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HomeMy WebLinkAbout02-26-09PETITION FOR PROBATE A/ND GRANT OF LETTERS REGISTER OF WILLS OF w~~t~rlo,r~ COUNT', PENNSYLVANIA Estate of ~ ~ ~ C ~ ~. C-7Ci 'J ~'•" also known as ,Deceased File Number ~ ~ ~ ~ ~ -t Social Security Number ~ `~ ~ ~ l ~ _ ~ L` '~ 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) is /~e the named in the last Will of the Decedent dated `~/,3,/ /~`l7 and codicil(s) dated (State relevant circumstances, e.,., 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) offend for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ^ I3. Grant of Letters of Administratio (lfapp[icable, ewer: c. t. a.; d. b. n.c-t. a.; pendente lire; durance absentia; durm~ninoritnte) c=s ,ten Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spa~sa if any) atttt'hetrs: rf7f i Adn~inistratiott, c. t. a, or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) t ~ ~-7 ~ _ Name Relationshi ResiderrcE;j -~ ~ - __ s r._ i ~ --. -~ _. _ _ .. . -' ~= ~ - i - _~ ~ -r, D N (COMPLETE IN ALL CASES:) Attach a/d~ditional sheets if necessary. ~'"~ tDecedTent was domic le at de~lath i1n CJ:'vt~~'i ~A/1r-9 County, Penns hvlania with his /her last principal residence at `f ~! L~.1^ t I ri .'Ic'y ~P K-[-t ~ ~T~'7 C~ 7 t Gl/f c~c f b'• S ~'/ ~ 7 U j l~ (List street address', town/city, township, county, state, zip code) Decedent, then ~ years of age, died on Decedent at death owned property with estimated val (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania situated as follows: Form R6V-03 rev. 10.13.06 at l~dw~rrt~ ~GZ /ti~ ~c-, ~ ues as follows: All personal property $ y COC , CGS Personal property in Pennsylvania ~ /VA Personal property in County $ N,q $-51 Page L of 2 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: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF C~~r-r.~'; ,c~~c~l _ 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 me the ~_ day of ~P. r ,~~t 1 ~ ` ~~, or the Register C. -- lure onf Persona! Representntive 1/ ~1-- r of Persons! Representntive Signnture of Persona! Representative r~ ~~ i =C t TS r--~ ~~ _;.~ O'ti f~~ -_, ~ `- ~~ '17 _ y N Fi((le~~Number: ~ ~ U`'1 G ~c1 CJ ~'"~ Estate of Y-1 ~ 1 <- ~' ~ • ~ ~ D V~(~ ~ ,Deceased Social Security Number: ~ ~ Z ~ `~ ~,0~ L Date of Death: ~= ~r ~c~ ` t L 1 2~ • - -r .; ._.~ c- AND NOW, _ ~ ~ ~~~ti a ~ , ~~, > in consideration of the foregoing Petition, satisfactory proof having been presented before(~me, IT IS ECREED that Letters ~2~ ~-r~n~~ are hereby granted to 1'0.'`• ~-~ cam- ~ ~ ~~'~ t~ ~'~ ~+~~` ~~ ~-~~-c c rn . ,~'~~ *~e r in the above estate and that the instrument(s) dated -~2~Pmbe~ 3 1~1~` ~ described in the Petition be admitted to probate and filed of record as the last Will and Codicil(s)) of Decedent. '` \~ FEES ~~ p ~~('`.( ~ `^) (, Register of Wills '~•~ _~ Short Certificate(s) .. =..... $ °~ ~ Attorney Signature: Renunciation(s) .......... $ _ Attorney Name: l.