Loading...
HomeMy WebLinkAbout07-10-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Betty W. Casey ~ File Number ~"~ ~ ~..' ` ~ L'~ ~~~1~~ also known as Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) (If applicable, enter: c. t.a.,' d. b. n. c. t. a.; pendente liter durante absentia; durance minoritate) Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Kathleen D. Roth last Will of the Decedent dated 5/21/2004 named in the and codicil(s) dated (State relevant circumstances, e.g., renunciation, death of executor, etc.J 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 Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if an~nd heirs: (If Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A ahnve WWII ~~,.,,,lo.o t;..~ „rz.,,:.... ~ .--, Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at 2100 Bent Creek Boulevard Mechanicsbur PA 17055 Silver S rin Tw Cumberland Count (List street address, town city, township, county, state, zip code) Decedent, then 84 years of age, died on 6/26/2009 at Bridges of Bent Creek 2100 Bent Creek Boulevard Mechanicsbur PA 17055 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 65 000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 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 form to the undersigned: Signature Typed or printed name and residence Kathleen D. Roth 119 Cambridge Drive A A~~L ~~.__~__.. ,Deceased Social Security Number 201-16-3214 Form RW-02 rev. /0.13.06 Page 1 of 2 --~-~•• --•.... ~~ ~ H[iL IHJGJ:~ .vrracn aaautona[ sheets ifnecessary. 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 a/nd subscribed before m/e th/e ~C' day of ,/ l~l G , ~ 200A /~~ ,,,~i. ~ r ~ For the Register of Personal Representative Kathleen D. Roth Signature of Personal Representat;ve S;gnature of Personal Representat;ve r~~-> c"? c~ ~ ~~> ~~ ~ ~~~ C' i -C ~ r..__ -'' `i.t /i~,~ CJ File Number: ~ ~ L- ~1 L L Jy ~ -' .,CJ Estate of Betty W. Casey ,Deceased .x:" ~J c.,3 0 ~._., ~, ~'; s- ~`. .} Social Securi Num/ber: 201-16-3214 Date of Death: 6/26/2009 AND NOW ~~~'f <`'~U~ !.c_ (~. 2009 -. , , in consideration of the foregoing Petition, satisfactory proof having been presented befo~ me, IT IS DE ~ ED that Letters Testamentary are hereby granted to Kathleen D. Roth in the above estate and that the instrument(s) dated May 21.2004 described in the Petition be admitted to probate and filed of r ~ Ark as thMast Wil, l,¢and Codicj~(~) of Decedent. FEES c~~=i'~1'(,~( ~ • _ '~ ~ ... Letters ................ $ 135.00 Ije~;ster of Wills ( ~ ~ Short Certificate(s) .........y. $ 16.00 Attorney Signature: ~ n - ~ l Renunciation(s) ................ $ Automation Fee ,,.. $ 5.00 Attorney Name: Christa M. Aolin JCP Fee ..., $ 10.00 Supreme Court I.D. No.: 207949 Will .... $ 15.00 .... $ Address: 845 Sir Thomas Court. Suite 12 .... $ .... $ Harrisburo •••• $ PA 17109 .... $ $ Telephone: (717) 541-5550 TOTAL ............................. $ 181.00 Form RW-O2 rev. 10.13.06 Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate #his copy by photostat or photograph. -ee l~l3r thl~ certif)~.Itc St~ OU '~ ~ . . ~~ ~~li Cf P Lhi~ I I ~ )j t !u u s jn:a h ~ ~ hr)c a1i~r „ ~ ~ ~.