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HomeMy WebLinkAbout03-11-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Estate of M ~'~ ~ LL's-- ~ L ~~ ~ ~ --; also known as COUNTY, PENNSYLVANIA File Number ~ D` ~,~ Social Security Number ~ ~~ _"1 ~ " ~ ~ ~~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) ~ • A. Probate and Grant of Le ter Testamentary and aver that Petitioner(s) is /are the ~/ ~ ~" ~~` ~ las Will of the Decedent dated $ ~ 1 ~ ~ a a ~ i named in the and codicils} 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 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 liter durance Deceased ~'~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the follo~~~ Adrrtinistratiort, c. t. a. ord. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) t Name _ _ Relationship se (illy) an:l~etr~ (If (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was d micil~d at death in ~~ ~1 u ~ ~~'' ~ ~ "~ Count Penns lvania with his /her last principal residence at ~~~ M 1 L ~ ~(~S t~ N ~ t, y' y ~~~~~ ~~~ ~G< «««~~~~, ~uw,z~ry, township, county, state, zip code Decedent, then `y years of age, died on 3 , ~ ~ at Decedent at death owned property with estimated values as follows: (lf domiciled in PA) All personal property (lf 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: $,~~oo~~~,U~~ e Wherefore, Petitioner(s) respectfully request(s) the probate of the last Wil] and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: ature t"yped or printed name and residence 5~~ ~ ~.~ ~•J~ ~ ~ ~ ~ t~~f S (~ A~' ~.r, Erg ~~.~ Form XGV-OZ rev. /0./3.06 Page 1 of 2 Oath Of Personal Representative CO~I~fON',VEALTH OF PE;`r'tiSYLVANIA COiJNT~r' OF SS The Petitioner(s) above-named s~vear(s} or affirm(s) that the statements in tl-e foregoing Petition are tine and con-ect to the best of the kno~.~•ledge and belief of Petitioner(s) at:d that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and tn~ly adnii»ister the estate according to law. N Sworn to or affirmed avid subscribed -- ~ ~ ~'~=' before me tl~e _ ~~ day of '~ For thz Register " Signature of Personnt Rzprese~"tative Signature ojPersonal Representative S~g~tnt:u•e ojPersa"al Representative 4~t r ~ ~ ~~ ~ ~ ~ r. ..J.~ ~~ ~ a71 ~ ' i ~ '+'~' '.'~ . ~ .. ti ~,? ~' ~ Q'~ File Number: ~ ~ ' `~ `~ d ~~ ~ ~ `~ n ~ - ` Estate of 1 ~ ts.~,.i~t.~.~ ~ C.NC~--ri._`.~ ,Deceased Social Security Number: ~U ~ - `~ ~ ~ 3~ ~ Date of Death: ~ - 1 -- AND NO`vV, ~~--~'C-~-- ~ ~ , c~y t ~ ,inconsideration of the foregoing Petition, satisfactoi;i proof having been presented before me, IT IS DECREED that Letters ~ ~~0..'~.~'~a...~~t are hereby granted to ~~ctt~ (~,~ l2C? nS in the above estate and that the instrument(s) dated p ~' `~"~ 1 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Q ~ ~ n -.,~ FEES Letters ............... $ ~~~ . ~~ Short Certificate(s) ........ $ • ~~~ Renunciation(s) .......... ~ VCS ... $~~ v~ ... ~ ... ~ ... S ... $ ... ~ ... ~ TOTAL .............. S ~O ~~ • S~ Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Telephone: Regis ter of FYi!!s Fnrn, RFV-U' ,•~~. tai~.vr, Page 2 of 2 Z~l~ ~ C~~ ~, ~~ )~r~ ~ ~~ ~ ~ L~ %a- C~ '"~0 ~ 1 l~ OCAL REGISTRAR'S CERTIFICATION OF DEATH • WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 16194546 Certification. Number ;.r s,i REV tlr'2006 vPE PRINT MA PERMANENT BUCK INK 1 Nartr a Deceden lF~• nudar ~. suMul ~7 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. ~'-a -__--- ca _~__.__ __.._ ~ c _ 4 3 aU E.~ ~ .~.. ~~ ~~~ ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ~r ~ CERTIFICATE OF DEATH `~~-~ ~ '"" (See instructions and examples on reverse) STATE FILE Ntl Dar a own 1 v ~ ~\ "~ ace. Plan d Deam (Check any orrl _ . ... __ ._....