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HomeMy WebLinkAbout09-24-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of GERALDINE M. HAZEN also known as GERALDINE HAZEN File Number Social Security Number 269-18-4996 Deceased 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 / aze the EXECUTOR named in the last Will of the Decedent dated 11 /1/2006 and codicil(s) dated C7 ~ (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ Q ~°~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution oft}+rre~tstrumert~ offene~" __ for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ '~' r- ~ ` ' T ~-. ~'i-i r ; ~ - - B. Grant of Letters of Administration f r ~ E ` _ (/f applicable, enter: c.t.a.; d. b.n.c.t.a.; pendente liter durance absentia; durprtie~tnStitate)A _. ~. =I7 - _ --, Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following s~use (if any) ~ heirs:(]f "-? Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) a Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his /her last principal residence at 4905 East Trindle Road ~~tNar/,rterteh i1F PA ~A~-'F-/~is0 Hamoden Two Cumberland County (List street address, towrr~ciry, township, county, state, zip code) Decedent, then 90 years of age, died on 9/20/2009 at 4905 East Trindle Road Hamoden Twp Cumberland County 6er~+f+11- ~t1~c~r~vcs~-3u~~, PA -~A~-1l~~tQ 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: $ / ~ y ~ ©ov ~ civ 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: Typed or printed name and residence David B. Hazen Page 1 of 2 Form RW-02 rev. !0.13.06 (COMPLETE /N ALL CASES:) Attach additional sheets if necessary. Oath of Personal Representative COIvIIvtONWEALTH OF PENNSYLVANIA ; SS COUNTY OF UMBERLAND _ 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 subscribed bef e m the ~ day of E~ dC~~ Signature of Personal Representative Signature of Personal Representative the Register Signature of Personal Representative File Number: ,~1/ ~ v ~ " ~`~ C/? _t~ f =_. ~ N ~~ 'C~ )C -r ~ GC1 :U = Estate of rERALDINE M HAZEN ,Deceased ~:.; ~- ~.:,.. ~: _ _' --- Social S curi Number: 269-18L-4996 ~~ Date of Death: 9/20/2009 AND NOW ~/ ~`J~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to DAVID B. HAZEN in the above estate and that the instrument(s) dated November 1 2006 described in the Petition be admitted to probate and filed of recor~ ~s the last Will (ar)d Codicil(s))~7fpeceden~ FEES w-- ~.,, ..... ~ ~ ter. •...•••••......• /~• (~D Reg' ter of Wills Letters ••••••••••••• $ c. , /' C,U ~G l~ Short Certificate(s) •••••••••••• $ Attorney Signature: Renunciation(s) •••••••••••••••• $ $ f~ Attorney Name: David H. Radcliff i , •••• $ ~~~ ~ Supreme Court l.D. No.: 25483 .... $ ~ $ Address: 1011 Mumma Road. Ste 201 .... $ •,.. $ PA 17043 .... $ $ Telephone: 717 236-9318 TOTAL ............................. $ 121 Form RW-02 rev. !0.13.06 Page 2 of 2 , , .. . It I.`, i ~~ LOCAL RECaISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee tilt this rertifirute, `~fi.0O ~"'°~~\ ~~~p~SH OF pf~,'y\ ,, ,~' ~_ ' \o ay a`I i~ .r f `_ * ''? ~~ > 4~;. ~~ l P X5690535 --99r~-- ~~~;,~~~ \ENZ_d`~ Certification Number """~"~~~ This is to ccrtil~v that the. information here given is correctly copied from an uri~~inal Certificate of Death duly lilcd ~A~ith nu as local Re«istrar. The ori~~inal celtilicltc will he li)rearded to the State Vital RL.cord: Oflier for Permanent tilin~~. /?~.. ~°~ s ~ z loos Local Rr}~i~n-ar Date Issued r~ C7 - v .,o ;- cn °_: ,~ _ rat ,_ , ' ~ C J _T " Q _ _ r- 17 r~ ~ - ' ~ . - ~/~ , t L1+ ~-~ ~ I REV +trmos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS IinnrR4EMNrl" CERTIFICATE OF DEATH ADK INK See instructions and exam les on reverse P ) STATE FILE NUMBER 1. Name of Decedent (FIrsL mitltlle, last, srMix) 2. Sex 3. Social Security Number 4. Date of Death (Month, tlay, year) Geraldine Hazen Female 269 - 18 - 4996 Se tember 20 2009 5. Age (Last Birthday) Untler 1 ear Untler 1 tla 6. Date of Birm Monm, da , ear 7. Birth lace Ci aM state or tot al count 6 a. Place of Death Check onl one) 90 Mmms Days Nours Minuses 1918 November 3 OH Sunbury Hospital: Other YrB , , D „ ^DOA ^ In alien) ^ ER I Ou anent g ^ Residence ^ Olher~ Specify. ursin Home Bb. County DI Death Bc. City, Boro. Twp. of Death 0d. Facility Name (If nos institution, give street and number) 9. Was Decedent of Hispanic Origin? l~r4o ^Yes t0 Race. AmerKan Intlian, Black. While, etc. Cumberland Hampden Twp. Country Meadows Retirement Cotmtunit (II yes, specity Cuban, Me„iDan, PuenD RiDan, etc, ISpecilyg White t t. Decedent's Usual Occu alien Kintl of work done Burin moss of worki life. Do not state relved 12. Was Decedanl ever In the 13. Decedent's Education (Specify only highest grade completed) 14 Marital Status. Marred, Never Married, 15. Surviving Spouse !II wile, give maitlen name) rntl °I W°`„ h T Public ei~c~%oo~s U.S. Artnetl Forces? Elementary / secdntlary (0.,2) 4cDaege (, .4 qr 5.) Wldowetl, Divorced (Specify) Widowed eae e ^ Yes ~ No t6. Decedent's Mailing Address (Street, city! to n. state. zip cotle) Decetlenl's Did Decedent Hampden PA Live in a 77 T ~ Y D d t Li d 4905 E. Trindle Rd. en ve a wp c . es, ece Actual Residence 77a. Stale 7DwnahlD? 