HomeMy WebLinkAbout12-18-09 (2)PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C~~ COUNTY, PENNSYLVANIA
Estate of r~L-Nt,v"~~ L - ~AA
also known as
Deceased
File Number tT 1 _ U ~ ~ I 1 a'
Social Security Number t ~~'`-~~ - 1QOOo
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or B' BELO f3!
u A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / aze the ~ n t ~~ named in the
last Will of the Decedent dated ~? ~ N e(r ~a•, (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 bom 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
Qfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durance absentia; durance mfnoritate) ~
O .T.l
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following (if any) heir~~'1~- j
Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) `~ ~ ~ ~°-' 4-rj
. y'v'' .F' c.n `-
(COMPLETE INALL CASES:) Attack additional sheets if necessary. .~
Decedent was domiciled at death in ~ County, pe~rnsyly a with~his (her last pr ipal residence at
S.aRAjl ~ D~ ~ ~s •~~ iQO ~ i•JC~'1 TA . ~ Hl~l2
(Lut sheet nddress, tow~dciry, township, county, stnte, zip code)
Decedent, then _9s~ years of age, died on { at _ s/~ 1~Y/"1
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ ~~°~ ~
sitrtated as foll
Form RW-OZ r•ev. ro.13.06 Page 1 of t
Wherefore, Petitioner(s) respectfully request(s) the probate of the last W ill and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to
the undersigned:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
/~ SS
COUNTY OF ` (JM
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) wild well and truly
administer the estate according to law.
_ ~~
~
Sworn to or affirmed and subscribed \ .
Il~._
'Q.~
Signature oJPersonal Representative
before me the ~ day of ~ /~ ,
' ~
i Signature of Personal Representative ('~ ~q
C
Foi Register
Signature ojPersonal Representative
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File N~u^mber: C7`' (- ~ ~I
Estate of t7L~A~a~ L: ~~QQS
~~ 4
Deceased
Social Security Number:. ~7~. ZD'" GpGd Date of Death: ~~ ~ ~
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AND NOW, ,~_lQ('~, m -~ r ~ -i~n-~,conis~ideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters F~STt~I~LF/)-~£l
are hereby granted to ~ j}~ ~ ~~
in the above estate
and that the instrument(s) dated ~/(~~ % ~ ~(~
described in the Petition be admitted to probate and ilf ed of record as the last Will (and Codicil(s)) of Decedent.
FEES ~~
Register of Wil Z7~ f- ,
Letters ............... $ (- _
Short Certificate(s) ........ $ - Attorney Signature:
Renunc-
$ I /~ Attorney Name:
- • • • $ -~~~ ~,L~,L Supreme Court I.D. No.:
$ Address:
... $
... $
... $
' ' $ Telephone:
... $
TOTAL .............. $ _
For•nt RW-0' rev. IU.(3.06 Page 2 of 2
_ _
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H10~R95 RF_F 101/071 ~~ - ~~~-~.~
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 15690979
Certification Number
iEV t12oa COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
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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. Thc; original
certificate will be forwarded to the St;~re Vital
Records Office for permanent filing.
D`' OCT 0 6. 0~-
oc Re strar Date Issued
Dboodpon Pemlil No. ~.,° ~ ~ ~ ` `~
003359-00001 /5/3/01 /EGM/KLT/ 145764.2
~~~t~~ tll ~~d ~P~~~ritE~f
OF
GLADYS L. HAAS
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I, GLADYS L. HAAS, of East Pennsboro Township, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby revoking and making void any and all
Wills or Codicils at any time heretofore made by me.
ARTICLE I
DEBTS
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done. I direct that all taxes that may
be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary Estate as part of the expense of the administration of my Estate.
ARTICLE II
SPECIFIC BEQUESTS -HEIRLOOMS
I give and bequeath unto my daughter, DONNA L. HAAS ORZECHIOWSKI, of
Birdsboro, Pennsylvania, the jewelry, dishes and knickknacks which are family heirlooms having
belonged to my mother-in-law, Blanche Haas, provided my daughter survives me. If my daughter,
DONNA L. HAAS ORZECHOWSKI predeceases me, I give and bequeath the same unto my
granddaughters, KAREN S. HAAS, of Mechanicsburg, Pennsylvania, and KENDA M.
CARPENTER, of Niles, Michigan to be divided between them as they shall agree.
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003359-00001 /5/2/01 /EGM/KLT/ 145764.2
ARTICLE III
SPECIFIC BEQUEST -TANGIBLE PERSONAL PROPERTY
I give and bequeath the remainder of my tangible personal property (not including any cash
or securities) unto my son, E. ALLEN HAAS, JR. and my daughter, DONNA L. HAAS
ORZECHOWSKI in as nearly equal shares as practical as they shall agree. Should either my son
or my daughter predecease me, I give and bequeath the same unto the survivor of them.
ARTICLE IV
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate unto my son, E. ALLEN HAAS, JR. and my daughter, DONNA
L. HAAS ORZECHOWSKI, in equal shares, provided that should either predecease me, I give
and bequeath such child's share unto his or her then living issue, per stirpes, and if there be a failure
of same, then I give, devise and bequeath such deceased child's share unto my surviving child, or, if
deceased, to his or her then living issue per stirpes.
ARTICLE V
UNIFORM TRANSFERS TO MINORS ACT
In the event that any beneficiary of my Will shall not have reached the age of twenty-one
(21) years at the time for distribution of his or her share, distribution of said share may be made in
the discretion of my Personal Representative after considering the age and needs of the beneficiary,
either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to
Minors Act, 20 Pa. C.S.A § 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform
Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My
Personal Representative may designate as such Custodian any institution or person, including my
2
003359-00001 /5/2/01/EGM/KLT/ 145764.2
Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in
effect at the time such distribution is made. A receipt for any payment or distribution so made shall
be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or
be liable for, the application of such proceeds thereafter.
ARTICLE VI
APPOINTMENT OF PERSONAL REPRESENTATIVE
I name, constitute and appoint my son, E. ALLEN HAAS, JR., Executor of this my Last
Will and Testament. Should my son, E. ALLEN HAAS, JR., fail to qualify or cea$e to so act, I
name, constitute and appoint my daughter, DONNA L. HAAS ORZECHOWSKI, alternate
Executrix to complete the administration of my Estate, and should she also fail to qualify or cease
to so act, I name, constitute and appoint my granddaughter, KAREN S. HAAS, alternate Executrix
to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be
required to post bond for the faithful administration of the duties required in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, this ~ day of /~ , 2001.
(SEAL)
GLADYS L.
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
~~
3
003359-00001 /5/2/01 /EGM/KLT/ 145764.2
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
We, GLADYS L. HAAS, ~ ~m tnd c, _ .S~ ~~~ .c r~ and
~o t \ . n~~ ~ c3~ ~ _ ,the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will
and that she had signed willingly and that she executed it as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
GLADYS HAAS
Witness
f
Witness
Subscribed, sworn to and acknowledged before me by GLADYS L. HAAS, Testatrix, and
subscribed and sworn to before me by ~ fin-. , ~~, C~ . ,~ ~ , ~ ~-~ and
~. A~ c ~c-~ 1 l . C nisi c 1. a ,witnesses, this ~h day of , 2001.
Notary Public
NOTARIAL SEAL
MICHELLE M. BROSS, Notary Public
Lemoyne 8aouph Cumberland Co.
4 My Commission Expires Sept. 23, 2002