HomeMy WebLinkAbout04-09-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of WARREN F. BAILEY
also known as
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COtYIPLETE 'A' or 'B' BELOW.)
File Number ~ ~ ~ ~i d ~.~
Social Security Number 225-10-3254
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the CO-EXECUTORS wed in the
last Will of the Decedent dated JUNE 5, 2006 and codicil(s) dated ~ e ~ a
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(State relevnnt circumstances, e.g., renunciation, death of executor, etc.) -_ ;;,, lD -
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the_i txtent(s~afl'ered{'.
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for probate, was not the victim of a killing and was never adjudicated an incapacitated person: _? `-
B. Grant of Letters of Administration ~ C..J •
(lfapplicable, enter.• c.t.a.; d.b.n.c.t.a.; pendente liter durante absentia; durante minoritate)
Petitioner(s) after a proper search has /have 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.)
(C0~11PLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at
20 North 12th Street, Apt. 108, Borough of Lemoyne, Cumberland County, Pennsylvania 17043
(List street nddress, town/city, township, county, state, zip code)
Decedent, then 88 years of age, died on March 23, 2009 at home
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 2,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 25,000.00
situated as follows: 165 Old Quaker Road, Etters, York County, Pennsylvania
Form aw oz rev. 10.13.06 Page 1 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
COUNTY OF CUMBERLAND
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 to or affirmed and subscribed
before me the ~-~ ~~-d~gay of
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Fer the Register
File Number: a ~ Q~l ~~~~ ` r~ ~ _~
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Estate of WARREN F. BAILEY ,Deceased .fi . .
Social Security Number: 225-10-3264 Date of Death: MARCH 23, 2009
AND NOW, ~~
C~(.a-c,1 C.T ~- `4w ~~ , ~~~I , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters TESTAMENTARY
are hereby granted to MICHELLE KOONS and WILLIAM W. PENSINGER
and that the instrument(s) dated JUNE 5, 2006
described in the Petition be admitted to probate and filed of
FEES
Letters ... ~ .~. ~.4.u% .. $
Short Certificate(s) ..~~..... $ 1
Renunciation(s) .......... $
_ I .~~ t ~ ... $ 1 ~"
~ ~ ... $ 5
... $
... $
... $
... $
... $
_ ... $
TOTAL .............. $ 1~~:xK --~•~6-
in the above estate
recofd as the last Will end Codicil(s~ of Decedent.
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ister o ills
Attorney Signature: '~--
Attorney Name: L A MARIE COYNE
Supreme Court I.D. No.: 53788
Address: 3901 MARKET STREET
CAMP HILL, PA 17011-4227
Telephone: 717-737-0464
Form nw-oz ,~w_ 10.13.06 Page 2 of 2
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OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by phatastat or photograph.
Fec {r?r this c~rtilic~r(~°. ~f~,Oi)
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Ccrtlliratiou I~(Inihcr
REV 11/2006
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reversal _ ~ x ,-. r ~ . -, .~
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1. Name a Decedent (Rrst mitldle, ix) 2. Sex 3. Social Secunry Number t d. Date of Death (Month, tlay, year)
S. Age (Last Birthday) Under 1 year Under 1 day 6. Dale of BiM (Month, da ,year) 7. Birthplace (City aM state or foregn country) ea. Place of Death (Check only one)
(J(~ /yx/ uomr5 pan Noun ktinubs
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r/ r~ Yrs, /v e
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^ Nursing Home Residence ^Other ~ Spe6ry:
Nb. County of Death 8c. City, Boro, 7wp, of Death Btl. Factliry Name pf rat in&titNan, give street and number) 9. Was Decedent of Hispanic Origin? ~ No ^ Ves 10. Race: American Indian, Black. White
etc
Cumberland Lemoyne ,
.
