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HomeMy WebLinkAbout06-04-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Joseph A. Kovalcik also known as COUNTY, PENNSYLVANIA File Number 21-10-~~' 7~ ,Deceased Social Security Number 209-20-9463 Mark A. Kovalcik Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' BELOW:) QX A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) last Will of the Decedent, dated 01/10/2010 and codicil(s) dated 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 app rca e, en er.~ c..a.; .n.c..a.; pe en e r e; uran e a sen ra; uran a mrnon a e 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.) I ~ `$ 1r ; Name Relationship Residence ~, .;_..3 , .,.:.~ , . -~-~ ~ ~ 3 ~ _ e . C . •7 J ~ -~-a {COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 407 Woodland Avenue, New Cumberland, New Cumberland Borough, Cumberland, PA 17070 (List street address, town/city, township, county, state, zip code) Decedent, then years of age, died on 02/16/2010 at 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: 150,000.00 Wherefore, Petitioners} 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: Signature Typed or printed name and residence Mark A. Kovalcik Post Office Box 396 ~ ~ /~ +~ ~ Chaptico, MD 20621 Form R -U2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 is/are the named in the 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 this (,/1'/ day of ~__, ~ ~/ Fort Register Mark A. Kovalcik Signature of Personal Representative ra C~ ;~: _ A _ j., 3 ...; ~ of Personal x File Number: 21-10- ~j 7~ - ~ ©? Estate of Joseph A. Kovalcik ,Deceased ""~ f.~ ..,r L.r f' .~'..i.. ~:.~ ~ Social Security Number: 209-20-9463 Date of Death: 02/16/2010 AND NOW, ~ D , in consideration of the foregoing Petition, satisfactory proof having been presented before me, I IS DECREED that Letters Testamentary are hereby granted to Mark A. KOVa1C'tk in the above estate and that the instrument(s) dated 01/10/2010 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............................................ $ ~"C~ Short Certificate(s) ........................ $ r,2 • ~~ .~- Renunclatlon(s) ............................. $ $ 15 av ,J S $ ,~3 ~o t $ $ $ $ $ TOTAL .................................... $ ~ ~ ~ . Att Att Address: 429 South 18th Street Camp Hill, PA 17011 Telephone: 717/730-7310 Form RW 02 Rev. i0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Supreme Court I.D. No.: 41263 BEFORE THE REGISTER t)F WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JOSEPH A. KOVALCIK, DECEASED NO 21-10-0573 DECREE OF THE REGISTER OF WII.LS AND NOW, this 7th day of June, 2010, upon consideration of the Petition for Grant of Letters filed by Mark A. Kovalcik, for the above decedent and the instrument offered for probate as the Last Will and Testament, which is dated January 10, 2010, and containing certain modifications thereon, the Register of Wills having given consideration thereto, has made an official determination regarding those modifications and renders the following decision: IT IS DECREED that the instrument be admitted to probate as The Last Will and Testament of Wilma Finui. The obliteration appearing on the second page, Article IV Section 2, "if Mark A Kovalcik survives me. If Mark A. Kovalcik does not survive me, I give this gift to" is admitted to probate leaving Section 2 to read "I give my home 407 Woodland Avenue New Cumberland Pa and all of its contents to be divided equally between to Mark A. Kovalcik and Jill K. Weaver. IT IS FURTHER DECREED that Letters Testamentary are hereby issued to Mark A. Kovalcik this date. Mark A. Kovalcik shall have all the rights and duties of a fiduciary under the laws of Pennsylvania and shall proceed with the administration of this estate according to law. ~. c~ ' ,r ' ~ t"'~ E.....s ~,'. j '--~ ~ •-M' i u~..j ~ :x`:~ Glenda Farner Strasbaugh, Register ills ~x. ~ ~• T ~ a ~I~~ ~~ ~`~ ~~ STATE O F M A~ ~~ Y L~~ ~~~~ R A rat D - Department of Health and =Mental Hygiene Division of Vital Records ` ;` -~ Please Type or Print in Black Indelible Ink. Ensure All Copies Are ~ e. For State a# Maryland /Department of Health and Mental Hygiene ' R~ ar ' Certificate of Death Qa„ ..