HomeMy WebLinkAbout11-16-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF COUNTY, PENNSYLVANIA
Estate of File Number ~ - ~~ ' ~ d
also known as ~!,
Deceased Social Security Number o~ ~ ! o J~~~
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.) __ --~~,,cc,,
~A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ~~,.~'GG'(~C/f1 named in the
last Will of the Decedent dated 6-l S/-7'S/ and codicil(s) dated
(State relevant circumstances, e.g., renunciation, death of executor, etc.J
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
B. Grant of Letters of Administration
(If applicable enter c t a.' d. b.n.c.t.a.; pendente lile; durance absents;
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Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following'spouse (if any~nd heirs: f~
Administration, e.t.a. or db.rr.c.t.a., enter date of Will in SectionA above and complete list of heirs.)
Name Relationship Residence I
(COMPLETEINALL CASES:) Attach additional sheets ifneeessary. ~),A/l
Decedent was domiciled at death in aunty, Pe ylvania with is /her last pr' cipal es~ce at
(List street address, town/city, township, county, state, .:ip eodeJ q
Decedent, then ~ years of age, died on `~i2 ~ / at
Decedent at death owned property with estimated values as follows: ~/`~""'~' i}'
(If domiciled in 1?A) All personal property $ J~ ~~ ~~
(If not domici]ed 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 yndersigned:
name and residence
~;~~~ ;~.~t'~~-~-. I /biz ~,-, ~.[' ~'~r~ d'~ ~~ol~
FormRW-01 rev. !o.ls.o6 Page 1 of 2
Rw-o2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF f`~~~'~'t-~~~ .
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 and subscribed
before me the ~ day of
ry r~~
_ ~ ;~
---fir
_ For the Register
Signature of
Signature of Personal Representative
Signature of Personal Representative
a
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File Number: ~ ~ -' ~ q _ ~ ~ ~ ~
C7~ ~,
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- _ ~ ?° . s
~
~ C~ r--- ,~r~
Estate of , D~eased ~ '~"~ ~?
Social Security Number: ate of Death: ~
AND NOW,
having been presented before me, IT IS DECREED that
aze hereby granted to
_ " ~ irrthe above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. ,
FEES
Letters ............... $
Short Certificate(s) ........ $ l ~ • OU
Renunciation(s) .......... $ ~ U , UO
~(~ ... $ 1 ~. ~U
~iv~tsma.t-~ cm ... $ v. ~U
... $
... $
... $
... $
... $
... $
TOTAL .............. $ q:7 - ~5O ~'
in consideration of the foregoing Petition, satisfactory proof
Attorney Signature:
Attorney Name:
Supreme Court LD. No.:
Address:
Telephone:
Form RW-02 rev. 10.13.06 Page 2 of 2
RW-02
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 15691429
Certification Number
This is to certify that the information here given is
correctly copied from an original Certif: cote of Death
duly filed with me as Local Registr~~r. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
/~,~,,1__,~_rJ ~'' drr ~l~ ~~,,,
Local Registrar Date Issued ~
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS L7Q~ A _
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a CERTIFICATE OF DEATH ~C ~
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(See inetructlons end exsmplee on reveree)
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STATE FILE NUMBER
,
~ s7
1. Nerve d Deceaerd (Fktl, meddle, btl. edmr)
' 2. Sss 3. Satltl Seatlry NlaMer 1. m (Manor, day, Year ,v3 _.~.
(
ellen S
son Female 201 -18 - 0557 October 21 2
;.
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S. Ape (utl BirtlMey) Under 1 UMtl 1 S. Dent d BIM MaMh 111 7. erq eWe a fore Se. Plop d Deetl1 Check one
IAOnen DeYe Ildee AYnrM1 H~°'+tl: Omer:
" 87 vro. June 9 1922 llarrisbur Pa LM lna+nem ^ ER I oaglelbnt ^ DOA ^ Nurokq Home ^ R«idence ^ dMr . Speciry
- ee. Cauay d D«m lk. CAy, Mro, Twp. d Deelh Bd FeelNy None (tl rid inetllutlon, av ebest end darmd) 9. w« Decedent d Fhpank Ongb? No ^ Vu 10. Rea. Artwrban Indm, Bbck, Whiu, eb.
