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HomeMy WebLinkAbout04-19-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA File Number "-=-' ~ /`~ ~~! -lam Estate of James H. Staver Jr. also known as ,Deceased Social Security Number 18630646 Nellie D. Staver Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' OR 'B' BELOW.) named in the a A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the eX2CUtor last Will of the Decedent dated 6/21 /2993 and codicil(s) dated none (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: n0 eXCeptIOnS B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente late; 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 ru Administration, c. t. a. or d. b. n. c.t.a., enter date of Will in Section A above and complete list of heirs. Reside c = Relationshi _ -} ~ - j ~C7 , , _._ -~-r r- _ - -'~ Cfi ~~~ - " i, _ - r ~ .... : i (COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at 127 Kline Road Shi ensbur PA 17257 Southam ton Tw Cumberland Cnt . (List street address, townlciry, township, county, state, zip code) Decedent, then 73 years of age, died on 9/15/2009 Chambersbu Chambersbur4 Hospital PA 17201 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 none $ 1.000.00 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 undersiened: Signature Typed or printed name and residence Nellie D. Staver Page 1 of 2 Form RW-02 rev. 10.13.06 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 f ,~ ~~ ~ ~ ~ E ° ~~ ~~f,~ II ~~ 1 i Signature of Personal Representative Nellie D. Stayer before me the -~ day of ~ - -- Anrll 7n10 Signature of Personal Representative t~~~^j --o ~ ~ t Signature of Personal Representative ~ ? ~-~ ~-~ y. ` or the Register ~-, ,~ -n ~ - _ _ ~Z w File Number: Estate of James H. Stayer Jr. ,Deceased Social Security Number:186306466 Date of Death: 915/2009 AND NOW, Aoril ~~~ , 2010 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testaments are hereby granted to Nellie D. Stayer in the above estate and that the instrument(s) dated June 21 1993 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. _ ~~ ~ ,~ ,~ i FEES Regtster -f Wil _ ~C..2, Letters 20.00 - `~ Short Certificate(s) •••••••~~••~ $ _ 4.00 Attorney Signature: Y Renunciation(s) ~~•••~•••••••~•• $ { Attorney Name: Jo I R. Zullin er /,, ic;S fee .... $ 23.50 Automation fee .... $ 5.00 Supreme Court I.D. No.: 17516 Will .... $ 15.00 $ Address: 14 North Main Street Suite 200 .... $ Chambersburg "" $ 17201 ••,. $ PA "" $ Telephone: (7171264-6029 .... $ TOTAL ............................. $ 67.50 Page 2 of 2 Form RYl' 02 rev. 10.13.06 OCAL REGISTRAR'S CERTIFICATION OF DEATH WAi~NING: It is illegal to duplicate this copy by photostat or photograph.. Fee 9~1r it~n~• ~.~enit ate. `*b.UU ___P__1584_8424._ C'cltifuai tyl) ~tif:n)he~ Mtd5~1i3 REd i12dPi TYPE I PRIM IN PERMANENL BLACK INK 1~ l%~, ri 0 This i, to ceriil~ :h~Lt tart lt)fnr;t+.~t(~r>n _ eil._r i'. c~or)ectly~ copied f)~ ~)t) art ~)i~inai C .,sltl~i_ i ' ta` r~)t:,a'. iluly~ filyd wiU~ i~i~. .I'~ l.o~~al I{c (~~1~~:) C;~t~ tl)~) i,)~i! certificate u'iil h,~, i<?nk,rr~le~i .,.. ,!atr ~~~rl' Record ~ Offire t~l,(~ ~rnr )etlt fill)?~_. ~, -- i ,/~ qq . /~Q (Y1e~_~~_f_`~1._-- Loc~ Re~~istr:u ~ I~.)t.~ Iti,(:cti co ~7© ~ - , ~ ~ t, `i~C7 ~ y C~ ~ ~,~ , (~ ~ ' , ~~~~ C ~ ~ , ; ' ya. ' , C> -mac ~ --- i"~'_ c..T-1i COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ a -- ' CERTIFICATE OF DEATH -t~~ „_. ` ~ ~i ICm inefrrrrtinnc And eYBTDI@S ON y0V0TSB) ererw ni w wiuwwa~ 2. Sex 3. Sand Secudly Number 4. Date a Dedh (MOnm, day, year) 1. Name d Decedent (First, mitlde, last, sufla) Ce 186 - 30 - 6466 Se .t. Ma 15 2009 . Jamey H. Shaven Jn. Age (Last Binhday) Under i year Under 1 tlay 6. Date d Binh (Mmth, day, year) 7. anhpace (City entl slate or foreign country) ea. Place