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HomeMy WebLinkAbout07-10-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Estate of Connie J Humer Richard also known as COUNTY, PENNSYLVANIA File Number 21 - 09 - ~`~ ,Deceased Social Security Number 176-34-8939 Carl R. Richard Petitioner(ej, 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( is/ar~the Executor named in the last Will of the Decedent dated 03/05/1992 (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 I applicabe, enter c.t.a.: d. b. n. c.t.a.; pe ente de; durantea senha; urantemmontate) 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 Administratton, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ,.~ n ~ Name Relationship Residence -- :c~ c_ r-- ;, i , ~ - ~~ ~ = t . V (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with ~ /her last principal residence at w 2 Connie Drive, Mechanicsburg (Silver Spring Township) Cumberland County, PA 17050 (List street address, town/city, township, county, state, zip code) Decedent, then 64 years of age, died on 06/16/2009 Decedent at death owned property with estimated values as follows at Holy Spirit Hospital, East Pennsboro Township (If domiciled in PA) All personal property $ 20,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 150,000.00 situated as follows: 2 Connie Drive, Silver Spring Township, Cumberland County, PA Wherefore, Petitionertca respectfully request(s) the probate of the last Will aad-6eclisil~c}presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Signature Typed or printed name and residence (-. Carl R. Richard 2 Connie Drive „n ~) ~ Mechanicsburg, PA 17050 CUMBERLAND Form RW-02 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 } SS COUNTY OF Cumberland } The Petitioner(e~ 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 PetitionerEs) and that, as personal representative(a~ of the Decedent, Petitioner( will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ~Q~~? `day of 1 For the ister Sfgnature of Personal Representative Signature of Personal Representative ~ c~ c__ cw © vo -~~~ Cam" r _ r' r~' ~ ~ ~ File Number: 21 - 09 ' ~ ~ `~ ~ - i r.-~; ~ ,r"l ;~ ~ Estate of Connie J Humer Richard , Deceased ^~ ?' N CU Socia~~l``Securi~ty//11Nuiimbge~r: 176-34-8939 /~ Date of Death: 06/16/2009 AND NOW, ~V~ t..t..c..Lt vim ~~(,(,~'.C~ l.C~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECRE that Letters Testamentary are hereby granted to Carl R. Richard and that the instrument( dated 03/05/1992 described in the Petition be admitted to probate and filed of record as the last Will(a+ad-Ce~~s+~}of Decedent. FEES Letters ............................................ $ d ~ (J~ Short Certificate(s) ........................ $ 12.00 Renunciation(s) ............................. $ YV i r~ $ I~,D(7 ~~ $ j0,~ ~~~~~ti $ 5,~~ $ $ $ $ $ $ TOTAL .................................... $ 3~a A' in the above estate Supreme Court I.D. No.: 21542 Ball, Murren 8~ Connell Address: 2303 Market Street Camp Hill, PA 17011 Telephone: 717/232-8731 Form RW-OZ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Attorney Name: Richard E. Connell Esq. LOCAL REGISTRAR'S CERTIFICATION OF aEATH WARNIN G: It is illegal to duplicate this copy by photostat or phota€~raph. Fc'C' fIN- lhlti CCI'UI~1Ctl[i, `,y(i.OO ;i.'I . l~~ l~~}) 1~~11~ i ~,.' I (~ ~~;;( ll - 11~' " L Ull ~~'l~~ 3va'!1 ,I ~~ ~ ~/~ /I+ '-~ ~~ ~`~ ~`O1"CtL ~ ~' r(~II ~ I~TIlI I~ Ii~lil ~C111 t.. i~~ ~~ ~)ti; ~~~ ~ ~= rte; Litily `I)<<! »~( r~ a 1_. y,~); 12t Cel'titt 1[ 1 ~ 1 I?- '~ l ~~i,t ) i}~~ (~)I>'il t , ( l'i J I ~ ~ z t . , 1 ~ ~ tt (ec , t l I~~ taic Vv a 'b~ P.i'll~iC~ ~.)li' 1.~:. ~L t 1 l'1Lt I :fllL`. 5 6 5 9 0 ~ 1 P ~ P~? ~ ~' ~~~'A 1 ~~-~- I•v~ ~~ L ~' ~ o ~ 1 . -- -- - ------ ~ r, ~, Hrh; ~ _ --- -- 1 _ _ CerutiLatlur, ~un,ber ~~~i ,f!a% -.