„ .,c-.~~~ - "~`~ ~. ,I *, SIC ~" .. ,7 ~~} c.~ -°.r~ v 1. Decedent's Narra (First Middle, L8St) 2. Date of Death 3. Time of Death Jose h Anthon Rovalcik Febiua oa~6 201:0 5:05 a M 4a. Facility Name (lf not institution, give street and numt~ 4b. City, Tawn, or location of Death 4c. County of Death St. 's Nuns Center <: Leonardtown ~ St. Mary's ' 5. Social Security Number 6. Sex T. Age pn yrs. 'last birthday) ' If U Y 8 Date of Birth 9 Birth la (Bi l F i ~ 1 ®M 2 ^ F Months ys Honra Min. t ~ . p ce a a or oro gn 2 _ .. 82 Yrs. ~ •198 2 Penns lvaai .Usual Residence of Decedent O 10a. State 10b. County 10c. C+ty, Town or Location 10d. Inside Ctty Limits ' i. O 1 ^ Yes 2 IB No toe. Street and Number 1 i 10f. Zi Code P 10g. Citi2en of VNhat Country? ~ ! 38051 Cha tico road 2Qb21 B S A ~ 11. Marital Status 12. Was Decedent Ever in U.S. Armed Forces? 13. Was Decedent of Hispanic Origin? (Specify Yes or No- If Yes, specify Cuban, Mexican Puerto Rican etc.) 14. Race -American Indian, 1 ^ Never Married 2 Q Marred 1 $I Yes 2 ^ No , , Black, White, stc. «. 3 ~1 Widowed 4 ^ Divorced If Yes, Give Year or Dates.. 1 ^ Yes 2 ~ No S ~~. _,' Mite S~~ry' 15. Decedent's Education (Specify only highest grade completed) 18a'. becedent's Usual Occupation ' (Give'kind of wo-ir done during most of working 16b. Kind of Business Industry Elementary/Seconday. (0-12) College (1-4 or'5+) lifs_ Dp NOT use retireCt) - ~1 12 Sales>ssn I~il.l ~ an m 17~Father's Name (First, Middle, Last _ . 18. Mother's Name (First, Middle, Maiden Sumamel John P. Kavalck AmQa;, B , K7cof chok 19a. Informant's Name/Relationship (type, Print) 19b'. Maibng Address (Strtset artEi Number or Rural Aoute Number, City or Town, State, Zip Code) P 0 boa 6 Cha tiro MD 20621 20a. Method of ttion Dispos 206. Place'af Di6po3ition (Name of ~ Date 20c. J~ocation -'-City or Town, State 1 ^ Burial 2 ^ .Cremation 3 ~ Removal from State Cemetery; arerrrafory or other place) ~ 4 ^ Donation 5 ^ otner(Sf~i1Y1 Rolling -Green '0220/201 LOwer AllenTownshp,PA 21. nature of Funeral Service 22. Name and Address of Facility Brinsf i@~ P A. d FtiIIeral HO)•e , , • F le S, S>•ons M0120 22 55 garll. Rd. Leonardtovn, MD 20650 23a. Part 1. Enter the disease, or complications that caused the death. Do not enter the of 9ry ,such as d or respirat arrest, q pproximate shock, or heart failure. List only one cause on h tine. ^ Interval Betw .Immediate Cause (Final On disease or ccoraidttion resultin in death) a• g Due to (or,' a c:onseq : ~. Sequentially list conditions b. , , if any, leading to immediate. Due to (or as a ctmsequerrce df); ," ' • cause. Enter Underlying ~ Cause (Disease or iinlury r that initiated events c. LY resulting in death) )Last Due to (or as a consequence of): d.' / ' ~ IF FEMALE: 23b. Was decedent r Want P ~ ? 23c. If res, outcome of pregnancy Ll [~ 1 live Birth 2 Fetal Beath 3;^ Ectopic pregnancy 23d. Dates of delivery • ti • in the past 12 months 1 ^ Yes 2 ^ No 4 ^ Pregnant at time of death 5 ^ Other,(specify) Month Day Year !~, L 9 ^ Unknown 9 ^ Unknown:.... _ a Part II. Other sign cant conditions contributing to death but not resulting in the underlying cause given in Part I. 23e. Did tobacco use contribute to the cause of death? ~~: 1 ^: Yes 2 ^ No 3 ^ Probably 4~ Unknown r _ 24a. Was an 24b. Were autopsy findings available i I~ autopsy pr or to completion of cause of ~ ~ perfo ? 1 ^ Yes 2 N death? o 1 ^ Yes 2 ^ No 25. Was case referred to medical examiner? 26 Place of [)oath (Check only one' 1 ^ Yes 2 ~ No Hospital: 1 ^ In tient 2 ^ ER/Out ient 3 ^ DOA ~~~ 4 Nursi Home 5 ^ Residence 6 ^ Other S c" 27. Manner of Death 1 ~ Natural 5 ^ Pending 28a. Date of i u nj -Y (Month;,. Day, Yitar) 28tj: Time of inNrY 2$e. Injury at work? ; 28d. Describe>how injury occurred 2 ^ Accident Investigation 3 ^ S i ide 6 ^ C ld t b M 1 ^ Yes '2 ^ No ~ ~ u c ou no e 4 ^ Homicide determined 28e. Place of Injury - At home, farm, street, factory, office building etc (Specify) 28f. location bi9et and Number or Rural Route Number, (S x t , . City i Town, S ate) v 29a. ~ertifier 1 Certifying Physician: To the best of my knowledge, death. occured at the time, date and place, and due to the cause(s) and manner as stated. (Check 2 Medical F.xam&ter. On the of examination and/or investigation, in my opinion, death occurred at the time, date and piece, and due to the cause(s) and manner stated. only one). 