d Death (Check only one) 5 Other: , uonlrts- Days ttwrs µmnn Hcepirel: June 12 19 3 6 S lu enb b PA ixJ Inpatient ^ ER / OulpeaeM ^ DOA ^ Nursing Home ^ Residence ^Other - Specity: 7 3 Yra. • 8b. County d Death ec. City, Boro, Twp. of Death etl. FadMy Name (N not indaulion, give alreet and number) 9. Was Decedent d Hispanic Origin? No ^ Yes In vas. spedN Cuban, 10. Race: American mdan, Bledc, While, etc. (sv~rt ccnh,Zi,n Chambendbung Chambeh.abung fiobpcta.b Mexican,PuenoRicen,dc.) Fn • (Uhite . Decedent's Usual Ibn Kind work done dur' most of waki life. Do rat state retired 12. Wes Decedent ever in ill 73. Decedent's Eduwbon (SpeiMy onN highest grade amgleted) 14. Marital Satus: Martieq Never Married, 15. Surnving Sparse Ia rile, give maiden name) WMowetl, Divorced I~dN) 11 . U.S. Amred Faces? Elementary I Sewntlary (042) Cdlege (1 A or 5a) Kintl d Woa Kind d Business I mdcelry ed Ne 12 Man~ci ?,~i.e Jon.e~, , Su eJCV.i,6an. Va,P~e uanni.ea ^Y~ ®~ Decedent's Meiling Address (Street, city/town, slate, dD cede) Decetlenfs PenYlb y.2vani.a. ~~d~' rrriy~ Sau~h.amp~an Twp. 17c. L-7 vas, Decedent lived n 16 . 12 7 K.P.i.ne Rd. Adtral Residence 17e. Sate Township? 17tl. ^ No, Decedem LMetl wkMn Qand Cumben /Bore Ci . Adua,Umilsa S6u:.ppendbung, PA 17257 t7b.Counry N t& Famrer's Name (Ftrst mMde, Iasi, suKa) 19. Mother's Name (First, midde, maiden surname) Heben2,i Loue~ta G Jame, H. S~avvJe, Sn. . . 20a. mremreM's Name (Type / Pnnq 20b. InfamaM's Meting Address (Street city /town, 6rete, sW ~) ne Rd. Shi enbb PA 11257 127 K.~i . Ne2,Pi.e S~aveJc oskun ^ Cremallen ^ Donation 21b. Dale d Disposition (Momh, daY• Y~r) 21c. Place d Disposkion (Name d cemetery. aemarery a other plxe) 21 d. Lomaon (City I Corm, slate, tip code) d d Dis M th p e o 2ta. ~Budal ^Remoral iron Sate ~~.~d'~nia0on oine~r?""°`~'d^YBa^NO Se ~. 19 2009 S ni.n H.iX.C Ceme~eh Shi en.abun PA 17257 ^ Other- Specify ~ 22a. ~ ref ectetg as such) 226. License NwrAer 22c. Name end Address d fadNty 014831-L Fa e,Cean en.-Bni.cken F`. H. Inc. PU Bax 336 Sh.i, endbun PA 17257 e Kerns n ~ irg 23a. To the best of my knowledge, death a:cuned et th time, date and places . (SigreWre end Mre) 236. License Number a not available at 9me d tleam re n - ~ ~ q .. 23c. Dale Sig (/Mont tlay, year) J ~d ~~ " 3 n ~", /v cause d death cen9 . y Time d Death 25. Dde Prortounced (Month day, ar) 26. Was Case rred Medcel Ezamirer / Canner 24 for a Reason Omer n Cremation or Daretion? . Kerns 24.26 must ce conpleletl by pew ^ Yes No wno pronarnces death. ~y. ~ M• CAUSE OF DEATH (See Instructions entl examples) r Appoximale intend: Pan II: Eller other saMf~cnt caMdbls caanbulino to tledh, wen in Pen L e n i d d 28. Did Tobacco Use CoMnbnte to Death? ^ Yes ^ Probady ng caus g e y ie u Kern 27. Pen 1: Enter the grain d evenLS -diseases, kqurles, or cemplicatgns -thd tltrecgy caused the death. W NOT ernar terrnkW events such es cardiac arrest, r Oreet to Deem bn not resd6n9 in ~NO ^ Unkrown respiratory erred, a veMncular faxillalion wshout showing the etidogy Lill ody one cause m eed~ lire. , r IMMEDIATE CAUSE (Final disease or ~ r ~~ caM9an resukirg m deem) _~ g ~ 29. II Female: ^ Na pregnant wkNn asst year Duet (or as tie ~ ^ Pregnant al time of tlealh Sequentialtyty list cendkbm, d any, b. ~ ^ Nd pregnant, bd pregnant within 42 tlays IaatlMgg to the cause kmetl on Nne a. Due o e d ~ r Enter are UNDERLYING CAUSE t of death - (dsease a kqury that inkleletl the c. r ^ Na Pregnant, M pregnant 43 days to t year events resulting m death) LAST. pus to (or r r helae death d. • ^ Unknown it pregnant within the past year 30a. Was en AWapsy 306. Were Autopsy Findings 31. Manner d Deem r 32e. Dale d Injury (Month, day, yea) 32b. Describe How I 'u Occurred rN ry ~ 32c. Place of Inury: Nate. farm, Sred, Factory, 0%ice &nMing, etc. (SpedlYl Penomed? Avaaade Prbr to Canpletim ofNalural ^ Hatticitle nl a Cause a Deam7 • ^ AcddeM ^ Pending Inwrstigetbn 32d. Tine d Injury 32e. Injury et Wak? 32O ~t 32g. Location of Injury (Bred, city /fawn, state) ^ Yes IYI No -iY' ^ Yes ^ No ^ Yes ^ No serger ^Pededdan Driver l Opereta ^ ff ^ Sukitle ^ Cadtl Nd be Detemuced M ^~ ~~ 33b. Sig re end Title d CeNiler 33a. Cenaler (check oMy one) • Cerldyfng physician (Physician cenilyklg cause d tleam when another physidan has Pronounced deem ell cortplded Kem 23) , To the best d mY knowledge, death occurred due to the cease(s) and mercer as suled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ __ _ • Pronouncing and cenlNing physician (Physkaan bah praaundng deem and ceniying to reuse d death) 7o the best of my knowledge, death oceurretl d the time, tlde, and place, end due to the cause(s) end manner as eteted- - - - - - - - -- - - - - - - - - ^ 33c. Cleanse N bar 33d. Da Sign day, ar) (1 `/7- • Medical Examined CafOlrer On the baste d examination end 1 or Investigation, in my opinion, dedh occurred at the lime, date, erM place, and due to the cause(s) end menrrer es steterL ^ 34 Name ress of n Who pidetl a o],Qeayt~l~m 27) T ~J,~ ~-• t ` 35. Registrar's Synalure ant Didricl Nu r 2i < ~ zl ~ Irl 36. Dare F' (Noah, tlay, year) ~4 ~ ~ ~ ~ v D'aposaion Permit No. ~ ~ I ~.3 () JRZ:cb - April 13, 1993 LAST WILL AND TESTAMENT I, James H. Stayer, Jr., of Southampton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my will, hereby revoking any and all former wills and codicils ther~~o by ~o heretofore made . '.. -`;' c~ %~ r =~ ---~ ~ ~'~ FIRST „~_;C~ °f, I direct that all my just debts and funeral expenses ~. including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease as a part of the expense of the administration of my estate. SECOND \~ I give, devise and bequeath the residue of my estate of every ~' ~` ;t`~y nature and wherever situate to my wife, Nellie D. Stayer, providing i she shall survive me by thirty days. .- ,: ,. ~~ TEIP.D w,.~ Should my wife predecease me or die on or before the thirtieth 1~ ..,~ day following my death I give, devise and bequeath the residue of :3 `~ my estate of every nature and wherever situate to my children, ~;. ~. t _:1 W F"1 i ') ~ i Page 1 namely James H. Stayer, III, and Kenneth R. Stayer, in equal shares, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death shall be distributed to said beneficiary's issue, per stirpes, living on the thirty-first day following my death, and in default of any such then-living issue, such share shall be added to the share or shares of my other child. FOURTH In the event my wife, Nellie D. Stayer, my children and their issue predecease me or die on or before the thirtieth day following my death, I give and devise the residue of my estate of every nature and wherever situate to Memorial Lutheran Church, Shippensburg, Pennsylvania, Prince Street United Bretheran Church, Shippensburg, Pennsylvania, and the Masonic Home, Elizabethtown, Pennsylvania, in equal shares. ~°;'~ FIFTH ,~ a In the event that anyone entitled to a share of my estate ,~ .a ~~ should be under the age of twenty-one years at the time for t distribution to him or her, l constitute and appoint my sons, James H. Stayer, III, and Kenneth R. Stayer, as trustee of any property which passes either under this will or otherwise to said ;~ ~`~ beneficiary. Should both my said sons predecease me or fail to ,... ', qualify as trustee, I appoint the Mellon Bank, Shippensburg, Pennsylvania, as trustee of any property which passes either under Page 2 this will or otherwise to a minor beneficiary. Said trustee shall in the trustee's sole discretion and without order of court, use principal as well as income from time to time as may appear to be