___ r. , I.. C)C':11 iZl~r.1':.E ~ ~). tlc {~~.UL'cz hJ [7 ~ Q vv ; I l_. '~ ~ ', a ~. r_..i ~ ~ . ~ ) r , ---1 ~ ~ i C C ~ ~~ ...~ - .. , 1 -,Lj-Tz ~ ~ c~ = _ _ ~ - ~ ~ i N Cb N1cs 1a3REV wzuos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE / PRINT IN PERAIANeLT CERTIFICATE OF DEATH elACN INK (See Instructions and examples on reverse) STATE FaE NuNfBER _ j ,1 n t Name of Decedent (First, mddle, last, suffix) 2. Sex 3. B°aa Security Number 4. Dale of Deam (Mmth, day, year) Connie J. Richard Female 176 - 34 - 8939 Jun 16 2 0 5 Age (Last B~rthdayl Unner 1 year D(Mer 1 day fi. Date of Ginn (Monm, day, year) 7. Blrttpkce (City end aaro a coumryl 4. Plaza a Oeatn (Cnak on one) w,n,ns Days Iwers kwww Hospital: Other. 64 Yra July 27 1944 r'IechanlCSbu PA ®mpallant ^ERIOutpatrent ^DOA ^Nursuy Noma ^Rawdance ^Dtnar Spec,ly 80 Cwnty of Dealn Bc City. Bao, Twp of Death Bd. Facility Name (II not msautron, give street aN Ixxnmr) 9. Was Decetlenl of Nispanx: Organ? [~ No ^ Yes 10. Race. Arterkan mda°, Beck. White ek (n yea speaN Cuban. ISpeoM Cumberland Fast Pennsboro Hol S irit Hos ital Maxkan. Pee"° wca^, etc l White 11 Decedem's Usual Occu Iron IKind of work d one B urin moll of wmkin life Do not stale retired 12. Was Oecetlent ever In me 13. Decetlem's Education (Speary only h~gnest gratle comp leted) 10. Manta Blalus. Manned. Never Marrietl, t5. Burvivlrg Spo use (If wde, glue maiden name) Nand cl Work Nind of Business I Industry U. S. Armed Forces? Elementary /Secondary (612) College (1 4 a 5r) WboweQ Divorced (Specil)'j pc3lrini_~ati~.e ~ Gx'rc#arial ^Yea ~Nn 1 2 Married Carl R Richer IB. Dc¢edenl§ Mailing Atldress ($Ireel, city /town slate. zip cotla) Decatlenl's Penns lvania DsdeDn aim ~ Silver .S pring Y 2 Connie Drive Actual Resitlence 17a. State I7c Yes. Decedent LrveO n ,xp. T°wnanw? ,7G ~unry Cumberland nd ^ Nn.Ixceaam Liratl wimin Mechanicsbur PA 17050 Actual Limrts a Gry / Bao 1B Fadmr'S Name IFir51, middle, last, sumx) 19. Mother's Name (First rtitrldk, maiden 5allanl6) Willard C. Homer Ethel V. Knisel ZGa Informants Name (Type / Pnnll 2Cb. Informant's Mailing Addess (Basel, city I tam, etas, zip code) Carl R. Richard 21a Manta of Disposition ~ ^ cremation ^ Donalan 21b. Date of Disposition (Month, daY. Y~r) 21 c. Place d Dlsposilbn (Name d cemaery, crematory a oma place) 210. Locatron (city / town, stale, zp ~) (~ BunW ^ Remava Irom Sate ~ Was Cremation or Donation Aumalzed [] Other .Spa,;,; ry: Oy Medkal Examfrar/ Caonari ^ Yes ^ Nu June 19 2009 t Of H V 22a wed ,sera en (or rson acan~sucn) 22b. Licrose Number 22c. Name and Addese d FxWry 8 Market Plaza Way - - FD - 014889 Mal zzi Funeral Home Mechanicsbur PA 17055 C le s 2 mry when cart 23a. To ma best of my knowledge, death occurred al tlw lime, date arro pace slated. (Slgnatae end Ifs) 23b. Ucense Nrxnber 23c. hate Sgned (Moan, day, year) ysroan is na availaDl¢ al linre of death to Z ~ ~ ~ canary woes a tleam. ~^ `~Y ~ J {p I Hems 2J 20 moat m caiµgaled Gy pprawr 24 Time of ueam 25. Date P a0 eatl (Homo, day, year) 26. Was Case Rekrred to Medal Examiner I Coroner la a Reaacn Other than Creme a Donation? ono pia,ounces death 1 • OD M. u ` ~ ^ Yes No CAUSE OF DEATH (Sea Inatrueslona and examples) r Agproxanele nrorva: Pan IL Enter amr ' ffi~, 2fi. Dk Td,a¢ro Use CmtrlGuro k Deem? Item 27 Pan f Enlai the tiGagSysLl:llli - diseases. mjuues, or wmplicalrons - mat drrxtly caused Im Beam. DO NOT solar lermina events arMm % ardac arrest, 1 Onset b Daam but nd resuitifq le the umm~yxy reuse given n Pmt I. ^ Yea ^ Promdy raspi,alory anoal. a vemricukr fibrillaa°n without 5howiny Ina elrology. List °ay one Luse on nacn sire. ^ No ^ Unkrawn INYEDIATE CAUSE Final dseasn a ~ 11 /' Caldllen resdnmg h death) _-' a ~~ R ~ Q ~~ ~ 29. II Fernnk ^ Due to for as a con qu a