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HomeMy WebLinkAbout06-22-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of _ also known as Lois H. Barton COUNTY, PENNSYLVANIA File Number 21-09- d 7~ ,Deceased Social Security Number 168-36-6562 Donald H. Painter Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or `8' BELOW.) ^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the last Will of the Decedent, dated 06/28/2002 and codicil(s) dated 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: B. Grant of Letters of Administration appica e,entec c.t.a.; .n. c. t. a.;pe ente ie; uranea senGa; urantemmontate o Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spo~s (if any) and~irs: (If _, ," Administration, c. t. a. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) ~_ © _ :. ~L7 ~ C ` . Name Relationship Residence ~r ~r'z ~~ _ _..~,~;~ ,_~ _ 1(~ t , __, ~ - = ~ ~ ~ (COMPLETE IN ALL CASES.) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 325 Wesley Drive, Mechanicsburg, Lower Allen Township, Cumberland, PA 17055 (List street address, town/city, township, county, state, zip code) Decedent, then 9Q years of age, died on 05/31/2009 at 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 $ Value of real estate in Pennsylvania $ situated as follows: 52,000.00 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: ~Ignature Typed or printed name and residence I y Donald H. Painter 9 Hedgerow Court ~~~/`r~j'f ~~'~ ~ Oaklyn, NJ 08107 Form KW-UZ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 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 before me this ~~ day of ~c z~~ (~~ For the Register i ~~ J ~ ~:~ y CCC Z~i/~~~C~-yL'~ Signature of Personal Repre entat~ve Donald H. Painter Signature of Personal Representative C- Q 7 =i C..- i ce -'- ~ C.' .~ Signature of Personal Representative ~- ,,,, t'n w - - ~~ ~ _ - 7 File Number: 21-09- ~;t,~``~~ ~ w ' ~ i Estate of Lois H. Barton Social Securit~ Number: 168-36-6562 AND NOW, ~~ ~~G'fLiG1 ~:~~ ,_ L,~J'~( having been presented before me, IT IS DECREED that Letters are hereby granted to Donald H. Painter ,Deceased Date of Death: 05/31/2009 ~~ , in consideration of the foregoing Petition, satisfactory proof Testamentary and that the instrument(s) dated 06/28/2002 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ....................................... ..... $ ~~ N ©~ Short Certificate(s).......~....... .... $ /~ . UU Renunciation(s) ........................ ..... $ -~~~i~ $ ~~ °`' J~ i~ $ ~u, ~~~~ ~-~A $ $ $ $ $ $ TOTAL ................................. ... $ ~ 7 / °~ in the above estate Ati At1 Address: 429 South 18th Street Telephone: Camp Hill, PA 17011 717/730-7310 Form RW-O2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Supreme Court I.D. No.: 41263 IOS.gU"- REl' ~(I U077 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. X6.00 Certitic,ation number 7EV 112006 PRINT IN ANENT ;K INK This is to certiSv that the information here ~yi~en is correct)}' copied frrnn an ori~„inal Certifirtte of Death duly filed with nrti a. Local Registrar. The ori~~ittal certificate will he torwarded to the State Vital Records Office for perms C<~_~1 Local RegisU.u ~"~ r= ~ -~ ~~ ~} ~ r _ ~, ~ cn ~;, L:'.