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HomeMy WebLinkAbout04-14-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Kathleen M. Smith also known as n/a Deceased Social Security Number 203-OS-2255 Celia A. Zei ler and Shirle A. Kirk 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 Co-Executrixes last Will of the Decedent dated January 19, 2009 and codicil(s) dated n/a (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: n/a B. Grant of Letters of Administration COUNTY, PENNSYLVANIA File Number ~ ~' ~ ~ _ (.J~ ~ 9 (If applicable, enter: c.t.a.; 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.) C~7 ., ~, Name ~,. - .{w .. 4 •-~.. ..~.7 - ..:;,, ; ---• ,, ,,. '-r-~ ~... ,-'1 l~ ~ ~'I` i (COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ -~ _..... Cumberland Coun Pennsylvania with his /her last principa~residence at -- ~~''~~' t Decedent was domiciled at death in h'~ 3 Z ~ ample Bridge Road Mechanicsburg Silver Spring Township Cumberland County Pennsylvania 17050. * ~ (List street address, town/city, township, county, state, zip code) Decedent, then 91 years of age, died on March 28, 2010 at Harrisburg Pennsylvania *(the certificate of death erroneously notes the Decedent's residence in Dauphin County Pennsylvania) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 10,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 75,000.00 situated as follows: 37 Sample Bridge Road, Mechanicsburg, PA 17050 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: Celia A. Zeigler 913 Snapper Dam Road, Landisville, PA 17538 ~~'~~ ~ ~ ~ ~ Shirley A. Kirk 308 Woodruff Way, Harrisburg, PA 17112 named in the Form RW-02 rev. 10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS 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 ` t~ before me the 1 ~ day of G or the Register Sign lure of Personal Representative / J .... . ~/ Si ature o Personal Repr five Signature of Personal Representative File Number:~~-- ~ ~~ ~ J 1 1 Estate of Kathleen M. Smith ,Deceased Social Security Number: 203-OS-2255 Date of Death: March 28, 2010 AND NOW, ~~ ~~~ ~ ~ ~-~ 1 ~. in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Celia A. Zeigler and Shirley A. Kirk in the above estate and that the instrument(s) dated January 19, 2009 described in the Petition be admitted to probate and filed of record as, the last Wall ('and Codicils)) of Decedent. ^ FEES ~'~ ~~ Register of Wills Letters ............... $ _ Short Certificate(s) ........ $ ,- y • U~ % Attorney Signature: Renunciation(s) .. $ Keith O. Brenneman Attorney Name: ... $c~ ~ +~~ Supreme Court I.D. No.: 47077 Address: Snelbaker & Brenneman, P.C. ... $ .. $ 44 West Main Street $ Mechanicsburg PA 17055 ... $ • • • $ Telephone: 717-697-8528 ... $ TOTAL .............. $ c~--1 l ~6U a~@' Form RW-02 rev. 10.13.06 Page 2 of 2 I~S.R05 REV (OIlO?) 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 16245087 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. ~ ~~ Local Registrar Date Issued Certification Number N1a T 0 ~. to U 0 C`7 ,~-- .::~7 ~ ~ ..~ "7- ( '. ~ '4~ ~ t~-LLB C~ 143 REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS - '(PPEE~I~IN aLAf~c IMC CERTIFICATE OF DEATH ~ '~ (See instructions and examples on reverse) STATE FILE NUMBER -~., -. ~. ck _. .. ~/ . ""C7 f l -~ ~ ~ ~• ...,. ~ ~': ~ r t ~.a.` i ~.s ~ ~ ~ . _Y ' • . , .~ r~ 1. Nems d DeCedud (RreL middle. Int, srAPoc) 2. Sax 3. Sadd Severity Number 4. Dote d pests day. year) Kathleen M. Smith Female 203 _ OS _ 2265 rch 28, 201''d s• A9• (~ ~Y) Urtder t Undo , fi. Date d Bkm 7. ~ and stab a ~ M. Place of t)eatn cxre~k ar 91 vrs MaArs I)•ye liorwe sEryrlea February 3, 1919 Wilkes-Barre, Pennsylvania ^ ~ / o~e~t ^ oat ~ ~ ^ ^ ~ Bb. Cornty d Deatlr fa. City, Bono, Twp. d Deatlr Oct Faddy Name (d not kretiNEon, 9M street and nunber) q~11 9. Was psaders d tEspenic Origin? to No ^ Yes 10. Race: Arnericen Indian, Black, WhM, etc. Dauphin Harrisburg Harrisburg Hospital (, " , ''~~ ~; ( White , , , „ ~) 1 t. Decedurrs lJswl 10ra d wok d ab most d Be. l7o rat state 12 Was Decedent ever in the 13. Deaderq's Education (Specify ary highest grads compl eted) 14. Marital Satus: Martied, Never Marred, 15. Srwvi~4rg Spo use IE wile, gNa maiden name) Kea d Wark Kia d Busirrns/ Indwtry Homemaker Own Home U.S. Armed FareesT ^ yw ~No l !,¢.,.,,,,,a,rY (412) I'~^""'° CoNe9e (1 i a St) wNbM1ed Drvaroed (Spea'NI Widowed 1B. Decederd~s Mailirg address (Street, ~ /town, state, np rAaa) Decedenrs PA Da Decederu eat a Hover Live n a 17 id d i Act l R 17 Y D d t li T S 308 Woodruff Way ence en ve n ua es c. . es, ece wp. a. late T;pp Harrisburg, PA 17112 17b. ,ouMy Dauphin 17d. ^ fVO,DecedadLivadwithin Actual Limits d fXty /Born 19. Fathers Name (Fast, midde, lest, sulfa) Edward Hart 19. MoMefs Name (Fret midrAs, maiden wmems) Cecelia Daly 20a. IrtformanPs Name (Type /Print) 20b. lnkxment's Mailing Addreac (Street, / town. >vb, zq code) Shirley A. Kirk 30~ Woodruff Way Harrisburg, PA 17112 21a. Medod d Disposition r ^ Cremation ^ pabpo,l 216. [)ate d Dispaition (Mordh, day, yearf 21c. Place d Dispositon (Name o1 oernsbry, aernabry a otirx place) 27 d. Location (City/town, state, zip Dods) ~ IirxW ^ ftsmovalkomsrale ~ wesCrwrrslbnattaWlanAWrortad April 2 2010 Indiantown Gap National Cemetery Annville, Pennsylvania 17003 ^ qhu - ' by Medcal EmNrr/ ^ Yaa^ No , 22a d FrarerN achg as such) 220. License Number 22s Name and Addrsa d FadFy FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055 Conpbk t any awtilytrg To the best rie Ems, date and place stated. (Signabwe and title) z3b. License Number z3c. Date Signed (Month, day. year) physicisrl is na availed. r Ems d dean b ~Y terse d dean. e" r fNlntrr~c ll.~ '~~ / o INrrs 24-26 must M completed by D~ 24.7sne d Death 25. Date Dead (MOmh, day, year) 26. Was Case Refs,,n~seLd to Medical F~cunkrer I Corarsr for a Realm Other than Crartratlon a Daratial? who prarwass desM. Q ~ fd. ^ Yes LJ No CAUSE OP DEATH (See Instructions and sxamp4as) , Approtirtsb imervak Pan II: Enter odra ' 26. Dld Tobsoco Use Corabute b DeathT ksm 27. Pan L• Fsbr the - dam, injuries. a compiealims • tiW directly r~ueed Ere death. DO NOT enter terminal evaWS arch u ardse ertast. ~ OrsN b Death btR not rewltirg in the uraeriyrg cause given in Part I. ^ Yea ^ Probably respiratory arrest a ventriarW BMiNetion witlaW stowing Ere etiobgy. List only one suss an each Ere. , r No Unknown ~E TE CAl1SE dieeass a r wcadtlan rsadtlng n dWh) ~_ a ~i17/I!~/)9 C ~/I/1 G S ! i ~ ~/¢ 29. tl Female: ^ N t e rent wAlfw t Due b (a as a casegwrra dl: r Ix g o n hes Year ^ Pre9nar4 at line d death b ~ ~ e W /t,~~i /~!`J S s ^ b teats fW W mk i a Etitu Il11DEFLLYIgfi CAUSE t>va b (a as a coroequatrb dl: r ' p Nd pregnerd, but pregtent witlwi 42 days d deaEr (d sew a i^MwY Eat irrPostad the c r evems reurNE n death) LAST ~ ~ /¢t%~ /7 ^ N b g . ~ Due b (a as a cormequeroe oQ: r a pregnant, ut pregnant 43 days a 1 year before death d. ~ Ursrnowrr tl pregnerd within the past year 30s. Was an Autopsy 30b. Wee Au[apsy Findrge 31. Manner d Death 32a. Date d Injury (Mawh, day, Year) 32b. DescrEe Fbw Injury Oawnsd 32c. Plaa d Iry'ay: Flame, Famti Street. Facbry, PsrMrrned7 Avaieble Prior b Carpktion d Cause d Daeth7 rc~! ~~ ^ ~ IX ~e ~~9. •b. (SOeuh'l ^ Yas ~ No ^ Yes ^ No ^ Aaidem ^ Pawling Inveafipatlon ~. Tme d Injury 32e. Injtey et Wak4 32f. tl TransportaEan Injury (Specify) 32g. Location d injuy (Street. ary /town, state) ' ^ Suicide ^ Could Nd M Determined M ^ Yes ^ No ^ DriverlOpenta ^ Passenger ^ Pedestrian Otlwr - Sywray 33a cetllw (dwck brYy a») 33b. Slgnetiwe and Tdb • Certllying phyefeWi (Physician awtitying ease d death siren erotlnar ptryaicien hss pronorraed deem and completed Item 23) to tM Mat of my bawNdge, deelh oavnee due to the eawys) and mmner r attract _ _ _ _ _ _ _ -------------------------- ~1 ~ bg and anirying PM~„ IPilyelaafl ~h Dlaalrrw+lg deatli era owEryng b taus. d deNh) Totf ed l M Md d tl d ttMti d d ^ 33c.liuneaNurtrbe DekSigrsd(MOnth,day,yoar) r s my unow pe, r roasrre a ma, NS,andplaa,area,.btMaw.p)andmennx,aat.a ------------------ • 1ledbalEsamin.t/coroner ~De C~ 3 0~ 1kn tlra beW d examtrsdon and / a bveatlgatlon, In my aplnbn, death ocamd a< dre tMrre, dMe, and p4a, and dw to the awe(s) acrd mtrwrer as etabcL ^ 34. Nuns and Ad/dress d Parson ~~Conyle<ed d Daatln (Eem 27) Type /Print . s ~ L ~ 1 ~ ; ! 