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HomeMy WebLinkAbout09-25-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of MARIAN M. ADAMS File Number ~ ~ - ~ I - ~~~ry 1 also lrnown as Deceased Social Security Number 201-16-4626 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 /are the EXECUTOR named in the last Will of the Decedent dated 11-01-2000 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 (/fapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente liter durance absentia; durante minoritate) 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.) Name Relationshi Residence c~ t.._ n .rn - ~ a ...-- _... ~ - _ .; (COMPLETE lNALL CASES:) Attach additional sheets if necessary. - ' ' '~ . -`; ~~ -.: i ; ,- ~_ Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal re~d~g~~ ~'' ,~ . ~-- ~ ~ ~ 45 EAST NORTH STREET CARLISLE PA 17013 ~ -~ ~- (List street address, town/city, township, county, state, zip code) - ~ -'i N Decedent, then 86 years of age, died on SEPTEMBER 14, 2009 at CARLISLE REGIONAL MEDICAL CENTER (,~ S MIDDLETON TWSHP CUMBERLAND COUNTY PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 26,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 75,000.00 situated as follows: 45 EAST NORTH STREET, CARLISLE, PA 17013 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: T .UI~AA/%X -dh ; N I ~H- ~~ I ~UGLAS L. HALL, 26 BELLA[RE AVE., CARLISLE, PA 17013 Form RW-02 rev. 10.13.06 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 affirrm~ed and subscribed before me the ~S ~~- day of v~ ~ ~~~ . For the Register A Signature of Perso al Representative Signature of Personal Representative Signature of Personal Representative File Number: ~ - ~ - ~ $~ 1 Estate of MARIAN M. ADAMS n cs ~ - r~ ._~-~ ~ ~ ~ i-~'l t .. Cr7 -p -• Tl Z ~ P~ ~~ - ~.:' rl ~ N CJ; Deceased z r t it i Social Security Number: 201-16-4626 Date of Death:09-14-2009 AND NOW, ~ (~~ rr.IcL2ti ~5 ~ `~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY aze hereby granted to DOUGLAS L. HALL in the above estate and that the instrument(s) dated NOVEMBER 1, 2000 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............... $,~1G? 0 . (A~ Short Certificate(s) ........ $ i}c=` • ~-'~% Renunciation(s) .......... $ JCP ... $ t~ ,i;~ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $3~G ~'1: ~ Attorney Signature: Supreme Court I.D. No.: 22080 Address: 1 IRVINE ROW CARLISLE, PA 17013 Telephone: 717-249-7780 Form RW-02 rev. 10.13.06 Page 2 of 2 Attorney Name: WILLIAM A. DUNCAN OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It iss illegal to duplicate this copy by photostat or photograph. hee for this certificate. X6.00 //rte"`'-'~ == -I-hiti i~ to c~rtily th~lt the inf<)rmation here ~~iven is ,rrf'" ~jNOfp ,~ t~,P,---~Eiy?;- currrcll~' rir(~reLl Cr(,In an uri~~inal Certificate of Death yd``~~~~ ~ ~`~l duly filctl ti~iih me a.; Local 1Ze~~isU~ar. The original ~~' ~ z, cc)tllicatc will hr liu~~:u~ded to the State Vital ?vi ; a~ RlC(yrC, h)11icr IiIr hern).ihcnt filing,. * ' ~,,.a,~,~ ; ~, , ,t . _. P 15 7 3 0 0 0 4 ~~~~~9T ~ ~~a~~''r~ ~5~~. ~ ~~~~~ s Ep ~ ~ zoos '--.. MEND OF 11~, ----------- Cel"t1flCatl011 NUl7lher •~~°/yd~~" 1_Ur~ll )fie°_I,tilritl' Date Istiucd r`.i n d -r-~ ', -~- C7 -p ~ ; ; =m Iv --; .:_ -:T-1 ~ ~ i ?r- Za ;) -- ~. - ..