~TA~ ... $ ~5 ... $ t l~ Supreme Court LD. No. ~~ ~ ~ • $ ~ Address: ... $ ... $ ... $ ... $ • • $ Telephone: ... $ - o TOTAL .............. $ ~~ Page 2 of 2 Form RW-0_' rev. 10.13.0( OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee tier this certificate. Sfi.00 p 15~'~ 6474 Certification tir;n7her This is to crrlif: that the information here t~i~en i~ co)-rectly copied ti~om an original Certificate of [death duly filed with ~~nA° as Loral Registrar. The ori~Tinal certificate ~~~ill bt, forwarded to the State Vital Records Office ;ur permanent filin~~. Local Re_Tistrar gate Issued ~.~} C7 c°~ a I y'~ f rt C17 c°~ -, -- ' ~ -~ ~ N :::: ~~ - _ <: ~ -_'~a O1 ~ ~: ~ - -- .~„]~; ~ ~ : , N ~> W HtU3~tJ3 REV 112006 TV PE PRINT IN PERAIANENi BIACK INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH ^ (^~ ^ ` (See instructions and examples on reverse) STATE FILE NUMBER ~ ` ! 1 G 1 \ ~~ / ` I Name of Decedern jFrsl, matlk, last 5umxj 2. Sex 3. Saul $etunry Number a Dale W Deam IHOnIh, day. year) Alice M. Coover _emale 162 - 14- R081 2 21 09 5 Age (lass Binntlayl Urvkr 1 year Undel I tlay 6 Dale d Bum (Month, day. year) 7 &naplace (C alk swe a tae coudryt fia. Place d Death ICaecY bnry one) M.nm, Dap hour., Miu„ias Hospaal'. Ola¢r: 9 0 YI, 1 0 / 3 0 / 1 91 8 H 1 cko r P . `~'npeliEnl ^ Efl I Odpaaenl ^ DOA ^ Nurvny Hume ^ Hes.tlance [~Or,er Spauy db C°unry of Death &:. Clly. Boro. Twp of Death Bd FaNity Name (11 rwl nslaulan, give sweet artl dumber) 9. Was Decedem of Hispanic Ong~nP No ^ Yes 1U Race An,encan Ine~an. 61acA f]r.l¢ el. pf Yes, specify Cuban, ISpc'L,ly Cumberland Ea t Hol S i '"¢"aa" p"¢"°R"~" ¢"' Whit 1 T Daetlam's Usual Oct aUOn iKintl of work Done tluri moll al waAin tlk lb rot stale redretl 12. Was Decedent ever m dre 13. DecetleM's Educatan ISPetdY only lughesf grade wmpleled) 11. Mardal Slalus'. Marrle4 Never Marred. 75 Survinrg Spouse (If wde, give maNen name) Widw~eQ D~varced ISy,ecdyl Kilo of Work Kmd ul Buvness! mtluslry U.S. Armed Forces? Elementary 1 Secondary (0-72) Cdkge (1 ~a or 5e) Secretor School ^y¢a 4N° 2 TAidowed s Detedem'sMatlingAddreaal$Ileel t~nimwn alate,zipcodef Dec¢dems DidDecedern Ham den Uetetlenl Lived .n P T„y Pennsylvania Lla¢ a a nt L~ Yes 4905 East Trindle Road Apt97 . . Actual Reaaelke ,r stale T°"nah'°? ,7d^NaDa~¢d¢mt,~¢dwuh~ ,Ib. coldly Cumberland Amaal rm~ud cdY, 6oro Mach nit 1d Farrar s Nana IRrsL middle lass sudnl 19. Homer's Name (Post made, maltlen surnemel Robert Wilson McPeak Maude Mar Haller 20a Inlorn,aMS Name IType r Pnnll 20b Inlamant's Magog Adtlress (Street. wry I rown, stale, zip code) Patricia A. Smith 143 Beachwood Ln. Chambersbur P. day yeer) osition IMmm Date of Dis 21 b Place of Dlspasitan (Name d carlrelery, cremaary a omer pence) 21c ltd. Catalan ICAy r town, sole. zp cotlel 21a Alemod of Duposmon ^ Cremaual ^ Dalatim , p . . Buual Ramc~u nom -Iola ~ Wes Cremation a Donation Aumori:ad ^ ~ • ~ y] 2/26/09 ollinq ;reen Memorial Park Cam Hill PA 17 NO ~ rueditalE=ainlner7cordMrP ^Yea % sper,r ^ol cy qn¢I servw Laena sonaai aa~ 22a s~gnala z20LitenseNamber zzcNameaMAddreaadFatary Neill Funeral HCme, Inc. ~ ~ ~' - Fp 013239 L 3401 Market St Cam Hill P ,~ ~ __ F . Complete Ite s 23ac only wrren cenitymg 13a To me best W my Wlowletlge tleam occunetl al me Nm¢, tlate ant place staled ISignatae erld Yk) 23b. Ucense Number 23c. Date Siynetl (MGnm, day, year) yh~sician is rut availaae al lone ul ceam 1~ Candy cause °I death 2d Tlme ul Dualh /1 ~nounced Deed jMonm, day. year) 25 Dale Pr 26. Was Case Relened to Med¢el Examiner /Coroner la a Reason Otnel rt'~an Cremati°n or Donatwn? deans 2i:.o niu;l ua cumplelW Oy yan~y, rvnu V,uno:u,cas ;loam ,~ (~ ~ M 1` e / !