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HomeMy WebLinkAbout07-02-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Anna R. Hizer also known as .Deceased COUNTY, PENNSYLVANIA File Number 21 - 09 (~ (~ Z;() Social Security Number 219-07-6556 L. Cibros Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or `8' BELOW:) QX A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the last Will of the Decedent dated 06/2411975 and codicil(s) dated Edmund E. Hizer Executor died Se tember 16 1996 (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 app ica e, en er c..a.; ..n.c..a.; pe en e i e; urante a sen ia; uran a mmonta e 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. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) to Name Relationship Residence ~ "' ~ r-- r - 7 _ 1 r=~^; r-_ C7 ~ ~D '.,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 100 Mt. Allen Drive, Mechanicsburg, Upper Allen Township, Mechanicsburg, PA 17055 (List street address, town/city, township, county, state, zip code) Decedent, then $7 years of age, died on 06/20/2009 at Holy Spirit Hospital, Camp Hill, Cumberland County, PA 17011 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: 230,000.00 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: Signature Typed or printed name and residence Nancy Jean Weimer (Nancy H. Weimer) 713 Alberta Avenue - --- Mechanicsburg, PA 17050 Louis artino (Mary L. Cibroski) 79 Hilldale Drive 1! n ~ ,, Ephrata, PA 17522 Form RW-02 Rey ~o-~s-zoos Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } 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~~i~ or the Register Nancy Jean Weimer (now known as Nancy „ H. Weimer) Mari Louise Martino (now known as Mary L. Cibroski) Signature of Personal Representative Fiie Number: 21 - 09 ~1(l7 2c~ Estate of Anna R. Hizer Social Securiiity Number: ~2111~9^1-07-6556 AND NOW, ~t Z ~~t/f t having been presented befor me, IT IS DECREED that Letters Test. are hereby granted to Nancy Jean Weimer (now Attorney Name: and that the instrument(s) dated 06/24/1975 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. ~? FEES Letters...~?L) c~UO C- Short Certificate(s)....... J.... ........ $ 2~ Renunciation(s) .................... ......... $ [~+~1 $ ~s J ~ ~' $ /y ~~~ $ ss $ $ $ $ $ TOTAL ............................ ........ $ and Marv Louise Debra K. Wallet ~l'Vnr-' tstate' ~~ ~~~,-yin the above ~ ~~~ tV ~ 3 :7~ C7 : ,.,{ . G~ m Supreme Court I.D. No.: 23989 Law Offices of Debra K. Wallet Address: 24 North 32nd Street Camp Hill, PA 17011 Telephone: 717/737-1300 Date of Death: 06/20/2009 in consideration of the foregoing Petition, satisfact~r proof .o r1 d .Deceased Form RW-OZ Rev. f0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Attorney Signature: y,~,,,~,~, ~, ~~„~,~,~- 105.80~ E2BV tt1 U117) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. X6.00 ~ f.. rr-- .ha t'^C ~~ • ~% / '~ Certification Number This is to certifb~ that the infurmanon h~l~e giv.