(s0•dA')
M
~
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East Pennsboro axl
mr, Pue
ro Rben, etc)
White
+1. DeoedenYe tAwr man d work acne matl d Ale. Do tat etaM 12. W« Deeded ever h the +3. DeoeaeM'e EdaWbn (Spedp ooh Iligh«t 9r•d• mmvbbdl 1/. Merllel Slabs: Married, Never Memed, 18. SuMVirg Spouse (II wife, give maide n name)
IoM d Work IDMd Brakuealirialuay U.S. Armen Fom«T Elementary I SecdWery (P12) Cdlege (1-/ or St) W~NBa' Diyorc« (SPedN1
Secrets AMP ^ v« ®Ne 12 Widowed
~ 18. DecedenYa McYkq Atltlr«a (Se«4 aY /tam, vela, rlp Dade) Decedenl'a Pa Dla Decedent
2117 Princeton Avenue A~ Reeklenn 17a. State T
17a ^ Y«' Dec~de"'t;vee" 7wp
Hill P
17011 ownship?
+n.coamy Cumberland ,7a.~
~utMivedwMin Camp Hill
a uelL CitylBoro
10. FetluY1 Name (Flrtl, nedtlle, lest, eulhz)
Paul Kramer 19. Motfar's Name (Flat. nedde, melee" wmeme)
Ellen N/A
20a. kllowned'a Name (Type I Pnml 2W. IMOmlyd'sMe9kg Adarou (Saetl, cAY / bwn, tlete, d0 cone)
21e. Aletlrod d Diepailbn i ~ Cramatlon ^ Donatlon 210. Wb d Diepoekbn (Ma,m, d•y, yur) 21c. Place d Diapuiem (Noma d amakay, cremebry d odwr plat.) 21d. Loceeon (Cey /town, stab, zip co0e)
• ^ o^lrar R.metlham~ab ~ y«YMEarMw caaner~Y«^ No October 23.2009 Ho1linQer Crematorv Mt Hollv SDr1nQS Pa
22a. larval liew« (- or tl~~9a wsh) 22b. Lirwa Nianber 22e. Name ant Adareae d FadNy
Cmpeb' 29eebdy a4ien oertllykp 23e. To the betl of my knowledge, a«m ocarred et tlr tlme, nab eM phce awed, (SpuNro ant ntlel 23b. tkenu Number _ 23c. Data S
~9eed (Month, aeY• Y•e<I
phyakian not aveibbb tl lbw d deem b
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ads
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~ 28. Wu Ceu Ralen« b McAW Euminer I Carawr for a Reason Omer then Cremeaon a Donekon?
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CAUSE OF OFJITN (Sea Inetructlone eM aaempNa) ~ Appmskreb Inbrval: Pan h: Eder otlw 28. Did duao Use Cadnbub to DeamT
Item 27. Part I: Enterthe drk, deven~ - duuaee, k~udes, d conpecelbnc ~ nut dreafy ceueee Iha d«M. DO NOT emar bmanal events aunt ea cardiac aneet~ i duet W DeaM
i but not rudf in tl~e undo
mg nykig ceu« given b Pen I.
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reepirotary em«I, or ventricular Abn3edon admaul ahowkg the etiobgy. Lint only one calve on eefi Ibe.
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E CAUSE 11F~met disease a
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(Aee«e a Yl)ur tMl kilbbd 9w a ~ '~ {~ r
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Due ro la u e
mwagana of): Nd pregnant, but pregnant 43 days to + yur
a. ~
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^ Unknown N prepreM wfawi me put year
30e. W« an Aulopay 30b. Waro Aubpey FMriAe 31. Mmmer d D«m 32e. Deb d InMay (Manor, day. ye.rt 32b. DeeMM How In)ury Oxuned 32c. Place d hkuy Home, Ferm, Street, Famory,
Penamed? AveiehM Prior b Canpelbn
,
^ Nahatl ^ Homblde Oleo &dMhg, etc. (SPedN1
d Cause d Deetli.