~ U G Yl L ` 1 ~ ~~ ^ Ves ^ No CAUSE OF DEATH (Sea inatructlons end eaampbe) r Appruxunale Imerval- Pan II: Engel other SlgoigGAW.GSN~s t'9Uq$Wel91q ~alh. 23 DA Tobacco Use Cumlaule to D¢aln? Item 21 Pa 1 I Enl~i nlr O~1 O s,r~113 Ju tales or ' mylrCaudna - Thal d iedly tauaetl the Jaam. DO NOT enter le nmal c rents soon as cartl,ac anesl, t Onset to Deatn bd not lewtlag in dre uraerlyirg cause given In Pan I ^ YES ^ Plwedy raspnalory anesl. or vanlncular Ianllulion witlruul sliawing me alwluyy. Us'l only one cause al each one. r ^ Ilu ~}MAnuwn IMMEDIATE CAUSE 11final dix~ux a A contl,tl0n rasutung re Jealn) ~~~~ 1 ~- ~ tll~ ]` 29 ICI -fyem{ale ear riar l w~thii u l rrol re _~ Dua to la a a consequence ol). - a , , y , y y b V ^ Plegnanl el aln¢ d deem rxlnnns d ar t a a l S ,,. U c~ , eq~an a y is kaaing to ma cause asletl on line a Dua Ib for as a consequence bp: Enle Rw UNDERLYING CAUSE Vial ina,atetl Ina fds¢ase ur iryur Nol I. Da I xnnu, a2 rle,s ^ VreyMn Vreylan d dean y evenl51e5Lilinq in deolh7 LAST t ^ Nol pregnant but Wagnaia a3 tleys l0 1 year a t Due to for as ,~nsequence ol). d balsa dean ^ UrNnown d preguanl wilnin ore ya,l yea 3Ga Wa - ~ Aulcps; 33o W A 1 p y F ntl ngs 31 M Nef of D¢am ~ 32a. Dale of Iryury IMOnm, day. year) 32o Describe Haw mryry Occurred 32c Place d IryaY'. Home farm street. facwry Ddx,'e Bred lg etc tSrxc,tyl PaA nod? A,I buP orwCompltlc- ~~1/ gI~W ^Ha, ode ~ ul caaae or D<anP ~ ^ AcuJenl ^ PenJ~ny Invesayauun 32tl Tema d Inlury 32e- Iryury a1 Work7 32L g Tlareporlalan Ilyury (Spenlyl 32g Laelmn W Ilyury Slreel, aIY. Icwn stale) ^Yes ( [_] yas ^ Yes ^ No ^Drivarl Operator ^Passenger ^Peceslria, ^ Su¢Ae ^ CodIJ Nol be Delennined M -]Other - Span) y' 33a Cent - I ne k one) 33b Signature antl Ttle d Ce - ~y , y ^/~/ ' • C rely' g ynyfk. P Y ce ly g ' '1 Jc Ih I - Inn VI ~ .. h' p iwaweU deann ern) canVkl¢tl Ite n 231 ^ ; V _ T manta f YW kdge aeatn dauel In (1 rM staled________________________________~ ltymq phyelclan IPnys t an both Vmnu a g tlea1, ara ce Lty d9 b cause W tleaml e d ^ d c • a 33c. License Number 3b Date rynM IMonln day. year) g n o y wkdge, deals occurred at me hme,dale, and plaza, and dw to tae ceusela)and manner as elated------------------ To tae seal of m Yx/~tf~ ;1~~ ~•[_AI. ~ ' - `•J t/ v r `( Z L~ • Medical Examiner I Ceron¢r 0 me basis oy eaamirralion and I a love Wyation, in my opinion, Beam acurt¢d al tae Ume, dale, and plate, and due to tae caueela) ant manner at ataled_ led La/~us~~1'fpD.e~am~fl/t~em 271 Type IfP~rml ~~e,.ss((-J~HReI'SO~n WooIjC/p\~,dl'~~ ( w~ • ' r d D lr I N b S 1 36. D Fged IAwdm, tlaY, Year) , Wl0 av-y Ala' ` Y "--1 + ~ r /) I / \ ~.-+- , p i tae an u qis~ . a qna 35 Re - I ,~I ~ ~ I / E~ I z2 D l / v`/ ~ x u- ~ t% n~.n,,.