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HomeMy WebLinkAbout04-08-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Faye S Hench also known as COUNTY, PENNS1YLIVANI~IA File Number 21 - jt1 "' V 37~~u Deceased Social Security Number 162-22-7369 Anita E. Lauck and Cind Fa a Forbes Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' BELOW.) © A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executors named in the last Will of the Decedent, dated 01/~0/20(1'~ and codicil(s) dated C`~~~nn~i~finn of Rare lf`P 1 I anort 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: IPV ^ B. Grant of Letters of Administration ~ws app rca e, en er: c..a.; ..n.c..a.; pe en e r e; uran e a sen ra; uran a moron a e .~ }, Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spot~gany) and~irs: ((~ Administration, c.t.a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list ofheirs.) ~~~~ ~ t -; Name Relationship Residence ~~ C? t" =' ~ ~ ~~_ ~ ~ j :~ tlt CD (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 5002 McDonald Drive Mechanicsburg, Hampden Cumberland, PA 17050 (List street address, town/city, township, county, state, zip code) Decedent, then _~~ years of age, died on 03/08/2010 at Harrisbur4 Hospital Decedent at death owned property with estimated values as follows (If domiciled in PA) All personal property $ 1,929.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 0.00 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 ' ~ - / . /` _ ~ Anita E. Lauck /' r ~~ ~ 421 &th Street New Cumberland, PA 17070 `~ ~~ `~ ~_ Cindy Faye Forbes ~~ ~ a L,, 5002 McDonald Drive Mechanicsburg, PA 17050 r6L(.!/ 7Ciyu'GL''X ~ ~ ~1Q /r i 2~ / ~~ / ~ya ~/J Form RW-U2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. 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 this i~~ V l day of ,, ;~~ ,, Fort Register Signature of Signatun: of Faye Forbes N File Number: 21 Estate of Faye S. Hench , Decea .... Social Security Number: 162-22-7369 Date of Death: 03/08/2010 x,. -= `- ~C ~:t' ~7 t rte- `.~=+ CO -~x ~ _:J 3 ,-; .~_~ ~ FTl .. _ .. c.If t.^ ,~ ~~ CD AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Anita E. Lauck and Cindy Fave Forbes in the above estate and that the instrument(s) dated 01/30/2003 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) ............................ $ $ $ $ $ $ $ TOTAL ................................... $ Form RW-OZ Rev. 10-13-2006 Register o/Wills Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Hummelstown, PA Telephone: 717/533-3280 E-Mail: glj@jsdc.com Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 James, Smith, Dietterick ~ Connelly, LLP 134 Sipe Avenue l~iU-U37~ 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 161_7_5880 Certiliunir_m tiurnber This is to L:err;l~~y ti~at the inJorn~ali~~n here ~>ive)~ 1`; correctly copied ~rctf3~ an original C'.rtil~icatr of Death duly filed ~~ith )nL~ _,< Luca; Rc~~i~trir The ori~~il~ai certificate will h~-: for'~a~~u-de~i t~~ the Stale Vita' Records OTfice ?~~) lYernianent filirr~,. MAR11210 Local Regl,t r~rr i`}7 ~ ~ ~ ~ >a L' r~T tt~'1 {{{'^^'~"""''y'' ~ -'. i ,"...., C~ ~ Cy C~ ~~~ ~ ~` ' ~ •-~,< Cd 3 REV 112006 PRINT IN RMANENT ACK INK 1. Name of Decedent (First, middle, last, wmx) 5. Age (Last Bmrwayl ~~° MomhS Yrs. 6b. County of Death in . rA~ ., n Kind COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NUMBER 2. Sex 3. Social Security Number 4. Dat f Deem (MOnm,l day, y6ap1 i/G~ Under 1 tle 6. Date of Birm Monm, da , a 7. Bi lace C' and stale a forei coon Ba. Place of Deam Check on one Other Hospital: fa Hoars MmUles ~ _ r~ 7 r J ^ Residence Peci '- / 7 ' / rr( k) ~' L'~ c° G~ • ~ ~ y ~~ InDalient ^ ER / Outpatient ^ DOA ^ Nursing Home ^ Other - 5 ty: rve sheet and number) 9. Was Decedent of Hispanic Origin? ~ No ^Yes 10. Race: American Indian, Black, White, etc. Bc. City, Boro, Twp. of Death 6d. Facility Name (If rrm instiNaon, g' (If yes, specify Cuban, (SpeayJt J r Mexican, Pueno Rican, etc.) ~~r! t ~~ re tlurin most of world IAe. Do rwt state retired 12. Was Decetlem ever in me 13. ecerknt's Education (Spedry Doty highest grade completed) 14. We"d18Dworoedn~Specrly)r Married, 15. Surviving Spouse (II wife. give maiden name) Kind of Business) Industry U.S. Armed Forces? Elementary I Secondary (0-12) College (1A or 5+) I ,Q CU /f~7 r-~r•:t~ /-/a x4.~.- ~~~ z I 16. Decedents Mailing Address (St/ree~t, city /town, state, z/lp~ code) . ~~Z7 CJ ~ ~ L ,~/ c/ ~CL~ p4+~ . ^ Yes ~ No / DecedenCs ~ Did Decedent ry h Np~ Twp Actual Residence 17a. State ~ Live in a 17c>~Ves, Decedent Lived in ~~ Township? 17d ^No, Decedent Lived within ClrylRoro 17b. County J ~ "" '~ A ~ fir'"'f' Actual LimAS of a 19. MomaYS Name (First, middle, maiden surname) 18. F~eYS Name (rlrst, micare, ras eon •rv .JOhCf G .3hum~+. k~~ 20a Intortnant's Name (Type I Printl 2ta. Method of Dispositon r ^ Cremation ^ Donation Burial ^ Removal Imm Sate r ~ ~drarnl ~amlrcer~l CtoroneYl died ^ ^ Other ~ i : 2; 22a. Signature of Funerel Service ee (or person acting as such) Complete items 23a~ only n ceniryinq physkian k not available at time of deem to cedity cause of deem. Items 2d-26 must he completed by person who pronances death 23a. To me best 24. Time of Deam yj /_ v/~ 7 M L cc ~: / ` 20b. Informant's Mailing Address (Sheet, city I town, stale, zip code) QJ' /YJr d/. Cs / J 21b. Oate of Disposhion (Month, day, year) 2IC. Place of Disposition (Name of cemetery, crematory or other place) .~ - ~~-•~o:~ Resf/coo..( G'e~~t~-'-. Yes^ No b. Lic~efnse Number 22c. Name arid A/dMess of Fac/il/i/Ity t ~F.i OI~ ~ "L ~' Gy 4/•!J'/~'G' Gtr ~. eiro • ~irC ,. ~r-J 23b. license Number the Mme, date end pkce stated. (SignaWre and title) 25. Da ~rvwnm,y%irro,r~~~~f CAUSE OF DEATH (Sae InstruNlons and examples) / ' ~""~ ~~~~-~ ~~-~ mat directry caused me Beam. DO NOT enter terminal evems such as cardiac azres6 r Onset to Death G b Item 27. Pan I: Enter me rho n of events ns ~ cet -diseases, injuries, or comp ~ n without showing me efiology. List Doty one cause on each line. ti ill fi respiratory attest, or ventr br a o k:ukr IMMEDIATE CAUSE (Fi al disease or death) I lt q /1 )~j.-r-r-2„ p;7,] r;; ,,3.~ t7 ~~/~~~~("/a;71")~(, ~ n ng condition resu a Due to (or as a consequence op'. ~) . i/ - SSeeppuenNalNlistwndAicns,Nany, b, leadingg to the ease ksted on 6ne a. Enter fhe UNDERLYING CAUSE Due to (or as a consequence otj. (disease m injury mat inriiatetl the c evems resulting m death) LAST. Due to (or as a consequence ot): d. th 32a. Date m Injury (Month, day, year) f D 320. Describe How Injury Occurred 30a. Was an Autopsy 3W. Were Aut ea aJnner o . M opsy Findings 31 PenomaN? Available ~ - , Prar to Completion Ld"Natural ^ Homicide ~. ,L VJar4,PN / 23c. Date Signed (Monm, day, year) 26. Was Case Refer~rt-.e-d~ ~to Medical Examiner I Coroner for aReason Other man Cremation or Donation? ^ Ves L~No but not resuPong in me undedyinq cause given in Pan I. ^ Yea ^ Probably ^ No ^ Unknown 29 If Fem e. of pregnant wilmn past year ^ Pregnant at time of tleatn ^ Not Dregnant, but Dregnant within 42 days of death ^ Not pregnant, nut pregnam 43 days to 1 year bebre death ^ Unknown J pregnam witnin the past year i 32c. Place of Injury: Home, Farm, Street, Factory-- Office Budding, etc (Specity) of Cause of Deam? 32d. Time of Injury 32e. Injury at Work? 321 It Transponaaon mryry ISpearyJ 32g. Location of Injury (Street, city I town, state) ~~----,, ~~ ^ Accident ^ Pending Invesdgadon ^ DrNed Operator ^ Passenger ^ Pedestrian ^ Ves C>yN1o ^Yes ^ No ^Yes ^ No ^ Sukida ^ Could Not be Determined M. ^ Omer -Specify: /. 