(N yes, speciry Cuban, (Speciryl
20 North 12th Street, Apt. 108 Mexican,PuenoRicagetc
)
.
white
11. DecedenYS Usual Occ Ran Kind of wok done dun mast of workin Gfe. Do not state retired 12. Was Decedent aver in the 13. Decedent's Educalan (Specify only highest grade completed) 14. Marital Status: Monied, Never Marred, 15. Surviving Spouse (If wife
dive maiden name)
Kind of Work Kind of Business I Indust
ry ,
U.S. Armed Forces? Widowed, Divorced S ci
Elemenu /Secondary (0-12) College (1-4 or 5+) (~1 N)
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Machinist Federal Government ®vea ^Nm
2 ~?;l~u(;.; ~.~
tfi. Decedent's Mailkg Address (Street city /town, state, zip )
~1 ¢h ' - ~~. / CI ~
a~ Decedent's r' 11 11 ~ r \ Did Decedent
Actual Residence 17a. Slate L N 6V S Y L V ;R (V t n Live in a 17c
^ Yes
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17b. County GA.ry v I~~L (~- LJ} N ~ Township? 17d W Act
ivetl within LemO
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Ciry I Bora
' 16. Father's Name (First, middle, last suNix) 19. Mother's Name (Rrst made, maiden surname)
William Edgar Bailey Cora Jane Smith
20a. Intortnanl's Name (Type /Print) 20b. InlortnanYs Mailing Address (Street, dry I town, state, zip code)
Mir_helle C. Koons 121 N. St. John's Drive, Cam Hill, PA 17011
21 a. Method N Disposition ^ Crematan ^ Donation 21 b. Date of Dispositon (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 21 d. Location (City /town, state, zip code)
0 Burial ^ RemovaltromState WasCremetianorDOnatlonAlMOrized^Ves^No
^ Other - S i by Medcal Examiner / Comler? March 26, 2009 Blue Ridge Memorial Gardens Lower Paxton Twp. ,PA 17112
22a. Sgnature of I or person ailing as such) 22b. License Number 22c. Name and Adtlress of Facility
- FS 012 849 L Parthemore FH & CS, Inc., P.O. Box 431, New CumberlaT~d, PA 17070
Complete Items 23ac o w nirymg 23a. To the best of my knowledge, death oxurtetl al the time, date and place stated. (Signature and titN) 23b. License Number 23c
Date Signed (Month
da
ear)
physidan rs not available tl of deem to .
,
y, y
r»niry cause of death.
Items 2d-26 mull be completetl by person
who
ronounces death 24. Tme of Death A
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~ 25. Date Proraunced Dead (MOnm, tlay, year)
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~ 26. Was Case Referted to Medical Examiner /Coroner for a Reason Other than Cremation or Donation?
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CAUSE OF DEATH (See instructions and examples) r Approximate interval.
Item 27. Pan I: Enter the chain of events -diseases, inrynes, or complicatans -that directly caused the death. DO NOT enter terminal events such as cardiac anest Onset to Death
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h Part II: Enter Omer sgnificanl coiMit ~ c nl ~ rte to de m,
but not resulting in the untlenying cause given in Pan I. 28. Did Tobacco Use Contribute to Death?
^ Yes ^ Probably
resp
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d
lation wit
out showag the eliobgy. List only one cause on each line. r
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IMMEDIATE CAUSE (Final disease a
^ No (Unknown
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Due to or es a cons uenee of :
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Sequenlialy list condfiom, if any, b J n ~ c~ x L ~~ a r
leading to the cause listed or line a. / / ~~/ r ~ ~ ~ ~ 1 ~~ tC (J __ ~ (~ 1'~ ~ ~} (
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c, ~ 7 E; `~ / ~~ ~~ {~~ ~y Not pregnant wimin past year
^ pregnant at time of deem
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Enter the UNDERLYING CAl1SE Due fo or as a consequence ot): r
(dsease a itpury that ai6alei the
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Not
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d. ~ before death
^ Unknown it pregnant within me past year
30a. Was an Autopsy 30b. Were Autopsy Fintlings 31. Manner of Deam 32a. Date of Injury (Month, day, year) 32b. Descrae How Injury Occurretl 32c. Place of In Home, Farm
fury ry
Slreel
Facto
Penormed? Available Prior to Completion n~oorr
C] NaNral ^ Homakle ,
,
,
ONice Building, etc. (Sped/y)
of Cause of Deam?