^ Acdtlent ^ Pendkp Irwuligeeon sza. Tkne d lryury 92e. Iryury tl Work'1 321. M Tremponatlon MaY (SpxVly) 32g. Lanalbn d kjury (SOU6 coy /town. tleb)
^ v« ddb ^ v« ^ No
^ Suidde ^ coda 11d M D.brmkae M ^ Y« ^ No ^ DM•ry0gwor ^ Peuwgx ^ P•0eeben
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• C•~YInD PhY•M•n Ian ~Ykq ww d duet velum erpnur phyaicien h« Manamcsd deem ens sanpktad Ntln 23) _ ~ L',) ~"g_.'1'!~'=_~.1..:.~'t-< ~\j`!., . 7~t;(
To Uu Mat a my br••'bd-6 tleetlr ocorerW dru to fhe eeueye) erM mrnw «ehbd _ _ -' _ -- _ _ _ -"' _ _ _ _ _ _ _ _ _ -' _ _ - _ _ _ _ _ ^ _.
• Oronourcing ant aAlyNg PNY•bien IPhyakier~ heel prarourarg deem ens artilybg b cum. d a«m) 33c. Lkenu Number 33d. Deb signed (Monet. a. year)
Toth Mtldmy bl••bdg•, death oanaredtltM tlme,deb, and pMo•,eM da.bnre aueye)end memw «etwd_ __-____ ^
• te.aetl Eaamkur/c•ra«r ------ {v~,'~ Q- 3 ~~- ~=~ f C 1 ~ t ~' `1
On tM b•W d •nmkrtlon end I ar Inwag.non, u my opnbn, ee.th ocaana at tM rim., d•b, •na p1.u, end au. to tM eetny.).nd m•nn•r u wnd_ ^ 31. Name em Ame« d Rxedr who Oe d Ikem (meet z7) Type /Rant
~^"" t 1 a t~',c~+~t.~ Tka~a 1vG-EmA
38. Regroar~~~~' ~ ~ 36. F)ba ( deY. Y•e~ 17~'(,. S'' .1L'it~' }
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Disp«Poon Permb No.
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
~~ ~ dg_ c~c~a
Estate of ~,~~~~/~` l ~"~-~~Z~, ,Deceased
l
~'I m-~~~
and ,
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well-
acquainted with
with the handwriting and signature of the decedent, and that the signature of
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
is in his/her own proper handwriting.
and am/are familiar
(Signature)
(Street Address)
D ~ ~ /~ ~. /7U~/
(City, State,"Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
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before me this f,3 day
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Deputy ~ r Register of Wills
p _
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Form RW-04 rev. J0.13.Oh
RENUNCIATION
REGISTER OF WILLS
~~ COUNTY, PENNSYLVANIA ~„a
G u - l C~
Estate of
/P,/ Si,
I,
Sim ~so~
~_ =~-'
o ~,? yc~
~~ ~ y~~
~- CIy ~ C~.-:; c~t
c~ ,~ecea~~,
v? ;_ u
in my capacity/relationship as
(Print Name) ~
~,.tJ of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
_~
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
befor me this r~ day
of a l~- `, E7'
putt' for Register of Wills
(Signature)
~r~Ce
(Street Address)
~~rLl o/
(city, stare, p)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this day
of ,
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06 RW-O6
RENUNCIATION
~ ra
~
~ ~ ~''
~ ~,~
`
REGISTER OF WILLS
r~ ~ ~
c+ 2 '~~
~~
-`
1Vnn~N~~ COUNTY, PENNSYLVANIA ~~jp = ~`; `~
c~~ =
al - 09 - lbl~a ~ t ~
~ ~ ,
0
Estate of 2 ~ ~l ,Deceased
I, t'/ / Y J • ~ ~ Vy~~7a , in my capacity/relationship as
~int ameJ ~~
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
fo IVo~e~b~~ , ~O~~C
(Date)
(Street Address)
C
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of ,
day
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
Executed out of Register's Off ce
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciatio,~ for the
posts stated within on this ~,~-I'- day
of IV~l1t~ YYI YLP 1/ _ ~1"Y\4 _
0~~. ~ c~
Notary Public
My Commission Expires:~(~ I ~~~ 20~
(Signatwe and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTARIAL tEAL
AMIAEE L RAtiND
Rw-O6 Notary h~bNc
rlAaalseuRa cm, awnuN couNTy
My commiulon Expit~t Apt 17, ZOl l
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LAST WILL AND T~STAN~NT `"'~"~ ~
c:~ n C~ y„
MARYELLEN SZMpSON `~~ ~
w
0
T, MARYELLEN STMPSQN of Camp Hi11, Cumberland County,.
