HomeMy WebLinkAbout04-21-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of CLARA E. HUZEY
also known as
Deceased
COUNTY, PENNSYLVANIA
File Number ~ ~ ~Q - ~.~ ('`; oZ-
Social Security Number 195-07-6280
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 /are the EXECUTOR
last Will of the Decedent dated SEPTEMBER 13, 2002 and codicil(s) dated
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
Except as follows, Decedent did not many, 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. Crant of Letters of Administration
(If applicable, enter: c.t.a.: d.b.n.c.t.a.; pendente life; durance absentia: durance minoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) atxbheirs: (/f
Administration, c.t.a. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.)
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Name Relationshi Resid ''cam "L7
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Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at ~ '
801 N HANOVER STREET CARLISLE CUMBERLAND COUNTY PENNSYLVANIA 17013
(List street address. town city, township, county, state. zip code)
Decedent, then 93 years of age, died on MARCH 30, 2009 at CHURCH OF GOD HOME, 801 N. HANOVER STREET,
CARLISLE CUMBERLAND COUNTY PENNSYLVANIA 17013
Decedent at death owned property with estimated values as follows
(If domiciled in PA) All personal property $ 3,500.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
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 fonn to
the undersigned:
n~~ \ ~_ v,, ,_ l~~ I PNC BANK, NATIONAL ASSOCIATION, 4242 CARLISLE PIKE, CAMP H[LL, PA 1701 I
named in the
Form RW-02 rev. 10.13.06 Page I of 2
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
c'-
bef re me the ~ ~ `' ~ day of
i ~ ~rte~Q
For the Register
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Signature of Personal Representative
Signature of Persona[ Representative
Signature of Personal Representative
File Number: ~r ' ~ - ~ ~ $ ~.
Estate of CLARA E. HUZEY .Deceased
Social Security Number: 195-07-6280 Date of Death: MARCH 30, 2009
AND NOW, ~~~_ ~~ , c~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters TESTAMENTARY
are hereby granted to PNC BANK, NATIONAL ASSOCIATION
and that the instrument(s) dated SEPTEMBER 13, 2002
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
. ,
Letters ............ $ 30.00
Short Certificate(s) ........ $ 8.00
Renunciation(s) .. ........ $
JCP $ 10.00
AUTOMATION FEE $ 5.00
WILL $ 15.00
... $
... $
... $
... $
... $
... $
TOTAL ....... ....... $ 68.00
Attorney Signature
Attorney Name:
in the above estate
Register of Wills ~3 lJ \\ ) p„f)
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ROGER B. IRW ,ESQUIRE
Supreme Court I.D. No.: 6282
Address: 60 WEST POMFRET STREET
CARLISLE, PA 17013
Telephone:
717 249-2353
Form Rl{'-02 rev. 10./3.06 Page 2 Of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, `!ifi.l)0
15 ~..8~~ l`~
Certii~ication Numher
This is to certify that the int~~rmation here ~*iven is
correctly copied from an original Certificate of Death
dn4y filed with me as Local Re~~isuar. The original
certificate will be forwarded to the State Vital
Kerords 17ffice for permanent filing.
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Local Re<.*isu~,u- llate Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS O
REV 11!2006
PRINT IN CERTIFICATE OF DEATH I
1ANEnIi
,K INN (See Instructions and examples on reverse) STATE FILE NUMBER
4. Dale of Death (Month, daV, year)
2. Sex 3. Social Security Number
i
1. Name d Decedent (First, mkde, teal, sucix)
6280 March 30, 2009
07
Female 195
_
_
Clara E. Huzey
Age (last &nhday) Under 1 year Under 1 da 6. Date of Binh (MOnIh, day, year) 7. f3lnhplace (Ci antl sate or foreign cardry) Ba. Place of Death (Check Doty one)
5
.
Montns Days Mpxs Mkiulas HOSpllal: O~t(her:
93 Marsh 5, 1916 Fairview Twp., PA ^m
auam ^ER/ompadem ^DOA []Nursing Home ^Residence ^Omer SpeciN
p
Yra,
Bb. County of Death fie. Clry, Dora, Twp. of Death Bd. Faciity Name QI not institution, give street and number) 9. Was Decedent of Hispanic Ongin? ~ No ^Ves 10. Race: Amencan Indian, Black, White, etc.
ecif
Cuban
lSDenM
(II
es
s
• Cumberland Carlisle y
,
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Church of God Home Mexlcan,PaenoRlpan,ek.) White
11. Decedent's Usual Occu lion Kintl d rood done tlunn moll of wohin Isle. Do not stale retired 12. Wes Decedent ever In Ina 13. Decedent's Education (SpeciN only highest grade completed) 14. Marital Slalus. Monied, Never Married, 15. Surviving Spouse (II wile, gwe maiden name)
Widowed. Divorcetl (SpeciM
Kind d Work Kind of Business 1 Industry U.S. Armetl Forces? Elementary I Secondary (0-12j College (1.4 or 5+)
Office Manager Retail Clothing p~
^Yea pJND 12 1 Widowed
16. Decedent's Mailin Address (Street, c r sown, state, zip coda!
9 N Decedents Penns lvania Did Decadent
y Lrve Ina 17c Ves
Decedent Lwed In TwD.
