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HomeMy WebLinkAbout10-29-09IN RE: Estate of Richard Foutz, Deceased. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION SMALL ESTATE PETITION UNDER 20 Pa. C.S.A. &3102 To the Honorable, the Judges of Said Court: The Petition of Mrs. Debra Foutz (the "Petitioner"), wife of the Decedent, Richard Foutz, deceased, respectfully states that: 1. Richard Foutz (the "Decedent") died on October 3, 2004, a resident of 138 B Street, Carlisle, Cumberland County, Pennsylvania. He was fifty-four (54) years old at the time of his death. A Death Certificate is attached hereto. 2. The Decedent died of cancer. 3. Decedent died testate, but the will has not been probated and is attached hereto. He is survived by the Petitioner, his wife; Karla Dietrich, Amy Millwood, Jana McMinn, and Marcus Foutz, his adult children; and Matthew Foutz, his minor son. A Certificate of Concurrence to this Petition from each adult child is attached hereto. 4. All of the property in the probate estate of which the Decedent was seized at the date of his death was jointly owned by Decedent and Petitioner, save the following property valued as of the Decedent's date of death: The proceeds from one life insurance policy (#BL0973551) issued by the Beneficial Financial Group in the amount of $15,500.00. 5. There are no administration expenses, debts and taxes outstanding as claims against the estate. "" C"7 v -~C1 ~ 6. Petitioner is aware of no claims against the estate which are not admitte~~ ~~' <, ~ '_~ ' 7. There are no other parties known to Petitioner who have or represent an ` `~ - interest in the estate who have not joined in this Petition. `-;'=:; -~a '` - ~~ w -~, w Wherefore, your Petitioner prays your Honorable Court to approve disbursement of all proper proceeds to the Estate as set forth in the foregoing Petition and .discharge the Estate. Dated: /Q ~ l o~g ~ avid D. Vassilaros, Esq. Atty. ID# 203407 35 Clouser Road Mechanicsburg, PA 17055 (717) 620-9690 VERIFICATION I, Mrs. Debra Foutz, verify that I am the Petitioner in the within petition, and that all the facts contained in the foregoing petition are true and correct to the best of my knowledge, information, and belief, and that this verification is subject to the penalties of 18 Pa. C.S.A. §4904 relative to unsworn falsification to authorities. ~- i~%i~. Mrs. Debra Foutz Petitioner Date: /~ 02~ CONCURRENCE WITH PETITION FOR SETTLEMENT OF SMALL ESTATE I, ~ r(`i~ ~ ~ .l A7C~X'~C am an adult child of Debra Foutz and Richard Foutz, and I hereby affirm that I have read and understood the foregoing Small Estate Petition and that I concur with my Mother filing the foregoing. Small Estate Petition under 20 Pa. C.S.A §3102. Date: ~ Z ~ ` y ood CONCURRENCE WITH PETITION FOR SETTLEMENT OF SMALL ESTATE I, Y C C am an adult child of Debra Foutz and Richard Foutz, and I hereby affirm that I have read and understood the foregoing Small Estate Petition and that I concur with my Mother filing the foregoing Small Estate Petition under 20 Pa. C.S.A §3102. Date. ICar etrich CONCURRENCE WITH PETITION FOR SETTLEMENT OF SMALL ESTATE I, ~GC'S ' O~ ~ am an adult child of Debra Foutz and Richard Foutz, and I hereby affirm that I have read and understood the foregoing Small Estate Petition and that I concur with my Mother filing the foregoing Small Estate Petition under 20 Pa. C.S.A §3102. Date: -__ _. Marcus Foutz CONCURRENCE WITH PETITION FOR SETTLEMENT OF SMAL ESTATE I, .