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HomeMy WebLinkAbout09-30-09PETITION FOR PROBATE AND GRANT Ole LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of FERN E. HESS also known as Deceased COUNTY, )PENNSYLVANIA File Number~~ ~- CJ~-~ - C}! Social Security Number 174-16-0480 Petitioner(s), who is/are 18 yeats of age or older, apply(ies) for: :7 ca (COMPLETE 'A' or 'B' BELOW.) ~ O `~ ~ ` : , j c/) - ~~U - ®/ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executrix _ ; .,-, tested in the , 'i last Will of the Decedent dated December 7, 1983 and codicil(s) dated r -" ~ - i ~' - 1 T~~y~ __~t .1y __ (State relevant circumstances, e.g., renunciation, death of executor, etc.) _~ -' 7 '' v N ..-.:> 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}s#fered for probate, was not the victim of a killing and was never adjudicated an incapacitated person B. Grant of Letters of Administration (Ijapp[icable, enter: c.t.a.; d.b.n.c.t.a.; pendente liter durante a.5sentia; durante minaritate) 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 (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his !her last principal residence at 524 Orrs Bride Road, Camp Hill, Cumberland County Pennsvlvania 17011-1445 (List street address, town/city, township, county, state, zip code) Decedent, then 91 years of age, died on July 20, 2009 at ManorCare Health Services, 1700 Market Street, Camp Hill, Cumberland Countv, Pennsvlvania, 17011. Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 7,000.00 (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: Si nature T ed or rinted name and residence ` Jane E. Hess ~Q~~ ~ 524 Orrs Bridge Road Camp Hill, PA 17011-1445 Form RW-01 rev. 10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PEI~INSYLVANIA 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 wel l and truly administer the estate according to law. u Sworn to or affirmed and subscribed ~L~ ~ _~..~ ~' ~ before me the ~ day of Signatur ojPersonalRepresentative c ~~ - Signature of Personal Re resentative ~ ~ p ~ ,..-, • ,1~p ~ ~ Q ~ (~ ~^ c- s ';~ V7 ~ ` For the R ter Signature ojPersonal Representative T" C7 -- ; -O - r - r~'~ C.,} , 'i ... J ---i Q _ 'J .. ~-.J t ~a 't ' ~ File Number: ~ ~ - U ~ - ~ j ` ~ ~ ~~ . - N ,. j Estate of FERN E. HESS ,Deceased ~"~ Social Security Number: 174-16-0480 Date of Death: July 20, 2009 AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Jane E. Hess, Executor and that the instrument(s) dated December 7, 1983 in the above estate described in the Petition be admitted to probate and filed of record as the lastW_.i.~ll (and Codicil(;,)) of Decedent. FEES ~~ .~ i'1 r' ,~,~ r-l~~((~VL~ ~~ ~~ . ~ . ~ ~ .~ ~ v~ <y 1'i 1 C~~' $ 45.00 ~~' Regist ~ o Wills ~~ Letters ............... '> /1 Short Certificate(s) ........ $ 4.00 Attorney Signature: ~ ~/~Zp Renunciation(s) .......... $ ' Attorne Name: Linda J. lsen, Esquire m ~,tJ i .~ ~ . $ 15.00 y l~~ ... $ i(~ . ~~ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ 7 C(. (.~ b~QO Supreme Court I.D. No.: 92858 Address: Killian & Gephart, LLP 218 Pine Street, P.O. Box 886 Harrisburg, PA 17108-0886 Telephone: (717)232-1851 Form RW-02 rev. 10.13.06 Page 2 of 2 ~~ ~~ K H .OS 8(15 kCA' rn l!