,
ActUel Residence 17a. Slate Township?
801 N. Hanover Street caan Cumberland 17tl. No,DecedenlLivetlwithin Carlisle y
l cif learn
nb
Carlisle PA 17013 .
N ActualUmilso
18. Father's Name (Rrst midde, laze sotto;) 19. Momer's Name (FIrsL middle, maitlen surname)
rie Pearl Danner
C
Robert Harrison Smith ar
206. Informant's Mailing Address (Street city /town, state, >jD code)
20a. Inlormam's Name (Type 1 Print) MD 21029
Clarksville
ilford Rd
6352 G
Barbara S. Law ,
.,
u
21a. Method of Disposition ^ Cremator ^ Donalbn 21h. Date of Disposition (Month, day, year) 21c. Place of Disposidon (Name of cemetery, crematory or other place) 21 d. Laalion (CiN /town, slate, zip code(
^ epnai ^ Removalcomstate j waacremMlanprponanpnaulnan:ea April 2
2009 Rolling Green Memorial Park Lower Allen Twp. ,PA 17011
Omer - Specity: by Medcal Examlrer I Coroner? ^ Yes ^ No ,
~ 22a. Signature d Funeral Se ' en (or pe on acting as such( 22b. license Number 22c. Name and Atldress of FadliN
FD 012 848 L Parthemore FH&CS, Inc., PO Box 431, New Cumberland, PA 17070-0431
~
Canplete earns 23ac Dory when ceniN' 23a. To me best of my knowledge, death occurred al the limesdate and place1stated. (Signature and tAle,)-ry 23h. sL!kzens~e Number ~ 23c. Dale Signed (Month, tlay, year)
~'L i '- N `[_ 1 ~ 1- ~ y ~Z C r~ ~ .; = ~~ ^`'~- ~ 27 i-% L• ~~ ~' r~
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ailable al lime of death to ~
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av
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physk
L^ Y W `t"- ~ ..l ~~VJJ"""~~~
ceNfy cause d deem.
26. Was Gase Referred to Medical Examiner I Coroner for a Reason Other man Cremation or Donation?
ate Pronounce0 Dead (MOnln, day, year)
25. D
Time of Dea
24
.
77
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Items 24.26 mull ha completed oy person
\
who pronounces death. ~' , 7 ~ e, M. ~ \ ~ CJ ~ U ~ ~ C 1 ^ Yes '~No
I
CAUSE OF DEATH (See Inatructlone antl examples) , Approximate interval: Pan II: Enter other,dgdflc st crv+dions mntnhtP rte to deem,
iven in Pan I
s
d
rl
i
i
h 26. Did Tobacco Use Contribute to Death?
^ vas ^ Prohabty
Pan 1: Enter die chain of events - tliseases, injures, or complkalions -Thal directly roused the death. DO NOT enter terminal events Such as cardiac arrest, t Onset to Death
Item 27 .
ng cau
n t
e un
e
y
e g
but cwt resulting
.
respiratory arcest or ventrkular fibrillation without showing me ecology. List only one cause on each qne.
i No ^ Unknown
IMMEDIATE CAUSE (Final disease or C r / ~f' / 1
'W
S ~ -TC. t
In deem)
condilbn resultin
[- fl ~j
] 29. Il Female:
nant within past
ear
~ Nol
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_~ a J
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Due to (p5 as a consequence oG y
D
g
^ Pregnant at time al Beam
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it an
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dto
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n con
ns,
Sequentially
y, b. tC~r_ G
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1
to the cause listed on line a
leafin ^ Nol pregnant btu pregnant within 42 days
g
. Due to (or as a consequence op: r
Enter the UNDERLYING CAUSE
Ina! indlaletl the
disease or Inju
i of death
p
ry
(
avenu resuking in tleeth) LAST. No1 ant but t 43 tla s to t
^ pregn pregnan y year
Due to (or as a consequence o0'. before death
^ Unkrpwn it pregnant wi(INn Ire Dasl year
d
30a. Was an RNapsy 30b. Were Aule{sy FimNngs 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Descnhe How Inlury Occuned 32c. Place of Injury. Home, Fann, Street, Factory,
Office Buioing. eta lSD~ihl
Pedom;ed? Availade Prior to Completion ~T7~I
tLJ Natural ^ Homicide
of Gauss of Dea1h7 ^ Accident ^ Pendng Invazligalion 32tl. Time of Injury 32e. Injury al Work? 32f. If Transportation Irryury (Specity) 32g. Locator of Injury !Street, city /sown, stele)
^ Ye5 No ^ Yes ^ No ^ Yes ^ No ^ Dover/ Operator ^ Passenger ^Pedeslnan
^ Suicitle ^ Cab Not De Determined
M
^ Omer ~ Speafy: ---)
33a. Ceniller (check only one) 33b. Signaure/aM, T111e of icer
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/
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• Car0lying phyelclan IPhyskian cenitying cause of deem when aralher physician has Dronouncotl tleam and completed Item 23) ~
death occurred due Io the ceuee(s) and manner as eletsxL _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
To the beat of my knowledge ,
.