°n is correctly copied fr >m an original Certificate of Death duly filed with me ,(s Local Registrar. The original certificate will he for~~~arded to the titate Vita; Records Office 1~u,~ pe)manent film,*. Local Registrar ~ ~ ~ [~rtiX~ Issued tv ,_ ~~ _. ~O -ti ` . C~~ _ _; _ ,:. ~~ c N,~,~ ~, ~~~ COMMONWEALTH OF PENNSYLYANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TvPEy~T~" CERTIFICATE OF DEATH ~,~ /1 ,.~ axtic x~ (See fnsVu6tions and examples on rove~ae) STATE FILE NUMBER 1~ ~ ~ __ ,, l~ ~ C' w C ,. Name d Deddud IFasL . maL stria) 2 3. Sadel Seaaky Numbu 4. DeN d Daam (Madh. daY• YeaB 5. Aga (~ Bidday) Urdu t yw lxder 1 B. Dam d Bkm (~~ 7. ~ (GN and amts a ~ dreary) Be. Plod d Oatlh (fleck one) ww ~L ~' ~~cC ~qy; Other: uwatw urn ~" Maas !CC) ~ ' !.~ ~ / V / / ~. ~ / ~ , h>a~ ^ ER / ^ DOA ^ Nurskg Flume ^ Rasitlutd ^Omu - Spetny. ~'T b YrA Ba Fatal Nrd 111 mt irs0'lfa,. 9~ abaM antl 9. Was [kceU«rt d NuD~ Dries? No ^ Ya ,0. Had: Ndndn In6rt aad. WN1a. ek. Bc CM. Born. Twq. d Dean • m. cans a Daxr~~/l~}n }-y/ l _ ~~ Ix yea, spade flrbart. ISpeciy1 ~vL SPRIT /~ZIs(/ ~/~L ~ Meaen.PwMRdn.NC) ZU;'~-1 '-"-" '~ C p ~r C ~m1~ ~'M •' ^' DeddenYs Usual Knd d wax doe ~ mood as Do na ebb ree 12 wen era n tM 13. DecedenCS Eacsxart (~"Y o^N g~ dntabm~ 14. Marnd Sbeu: Marisa Never Madd, 15. Sari'tn9 Spouse (n wrce, gee maids, nano) ed.1~'~°° (Spedly) Wdow • n , . U.S. Andd Farris? tertmnmry / Sec«dary (o-,2) Cdb9e I,d «Sw) Imdawak lce,daBusdas/~ L(J1~CtvEO ©a(~~ ma~IVrvc7us~.~. ^Yas tb / D«edun's Did p.doax ,B DaedrKs Mailing Atlaess (Sbeu, dY / own. ebb, t4 tab) AdW Rudatd t7a smm ~~ Liven . 17c ^ Yea. peddaw Lhed'n Tw~~ N D y T0'r"s"'D? L ' ~ l r No, Deddd livwd wimp na . L E /60 ~ T Q- ciry/Bao ' ~~ ~ mad Aadl L _ ,m. wady _ ii-±1_ etJ~_ ' ~t ,9. Mara Nan. ka I ~ L ~ ,F ,& Fax~a ~ ~ `` ~' s ~ w ui' ° 2fm. Inlamanfs Name (T / Pnnq ZCb. Infamam's ~ Address lsaeeL ~ / bwrt. smb. ~ _ rv l~ W E ~ r-~~- i3 -tic e ~ ,- 2tD. Due d Disposiim jM«M, day. Y ~ 2,a Place d D'sP~pn (Nod d dmalaY. ««d1aY «dia place) z,d. Lacexm ~ / bwn. amb, nP dOe) p 2,a Maenad d aapdiud i ^crema,bn ^ DaiMan .1 L_ 2 4 //'J Q / 7 _ ~ / ~ r OOL( CQ / • / ,CL U ~» l v' Burial ^ Remwd aom Sae i Ys4PSl Eaamnr CaorteY! ^Yea^NO ~" f•'7 ^ Otltu-Spealy: 22c. Nara and Adders d Fedxy _ .. d Funeral Service licensee (a autig as sudl ?~. Lidnse IxnBer / ~ 8 ~ ~f ~ "I 23E. LpKense Number 23c. Dab Sigxd ( dfi'. Yea) Rena 23at grey wdn caeiMng 23a TOld rimy mawleage•deem aarmd atlte ems, oared Pbc•sttled.ISigdaae •/ dSo `30'q L 4y6 ay,~- a°°~' ~ I` pnysoan U rt« avaka6b a and d dean r ~ O 6/ U O !`~ «Damkd? 4 1}M d~ / 9 a din ti tl C O t . pn rema an dr"h dose . 