33h. Sgnature and Title of Cenilier S / 33a. Certifier (check any one) , \ `/L-"~ ~ Cedirying physlckn (Physician cenirying cause of deem when anomer physician has pronounced Beam aM completed Item 23) - - - - - - - - - - - - - - - ~f 33d. ate S ed (Month To the best of my knowledge, death occumetl due to the cauae(a) and manner ea stated _ _ _ _ _ _ - - - - CJ 33c. license mbar , /~/ ~~ ~~ Pronoundng and eertltying physician (Physician both pronouncing death end cediryirg to cause of deem) . /([~ `- Tome best of my knowledge, death occurred et the time, date, and Plnce, end due to the cause(s) and manner as stated- - - - - - - - - - - - - - - - - - ^ GGee • Medial Examirorl Coroner ~~/)~1~ ~~ On the hems of exnminmlon and I or Investlgetion, In my opinion, death occurred at the time, data, and pkce, and due to the cause(s) end manner as sated_ ^ 34. N§mepnd Add~s~~rson o C /(;t! urn ath (lt TY 38. Dnat/a Eiled 1 m. der, year) /J (/fn•~/JJ p7 Regislrafs SgnaNre District Nu ~ I ~ l ~ l 02 l ~ l / I ,.7~ //~ d~d 0i7 J~ y . ' ~ / / 6~S"~ f~{J Disposition Permit No. 21 d. Location (Ciryltown, state, codpa) / /r: Last Will of FAME S. HENCH I, FAYE S. HENCH, the Testatrix, a resident of Cumberland County, Pennsylvania, declare that this is my Last Will. I hereby revoke all my previous wills and codicils. Section 1. Marital Status I am currently not married. Section 2. Children Article One ~.,~ ,,~, r = . ai Introductory Provisions ~ ° ~ ~ ~ ~ ~ ~ _; ; ~-~rn ~ ~ ~.. ~~'~ ~Q~ ~~ sa. ~ ~. 4`f3,~ ~' ~ = All references to "my children", subject to the exclusion of any child under subsequent provisions of this Section 2, are to all of the children so identified in this Section 2, but only to those children and any children born to or adopted by me subsequent to the execution of this, my Last Will. a. My Children The names and birth dates of my children are: Name CINDY FAYE FORBES DIANA R. GRIFFITHS ANITA E. LAUCK BERNICE L. LAPORTE Birth Date January 11, 195 5 June 2, 1958 August 4, 1961 July 5, 1966 Article Two Appointment of My Personal Representatives Section 1. Nomination of My Personal Representatives I appoint the following to be my Personal Representative(s) in the order of priority in which their names appear: ANITA E. LAUCK AND BERNICE L. LAPORTE, OR THE SURVIVOR OF THEM; THEN CINDY FAYE FORBES; THEN DIANA R. GRIFFITHS If, for any reason, the Personal Representative(s) named above are unable or unwilling to serve, the next successor Personal Representative(s) shall serve in the order of priority listed until the list has been exhausted. Unless otherwise specified, if Co-Personal Representatives are serving, the next named successor Personal Representative shall serve only after all of the Co-Personal Representatives cease to act as Personal Representatives. Section 2. Waiver of Bond No bond or undertaking shall be required of any Personal Representative nominated in this Last Will. Section 3. General Powers My Personal Representative shall have full authority to administer my estate under the laws of the Commonwealth of Pennsylvania relating to the powers of fiduciaries. My Personal Representative shall have the power to administer my