Loading...
HomeMy WebLinkAbout03-06-09PETITION FOR PROBATE AND GRANT O:F LETTERS REGISTER OF WILLS OF L trt,•rn A~~.21.t4r>D COUNTY, PENNSYLVANIA -~i-o9- D~a~ Estate of ,~'> J~[1 tl C . ~7t-~'-~ K `~ `'~ File Number also known as Deceased Social Security Number r`~~-ta -1.Iz~. Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (CO,LIPLETE 'A' or B' BELOW:) ^ A. Probate and Grant of Letters T stamentary and aver that Petitioner(s) is /are the ~ :;IL.C..u~"~'t~ named in the last Will of the Decedent dated ~ (> 05 and codicil(s) dated 'l'l l)'+L.ti.~ (Stare relevart ci,•cu,nstances, e.g., renunciation, death ojexecutor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child bom 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 (Ifapplicabte, efter.• c. t. a.; d. b. n. c. t. a.; pendente liter durante absentia,(Zl,~rnnte minorit~ _ C © Ica __, .=~ -t Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the follow~ouse (if and ~je'i'xsy.~f' Ad,niltistration, c. t. a, or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ?'? "7T C7 ~ ~ --; rj Name r_ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in ~ tc,2 ;~v ~ Th.: ~~ 5%. ~ m Q,l (List sheet address, town/city, torvnsh p, county, state, zip code) N County, Pennsylvania with his /her last principal residence at Decedent, then ~_ years of age, died on ~ 1( ~ ~ at .2~ 4 ~1 ~~ 2~ S?; S wm m c ,C.tJf~LFy PA~ 1 ~ 033 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 $ ~ O O D Value of real estate in Pennsylvania $j~j n 53 ~ ~J35 situated as follows:_ oZ©Q ~1 t ~t~ 5 i 5eR-.m m ~ ~~ ~ ~ 1" /} ! ~-Uq ~~ 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: i~=,et=~ x 1(16 l-~ ~~ -~~ i~ i ~~- For,u RVV-0? rev. !0.!3.06 Pabe I Of Z Oath of Personal Representative COlvii/IONWEALTH OF PENNSYLVANL4 r ` ~n p ~` n `n SS COUNTY OF l iL.~~1 1 1~U ILI.I l~ . 'The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con~ect 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 For e Register Si~naa,re ojPersonal epresenlative Si„onnture ofPersonaf Representative Signature oJPersonnl Representative cN~- c 'ti.i y. ~ 1 ~..~ ' f t-'i l File Number: ~ ''~ ~ w _-~;.,'~. Estate of __ ,Deceased N ~QCk F. l ~'f7,IC~C~U ~ ~ Social Security Number:J d ~ ~ ~~ ' ~ ~ a v~ Date of Death:~= AND NOW, U'~ ~r IV~G / ~ , ~~, iu consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters T~ ~fam Pn 1Y 1 are hereby granted to ~(.{ SCe., /'1 V . ~S-f u ~~ee 4 _- in the above estate and that the instrument(s) dated S ' ~ - described in the Petition be admitted to probate and filed ofrecoJr-d~a~s the last Will (and ~Cod~icil,(s)) of Decedent. FEES ~L~Y( Q ~ ~ - ~ ~(/l:n-~~ Letters $ 135 0o Register of Wills G~, Short Certificate(s) ........ $ •~D Renunciation(s) .......... $ ~.~~ I~Ui ll ... $ 15.00 yC1~ _ ... $ l U• OD ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~7g. ~ Attorney Signature: Attonney Name: Supreme Court I.D. No.: Address: Telephone: tarn, Rw-n' rev. 10.13Ar; Page 2 of 2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 14544002 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ~ SEA- o ~~ Local Registrar Date Issued REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS /PRINT IN MANENT CERTIFICATE OF DEATH tCK INK (See instructions and examples on reverse) t7 ru 0° ,, '~ ~ ~~ ,^? C ~~~ ~ t \ i- t \~~`~ e _ N 1. Name d Decedent (First, mitldle, Wsl sulkx) Jack Ernest Stuckey 2. Sex M l 3. Social Security Number 184 1 4. pale of Death (Month, day, year) a e _ 2~ 2122 September ll, 2008 5. Age (last Sinhtlay) Under 1 year Under 1 tley 6. Date al &M (MOnm, day, year) 7. Binhplece (Ci s1tl stele a foreign count j M. Place of Death (Check only one) Nwelw Oan Hows Nkims Hosptal: Other. 