^ Yes ~No ^ Yes ~NO ^ ACtl0en1 ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 321. II Transportation Injury (Speciy) 32g. Lxelion of Injury (Street city I lawn, stale)
^ Suaide ^ Cald Nol be Determined ^ Yes ^ No ^ Driver/ Operator ^ Passenger ^Pedeslnan
M Omer -
33a. Cenlfier (check only one) 3 . S~ „tyre era Title of Certlf'rer '
• Certifying physician (Physaian ceniryirg cause of death when another physidan has pronourcad death and completed Item 23) L ~ - -. -- ~, t'"
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To the best of my Ivawledge, death occurred due to the rauae(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 1
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• Pronouncing and certifying physician (Pnysaian both pronouncing tleath antl renitying to cause of deem)
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• Medical Examiner I Coroner Ll ~ ~ ~ ~~ ~ ~~ ~ Jl
On me basis of examination and I or investigation, in my opinion, tleath occurretl of the time, date, and place, and due to the cause(s) antl manner as stated_ ^ .~
34. Name and Adtlress of Person Who Completed Cause of Deam (Item 27) Type /Print -
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36. Registrar' nature and Di m
® ~ I dl lI ,~~ / ~ ~ I 36. Date Flletl (Month day year)
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I, WARREN F. BAILEY, of the Borough of Lemoyne, County of Cumberland, Commonwealth
of Pennsylvania, declare this to be my Last Will and revoke any Will or Codicil previously made by me.
ITEM 1: Upon my demise, I direct my body be released to Parthemore Funeral Home,
Cumberland, Pennsylvania where I have pre-arranged my funeral and burial services. I direct that
body be laid to rest in the cemetery plot I own next to my beloved, late wife, ELEANOR G. BAILEY.
ITEM 2: I direct that all my just debts and funeral expenses be paid as soon as practical
after my death.
ITEM 3: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of
_,, ~ "~, the expense of the administration of my Estate.
~\. ITEM 4: I give, devise and bequeath One Thousand Dollars ($1,000.00) to the
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~=+,~, PENNSYLVANIA CAPITAL REGION CHAPTER OF THE AMERICAN RF,D CROSS, of 1804 N.6`~'
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~:" Street, Harrisburg, Pennsylvania, or its successor.
~~
c~ ITEM 5: I direct that upon my death, my Executor immediately liquidate my estate, both
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~; " ~ personal property and real property.
Page 1 of 7
ITEM 6: I give, devise and bequeath all the rest, residue and remainder of my estate of
,very nature and wherever situate, together with all insurance, in equal shares, to the following named
Beneficiaries provided that the named beneficiary shall survive my death by thirty (30) days:
a. One-Seventh (1/7) of my Estate to my brother, CALVIN F. BAILEY and my sister-in-
aw, CHARLOTTE BAILEY of 104 Grove Court, Stephens City, Virginia, or the survivor, per stirpes;
b. One-Seventh (1/7) of my Estate to my sister, CLARA STULTZ of 6036 Richmond
Iighway, Apartment 604, Alexandria, Virginia, per stirpes•,
c. One-Seventh (1/7) of my Estate to my sister, PAULINE SWINK, of 10339 Reid Lane,
lokesville, Virginia, per stirpes;
d. One-Seventh (1/7) of my Estate to my sister-in-law, PATRICIA PENSINGER OTTO, of
Mechanicsburg, Pennsylvania, per stirpes,
e. One-Seventh (1/7) of my Estate to my nephew, WILLIAM W. PENSINGER, of
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Mechanicsburg, Pennsylvania, per stirpes;
£ One-Seventh (1/7) of my Estate to my brother, BASLEY T. BAILEY, of Berryville,
/irginia. In the event that my brother, BASLEY T. BAILEY, predeceases me or fails to survive my
Leath by thirty (30) days, then this share shall be divided equally among my aforementioned
Beneficiaries, CALVIN F. BAILEY, CLARA STULTZ, PAULINE SWINK, PATRICIA PENSINGER
)TTO and WILLIAM W. PENSINGER; per stirpes, and
g. One-Seventh (1/7) of my Estate to my friend, MICHELLE KOONS, of Hershey,
'ennsylvania. In the event that my friend, MICHELLE KOONS, predeceases me or fails to survive my
Leath by thirty (30) days, then this share shall be divided equally among my aforementioned
Page 2 of 7
beneficiaries, CALVIN F. BAILEY, CLARA STULTZ, PAULINE SWINK, PATRICIA PENSINGER
OTTO and WILLIAM W. PENSINGER, per stirpes.