17tl. ^ No, Decedent Livetl within Cumberland Mechanicsburg, PA 17050 77b. County ActDal umaa Df C~tyi Rnrn 18 Father's Name (First, mitltlle, last, suffix) 19. Mother's Name (FIrsL mitltlle, maiden surname) Asa Myers Carrie Ro ers 2oa.~fonnagrsNa (T~p~r Prm„ avtQ r~azen 26b-InfD~t~t~~ain~da~er t. i)jly ltDWfl, at~a~em OH 44460 21 a. Method of Dlsposiuon ~ Cremasion ^Donauon 21b. Date of Disposition (Month, day, year) 21c. Place of Dlspositlon (Name of cemetery, cremaary or ocher place) 2ttl. Location ICiryltown. stale. rip cotle) ^ Burial ^ Removal from Stale r WesCrematlonorDOnetlonAUtharizetl ^ • Sept 23, 2009 Hollinger Cremation Services Mt. Holly Springs, PA N° ^ 1)fher ~ S e,i ' r by Medical Exami er? h--1 Yes w 22a. attire f Funeral Service rise so as such 22b License Number 22c. Name and Atldress of FacillryMyers-Harner Funeral Home Inc . 014819 Complete Gems 23a<onry when caditying 23a. 7o the bell of my knowledge, death oaurred al Uie ~ e, date end place stated. (Signature and title) 23b. License Number 23c. Date Slgnetl (MOnlh, tlay, year) physician a rat available at time of death to `~ ~ ~ _ > ( ~ yZ~ _ ~ ~ / J / l l ~ ~ ~a Cl (~'`p V ~Y~ xX V ~(y U U - cenity cause of death. ~ ~+L . ~ K (~ Isems 24~2fi must be comoletetl by person 24. Time of Death 25. Date onouraed Dead (Month, day, year) 26. Was Casa Ref rr to Medical Examiner /Coroner for a Reason Omer than Cremation or Donauon'+ who pronounces death. ~ ~ I ~ A M. ^, ~.Q !~' /x~ ~Y ~ ~ ~ Q ~ C ^Yes No CAUSE OF DEATH (See inatructtons and xemples) r Approximate Interval. Pan II. Enter other significant conditions cenlrihutinq to death. 28. Dltl Tobacco Use Contribute to Death? Item 27 Pan I: Enter sae than of events -diseases. inlunes, or compli°alions ~ that directly caused the Beam. DO NOT enter terminal events such as cardiac arrest, Onset to Death bus nos resulting in :he undertying cause given in Pan I ^ yes ^ Probably respiratory arrest. or venbicular'ibnllation without showing the etiology. List Doty one cause on each line. i'~-. ~'Nb ^ Unknown IMMEDIATE CAUSE /Final disease or ~~/ condition resulting ,n deaths _~ ~~ ,, ~, L /~ ~r a 29. If Female. re nant within ear ^~~Not ast ' Due to for as a cons ante ol) Seq entialry Ilst Cond'nlons, it any, p f?7yl `Lq, ~~ ~. ~" ~~ p g p y ^ Pregnant at time of tleath ^ leadnqq to the cause Ilstetl on line a. ~ Nat pregnant but pregnant within 62 tlays Enter me UNDERLYING CAUSE Due to (or as a consequence DI): of deem (disease a injury Uat initiated the ~ 43 ^ N I evens resulting In tleath) LAST. Due to (er as a consequence off'. ot pregnant but pregnam tlays to year before Beata d ^ Unknown if pregnant within the pest year . 30a. Was an Autopsy 3170. Were Autopsy Fintlings 31. Manner DI Death 32a. Date of Injury (MOnm, tlay, year) 32b. Describe How Injury Occurretl 32c. Place I Injury. Home, Farm, Street. Factory, Pedormetl? Available Prior to Completion of Cause DI Death? py I~YMatural ^ Homicide Ofllce Buading, etc. ISpecity) ~ ^ ^ ^ ^ Accdenl ^ Pending Investigation 32d. Time of Injury 32e. Injury al Work? 321. If Transportation Injury (SpeciyJ 32g. Locallon.oljlnlury tStreeL cty. town, slates NO Vas Yes No id ltl N s b D t i d ^ S i ^ C ^Yes ^ No ^ DrmerlOperator ^ Passenger ^ Pedestr an. . erm ne u c e ou o e e M ^ Diner ~ speciry 33a. Cenitier (check Dory one) 33b. Signelure arM T' of Certi' ---~• , • Certnying physician (Physiman cenitying cause of death when another physician has pronouraed death and completed Item 23) deem occurred due to the cause(s) and manner as stated To the best d m knowled e ~-~ ~~~'~ . - ~ ._-- ' ~ :" '_~ l~J2l , i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ y g , • Pronouncln antl cert n h slclen Ph clean bom onouncin deem and cert n to cause of tleam 9 lM 9DY ( Y Pr 9 fi"9 I To the bent of my knowledge, death occurred at the time, date, end playa, antl due to the cause(s) and manner as etetetl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. Liranse Nb r z~Y1 ~ 'J ~~ /G-/J/ 33tl, ate Signed (Month, day, year) ~ ~ , y ;" 1 J_1 ~ :.