~ an a /~. C iVl t~n /1 am an adult child of Debra Foutz and Richard Foutz, and I hereby affirm that I have read and understood the foregoing Small Estate Petition and that I concur with my Mother filing the foregoing Small Estate Petition under 20 Pa. C.S.A §3102. Date:~~~ '~ ~' ~_. McMinn _ __ _ _ This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat ar photograph. Fee for this certificate, $2.00 P 10590563 No. tk~ H1Q5.143 Rev. 2187 ,.. Local Registrar OCT 4 2004 Date COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE nF n~eru TYPFJPRINr IN PERMANE eucK w O VI 2 W °w w D O STATE FILE NUM NAME OF DECEDENT (Feat MMda, Leal) SE% SOCIAL SECURITY NUMBER DA E T OF DEATH (MOnn, Dey, Yeah ,. Richard E. Foutz AGE (LSaI glMdey) 7' 4• DATE OF BIRTN BIRTHPLACE (Clry ^M _ Monih^ Days Flouw Minutes (Mash, DaY~ Year) State or Fa^ign Gantry) o X54 Yom. my 6 ,1950 Oceanside ~ CA Mp.r4 ^ E/UOaWtlenl ^ DoA ^ N•YrN ar,r ® ^ Reunrv flenre Iewdhl ^ CW NfY OF DEATH CITY, BORO, TWP OF DEATH FAGLITV NAME (B not InalElalan, qNe saeel end reanDer) WAS DECEDENT OF HISPA IC ORK,IN7 RACE -Amedan IrMlen, elatlc, WNN n , ' w. CLUnberland y , „ No~YearlUyecl ePWN CLDen, (SPacHy) ~ Car2191e Wtllte 138 ~ B Street M RNa l t ~ r ; e c. OECEOENI'S USUAL OACeC^qUPATION KIND OF BUSINESS! INDUSTRY AS DECEDENT EVER IN DECEDENT'S EDUCATION MARITAL STATUS - Mpnhd, ,8 SURVIVING SPOUSE ~ U.S. ARMED FOgCES7 tlsvsr M (elwerYplb; LibMw s rdW Vadti re re0l e Nad, No+N, sNe mrannem.> Yea ^ No~ Dlwrced (~OeclM) ' ,,.Atarrant Advisor „bAUtomob le Deale ,: ,s '°"' "~'""' . ,4. ,e. Debra Dee Blac OECEDEM'S MAILING ADDRESS (Street Gryrtawn, Stall, Zip ) DECEDENTS 17a. Sule 138 "B" .Street RESIDENCE PA a aaasm ,7e. ^ Yes, decedxn Wed in Mp. ,.,Car1i81ey PA 17013 on"oalere ,7b.Ceuyy C`ITI,IF,nrlanA toenehiP9 ,Td.~ "10tleCatla't~`"~ vdUlln ectuM Iimtte Gty/boro. FATHER'S NAME (Flaat MMdle. Leet). MOTHER'S NAME (Flat MIdAs, M^Wsn Summa) +,• rt Eddie Foutz ,, , IN E (TYpelPdrrp INFORMANTS MAILING ADDR (StreM, GIyROWn, $tna, Ap ode) xo.. Debra FOUtz m,, MLT ~ BIx~W ryF ~, C 1-L DATE OF DISPOSITION PLACE OF DISPOSITION• Neme at Cemstay, Crxnelory L TI N - Clty/TOwn, Slele, Zlp Code Don^tlon L•]{ L,itemov^I Iran SlM ^ (Mn+N. n•r. r.d or Olher PI^a :,• °"°r~p"m') ^ x,b October 9 2 x . ,a. ?e. SIG FU E. L U ASSl1CM LICENSE NUMBER NAMEANDADDRESS FACLLITV Hoff -Rath Funeral Home xxb. x2e. same ( ~ ~ n drs INna, deb ^rW phce sl^ LICENSE N MBER DA E SIGNED PNYalden Is rra evweda N tNna ar deem ro ro tl» " ~ /~ _ ~°~. ~Y vim) ar8y aces a ds^th. 2Ji fib, ! I!^ma 2418 mwt be eomPlated M TIM OF DFJLTH DATE P ONOUNCED DEAD (MOnW,~ WAS CASE REFERRED TO A M DICAL EXAMINER /CORONER? Parser a,ro pronances d.^W. 3 : 3 ~ ' - M. 26. M Yea ^ No ,~/ 27 F W^ PART 1 . n : r lYeru,tNudee•reon0lkWane•4r1•N erreN MdeeOi. De nel amwtlr er6e, dyYq, weh •. radYc or xnet, eh•eY erhxrl haler. LYt osy ea. m.ee eeeN err. ;Appratlmats PAR II: Older eipnBOenl conatlonecmmbutlnq to deaM,dA .interval rot reeubng In IM undedyirp uusa given in PART I. IMMEdATE CAUSE (FMN ~ oneel ^M death dNeasa a avrdNwn mulDq in deelh) ~~ e. M ~ ~' ~ } c..~- C L ~ G h.l L~ L'c v ~' 3epnrrtl^ry XY contlitlone b. e ^rry, Is^riq ro ennrs6^,s aT: aw^s. Enler UNDERLYING CAUSE (DWesadlryay °~ slat Mtl^tW avant raeulUnO an deser 1 LAST d. ( ~ WAS AH AVTOP$V WERE Al1TOPSY FMgNGS MANNER OF DEATH DATE OF INJURY TM1E OF INJURY INJURY A7 WbRK7, DESCRIBE HOW INJURY OCCURRED. PERFORMED? AVAILABLE PRIOR TO e4ma, p•y, yew ^ COMPLETION OF CAUSE Naa^91 ~ Homltlds ' OF DEATH? ~ Actldenl ^ Palling Inwstige8on ^ Vas ^ Nb ^ ~, M JOC Yss ^ No ®' Vu ^ No ^ 3Wtlde ^ Could rol be datamlined ^ 7 d a P UCE OF INJURY - At home, r in, ^Ireal feaory, olACe L ~ TION',(Stron, ClyRawn, SIaN) ~• ~- 2a. bpi ..l•, (e,rtlryl CE RTIFIER (Cne U a Ny a re) R p Ny g ~ ~ (phy n dr phv ~r^^ omn ourked tleaM BM completed itdm 27) • T° U~re ba! W my Im.wMap(, d~^^pl oee rr dw Mmtlle u~ r MM ~~ SIGNATURE ANO TITLE OF CERTIFI R .