~?, G-2`i ~ _ ~ I LOCAL REGISTRAR'S CERTIFICATION IMF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.00 This is to rertif~~ that the information here rvt~n is con-cctly copied Il-om an ori~~inal Certi'icate (t1 Death duly filed with me as Local Re,istrar. The eri;,inal ccrtil~icate will he forwarded to the State Vital Kecords Office for per(nanent filing. ~~~ ~~ ~K~~~~x- ~u ~ /~l~n:~ Local Rc'zistrar Dzte [ssa~d Certification (dumber 1105143 REV 112006 TYPE I PRINT IN PERMANENT BUCK INK :~ I~ u 4n Y !V ~~ C ~ ~ c_a c-~ i `~ 1 , ;. 1 =r-1 ~ ~ "-~ ! ~ ~ "Z7 ,. .i7 ~ CT'1 W ~_ :..~ .. ~, ~ 1 1-~ N - ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NUMBER t. Name d Decedent (First, midde, last, sumx) 2. Sex 3. el my Number 4. Dale of Deem (MOnm, day, year 11~ 0480 Jul Female ~7~ 2 09 20 _ y , Fern E. Hess 5. Age (Last Brmeey) Under t year Under t day 6. Data of Birth (March, day, year) 7. BiMplace (City and elem or foreign man ) ea. Place d Deeth (Check only one) 91 "'""m °°" '"'" '"""°` August 16 1917 Hoapael: Diner: Youngstown OH ^Inpedent ^ER/Ompatiert ^DOANursing H0rr16 ^Resitlence ^Othm-Speciy: Yrs Bb. County of Deem &. City, Bom, Twp. of Death Bd. Fadliry Name gf not instimfion, give str9el aM number) 9. Wes Decetlenl of Hispanic Origin? ®No ^Ves 10. Race: Amedran IMian, BWCk, While, etc. Cumberland Cam Hill P Manor Care Health Services nfrea•wedtyc°ba"' P Ri ( M ite ~n,dc.) Mexican, Oeno 11. Decetlenl's Uauel ~ Kind d work d ine dud most d vurW Nk. Do oat stale re6r 12. Was Decedent ever In the 13. Oecetlent's Etlucetien (Spedry Doty nighesl grade cmnp leled) 14. Merlhal Status: Mertmq Never Martietl, 15. Surviving Spo use QI wile, give maiden name) Kud d Work Hind of Business / IMustry U.S. Armed Forces? Elementary I Secondary (0-12) College (1-4 ar Sr) Witlowed, Divometl (Specify) Home Maker Own Home ^Yea [~NC 12 Widow t fi. Decedent's Maieng Atltlress (9red, dry I town, state, zp coda) Decadence Dm Deretlam r~fY Ham den PA Llve in a 17c Decedent Lived'm P Tw Ves 17 A N l R itl Sl t " 524 Orrs Bridge Rd. p. . c e ee ence e. a e . L Y r atlip? Camp Hill PA 17011 1m. county Cumberland 17d'^ ~a,°~ ~tgw~w,mm cM/13am t fi. FatAer's Neme (Fast, mitltlle, lest, sdlix) t8. Mo Ys Name (Pint, b, meitlen sumama) ~ ~ Albert Engel inze innie 20e. InfommnYS Name (Type /Print) 20b. Inlartnanl's Meiling Address (Street, City I fawn stele, zip e) 11 Jane Hess 524 Orrs Bridge Rd., amp Hill PA 170 27a. Method d Disposition I ^ Gemaarn ^ Donation 21 b. Dale of Disposition (Month, day, year) 21 c. Place of Dispossim (Name of cemetery, crematory or Diner plain) 21 d. Loratbn (City I town, slate, zip mde) ® Banal ^ RemovellromSlate ~ w.ecmm,tlonorDOn.aonannnoH:ea July 24, 2009 Grandview Cemetery Johnstown PA ^omar - spea7y: by Medial lix.min.r / comrlarv ^ vea ^ Nn 22a. 5grraluredFyleml Service ~ acdng ace 2zb. license Number 22c. Nsme entl Addressd Facility Ho man-Rot unera Dine rematory - _ ir/ 138425 219 N. Hanover St., Carlisle PA 17013 Camglete Iterrw 23ec ady when certifying 23a. T bell f my krgwletlge, dam acwrred et dre dine, date and plain slated ($i¢ieNre entl tltle) r ~ 23b. License Number 23c. Det Signed (Month, day, year) a na mellabb at time d deem m ~ ~ ~ e q ©S o o ~ .