2;5,3 u ~~ l /~~• l I. ~ ~ ~ ~ ~ ;'~; '1~ -k ~ ~, ~/ J f/ ~Fti ~-~ fir, ,Y-,Ghi2/SBf/; ,~ /7/~ ~ Disposition Permit No. C ~ / • ~~`~ LAST WILL AND TESTAMENT ennsylvania, being of sound and disposing mind, memory and understanding, do he~'by make, OF Q .~' .,~, ~ 1 ~ ~ ~ ;i KATHLEEN M. SMITH ~ =~ '~ ~ f4 I, KATHLEEN M. SMITH, of Silver Spring Township, Cumberland`~ounty, ~ ~~ ~ - =~ j~ ~ .q ublish and declare this as and for my Last Will and Testament, hereby revoking and making oid any and all wills by me at any time heretofore made. ~' 1. I order and direct that all my just debts and funeral expenses be paid as soon as icable after my death by my Executrixes or Executrix, whichever the case may be, inafter named. I direct that all taxes that may be assessed as a consequence of my death shall be paid my residuary estate as part of the expenses of the administration of my estate. 2. I give to my stepdaughter, PATRICIA A. MILLER, and my stepson, GERALD E. SMITH, each the sum of $10,000.00. In the event either of my stepchildren above named should predecease me, I direct the such deceased stepchild would have received hereunder shall be given to his or her issue urviving me per stirpes and if there should be no such issue, then such share shall lapse. 3. All the rest, residue and remainder of my Estate, real, personal and mixed and ever the same may be situate, I give, devise and bequeath in equal shares to my ughters, CELIA A. ZEIGLER and SHIRLEY A. KIRK. If either of my daughters above named should predecease me, I direct that the share such ceased daughter would have received hereunder shall be given to her issue surviving me per and if there should be no such issue, then such share shall lapse. 4. I hereby nominate, constitute and appoint my said daughters, CELIA A. ZEIGLER, SHIRLEY A. KIRK, or the survivor of them, as Co-Executrixes or as Executrix, LAW OFFICES SNELBAKER & hichever the case may be, under this my Last Will and Testament. I further direct that BRENNEMAN, P.C. neither daughter serving as Executrix hereunder shall be required to post any bond to secure faithful performance of her duties in the Commonwealth of Pennsylvania or in any other urisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and estament written on two (2) pages this 19th day of January, 2009. '~~ ~'/' / .~' SEAL _( ) Kathleen M. Smith Signed, sealed, published and declared by KATHLEEN M. SMITH, the Testatrix above as and for her Last Will and Testament, in our presence, who, in her presence, at her uest, and in the presence of each other, have hereunto subscribed our names as attesting tnesses. ~'~`~/` ""' ~L~J~/tj (SEAL) LAW OFFICES SNELBAKER 8C BRENNEMAN, P.C. iti ~~ (SEAL) -2- COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND SS. We, KATHLEEN M. SMITH, KEITH O. BRENNEMAN and SANDRA K. SHOWERS, Testatrix 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 Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein pressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix ~" ~~ ~ ~~ Witness ~~~~~ Witness Notary Pu is ' COMMONWEALTH OF PENNSYLVANIA LAw o~icES Notarial Seal SN E L B A K E R& Susan L Matra, Notary Public Mechanicsburg Boro, Cumberland County BRENNEMAN, P.C. My Commission E~ires Nov. 24, 2'011 Member, Pennsviva~~a ~sSOriation of Notaries ubscribed, sworn to and acknowledged before me by KATHLEEN M. SMITH, Testatrix, and bscribed and sworn to before me by KEITH O. BRENNEMAN and SANDRA K. SHOWERS, tnesses, this 19t" day of January, 2009.