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HomeMy WebLinkAbout04-09-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of IRENE H. MACIEJEWSKI also known as COUNTY, PENNSYLVANIA File Number ~/- ~U "'~ ~~~ Deceased Social Security Number 073-16-0699 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 EXECUTRIX last Will of the Decedent dated March 7, 1995 and codicil(s) dated named in the (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. n.; 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.a. or d. b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Decedent, then 94 years of age, died on March 30, 2010 at Messiah Villiage 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 situated as follows: $ 1,000.00 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: or printed name and residence '~,(l J~ U ~. ~~~/~ ~ ~ I Delphine I. Albert, 5265 Meadowbrook Drive, Mechanicsburg, PA 17055 Form RW-02 rev. 10.13.06 Page 1 of 2 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ,~, ~ ~ ~_ ..~~ ._,,,, Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last princi~ residence atv ~- 100 Mt. Allen Drive U er Allen Townshi Cumberland PA 17055 Clt (List street address, town/city, township, county, state, zip code) alnc Roc ov~,r mr~n~, 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 ~.6~~ Certification 1~lwnber~~ ENS OF 1 7k This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me a~ Local Registrar. The original certificate will he forwarded to the State Vital Records Office for permanent filing. Local Re ~. rar Date Issued __ _ C'1 _ ,~ ~ ~."'~ ::~:- '~' e `rte .,.Tz~ ~ ~, ~ ~ T~' ' a 4 Ti t-~'T-• '~ ~---t '~ ~ ~3 _ ~~ ~ to =~..} ;-..~ ' ` ~ ~ ~ r: ' r ` ` I43REV 1112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ 'E! PRINT IN ~ ~ Z t ..-~; " ar:,:-y . eRMANENT CERTIFICATE OF DEATH ll ACK INK -~ >Y-~- (See instructions and examples on reverse) STATE FILE NUMBER '_ N ~.^~ t"-t. t Norte d Decedent (Post, midde. lass, sutln) 2 Sex 3 Sotwl Security Number 4 Da atn (Month, day, year) I~cene Nenn.i,e~~a Mae,i.e 'ewbh..i. Fema.2e 073- 2G - 0699 March 30, 2010t~Q 5. Age (lass Brnhday) Under 1 year Under 1 da 6. Dale d &dn (MOntlt, da ,year) 7. &rthpWCe tCey and sate a Wr country) Ba Place d Death (Check oNy one) Honors Oays Hours wrsnes Mospdal: Other Yr 9 4 June 1, 1915 Bu a.Eo , N y ^ lripatatn, ^ ER / Outpatrenl ^ DOA Narsing Home ^ Residence pother . SDecdY~. 80 County of Oeath & Coy, Boro, Twp. d Death 60 Facerty Name (II rqt initrtuaon,yrve street and rtumDer) 9 Was Decedent of Hispanic Origin? ®No ^ Yes 10. Race: American Indian, Bla[k, Whde, etc. w ~yy- /~ ~ pl yes. spenry Cuban, (SVciM L Comb en~a d A.P,~.en T ~ ~.t... / r t~`~'~'"l ~•2 p Merrican. Puerto Rrcan. ek.) ,1. Decedent's Usual Occ ton Kind d wotk done d ui most d kle. Do rid sole rewe0 12. Was Decedent ever n the 13. Decedent's Eduwtgn (Spepy only highest grade compl eted) 14. Manta) Status: Marred, Never Married, 15 Sunivirg Spo use (II wife, give meatier name) Kind d Work Knd d Business I klduslry U.S. Mmed Faces? Elementary !Secondary (0.12) CoOege (i-4 or 5.) Wrdawed, D;v«~ (~M N O~•s f(~w 10 W.i.dowed - 16. Decedent's Mating Address (Street, crry I sown, state, zip code( Uxederr's Drd Decedent app ~ en Twp A,( ( m a PA L^' A.~.~ en Da 100 M~ , . . • Twp. e t 7c. [Yes, Decedent Lrved n Actual Residence 17a. State Township? . 17d ^ No, Decedent lined w4hin ,7b CowdY Cumb en.~and M ec ha n.i.c h b un PA 17 0 5 5 Adaal LimAS d ciy l Bora t8 Father's Name (First mWdie, last, suKix) ,g. Mother's Name (Fast, midge. metier surname) Ceee.2.i.a Snedz.i,n~fz.i. 20a Informant's Name (Type /Print) 200. informants MarMng Address (Sweet, my / rovm, sWle.:~p code) Deb h.ine A.~bea.t 5265 Meadowbaooh Dn Mechan-i,c~sbu~cg, PA 17055 21a. Mewed d Disposaion ^ Crematron ^ Donation , 210. Date d Orsposnan (Month. day, year) 2IC. Place d pisposdxn (Name a cemetery, crematory or other place) 2t d. Location (Gry !town, state, zip Dods) ~ ~ Burwl ^ Removal Irom State Wa Cremstlon a DonsWn AuUtorized ^ t3ltter . soe~N: by titedlar Esanitter! Corontr7 ^ Y.s O No A ~c.i.L 5 2 010 ImnzeuPnte Neatrt o Cemet Ab b o~~~s own, PA 173 01 _ 22a Sgnstura d Funeral Serv+te Licensee la tt•t~+ ~^9 as such) 220. license NurMa 22c Nana ono Address d Faakry - - i 013564-L Fei~Sen Funi2na.~ Nome, Inc 306 Nano.