~ 7 ~ carne d deem. ~ ~ G ~ herre 21-26 mull be oanpleletl by person 24. Time d Death Q 25. Dale Pmmunnxsd Dead (Monet, day, year) qq 2fi. Wes Case Pelerted o Medical Examiner! Coroner for a Raasan Other men Cremellon m Donetron? who pronmxrcwa seam. ~~ QOM. ~ y ^ Vas ~No CAUSE OF DEATH (See Inetructlona end e:emplea) r Approdmele interval: Pad IC Eder mbar sirylNlceM mrdtnrs comnbdinw to deem, 28. D'd Tobama Use Conbibde to Deam? Item 27. Pen I: Emer me chain d events - dceaees, iryunea, a canpl'ratians -mat mredty termed the deem. W NOT enter terminal evems such es cardiac ertesl, Onset m Deem but rml resulting in the uMenymg reuse given in Pan L ^ Yes ^ Probably resgretary ertesl, or ventrkuiar fibneedm witlqul shomng me etiology. Llsl Doty one cease m each lino. ^ UnNrwwn m~rMdro~mArcsulha g$n IF ~I)disease m .cam L des _~ a. J -{. r...~ ~/e 1 I _I /: s / +~ 29. II F le: i ~ Duet (or e m enc es t Pregllanl w thin peel year 1,, I ~., L~ }. ~ My est mMeiav, a arty, b. 'l Y 1 ( ~1J~ I l I (/17f1L/~ i ~ ~.$ ~ ^ P egnanl al Ame of deem betlxq dx listetl on lirw e. Due to Fnmr the UNDEIILYING LAUSE (or es a wnsequenc off: ^ Nat pregnant, but pregnant wimin 42 days (d6Bd8! a'ryuy Ihal inelebtl the ~ exen~ rewltry x, deem) LAST d aaam . Due to (or as a consequence oD: Nol M, but 143 da 1 1 ^ pregre pregnan ys o year d. belwa death ^ Unknown A pregned wimin me pest year 30a. Was M Autopsy 30b. Were Adapsy Findings 31. Manner d Deem 32e. Dale of Injury (Mmm, day, year) 32b. Describe How Injury Ocwmetl 32c. Plain d Mhay: Homo, Fertn, SlreeL Factory, Ponametl? Aveilebk Prbr Io Completion d cause d Daam? atmel ^ Homicide Oaice Building, em. (Speciy) ^ Yes ~ ^ Yes ^ No ^ Accident ^ PBMirg Irnestlgetbn 32d. Time d Injury 326. Injury et Work? 321. II Trensporletlon Injury (SpsrAyf 329. Lacel'wn of Injury (Steel, city I town, stale) ^ Suicide ^ CauM Nd be Delertnined ^ Yes ^ No ^ Diver! Operemr ^ Peeswrger ^Petleserlen M Omer ~ Spen'ry: 33a. Cenrrer (dnede mry one) 33b. azure e e of Ca ' CarlNying phydekn (Physi6en cenAN"g reuse d death when anomer physidan nos prenauncetl deem ald canpleled Item 23) Ta tlne beMd my knowledge, deem occurtetl tlue totM UUSNsl entl manlrer as smbd_________________________________ r Prortoundng and certlrying physlclen (PhYSidan f3om prorxlmlcirg deem and cedirying to cause d deem) T f m th li l h h b k l d d d d d ^ 33c. License Number 33d: Dale Siglmd IModh, deY year) _ _ _ - _ _ _ _ _ _ _ _ my now ee o t e est o e ge, occurre at e me, ale, an p ea, entl due to t e cause(s) entl manner as sUletl_ _ _ _ _ _ '' ``,, _ ~ - Msdkal Examiner /Coroner X1.7 (~ On me baeM of euminetlon entl / or Inveetkplbn, In my oplnbn, tleeM occurred el the tlme, tlMa, entl place, eM tlue to the ceurre(e) entl manner es abted_ ^ e aM Atl ress al Pe Comp10 Cause of Deem (Item 27) Type! Print ~ 35. Regislmi s tl Drs to Flletl (MOnm, day. year) ~ (e R-~ ~ Dispoaitlon Parma No. o3~f ~ ~' c~ ~_._ _ . _- ~, ., e, ,. _. -' ~, ~.,_ ` '~ t,_~ v~ ~ Cn ~, r- `~, ~- --~~'~ ~. ~_ ~ -`~ c.>:_. {__ -- , _, ~~`,:; , O~ LAST WILL AND TESTAMENT OF FERN E. HESS I, FERN E. HESS, of 2463 Berryhill Street, Harrisburg, Pennsylvania, being of sound mind, memory and Lmderstanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments, or Writings in the nature thereof, by me at any time heretofore made. FIRST: I desire and direct that all my just debts, fimeral expenses and the expenses of the administration of my estate, including all inheritance taxes, be paid by my hereinafter named i Executor as