85 yre 9/25/1922 Slnmerdale PA , , ^Inpaned ^ER/Out nad ~ry}F,, y pe [DOA ^ Nursing Hama CJ Resdence ^Omer ~ Speci ~. M. County of Death &. Clry, Boro, Twp. of Death Bd. Fadliry Noma (II not Insdlufion, gNe street eM number) 9. Was Decedent of Hispad: Origin? [~ No ^ Yes 10. Race; American Intlian, Slack, While, arc CLII~erland East Pennsboro ~y~,,~ 209 3rd Street (II Yes, spetly Cuban, (sP•MM `^ " I Mexican, Puerto Riran, etc.) White t1. Decedents Usual bon Kind of work sale Make most d wa ~ xe. Do not spte re11rM 12. Was Decedent ever in me 13. Decedent's Education (Specify only highest grade campleled) 14. Mantel Sfems: Marred, Never Memied. 15. Surviving Spouse (If wife, give maiden name) KkN of WoM Kintl of Business I kakrs U.S. Armed Faces? ry N ( I legs It-4 ar Ss) Widowetl, Dixrorced ISpeMM M Elements / Secontla 0-12 Col Su ervisor New Cumberl d A D p an . ep. ®ree ^Np 12 2+ Married Vera Cook 16. Decedent's Mailing Adtlress (Slree4 city / town, stale, ziP coda) Decedent's Db Decedent PA 209 3rd St . Aptual Residence ne. slate LNe in a nc ~] roe Decedent uved in East Pennsboro SLffilerdale, PA ]7093 , Twp Township? f7b county Ci~berland rid, ^ p~N ,t uved wimm ' l o city /Sao 18. Fams s Name (Fks4 middle, lest, sumxj 19. Homer's Neme (Flrsl, middle, maiden sumama) Justin M. Stuckey luara Jane Bean 209. InlameM's Name (Type / Pnnl) 20b. IdonrenYS Maikng Address (Sheet, city / kwvn, state, zip code) Vera Stuckey 209 3rd Street Sumverdale, PA 17093 21a. McOgd d Disposition ~ ^ Cremation ^ Donation 21b. Date d Dispoaitpn (Momh, day, year) 21c. Place d DlsposKbn (Name of cemetery, crematory a other plaafl 21d. Laatpn (City! town stale riP code) ~] Burial ^ Removal from Slate ;Wes Crelnetlon a Donation AuNglzad ^ oma-spedry: ; byMediWEsemklerycaoner7 ^yes^Np 9/16/2008 Rolling Green Cemetery , , Lxaer Allen 'I~7p. PA 17011 _ 22a. SlgraNre d Fungal Seryief- rises la prison ectlrg as such) 22b. license Number 22c. Name end Address of FacRly - ':~ '' ,,~, ,;,/_-.c,.... ~ FD 012774-L Richardson Blmeral Home Inc. 29 South Enola Drive, Enola, PA 17025 Canplele Kerrs 23at ady wEen urerdfying 23a. Ta IM d my knowledge, death aaurred el the time, dale arW place staletl. (SlgnaMe aM doe) 23b Lionse Number 23 D S phyeMen a rid avaaade at ems d deem l0 . c. ate i nad Momh, tla 9 ( y, year) ceridy cause d seam. ~ Hems 21-26 must M competed by person ,• wYw pronourlDS dim. 2<. Tune d Death 9 : 23 P M 26. Dale Pronounced Dead (Manm, day, year) Sept®ber I I 2008 28. Was Case Referred to Medical Examiner /Coroner to a Reason Other man Cremefmn w Oonetbnl . , ^ Yes ~ No CAUSE OF DEATH (See InatruMiorls end examples) ximate interval: Kam 27. Pad I, Emer the Main d evens - dkseases, injuries, a complications - Ihet di r APPr° rattly Dusetl ate death. W NOT ceder lennmal events suM es cardiac anesl Pan II: Enter other SIg01GCa0U:ondnions contllhutinc 1o tleam, 26. Ditl Tobacco Use Contribute to Deem? , r Onsd N Deem respirelory arrest. or ventricular lesrillaticn wnMd showing dre eaalogy. List Dory one rouse an eaM kne. ~ but rid resulting in me untledying cause n in Pan I. ~ Vas Proceed ^ ^ INYEDIATE CAUSE /Foal disease or /~ ~ ^ No ~ coritlitlan resutng let rkam) _,~ a ~ ~ ~T ~ 29. If female: - D ue to for as a consequence off: Sep~enaeN list candKions, it any, h r ~ ^ Ncl pregnant wimin past year ^ Pre nant al tlm f d h lea m the cause ksled an line a. I D g e o eat ue to for as a consequence off: 1 Emer UNDERLYING CAUSE r ^ Nat pregnant, but pregnant within 42 days (tkSeaae a nryry met ea6st c, r evems resultig m tleam) LAST, r D e to of tleam u (or as a consequence o0: ^ Not pregnant but pregnam 63 tlays l0 1 year d. r I Mlae death ^ Unknown if pregnant wilhm IM past year 30e. Was an Autopsy Pedormetl? 