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HomeMy WebLinkAbout05-11-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Stacia I. Kaminski also known as File Number !-~' , I C.s' V Deceased Social Security Number 18412-1653 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 Mary Ann Charles named in the last Will of the Decedent dated March 28, 2008 and codicil(s) dated (State relevant circumsdances, 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. a.; d. b. n. c.t.a.; pendente liter 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.) r.~ C7 ° w~.._.,.,. n_~...:~_..t.:_ n ~x ,._ ... .. ~J'~ ~ ....-.. .I . ... J ~ ...: _:.;.. r -_~ l_~ _._~ ~ ~ - ` 1 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ` ' `T fV -_-° Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principTa'I residence aQ~ -~ ~~ The Church of God Home. 801 North Hanove~treet, Carlisle, Cumberland Countv. PA, 17013 (List street address, town/etry, township, county, state, zip code) Decedent, then ~ years of age, died on May 1, 2010 at The Church of Goci Home, 801 North Hanover Street, Carlisle, Cumberland County, PA 17013 _ 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: $ 30,000.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition anal the grant of Letters in the appropriate form to the undersigned: Si nature T ed or rinted name and residence ~ _ _ Mary Ann Charles, 90 Nittany Drive, Mechanicsburg, PA 17055 Form RW-02 rev. 10.13.06 Page I 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 ,e ___~_~-__ day of r7 ~. ~G-L !~}~ tl For the Register Signature of~rsonal Representative Signature of Personal Representative Signature of Personal Representative ~'__ File Number: ~ ~ f L~ ~ ail Estate of 5 t a c i a I. Kaminski ,Deceased Social Security Number:184-12-1653 Date of Death:Mav 1 2010 AND NOW, ~ ~ ~ ~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, I IS DEC EED that Letters Testamentary are hereby granted to Ma Ann Charles in the above estate and that the instrument(s) dated March 28, 2008 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES ~ ~~ (1~} Letters ............... $ Short Certificate(s) ........ $ ,~1~ c;t -- Ren~nciation(s) .......... $ v ••• ~G ~C',' ... $ ~_~ ~ ~. ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ tJ ~G` _~ Wills Attorney Signature: `~ v" - Attorney Name: Andrew C. Sheely, Esquire Supreme Court I.D. No.: 62469 Address: 127 South Market Street P.O. Box 95 Mechanicsburg, PA 17055 Telephone: 717-697-7050 Form RW-02 rev. 10.13.06 Page 2 Of 2 y z1_lG'--~y~~~' LOCAL REGISTRAR S CERTIFICATION OF DEATH WARNING: It is illegai to dupllicate this copy by photostat or photograph. f~lC 1~u~ i~li. _LI~(;~1c Lli<. SC~.U(1 I,trp,~141 ~F tiF' I lu, Is to cetttiv that the mlonnatwn hLtL _*t~en is 1,, ~k,,-- ~iVy~, ~, cnrrrctl~ L ITpiL°d Irol7t ,:ui uu~inal Certittc rtL of Death ;~ o~ ~ ~ ~r Flu ~ filed with the ~i~ Lt~~dl R~.