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HomeMy WebLinkAbout12-04-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF c~ Al a f=~2L,gNt~ COUNTY, PENivSYLVANIA Estate of __ ~~ 1"{~ ~aS ~H ~E~2Lt~S f ~ File Number ~ t ~ " ~ ~ ` ~~ also known as Q Deceased Social Security Number f 9~ ' ~~ ^ ~(C ~/ 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 ~.'1Kt-r u~y--r~,~ named in the last Wilt of the Decedent dated ~ / tz J za a 3 and codicil(s) dated ..~--- (State relevant circumstances, e.g., renunciation, death ojexecutor, 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: ~_ ~~) .,a ~;r ~ ys ^ B. Grant of Letters of Administration ,-~, (ljapplicable, enrer.• c.t.a.; d.b.n.c.r.n.; pendentellre; durance absentia; nt"noritatd~l ' '- ~~''77 Lf"= = =; ,^`'p Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followi if any~,rtd he~>~ ~~) Adntinistraliott, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~--~: *-; r°i Name ~ Relationshi e ~.. - ,_ ...»„ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in f VM(3Ln I,A.N1~ County, Pennsylvania with his / her l~st principal residence at $ ~(o t.~- CyM1~02C.A,N~ RoA~ ~ pk /~4ZS (~Ytfi~/~ri/M~B 'T7u-NSI~rP' (Ltst su•ee[ address, town/city, township, county, state, zip code) Decedent, then ~-years of age, died on /d 31 ZQO at __ __ ~ ~ 30 (° ^'1 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ ~ / t~ O a'7 -~ (If not domiciled in PA) Persona] property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 1./oM~ ~-~ Stc., W CCJ~gp«M.,h a rtn ~vo t_h Pq f 7 a ZS 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 T ePd or rioted name and residence .J ~ t>QL f ~ L.V 1 ZtSa 8 N u L a Fm~ut RYV-0? rer~. 10.13.oa Page 1 of 2 Oath of Personal Representative COMiV10NWEALTH OF PENNSYLVANIA COUNTY OF L~I.tM~~21_.~4~b SS The Petitiouer(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are hue and con•ect 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 - For the Register Signature ojPersonal Representative Signature ojPersonal Representative File N--u~m--ber: ~'''~'' 1 - I I ~~ Estate of Jdaf~tl ~o S ~i°H 1 ~~iQL.O Ste,! ,Deceased Social Security Number: f 9C~ •-/ ~ - '~ [o S ! Date of Death: I O ~ 3 1 ~ Lyd AND NOW,. ~ , ~U~, inconsideration of the foregoing Petition, satisfactory proof having been presented before me, IT S DECRE ~ thp~_tLe~jters T~S~inrten-4a~^u are hereby granted to ~.~l1Li.f ~ . L (1,(R,l~ and that the instrument(s) dated ! ~ ~gjj described in the Petition be admitted to probate FEES Letters ............... $~~ Short Certificate(s) ........ $ •~~ Renunciation(s) .......... $ ''- ... $ OD ... $ D.d~ ... $ ~5.~ ... $ .. $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~~U2•~a O in the above estate filed of record as the last Will (a~,d Codicil(s)) of Register Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: ha Telephone: Form RW-U? rev. fU.13.U( Page 2 of 2 ~. 4.9 imsos errs rovo,t ~ ~ _ O~ _'' ~~ 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 15691918 Certification Number 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 Che State Vital Records Office for permanent filing. ~~-vn-~ ~ ~ NO}~ 0 5 ~OOg Local Registrar Date Issued N to ..a ~ ~ :--~~ ~ ~~ =v f 'r'1 r°n t C~ ~i ~<- .