- _ _ ~ 0 _i '=J _ j - ?~ fV Htos-t+3 REV nrzogA COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ' PeAyWPWR'EM" CERTIFICATE OF DEATH BUCK INK (See instructions and examples on reverse) STATE FILE NUMBER ~~ ~l 0 1. Name d Decedem (First, midtlle, last, sufix) 2. Sex 3. Socal Secumy Number 4. Dale of Death (MOnm, day, year) Female 201 - 16 - 4626 Se tember 13 2009 5. Age (Lass 8inhday) Unbar 1 year Undx I tley 6. Oale of BiM (Month, da , ear) 7. &dhplace (Cdy antl state or fo count) ge. Place d Death (Check ady one) 86 "°'"~' °"' "°" '"w"" Sept. 17, 1922 Carlisle, PA '"`P~' °tl1eC Yrs. [jgripadam ^ER/Outpatlem ^D0A ^Nureing Hama ^Residerica ^Omer-Specity: gE. County of Deam &. CMy T of Death ad. FaciAty Name (II not ImMulbn, glue atraet entl number) 9. Was Decedent of Hlspank Odgin? No ^ Yes 10. Rate: American IMian, &eck, WhA6, ek. Cumberland S. Middleton~rp. Carlisle Regional Medical Center (fn ~a,oa s (5°a"M e ett.) White 11. DecedeMS Usual free Kkd d wan G one dam most d IAe. Do not state redred 12. Was Detetlenl ever In the 13. Decedenf5 Education (Specity only highest grade comp leted) 14. Mandel Sb1lus: Mamed, Never Merdeq 15. Surviving Spo use Qf wile, give molders name) Kind d Work KM d Business I IMU6by U.S. Armed Fomes7 Elementary /Secondary (0-12) College (1 < or bi) W dON'~• Divorced (Specil)1 Waitress Restaurant ^Yaa t~No 8 Widowed 16. Ys Marling Adkass (Street, dly I sown, slate, ~ code) 45 E . North Street Decedent's Dd Decedent Aaual Reaidenca va. slate PA Lena m a no. ^ Yea, Decamm mad m Twy. Carlisle, PA 17013 ,m.coanry Cumberland TmmahlP? +Td.C}~NO.Decedenlutmawdmn Carlisle CiryrBoro Actual Umits of 18. Famer'a Name (first, midde. last, sulrix) 19. Momer's Name (Frst, middle, maiden sumeme) Lee Gibb Sarah Glass 20a InfwmenYs Name (Type / PnM) 20h. InfwmanYS MalArg Address (Bred, clfy I town, state, rip mde) Do las L. Hall 26 Bellaire Ave., Carlisle, PA 17013 219. Mamotl d Dispoalli9n ~ ^ Gremadan ^ Donation ' 21 b. Date d D19pceitlon (MOnm, d9Y, Ya9r) 21 c. Place d Dispoaitian (Name of cemetery, cremalwy w Omer plate) 210. Location (City /Town, slate, dp Code) p Barial ^ RemwalfromStale waacrmtetlonorporutlonAUtlbdzetl Sept. 17, 2009 Letort Cemetery Carlisle, PA 17013 ^ DIIIer ~ Speey: I M' kNdkal Exammm / Coron9r4 ^Yaa ^ No 22a. s~rawra d F person a,9kg as adth 22b. Ucense Nwnber 22t. Name arse Addreaa d Fadlm Hof fman-Roth Funera Home & Crematory , Inc -~_ 138425 219 North Hanover Street, Carlisle, PA 17013 Canplete dams 23a-c ody when certltying 23a. mt Lest d my krwM ,deem asurt al me fime, dale and Dlece stated. ISgnature aM IAIe) 23h. Lkerree Number 23c. Date Signed ( Ih, day, year) a~ eetdrtreddeamro ~ ~~ '~'t~ - D 5`3 8r / L 4 / a~ y dams 2426 must De cen9leled by person 24. Time dDea th / 25. Dale Prwwuiced Dead da year) ~ 26. Was Case Relerred to Medical Examiner /Crooner far a Beeson Other than Cremation or Dwlatbn? wM prawurxoa deem. G ! . ~ 7 ~ M. Gj / 9J ~ ^Ves CAUSE OF DEATH (See Inatruetbna