~~L~ -T'I ~`~' •TJ ~ _-{ ~• (vent filin~T. JUN 0 4 009 1'•~a ~ Date~hsued ~o ~~, t._. , ~ ' C ~C_ < . N ; =1 : . N ~- --~~ c._.. .. .: :" i W COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) `~ \ R C1 l1 ~ Cl~ 1. Name of Decedent (first, middle, ass, sufix) 2. Sex 3. Social Security Number v ~ 4. Dale of Deafh (Month, day, year) J v Lois H. Barton female 168 - 36- 6562 May 31, 2009 5. Age (Last BiMday) Under t year Under 1 day 6. Dale of Binh (Month, day, year) 7. BiMplace (Ctty and slate or foreign country) ea. Place of Death (Check only one) Months Days Hours Minutes HOSplta: Other 90 Yra. November 23, 1918 Rockhill Furnace,PA ^Inpeuenl ^ER /Oulpabenl ^DOA ^NUrsing Home ®Residence ^Other-Spec;fy. Bb. County of Deam &. City, Boro, Twp. of Deafh 6d. Fadliry Name (I1 not institution, give street and number) 9. Was Decedent of Hispanic Origin? ®No ^ Yes 10. Race: American Indian, Black. White etc , . (If yes, specify Cuban. (Specify) Cumberland Lower Allen Twp. Bethany Village Mexican,PUenoRican,etc.) white 11. DecedenYS Usual Occu Iron Kind of worlc done Burin most of workin life. Do not state retired 12. Was Decedent ever in the 13. Decedent's Education (Specify only highest grade completed) 14. Marital Status MameQ Never Marred, 15. Surviving Spouse (If wife give maiden name) , Kind of Work Klnd of Business / bMustry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (SpeciM Teacher Education ^vea ®NO 12 4 Widowed 16. Decedent's Mailing Address (SlreeL city /town, state, zip code) Decedent's Did Decedent Penns lvania 325 Wesley Drive, Bethany Village y Aqua) Reaidenre na. Stale Live ina nc Yea Decedem Lrved io Lower Allen ~ TwP Mechanicsburg, PA 17055 . Township? 17b. coony Cumberland rid.^Nn, Decedem Lived witnm Actual Limits of City ~ 6aro 16. Father's Name (First, middle, last, suffix) 19. Mother's Name (First, middle, maiden surname) Emory Hallibaugh Annie Miller 20a. Inlortnant's Name (Type / Pnnq 20b. Informant's Mailing Address (Street, city /town, state, zip coda) Donald H. Painter 9 Hedgerow Court, Oaklyn, NY 08107 21a. Method of Disposition ^ Cremation ^ Donation 21 b. Dale of DisposAbn (MOm4 day, year) 21c. Place of Uspositron (Name of cemetery, crematory or other place) 21tl. Lcealion (City I Town slate zip code) y~ Burial ^ Removal from Stale ;Was Cremation or Donation ANhorized ^ ~r speclry j byMedicalExamMer/Coroner? ^Yea^NO June 3, 2009 Rolling Green Cemetery , . Lower Allen Twp. ,PA 17011 22a. Sig a o user I S ice Licensee rson acting as such) 22b. License Number 22c. Name and Address of Facility - G~----a FD 012 848 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Complete Items 23ac only when reniryinq physician is not available at time of death to 23a. To the best of my knowledge, death occured al me fime, date and plat t (Sgnature arM tNe)., 'J v 23b. license Number 23c. Dale Signed (Month, day, year) cedAy cause of tlealh. %Yy ~ 2~L+-+Qi' ~~ .7t~'~ r x71+ w 1~ 1 (r1 ~_J ~ ~L./L,~7'.:J Items 24-26 mull be completed by parson who ronounces death 24. Time of Death ~' u-~ 25. Date Pronounced Dead (MOnlh, day, year) ~ V ~~ 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other man Cremation or Donation? p . M •~ l I 1G,\ ~I ~ -~ ^Yes ~No CAUSE OF DEATH (See InShuMlons and examples) r Approximate interval: Item 27. Part I: Enter the chain of events -diseases, Injuries, or complications -that directly caused me death. W NOT enter terminal events such as caNiac artesL Onset to Deafh Pan II: Enter other tgnihcanl cond'1 ohs cnntnhutinglo Bea h, Mn not esuhing in the underlying cause given in Pad I 26. Did Tobacco Use Contribute to Deafh? ^ Yes ^ Probably respiretory artest or ventricular fbnllatbn wilhoul showing the etiabgy. List only one cause on each fide. r . ^ No ^ Unknown IMMEDIATE CAUSE Rrel disease or (( n coMtlion resulti n rig I Bea , th a ~~ i7 ~ ~ C R4 S P~ •Y ' 1 V ~7 ~s f ~/,/~/~ I 29. II Famala: -' Due'to~(ornasCa conse(q~uence off: n.