~. r ~:~.. ~ © 3 REV 11/1885 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS I PRINT IN ~ I~ CERTIFICATE OF DEATH (See Instructions and exampka on reverse) srerc rn c w junco 1. Never d Decatlra (Fkal nYdrlN, Mel aldMl) 2. Sax 3. Sadel Seourky Murder {. Deb d Dam (Modh, day, year) John J. Perloski Male 190 _ ]8 _4689 October 31, 2009 5. Aq (teat Bktldey) IMder 1 lAldar 1 8. DeN d Bk81 Moreh 7. ell pall a Be. PNoe d Deem YxNdr aro 5 Modha Dave floue YenlAr ~ N el: Other, yre August 5, 1924 Sugar NDtch, PA [a InpayMt ^ ER ! gryNtlent ^ DOA ^ Nurekq home ^ Residerx;e ^ Oder - Speciy. Bb. Couey d Dam !k. City, Soro, Twp. d Dsem !d. FedBy Name (8 not klemutlm, pM street end nuMer) 9. Wa Deudere d NYP•nw ~^? NO Vee 10. Reee: Anwdcan Inden, Bleak, While, ex. CYmberlaTd East PenT3sboro Itap. (Y ya, epedly Cuhen, (Specdyl HDly Spirit Hospital Maxksn, Puerlo Rken, etc.) White 11. DeadaYa UauY Sod d work done Irol d Me. Do rld eWe ~ 12. Wa Denderrc ever m the 13. DepedenCe Eduutlon (Specify Doty hiptlal grade cmplWd) id. Merhd S1e6r: YNded, Never Mauled, 19. SunrNing Spouse (Ii wile, gh'• maiden name) Ked d Work Ne~d~a /In~IWry cloth Qttter Hbg. l1T>_ltren s Dress U.S. Amrd Forus? Elemadery ! $pmrMery (P72) CeYSp• (1-4 or 5t) Wldowed (SPedh1 ~ Ya ^ Na i11 15. Dendrirs Meikq Adana (shat ary! Nam, eNN, rip catle) 516 Wesr Qmberlatd Rd. D.cemnra PA Die Decedem East P e n n s b o r o T w AawlRaidenae ne. sNU l"°ma t7a.®va, Decedent livetl kl p'rwp PA 17025 Elwla rlaTd TownehVP 17tl. ^ No, Decedent Lnred wahin fro. co,mry , Actual LimYad cirylR«o 1B. Fdhr'a Name IFkat middle. Nbl, rdhxl Frank Perloski 19. MomeYS Name (First, mddle, meltlarl eumeme) Isabel Wroblewski 20e. mMnerl'a Wme (Type ! PINq Jeffrey J. Perloski 28b. tnNunenl'a MYI Address (Shat dy! bwn eleN, zp mde) 21508 forth Ruh1 Road Freeland, Maryland 21053 21e. Ma81od d I ^ Cremetbn ^ Danetbn 21b. DeN d ONpaitlon (MOdh, day, year) 21c. Place a DlapoeYbn (Name d amalery, ttemrbry a omr piece) ltd. location (CNy/corm, slate, zip code) ~ 14W1 ^ RerrlowlhomstaN ~ waCrametlon«DartlalAutllodad ^ omar- I lxy asset EernAlrlCaarrYl ^ Va^ No November 6, 2009 Gate of Heaven Cemete r'Y Mechanicsbur PA 17055 8 22a. St9^•aa d,FUnrd txervi~ licensee (« person wimp a such) 226. Lianas Nlmber 22c. Nelre ell Addae d FedYy ~.~ FD 012774-L Richardson F13neral Home Inc. 29 S. ETUOla Dr. ET1ola, PA 17025 ConpNte iWlre 23et only wMn arYlyep Deer amy knowNdge, dam ocanled at . deN all pNa elated. ISbNmre tltla) 236. liarm• NlenMr 23c. Date Signed (Mmm, day. Peer) plyakien u na avWbN n ma d dam N cersy slue d dam. /~ ~.t.~--~'' U ~ p I ~ I Y l¢ ,~ 1-- ~r,~ J~.~ ll~'- H7>y4'~ ,'~ +~.~1 v j Ilrrw 2{-28 muel be aorryMed by parem who ranux»a dam 2d~ Trne d Deem ~("~ ~ 25. DeN PArorlolslsed Dad 1 ~ d•Y~ Yom) iLn l ~ 28. Wa Caa Rderred N Medkel Exeminx /Caoar la a Beeson Od1er man Cramelbn or Danana7 ^ ~. p . ~' M. . -~a,r ~ Ya ~ No CAU86 OF DEATN (Sae IroWCtbela erwl exempNa) I ApproxNleN Nlervel: Pan II: Eder omr ' 28. Dp Tabeao Ua DanhIbllN N Dam? fan 27. Pen 1: Eller me - deeeas, irquda, «arrgeaaone - mel dkxMy uaetl me dam. DO NOT ewer bmlial ovate such a aNiec arrest, I Onsel M Deem I 61d not reaumrlp h the InltledyYlp teas piuen N Pad L ^ Va ^ ProheNy rapimary erred, «venhx:der BeNeYa wehad aMwinp me etiology. LNt only arse sue a all Yoe. I / 1 ^ No ^ Unkrnwn CCAA ~FwI /3.,/1 ~ /~ W 7A h~ ~1~~i~L-( reeul6rlg~deem) e 'mss ~~+' r~~~ ' _" - i ~~'~ ~~~j ~ ~~ 29. If Female: 9 f/ • ' ~ a. L "[.