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HomeMy WebLinkAbout02-16-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of LO U I S E A. GRAY File Number of ~ " ~ ~ -" (~ j 3"~ also known as LOUISE ANNA GRAY Deceased Social Security Number 158-48-1148 N. CORNELL GRAY and DAVID A. GRAY 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 00-EXECUTORS named in the last Will of the Decedent dated 12/11 /2006 and codicil(s) dated (State relevant circ•umstanc•es, e.g., renunciation, deuth of executor, 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: B. Grant of Letters of Administration (If applicable, enter.• c•.t.a.; d.b.n.c•.t.a.; pendente life; durante absentia; durante minoritate) 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.u. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) -e . L~ ~ ~...;_, ; _,~ ~p ~~ (yam ~ `T~ ~ .-~-, .- i,..= ..' r= .... ;~~:`.. J (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ `"~ •• ~- ~ ~~ 4 __ Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his /her last principal residence at ~ 735 OAK OVAL MECHANICSBURG PA 17055 (List street address townlctty township, coeenty state zzp code) Decedent, then 98 years of age, died on 1/14/2010 at BRIGHAM & WOMEN'S HOSPITAL T N A H TTS Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ _ 825 00 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: Signature Typed or printed name and residence ~.'~ ~ I N. CORNELL GRAY ~ Cam'-~•~ i i) 7 I- A A A I T LJ /'1 r- w 1 r r, r~ ~• ~.~--/\}~~~ DAVI D A. GRAY /' /17 C~1 111 A\ArY9 1'1n~~ it ..... ..._. .- . Form RW-02 rev. 10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA 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 well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the day of 2D1~ ~. For the Register .... $ .... $ 15.00 .... $ 23.50 .... $ 5.00 Social Security Number: 158-48-1148 ~ f ~ Date of Death: 1 /14/2010 AND NOW, ~ to , 2010 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IS DECREED that Letters TESTAMENTARY are hereby granted to N. CORNELL GRAY AND DAVID A. GRAY and that the instrument(s) dated 12/11 /200 in the above estate 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) Renunciation(s) ................. $ 610.00 ............ $ 24.00 WILL JCP AUTOMATION FEE Signature of P~ersona~l Representative~~- N. L RAY Signature of Personal Representative DAV A, GRAY r.~ Signature of Personal Representative ~ o -~. f T'{ 7 ~~ ~ ~ ~ - ~, t' ~ C -~ .'J ...w ,. ;_ cry ~ Supreme Court I.D. No.: 34838 • • • • $ Address: .... $ .... $ TOTAL ............................. ~, ,_,Cj File Number: l C~ 013'1 ~~ ~ c~ ~ ~ _. _ ..~-~, ~. ~ -~ ,,~~ ~ :' ~~o: Estate of LOUISE A. GRAY ~ ~ ~ ~~~`~ ; D~eased © ,,~ $ Telephone: $ 677.50 WIX. WENGER & WEIDNER PO BOX 845 HARRISBURG PA 17108 1717) 234-4182 Form RW-02 rev. 10.13.06 Page 2 of 2 Attorney Name: DAVID R. GETZ ESQ ~8isus,s~Td~ `''9 B®g~'®IYIIA N y ~®ND79'A®. '+~ ~<ry 163®. ,~~~~ `~Q'~fINE 1J0~~ REGISTRY DIVISION OF THE CITY OF BOSTON COUNTY OF SUFFOLK, COMMONWEALTH OF MASSACHUSETTS, UNITED STATES OF AMERICA .~.~ Certificate ~ No 9 7 4 6 3 I, the undersigned, hereby certif y that I hold the of f ice of ...................... ....... . City Registrar of the City of Boston and I certify the following facts appear on the records of Births, Marriages and Deaths kept in said City as required by law. ~je ~ommonb~eaCtlj of ~ia~gaclju~ettg ERSE SIDE) STANDARD CERTIFICATE OF DEATH REGISTRY OF VITAL RECORDS AND STATISTICS ( aS DECEDENT -NAME FIRST MIDDLE ` Louise Anna Gra _- ~ -- - -- _ ;. Death ile: ^ UU319 STATE USE ONLY 3T SEX DATE OF DEATH (Mo., Day, Yr.) Fem 3January 14, 2010 ~SPITAL OR OTHER INSTITUTION -Name (1/ not in either, give street and number) 4a Boston 4b Suffolk 4°Brigham & Women's Hospital PLACE OF DEATH (Check only one): SOCIAL SECURITY NUMBER IF US WAR VETERAN 11H~~..OSPITAL: OTHER SPECIFY WAR Inpatient ^ ER/Outpatient ^ DOA ^ Nursing Home ^ Residence ^ Other (Specify) 6 7 ~ O _ /. O _ 1 1 /. Q 7 _ _ _ ,Oa 98 b ~ ~ ~ ,od Feb 6, 1911 „West New York, New Jerse MARRIED, NEVER MARRIED LAST SPOUSE (If wile, give maiden name) USUAL OCCUPATION KIND OF BUSINESS OR INDUSTRY WIDOWED OR DIVORCED (Prior - ll Refired) 12 