30b. Were Autopsy FinMngs gvasade Prior to Companon 31. Manner of Death 32a. Dale of Injury IMmm, day, year) 32b. Describe How In u Occurretl I ry 32c. Place d Injury: Horne, Fann, Slreel. Factory, ' d Cause of Death? ref ^ HomiMde Olke Suild mg, etc. fSpea/y) ^ Ves >~No ^ Yes o ^ Acadenl ^ Pending Investigalbn 32tl. Time of Inury 32e. Inryry al Work? 321. II Trensponalan Injury (Syxicily) 32g. Lacalion of Injury (Slreel coy I sown, stale) ^ Suiade ^ Could Nol M Determined ^ Ves ^ No ^ Dmar /Operator ^ Passenger ^P en M. oma - spent': ~' ~~ ( °~ °~) 33b. Signature and Tlk of Cenili • Certllying physidan (Physidan cerlilying cause al death when anoder physician has pronounced death and completed Item 23) To the East of my knowledge, death occurred due to the oase(s) end manner ore slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • Pronouncing rid certif in h elclen (Ph id h m tl - y g p y ys en pronoun o ng deem and cemrying to Dose d tlomj T tl 33c. License Number 39d Dale Si netl (Mmlh d o 1e Met of my knowledge, death occurred at me tlme, date, end pace, std due to the cause(s) end manner m sUtad-. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • Metlkal Fxamlrler /Coroner Gs / 16 ~ 3-L L . g , ay, year) 9 -~ ~ / L~ On 1M Mail d examinehon end / or investigation, In my opinion, death occurred et tM lime date and place and tlua to me Dose(s) nd d ^ , , , a manner es eMa _ 34. Naame arid Address of Person Who Complgtea Cause of Death (Ka m 27) Type ! Pnnl 36. Registrar's store arid Disl {` Ll t /; ~} L .M r t Q ~ ~ lIC2i 36. Dale Filed (Monm, day, year) ( Disposition Parmil No. ~ ~T~., ~~ ~~ 'J ~. ~. ~ =.: ~i ~9-~~3 N Last Will of Jack E. Stuckey ,~~° ~ ~;~~? ~ .~ ;~, ~ I, Jack E. Stuckey, of Summerdale, Cumberland County, Pees`~l~nia~n being of lawful age, sound mind and memory, and under no restraint, ~~ ~~ lisp this as my Last Will, revoking all other Wills or Codicils previously made Vie. _.., w FIRST: All expenses, fees, costs, and taxes related to this estate shall be pai~ from the probate estate assets, including but not limited to funeral expenses, grave marker, the costs of my final illness, Inheritance, Estate and Fiduciary Taxes; and all gifts and bequests shall be paid from the net distributable estate. SECOND: I give, devise, and bequeath the remainder of my entire estate, real, personal, or mixed, of every kind and nature, and wherever situated, which I may own, or hereafter acquire, or have a right to dispose of at my death, to my wife, Vera C. Stuckey, provided she survives me by 30 days. THIRD: In the event that my wife, Vera C. Stuckey does not so survive me by 30 days, (a) I give my real estate to my daughter, Susan J. Stuckey (b) I give my furniture, household and personal effects, and other tangible personality of like nature, other than cash, securities and insurances, thereon as follows: half to my Daughter, Susan J. Stuckey and half to my Daughter, Marilyn S. Rich, consistent with certain written instructions I have provided to my executrix relative to the distribution of said items to my aforementioned daughters, respectively, provided