Pennsylvania, declare this to b~..my.Last Will and Testament
hereby revoking any will previously made by me.
'7'7
~'.,
i""'I-"i L: i
~~~ L "9
"7 C.`)
rk
' .._~
I - I direct payment of my just debts and funeral
expenses out of my estate as soon as practicable following my
death.
II - I devise and bequeath my fourteen-diamond dinner
ring to my daughter, Valerie J. Hammacher. Should my said
daughter predecease me this legacy shall lapse.
III - I devise and bequeath all the rest of my tangible
personal property including household goods, ,personal effects,
furniture and clothing to my three children, Cambridge G. Simpson,
Valerie J. Hammacher and Mark S. Simpson, share and share alike
and my executor shall have the power to distribute this property
to my said son, Mark, even though he is under the age of eighteen
(18) years, without further responsibility to him.
IV - T devise and bequeath all the rest, residue and
remainder of my estate of every nature and wheresoever situate
as follows:
A. A one-third share to my son, Cambridge G.
ARNOLD, SLIICE & BAYLEY
ATIOINHYD AT LA~r
21(19 MA0.KET STREET
CAMP HILL, PEN NSV LVANIA 1~(Il l
Simpson. Should he predecease me his share shall be distributed
to his issue who survive me including afterborn issue. Should he
have no such issue, this legacy shall lapse.
B. A one-third share to my daughter, Valerie J.
Hammacher. Should she predecease me her share shall be
r
~~-- ~ ~ Page 1
__ ___ ~___ _ __ T
distributed to her issue who survive me including afterborn issue.'
Should she have no such issue this legacy shall lapse.
C. A one-third share to Cumberland County ~Iational~
Bank and Trust Company of Camp Hill, Pennsylvania, IN TRUST for
my son, Mark S. Simpson. The trustee shall invest and reinvest
the trust estate and shall have the power to distribute income
and principal to or on behalf of my said son for his health,
welfare, maintenance, support and education until he attains the
age of twenty-one (21) years at which time the remaining trust
estate shall be distributed to him absolutely. Should he pre-
decease me or die on or before attaining the age of twenty-one
(21) years, then his share shall be distributed to his issue
surviving him including afterborn issue. Should he have no such
issue then it shall be distributed. to my then living issue per
stirpes.
zy - The trustee is hezeby expressly authorized an,d
empowered in its sole and absolute discretion:
A. ~o purchase or otherwise acquire and to
retain, whether originally a part of the trust estate or subse-
quently acquired, angz-and all stocks, bonds, notes or other
securities, or any variety of real or personal property, includi
stocks or interest in investment trusts and common trust funds,
as it may deem advisable, whether or not such investments be of
the character permissible for investments by fiduciaries or be
unsecured, unproductive, underproductive or of a wasting nature.
Investments need not be diversified and may be made or areta~,n~d
with a view to a possible increase in value.. the trustee maX at
any time render liquid the trust estate, in whole or in part,and
hold cash or readily marketable securities of little or no yield
for such period as it may deem advisable.
B. To sell, pledge, mortgage, transfer, .exchange,
convert or otherwise dispose of, or grant options with respect to
any and all property at any time forming a part of :the trust
estate in such manner,. at such time or times, for such purposes,
fclr such prices and upon such terms, credits and conditions as
it may deem advisable.