~7 ~ 1 I/~ F ~/ I ^ N h J~ r /~ ; / ~ Z9? v ' ~Yl' ~ ( ~ [~ d preganl wim pat year ^ Pregnant el nma d aem G . / 7 s~ w aargNw. a rry. t,. i ' J~ 7 r // 1 b 6Nd Y alts a oe e. I p y ( ~ ~ ~ i ~ Nd Dregam, nut preprlenl wnNn d2 days I ~,~ ,~ ~ ~ / ~ dW W m~kav CIet F~! V~Gr d w`J~ ; n /l, ~ ( ( Iri~Y d me axenN IaeUYly" 7n seem) u3T. o~ '/~c Y J of dam ^ CC((.. / r N (~• ~ ~~ Not prepnenl, but pregnant d3 days ro t year ` ~ I d' ^ Drxolavn I preplare Wldnn thB pBat Ye9f 30e. Wa n AuNpey 39b. Ware AuNpay Fildklpe 31. kkmer a Deets 32a. DaN d nMuY (Monet, day, year) 326. DeeaEe 11ow Nlury Occure0 32c. Plea d IrljurY Horne, Farm, Sbal, Faaory, PsdarnM? Avelede Pd« N Corrysetbn ^ klanad ^ ~ 08ke SuYdkg, etc. (Soxrly) d Gua d Deem? ~~ ^ Ya IJ Na ^ Ya ^ No ^ Aatidenl ^ PeMYIp klraapetlon 32d. Tyne of Ntlury 32•. NhxY el Work? 321. N Traep«NXon injury (SpeclyJ 32g. LacdNn a injury (Sired, dY / tmvn, dde) ^ Suidde ^ Could Nd be DeNrtrIYW ^ No ^ Ya ^ pNer/Dperet« ^ Peaenper ^ Pedatden M Oalar- Specfy: ., 33e. CerWler (dlea Doll' arse) *q crla d deem when enomar 6 akron Me lonanud dam end mm NNa tam?;Y) • C«+AmY pMeNNn ( adY 336. n TMIe a CedYNr 9 ~ ! p y p D To1M Mddery NawNdp•, deMh aoalrrad dlN atlN Uage)end me«rraehNd_________________________________ ^ ~ prornulleYlp ref artllyhq gMalaNd (PhyeicWt boel praaucxp deem ell nrlXyXlp N seas d deem) r~ Toth UeddmY kelowNdpe,d•rh aacrwredard»tke.,em,.ad p4u,rM daNm.aweye)eM mwlraeq«d__________________L.1 ~ ~ ~'!7"3 .. J7 ShIryIW2(Ma~n7my. day, Peer) '] V ~ ~~~ `~C71 ~ •Z~~~" I • YYgear ExrllMrfC«arw / L i f` [ on tlw save d eerNnetl•n end / «Nvadpetlon, In my opinion, eam oaurtad M dw INw, tle0e, ens pNa, end du N tM ceas(e) end merger a etaled_ ^ 3{. end Addraa/d~Peraan Wlw CanlneNtl Gua d Deem (hem 7) T ! Pnnt ~. Il t L L C Ca L'LL i~ a 66 h/ ~~'1 h ~ '77'1~ 1'~1•~ 35 R ub ~ d ~ l ~. ~ i L- J y ~ 7 (v ~ . eg er r / - I -;I I / I ~I ~ I _J 36. DeN Fllad (Meet, day, Year) /i /5~/~ao 9 ~.-, t-t ?.~J-- ~3.~-/ ~i "L ~-' Dispersion PennB No. ` ~ '~ ~ C/ ~ ~ ~~ .Z/-49- //Z~' ' LAST WILL AND TESTAMENT r (Pour-Over Will) OF ~ , ., JOHN J. PERLOSKI © ~-,,~'i, rn ~ ~.~ c ', £~' ;. Via' H)ENTITY I, JOHN J. PERLOSKI, residing in the County of Cumberland, Commonwealth o ~'s lva " " ~} y ~, ~-- rr~ being of sound mind and memory, and not acting under duress or undue influence y persa i `ca :;, whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby re~rke all otl~ ~' former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 190-18-4683. I have the following children: Jeffrey J. Perloski, born June 21, 1956, and JacquelineTaylor, born November 21, 1952, and JoAnn Perloski, born August 22, 1961, and Jeanne McBride, born May 11, 1963 DEBTS, TAXES AND ADNIINISTRATION EXPENSES I have provided for the payment of all my debts, expenses of administration of property wherever situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other than any tax on ageneration-skipping transfer that is not a liability of my Estate (including interest and penalties, if any) that become due by reason of my death, under THE JOHN J. PERLOSKI REVOCABLE LIVING TRUST executed on even date herewith (the "Revocable Trust"). If the Revocable Trust assets should be insufficient for these purposes, my Executor shall pay any unpaid items • from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allowances by court order. PERSONAL AND HOUSEHOLD EFFECTS It is my intent that all my personal and household effects were transferred to the Revocable Trust as a result of the Declaration of Intent signed this date. If there are any questions regarding the. ownership or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me this date in accordance with