3 Certifying: Norse . the best of,my knowledge, death occured at the time date. and. place„and due to-the cause(s) and manner as stated. 29b: Signature and of certifier 29c License ~9,umbe- ,:_ 29d. Date signedf nth, Day; Year) ~ - _ p .~` - ~ _. 30. Name and of person whoa _ of death (ttetit .: ;;' q 1 31. Date filed n Day Year) ' trays Signature ., , " ~_ _.._ ~.__ ;: ': I HEREBY CERTIFY THAT THIS DOCUMENT IS 274175 AL A TRUE::COPY OF A RECORD ON FILE IN THE DATE! SSUEp ' ~ QIVI~IQ~V OF V[TA~ RECORDS. • .:. sr: ,a. .. ,. ..-;.:w,» .. ,.wx;--... .,n.,,~ ... e. .. ..,.:... ,.... .: ,...r. ..~ .. .;.. .. ,, ... !.:.. „d: ~:.a:. .K,.. .. .,,.,. ~.~ sww wYrrnart..~.w,>...rwAa.«u~rww.m.~.,....m w,.~.~«w „e .. _ ..... ....ww.....r,. M ..... .. JU ~~~ _ ~ ~ ~ 1 ~~~~~I`~ '<STATE?REGISTRAR > DO NOT /#CCEPT U'NL.ESS ON>SECURITY,PAP..:ER WITH SEAL CIF VETaI_ RECORDS C.G.EAR~Y Etv1BQ~SEn. >. ,\ _ _ - Q tr.~ ~ ~' ;wt . ~~ ` ,t 1.1 i f ` ~ ' l~' t` { { ; . t LAST V~ILL AND TESTAMENT ~ _~ , . - OF ~~~ ~ - s ` ~x ~:~'4 KOVALCIK JOSEPH A ~~ cx> ~~~~~ rn . ,..a I, Joseph A. Kovalcik, a resident of New Cumberland, Pennsylvania declare this to be my Last Will and revoke all former Wills and Codicils. ARTICLE I Identification of Family At the present time I am unmarried. In making this Will I have in mind my children, Mark A Kovalcik, born 1957, and Jill K. Weaver, born 1961, but does not include any children hereafter born to or adopted by me. Any reference to a "child of mine" or "my children" shall include the persons named or referred to in this Article. ARTICLE II Disposition of Remains I direct that my remains be buried with my wife. I authorize my Executor to carry out these directions and wishes, particularly those for the disposition of my remains. ARTICLE III Appointment of Fiduciaries A. Appointment of Personal Representative. I appoint my son, Mark A Kovalcik, as Executor of my estate. B. Bond; Court Supervision. My Executor shall have the right to serve without bond and to administer and settle my estate without the intervention or supervision of any court, except to the extent required by law. Nothing herein shall prevent my Executor from seeking the assistance of the court in any situation where my Executor deems it appropriate. ARTICLE IV Specific Gifts A. Gifts of Specified Items of Property. I give all my interest in certain items of tangible personal property to the beneficiaries designated in this section as follows: f Will of Joseph A. Kovalcik Page 1 of 6 Initials: Date: ~ l 1. Specific Gift One. I give my 1996 Oldsmobile to my son, Mark A Kovalcik if he survives me. If Mark A Kovalcik does not survive me no property shall pass under this Article. 2. Specific Gift Two. I give my home 407 Woodland Ave New i ~ ~ Cumberland Pa and all of its contents to be divided equally between to Mark A Kovalcik I~ 1€ i.C ~ .,«l~ /, u(~Va~['~j ~ on .,,.+ ,,,~.~,^iTQ =': T~,~T~1"° ~~'1-r~+S ~(~rti d Jill K. Weaver. B. Insurance. I give to each recipient of an item of tangible personal property my interest in any insurance covering the item. My purpose in making this gift is to give each recipient the benefit of insurance coverage for which I have already paid. It is not my intention to give any recipient the proceeds of an insurance claim that exists but is unpaid at my death. ARTICLE V Disposition of Residue A. Provision for Descendants. I give all of the rest and residue of my estate, wherever located (hereafter referred to in this Article as "residue"), to my descendants if they survive me per stirpes. 