~ti - /y~,-\ ~ c1,rrL~t , ~, ~. irty, ,m ',n ' ( ~: t.f)r,U~ ,>f ICI s~=~ ,,,~~ , ~ ~ z lulu )Ire ` I~~L ~,;)c,)1 9z ~:i ',t) ,3~ Thy ,,) i~, ~ 1 ~ ~)~w~l,~,l), , , _ (r,l~,Y~))1 ~1 ~1 , t „~ 5~ j l~ ti '-''~ °y Abe ~ a ~~~Ct lt~~ !J111Y . l,yi- I)r 77d3ll~ Ill ~t( 1 P 15656230 #. ~, a 1' °~~ ~~°~ -- ,`e ~ /~ Ci?t)ti~at)13); ~umher .\M~~T,QEI j 1 ,.: ~~' _ _ ~ _LLL (.:Ira' i 4,_~:> j ~ ~-~ )te l~s~x~- t_.. _ . Ii=a C ` - -~ c-7 4 r- ~: - -':~Yrn -_ - ~ - - ,_, , ~: ' r"~? ~ ~ J L~ ~T~ - ~ _ "f I iy r .. _~ ~'I ."~ ae+ n 2uu6 FR i " COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS '~ ~ - ~~ ' IN E iN ~~~icK InKT CERTIFICATE OF DEATH ~ (See instructions and examples en reverse[ .1 1 T~, r : n ' _ ~~ ! 1 I Name of Deceaea IFrst. mdtlte. last. sunul ..,...~.;~~,...;.,o~„ ~. __ mow.. i I 2. Sea 3 Socw Sa:unly Number 1 Dala al Dealn IMonm, day, year) Betty W. Casey Female 201 - 16 - 3214 June 26, 2009 > Age ILasl Bnndayl Under 1 year Urger 1 Day 6. Data of &nn IMonln, day. year) 7 B innplace ICIry arb slate a loreign cwnW l 6a 71ace of 0¢aln ICneck Doty oriel +umns a, ~.,~„ aw,was Hosvnal. Olner 84 Yrs July 17, 1924 Chambersburg, PA ^tnpaa¢nl ^EP: Ompalmnl ^DOA ®NUrstng Home ^Res~dunce ^Clner Slx ,ry 3o Caunty aI D2am .~ Coy Som. Twp al Dealn 6d FucARy Name 111 rql inselulton . glue street :ub numoerj 9. Was Decedent al M,span~p Onginn ®No ^ Yes IO Tate AmerCan Irgan, Boca NT,Ie ett Cumberland Silver S tin Tw B id f B . . pl yes, spenry Cuoan. ISVeaM M P R r es o eaKan. ue"D ent Creek aaRelp, White 11 De.:20¢rn i lliudl I;cCUWhcn ,Nina a wort, aCr.2 B unn„ ~JSI al workin Lle 00 na stale reliledl 12. Was D¢C2tlen1 2var m Ina 13. Decedents Educdnun $pecAy only highest ~: dd¢ Ccmp lel¢tl) li Mdnlal Sl l M N M I(uW of Wua Rand at Busnass! Inaussry U.S. Armed Forcesn Elementary I S¢conoary 1012) CoAaga 11-i or 5») . a US: dmed. avef drr;ed wwowed. Oworcad f Specrry) I$ $urvrving Spara¢ ~ Il rile. gwe mLden nLY,a) Clerk Retail ^Yes &]NO 12 Widowed !6. Decedents Marking Aodess iSreel, clry' town, stale. tp code) Decedents A l R n Db Decedent Pennsylvania cwa eawence a 9ale 2100 Bent Creek Boulevard LlYama „d Yaa, D2cadanl Lxadm. Silver Sorine Tw Mechanicsbur PA 17055 170Gounry p rtlwnsnrp, „d.p ND oe<aaar,tL;.aox;lnm Cumh nand 18 Fam2rs Name IF~nI m;ooe ' vl sullul Actual Lm,la W CeY: Sao . , . 19. hbmer s Name IF;rsl. mdote. maven wmamel Herman W Warner Catherine Wile ?Od. Inlormant5 Name ITypa; Pnnlj 20b. Inlormanl s Maainy Address ISlrael. Cary :own, stale. I~p coDej Kathleen Roth ?Ia Malnad at Dspos;lun ~ Cramaoon ^ Daldl,on 21 C. Oale at D;sWsuron jMOntn, ,lay. year) 21c. Place ul Di>po;Il;on .Name of cemetery. crematory a timer ;,aces 2:d '_.,Calwn lGry lawn, sale. z;p iooel ^ Bunar ^ Removal !tom Sala :Was Cremation a Donation Ausnorized / ,-- ^ omer sdz<~n DyMedmalEaaminerYCDrorrr7 l~7Ye:^ND June 29 2009 C remation Societ of PA Harrisbur PA zza s un sarvw enseelDrpersonaorgaasucm zzD lsenseNwncer zzc NamGandAdaesadFarnlry Auer Cremation Services of Pennsylvania Inc - FD 013376 - L w , . 