ITEM 7: Until distributed, no gift or beneficial interest shall be subject to anticipation or
voluntary or involuntary alienation.
ITEM 8: I appoint my nephew, WILLIAM W. PENSINGER of Mechanicsburg,
Pennsylvania and my friend, MICHELLE KOONS of Hershey, Pennsylvania as Co-Executors, of this my
Last Will.
ITEM 9: My Co-executors shall have the following powers in addition to those given by
law to be exercised by them in their absolute discretion, which powers shall be applicable to all property
held by them, effective without the order of any court and until the actual distribution of all such
property:
a. To retain any investments at discretion including stock of any corporate fiduciary
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hereunder or of a holding company controlling it;
b. To invest and reinvest in the executor's discretion as permitted under Act 28 of 1999, as
amended, the "Prudent Investor Act," with the specific right to invest in stocks, bonds and real estate,
including non-income producing residential real estate for the occupancy of any present income
beneficiary or beneficiaries, and in such diversified, proprietary money market and mutual funds,
including such mutual funds of any corporate fiduciary hereunder or those of any successor or affiliated
corporation or a holding company controlling it, as my executor and trustee deem appropriate;
c. To sell, to grant options for the sale of, or otherwise convert any real or personal
properly or interest therein, at public or private sale, for such prices, at such time, in such manner and
upon such terms as they may think proper, and to execute and deliver good and sufficient conveyances,
Page 3 of 7
assignments and transfers thereof without liability of any purchaser to see to the application of the
purchase money;
d. To borrow money and to secure the repayment thereof by mortgage of real or personal
property, pledge of investments or otherwise, without liability on the part of the lenders to see to the
application thereof;
e. To compromise claims by or against my estate or any trust created hereunder;
f. To allocate and distribute different kinds or disproportionate shares of property or
undivided interests in property among beneficiaries or trusts, in cash or in kind, or partly in each;
g. To register investments in the name of a nominee or to hold the same unregistered in
such form that they will pass by delivery;
h. To join in any recapitalization, merger, reorganization or voting trust plan affecting
investments; to deposit securities under agreement; to subscribe for stock and bond privileges; and
generally to exercise all rights of security holders;
i. To manage, operate, repair, alter or improve real estate or other property, and to lease
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real estate and other properly upon such terms and for such period as my executors deem advisable even
for more than five (5) years and beyond the duration of any trust;
j. To deduct administration expenses upon either the federal estate tax return or fiduciary
income tax return with or without adjustment as between principal and income, as my corporate or
disinterested executors shall determine;
k. To associate with them in the absence of a corporate fiduciary, an accountant, custodian
and investment advisor, and other agents and to compensate them from principal or income or both, as
my executors shall determine, such compensation to be a reduction of the compensation of my executors;
Page 4 of 7
To associate with them at any time, in their absolute discretion and of their choice, a
fiduciary which shall have the same powers as my executors, such designation by my executors
acceptance by a corporate fiduciary to be in writing;
m. To combine, without prior court approval, any trust herein with any other trust with
similar provisions, although such other trust may have been created by separate instruments