~ ~G'~ dcal Examinerl Coroner • M / ' ~ /-~/ 'I C y ~ _ ~ ~ '~ ~ e On the bells of eaamrnatlon and / or mvestlgatlon, In my opinion, death occurred at thn time, date, and place, and due to the cause(s) and manner as stated_ ^ _, 34. Name and Address or Person Who Compleletl Cause of Death (Item 27) Type /Print /~ Regrstrars Si aNre and Dstrict Numhe 36. Date Filed (Mont day, year ~ ) ...+ ..- ~ -_ _~_- a DiapDaitidn Parma ND. 0366742 LAST WILL AND TESTAMENT KNOW ALL MEN BY THESE PRESENTS, that I, GERALDINE M. HAZEN, currently residing at Camp Hill, Cumberland County, Commonwealth of Pennsylvania, being in good health and of sound and disposing memory do hereby make, declare and publish this as my Last Will and Testament, hereby revoking all former Wills and Codicils heretofore made by me. FIRST: I direct that all of my debts not barred by the statute of limitations, h•.y expenses of my last illness, funeral expenses, costs of administration and claims mowed in ffie 0 administration of my estate shall be paid by my Executor hereinafter named, from'i `estate soon after my decease as shall be found convenient. - ~"~='~_'.`r-'- ,~ _;, u Y -, ~ J xm SECOND: I bequeath my automobiles, household and personal effects, arrxl, other ~> .,... tangible personal property of like nature (not including cash or securities), together with any-- existing insurance thereon, to my sons, DAVID B. HAZEN and GARY F. HAZEN, per stirpes, to be divided between them as they may agree, in as nearly equal shares as possible, provided that if they are unable to agree then they shall make selections in turn with the oldest going first until the dollar value of the items selected is as nearly equal as possible. It is my intention that if either son should predecease me, his share shall pass to his descendants. THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, whether real, personal or mixed, and of any nature whatsoever and wherever situate, to my sons, DAVID B. HAZEN and GARY F. HAZEN, in equal shares, per stirpes. It is my intention that if either sor. should predecease :::e, his share Shall pays to h.s descendants. FOURTH: Provided that he agrees to serve without commission or compensation, I hereby nominate, constitute, and appoint DAVID B. HAZEN, as Executor of this, my Last Will and Testament without necessity for posting security regardless of state of residence. In the event that DAVID B. HAZEN shall predecease me, or be unwilling or unable to act as my Executor, as aforesaid, then I nominate, constitute and appoint GARY F. HAZEN as Executor of this my Last Will and Testament, without necessity for posting security regardless of state of r.'J::r' residence, under the same condition that he agrees to serve without commission or compensation. FIFTH: My :Executor shall have, in addition to the powers and authority conferred upon my Executor by law, the following additional powers and authority: To sell at public or private sale, exchange, transfer, partition, give options upon, repair, lease, mortgage, pledge or otherwise dispose of any property, real or personal, at any time constituting a portion of my estate, and upon such terms and conditions as the Executor shall deem wise. 2. To invest and reinvest any money at any time in such bonds, stocks, notes, real estate, mortgages, life insurance, annuities or other securities, or such property, real or personal, as the Executor shall deem wise, without being limited by any statutes or rule of law regarding investments by the Executor. To retain, without incurring any liability, as investments, any property owned by me at the time of my death, as long as my Executor may deem it wise, and even though such property is not the kind of property an Executor would purchase as an investment; and even though to retain such property might violate sound diversification principles. 4. To cause any security or other property which may constitute a portion of my estate to be issued, held or registered in the Executor's own name, or in the name of a nominee, or in such form that title v~Till pass by delivery. 