oQ~. r ~ ~ ~ ~ ~ / ~ Na pagrlMil wllnln pa51 y¢a! ^ Pregnant at ume d deem - ~ ~! jt L ~ ~ StpuzmaAy list caWdare, It any, G ~. U ~ Isednp to me cause isled on line a. Dua to (or as a consequence o0: t ^ fbt pegnard. do pregnaa wrttun i2 days Enter 6~e UNDENLYWG CAUSE I ' d duaHl ~~~ 1 IdLUaaO ur InlI~xyy oral naliJly f) qq / a ( k u venk Iesull,M1g Li deuM) l BT. Due to (or as a consequence ory. ^ Na preyrNnl, Gut pugnam G3 days b I year d. more deem ^ IlMrown a pragrrant weM are peel Year 3oa. Was an Autopsy 30b. Were Autopsy Findngs 31 Ma her el Daam 32a. Date a Irrjury (Monm, day, year) 32G, Describe Now Iryury Occurted ffic. ~ ~~ Morrie Farm, Barest Fagay. Pencrtnc-0? Avadaae Pno, Io Cwnpkuun ~ ^g' ek. (Sp~ryy a Cause a Dealn? Nalulm ^ Homicide ^ Accidem ^ Pending Invesliyduon 32d. Tme a Irryury 32e. Injury al Woa? 321. If Trerrepataaon Injury (Bpenry) 329. location d 4yury (Brea, cay I Tarn. slate) ^ Yes ~NU ^ Yes ^ Nu [] Swoae ^ Could Nol m Dekrmined ^ Yes ^ No ^ Onver / 9paraa ^ Passenger ^Pedew,an M ]Omer ~ Speciy: 33a. Ceraler (check only one) Sgnature and naa a Ced( • Certifying pnyskun IPnp¢ian cemfymg cause of Oeall', when arwlner physwiun has pronoum:ed death and completed Item 23) death occurred due to the ausgs) and manner u acted„ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ To Uro met of my knowledge - , • Pronouncing and cenilying physician IPGYsiaan Gam Vronouncmg deem arM certirylny to reuse a death) ^ 33c. License NumGer 33d. Dale Spited (Mmm, day, year) To Uro ma al my Wrowkdge, deem occurtad at the lime, Gate, end plxe, and due to IM cause(s) end manner as alalsd_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ i l C M ka E ~ O ~D L ~ ~ ~O U aam ner oroner • ed On me Oasis of axamination and I or invesligalion, in my opinion, deem occuned at Ih~ ma, dale, and Place, and due 1o IM ceufe(a) and manMr a ataled_ ^ 34 Na ¢ aM Atldra55 a Person Wm Completed Cause of Deam Qrom 27) Type I Pnnl m ~ de 3E Daro Fued IMmm arl ~ „~~• o.. ~ ~ J to 3s. f>~g~yan~r~a)a~e a~sv~~mr _ __ _ _.. _ _ - IY~1I /•VUVIYL.. ~ la I .ri I .~, I .~ I ~i I , r. m p(`C ~$~yOU~ 5 n3 N . ~ 1 `~-1' rea ~a.rr I X4,.4- '7a~ 1 ~..__....._ o_._...,.. 0318674 'w'r C'7 ~n O ~,,. C~ 1~ ` , n : Q ._, L AND TESTAMENT OF CONNIE J • HUMER RIC ~ :;,; ~ _.~ ~` LAST WIL ~ ~_` ~ - , ~_ .__. _ ~~ ~.~ gUMER RICHARD. of the Township of Silver"~ r.,~ I , CONPiIE J . a~ being Spring, County of Cumberland, and State of Pennsylvania, mind and memory, health and of sound and disposing in good bodily and not acting under duress,. menace fraud, or undue influence of any person whomsoever, merely calling to mind the frailty of my worldly of human life, and being desirous of disposing so to do, I do goods while I have the strength and capacity TESTAMENT. LAST WILL AND make, publish and declare this my I hereby revoke, cancel and annul all my former Wills and b me at any time made, Testaments, including codicils thereto, Y LAST WILL AND TESTpilriENT . and declare this alone to be my AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRUST ME WITH IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ: ITEM ~, I direct that my Executors hereinafter named pay and discharge all of my just debts, funeral and testamentary expenses. ITEM 2. All the rest, residue and remainder of my entire ---- consist of, estate, wheresoever situate, and whatsoever it may absolutely, and in fee, to my I give, devise, and bequeath, In the event my dearly dearly beloved Husband, CARL R. RICHARD- or beloved Husband dies with me in a simultaneous disaster, thirty (30) days, then I give, fails to survive my death by devise, and bequeath by entire estate, wheresoever situate, and whatsoever it may consist of, to my dearly beloved Son, BRADFORD M. HUMER. C CIE HUMER RICHARD 1 I nominate