+yt,~ . i r^r ^Mf^d. ' TPR ~W~ ~ AND CERTIFYING PNYBICIAN (RryNdsn bah pnxlougrlp death yq cerdyhq p pyN o(deayl) my MnoWdO^ da^tl, oeeurr^d t N tl LICENSE NUMBER '. DATE SIGNED (MOMh, Dey, Vs~) , ^ ro me, d^Le, ^nd pl^a^, ^nd du^ to tll^ uwalq ^nd m^nn^r u ehhd ...................... ^ 7,e. M 4 O ~' i O L ' 71d. r^~Y ~4 'MEDICAL EItAMMERICORONER On th^ b^^h M ^xamin^tlon en WOI klvtltlp^dpn. M Im ogMOr4 oath OooI1RM ^t 1M tlm0. d^la, Nld p1^G, end dw M tll^ uu mnrr^rurt^tW .................. ` ~a NAME AND ADDRESS OF PE Vµ410 COMPLETED CAUSE OF DEATH Ilem 27) Type a Prkd M a ~ ~(4~ LF R„^(,J,• ,y~ J u ~ r ' ........................ ^ ],^. ........................................................................................................ . .. . . a~ Ys J o ~ N t: yLu lk [GQLCe.~ U-f 4 n.,,s 72 REGISTRAR'S SIGNATURE AND NUMBSI~\J (q,~~ ~ ~~ ~ 'f{'~~ 7J. GiaM1@ ~• \ ~ ~ K DATE FlLEO (Mardh, Dey ear) 70. n ~r L"~ -`' ~,q ~-~+~ .. 234~~mcalsr'Vk~y East ~ ~ YS"1~~.3.. t::r e~. ,f._. ~A '~ ~ - ~ 2' '$,.~'. 5 ;,,~' ~ ~ _ Sr-;lam ti _r~ ~:t^~ ~. ,s -- :u ~~~~ ~ ! -s u; _'25$-943 ~ ~ _ ~ + _ ~ _ ~ 'Chain Y - .' C i , L ~ , L .. _. ~ - ~ ~ ~ - .i.. . -~'~ ~ __... x`~~ LAST WILL AND TESTAI'-~NT OF I, Richard Eddie Foutz, of 130 B Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding do hereby declare this as my last will and testament hereby revoking all wills and codicils previously made by me. FIRST I direct payments of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable, for the purchase, erection, and inscription of a suitable marker in my memory. My personal representative shall have sole discretion whatsoever to purchase or not to purchase any such marker. Further, my personal representative shall have sole discretion to arrange for my body to be laid to rest in any manner as my personal representative shall deem practicable. - SECOND J ~~ I give my entire estate to unto my wife, Debra Dee Foutz. In the event that my wife, Debre Dee Foutz, does not survive me by thirty days, I give entire estate to any living children -~ who may survive me by thirty days in as nearly equal shares as practicable, and not per stirpes. In the event that my child or any children that I may have at the time of my death have not attained `~ the age of twenty-five (25), my estate shall be placed in trust by my personal representative for the support and benefit of my children who have not attained the age of twenty-five. My personal ,~ representative shall distribute my estate to any children that I may have in as nearly equal shares -- as practicable, and not per stirpes, once each child has reached the age of twenty-five (25). In the event that my wife, Debra Dee Foutz, does not survive me or is unable to care for any minor children that I may have, I nominate, constitute, and appoint my daughter, Karla Michelle Dietrich, of 2320 Enola Road, Carlisle, Pennsylvania 17013 as Guardian of the Person(s) of my Children, and as such, Karla Michelle Dietrich shall have the authority to make any decisions whatsoever that I could legally make regarding any minor child that I may have at the time of my death. FOURTH 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. ~,.--,, r _ ~..