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skian both pronouncing death and canirying to cause d tleath)
ician (ph
nlf
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h 33c. Cleanse Number 33tl. Data Signed (Morin, tlay, year) (
y
y
ng p
ys
• Prorroundng and ce
To Ilre bast of my knowledge, death occurretl at the time, date, and ploce, and due to the cause(s) end manner as atated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ M •,
,? S ~,. µj C f
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• Metlkal Examiner/Coroner Q
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un me Dears or exammanon aria . m ,~wr:ar~ye•,.,,,. ,,, ,,,y .,N,,,,,,.,..,~„.. ,,.. ....................._, --._, ...._ ,..___. _._ _ _ _
35. Regt5lrar 5
~.. ,.a,~,«~, ~~lCyk~a-~•.VIJGrr..l.r IS t IY1Y~ ..- , ,.
;.'T3 lv 'r`31~L'[1ylslCucx ^,^~ I'1..~- t~ollx~ Spt 117 '- ~~{~ 17(i (r^`~
!~ ~ / 36. Dale FileO (Month, day, year)
I= 1 I I f l I .,//.,r/.~~,a
Disposition Permit Ne. ~. 0 332430
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LAST WILL AND TESTAMENT
I, CLARA E. HUZEY, of Carlisle, Cumberland County, Pennsylvania, do hereby
make, publish and declare this to be my last will and testament, hereby revoking all wills
heretofore made by me.
1. I direct my personal representative to pay all of my debts, funeral and
administrative expenses as soon as convenient after my decease. I direct that all
inheritan~® taxes ~mpesed or payable by reason of my death and interest and penalties
thereon with respect to all property, whether or not such property passes under this Will,
shall be paid by my personal representative out of my estate.
2. I give, devise and bequeath all of my estate of every nature and wherever
situate to my husband, Clifford L. Huzey, provided that he survives me by a period of
sixty (60) days.
3. If my spouse does not survive me by a period of sixty (60) days, then I
direct that all of my estate of every nature and wherever situate be added to the existing
Trust created by me and my husband and modified by a Revocable Living Trust
agreement, dated April 10, 1998, and by amendment dated September 13, 2002, and
that all proceeds be distributed according to the terms of that Revocable Living Trust, as
amended on September 13, 2002, or any future amendments.
4. I nominate and appoint PNC Bank, N.A., its successors and / or assigns,
to be the personal representative of my estate, to serve without bond.
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5. I suggest that my personal representative retain the services of Harold S.
Irwin, III, Carlisle, Pennsylvania in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day
of September, 2002.
_~`~~~~ (SEAL)
CLARA E. HUZEY
Signed, sealed, published and declared by the above-named person as and for a
last will and testament, in our presence, who at said person's request, in said person's
presence ancf in the presence of each other have hereunto set our names as
subscribing witnesses.
~~,~~~
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ACKNOWLEDGMENT AND AFFIDAVIT
WE, CLARA E. HUZEY, HEATHER A. BARBOUR and RHONDA S. IRWIN, the
testatrix and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that
the testatrix signed and executed the instrument as her last will and that she had signed
willingly, and that she executed it as her free and voluntary act for the purpose herein
expressed, and that each of the witnesses, in the presence and hearing of the testatrix,
signed the will as a witness and that to the best of their knowledge the testatrix was, at
that time, eighteen years of age or older, of sound mind and under no constraint or
undue influence.
CLARA E. HUZEY
HEATHER A. BARBO R
_ !
RHONDA S. IRWIN
COMMONWEALTH OF PENNSYLVANIA
:ss:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by CLARA E. HUZEY, the
testator herein, and subscribed and sworn to before me by HEATHER A. BARBOUR
and RHONDA S. IRWIN, witnesses, this 13th day of September, 2002.
Notarial Seat 1 ~~/`~~
Hardd S. Irwin !11, Notary Public Notary Public
Carlisle Boro, Cumberland County
My Commission Expires Sept. 23, 2002
Member, Pennsylvania Association of Nntanes