~Ttstrar. The oltginal ,,;; .r ~. ~ ~~ ~ z !, ~ ti( ~~atc~ ~ ;I he fl~rwar 'd ttT the. State Vital I~ ;x-~I v i ~a~l Lc~>r~ls Ot ~ I~ r r7eanrzn nt filing. a r% P 16493809 _ ~ ~~ ` ~.. ,,, _._ -... __ _ _. rl.' 1 --- --- 49r'1fENT D ~~P' ~~ r rruh~:L.uail rumia'I ~'~ _- '~` ~ -u al Re~~i~tr..r Date Issued t'V n ~ C~ © O a. ~ ~t• , ~ A y _ ~.Sr~" "SC a - .J _ '~ T C~`__ r` , J ~ C~ , CD ,a Hansla3 NEV ur2ro6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECOFtOS TYPEf PRWT IN PERMANENT CERTIFICATE OF DEATH BLACK INN (See Instructions and examples on reuersel _._.__ _. _ 1. Name d DecMml (Rri. znidde.IaM, w1Yx) 2. Sex 3. Social Security Number a Dale d Deam (Month, day, year) Stacie Irene Kaminski F 184 - 2 - 165 1,?010 Y 5. Age (last BlNgay UMer 1 year UMer 1 day 6. Da,e pt BiM (MOnm, tlay, year! 1. Snhplatt (City and slate w foreign munlry) ba. Place of Oea1h (DhBCk Doty one) Naxtw p.ye Wars m, Hospital: O~~Vtyyer. 8 8 y„ M ~ 10 -16 -19 21 P 1 ym o u t h P A ^ Inpafwm ^ ER / Oulpanenl ^ DOA L'J`NUrsn g Hpm¢ ^ Rasitlence ^aner Spadry bb. County or Death &. City, Bwo, Twp. of Deam M. facility Name (II not msdtulbri, give slr6el and number) 9. Was Decadent d Hispanic Origin? ~ No ^Yas 1 V. Race. AmeYtcan Indian, BYlck, While, etc. Cumberland Carlisle PA pl yes, speciry Cuban, The Church of God Home Mexican, PUerb Rk an, ¢lc) (speciM 11. Decedent's Usual Don Kira of work done Burin .most d workln file Do nd stale retired 12 Was Oecetlenl eve' m the 13. Decedent's Education (Specify only n~ghesl grade .ompletetll 14 Marital $blus: Married, N¢ver Married IS Surviving Spouse (II wild give maxlen names Kir4 d Wclx Kb of Business I Industry U.S. Armed Forces' Elementary I Secondary (0-12. College II-a or ») Wttlowed, UNOrced Specilh . . Seamstress Garment ^vaa g]Np 12 Widcwed None Ib. Decedent's Mailing Addess ISUen, cM /lam, stale, zp mde) Decedent's Did Decetlent PA 801 North Hanover St Aduel Resbence Ra. SYale Uve in a th Yea Decadent Livetl In ^ Twp Carlisle PA 17013 mwrehip~ vo.cpanry Cumberland ITtl.~Np.DeademLNadwlDm Carlisle AdPaltnNlad cIN/~rd 18. Fatlwh Name (Ferri, midge, bsl, Suit l Charr~es Pasek 19. Monier i Name (First. midge, maiden surtwrrel Maryanne Ferus Pasek 20a. Inlormanl's Name (Type 1 Print) 2W. Inlwmanl's Maipnq Address (Street. city I born, slab, Tip coda) MaryAnn Charles 90 Nittan Dr Mechanicsbur PA 17055 21 a. McUgd d Dapovpon ^ Cremation ^ Donation 210. Dab d DisposNUn (Month, day, year) 21 c. Place of Dspdsllian (Nam• d cemebry, crematory or omer place) 21 tl. Loapon (City I sown, slate tip copal (~ Bpdal ^ flemwanransata wa:cremenanprDpnauPnAmnpri:ed ^ Od r ~ S A M b dMd E i ^ ^ May 4, 2010 St Casimirs Cemeter y , Mulhlenbur ~'A la pec Y y e iem nar I Coroner? Yas Na e g 22e.' redfuwrd$srviulkeryepc.(yrpersonM4n9azSUCh) ~ 22DUCeruaNUmber 22c.NameantAddr~ssolFazlltN Aiszczek-Desiderio Funeral Home Inc •,`U• ,~,-,,.,.. ".~ C., ~;y~ 012374-L _ 67g Carey Aare Hanover Tw PA 18706 • de Ilpna 23ac oMy when carliping 27a. To lde bast d my knowkWge, tlealn occurretl at the Bore, tlale ant place staled Slgnalure ant line) 230 License NumDf r 23c Date Si n d M ty ma r phy3xian rs rid ava0apb al lime d Beam to . g e ( on , y, yea f cengy cause d deaN V ~ ~ O' 0 Items 2b26 meal pa complete0 M parson 23 Timed am 25. Dale Pronounces Dead (Mpntn. tlay, year) 26. Was Case Rele,red b Medical Examiner r Coroner for a Rea Olnar man