HomeMy WebLinkAbout03-11-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of Rodney V1%. Painter
also known as n/a
COUNTY, PENNSYLVANIA
File Number ~ ~ ~~'~ ~ c~~~ :~
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' ar 'B' BELOW.)
Social Security Number 171-28-0386
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executrix
last Will of the Decedent dated November 12, 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: n/a
® B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d. b. n. c. t. a.; pendente lice; durante absentia; durante minoritate)
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Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following<~~e (if anyd heirs: ~
.9dministration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) _ ~,~ ,:~
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
680 Creek Road, Carlisle, North Middleton Township, Cumberland County, Pennsylvania 17013
(List street address, town city, township, county, state, zip code)
Decedent, then 73 years of age, died on February 24, 2009 at M.S. Hershey Medical Center, Hershey, Derry Township,
Dauphin County, Pennsylvania
Decedent at death owned property with estimated values as follows
(If domiciled in PA) All personal property $ 112,595.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 1 10,000.00
situated as follows: 680 Creek Road, Carlisle, North Middleton Township, Cumberland County, Pennsylvania 17013
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:
or printed name and residence
Tanyia L. Forrester, 97 Victory Church Road, Gardners, PA 17324
Form RW-02 rev. 10.13.06 Page I Of 2
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ "
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBELRAND
SS
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 tc or affirmed and su'oscribed
. _._-
Signature ofPers<
before me the , ~ _ day of
~(~~~ 2009
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or the register
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Signature of Personal Representative - ~ `'-}
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Signature of Personal Representative ' ~'~ -" --~~
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File Number: ~ ~ (~~ L ` ~5 ~ _.?
Estate of Rodney W. Painter ,Deceased
Social Security Number: 171-28-0386 Date of Death: February 24, 2009
AND NOW, ~G,-~ ~~h ~ ~ ~ _ - , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT [S DECREED that Letters Testamentary
are hereby granted to Tanyia L. Forrester
in the above estate
and that the instrument(s) dated November 12, 2007
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ... ~~~~~~ .. $ 31~
Short Certificate(s) .. ~ .~.... $ ~ 8
Renunciation(s) .......... $
J ~.`~' ... $ ~ ~
~~ ...s
... $
... $
... $
... $
... $
... $
TOTAL .............. $ 3~---o-Qo
Register of Wills ~ j u'"'~
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Attorney Signature: ~ - ~~ • t~'~ ~~~
Attorney Name: ark W. Allshouse, Esgf~ire
Supreme Court I.D. No.: 78014
Address: 4833 Spring Road
Shermans Dale, PA 17090
Telephone: (717) 582-4006
Form RW-02 rev. 10.!3.06 P2ge 2 Of 2
ARNING: it is iliega! t€s duplicate this ~c~~y ley ~Sh~tL~stat ~~r ~r~~t,s,;:;~ >~l'
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH -q1
(See instructions and examples on reverse) RTgTE FIVE NIIMRFR ,^X ` (~I C~ n~'l 2 ;~
t. Name d Decedent (Frst middle, Iasi su8ix) 2. Sex 3. Sodal Seadry Number 4. Date of Deam (Mwth, day, year)
Rodney W. Painter Male 171 _28 _ 0386 Feb. 24, 2009
5. Age (Last OirBdeY) UMa 1 a Unda 1 day 8. Date d Sint (Monet, day, year) 7. BiMplace (CBy and slate a lareign country) ee. Pbca of Dum (Check any are) -
73 Mwww °°" "°°" "~"° Dec. 28, 1935 ,"~°~/~ °"re`
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anon,
vrs.
hQ lnpatiaM ^ER/Oulpatienl ^DOA ^Nursing Home ^Residerma ^Oma-Seedy:
eb. counry of Deam Bc. City, Born, Twp. W Deam ed. Feciliry Narw (II not insBMbn, gNe street and number) 9. Wes Decedent al Hlepenk Ongh7 ®No ^ Vas 10. Race: American Intlbn, Black, Whae, etc.
Dauphin Derry Twp N Tea, >aecXr aban, ( Whi t
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Hershe
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enter Maxigan, wane Rlaan, etas
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11. DecederrYS Usual Oa tlan Khd d wxak dare dud moat d IAe. Do not stela retlred 12. Wes Decedent ever in the 13. DecedenYS Educatlon (Specify wy Nghest gretle conpleted) 14. Mantel Sa616: MerrieQ Never Monied, 15. SurvMrg Spouse (lf wife, give maiden name)
Kind dWak Hkd d Bushass / lndusW U.S. Amad Faces? Elementary /Secondary (U12) College (1-4 or 5+) WaoweQ Dborced (Spacily~
Technician Nav Su 1 De k3n'~ ^Na 12 Widowed
16. DewdenYS Maiing Address (SUeeL oBY /town. state. zip code)
680 Creek Rd. Decedent's pA Did Decedent
AatualReeidence ne.Slate Uyelna 17a
DewdenlLNedin N. Middleton
®yea
Carlisle, PA 17013 .