Widowed ~Jorman Nelson Gra 14a Homemaker t4b Own Home RESIDENCE - NO. $ ST , CITYlfOWN, COUNTV, STATE/COUNTRY ZIP CODE ,5a 735 Oak Oval, Mechanicsbur , Cumberland, Penns lvania 15b 17055 FATHER -FULL NAME STATE OF BIRTH (Il not in US, MOTHER -NAME (GIVEN) (MAIDEN) STATE OF BIRTH (ll not it name country) name country) gorge Frederick Goetz „New Jersey 16 Johanna Leeger 19New Jerse INFORMANT'S NAME MAILING ADDRESS - NO. 8 ST., CITYffOWN, STATE, ZIP CODE RELATIONSHIP 20 N. Cornell Gra 14721Manthorne Road, Boston MA 02132 22Son 23 METHOD OF IM EDIATE DISPOSITION FUNERAL SERVICE LICENSEE OR OTHER DESIGNEE LICENSE k BURIAL CREMATION ENTOMBMENT REMOVAL FROM STATE Robert M • Folsom 2 5882 DONATION ^ OTH.SPEC. 24 WAS DECEDENT OF HISPANIC ORIGIN? RACE (e.g. White, Black, American Indian, etc.) DECEDENT'S EDUCATION (Highest Grade Completed) (If yes, Specily Puerto Rican, Dominican, Cuban, etc.) (Specily) Elementanr Sec 0-12 Colle e 1-~~ ]$[NO ^ YES White 8a S eci Sb 9 2 AGE -Last Birthday UNDER 1 YEAR UNDER 1 DAY DATE OF BIRTH (Mo., Day, Yr.) BIRTHPLACE (City and State or Foreign Country) (Yrs.) MOS. t DAYS HOURS I MINS PLACE OF DISPOSITION (Name of Cemetery. Crematory ar other) LOCATION (Ciry/Town, State) 26a North Purchase Cremator 26bAttleboro, Massachusetts DATE OF DISPOSITION NAME AND ADDRESS OF FACILITY OR OTHER DESIGNEE 2M°~°anr)19 20.10 26afbFolsom Funeral Svc 63 Bel rode Ave Boston 29 PART I -Enter the diseases, injuries, or complications that caused the death. Do not use only the mode of dying, such as cardiac or respiratory arrest, shock or heart failure List only one cause on each line (a through d) PRINT OR TYPE LEGIBLY. IMMEDIATE CAUSE (Final disease or condition resulting a. Mesenteric 1 S C hem 1 a in death) ~ DUE TO (OR AS A CONSEQUENCE OFJ Sequentially list conditions, if b. atherosclerosis disease any, leading to immediate DUE TO (OR AS A CONSEQUENCE OFJ f' I"t~~ cause. Enter UNDERLYING _~ r'''}t~~ f.,,., CAUSE (disease or injury that c. °• initiated events resulting in DUE TO (OR AS A CONSEQUENCE OF) •['~. death) LAST =~. d. „-.~ f PART II -Other significant conditions contributing to death but not resulting in underlying cause given in Part I. WA~.A 't' C7 30 MED. EXAM. ,,~~44 MANNER OF QEATH DATE OF INJURY NOTIFIED? ~I NATURAL [I HOMICIDE ^ COULD NOT BE DETERMINED (Mo., Day, Yr) (Yes or No) n0 33 ^ ACCIDENT ^ SUICIDE ^ PENDING INVESTIGATION 35a DESCRIBE HOW INJURY OCCURRED PLACE OF INJURY (At home, LOCATION (No. & St., Ci farm, street, factory, office bldg.; etc.,) Specify Z 36a To the best of m inowledge, death a V cause(s) state I in (Signature l y = and Title W E ~ z DATE SIGNED (Mo.. Day, Yc) VZO 36b January 14, 2 LY at the time, dates and place and due to the 0 36c 9 ~ 10 A (res or rvt 31 35b era ~n me oasis of exam(nauon anaor mvesAgalion in m a w date, and place and due to the cause(s) stated. (Signature o < and Title E W z DATE SIGNED (Mo., Day, Yr.) OJD M ~ a 37b A 02131 Approximate Interval Between Onset and Oeath hers ,~.~ ~~~ v.^"°F' I AVAI PRIOR,~Q.. '`~ COMRLi80N OF Fa' 32 ~i0 t~~ ° ''~ 1 JURY AT WOR! es or No) M 35c nion death occurred at the time. 37c M PRONOUNCED DEAD (Hr) o ¢ NAME OF ATTENDING PHYSICIAN IF NOT CERTIFIER ~ w PRONOUNCED DEAD (Mo., Day, Yr.) ~ V 36d ~ ~ 37d NAME AND ADDRESS OF CERTIFYING PHYSICIAN OR MEDICAL EXAMINER (Type or Prinf) 36 Susan Hunt,M.D. 75 Francis Street,Boston,MA 02115 WAS THERE A IF YES, DATE IF YES, TIME 40d NAME OF PRONOUNCER PRONOUNCEMENT FORM? PRONOUNCED PRONOUNCED (Yes ar No) 4 Il 0 4 b 40c M DA B RI R. IT U D ~ RECEIVbp~N THE CITY/TOWN OF SSG A ~~D~~~ 1. ~ _. a /~ J~ t.~~ ~ CLE. 'S. ~~ 4 I further herby certify that byannex- a~isn,.__t-h,~Re~'ords the following- named cities. and to ns are in the custody of the City Registrar of Boston: - ANNEXED East Boston. ` ...................1637 South Boston~¢ .............. ....1804. -Roxbury ..........................1868 Dorchester.... ........... . .....1870 Charlestown Brighton .................1874 West Roxbury ~-•~- ~. Hyde Park ........................1912 WITNESS my hand and the SEAL of the CITY REGISTRAR on this.... .............>~~} b~.~i,l,..?01~..... ........... .A.