1. Provision for Others. If I am not survived by any of my descendants, I give the entire residue to my heirs. ARTICLE VI Alternative Methods of Distribution A. Purpose of Article. Recognizing that under certain circumstances the terms of this Will may direct that property be distributed outright to a person who is under age twenty-one (21) or under a legal disability; I make the following provisions to facilitate the distribution of property to such persons. B. Alternative Methods. Whenever the terms of this Will direct my personal representative (referred to in this Article as the "fiduciary") to distribute property outright to a person who is then under age twenty-one (21) or under a legal disability, the fiduciary may retain pursuant to Paragraph C. of this Article or distribute all or any portion of that property in any one or more of the following ways: 1. Delivery directly to the beneficiary; 2. Delivery to the parent or stepparent of the beneficiary; 3. Delivery to the guardian of the beneficiary's person or property; /" ,. Will of Joseph A. Kovalcik Page 2 of 6 Initials: Date: ~ b 4. Delivery to any Custodian for the beneficiary under the Uniform Gifts to Minors Act; 5. Delivery to any then existing trust created for the beneficiary; 6. Deposit in a financial institution in an account established in the name of the beneficiary alone pursuant to the laws of the State of Pennsylvania; 7. Storage of any tangible personal property in safekeeping with the costs of storage to be borne by the beneficiary; or 8. Sale of any tangible personal property and delivery of the proceeds in any manner permitted by this Article. Provided the fiduciary acts in good faith, upon delivery of any property in accordance with the provisions of this Article, the fiduciary shall be discharged from all responsibilities in connection with the property. C. Discretionary Trust. Any property not distributed as provided in Paragraph B. of this Article shall be retained by the fiduciary in trust for the beneficiary on the following terms and conditions: During any period in which the beneficiary is under a legal disability or under twenty-one (21) years of age, the fiduciary shall pay to or apply for the benefit of the beneficiary so much of the income and principal of the trust as the fiduciary, in its sole and absolute discretion, determines is advisable for the beneficiary's health, support, education and general welfare. At such time as the beneficiary is neither under a legal disability nor under age twenty-one (21), the fiduciary shall distribute any remaining trust assets to the beneficiary. If the beneficiary dies before all of the trust assets have been distributed, the fiduciary shall distribute any remaining trust assets to the beneficiary's estate. ARTICLE VII Administrative Provisions A. Powers and Duties of Personal Representative. My personal representative shall have all of the powers and duties granted to or imposed upon personal representatives serving with non-intervention powers pursuant to the laws of the State of Pennsylvania. B. Debts and Expenses. All expenses of administration chargeable to principal, the expenses of the disposition of my remains, and all my legitimate debts, if and when paid, shall be paid from the principal of my residuary estate. No debt need be paid prior to its maturity in due course and except as otherwise provided in this Will no interest in any property passing under this Will need be exonerated. Will of Joseph A. Kovalcik Page 3 of 6 Initia Date: ® !