necessary for the beneficiary's welfare, comfort, medical care, recreation, support and education, without responsibility to the beneficiary or to any person taking care of the beneficiary; and the remaining balance in the hands of said trustee shall be distributed to said beneficiary when he or she attains the age of twenty-one years. If such beneficiary dies prior to attaining the age of twenty-one years, said trustee is authorized in the trustee's discretion to pay part or all of his or her funeral expenses and the remaining balance in the hands of said trustee shall be distributed to his or her personal representative. In the event the funds held by the trustee for any beneficiary become in the opinion of the trustee too small for proper and efficient administration, the trustee, in the trustee's sole discretion, may deposit such funds in a savings account in the name of the beneficiary. SIXTH ,` , ~.j Any fiduciary under this will shall have tine following powers ~ in addition to those vested in them by law and by other provisions ,; \,; of my will applicable to all property whether principal or income, including property held for minors, exercisable without Court 4 approval, and effective until actual distribution of all property: °~ A. To retain any and all of the assets of my estate, real `; ~` ~,., ;. , Page 3 or personal, without regard to any principle of diversification of risk. B. To invest in all forms of property including stock, common trust funds and mortgage investment funds without restriction to investments authorized for Pennsylvania fiduciaries as they deem proper, without regard to any principle of diversification of risk. C. To sell at public or private sale, to exchange or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or controversy. F. To distribute in cash or in kind or partly in each. G. To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. EEL'LNTH 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 a part of the ~, expense of the administration of my estate. ,i~ Page 4 EIGHTH I appoint my wife, Nellie D. Stayer, as executrix of this my will. Should my wife predecease me, fail to qualify or cease to act, I appoint my sons, James H. Stayer, III, and Kenneth R. Stayer, as co-executors of this my will. Should both my sons predecease me, fail to qualify or cease to act, I appoint Mellon Bank with offices in Shippensburg, Pennsylvania, as executor of this my will. NINTH No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my last will and testament, consisting of six typewritten pages, the first four of which bear my signature in the margin for the purpose of identification this ~/ ~ day of ~r~[tic.L_ , 19 ~ . frt ~ ,~ ~~..~ ~~ ~~~'l.~ ..-~:....~ ( SEAL) Signed, sealed, published and declared by the above-named testator, as and for his last will and testament in our presence, who in his presence, at his request and in the presence of each other have hereunto set our hands as attesting witnesses. Page 5 residing at ~~~~~~ ~,c.~ G,!y~_ ~~ h~~ ~~ l/f~~~~!~~/' ~ p~~~-t-~- residing at~'o N We, James H. Stayer, Jr. , JD-~ ~ ~ ~~ ~~; ~c s e ~' , and V~~iC ~. J ~ ~ S~ the testator 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 testator signed and executed the instrument as his last will and that he had signed willingly (or directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator signed the will as witnesses and to the best of their knowledge, the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ," Testator `(~ ` Witness y Witness Subscribed, sworn to and acknowledged before me by the above-named testator and subscribed and sworn to before me by the above-named witnesses this lisfi day of JK /~-~ 19 X13 1 -~ r "~~otary Publ' !lOTA~AL SQL LOTS ~. R6El~„ ~t~~ b~sab4ic age 6 S~6 rp'S~r~, Cutsa~~ Cc., P!~