4100 Jonestown Road, Harrisburg, PA 17109 G lams 23a~c uay n cemrytng slwn.s not a.muDN me al deem ro 23a 'o ~.na Test of my krnwkdge. Deem aculrjQ at me e, dale and place staled. IS;gn S i / awre and Idlel . /~ 230. License Numcer 23c. Dale S. neO IMonm. 9 d)1 1 Y amry cause of Team. C~ ~~Y- c•e/lL(.+`-^' ~ ~(J~ /I~L` D ~ ~ a ~~ G ~ ~ r ~ G el I/ '.lams 2a-26 must x compt¢tatl dy person woo pralwnces seam 23. Tema ~I Cealn 25. Dale Prorauncetl De IMO/n In, day, yearl 3 ~ Q Q / 2fi. was Case Relerred to Mescal E.am~ner Coroner br a Reason Glne( Uun Clemauon a DauDm~ ' ~. M. . Z G (~ 9 ^ Yes ~No CAUSE OF DEATH )Ses instructions and aaamples) l Approalma;e .nl2rval. Item 2, Pan I Enter the _na;n al everts - dseases. ,nWnes. a WmplKalvans - lhal6reclry reused 91e Team. 00 N0T emer lenninal events soon as cardiac arrest On et t D m Pan o. Emer Omer ;ronnc~anl r; orw,uons_Een~ro~g 1° ,e ,n 2g pq Topacm Use CanlrmuY m Oeamy r¢spaarory direst, a vanlrNlldf hDnWaon xlmiWt SMWIng VN etiology. ~4 aey OrK Cause M 8acfl lme. . s o ea Wt rwl resdang ;n me umanymg cause given n Part I. ^ Ves ^ Prmady IYYEDIATE CAUSE 11Fwl tllsease a J ^ ~ ^ DIadlDwll ~ ~"s ' "~ ~~~ ~~, CondNOn rewlwg m deaml _- a. !1 /.l.~rw8"/^~'^•I /~ ':C_.C~S"Y'~• `T ~ ~ /_ „/ t~"r' /' I /' ~ (--CC (/L( W S~ - 29 II FerwN. Dux to nor as a co a uer¢e ol: 9 1 / ^ Not prepun xevn pa4 year Sequem Iry ;isl conauals. A any, 0 m I v ~ ~~ ^ Pregnant m IxM d seam o e cause wee cn ,ne a. pue m s a copse Enter t UNDERLYING CAUSE fora quanta all: ^ Na cre wn Da N a ' s loseasa a mjwy IMI ;mlHled me anu rewn,ng ,n ,leaml LAST. g . w rl z aays Ws 9nar d dean Oue to Ier as a consequence oQ: ^ ~ pregrwe, ~ Me9'tara ~ ~~ b 1 Year d. ~ Debra seam ^ Unw+rown .I pregrwA aamn de Dust year 30a 'Nas an Pulopsy 300. 'Here Autopsy FrtWmgs 71. Harmer d Deam 32a. Dale ul Injury lMOnln. day. year) 72o DesCnOa How Injury CccurraD PerbrmeuY Ava;wc;e Prwr to Comoleum ,--,/ 32c. Plxe ct'.njury: Mara Falm Aleel, f Cory, Od,ce & .an etc eal IS of Cause of Ceamn YJ Nawra ^ Homtcbe g, . . p y) ^ Yes ~'b ^ Yes ^ No ^ Acc,denl ^ Pending InveSDgalgn 32tl. rime aI Injury 72e Injury al Y/orh? J2l II TransDCraecn mlury ISpanM1l ]2g. Laauon ul Injury ~SlrcaL c;ry ; sown. ;later ^ Sukiue ^ DWId Na be Calermtne0 ^ Yes ^ No ^ Dmr¢r Cceralor ^ Passenger ^Pedestran M Omer ~ Spec.ry 37a. Cannier cnecx antY coal • C¢rtdytng physician ~Pnysician camfying taus? :1 :earn xnen another pnystcan nas proncunce0 Oealn end .cmptelatl Item 271 i3a S~gnatur¢ artl T.lle of C2nther / ~{ // J ~ . To Ina Oesl DI my MowNdge. deem atoned due Io the causgsl and manner ai aYle4 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pronouncrn and cMil m MaicNn Pn r m _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ - ~~ ""•.' (/ Y.^-'-~w•-'"!'