~ .ems ~y / .s~ Sequenliatly list conditions, it any, b. ~ uy a L L ~~~ , ~I} s 1 1 1 yi~ ©f C ~~Q 7J (L y ~ ~ ~ leadingg to the cause listed on Nne a. ®Nol pregnam within pass year ^ Pregnant at time of death Enter the UNDERLYING CAUSE Due to (or as a consequence of): L V N ~ I S Q ~ r ^ Nol pregnant, but pregnant wimin 42 days (disease or injury that inNatetl Ne c. events resulting in death) LAST. r of death Due to (or as a consequence olp. r rQ ~- n r ^ Nol pregnant, bm pregnant 43 days to t year ,~,~ d(AN ~1F ~~VE ~U`Jl ~1 I 11 ~...~1`~ ~ before death ^ Unknown it pregnant within the past year 30a. Was an Autopsy P n ? 3W. Were Auopsy Findings 31. Manner of DeaM 32a. Date of Injury (Month, day, year) 320. Describe How Injury Occuned 32c. Place of Injury. Home Farm Street Factory e ormed Available Prior to Completion I . I "~.r +'°~°rel ^ Homicide ~ , , , , OAIce Buildln Ic Sea 9~ a / p ty/ of Cause of Death? Y ^ Yes ~S"V ^ Yes ^ No ^ Accident ^ Pentlirg Investlgatron 32d. Tme of Injury 32e. Injury al Work? 32f. If Transportation Injury (Specify) 32g. Laalion of Injury (SVeel, city I town, state) ^ Suicide ^ Could Not be Determined ^ Yes ^ No ^ Driver /Operator ^ Passenger ^ Pedestrian M ^Other - Speciy~ 33a. Cenifier (check only one) 336. S' lure and Title of enaier • Cenitying physician (Physidan cenilying cause of death when arwther physician has pronounced deaM and compleletl Item 23) ~/~~~•, I To the best of my knowledge, death occurred due to the causes) and manner as steted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ - • Pronouncing arM rertNying physlgan (Physician boM pronouncing death and cenitying to cause of death) To the best of m knowled death oocuned at Me tlme e date nd l d d t th d ^ 33c. Lk se Number 33d. Dale Signed (M th, day. year y g , , , a p ace, an ue o e causes) an manner as shted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medical Examiner/Coroner ~ ~ ~ ~ 1 ~ 1 -l s ' O On the basis of examination and / or investigatlon, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as slated_ ^ 34 Name and A dd res s of Pe rson VJho Completed Cause of Deafh (Ite m 27) Type I Print 35. Registrar's azure and Distr~4pl~1 ~ ~~ / ~ - `,</ / - I ~ i ~ I I 36. Date filed (M Ih, day, year) ~ 5i- ~ y ~ ( ~ ~ " 2 I - "'• ~ J , , v 3 fib T~vV•~C11/~ ~~ ~~ 1~l ~A I DSDOSII10n Permit N0. \~ ~ Z 5 ~ LA ' <~ r,~,~ ., Ci i ~ ~~~ ~JL. ~~/(J i ~.. .. ~ Q~~i~~1/ .,_ 1 __'~ -. ('l 3 I, LOIS H. BARYON, of Lower Allen Township, Cumberland County, ~ J;, J ~.,,, ~' ~.~ Pennsylvania, declare this to be my last will and revoke any will previously made~y-ine. ~ . ca ~ ITEM L I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing ,I under this will or otherwise, shall be paid from my residuary estate as soon as practicable ;~.'' after my decease as a part of the expense of the administration of my estate. ~y ~j` ITEM IL I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, as follows: A. Twenty-nine (29%) percent to my sister, ADA PAINTER, of Flourtown, Pennsylvania, provided she survives my death by thirty (30) days. Should she predecease me or be deceased on the thirty-first day after my death, her share shall go to her issue, per stirpes, as survive my death by thirty (30) days. B. Twenty-eight (28%) percent, in equal shares, to my niece, SANDRA HANCOCK and my nephew, F. THOMAS WILSON, provided they survive my death by thirty (30) days. Should they predecease me or be deceased on the thirty-first day after my death, their share shall go to their issue, per stirpes, as survive my death by thirty (30) days. C. Twenty-eight (28%) percent to my brother, ARTHUR HALLIBAUGH, of Rockhill Furnace, Pennsylvania, provided he survives my death by thirty (30) days. Should he predecease me or be deceased on the thirty-first day- a ier my death, his share