,
Twp.
17b.canry Cumberland r ship? nd.^Nd,Dewdentuaedwimin
Aduel Limhs of CM / Bono
iB. FameYS Name (First, midlb, last, suffix) 19. Homer's Name (Frsl, mkldb, maiden sumeme)
Earl R. Painter Ellamirl Detweiler
20a. InfamanYS Nana (Type / Pdnt)
Tanyia Forrester 2W. Informants Mailing Address (Street, dry / mwn, bale, by code)
97 Victory Church Rd., Gardners, PA 17324
21 e. Metlad d DiapoaiBw ~] Cremation ^ Danetbn
~ 21 b. Daa d Dispo&liar (Month, tlay, Year) 21c Plow d Obpwition me of cemetery, aemeary a oma place)
L lid. Location (Ciy I rown, sate, zip code)
^ s,w ^ RamovalfromSbte
cremetbnaDautlonauthorimtl Feb. 26, 2009 Hoffman-
oth Funeral Home & Carlisle
PA 17013
^ Omer- Exemlrrer/Caarar? Yes^No ,
22e. Signaare ngu 22h. License Number 22c. Name ant Addressd Fadliry o man- of unera Ome rematory, nc.
- 138504 219 N. Hanover St., Carlisle, PA 17013
Canpba Items 23ac ay when cadMn9 . To me best of my kraaledga, tlum scarred al Ba tlrta, dale and pace stated. (SigneMre and title) 236. License Number 23c. Data Sigwd (Month, daY. year)
physk:ian b wt avatlabb at ame d
wNly Cause of aaem.
Hems 2428 must Ee wmpletetl by person 24. Time of Deam 25. Date Pmneuraetl Deed (Mwm, day, year) 26. Was Case Referred to Medical Examiner / Carona for a Reason Other Man Cremation or Donation?
who prawunces deem. ' z(} ~ M, r u ~i Y ~ µ ~ ~ ^Ves ~ No
CAUSE OF DEATH (Sx Inetruetlana end azamples) , Approximate interval: Pan IL Enter oma signific~m asaifrns cwnmtun ng m deaLn, 28. Did Tobacco Use C°nhibNe to Deam?
Item 27. Part I: Enter me cNah d evenb- diseases, hjurbs, or complicatbw-mat direay ceased Ba deem. DO NOT enter lemtinel evens such as cardiac anent, Onwt to Deam but not resultlng in Ba undedy'ag cause given in Pen I. ^ Yes ^ Proba6y
respiretay anent, a venbicular hbdlblhn wk1aM showing tla etbbgy. List wy as wane w each liw.
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^ No LYJ Unkmwn
tl,1k
ED1ATE C~U$E I
inal diseaw a ,~x~ ~, p a., ~~~.{~~ 1~~
wrrdfion reedbrgm em) _' a. IN~I M1Y1(_~R~L]RI\1. 1-I YIGMO(~a Yll\VL~
29. II Female:
Due to (or u a wnsepuenw on: ^ Np pregnant wimp past year
SequenUmaBy wnd~~.a ~n~, a b. ^ Pregnant at time of deem
Erur UNDERLYING CAUSE Due to (a as a ansepuerrw o(f: ^ Not Pregnant, but
pregnant wBhm 42 days
fdweeu a merry Bret iMBeted me C
is resalbng m deem) LA t of deem
Due m a as a con
( sequanw oQ: Nat
^ Pregnant, but gagwnt d3 days to 1 year
d. belae tlum
^ lMkriown if pregnant wkhh ma past year
30e. Wee an Adopsy 306. Were Autopsy Firxlings 31. Mama W Deem 32a. Date d Injury (Monet, day, year) 32D. Desafie How Injury Oaurred 32c. Plow d Irqury: Hone, Fann, SBea, Factory,
Penamed? Available Pdor to Campletlon ,--/
6/J Neturel ^ Homicide Omw BWldrg, eta. (Speah)
d Cause d Deam?