quickly and conveniently as may be after my demise. SECOND: I give, devise and bequeath th.e entire residue of my estate to my beloved daughter, JANE ELIZABETI HESS, or her issue per stirpes. THIRD: In the event my beloved d.aughte:r, JANE ELIZABETH HESS, has predeceased me without issue, I desire and direct that the residue ': of my estate shall be distributed as follow;: a) One-fourth (1/4) thereof to t1-~e FIRST CHRISTIAN CHURCH of Johnstown, Pennsylvania or the successor congregation thereto. b) Three-fourths (3/4) thereof tc- my sister, RUTH ENGLISH. In the event that my sister, RUTH ENGLISH, has predeceased me, I t desire that her share shall be divided as follows: 1) One-third (1/3) thereof ~chall descend to the FIRST CHRISTIAN CHURCH of Johnstown, Pennsylvania or the successor congregation thereto. ,, ,F, ,~ 2) One-third (1/3) thereof t:o my b w, .~ ~..a.-~,~, DISH, in the event he survives me. In the event he does not '': survive me, I desire that his share shall descend to TINA RUSSO KEYSER f i or her issue per stirpes. ~ 3) One-third (1/3) thereof f:o TINA RUSSO KEYSER, or e~ :Hess Page One of Two Pages. ~- her issue per stirpes. In the event that TINA RUSSO KEYSER dies without issue, I desire that her share shall descend to the FIRST i QIRISTIAN CHURCH of Johnstown, Pennsylvania or the successor i congregation thereto. FOURTH: I name, constitute and appoint my daughter, JANE ELIZABETH HESS, to be the Executrix of my esi~ate. In the event that daughter, JANE ELIZABETH HESS, has predeceased me or is for any ~ mY I reason unable to so act, I name, constitute ,end appoint my sister, l RUTH ENGLIGH to be the Executrix of my estate°. In the event that my sister, RUTH ENGLISH has predeceased me or is for any reason unable to so act, I name, constitute and appoint to be the Exeuctor of my estate the Paster of the First Christian Church of Johnstown, Pennsylvania. IN WITNESS WHEREOF, I, FERN E. HESS, have hereunto set my hand and seal to this, my Last Will and Testament., this _ ~ ~ day of ~~'-C.F'~vwt~-F=~~-` , 1983. `%~ `~,~r ~ ~%~ (SEAL) ern ess Signed, sealed, published and declared by the above named FERN E. HESS, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in 1the presence of each other, have hereto subscribed our names as witnesst:s. /,~/ ~ WITNESS: Address : /;.~ '~ ,~~~~ ~~.- ,~ 1.~~~'Ci :,;.. WITNESS •_~ ' Lc. -. Address :_ f , ~;~ '~ ~ ~C~~~~`..~ _.C (t 1 ~ l' y ~ i7 ,--~ Page Two of Two Page OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS ~~ nC~i ~l{~~ COUNTY, PENNSYLVANIA Estate of ~~/V C . ~ /~~ [[ l ~~ /~U~1~~C~- ~ ~ /~-Gt i1 - and (each) being duly qualified according to law, depose(s) and say(s) that ~-"` acquainted with 1' ~/V' ~_ ~~f s5 with the handwriting and signature of the decedent, and that the signature of ~~ l2/lr; (: ~ ~ s5 to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ref k~ L ~~'SS ~~,~'~i C . t+ ~ s5 is in his/her own proper handwriting. ~Sl~l(GI!!1'C'~ (Street Address) (City, State, Zip) ~-' Executed ii: Register's Office Sworn to or affirmed and subscribed before me this ~~ day of ~ Cft2 ~ ~.e.7~ ~, Ct/ /~ ~/f~~eputy r gis of Wills Deceased she / he /they was /were Well- and am/are familiar (City, State, Zip) N %7 '~ r.8 O - ~ - .a - ; _,~ ~ ~ ~ ' ~ ~r~ - i ~ ~ 1 -:C7 _ _-{ .C- -: `t ~ b ~ Form R W-04 rev. 10.13.06