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HomeMy WebLinkAbout04-26-10.~ PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of ANN G. LARSEN also known as ANN GERRY LARSEN Deceased COUNTS', PENNSYLVANIA File Number ~/ ~ /O -6b `~~ Social Security Number 318-01-3843 JEAN WALTERS 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 last Will of the Decedent dated ~-e and codicil(s) dated Death of Thorkild R. Larsen on 02/11/2001 .N 1/ Y~ n~ s.~ V Executrix 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 (lfapplicable, enter: c. t. a.; d.b.n.c.t.a.; pendente/ite; duranteabsentia; duranteminoritate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following~ouse (if any'~td heirs: (!f Administration, c. t. a. or d. b. n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~© ~, ~r7 -,-, : ,-t Name j W .~ f'7't (COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ W ~ _~> [` ~.,t ~i Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 4905 East Trindle Road, Mechanicsburg, Hampden Township, Cumberland County, Pennsvlvania. 17050 (List street address, town/city, township, county, state, zip code) Decedent, then 94 years of age, died on March 23, 2010 at Holy Spirit Hospital, Camp Hill, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 50,000.00 (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 foil 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: X~ ~~ i _ ~~ ~~J I JEAN WALTERS - 2081 Dartmouth Street, Camp Hill, PA 17011-3834 Form RW-02 rev. 10.13.06 Page 1 of 2 s i Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF 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 _, ~~~ Sasrti.dn~o~- ~~-~. c~.A-, For the Register ~?~~-~~ Signature of Persona! Representative Signature of Personal Representative ^ ~~~ :J~ t_"~7 .-7 t.~~o ~::,~ File Number: L ~ ~ ~ ~ ~ V 1 ~~ Estate of ANN G. LARSEN Deceased rv ~-- 'O C N ~~ rn ~ 'q Cr w ~ ~. w ~-- .J Social Security Number: 318-01-3843 Date of Death: March 23, 2010 AND NOW, ~ ~ ~, 2Q ~U , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT iS E RE D that Letters Testamentary are hereby granted to Jean Walters in the above estate and that the instrument(s) dated September 5, 2000 described in the Petition be admitted to probate and filed of record as the last Wig (and Codicil( )) of Decedent. ~ ~ . /~ FEES ~ Letters ............... $ O Short Certificate(s) ........ $ ! Z.°O Renunciation(s) .......... $ ... $ .~ -~ (~.rl~ . $ ,, ck7 ... $ ... $ ... $ ... ~ !~ TOTAL .............. $ . So -~_ Form RW-02 rev. !0.13.06 Re ist r of Wills Attomey Signature: Attorney Name: Gregory , . Chef Supreme Court I.D. No.: 78443 Address: Telephone: 17 S. 2nd Street, 6th Floor Harrisburg, PA 17101 717-233-1000 Page 2 of 2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph, , 1=ee for this certificate, $6.00 This 'is to certify that the. information here given is correctly copied from an original Certificate of Death duly 1:iled with. me as Local Registrar. The original certificate will be forwarded to the State Vital Records Offic for p anent filing. P 16427620 . Certification Number n - _-.-, r-~j - - a v c r °::. ~~ .... .. __ .... _. 1. !~,, -~~, _~ _...: ' ~ ~ A .. _... . .. ...._ -~ W _, rri aps-w r1EV nrlaae COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT Of HEALTH • VITAL RECORDS TrPE PRwT w ~ "' .. CERTIFICATE OF DEATH (SN Instructbns and e>campbs on nvuse) ,,......_.,., ~1 e ~ I t. 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Ltanr NurOr 7011 Drs sq^a (NaR «Y• 1•s0 berararPtweaiYgs,Ornoceurwrer rrerr,rwwarwwyNwawaarrrara_-'------"-'----- ~ `.se ~ ,, ~ 3 y e. ~ ~~ (~ • rsekr EsaasarlCaaarr ~ ~ 4 er tlaW rrraaWlr sne/a wrwErlr,~ w assn olxrnar ttrtw,ara, art Pbaa. ra nrblM arrNN aM rrwrratari ^ 31. Nama~Aaaaad Pavan wro Caurdpaan learn xPl T7palPml ~ ~` ~ al ~ oZl o21 oZ.d~ s Far Hann. aar. raan ss V Y /'~ ^• 1-t c I I to I T <.t J .~, n r1. u A •i i 7 c r / oaraoarrPamtaNO. 0468182 r•' THE LAW OFFICE of: JAMES M. BACH Attorney-At-Law LAST WILL AND TESTAMENT n 4 ~~ o _ ~~C~ ~ ~_ ,7 ~~ m ~ . ~, C, ll..