-i,bbung S.t Fa~s~t B~c~in, PA 17316 Canplata Kerns 23at any wMn arwlyirp 23a. To itN best d my knowledge, desln aaurced at the tero. dak and place wted. (Sgrawue and ak) 23b. License Number 23C. Date Sgned (Month, day, year) physiciart is rid availe0le at tYrie d death a certify cause d death. Kerns 24,26 must De completed 0y person 24. Time d Death Moruh , G . year) 25. Daft PronoistcW Dead ( y 26 Was Case Relened to Medical Examiner I Coroner tar a Reason Other Than Crematbn a Danation7 ~ who pronounces death. ~1 (/! ~ 5' ~ M. f ~ / ~ ~CGLCII c~ ~~' 0 ^ Yes ~ No CAUSE Of DEATN (Set inswuellons and etumpNs) t Approxanale ntervat Pan IL Error doer 2B. Did ToDaaco Use Contribute to Oeath? Kern 27. Pan I. Enter the cyan d events -diseases, iryuries, or tampYcatroris -that drettly caused the death. DO NOT cola Nrmnal swots such as arduc arrest. t orKOt ro peaty Dul nor rewKirg in the underlying cause given n Pad L ^ Yes ^ Probady respiratory arcest, a ventricular hbngatxn widtOW SltOVrirtg Kre etiology. List any ors ease on each kre. ~ l - ^ ~ ,~Mkriown ~ t NWEDUTE CAUSE Final disease or condition rtsultxig n ~atn( -~ a. ~ ~(,~L>(- ~-~( ~~ C.. '~-, C~i~..'~-Q ~f ~ '1 /~[r t ~ 1 / I A'Yl CJ/) 7 1 ~~ 2g.,N~~.faJJ~~~°°°k: t Due to (or as a consequence ~: r ~ 4 kst onditions a L ~ .Clot pregnad wehn pass year b Pregnant at time d deaN ~, b. c . kt to tM cause ksted on kris a. t Due to (or as a consequence oq: Emer UNDERLYING CAUSE r /.. /- Not pregnars, Dal pregnant witNn 42 days (dsease a njury Thal rvuated Ne c r d LASL t ~` ~ c_.- d death events assuring n eath) Due to (or as a consequence o0: t Nd but t 43 da to , r ^ ~eg^a^l• Me9nan ~ 1'ea r before dealt • d. t UNtitrnvn Y pregrunl wKliiri wie pall year 30a Was an Autopsy 300. Was Autopsy Findngs 3t. Mama d Otath 32a. Data d wyury (Mond(, day, year) 320. Describe Now Injury Oaurre0 32c. Place d w4iM': Home. Farm, Sweet. Factory. Pedomied? AvaiW0le Prror to Completion d Cause d Death? wry ^ Homicae OKice Buikkttg, ek. fSGecM! ~~~~fff/ ^ Yes ~No ^ Yes ^ Na ^ Aondent ^ Peridirig Irneslgalan 32d. 7vro d Iryury 32t. Iryury at Work? 321. K Transpona0an Iryury (Spacrryr) 32g. loca0on d Injury (Street, my 1 town, stale) ^ Suidde ^ CoWd Nd be Delemwiad ^ Yet ^ No ^ Drner !Operator ^ Passenger ^ Pedestrian M Other - Speury: 33a. Cemtier (cMck oMy One) hysicun has prartwneed death and completed Item 23) sician (Ph sx:iari ceniyin rouse d death when arrodwr • CMil n h 330. SrgnalWe a facts Cemlxtr - ' 111 ~ p g y g P y y To tht best 01 mY knowledge, dent otturted due b the t:euse(s) and mama ss slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ - ~ `~~--2Z2 l • PronourKwg tnd unityfng physfWn (Physician born prorioiatcng deaM and certdying ro rouse d death) ~ To the fatal d my knowMdgt, death xcuned N the time, date, and place, end due to UM oase(s) sad mama as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33c. lrxnse HwtWer 33d. Date (Monty, da ,year) /'~ C v /~, / ~ / l ~ ~ ~ ~~ ~ • Medkal ExtmMa! Coroner J CJ C.d ~ ~ V (. On ire wsis of examinatron and 1 or nreswgaYron, in my opinion, death occwred N the Urrte, date, and place, sod due to ttte causgs) and manner as suted_ ^ ,~7 34 N a^Je and Address d P¢r Wh ,/ nnt o C9 ~Jed Cause d Death (tt e q~P y) T/yp~eJ,P ~ ~ b D ]6 Oats Fvtd (Monty da ear( / y ~ ~ ~ , j / 1 / ~~ ~ " " ` v1 v " - is)rrtt Num er 35 Regislr s 9gnature and ~ I ~ I ~ I v I a I ~l 1 . y. y 0 ~ ~ y~ ~~~ ~ ~S ~ ~ i /~ l r/~C'~` " ~- ~ :~ i 3 ~ ~.o o u~ - / Q Oispos4an Permit No.~cS ~~yi r ~~ ~r ~/ • !'~.A ,. ~' ~ "" ' ~" ~~ ~ ' ~ CJ t • ~ ~' i i ~F ~ ~-- ~~ r `'~ .~'. Ci:3~ ~~ i i .+ 4. ` f f '. M~1 i~ ~~~ =~ ~ t" ' =~` IRLN$ H. I~iACI$JEY~SRI ~ ~ ~~ - i .~ ~ .. ~ I, Irene H. I-Iacie jeWSki, of Washington Township, YorkCoun t~ I'~'~`, Fennsylvania, being of sound and disposing mind, memory and ~.~nderstanding, do make, publish and declare the following as and for m}~• Fast Will and Testament, hereby revoking and making void any and all Wills and Testaments, or writings in the nature thereof, by me at ar~y time heretofore made. I. I direct that all expenses of my last illness, including hospital expenses, expenses for medical care, funeral expenses and the cost of a gravemarker, as well as all debts or obligations owed by me at the time of my death, which in the opinion of my Executors are not subject to either a legal or equitable defense, shall be paid from my residuary estate, unless otherwise provided herein, as soon as practicable after my decease, as a part of the expense of the administration of my estate. II. I give and bequeath all items of tangible personal property which I may awn at the time of my death, including any automobiles which I may own, togeth~.r with any insurance policies thereon in equal shares to my surviving children, to be divided among them in k.irad as they may agree. In the event that none of my said children 17343.1~11uthor=SMtWser=LR ~~ ~. survive me, said tangible personal property shall be divided among their surviving issue equally and distributed to such issue in kind per capita. III. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatever kind or character and wherever situated, which I may own or have the right to dispose of at the time of my death in equal shares to my children, Delphine I. Albert, Joan F. Gruszecki and Diane L. Clarke. In the event that any of my children predecease me, the share of my deceased child shall not lapse but shall instead be distributed among said deceased child's issue, per stirpes. IV. My personal representatives and the Trustees of any trust created hereunder shall have the following powers and authority in addition to, and not in limitation of , any other rights and powers granted by law: A. To retain any property transferred, devised or bequeathed to them by me, or any undivided interest therein, regardless of the character of said property, or whether it is such as may be authorized by law as a legal investment by a fiduciary; B. To sell any estate or trust property, for cash or on credit, at public or private sale; to exchange any of said property for other property; to grant options to purchase or acquire any estate or trust property; and to determine the prices and terms of sales, exchanges and options; C. To execute leases and sub-leases for terms extending beyond the termination of any Trust established herein; to subdivide or improve real estate and tear down or alter improvements; to grant easements, give consents and make contracts relating to real estate or its use; and to release or dedicate any interest in real estate; 2 17343.1\Author=SM\User=LR D. To borrow money and to mortgage or pledge any estate or trust property in connection with the administration of the Trusts created hereunder; to execute promissory notes or other obligations for amounts so borrowed; and to secure the payment of any amounts so borrowed by mortgage or pledge of any real or personal property; provided, -"- however, that said authority may be exercised only to the extent that it is necessary or required in connection with the proper administration of my estate or any of the trusts created hereunder, and shall not be used for the purpose of -making speculative investments or for the purchase of securities on margin; E. To take any action with respect to conserving or realizing upon the value of any estate or trust property, and with respect to foreclosures, reorganizations or other changes affecting the estate or trust property; to collect, pay, consent, compromise or abandon demands of or against the estate or trust property, wherever situated; and to execute contracts, notes, conveyances and other instruments, including instruments containing covenants and warranties binding upon and creating a charge against the estate or trust property, and containing provisions excluding personal liability; F. To keep any property in the name of a nominee, with or without disclosure of any fiduciary relationship; G. To employ agents, attorneys, auditors, depositaries and proxies, with or without discretionary powers; H. To give proxies, to deposit securities with and transfer title to committees representing security holders and to participate in voting trust, reorganizations, and other transactions involving the common interest of security holders; I. To exercise any option to subscribe for or purchase any stocks, bonds, certificates, or other securities which may be given to it as the holder of other stocks, bonds, certificates, or other securities constituting a part of the estate or trust property; J. To purchase stocks, bonds or other property, real or personal, from the executor or legal representative of my spouse's estate, or any trust established by my spouse, even though such executor or legal representative is also a fiduciary hereunder; K. In the event that my spouse survives me, to join with my spouse or his personal representative in the filing of any income or gift tax return for any period prior to my death and without requiring indemnification from my 3 • 17343.1~1-uthor=SM~User=LR ., '. • spouse or his personal representative for any liability which may arise from joining in such return; L. To elect to take administration expenses on either the estate's federal income tax return or the estate's federal estate tax return in such manner as to provide the greatest overall #ax savings. My Executors are authorized but not required to adjust the interest of any beneficiary detrimentally affected by such election in order to compensate said beneficiary for any loss due to the making of such election; M. To exercise any election provided in the Internal Revenue Code or under Pennsylvania Inheritance or Estate Tax Laws with respect to the valuation of property for purpose of such taxes, and the time and manner of payment of tax, and no adjustment in any beneficiary's interest in my estate shall be made by reason of the making of such election; N. To deduct, retain, expend and pay out of any money belonging to the estate or any trust established herein any and all necessary and proper expenses in connection with the operation and conduct of the same, and to pay all taxes, insurance premiums on any policy constituting part of the trust property, and any other legal assessments, debts, claims or charges which at any time may be due and owing by, or which may exist against my estate or any trust established herein; O. To charge commissions or compensation for their services hereunder, which commissions or compensation in the case of a corporate fiduciary may be charged against or payable from both principal and income received on an annual basis at such rates as may be provided in its published fee schedule in effect at the time said services are performed; P. To make any distributions or division of estate or trust property in cash or in kind, or both. ~. I direct that all state and federal estate, succession, legacy, inheritance or other transfer taxes, however designated, together with any interest thereon, that shall become payable by reason of my death with respect to any property which is included in my estate for purposes of computing such taxes and subject to 4 • 17343.1\Author=SM\User=LR • ~' administration by my personal representatives, shall be paid from my residuary estate, as an expense of administration and without apportionment. My Executors shall have no duty or obligation to obtain reimbursement for any such tax paid by them even though on proceeds of insurance or other property not passing under this Will. VI. I appoint my daughter, Delphine I. Albert, Executrix of this my Last Will and Testament. In the event she cannot or does not desire to act as such Executrix, then I appoint my daughter, Diane L. Clarke, Executrix in her place and stead. In the event she cannot or does not desire to act as such Executrix, then I appoint my daughter, Joan F. Gruszecki, Executrix in her place and stead. All shall serve without bond. Any fiduciary who is an individual shall be entitled to receive reasonable compensation for his or her services hereunder and shall be reimbursed for all expenses incurred in connection with the administration of my estate or any trusts established herein. Compensation for any corporate fiduciary for its services hereunder shall be in accordance with its published fee schedule in effect at the time said services are performed. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Will this ~ day of ~~~~r~~' l 1995. ~ • (SEAL) Irene H. Mac e e k 5 • 17343.1V1uthor=SM~User=LR " - - ~ 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 oth~~`r, all being present at the same time, have hereunto subscribed our names as witnesses. 6 17343.1\Author=SM\User=LR _. COMMONWEALTH OF PENNSYLVANIA ) ( SS. COUNTY OF YORK ) I, Irene H. Maciejewski, the Testatrix, 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 said instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. I ene H. Macie~ew , Tes atrix Sworn or subscribed to and ackn wledged before me this ~,,- y o GL l~t„h 19 9 5 . Notarial Seal Lori A. Rodc~:.~rs, hSotary public Yerk, 1'r~ric County C ~3,,r~0~~1P VANIA ) Member, f/enr~yi~ar:~aPssoaa:An of Notaries ( SS . covN~rY of YoRx ) We, the undersigned witnesses whose names 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 Testatrix, Irene H. Maciejewski, sign and execute the instrument as her Last Will; that the said Irene H. Maciejewski signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, Irene H. Maciejewski, signed the Will as witnesses; and that to the best of our knowledge, the Testatrix, Irene H. Maciejewski, was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. " itne ~" ~~~ Witness Witness Sworn or subscribed to and ack owledged b fore me this da f ~a ~ h 19 9 5 . Notary Publi Lori A. Rod tern i Seal 9 , Notary Public York, York County MY Commission Expiras Sept. 10, 199 Member, Permsytvan;a ration of Notaries