the provisions of the section titled "Residue of Estate." RESIDUE OF ESTATE I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including lapsed legacies and devices), wherever situated and whether acquired before or after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the corpus of the above described Trust and shall hold, administer and distribute said property in accordance with the provisions of the said Trust, including any amendments thereto made before my death. If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the • POUR-OVER WILL Page 1 Testator residue and remainder thereof to that person who would have been the Trustee under the Trust, as Trustee, and to their substitutes and successors under the Trust, described herein above, to be held, • managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to the period beginning with the date of my death as are constituted in the Trust as at present constituted giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such Trust by reference into this my Will. EXECUTOR I hereby nominate and appoint Jeffrey J. Perloski to serve without bond as my Independent Executor of this my Last Will and Testament. In the event the first named Executor shall predecease me or is unable or unwilling to act as my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint JacquelineTaylor to serve without bond as my Independent Executor. Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this my Will, such words and respective pronouns shall be held and taken to include both the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named herein and to any successor to substitute Executor acting hereunder, and such successor or substitute Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the Executor originally named herein. EXECUTOR POWERS • By way of Dlustration and not of limitation and in addition to any inherent, implied or statutory powers granted to executors generally, my Executor is specifically authorized and empowered with respect to any property, real or personal, at any time held under any provision of this my Will: to allot, allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract with respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all of the powers in the management of my Estate which any individual could exercise in the management of similar property owned in its own right upon such terms and conditions as to my Executor may seem best, and execute and deliver any and all instruments and do all acts which my Executor may deem proper or necessary to carry out the purpose of this my Will, without being limited in any way by the specific grants or power made, and without the necessity of a court order. My Executor shall have absolute discretion, but shall not be required, to make adjustments in the rights of any Beneficiaries, or among the principal and income accounts to compensate for the consequences of any tax decision or election, or of any investment or administrative decision, that my executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as Federal Income Tax deductions. • POUR-OVER WILL Page 2 Testator SPECIFIC OMISSIONS • I have intentionally omitted any and all persons and entities from this, my Last Will and Testament, except those persons and entities specifically named herein. If any person or entity shall challenge any term or condition of this Will, or of the Living Trust to which I have made reference in the sections "Household