5. To consent to the reorganization, consolidation, readjustment of the financial structure, or sale of the assets of any corporation or other organization, the securities of which constitute a portion of my estate, and to take any action with reference to such securities which, in the opinion of the Executor is necessary to obtain the benefit of any such reorganization, consolidation, readjustment or sale; to exercise any conversion privilege or subscription right given to my Executor as owner of any securities constituting a portion of my estate resulting from any reorganization, consolidation, readjustment, sale, conversion or subscription. 6. To pay all costs, taxes, charges and expenses in connection with the administration of my estate, including such compensation to the Executor which shall be in accordance with established fees throughout the period of administration of my estate. ;~ 2 7. To determine what is "income" and what is "principal" hereunder, and my Executor's decision thereon shall be final; and to purchase securities at a premium or discount, and to apply or charge said premium or discount against income or principal as the Executor may determine. 8. The Executor may make payments to or on behalf of any person who is the beneficiary hereunder but in no event, however, shall payments be made to any creditor or other such person because of anticipation of payment by the beneficiary, and any such claim made by way of anticipation by the beneficiary shall be of no validity or legal effect. 9. To borrow money from any person, firm or corporation, including any corporation acting as an Executor hereunder, for the purpose of protecting and preserving or improving my estate hereunder; to execute promissory notes or other obligations for amounts so borrowed. 10. To employ legal counsel, accountants, brokers, investment advisors, custodians, managers and other agents and employees and to pay reasonable compensation out of my estate or any funds held hereunder to which said compensation is attributable, provided that my son shall not be compensated for his services as Executor. 11. To carry on any business owned or controlled by me at my death for whatever period of time my Executor shall think proper, and my Executor shall have the power to do any and all things my Executor deems necessary or appropriate, including the power to close out, liquidate or sell the business at such time and upon such terms as my Executor shall deem best. 12. To make distributions in cash or in kind. 13. To compromise controversies. 14. To do all other acts in my Executor's judgment necessary or desirable for the proper and advantageous management, investment and distribution of my estate. SIXTH: I direct that all transfer and inheritance taxes, state or federal, assessed because of my death, whether the funds, property or insurance proceeds to which such taxes are attributable pass under this Will or not, shall be paid out of my residuary estate; that my Executor pay, or provide for payment of all such taxes at such time, or times, and in such manner as my Executor deems best. 3 IN WITNESS WHEREOF, I, GERALDINE M. HAZEN, the Testator to this, my Last Will and Testament, typewritten on four sheets of paper which I have identified at the bottom of each page by my initials, hereunto set my hand and seal the ~ >'~ _ day of r~'~"~d~-~/`~'t' 2006. J ~ G RALDINE M. H N The preceding instrument consisting of this and three other typewritten pages, each identified by the initials of the Testator, GERALDINE M. HAZEN, this day and date thereof signed, published and declared by GERALDINE M. HAZEN, the Testator 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. '- COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF ~. ~n~ .~ n w~ ^%A I, GERALDINE M. HAZEN, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. i ~Q ~., ~ ~~~~ ~~ y~~ /O~' . GERALDINE M. HAZEN ,~i Sworn or affirmed to and acknowledged before me by GERALDINE M. HAZEN, Testator, the 5 ~ day of ~ ~JC%~I(~i~T'~ , 2006. (SEAL) Notary Public NOTARIAL SEAL DAVID H RADCLIFF Notary Public LEMOYNE BOROUGH, CUMBERLAND COUNTY My Commission Expires Jun 29, 2008 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF We f(Ar/~LEE,~V r~ ~t~SP~- and ~121'YIVI~ ~ l~1G/~~'YfiU _, the witnesses whose 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 Testator sign and execute the instrument as her Last Will; that she signed 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 Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by ~ Ti~f L C~/lr~ /~,. /1~ US~L- and ~ ~ S ~ da of ~ y~'G/~'~ 'r' 2006. ~;~,d~c~ ~, ~tg~ ~ /' ,iu witnesses, this y 3= c.._ , (SEAL) -- Notary Public ''~ NOTARIAL SEAL '~ DAVID H RADCLIFF Notary Public LEMOYNE BOROUGH, CUMBERLAND COUNTY My Commission Expires Jun 29, 2008 5