__., ~ 1CAv Ara save a rorergn mruMryl „w_,. Y "~ ~,: `, ~- i ~_.._.' r~.... ~ :. r --"'i .w~. ~ ~ 0 Aqe Mast Betlaayl ~•••••• rawme ~ 7 •~ - __ - . bps ~ Y1ie» P ~ . ^ ^ ER i owpawnt ^ DoA ®Nwsn9 Nan. ^ Rard.na ~E~. ~~2, ~ 9~~ /~s~r~Mo2E , . aruc Onpul? (~ No ^ Yes a tiis u oNrr • spar. to. Race: Maven tndrn. Btad~ IANre. eta _ ^~ / rn. a IN ~ rruAlreon, gyve s0ep and num0srl am FacAAy R 8d p OerM 9. was De (N yeS, SpecAy CuOn, (~. t BD. Courry d Doan . 8c. CAy. Bono. Twp. d Daatn ~ / 21 IJT CQl= E K D(7 ~s ~ rX > ~ ~G M.ncan. Pwrb Rrcan. Nc.) E (N ~ ~ we nrrden dame) N N - C ~I M ACI~L-~+9 i - S i t d ER SPIe 1 n tM pecederA's Education I~fi aef' ~& 9r~ GOrt~ 13 ~) 1e ~~ ~' MB• t~rver MameQ Onorced (SpeaM dowad W , 5. w e. y Survrvng Spow l KAd d work da , ti. Decedpds Usual r most d Me. Do nd star reWed 12. alai Decedpll ever n U.S. Amwd Farces? . ErnrnrrY r Secaraary (0.12) CoMge (1J a 5+) , r W t hG l.J tE' Kea a wont (lino a 8usuwss + ardwW ^Yes IbIHo I~owiE • J D.ad~+W.d.+ ,s'i ~°„a,..°;~"" ,7 lI~Y« , ~-yE~2 SP~!^)GS T.o. ~,~ , Qp . ~. - 16. DeaderKS Yrr!q AOdreai (~, uty r town, stall. pD ~) ywy,~, Rssrdaee 17a. Sur Townptip? 17d. ^ No. Oecederlt LivW eieen gp rY11s-L.E~ GAP R~• '3 Eli R N D Acfrl t,tate d /-'1 ~' u ggreoro 1 m. c«aNY 1 - EN~~-a, Pte. t~o~5 19. MdMr' Madre IFS rtudde. maaen parwrrl 1>-. Fatirr"s NarM (Pint, mrddl.. lap. s(.~) ~~ ~ 1 ~~ R G ~ ~ i R GR E55 cad.) tall > . -0 oR ~; L L E / ` • 20b. kdormarA's MaAn9 AOdrKS (SUwI ~ ~ weer. s £ ~J a ~q P RD G ~ -ro a s PA . . 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Dar PrMprfeed Dead ( .day. ynrl `~( ^ Yes ~'l~ Name 2e•26 mup W campMrd W Derson r y e; j M. '~\~.~.2 ~ V C ze. Da Too.ooo we car0ur r o.an, ~ wra ~ aam ~ f r Appwsenale reerval: Pan N: ~ ~nprrrW n ~ ~~ arse ~^ n Pet L ^ Yr ^ ProDetly CAUSE Of DEATH (S+e Imtrucslone and .xatnpus) DO PIOT eraer temrrl evenly such ae cpdiac anew. ~ Onse1 to Dale ~ ^ ur,rM d n . ea Nem 27. Pn t: Enw tlr ~il0,.p1lYifNi - Ateaeee, eMA~• a aongYCaliar4 - tnp ~~ catwd NN fefpeawry aReet. a verArN.'ular ODrilaaon erM101N 71a'Mn9 dr .taeQ1. t1p ~ OM CaeM Or1 each IIM. r ~ I nW.~-7 W r ~~. t~ r I n '~ 29. d fempe: ~.,,p W.VrIN ...! pep pwr . ~Q,~/i,~-, J~--•-_ ~Fina1 ~aea S I U N ~ ~dbn~ , ,urr M Nme d dawr ^ p, q ndea ip co --i. C, d ~'0 ~ t~ a p ) ~w• WAG- ' ~ Due w for ae a -- ^ Rp pm9nsn. Out pelt(( rM e2 dMe ~ SeQuuIWYtip axrolrar. 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Type ,Prat 1 Q .~` i~r^-~-\] On Nr type d eaarnry0on and / a investgpion ~ a r) .C O M ~ aleF~ed:Maus 7aY (earl *(~TV~ V~'!1J`V•W t~ +JJ~Y ~ ~ ~~Q 1 0 1 1 ~y~ ) 1Q~~/ . ,ls rTaq.scra~ s ~ a ~ D~>tr ~ ~ ii / Disposrtiar PermA No. LAST WILL c7 r•a ~ ~~, , ., OF ~ o ~ . ; ~~'~ r°~ -~~ ~ ~ t. Y, ~:a MABELLE B. EVANS ~:: ::~ ~ _ ~:.: a .. .,.... . '.J~-~-- N ~ ~"~ r'~~ _...~ .. ,. ,7 I, Mabelle B. Evans, now domiciled in Dauphin County, Pennsylvania, d eclare this to be mya~ Last Will. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise, and bequeath all of my property, real, personal, and mixed as follows: A. Thirty (30%) percent of my estate, shall be distributed to my son, Scott W. Evans, provided he survives me by thirty (30) days. If my son fails to so survive me, his share of my estate will be distributed in equal shares to his issue who survive me by thirty (30) days. If my son, Scott W. Evans, fails to survive me by thirty (30) days leaving no issue who survive me by thirty (30) days, his share of my estate will be distributed to my daughter, Mary Louise Graziano. B. Thirty (30%) percent of my estate shall be distributed to my daughter, Mary Louise Graziano, provided she survives me by thirty (30) days. If my daughter fails to so survive me, her share of my estate will be distributed in equal shares to her issue who survive me by thirty (30) days. If my daughter, Mary Louise Graziano, fails to survive me by thirty (30) days leaving no issue who survive me by thirty (30) days, her share of my estate will be distributed to my son, Scott W. Evans. C. Forty (40%) percent