and appoint CARL R. RICHARD as Executor ITEM' 3• ualify of this my Last Will. Should the Executor named fail to q or cease to act as Executor, then I appoint BRADFORD M. HUMER as Executor in his stead. ITEM 4. I direct that my personal representatives, as well as their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM 5. I direct that all estate, succession, legacy, inherit or other transfer taxes, however designated that shall become payable by reason of my death in respect of all property comprising my gross estate for tax purposes, whether or not such property passes under this Last Will, shall be paid by my Executor out of my residuary estate. ITEM 6. I grant to my personal representatives herein but not in limitation of those powers named, in addition to, vested by law, to be exercised without prior application to to retain or approval of any court, the power and authority indefinitely any property, to invest and reinvest any assets or the proceeds derived from the sale of assets, although said law, to not be of the character prescribed by investments may ro erty, to sell, convey, assign, transfer and encumber any p P pay, settle or compromise all claims, to make distribution or divisions in cash or in kind, and in general to exercise all powers in the management of any property hereunder which any individual could exercise in the management of similar property owned in his own right, and to execute and deliver any and all instruments and to do all acts which may be deemed necessary and proper. O~IE MER RICHARD ----- ----------- ------END--------- 2 ' COMP~IONWEALTH OF PENNSYLVANIA ~ ss "Y OF CUMBERLAND COUNT HUMER RICHARD ,TESTATRIX, whose name' '' I, CONNIE J. oin instrument, having ',~c;'ri signed to the attached or foreg g to law, do hereby acknowledge th..t. i duly qualified according LAS~1, WILL=~; i:ll: t- signed and executed the instrument nedmit a,~ InY C1-"cam `""' signed it willingly; and that I sig ~c~d. voluntary act Eor the purpose therein exprc's~-~ - Sworn or affirmed to and acknowledge~7 1?efo~~~" ~~'~~'~ th. ~r ~'S'tA°I';.:I:x;, t=n ~s 5th ,' 1~~ TF J HUMER RICHARD ~' ~.91~-1~I._.... o f h ____ , 19 9 2- - AA'' pp 1 77 ------ 1 i`l T.',I',1~.~ ~~fiL A? i Uf;P~ r ~ ; ' ~ _ ~ ~ ~ a ,c ~~ ~ r,', S~} _.._._s_,.._. ._..._ :x~ ~J 2:~~5 ~:~ N Ry PUBLIC _--- nn Mechanicsburg, My Commission T;xpire:~: instrument consisting of ,this and ta.o C--~ The preceding the signature of t'n~' other typewritten pages, identified by ublished and was on the date thereof signed, p 'IESTATRI:X, the TESTATRIX therein nam~~~ declared by CONNIE J. HUMER RICHARD as and for per LAST WILL AND TESTAMENT. ~1~ ~ orting Hill Roar" Sp AME~I.I Residing at 35 S SP pA 17055 GLADY B• Mechanicsburg, _ ~~~~ IS FORTI Residing at 352 5 Sporting Hill Ro,,~~l Mechanicsburg , PA__ 170`~'> A F F I D A V I T COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF CUMBERLAND we GLAU_YS B. SPRA_. MELD-I and _CHRIS _FORTI_ w:itn~ aces whose na e signed to the a~t~ched "~ ° ,,, ~. ~~~ ~- being duly qualified accordin< to law, ins `rume.nt, , say that we were present and saw TESTATRIX sign <~a~~~ ~ -~` ` ' instrument as her LAST WILL; tluntare actn7orwtl,~.~~ i~r~h ~ ~ . c~xec,_~ted it as her Lree and vo Y ^, expressed; that each of us in the hearing and ~ighL "i ~'~_ 'PESTA'CI2IX signed the WILL as witnesses; and that ' Ltl~ knowledge the TESTATRIX was at the time 18 or_ more yc~a ~ ~~ sound mind and under no constraint or undue influence. Sworn o~r affirmed to and subscribed to bef~>>"t= ''~'`~~ ~~~" CHRIS FORTI witnc~~~~.'>"'~~~ t~`~~~='~ GLADYS B. SPRAMEI_l_I and _ -- ~h...- day of March 19 92. - ------ _ NQ'tAR1A1- SEAL `"~ ARY PUBLIC A1'tORNEY ~Cumbe sand B ouH ~~,tacY P~ h a n i c s b u r. ~, P A ~~~~~~,~~4~913.1995 My Commission l~,xpir-e:~: 3