end ezemplea) , gppmximate interval: Part II: Enter older sianificem candtions cwdndtin9 to deem, 28. Did Tobeao llse ConhihUe to lx m? dam D. Pad I: Eder me chtin d events - tiseases, injurles, w mlrpkradorls -mat directly caused the death. DO NOT enter lertnlnal events such as caldac artest, Ousel to Daam but nd resuding n me underlying cause yven in Pant ^ Yes ^ Pmbebly respirelary artesl, w ventik.War ffirAlatlon widaut showing th didogy. Ud Dory one cause on each litre. ^ No Unknown W TEre~CA~ IF ~ disease w T.. ' ~ 1 I _ ~ de ~p \ \ ' 29. d Fernela: ~ > i S _~ e. _3 (:ter C'Co''/ C F--~ ~ Due to (w a consaquenra oB Sepumb'~y hat carldtiae, g any, 6, ~ a,y f ~r,,1 ~.vi ~ i ~;W S t ~~ ~'~ NOt pregn9m wiWn Pasl ye9r ^ Pregam at tlma d deem leaden b h reuse Msted on Arse a. Due to (w as a con o Enter the UNDERLYMG CAUSE ~lu9n:e Q: ~,~""~~ rti w vjuy mat vitiated me (= ~ ,~,'~- U ((f~ ,~ ~~L'~.S r_ c~cYrvj \ ' ~ § reealdrg m deem) LAST. t ~ ^ Not Oregnem, but pr Jlant within 42 da s Y d deem Doe to ( a5 d COrI5agU9nCe Of): ^ Nd pregnant, do pegnanl /3 tlay5101 yVan d. helare deem ^ Unknown A preglwtt wAhin dre pall year :30a. Was an AMopsy 300. Were AMapry Endings 31. Manner d Deem 32e. Date of Iryury (Modh, day, Year) 326. Describe Fbw Inlury Occurted 32c. Place of Inlury: Home. Farts, SIreeL Factory, Pedmned? Availade Pdw b Canpletgn Imo( NaNml ^ Nomi.ide Office BuAdng, etc. (Speedy) of Cause of Death? y~ ^ Yes ~NO ^ vas ~ No ^ Aardent ^ Pending Inveslgatim 72tl. Tme of Inlury 32e. Injury al Won? 321. d Transpodatbn Inyury (Specity) 32g. Lxalion d Injury ISlreet, dry /town, slate) ^ Sukitle ^ Could Nol be Delemdrred ^ Yes ^ No ^ Driver I Operator ^ Passenger ^ PetlesMan M ^Other~ Specity: 33a. Certifier (dletM any one) 330. Sipre iAe d Cenifrer • Cedllying p6yaklen (Physkian certitylrg cause of tleem when anomer physkian has prareurx:atl deem entl completed dam 23) To mle beatdmy knowlMge,dem occurred duerot6e ceux(s)and manMr es abtaL___________________ _____________~ - / r/r • Pronounckg aM nrldylrg physklan IP6YSkian Gam prarowung deem and cerdtyirg to cause d dears) T t b t f k Nd d m d lm li d H M l M d t t d ^ 33c. License Number ~l - 33d. Dale S' ed (Manor, day, year) _ - - _ _ _ o ea o my now ee h ge, occurte a a me, e , a p ace, a ue o h eauae(a) an manner as eGbd_ _ _ _ _ _ _ _ _ _ _ _ • Medical Examkrer / Gro ner A ,1 q r~ 1" ` ~ , -// 1 . 4, _ I i `) a On die basis of examr tbn and! or investigation, in my oplnbn, tleeM occurred at the time, dale, end place, and due to the cease(s) end manner as sl9ted_ ^ 34 Name and Adtlress of Person yVFre Completed Cause of Deam (Item 27) Type / Print Iy , l ( S f / Iw t( ~^.Li~ 35. Registrer's Sgn District pale letl (Honor, daY, yeary -- 1 Disposition Pertnil No. yt~-~~' LAST WILL & TESTAMENT ~~ ..~ OF -: c..Y p cn ~-- ' I, MARIAN M. ADAMS, of 45 East North Street, Carlisle, Cumberland Ca ~ --a ~_ r~ Pennsylvania, being of sound and disposing mind, memory and understanding, do herel~y;~ake, ~' ` ~ ' publish and declare this as and for my Last Will and Testament, hereby revoking any'afi~a~; ? other wills and codicils heretofore made by me. ` ~ ~~~ c~ _ ~~ _~ n~ FIRST. I direct that all my just debts and funeral expenses be paid from my estate as ~` soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot located in Kutz Cemetery in accord with my expressed wishes. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death as follows: One-third unto my son, Douglas L. Hall, One-third unto my daughter, Charlotte A. Jakomas, per stirpes, and One-third unto my daughter, Barbara Keck's children, Arthur Keck, Jr., Patricia Seibert, Cynthia Bowers, Robert Keck and Michael Keck. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death as follows: One-third unto my son, Douglas L. Hall, One-third unto my daughter, Charlotte A. Jakomas, per stirpes, and One-third unto my daughter, Barbara Keck's children, Arthur Keck, Jr., Patricia Seibert, Cynthia Bowers, Robert Keck and Michael Keck. SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate as follows: One-third unto my son, Douglas L. Hall, One-third unto my daughter, Charlotte A. Jakomas, per stirpes, and One-third unto my daughter, Barbara Keck's children, Arthur Keck, Jr., Patricia Seibert, Cynthia Bowers, Robert Keck and Michael Keck. SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGHTH. I hereby nominate, constitute and appoint my children, Charlotte A. Jakomas and Douglas L. Hall, as Co-Executors of this my Last Will and Testament. I hereby relieve my Executors from the necessity of posting security in connection with their duties, as such, in any jurisdiction in which they may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executors, in their absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executors and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto set my~~,,h~~??d and seal to this, my Last Will and Testament, consisting of two typewritten pages thi%~'day of , 2000. oJc?n ''t. .\ - ~~ ~~, L. ,.~ ~'~~~~ . ~ ''..''~ ~ "_'1J ~~ ~'y~~~-ems ~t ~d ~~ MARIAN M. ADAMS Signed, sealed, published and declared by the above named Testatrix Marian M. Adams as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. -,_ COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF CUMBERLAND I, Marian M. Adams, Testatrix 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. ) ~~~/ MARIAN M. ADAMS Sworn or affirmed to and acknowledged before me, by Marian M. Adams this ~ ~ day of~el~; 2000. ~~~ NOTARfAL SEAL~ KATHY L. YUYYERT, NOTARY FUyLIG `- CITY OF CARLISLE, CUMBERL~.'~D CO., P.~ Nota k1Y COId"11SSION EXPIRES AUGUST 11, 2G' 1 COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF CUMBERLAND We (~~ l~,ryy, ~{ - ~~nc Q,~v-~ and ~,'~.c,~ ~ i~~'~. 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 Marian M. Adams sign and execute the instrument as her Last Will; that Marian M. Adams signed willingly and that Marian M. Adams executed 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 witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by (ti;'~ 1~.~~ncah and c~~~c~ L, ~~~ ,witnesses, this ~s~day ofAstel~,2000. Nota NOTARIAL SEAL KATHY L. IIUNMERT, NOL'~~;',' ~'~"~ • ; CITY OF CARLISLE, CUMBERIe ;~ ~,,~'„ ~~, YY COIIIIISSION EXPIRES AUGUST fit, sw