and Personal Effects" and "Residue of Estate," then, to that person or entity, I give and bequeath the sum of only one dollar ($1.00) only in lieu and in place of any other benefit, grant, bequest or interest which that person or interest may have in my Estate or the Living Trust and its Estate. SIMULTANEOUS DEATH If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively presumed for the purpose of this my Will that said Beneficiary predeceased me. HN J. P OSKI Testator This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving Clause, signature of Witnesses, and acknowledgment of officer. I have signed my name at the bottom of each of the preceding pages. This instrument is being signed by me on this /L 6~ day of • • POUR-OVER WILL Page 3 ATTESTATION CLAUSE • The Testator whose name appears above declared to us, the undersigned, that the foregoing instrument was his/her Last Will and Testament, and he or she requested us to act as witnesses to such instrument and to his/her signature thereon. The Testator thereupon signed such instrument in our presence. At the Testator's request, the undersigned then subscribed our names to the instrument in our own handwriting in the presence of the Testator. The undersigned hereby declare, in the presence of each of us, that we believe the Testator to be of sound and disposing mind and memory. Signed by us on the same day and year as this Last Will and Testament was signed by the Testator. WITNESSES: Yl/Qih.G~GC-L~wn /yr'd cc-~1 (Printed Name of Witness) ADDRESSES: ~.9 S~ ~'U~~- /Zd /// vi/(~ ~~ ~ City, Sta ,Zip (Printed Name of Witness} .c~ /!/0 ~~9. ~i~ X70,2 .s" City, State, Zip POUR-OVER WILL Page 4 Testator COMMONWEALTH OF PENNSYLVANIA • COUNTY OF CUMBERLAND SELF-PROVING CLAUSE ' . /BEFORE ME, the undersigned authority, on this day personally appeared JOHN J. PERLOSKI, W ~ N D ~ ANN ~5,t-o ~,J and ~• o u l's ~ ~ • S i~~, / E R- , lrnown to me to be the Testator and the witnesses, respectively, whose names are subscribed to the foregoing instrument in their respective capacities, and all of them being by me duly sworn, JOHN J. PERLOSKI, Testator, declared to me and to the witnesses, in my presence, that the instrument is his/her Will and that he or she had willingly made and executed it as his/her free act and deed for the purposes therein expressed; and the Witnesses, each on his or her oath, stated to me in the presence and hearing of the Testator, that the Testator had declared to them that the instrument is his Will and that he or she executed the same as such and wanted each of them to sign it as a witness; and upon their oaths, each witness stated further that he or she did the same as a witness in the presence of the Testator, and at his request and that he or she was at that time eighteen (18) years of age or over and was of sound mind, and that each of the witnesses was then at least fourteen (14) years of age. n J HN J. P OSKI Testator -..... • Wi~j e~ s //~~ /VGvi~*~[.~L (,Lt's-n ~K-d~-~- r~ (Printed Name of Witness) '~ Witness ~~~s~ c ~ , tip, ~v~ ,P (Printed Name of Witness) SUBSCRIBED AND ACKNOWLEDGED before me by JOHN J. nPERLOSKI, Testator, and subscribed and sworn to before me by t',t/A ,yl~ A- ,~(iy~/ /72aw.y and _ ~ ~ ~i ~ a)t p , S t ~ yE 2 witnesses, this the / 1t r1, day of `1Votary Public, C-ommonwealth of NOTARIAL SEAL JOSEPH G MARCOLY, NOTARY PUBLIC INDIANA BORO. INDIANA COUNTY • MY COMMISSION EXPIRES SEPT. 15, 2003 POUR-OVER WILL Page 5