~m,n Parmd Nc. (. C% / O\ 5.3 / LAST WILL AND TESTAMENT OF ALICE M. COOVER KNOW ALL MEN BY THESE PRESENTS, that I, ALICE M. COOVER, presently residing in Hampden Township, Cumberland County, Pennsylvaniar~do hereby make, declare, and publish this as my Last Will and Testa~~xit, herby revoking all former wills and codicils heretofore made by me at any time ==' ~~°, --, r~-~ r;-_' u~ r~, PAYMENT OF EXPENSES ~~~~~ = ._Al I. Payment of Expenses. I direct that my Co-Executors, herehafter named,;~;_ ~ _~ shall have the power, but not the duty, to pay all my just debts, expenses of mast illness, and funeral expenses from my estate as soon after my decease as shall be found convenient. II. Personal and Household Effects: I bequeath my automobiles, household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, to such of my children as are living on the thirty-first day after my death, to be divided between them in as nearly equal shares as practical. III. Residuary Estate. I give, devise and bequeath the rest, residue and remainder of my estate, whether real, personal or mixed, and of any nature whatsoever and wherever situated to my children, in equal shares, per stirpes. IV. Powers of Appointment. No provision of this Will shall exercise any ro~vAr of ay pozntment I may have. FIDUCIARIES V. Co-Executors. I hereby nominate, constitute and appoint my daughter, PATRICIA A. SMITH and my son RICHARD M. COOVER, as Co-Executors of this my Last Will and Testament. In the event that either should predecease, not survive me, or decline the appointment, the other shall serve as sole Executor. VI. Bond. No Executor (Co-Executor) shall be required to give bond or enter security for the performance of their duties. ~ f, "~~ -1- ADMINISTRATIVE PROVISIONS VII. Management Provisions. My Co-Executors shall have, in addition to the powers and authority conferred upon them by law, the following additional powers and authority: A. Sell/Lease: To sell at public or private sale, exchange, lease, mortgage or pledge any property, real or personal, at any time constituting a portion of my estate, and upon such terms and conditions as they shall deem wise. B. Invest: To invest any money at any time in such bonds, stocks, notes, real estate, mortgages, life insurance, annuities or other securities, ox such property, real or personal, as Co-Executors shall deem wise, without being limited by any statute or rule of law regarding investments by an Executor. C. Retain: To retain, without incurring any liability, as investments, any property owned by me at the time of my death, as long as they deem it wise, and even though such property is not the kind of property an Executor would purchase as an investment; and even though to retain such property might violate sound diversification principles. D. Title to Property: To cause any security or other property which may at any time constitute a portion of my estate to be issued, held or registered in the Co- Executors' names, or in the name of a nominee, or in such form that title will pass by delivery. E. Expenses of Estate: To pay all costs, taxes, charges and expenses in connection with the administration of my estate. F. Allocate: To determine what is "Income" and what is "Principal" hereunder, and their decision thereon shall be final; and to purchase securities at a premium or discount, and to apply or charge said premium or discount against income or principal as the Co-Executors may determine. G. Borrow: To borrow money from any