Cremation w Donalim? who prwwurKas deaN. ~Iel M ' O /O ^Yes O~Np CAUSE OF DEATH (See'n3VUCtlona and exa las) t Approx male'marvd: IfMn 2). Pnn r. En er D han d even d - I rr pcations Iha1 drecdy causxtl foe dea DO NOT enter term nal av ~ as cardla awes Pan Il. Enlerpn $jgBflga lpmtlde smmn0.f q t oqy, 2q Uid'ooaao USe Gmbpute to DeaNn ~ n. ., Cnse to Dean respvnt arreri, w ventricular I briNation m tat showing the efglogy. L sl only one cause o each tine put no. ~ It gin the umerly r g cause gven N Pan I f~ Yes ~ a o0ad y IMMEDIATE CAVSE IFivl c4seas¢ or r./ I r / / ( ' "I Nu ^ UnMOwn ~ J~ I Lblydbpn resullhg in eam) _' a. ~{ 1 t ~ f ~. •}.~ 'I" ~ J t ~ `~ `-~ L. ` ~ ~f l ~ 29. If Female. Owe to (o' as a ronsaquence ob. /~ ( Spue flatly Net mntitims tl any b ~-- r ( ^F-{ v ~ ~ ~ [, Nol pregranl wimb pass year [ , , . ~ , / ~ 0 e Y v1 D ~ Z ~ . batingg to Bra wu tided an Yoe d. J Pregnant al bore of Beam Edw do UNDEflLYING CAUSE Due to (pr as a consequence ol). I ~ Nd pregnant. put pregna. r mthin # days a Sti~ase Pr mlaq mat irNieled the a rasulDrp n deaml LAST. P pl Beam Due to (ot as a ronapuence oD. L ~ Pregnant a3 daYS Ip 1 yeas ^ d. r ~ re ~ ^ Unkrwwn it pregnant wI1Nn Ne past Yaar 30a. Was an Autopsy P rf ]W. Wen AulopsY FnrMngs 71 ¢r of Deam 32a. Dale of Injury (MOnIh, day, year) 32d. Descdpe Mow Injury Occurred ]2c Place I Injury: Horne Farm Street Factor ormed? e AvNlade Prior to Gomplefim Nalard ^ r{pmKba . , , . y, Odx:a BuMirg, ek. (SDedMI I d caws. d Deam+ ^ Yea [~ Np ^Yas ^ No ^ Accident ^ Pending Invasligalron 32d Time of Injury 32a Inury al Wod'+ ]21.11 Transponafiwt Injury (Specify) 72g. LacaDm al Injury (Sorel, city I town, .slate) ^ $uiude [~ Cudd Not be Determined ^Yes ^ No ^ Driver! Operator ^ Passenger ^Pedesfnan M' ^Ofher~ $pecti/y 17s. Certifier Icheck only one! 37b. signature a qol CJlVlier 1 ~', • Cenitying physi<iart(Phystctan cwtitying cause of deaN when anotner physicun Aas Prprwunced Oealn and cpmple,etl Item 23) T ni D t f k l I y ~ y' i y\ o t es o my now edge, death occurred due to the cause(s) and manner as slaled_ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pron unci nt l ' 0 - - ..~ _ v t ~ v ~J o ng a nrl ry n9 P Y c (Physk an Dptn prwrounc ng Beam aA can N ng to rouse a dealhl To Ina GSl of m krwwlW e d m tl t th 33c. L ca t Number SB 3]tl. ale Signed IMprlm, Bey Yean y g a e 0m• dale end place and Bus to N• ceueNe) and I t tl ^ ' Metl cal ExaminerlCwoner , ^ ©~ I,, ~ ~ ~~ M t \ > ~ ~_ ~ ~ Y 6 ~ On 1 1 • e of examinalron en n ellgzron n my opnon dealn occurred at me I me, Oate and place and Due to Ina cause(s) and m nner as staleO_ ^ Y O ~ Name am Mgr ss of Parson Wlq Completed CPPus of Death ;Ite m 2Tl Type' Pmt 76. Rags DTs( N l,--~ //~ ~ ~ ~~~V ~~~~~ ~ 36.O~letl Mnlh, da,year) ~ ~ DpV:~ L- •xiC%R xh~t,lbY% M~ 11^nn ~ ~ ~. / - (~ - 3~)J CaV ci e 1~ a~ ,,.o,s P 173z`f ~' Disposition Permit Np. ~./ 'L 1 ( p I y OATH OF SUBSCRIBING WITNES' ES S ? N ~ ( ~ o _ `,~ ~ T_ te ,~ , , 1 r -' REGISTER OF WILLS 'r~r, -- ~ ~~ r_ ~ ~ _ . ~ ~ ~ ~ CUMBERLAND COUNTY PENNSYL~IANIA ~ f , ~ ~ . '~ c , -~ Estate of STACIA L KAMINSKI ,Deceased Andrew C. Sheely and Becky M. Knisely , (each) a subscribing witness to (Print Name/sJ the ®Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that sloe->Lkc /they was /were present and saw the above ~Fe,~~ Testatrix sign the same and that she / hey signed the same and that sl}e-><-ke /they signE;d as a witness at the request of the Testatvt-t Testatrix in her /his presence and in the presence of each other. (S re) (Si atur 701 Jenna Court (Street Address) Mechanicsburg, PA 17055 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills 927 Knepper Drive (Street Address) Mechanicsburg, P.A 17055 (City, State, Zip) Executed out of R'egister's Office Sworn to or affirmed and subscribed before me this _ ~ fh day of ~ h ~ ~~ :~ otary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original o ~!>r~~AIIFr_1'~Ai111~N NOmlki $ed Form RW-03 rev. 10.13.06 A~M1MIf01bap Sao.QmbMend 1T; ~1 R ~i R ` ^- ~..~ LAST WILL AND TESTAMENT r~Q ~ -~- ~, ~ , - ,~ ~ -.- L; ~ -, r7- `-°K ~ , _;<~ ._. STACIA I. KAMINSKI ~"° - ~,,, __, fv - : -~-~ _~J .J , n ~ .~ I, STACIA L KAMINSKI, of 90 Nittany Drive, MechanicsburgYO°. (Upper Allen Township), Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I direct that all inheritance, estate, transfer, succession and death taxes, as well as my just debts and funeral expenses, of any kind whatsoever, which may be payable by reason of my death, shall be paid out of the principal of my estate as the same can conveniently be done. SECOND: I give, devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my daughter, MARY ANN CHARLES. of Mechanicsburg, Pennsylvania, provided she survives me by thirty (30) days. THIRD: Should MARY ANN CHARLES predecease me or die on or before the thirty-first (31st) day following my death, I give, devise and bequeath all the ~'r~~, .~;;uuC and -ciilair~ier of niy csta~te of whatever nature arld wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my son-in-law, EDWIN K. CHARLES, of Mechanicsburg, Pennsylvania, per stirpes. FOURTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of all property: ., (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, e~:changes or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduciaries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (~i~ T~ make d!Stl"i~"';:t1C`:.^-, i.~,; : :' i~'~;'~r; rl;~p~ed i:i~i,~,{i~'iaC'leS in CaSil of 1Cl kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent provided for by the plan or the law. 2 FII{ I'H: I nominate and appoint MARY ANN CHARLES, Executrix, of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of MARY ANN CHARLE~~, I nominate and appoint EDWIN K. CHARLES, Executor, of this, my Last Wi11 and Testament. I direct that my Executrix or Executor, as the case may be, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WI-IEREOF, I have hereunto set my hand and seal to this, my _usi ~v'iil and Tesiarntni, this Z~~"~ day or iYiarch, 2008. ~1 2 ~ ~ ,~~~~~ (SEAL) STACIA L KAMINSKI Signed, sealed, published and declared by the above-narned Testatrix as and for her Lash Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. 70 ! ~,~.~ ~; C'r, Address f7~Sf ',' ':~s)]e r y _ , .. ., I , ~am~ - -~.._ . _. 3