estate under the Pennsylvania Probate, Estates and Fiduciaries Code. Article Three Disposition of My Property Section 1. Estate Planning Letter or Memorandum To the extent permitted by state law and not necessary to fully utilize my Unused Applicable Credit Equivalent, my Personal Representative shall distribute such of my personal or household items to such persons as I may direct by a written instrument signed by me and delivered to my Personal Representative. Section 2. Distribution to My Revocable Living Trust I give all the rest, residue and remainder of my property of whatever nature and kind and wherever located to the then acting Trustee(s) of my revocable living trust of which I am a Trustor known as the: FAYE S. HENCH LIVING TRUST, dated JAN 3 0 2003 ,and any amendments thereto. I executed said revocable living trust prior to the execution of this Last Will. Section 3. Alternate Disposition If my revocable living trust is not in effect for any reason, I give all of my property to my Personal Representative under this will as Trustee who shall hold, administer and distribute my property as a testamentary trust the provisions of which are identical to those of my revocable living trust on the date of execution of this Last Will, or as thereafter amended. Article Four Death Taxes Section 1. Definition of Death Taxes The term "death taxes," as used in this will, shall mean all inheritance, estate, succession, and other similar taxes that are payable by any person on account of that person's interest in the estate of the decedent or by reason of the decedent's death, including penalties and interest, but excluding the following: a. Any additional to the federal estate tax for any "excess retirement accumulation" under Internal Revenue Code Section 4980A. b. Any additional tax that may be assessed under Internal Revenue Code Section 2032A or 2057; and c. Any federal or state tax imposed on a Generation Skipping Transfer, as that term is defined in the federal tax laws, unless the applicable tax statutes provide that the Generation Skipping Transfer Tax is payable directly out of the assets of my gross estate. Section 2. Payment of Death Taxes Pursuant to the terms of my revocable living trust, all death taxes whether or not attributable to property inventoried in my probate estate shall be paid by the Trustee from my Trust. However, if my Trust does not exist at the time of my death or if the assets of my Trust are insufficient to pay the death taxes in full, I direct my Personal Representative to pay any death taxes that cannot be paid by my Trustee from the assets of my probate estate by equitably prorating and apportioning those taxes among the beneficiaries of this will. Unless specifically provided otherwise in my Trust, all death taxes incurred by reason of assets 'tieing transferred ouiside or m}- Trust or pro'o«te .,JLKte shin be assessed against those persons receiving such property. Section 3. Waiver of Right of Reimbursement Under Code Section 2207A I hereby waive my estate's right of reimbursement under Code Section 2207A. Article Five General Provisions Section 1. No Contest Clause If any person or entity singularly or in conjunction with any other person or entity, directly or indirectly, contests in any court the validity of this Last Will including any codicils thereto, then the right of that person or entity to take any interest in my estate shall cease and the demise of that person (and his or her descendants) or entity shall be deemed to have occurred prior to mine. Section 2. Captions The captions of