- y y ysc a . x 9 p proncunnnq death and ren,hling :c ~:ause d ~1¢etnl To Ih! Deal 01 my luwwl<dge. death occurred at Ina lima. dale. and plan, and due ID VN peaelaj and manner as staeed_ • Medical Eaam,ner! Cao On Ina Da f r D r d i _____ _ _ _ _ _ _ _ _ _ _ _ _ ~ rI i7a . a .'I,.moer ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ T L :7: ~a;e S.~rM h4;nln, <I l•, Z ~ O s a o aaamma an or tnvesliyatton. In my tip, n, d th occurred al tM lime. dale. and place, and due la Ina Cause151 and manner as vMlad_ ^ ~ ra ,a , and +ao;es> ,I Ferscn :rn rv, p;e:ad rauva ;I tee.'^, ~- .. n -; ~ /n Pr,nl n r _v . Sgna u. ~ t Nom 76 F I "A ~ ~ J ~~ff "`a ~' ~V~~NC •' I` /) le r r. n. ,]aµ /earl W D.sccs,ecnP~rmaND f13RFY9R4 '~-~IuC~/r(a' / ~ l`~/ ya ~ ~ r';. r,, ~~, ; A~` ..~ LAST WILL AND TESTAMENT OF BETTY W. CASEY I, BETTY W. CASEY, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously C7 rya r-~ ~ _ © ~-., ma e. _ ,,~., cr f r n _... - -~ r,_ ; ~ Article I ? -~ t -~. -~, l tiJ -~ My just debts and expenses of my last illness, funeral, and administration of rriy estate sh~ be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in a ccordance w ith a ny m emorandum w hich I h ave e ither handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to my daughter, KATHLEEN D. ROTH, of Cumberland County, Pennsylvania and to my son, JOHN W. CASEY, of Lancaster County, Pennsylvania. If any of my beneficiaries predecease me or fail to survive me by thirty (30) days, I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or she has no issue, the share(s) are to be added equally to the other shares. Article V I nominate, constitute, and appoint KATHLEEN D. ROTH as Executrix of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executrix, I nominate, constitute and appoint JOHN W. CASEY as successor Executor of my Last Will and Testament. I direct that my Executrix or successor Executor be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Executrix or successor Executor shall receive reasonable compensation for services rendered to my estate. Article VI In addition to the powers conferred by law, I authorize my Executrix and successor Executor, in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and -3- (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, BETTY W. CASEY, hereby set my hand to this my Last Will and Testament, on )yl Q a 2004. ;`~- BETTY W. CASEY In our presence, the above-named BETTY W. CASEY signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name ~~ C~ Address t~~S~~ ~fi ~ ~CG~r ~ /~~~~ ~~ / I/(~~ ~~ ~5;~~ hG~ ~~ 5 'f ~1~~ ~ ; pia -4- I, BETTY W. CASEY, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by BETTY W. CASEY, the Testatrix on _~~_ 2004. otary ublic TMw~,C'~'r~",~..,~ mr~NwucroNn.~~c.. ~raotNw,uloN ~s oec. ~~ ~ BETTY W. SEY We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me r ~1~ ) by .,~trGt ~ 1 ~/'~i'/'y~/C' and witnesses, on , 2004. 1 ~. tart' P blic L1N OF PENN~LIIIUpB NOTARIAL SEAL JACQIN111N: A.1(ELLK NOTAR'/ PUBLIC ~owm PAXfON TNN!, DAUPIRN CDINm MY COMMISSION EXPIRES DEC. 17, 2007 -5- r `// ~~7~ ~:~-c s~ ~ttness ~,~~~ ~ /.~, .~~,~ ,ti ~- Witness