they survive me by 30 days, per stirpes (c) I give my cash, securities and insurance to my grandsons, in trust, to be distributed by the trustee per the instructions I have given, provided they survive me by 30 days. It is my decision and purpose that my children not share equally in the distribution of my estate. I have specifically excluded Marilyn S. Rich because I have decided to give her share directly to her children to ensure that these monies are used for their college education, which is my desire. In the event that anyone challenges the probate of my Will or any provision thereof and is not successful in court of competent jurisdiction, then in such event, I direct and require that they pay the costs including reasonable attorney's fees incurred by my Executor in resisting such a challenge. FOURTH: If either Grandson receives property under this will and is under the age of 30 years, I give devise and bequeath his beneficial share to my Trustee, hereinafter named, to be held in trust for said individuals. The trust shall be administered as follows: (1) The Trustee shall pay or distribute to or apply for the benefit of such Grand child or grandchildren, as the Trustee in their sole discretion, deem necessary for their education (including trade school, college education, both undergraduate and graduate) or to make payments for these purposes ~~:, ~ , , :~ : -r v _,.., __ ~j ~.~} C ,., ~-.) ~ ._.- ~...i =~_" <_ ~,-, r -~ +.n ~--, _:f z without further responsibility to any other child or individual for whom such payments are made and to charge a portion or all thereof as an advancement, with or without interest, against their respective beneficiary share. The Trustee shall take into account gifts I have made to each beneficiary during my lifetime for the aforementioned purposes in determining the ultimate distribution of each Grandson's respective beneficiary share. (2) All decisions of the Trustee regarding payments are within the Trustee's sole discretion and shall be final and incontestable by anyone. The payment of income or principal may be paid to the individual or on his behalf, only for the purposes herein stated, or in the event of the individual's incapacity to his legally appointed guardian. No child or individual shall have a right or power to sell, transfer, assign, pledge, mortgage, alienate encumber, or hypothecate his beneficial interest in the principal or income of the Trust in any manner. To the fullest extent of the law, this Trust shall not be subject to the claims of any child's or individual's creditors or liable to attachment, execution, bankruptcy proceedings, or any other legal process. Notwithstanding the above directions, nothing herein shall be deemed to make the Trustee liable for any payments of principal or income which they may in their discretion make to a third person on the unrevoked order or direction of the individual. The Trustee shall have the sole discretion to terminate the Trust in the event the principal is so diminished that the expense of administering it exceeds the interest earued. In the event the Trust shall terminate the principal and any unpaid interest shall be distributed among the individuals as the Trustee sees fit, and the Trustee shall have no further responsibility for administering it. On the death of any child or individuals, during the life of the trust, the Trustee shall distribute their beneficial share, in the Trustee's sole discretion, to the surviving individual, or to the Trust. (3) The