Articles, Sections and Paragraphs used in this Last Will are for convenience of reference only and shall have no significance in the construction or interpretation of this Last Will. Section 3. Severability Should any of the provisions of this Last Will be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this will and all invalid provisions shall be wholly disregarded in interpreting this Last Will. Section 4. Governing Law This Last Will shall be construed, regulated and governed by and in accordance with the laws of the Commonwealth of Pennsylvania. I signed this, ::iy Last Will, cn JAN 3 0 2003 FAYE S. HENCH ATTESTATION CLAUSE On this JAN 3 0 2003 , FAyE S. xENCx, Testatrix, personally Published and Declared the foregoing instrument, as and for her Last Will and Testament, in the presence of each of us and all of us together, who, at her request, in her presence, and in the presence of each other, also signed the said instrument as witnesses. We further state that each of us believes that at the time she executed the foregoing instrument she was of sound mind and memory, of lawful age, and did so execute it as her own free act and deed and not under the constraint or undue influence of any person. Witness '~~~ r o ~1 ~ ~~ Street Address ity, State, Z'ip 1 Witness ~ ~ ;C~.~ 1 r~~.~~Sfi Street Address ~~~~. ~~.~ r~ ~ ~~~~~ City, State, ip COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN We, FAYE S. HENCH, ~.( {~'o lr'l ~ • ~'~/~:u~, ;~~ and ~~,~ C~ 1~` , tit ,the Testatrix and the witnesses, respectively, whose ~~ names are signed to the attached or foregoing instrument, being duly first sworn, do hereby declare to the undersigned authority that we were present and saw the Testatrix sign and execute the foregoing instniment as her Last «%ill; that the Testatrix signed it willingly, or directed another to sign it for the Testatrix, that it was executed as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the presence and hearing of the Testatrix signed the Last Will as a witness; and that to the best of our knowledge the Testatrix was at the time of sound mind and memory, of lawful age, and under no constraint or undue influence. x~~ FAYE .HENCH `~. W~ness Witness e SUBSCRIBED, SWORN TO and ACKNOWLEDGED before me, a notary public, by FAYE S. HENCH, the T esta>:rix, anti `~ C~,L )C1 and ~~~'~'? ~ ~ (, ~ • ~l ~ j~__, the witnesses, on this JAN 3 0 03 otary Public (SEAL) Notarial 5ea1 Linda L. Fatterhoff, Notary Public Deny'i~vp., Dauphin County My Commission Expires Nov. 8, 2003 RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA N 0 ~_~ Estate of Faye S Hench ~ ~ -r~ ap ~A ~::Y . ~ oa ;_~ -~~ ~ ~, Bernice L. LaPorte in my capacity/relationslT~rp as ~ ~~} (Print Name) of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Anita E. Lauck and Cind Fa a Forbes '=~-. tom.-~.-_ ~~"~^°) Bernice L. LaPorte 7827 Jill Creek Cove ~snrer ~a~~) Bartlett TN 38733 scar, state. zP! Executed fn Regfster's Office Swom to ar affirmed and subscribed before me this- daY of Deputy for Register of Wills Executed out of Register's Office Befare the undersigned personally appeared the party executing this renunciation and certified that he ar she exec tied the re nciafion for the pu ses stated wit~im on tt~cs,•.~--.day of ~ ~~- Notary Public J My Commission Expires: may. a-s-1 Z--~ (signature ene seal of Notary or ofhet official isles to admintisler oaths. Show fiats of e~katlan of Notary's commission) FWm RW-OB Rev. 10.13-200b Capyrlpht (o) 2008 form sofM`tu~ ~Y The L6dutlr GrCUP. Mc. ~,`~`~~~~~g~!!~ tf~~~~i////i G~ . c~1 A1~~. ~~ J~ s ~,~(~TRF~Y