26. Was Case Relened r McOiral Esarnirtu / Caener to a Reason Omer 24. Tme d Oeam 25. Dam Pranuced Dmd (MaM, day, Yeal A / 9 ^ yes (mac No M Pusan 2a (e ,7 0 300 M . O . . tlwlh. wro 1~4 /. CAUSE OF DEATH (Sa inauucttord sM examples) r Appmdmab Irtmrval: Pat II: Eder oma ' ~ 29. Da Triad Use DonnWm to Deem? ma drectF/ caused th dmm. DO NOT aria mrminal seeds sorb as dNa aresL , Odu m Deatlt Gd not rewl0rg n me uMedying dose given n Part I. ^ Yea ^~~,Y„~, a tdpM1dkod iryans rAan d evaas- dseads tl 1 E t • N - . , t : n er hem Z7. Pat o ~ """'""' tespiralpY awest a vermxvmr fbrilaed wnlatd sMwsg xre eeology. list ody orw duos d eatlt erta ^ WaEdATE CAUSE IIFinal dismsea ` M R/ S,y1(T 1L CCt~JGE~S11Vc ~~"~~~ _~~ Kl-SY IC~V)I-~ F"1"'s~l~/ C _ l~r+d Wayu^c witld^Pau Yea lh d ~ ' ea ) -~ a. / (._~C L 1 coaxed resu8^9 m ~1 7 ( ^ Pregrmm a, Md d dam Duo m la as a consegdrrw d): )"(`I ~QT(.(~ ~101V-~'ti COnrl'~c ^ Nd Pre9~t• but Pra4aa win,n 42 days SeWenkeky kn cddiliorw, a am'. b. PtiFUMC l~1({~ ma~q,p me dt se I'We0 d Ina a pas b (« as a tnr 4eQeent• dC d tleam F.rWar lre uNDERLYIND cAUSE ^ Nd Pre9dnl. bd pram 43 days m, year a • (drsease a njay tltu uaeated n u evertor resulrg n deem) LAST Dd b la as a conseQuerce aC i Oelare dam r ^ Udtrown rc pregrtad witMn me past yea d 30a. Was at Autopsy . 30a Were Autopsy Fndsgs 31. Hamer d Deem 32a Dam d hay (MOnth, day, Y~r) 32b. Dascde Haw IrquN Occurted 32c. Pence d Injury: Had. Farm. Street. Factory. Olkce Bviltin9. e,c ISpedryl Pedornted? Avaeabk Pdorb Caripedm ~NaNrd ^~~ a Cause d Deem? t7Y ^ Aagaa ^ ~~ l~gakon 32d. tens d Irtjay 32e. hay al wax? 321. tt Transportadm Irqury (Spearyl l.ocatan a kMrry (so-an. dv /,own. ammj ~ ^ Vas ~NO ^ Yes ^ No ^ yea ^ No ^ Drirer / DPuata ^ Passenger ^Pedestrian ^ Sudde ^ Cadtl Nd d Demrnited M. (~ _ ~ yY, eel (rhad oa CM'd 33b. SigdMa and Tdm d l/v'~ // ~~ ~~ ,~ "~ y\ -u`l y ia 33a: • Cednrin9 PM^~^ (RN~n d~Yn9 dose d deem when aroma ptysidan rtes pato«aetl leant ad dnglded aan 23) ~ ~ y , To lM leudmY knewrdxe. dsMh ecaered dwbtle ouaalsl~~w~aaab4________________________________ ~ lN _ 33d. Deb Sigted lMaah. daY,Y~) prorpnndng and dnnYr9 Pbyaidn (Physidal bdh Prp«tatdng deem and cumYd9 b dose d deem) d ddrtlr dasNsl ndnunrerualamd.._________________ ^ . ~ ~ { l ~,1 ~ ~r' ' eta oq Toth Eatd m„tarawreg.,d.m saursO Mtls mn.,d.r, andl~.~t N~ I N • MNktl Eaamxer I Corona and der. b x^ nose(s) aM enema ere smled_ aM pmd dam atN M n.,m. al Name and Address d Pe«m 6Mp Carglaed Cause d Deem (xa^ 271 Type / Pdra 3q , . . t ea ow nr dais d arannelion end, a xtrexatbn, r my eyniax de . ~rai,~ SV~t2C-r ~fcr,Rcr~ ~.R~ra~areadD~tNnmea// I,-~,.~al.~l~l 1. i n __ n ., / i n s ~lF~ln 36. Date FYed (Haab, dy, ~ as-off"' A N• ~~~,. s~reec ~ c~rrr~~u.:t?q i~ol - -, Dispositim Pemn No. Q ~~•J / ~~_ N C^r9 5 "i C LAST WILL AND TESTAMENT r_b - r-- OF ~~ -a `-_I `, ANNA R. HIZER ~-. ~~ ~ , ~ © t:~_ I, ANNA R. HIZER, of the Borough of Clifton Heigh, Pennsylvania, being of sound and disposing mind, memory and under- standing, do hereby make, publish and declare the following to be my LAST WILL AND TESTAMENT, hereby revoking all other and former wills by me at any time