Trustee shall distribute the principal of each child's or individual's beneficial interest on, or as practical, his 30th birthday. (4) I appoint my daughter, Susan J. Stuckey, Trustee of any trusts created herein. I direct that upon application, the Trustee shall receive yearly, a reasonable fee commensurate with the services rendered relative to management and administration of any trust created herein. FIFTH: I nominate and appoint my Wife, Vera C. Stuckey to the Executrix of my Last Will, granting to her authority to sell and convey any or all of my estate, real and personal, or mixed, upon such terms and prices as she shall deem proper, without obtaining any prior order of the court therefore. I also grant her full power and authority in the settlement of my estate, to compromise, adjust, and settle any and all debts and liabilities due to or from my estate, for such sums, and upon such terms and conditions, as she shall deem best. In the event that she shall for any reason fail to qualify or cease to act, then I nominate my daughter, Susan J. Stuckey, the Alternate or Successor Executrix. SIXTH: I direct that no bond or surety shall be required of any guardian, trustee, executor, administrator or fiduciary named herein. IN WITNESS WHEREOF, I have hereunto subscribed my name, and acknowledge and publish this instru,~ent, as my last will in the presence of the undersigned witnesses, on this -- ~~~ day of , 2005. Jack E. Stuckey Commonwealth of Pennsylvania County of Dauphin ss We, the undersigned witnesses whose names appear above, being duly qualified according to law, do depose and say that we were present and saw Jack E. Stuckey the Testator sign and execute the instrument as his Last Will; that he signed 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 the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. J ~ S ORN or a e to and acknowledge before me by the above named Testator this ~ day of ~Q~0.1~-- , 2005. N tart' c My commission expires: / UI ~ ~/U 1 ~ b lam. fit, ~ n The preceding instrument consisting of four pages, including this page, was on the date thereof signed, published and declared by 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. R Commonwealth of Pennsylvania County of Dauphin ss I, Jack E. Stuckey, the Testator, whose name is signed to the 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. ~. ,.,~ Jack E. Stuckey SWORN or affirmed to and acknowledge before me by the abave named Testator this ~ day of /-~-j~/1 ~ ~~- , 2005. Notary u ' My co fission expires: ...~~~ ,.~= ~ ~ ~" ~~ RENUNCIATION REGISTER OF WILLS ~~2.r COUNTY, PENNSYLVANIA 02i-~ - C~o2o2.~ Estate of I, ~. C ~ zip c.'a -,- ~ m ;T,,$ ~?-~~ ._: t= S ~'t,c ~-!«. _~~~, ~~.,_ Y ,..A "`. ~ c.,. . {..._ ., i ~.t.-'~ a 'T~.. _j..~ W i. ~I .~ A' ,~ deceased in my capacity/relationship as (Print Name) ~ - ~ K~r, N-t-t-r~C''~ X of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to c/~s~vy (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.!3.06 "_') /`'~ -; ~~ w' t_i_t , (~Y (Signature) (Str\\eetAddress) `~ 1 (City, Slate, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing thi:> renunciation and certified that he or she executed the renunciation for the purpose sta ed wit:hin on this ~`' day of- ~ ~,~uCi _ __ _ ~ ~~~~ Notary Public My Commission E~:pires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) ...,t;r`s^srtlUr?HVf?2~1?~'i Cf Per1r1~L'=V~.r';E'.. N©TAi~ilt~L SEAL BRYAN J. ii;`?'r...~, Notary Public ~~st Pennsburn T° ;~ t'-r,,.~rrt}+of Cumberland