~'1'1 ~ ~ TI --' ~ "7 _-1 .b ~ _ ~n , ~ ~ y~ FOR ANN G. LARSEN Last Will And Testament Of ANN G. LARSEN I, ANN G. LARSEN of the TOWNSHIP OF HAMPDEN, COUNTY of CUMBERLAND, COMMONWEALTH of PENNSYLVANIA, being in good bodily health and of sound and disposing mind and memory, and not acting under duress, menace, fraud, or undue influence of any person whomsoever, merely calling to mind the frailty of human life, and being desirous of disposing my worldly goods while I have the strength and capacity so to do, I do make, publish and declare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel and annul all my former Wills and Testaments, including codicils thereto, by me at any time made, and declare this alone to be my LAST WILL AND TESTAMENT. AS TO SUCH ESTATE IT HAS PLEASED GOD TO ENTRUST ME WITH IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ: ITEM 1. I direct that my Executors hereinafter named, pay and discharge all of my just debts, funeral and testamentary expenses. ITEM 2. I order and direct that my bodily remains be cremated. My cremation has been prepaid. ITEM 3. All the rest, residue and remainder of my entire estate, wheresoever situate, and whatsoever it may consist of, I give, devise, and bequeath, absolutely, and in fee to my dearly beloved husband THORKILD R. LARSEN. In the event my dearly beloved husband dies with me in a simultaneous disaster, or fails to survive my death by thirty days, then I give, devise, and bequeath my entire estate, wheresoever situate, and whatsoever it may consist of, to the following named individuals, share and share alike, per stirpes: (1) JULIA BORZOK (2) WALTER BORZOK ITEM 4. I nominate and appoint THORKILD R. LARSEN as Executor of this my LAST WILL and TESTAMENT. Should the Executor herein named fail to qualify or cease to act as Executor, then I appoint JEAN WALTERS as Executrix in his stead. ANN G. LARSEN Page2of4 ITEM 5. I hereby direct that all my personal representatives, as well as their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM 6. I order and direct that my Personal Representative(s) named herein use the legal services of JAMES M. BACH, as Attorney for my Estate. ITEM 7. I direct that all estate, succession, legacy, inheritance or other transfer taxes, however designated that shall become payable by reason of my death in respect of all property comprising my gross estate for tax purposes, whether or not such property passes under this LAST WILL, shall be paid by my Executor out of my residuary estate. ITEM 8. I grant to my personal representatives herein named, in addition to, but not in limitation of those powers vested by law, to be exercised without prior application to or approval of any court, the power and authority to retain indefinitely any property, to invest and reinvest any assets or the proceeds derived from the sale of assets, although said investments may not be of the character prescribed by law, to sell, convey, assign, transfer and encumber any property, to pay, settle or compromise all claims, to make distribution or divisions in cash or in kind, and in general to exercise all powers in the management of any property hereunder which any individual could exercise in the management of similar property owned in his own right, and to execute and deliver any and. all instruments and to do all acts which may be deemed necessary and proper. ANN G. LARSEN WITNESS ~/, Oz,~./ WITNESS Q S ANNE T. POWER KIMBE Y A. ROSS Page 3 of 4 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, ANN G. LARSEN, 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 the instrument as my LAST WILL; that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. Sworn to or affirmed and acknowledged before me, by: ANN G. LARSEN, the TESTATRIX this 5~ day of September, 2000. ANN G. LARSEN ~ ~~ ~' ~0~ " C~oun~,~~ J ES M. BACH, ESQUIRE MOB' ~ ~ NOTARY PUBLIC Mechanicsburg, PA 17055 My Commission Expires: 05/13/03 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We, SUZANNE T. POWER and KIMBERLY A. ROSS, the 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 sign and execute the instrument as her LAST WILL; that the TESTATRIX signed it willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each witness in the hearing and sight of the TESTATRIX signed the WILL as witnesses; and that, to the best of our knowledge, the TESTATRIX was, at the time, 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and acknowledged before me, by: SUZANNE T. POWER and KIMBERLY A. ROSS witnesses, this 5th day of September, 2000. WITNESS ,~/ ~ ~j~,~/ WITNESS y UZ NE T. POWER KIMBER A. R SS ES M. 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