of my estate shall be distributed in equal shares to my grandchildren who survive me by thirty (30) days. The distribution to each of my grandchildren shall be held in trust for that child's benefit under the terms and conditions set forth herein. Article IV In the event that any of my grandchildren are under the age of twenty-five (25) years at the time of my death, I direct that grandchild's interest be held in trust for his or her benefit as set forth herein: Page 2 of 6 A. Each trust shall be administered by my child who is the parent of the grandchild for whom the trust is created. B. The trust may be used to pay for my grandchild's post high school education expenses or any other need that my trustee deems appropriate for the child considering his or her age, education and standard of conduct. C. No distributions maybe demanded by a beneficiary and all decisions remain in the sole discretion of the trustee. D. When the beneficiary of the trust achieves the age oftwenty-five (25) years, the trust shall terminate and all accumulated interest and principal shall be distributed to the beneficiary. E. In the event that a beneficiary dies before termination of the trust, his or her interest shall pass to my remaining living grandchildren. Article V In addition to the powers conferred by law, I authorize my Executor, in his absolute discretion: A. to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, B. to manage real estate, Page 3 of 6 C. to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, D. to exercise any option or right arising from the ownership of investments, E. to compromise claims without court approval and without consent of anybeneficiary, F. to file any federal income tax return for any year for which I have not filed such return prior to my death, G. to make distributions in cash or in kind, or in both, and to determine the value of any such property, H. to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, and I. to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death. Article VI I nominate, constitute, and appoint Scott W. Evans, Executor of my Last Will and Testament. In the event of his renunciation, death, resignation, or inability to act for any reason whatsoever as my Executor, I nominate, constitute, and appoint Mary Louise Graziano to act as my Executrix. I hereby relieve my Executor, whether original, substitute, or successor, from the necessity of posting security in connection with his or her duties as such in any jurisdiction in which he or she maybe Page 4 of 6 called upon to act so far as I am able by law to do so. My Executor shall receive reasonable compensation for services rendered to my estate. IN WITNESS WHEREOF, I, Mabelle B. Evans, hereby set my hand to this my Last Will, on this ~©TN day of , 20 O1, at Harrisbur Penns lvani g, y a. Mabelle B. Evans, Testatrix In our presence, the above-named testatrix signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address ,,-~ ~ r . Pages 5 of 6 I, Mabelle B. Evans, Testatrix, who signed the foregoing instrument, having been dul Y qualified according to law, acknowledge that I signed and executed this instrument as m Will and Y , that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Mabelle B ~~vans, the Testatrix, this (s day of , 20~. ~ ~ .-. ~ ~ ~. TAR SEAL PA ~ IAA. PATTON, Notary Public Mabelle B. Evans, Testatrix Lower Paxton Twp., Dauphin Count ~y Commission Expires June 20, 20 2 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and volunta act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of a e of g, sound mind, and under no constraint or undue influence. Sworn to or affirmed and ~scrib~d t,Q before me I and ~ . ~ wit es, this ~~ day of _ , 20r~. NOTARIAL SEAL PATRICIa A. PATTON, Notary Public Lower Paxton Twp., Dauphin County My Commission Expires June 20, 2002 ~~~~ fitness Witness Page 6 of 6