•D. ~` / .................. .................................. ty Registrar By Chapter 31 of the Acts of 1892, "the certificates or attestations of the Assistant City Registrars sha~l have the same force and effect as that of the City Registrar." 37e M LICENSE NO. OF CERTIFIER ~'39 235333 TITLE ^ R.N. ^ P.A. ^ N.P. DATE OF RECORD JAN 2 0 2010 X 1063 ® 31 .. ~. LAST WILL AND TESTAMENT OF LOUISE A. GRAY I, Louise A. Gray, of Mechanicsburg, Upper Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, dm make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. Pro°vision for Taxes ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any property, shall be paid by my Executor out of the property passing under this Will that is not specifically devised or bequeathed as an expense and cost of ad~inistratio© f my Estate. My Executor shall have no duty or obligation to obtain reimburs nt for ~,y -~~~ such tax paid by my Executor even though on proceeds of insurance or otl ~ert~ot r ' ',~`~' passing under this Will. ~ ,- w ,TJ~ ~ ....~. ~~-.' =-~~ ..._ ~ . ` .~:... {_.~ Dispositive Provisions .~, ._ - ~-~ .. ITEM II: I give and bequeath all my household furniture and furnishing `~"~' ~~ automobiles, books, pictures, jewelry, china, linen, silverware, wearing apparel and all other like articles of household or personal use and adornment to my sons, N. Cornell Gray of West Roxbury, Massachusetts-and David A. Gray of Dillsburg, Pennsylvania, or if deceased, to their issue, per stirpes, to be distributed between them in as equal shares as practicable and as they may agree. If they are unable to agree, my Executor shall make such decision as to distribution. ITEM III: I give, devise and bequeath all of the rest, residue and remainder of my property, real, personal and mixed, as follows: (a) Three percent (3%) thereof to my granddaughter, Marilyn Louise Gray of Los Angeles, California; (b) Three percent (3%) thereof to my granddaughter, Janice Margaret Gray of Milburn, New Jersey; (c) Three percent (3%) thereof to my grandson, Jonathan David Gray of Falmouth, Maine; Page 1 of 6 (d) Three percent (3%) thereof to my grandson, Todd M. Gray of Seattle, Washington; and (e) The remaining portion thereof shall be distributed in equal shares to my sons, N. Cornell Gray and David A. Gray, or if deceased, to their issue, per stirpes. ITEM IV: If at the time of my death I am not survived by any of the beneficiaries named herein, I direct my Executor to distribute all of my property, real, personal and mixed, to those persons who would receive my estate had I then died intestate, a resident of the Commonwealth of Pennsylvania. Appointment of Fiduciaries ITEM V: I nominate, constitute and appoint my sons, N. Cornell Gray and David A. Gray, or the survivor of them, to be my Co-Executors (herein collectively referred to as "Executor"). ITEM VI: If at any time any minor child or legally incompetent person shall be entitled to receive any assets hereunder, I hereby nominate, constitute and appoint my Executor to serve as Guardian of the assets. Said Guardian may receive and administer all assets authorized by law and shall have full authority to use such assets, both principal and income, in any manner said Guardian shall deem advisable for the best interest of such person, including college, university, post-graduate or other education, without securing court order. Said Guardian shall have all the rights and privileges as to the Guardianship and the assets thereof as are herein granted to my Executor as to my Estate and the assets therein. ITEM VII: My Executor and Guardian are specifically relieved from the duty or obligation of filing any bond or bonds. P~~f~erc Qf Fid~!CiarleS ITEM VIII: In the settlement of my Estate, my Executor shall possess, among others, the following powers to be executed for the best interest of the beneficiaries: (a) To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interest therein, whether owned by me severally or in conjunction with other persons or acquired after my death by my Executor, and to consummate said sale or sales by Page 2 of 6 sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings that may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this Item VIII(a) or