ^ No , I ~ - 22a ig lure of Funem rvice licensee or pars cdng as such) 22h. Licerxse Number 22c, Name antl Address of Facility - -(, ~~ _ FO 012342-L Stone & Murra F.H. 408 3rd.St. New Cumberland P 1707 Co ~ to Items 23at only when cediryirg 23a. To Ih elf I my edge. death occunetl at the Nma, date and place statetl. (Slgnalure and line) 23h. License Number 23c. Date Signed (Month, day, year) loan Is rwt available at time of tleeth to rtAy cause of death. Items 24-2fi must de completed by cerson 24. Time of Death ~ 25. Date Proraunced Deatl (MOnm, day, year) 26. Was Case Referred m Medical Examiner I Coroner for a Reason Other than Cremation or Donation? who prorwunces Beam. ' [; ~ M. ~ r ~ C,7 ~ ~~ (,l - ^Ves No CAUSE OF DEATH (See instruetlona and examples) I Approximate interval: Pan II: Enter other sienificenl corNlilions conMbutinq to Beam, 26. Did Tobacco Use Cpntnbme to Death? Item 27. PaA I: Enter me chain of events - tliseases, injuries, a complicetions - that direary ceusetl the deem. DO NOT enter terminal events such as cemlec artesl 1 Onset to Deam but not resulting in me undedying cause given m PaA I. ~-xas ^ Probably respiratory anesL or ventricular AbnNation wimoa showing me etiolegy List only one cause on each line. ~ t ^ No ^ Unknown ~~ IMMEDIATE CAUSE (Final disease or 29. If Female. l conditbn resuNng in death) -~ a - v/ ' i N e Due to (or as o sequence oQ: r p.. Ot~ gnanl within past ear y ^ Pregnant al time of death Sequentially list contlitiens, d any, b ~ leading to the cause listed on line a. Due to (or as a consequence of): ^ Nol pregnant, but pregnant within 42 tlays Enter the UNDERLYING CAUSE (disease or injury that initiated the t of Beam events resulting m deem) LAST. Due to (or as a consequence oQ: ^ Nol pregnant. hul pregnam a3 days 101 year before death tl ^ Unknown it pregnam within the past ear . y 30a. Was an Autopsy 3CU. Were Autopsy Findings 31. Manner of Death 32a. Dale of Injury (Month, day, year) 32b, Describe How Injury Occurred 32c. Place of Injury: Home, Farm, Street, Factory, PeAortned? Available Pdor to GomplaNon of CaUSe of Death? ^ NaWral ^ HomKide Office Building, etc. (SpeciyJ ^ Accident ^ Pending Invesligalron 32d. Time a Inlury 32e. Injury at Work? 321. II Transportation Injury (Specify) 32g. Location of Injury (SlreeL city I town, state) ^ Yes ~{Ja ^Ves ^ No ^ Suicitle ^ Could Nol he Determined ^Ves ^ No ^ Driver! Operator ^ Passenger ^Petlestrian M. ^Other-Specify: 33a. Certifier (check only one) 33b. Sigiuture and TiNe of CenNier • Certlfying physician (Physician certitying cause Of death When aMthar physician has pronoua:e0 death and completed Item 23) ~ deaM occurred due to the cause(s) and manna as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ To the best of my knowledge , I r7sf '% , • Pronouncing and certitying physician (Physcian bosh pronouncing death and cenitying to cause of deem) ^ 33c. License Number 33d. Date Signed (Month, day, year) Ta the best of my knowledge, deaM occurred at the time, date, and place, end due to the cause(s) and manner es statetl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ E i /C ,!7 J ~7/f(/L. G:. ~r~ ~/~ Ji0 J oroner • Medical xam ner On the basis a examination and / a invesdgetian, In my aplnion, death occurred at the Nme, date, end place, and due to the cause(s) antl manner as stated_ ^ ~ Name and Address of Person Who Compleletl Cause pl Death (Item 27) Type !Print /1 a ' " ~ 35. Register's Slgnalure striCl Number ~ ~ i / / I I I III I ~ 3fi. Dale -led (Mont ,day, year) / 7~ ~ jG//;i•-t ~7`~J!'ih ` 1~/ ( ~~~%/ ,/~ ~ . i ~i ~~e ;~,1~ ~%~ v Disposkon Permit No. O ~ y l ~~I l~~ O ~ -~ cm:x ,_ .:_~ _ ~ c_~ ~; >: , e r~~~ c;~ `: _'- , . - I, WILLIAM J. OTSTOT, of 3605 Kohler Place, Apartment 15, Camp l-I~~y~`-, -=`a ' Cumberland County, Pennsylvania, declare this to be my last will and revoke any 11 previ~sl ~ ~ ~ R~ y ;, made by me. 1 •, ~ N •~ ~ ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker \, and all expenses of my last illness, and any and all taxes and assessments imposed by any ~ ~~ ~~ ~ governmental body as a result of my death, whether on property passing under this will or C--'~,~ otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a ~' ~` part of the expense of the administration of my estate. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all ~ ;~; other articles of household and personal use, equipment and ornament, together with all 1\~ `~~} insurance thereon and relating thereto, as follows: A. SIXTY (60%) Percent, in equal shares, to Janie R. Baker and Harold Z. Baker, or the survivor of them, provided they survive my death by thirty (30) days; B. TEN (10%) Percent to my granddaughter LAURA HARDIN, provided she survives my death by thirty (30) days. Should she predecease me or be deceased on the thirty-first day after my death, her share shall go to her issue per stirpes in equal shares, as survive my death by thirty days. C. TEN (10%) Percent to my granddaughter CHERYL MARSHALL, provided she survives my death by thirty (30) days. Should she predecease me or be deceased on the thirty-first day after my death, her share shall go to her issue per stirpes in equal shares as survive my death by thirty days. D. TEN (10%) Percent to my grandson ANDREW BAKER, provided he ~` survives my death by thirty (30) days. Should he predecease me or be deceased on the thirty-first day after my death, his share shall go to his issue per stirpes in ~, equal shares as survive my death by thirty days. ~''< `, ?~~,~ E. TEN (10%) Percent to my grandson SCOTT BAKER, provided he survives my death by thirty (30) days. Should he predecease me or be deceased :ti :~~ on the thirty-first day after my death, his share shall go to his issue per stirpes in ~ equal shares as survive my death by thirty days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate as follows: A. SIXTY (60%) Percent, in equal shares, to Janie R. Baker and Harold Z. Baker, or the survivor of them, provided they survive my death by thirty (30) days; B. TEN (10%) Percent to my granddaughter LAURA HARDIN, provided she survives my death by thirty (30) days. Should she predecease me or be deceased on the thirty-first day after my death, her share shall go to her issue per stirpes in equal shares, as survive my death by thirty days. 2 C. TEN (10%) Percent to my granddaughter CHERYL MARSHALL, provided she survives my death by thirty (30) days. Should she predecease me or be deceased on the thirty-first day after my death, her share shall go to her issue per stirpes in equal shares as survive my death by thirty days. ~~ D. TEN (10%) Percent to my grandson ANDREW BAKER, provided he ~ {~ ~~ survives my death by thirty (30) days. Should he predecease me or be deceased ~~~~ t\ on the thirty-first day after my death, his share shall go to his issue per stirpes in j~'y ~~ ~ equal shares as survive my death by thirty days. E. TEN (10%) Percent to my grandson SCOTT BAKER, provided he ~~, survives my death by thirty (30) days. Should he predecease me or be deceased ~~ on the thirty-first day after my death, his share shall go to his issue per stirpes in ~~ equal shares as survive my death by thirty days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my daughter, JANIE R. BAKER, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my son-in-law, HAROLD Z. BAKER, executor of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~"h' ; ;~ ~~ day of :~ z~ ~~~ .2002. ~.- WILLIAM J. OTS~'~ 4 The preceding instrument, consisting of this and FOUR other typewritten pages, each identified by the signature of the testator was on the date thereof signed, published, and declared by WILLIAM J. OTSTOT, the testator therein named, as and for his last will, in the presence of us, who at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. - .~ ,= ' ~ COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. WILLIAM J. OTSTOT%- Sworn or affirmed to and acknowledged before m by the tes ator~named above this .~~,~,~~d y of,, , .~ ;(~~~ %_' , 2002. a 1:, ~~ ~ J ~ s~.~;BZ r~. ., ._. , . ..,_ COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ~ _-- WF,_ ~ : r~,- :~ l ~_ ~/~'~ ~ ~" and ~f`l:I ~~ ~ -_~ _ C~1~'~Tl the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his last will; that he signed it willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; and that to the best of our knowledge, the testator was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and acknowledged ~efo~e me this ~~~,~ 2lav of ~ ~, ~~~,; X002 6