heretofore made. FIRST: I direct that all my just debts and funeral expenses be paid as soon after my decease as may be convenient to my Executor. SECOND: A11 the rest, residue and remainder of my Estate, real and personal, I give, devise and bequeath to my beloved Husband, EDMITND E. HIZER, his heirs and assigns, forever, conditioned, however, that in the event of his death within a period of thirty (30) days after my death, or if he should pre- decease me, the said devise and bequest of residue shall lapse or be divested, and in such event, I give, devise and bequeath the rest, residue and remainder of my Estate to my children, their heirs and assigns, in equal shares, share and share alike. THIRD: 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 apart of the expense of the administration of my Estate. FOURTH: I nominate, constitute and appoint my beloved IZER as Executor of this my LAST WILL AND E H Husband, EDMUND , TESTAMENT, and I direct that he shall not be required to enter security in any jurisdiction in which he may act; and in the event of his death, renunciation or inability to serve, then ~ ,r .~ /.~~ a `~ . I nominate, constitute and appoint my daughters, MARY LOUISE MARTINO and NANCY JEAN WEIMER, or the survivor of them, in his place and stead. FIFTH: I nominate, constitute and appoint the surviving parent as Guardian of the Estate of any minor to whom anything passes under this Will or otherwise and with respect to whom T am authorized to appoint a Guardian. IN WITNESS WHEREOF, I, ANNA R. HIZER, have hereunto set my hand and seal on this last page and my name on the margin e this ~/~) day of June, 1975• of the one preceding pag , ,~ 1.~~~ z~ ~-c`=; yI - f~~ti%; ~--~ (SEAL ,.;~` SIGNED, SEALED, PT.TgLISHED AND DECLARED by the above named Testator, as and for her LAST WILL AND TESTAMENT, in the presence of each others havephereunto subscribeduour~names1asthe presence of a ~ witnesses hereto. .. ..~" t N ~A+ME !~ ~ / Y ~ R. } .~ -t ADEN S -. - - - ' ~ ~~~ ADRES '~ '' NAME AD~s / ~~ - 2 - ~. i 0`~10~1 c; OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Anna R. Hizer Deceased ~JR-JG1~ ~I. 1n~~4n.fQ. and y+'`~,~ L.. Ct`t-SIG.~ (Pont Name/s) (Pont Name/s) (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with Anna R. Hizer and am/are familiar with the handwriting and signature of the decedent, and that the signature of Anna R. Hizer to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Anna R. Hizer is in his/her own proper handwriting. ~ . ~~~~ (Signature) ~ 13 R I b v +'k. Avg (Street Address) V1iltci+~~'t,+sb~/~ !7h I ~uJ O (City. State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me thi~day `- 'U ~ of , ~ ~ Deputy r Regi r of Wills C.~.~~ t~i~- , ~~ (Signature) '~ti I+~ ~ ~ d~~ L De. . (Street Address) hrtit,~ ~a ~ '~-six. (City, State, Zip) rv C7 CJ V° ~ ~' ~ ~ i t7 r° :a ~ r '- = r'; G _,. Form RW-O4 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.