elsewhere in my Will. (b) To pay all costs, taxes, expenses and charges in connection with the administration of my Estate. My Executor shall pay expenses of my last illness and funeral expenses. (c) To distribute my Estate in kind or in money. !f any assets are distributed in kind, they shall be distributed at their respective value(s) on the date(s) of their distribution. (d) To retain any investments I may have at my death so long as my Executor may deem it advisable to my Estate so to do. (e) To vary investments, when deemed desirable by my Executor and to invest in such bonds, stocks, notes, money markets, real estate mortgages or other securities or in such other property, real or personal, as my Executor shall deem wise, without being restricted to so-called "legal investments." (f) To mortgage real estate and to make leases of real estate. (g) To borrow money from any party to pay indebtedness of mine or of my Estate, expenses of administration or inheritance, legacy, estate and other taxes. (h) To vote any shares of stock that form a part of the Estate and to ^then,~~ise exercise a!I the Mowers incident to the ownership of such stock. (i) In the discretion of my Executor, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the Estate. (j) To distribute my personal property directly to the Guardian of the person of any minor beneficiaries hereunder. Page3of6 (k) To elect such settlement options as deemed most appropriate by my Executor with respect to any pension, profit sharing or other retirement plan in which I am a participant. (I) To do all other acts that, in the judgment of my Executor, are necessary or desirable for the proper and advantageous management, investment and distribution of my Estate. Miscellaneous Provisions ITEM IX: I hereby exercise all powers of appointment that I may have at the time of my death in favor of my Executor, and all property subject to all such powers shall be included in my Estate. ITEM X: Any person who shall have died at the same time as me, or in a common disaster with me, or who shall fail to survive me by ninety (90) days, shall be deemed to have predeceased me. IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will and Testament, consisting of this page, the next two pages, and the preceding three pages this 1~ day of December, 2006. 7 fff-~,~Q~ Louise A. Gray Page 4 of 6 SIGNED, SEALED, PUBLISHED AND DECLARED by the above named Testator, Louise A. Gray, as and for her Will, 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 in attestation thereof. -..~. { ~ ,; ;' t ,~ ~--- - - ~---~ Address Address r. ~ Address ~.__ ~_ ~ti~L~ ~r~~~ .. / 4 t ~ S'~ - ~~ r ~1 ~ v J 1 ~ ~. 7~~~ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN I, Louise A. Gray, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Swarn to or affirmed and acknowledged before me by Louise A. Gray, the Testator, this II`~'`day of December, 2006. ~ (iii ~,,_~~•!'~~'*,<<,9'..~'N L;F PENNSYLVANIA ~~ ~~ ~lc9tarial Seal T-~a~ ~~.-ar (?yr~ings Baughman, Notary Public c~yt3~ czf ~~arrisburg, dauphin County ~ iViv ~'omrrrissior Expires oTuly 12, 2008 hA>~trr~t~,,,y ~'~nnsylvania Association of Notaries Louise A. Gray, Testator r/ / Notary Public My Commission Expires: :r/i~%2~~~ Page 5 of 6 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN W e, L ~ l~ ..~ , IPA ~ t~Z and ~ 'C I_ ~ ,the witnesses whose ames are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as her Last Will; that the Testator signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness, in the hearing and sight of the Testator, signed the Will as a witness; and that to the best of our knowledge, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by _~~,~.d ~ (~z , ~' '~1 itS~fi2 ,and `~~;~~ ic~~_~.~11_~fr.~~~ ,witnesses, this~~ day of December, 2006. ~ ; ~~~ Witness ~= i Witness .l 1 ~. ._ fitness ,-, Notary Public ~~ My Commission Expires: -~/iz/~r~~~' 1=:\dbw\WiIIslGray\Louise A. - Will.doc t (~ ~ ~ vr::~~i;i'-I OF PENNSYLV~~NIA Notarial Seal ~ Ilar~~a ~hving~; Raughrnan, Notary Public A~ity of Harrisburg, Dauphin County ~ ~r/Iy ~'om~r~ission Expires July 12, 2008 ~.- `1~~y~~;J~;, i"'.,nnsyivania Association of Notaries Page 6 of 6