^ yes ~ No ^ Yes ^ No ^ Aaddent ^ PeMhg Invesligallon 32tl. rime d Inju7 32e. hwry at Wak7 32f. B Trenspwtatlon Injury (Spedhl 32g. Laatiw of Injury (Slreei dry /town, state)
^ Suckb ^ CaBd Nd be Detaminetl ^Ves ^ No ^ Driver / Opereta ^ Pesseager ^PetleMrian
M ^OBar - Seedy
a3a. catdbr (dank aXy sal 336. signature sad rme MBar
' CerttlyMg phyekden (Physhbn wrWyhg cause d dmm when erolher phyaicbn has pmmurced deem and wmpeled Bem 23)
-
To tlw beetdmy lmowbdge,dwth xcumddwrotM awe(el end manner es stsbd.:________________________________ ^ M
PrarrareaXrp eM wrtllykrg phyekien (Plryeidan Gam Pmrauv:k9 death end wrBying to wuu of deem)
• 33c. LJwnse Number 33tl. Date Sigwd (Mash, day. year)
To tla butdmy Mpwbtlge,tlwm ocanstl attla tlma, Oele, end place, anddw rothe cauae(al and mannauabbd__________________
• tAedkN ExanBrrar / Caanar
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On tlr bob d exsminetlon erM / a Investlgalbn, In my opblon, dMh occunsd et tlra mrra, deee, and pbw, and dne ro the wuea(s) arM menrar u atarod_ ^
34. Noma ant Address of Persm Wla Carpeted Cause d Death (item 27) Type / PnM
as. Regbtafa apd Dlaa~wr~' ?r
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~ b Rlad ( m, eav. r~r ~ M.S. Hershey Medics] Ctr.
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Disposdhn PertnB No. ~ ~ ~ 7 n ` f
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LAST WILL AND TESTAMENT , :? '~ -+ ~,
RODNEY W. PAINTER = ~ ~? ~ ` - ~ `
c> ~:~--
_ _ : , --- _
I, Rodney W. Painter, of Carlisle, Cumberland County, Pennsylvania, ~mg of ski d _ -i
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and disposing mind, memory and understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made
by me.
FIRST
I direct the payment of my just debts and expenses of my last illness and funeral from my
estate as soon after my death as conveniently may be done.
I direct that my remains be cremated and that my ashes be combined with the ashes of my
late wife, Dorothy L. Painter. I direct that our ashes be placed, along with my pre-purchased
marker, at my property located on Fox Hollow Road in Shermans Dale, Perry County,
Pennsylvania.
SECOND
I give and bequeath certain articles of my tangible and personal property in accordance
with a hand written list made by me during my lifetime and attached hereto. In the absence of
~`~ '~' such a list or designation on said list, said articles of my tangible personal property shall be
', added to the residue of my estate.
` ~' ~~
THIRD
~..
I give, devise and bequeath all the rest, residue and remainder of my estate to my beloved
'`~ - daughter, Tanyia L. Forrester, absolutely and in fee simple if she survives me by thirty (30)
days and she is not institutionalized in a health care facility or nursing home, or receiving
benefits through the PDA Waiver Program or any other public benefits program.
FOURTH
In the event that my daughter, Tanyia L. Forrester, fails to survive me by thirty (30) days
or in the event she shall be institutionalized in ahealth care facility or nursing home, or receiving
benefits through the PDA Waiver Program or any other public benefits program, I hereby give,
devise and bequeath my estate to my grandchildren, Amanda M. Forrester and Starsha K.
Keller, equally, share and share alike, per stripes.
FIFTH
In the event either of my grandchildren predecease me, I give, devise and bequeath my
deceased grandchild's share to her issue in equal shares, provide that if any beneficiary under
this Will has not attained the age of twenty-one (21) years, then I give, devise and bequeath my
entire estate together with any other property which may be added, IN SEPARATE TRUSTS,
(Great-grandchildren's Trusts) upon the following terms and conditions:
(A) To hold, manage, invest and reinvest the principal so received, and
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accumulation of income thereon, and to use, pay and apply the income and principal or so
much thereof as in Trustee's sole discretion may be necessary for the maintenance,
support, medical expenses and education of my beneficiary whether the same be born
before or after the signing of these presents.
(B) The payments authorized by this trust shall be made and without further
responsibility to said beneficiary or to any person taking care of said beneficiary. Said
payments may be made by my trustee directly to said beneficiary, or such of them as may
be, in the sole opinion of trustee, of such age and ability to handle properly the funds so
paid, or may be made directly to the person having custody and care of any of said
beneficiary, or may be made directly to any institution entitled to such payment by reason
of services rendered or to be rendered to any of said beneficiary.
(C) The amount to be paid for the benefit of any of my beneficiary shall be
determined from time to time by the need of each beneficiary, and the amounts and times
of said payments shall be determined by such need, provided that payments be made at
least monthly.