C. To borrow money for any purpose connected with
the protection, preservation or improvement of the trust estate
ARNOLD, CI IKF & BAriEY 71
Arrouv>,n ~r Iww ' ~
2109 MARKET STR EFT / ? s
CAMP FALL, PENNSYLVANIA t?61I ~; ~• ~ .~_ ~ ~/f/fZ.fl~J
~yi7
~ 1 ~V
Page 2
whenever it, its judgment advisable, and as security to mortgage
or pledge any real or personal property forming a part of the
trust estate upon such terms and conditions as it may deem
advisable.
D. To vote in person or by general or limited
~~ proxy with respect to any shares of stock or other securities
held by it; to consent, directly or through a committee or other
~! agent, to the reorganization, consolidation, merger, dissolution
!~ or liquidation of any corporation in which the trust may have any
interest, or to the sale, lease, pledge or mortgage of any prop-
erty by or to any such corporation; and to make any payments and
~ to take any steps which it may deem necessary or proper to enable
j) it to obtain the benefit of any such transaction.
E. To hold investments in the name of a nominee.
.+x~.ro~.n, stinca a ennEr
A7'cbttt>rn sr 7w~v
i'109 MARKET STR F.ET
CAMP HILL, PENNSYLVANIA 1'011
F. To make distribution of the principal of the
trust estate in kind and to cause any share to be composed of
cash, property or undivided fractional shares in property differen
in kind from any other share.
G. To execute and deliver any and all instruments
in writing which it may deem advisable to carry out any of the
foregoing powers. No party 'to any such instrument in writing
signed by the trustee shall be obliged to inquire into its valid-
ity, or be bound to see to the application by the trustee of any
money or other property paid or delivered to it by such party
pursuant to the terms of any such instrument.
H. To allocate receipts and expenses to principal
;I or to income or partly to each as said trustee from time to time
'1 thinks proper.
k~
<~ T am authorized to
,~
.,
,.
'~ V - I appoint Cumberland County National Bank and gust
;t Company guardian of any property which passes either under this
I
;; will or otherwise to a minor grandchild and with respect to which
appoint a guardian and have not otherwise
specifically done so, provided that this appointment of a guardian
shall not apply to property distributable under this wz,~.l tQ a
minor for whom special provision has otherwise been made herein
and provided further that this appointment of a guardian shall
supersede the right of any fiduciary in its discretion to distri-
bute such share to the minor or to another for the minor's
benefit. Such guardian shall have the power to use principal as
well as income from time to time for the minor's support aid
education (including college education, both graduate and
Ij
~~ ~ R
Page 3
a,
undergraduate) without regard to his or her parent's ability to
provide for such support and education, or to make payment for
these purposes, without further responsibility to the minor
grandchild or to his or her parent or to any person taking care
Hof the minor grandchild. The said guardianship shall terminate
Ias to each beneficiary when he or she reaches the age of twenty-
~ one (21) years.
VI - All taxes that may be assessed in consequence
of my death of whatever nature and by whatever jurisdiction
imposed shall be considered a part of the expense of the admini-
stration of my estate and my personal representatives shall have•-
the absolute power in their discretion to pay the same at once
whether or not the law under which they are imposed permits the
postponement of all or part of them to a later time.
VII - I nominate, constitute and appoint my
children, Cambridge G. Simpson, Valerie J. Hammacher and Mark S.
Simpson, Co-Executors of this, my Last Will and Testament.
My personal representatives shall not be required to post bond
in this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
on this, the ~~~` day of u _ , 1974.
i
-.
,>
~~~ ~~ ( SEAL )
aryellen S' son
exiror.D, suxa ~ snn>~
A'I'I'ORNEYS AT LAW Page 4
2109 YAlKF[ SR861'
C~IQ Hai, P~a[~snvwwu 170t I
Axrrow, s~.ucE & ann~
A770~Ptlra ei Iww
21119 MARKET STR EFT
CAMP HILL, PENNSYLVANIA 1 x(111
Signed, sealed, published and declared by MARYELLEN SIMPSON, p
Testatrix therein named on this and four (4) other sheets of
paper as and for her Last Will and Testament in our presence,
iaiho, in her presence, at her request and in the presence of each i
other, have hereunto subscribed our names as attesting witnesses.
~r_._.___ ,- Name Address
~`
Name dress
Page 5
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