by different persons, and, if necessary to protect different future interests, to value the assets at the
time of such combination and to record the proportionate interest of each separate trust in the combined
fund; provided however, that no such combination shall be permitted if the effect of such combination
would be (1) to violate the applicable rule against perpetuities; (2) to disqualify any interest in one or
more of such trusts for a deduction for federal estate tax purposes which would otherwise be allowable;
or(3) to cause the loss of the exempt status of one or more of such trusts from the imposition of the
n-skipping tax;
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n. To exercise any stock options which they may receive; to borrow such funds from any
as my executors may deem necessary for the exercise of such options; and to pledge assets as my
ors deem appropriate for this purpose;
o. No trustee shall be required to qualify before, be appointed by, or, in the absence of a
of trust, account to any court (and failure to account alone shall not be considered such a breach);
shall trustee be required to obtain the order or approval of any court in the exercise of any power or
ision granted hereunder;
p. To allocate any generation-skipping transfer tax exemption from the federal generation-
transfer tax to any property to which I am deemed the transferor under the provisions of Section
52(a) of the Internal Revenue Code of 1986 and its successors, including any property transferred
Page 5 of 7
my will and any property not in my probate estate and any property transferred by me during life as
to which no allocation was made prior to my death, to the extent necessary to cause the inclusion ratios
applicable to such transfers to be zero;
q. To disclaim any interest in property without court approval; and
r. To do all other acts and things necessary or appropriate in the management,
administration and distribution of my estate or trust.
ITEM 10: I direct that my personal representative, or his successor, 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 and seal to this, my Last Will and
Testament, this.5 T ff day of b/ C ',CJ ~ , 2006.
WARREN F. BAILEY .~.
Signed, sealed, published and declared by the above-named Testator as and for his Last Will and
Testament in our presence, who, at his request, in his presence and in the presence of each other, have
subscribed our names as attesting witnesses.
r~ r .~. 1-) ~; ~~ `~ ~''~`~_ residing at f U, ~1 ~~ ~~.. ,~~<. ~- ~ ,~..~~sxu~~ , / ~ ~-
~.~.-~..~J ~u.~~Cesiding at n,c.cc~.~,v~, C~...~ f%~ r-~o~s
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Page 6 of 7
COMMONWEALTH OF PENNSYLVANIA )
} ss:
COUNTY OF CUMBERLAND )
We, WARREN F. BAILEY, ,fit t~~ ~'~~ /~C'>`irw:r'- and
I ~. d~~,,,~~,~ ~r ~_~.~> ,~" ,the Testator and the witnesses respectively, whose names are
signed to the attached or foregoing 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 that he
had signed willingly, and that he executed it as his free and voluntary act for the purpose therein
expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as
witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years of
folder, of sound mind and under no constraint or undue influence.
i ~ ,
WARREN F. BAILEY
~ ,,,(„/L~-rte ~ ,C..~w ~-y,,~,,,,,,i
Witness
l? . ~'~-~-~-~~,~ /.Z.c-o. c~u~~
Witness
Subscribed, sworn and acknowledged before me ~ t 5 ~ /~~ -'~ fn ~ ~= ~u., h t; by
WARREN F. BAILEY, the Testator, and subscribed and sworn to before me by
~.,v~ ,~. d~ - l~s-,- ~r and ~~.- /~..~~~tw ~~_~=y~'~-~-.~t~ the witnesses, this
~ ~ 2006.
~ - day of c,,,,.-~. ,
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No ry Public (SEAL)
COMMONWEALYff df
NO]'ARtAl. Sflll
LISA MARIE COYlIf , ROTARY M~f.IC
HAMPDEN TWP., CUMBERLAMD COUNTY
MY COMMi S10N fxPIRES JUN 200$
Page 7 of 7