(D) All payments of principal and income hereby given shall be free from
anticipation, assignment, pledge or obligations of beneficiaries, and shall not be subject
to any execution or attachment.
(E) All principal and accumulated income, not so applied, shall be distributed
in equal shares to each beneficiary, when that beneficiary attains the age of twenty-one
(21) years.
SIXTH
I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate
passing under this Will or otherwise shall be paid out of the principal of my residuary estate.
SEVENTH
~~~ In addition to the powers conferred by law, I authorize any personal representative acting
~~ under this instrument, in his or her absolute discretion:
(A) To retain in the form received, or to sell either at public or private sale any
~~~ ~ real or personal property;
~~ (B) To exercise any options to subscribe for stocks, bonds, or other
investments;
~~ `, (C} To join in any plan of lease, mortgage, consolidation, exchange,
reorganization or foreclosure of any corporation in which my estate or any trust may hold
stocks, bonds or other securities;
(D) To sell, transfer, convey, mortgage, pledge, lease or exchange any
property, real or personal, which at any time may form part of my estate, for the payment
of debts or taxes, or for any purpose of administration or distribution, for such prices and
upon such terms as my personal representative, in his or her sole discretion, may deem
wise, and to execute and deliver deeds of conveyance or transfer thereof;
(E) To make settlements and compromises on such terms as my personal
representative in his or her sole discretion may deem wise without the necessity of
` obtaining any court approval thereof;
(F) To make distribution hereunder either in cash or kind, as my personal
~,
~' representative in his or her discretion may deem wise.
., ~ EIGHTH
' ~~ I do hereby nominate, constitute and appoint my surviving granddaughter to act as
\~ Trustee of the Great-grandchildren's' Trusts created in this, my Last Will and Testament.
Provided however that if she i n 'll'
s u wi mg or unable to act as Trustee, I direct the dunes of
L Alternate Trustee be performed by the surviving spouse of the deceased granddaughter.
r~ t~;
~ NINTH
1
~,. , ~ I do hereby nominate, constitute and appoint my daughter, Tanyia L. Forrester, to act as
Executrix of this my Last Will and Testament. Provided, however, that if she is unwilling or
~i
i unable to act as Executrix, I direct the duties of Executrix to be performed by my granddaughter,
Starsha K. Keller. In the event Starsha K. Keller is unwilling or unable to act as Executrix, I
appoint my granddaughter, Amanda M. Forrester to act as Executrix.
TENTH
I direct that no personal representative, guardian, trustee or other fiduciary appointed
under this instrument shall be required to give bond for the faithful performance of their duties in
any jurisdiction.
IN WITNESS WHEREOF, I, Rodney W. Painter, have hereunto set my hand and seal
to this my Last Will and Testament, consisting of six (6) typewritten pages, the first four (4) of
f/~
which bear my signature in the margin for identification, this /~ day of November, 2007.
Signed, sealed, published and declared by the above-named Rodney W. Painter, Testator,
as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our
names at his request as witnesses thereto, in the presence of said Testator and of each other.
~ ~ ~ ~~~
;~ ~ ~ :~ ~~ADDRESS ~,~-~ `~
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C ~~C~-~'..a~_~-•~ ~ }~-~.~, / ~ d / ~ to `~
.~ ' /~ ~, Pr~/,,-,7~~_ ADDRESS `7`~S~S~ ~-'r;t=~" f"~r-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF PERRY
We, Rodney W. Painter, ~r~ /~~ ~f~-~~~/Qf7~~ and
~~Cv~, ~ _ '~\\~,~,~L~. ,the Testator and witnesses, respectively whose names are
signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the instrument as his Last Will and
Testament and that he signed willingly and that executed as his free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testator signed the Will as witnesses and that to the best of their knowledge the Testator was at
the time eighteen (18) or more years of age, of sound mind and und~,r no constraint~cdue
influence. /
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Winter, T
l~9'D C ~c...Q....~ ~.~, ~'-,Witness
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MG~/C ct.~. ~l~l~~~-~~--~'- ,Witness
Subscribed, sworn to and acknowledged before me~bY Rodney W. Painter, the Testator,
and subscribed to and sworn or affirmed to before me by /1/Qr~/ ~ ~f7"iC~7~i?/I
and ~~~rY~ ~`~ ~ .(~~\5~~~~' ,witnesses, this /day of November, 2007.
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of Pu is
COMMONWEALTH OF PENNSYLVANIA
? Notarial Seal
SCarroll Twps Pe otarryy Public
rry Coun
MY~ommission Expires Mar. 23, 2008
6