shall go to his issue, per stirpes, as survive my death by thirty (30) days. D. Fifteen (15%) percent to my nephew, DONALD PAINTER, of f,~ Oaklyn, New Jersey, provided he survives my death by thirty (30) days. '1r-~, Should he predecease me or be deceased on the thirty-first day after my ~~ ~~~ death, his share shall go to his issue, per stirpes, as survive my death by thirty (30) days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my r. ~~! possessions and estate of every nature and wherever situate as follows: ~, `~" A. Twenty-nine (29%) percent to my sister, ADA PAINTER, of ~~; ~,;:~. FlcurtoEx~YZ, Pennsylvania. provided she survives my death by thirty (30) .~ ~f days. Should she predecease me or be deceased on the thirty-first day ~~ after my death, her share shall go to her issue, per stirpes, as survive my death by thirty (30) days. B. Twenty-eight (28%) percent, in equal shares, to my niece, SANDRA HANCOCK and my nephew, F. THOMAS WILSON, provided 2 they survive my death by thirty (30) days. Should they predecease me or be deceased on the thirty-first day after my death, their share shall go to their issue, per stirpes, as survive my death by thirty (30) days. C. Twenty-eight (28%) percent to my brother, ARTHUR HALLIBAUGH, of Rockhill Furnace, Pennsylvania, provided he survives my death by thirty (30) days. Sho~.ild he predecease me or be deceased on the thirty-first day after my death, his share shall go to his issue, per stirpes, as survive my death by thirty (30) days. D. Fifteen (15%) percent to my nephew, DONALD PAINTER, of Oaklyn, New Jersey, provided he survives my death by thirty (30) days. ~~ ~~~. Should he predecease me or be deceased on the thirty-first day after my death, his share shall go to his issue, per stirpes, as survive my death by thirty (30) days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject `~ ~_ ~. to anticipation or to voluntary or involuntary alienation nor shall they be subject to any ,.} y. execution or attachment. ,, ~, ITEM V. I appoint my nephew, DONALD PAINTER, executor of this my last ~; will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required ~to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF I have hereunto set m hand this ~ ~ `'~~~ " ' Y ~ '.~ day of ~. r~~:% , 2002. --p-- - -. j LOIS H. BARYON 4 The preceding instrument, consisting of this and FOUR other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by LOIS H. BARYON, 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 subscribed our names as witnesses hereto. __~~1 ~ ...., . f~ ~ ~r ~~. COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that l signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~' Sworn or affirmed to and acknowledged before me by the~testatrix named above this ~~~';~day of '~ ~ ~ /la,~_ , 2Q02. ~`~'~' ~'" ra it `~ ~ ,_, r ~, a, _ ~ eaem ~` s ..mss..,.....- .. ..:. ...'.: COMMONWEALTH OF PENNSYLVANIA ( SS: COUNTY OF CUMBERLAND ) WE, ~ r ~, ~~.~1C i f ~r"~4-~ and t~ta witnaeePC ~x~h~oo 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 the testatrix sign and execute the instrument as her last will; that she signed it 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 wit~~esses; and that to the best of our knowledge, the testatrix was at that time I8 or more years of age, of soun`d4 mind, and under no constraint or undue influence. ! -0 ,.--, t a ,'1 ~ cy J ~ ~ ~~~_ w,~ ,.."' _._i --- ~~ Sworn or affirmed to and acknowledge+~i before me this ~.~ ,day of ~~ ~{. ;_ 1'~. L~ 2 02. Notary Public -_. r..,,r _ ., , ..y ~-. ~ .~.,~,~,,.~. _ .: ~!.~ , '~~P^~°'I ~ .-°x~a ."dam ~3SP;°®,~,~E„ '~.. :S 1W lsaS~~.Jti!'ir .. . r~'mmxt .... ..x 'I:..w ..~