-~. r .,_-,,,.--_--~..~..~. e ~ I direct that no trustee,. executor, guardian, or otherfiduciary named, nominated or. appointed by this; my last cs~ll and testament, shall be required to post any bond or give a~~ security of any type for any purpose whatsoever, any law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. SIXTH In addition to powers conferred by law, I authorize my personal representative in his/her solute discretion to: A. Retain in the form received, and to sell either at public sale or private sale any real or personal property. ~ B. Manage real estate. ~~: C. Invest and reinvest in all form of property without being confined to legal investments, and without regard to the principle of diversification. `~ D. Exercise any options or ri hts arisin from ~ g g ownerstup of investments. E. Compromise claims without court approval and without the cons v ent of any beneficiary. ,,, SEVENTH I nominate, constitute, and appoint my wife, Debra Dee Foutz, 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 said wife, Debra Dee Foutz, I nominate, constitute, and appoint Alva Blackburn of 202 Fairway Drive, Mechanicsburg, Cumberland County, Pennsylvania, Executror of my last will and testament. ~~~~ ~~_ ~ or ~e .~ ~ ,~ , ~ *.~-c~ i ~ i a•" ~i.:h - a'n~: ~~ -~' " beef ~~ lure ~n -~ day- Q~ ` ~~ - ~ ~ ~~;~ Richard Ed ie Foutz Sued, sealed, p~bli$hed_ Fill and te~ament in the presence ~ d~decul/ oed~ his he Y above-named testator sight and prese~~ of each other, ha equest, in his sight and p~ enceoand n the hereunto subscribed our names as witnesses. ..~~F~, - ~ Address ~ ~j t3 5 `~ "~ ~ddress ~ j ~~~ic,~. ~~ Cc~r~~~ ~ Irll~' ~?v(3 ., .« L Richard E Foe3tz ~e testator u-Dose name is signed to the attached or foregoir~a in~rrumertt, hs~-ing been duly qualified according to Ian-, do herebyacknotivled~e that I signed :and executed the insrrurttent as my Iast v~-i11; and that I signed it v~~ilfingly and 'as my free and voluntary act for the gurg©sed therein expressed. We- n'~~1~ } ry cT1' and -r_;~: - , the witnesses whose names are signed to the attached or forgoing i trument, being duly qualified by law, do depose and say that we were present and saw the testator sign and execute the instrument as his last will; the testator signed it willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and the sight of the testator signed the will as a witness: and that to the best of our knowledge the testator was at least eighteen (18) or more years of age, of sound mind, and under no constraint or undue influence. ,~, Eddie Witness ,• -~ Witness COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND : SS w Acknowledgment and Affidavit Taken Before Attorney at Law On this -1 ~~ of 20p 4 ,before me, Pamela Mora, the undersigned officer, personally appeared, David Lopez, Esquire, known to me or satisfactorily proven to be a member of the highest Court of the Commonwealth of Pennsylvania, and certified that he was personally present when the forgoing Last Will and Testament of Richard Eddie Foutz was signed by the testator and witnesses. In witness thereof, I hereunto set my hand and official seal. N00MML IEAL RMAIU- MOM Nobs hifc CIMIItE 00R0110l1. C~IMOOOINflI M~- taaMNiMon ~~ fbv Z0, 2007 I~VlfJL0. Pamela Mora I, David Lopez, hereby certify that I was personally present when the foregoing Last Will and Testament of Richard Eddie Foutz was signed by the testator and witnesses, and this Acknowledgment and Affidavit is incorporated into the Last Will and Testament of Richard Eddie Foutz. s Lopez, Esquire