person, firm or corporation, for the purpose of protecting and preserving or improving my estate hereunder; to execute promissory notes or other obligations for amounts so borrowed. H. Employ To employ legal counsel, accountants, brokers, investment advisors, custodians, managers and other agents and employees and to pay them reasonable compensation out of the funds held hereunder to which said compensation is attributable. -2- I. Other: To do all other acts in the Co-Executors' judgment necessary or desirable for the proper and advantageous management, investment and distribution of my estate. VIII. Protective Provision: To the greatest extent permitted by law, before actual payment to a beneficiary no interest in income or principal shall be (i) assignable to a beneficiary or (ii) available to anyone having a claim against a beneficiary. IX. Death Taxes: I direct that all transfer and inheritance taxes, state or federal, assessed because of my death, whether the funds, property or insurance proceeds to which such taxes are attributable pass under this will or not, shall be paid out of my residuary estate; that my Co-Executors pay, or provide for payment of all such taxes at such time, or times, and in such manner as my Co-Executors deem best. X. Tax Options. I authorize my Co-Executors to exercise any options available in determining and paying death taxes in my estate. IN WITNESS WHEREOF, I, ALICE M. COOVER, the Testatrix of this, my Last Will and Testament, typewritten on three (3) sheets of paper which I have identified at the bottom of each page by my signature, hereunto set my hand and seal this ; ' ~'_day of : ,~. 1997. l 1 ~ ~' ?" ALICE M. COOVER The preceding instrument consisting of this and two (2) other typewritten pages, each identified by the signature of the Testatrix, ALICE M. COOVER, was on this day and date there of signed, published and declared by, ALICE M. COOVER, the Testatrix therein named, as and for her Last Will, in the presence of us who, at her request, in her presence, and in the presence of each other have s~ihscribed our names as witnesses. ~. ' ''~ i~~; ~ ~~~o. o ._. _. .o ~ - ,,~ , i r, ~,( ;~; -~. ~-- ~,.,-' .. -3- COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, ALICE M. COOVER, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the 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. ~; ALICE M. COOVER Sworn or affirmed to and acknowledged before me, by ALICE M. COOVER, the Testatrix, this.,3P~ day of~~y~"~ 1997. (SEAL) y , ~. ~' ~ Notary Public Notarla! Seal Gloria A. Cuddingtan, Notary Public Hamsburg, Dauphin County, PA tNiy Commission F~cpires Feb. 14.1998 COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN We, Catherine Moran Betty J. McClure ,and Richard E. Connell 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 Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or influence. :..:~-~:-~.;=_ ; .~ a '~... Sworn and affirmed to and subscribed to before me byCatherine Moran and Betty J. McClure and Richard E. Connell ,witnesses, this 3rd day of September , 1997. (SEAL) r %' ~ . Notary Public i Notarial Seal Gloria A. Cuddington, Notary Public Harri~urg, Qauphin County, PA My Commissicm Expires Fob. 14, 1998