~ C. Taxes. All estate, inheritance or other similar death taxes, together with any interest or penalties thereon, arising by reason of my death with respect to any property includable in my taxable estate, and any adjusted taxable gifts, whether passing under or outside of this Will, shall be paid from the principal of my residuary estate without reimbursement from the recipients or beneficiaries of such property, provided, however, that in the event any proceeds of insurance upon my life or any property over which I held a power of appointment are included in my estate for purposes of determining the federal estate tax liability of my estate, then the residue of my estate shall be entitled to receive from the recipients of any such proceeds or property the portion of such federal estate tax liability attributable to such proceeds or property determined in accordance with IRC § § 2206 and 2207. ARTICLE VIII Miscellaneous A. Number and Gender. Unless the context indicates a contrary intent, the plural and singular forms of words shall each include the other, and every noun and pronoun shall have a meaning that includes the masculine, feminine and neuter genders. B. Survival. To "survive" me, as that term is used in this Will, a person must continue to live for thirty (30) days after my death. C. Descendants. The "descendants" of an individual include only the following: 1. All such individual's biological descendants, except any per. son not born in lawful wedlock and his descendants, unless the biological parent who would otherwise cause him or her to be a descendant has acknowledged paternity or maternity in legitimation proceedings, or in an unambiguous signed writing identifying such person by name, or by raising such person in the same household; and 2. Persons adopted by such individual or one of his or her descendants, and their descendants. If the parent, who would cause a person to be a descendant as defined above, is replaced in an adoption proceeding, such person shall remain a descendant unless such parent voluntarily consents to the relinquishment of his or her status as parent in connection with such adoption proceedings. D. Heirs. The term "heirs" shall mean those persons entitled to inherit under the then-applicable laws of the State of Pennsylvania governing the descent of an intestate's separate estate. They shall inherit in their statutory proportions. Will of 3oseph A. Kovalcik Page 4 of 6 Initials: ' Date: ~ f / E. Exclusion of Pretermitted Heirs. Other than as set forth in this Will, I make no provision for any child of mine or descendant of a deceased child of mine. I specifically make no provision for any person (whether now living or hereafter born), other than a child named or referred to in Article I or a descendant of mine as defined in this Will, who maybe entitled to claim an interest in my estate under the laws of the State of Pennsylvania. F. Legal Disability. A person is under a legal disability if my personal representative determines, in good faith, that the person is incapable of managing his property or of caring for himself, or both, or is in need of protection or assistance by reason of physical injury or illness, mental illness, developmental disability, senility, alcoholism, excessive use of drugs, or other physical or mental incapacity. G. Title to Real Property. Upon my death, title to any real property passing under this Will shall vest in my personal representative in his fiduciary capacity and shall remain so vested until my personal representative distributes or sells that property, at which time title shall vest in the distributee or purchaser. H. Disclaimer. Except as may be otherwise specifically provided in this Will, in the event that any beneficiary disclaims an interest arising out of this Will or any trust created herein it is my intention that the interest disclaimed shall be distributed in the same manner and at the same time as if the disclaiming beneficiary had died immediately preceding the event pursuant to the laws of the State of Pennsylvania. I. Governing Law. The provisions of this Will shall be interpreted in accordance with and in light of the laws of the State of Pennsylvania. J. Corporate Successors. Whenever a corporation or other business entity is referred to herein, the reference shall include any successor organization. K. References to Statutes. In this Will, the abbreviation "IRC" shall refer to the Internal Revenue Code of 1986 as amended. Will of Joseph A. Kovalcik Page 5 of 6 Initial Date: ~ ~ I have initialed and dated for identification purposes all pages of this, my Last Will, and have executed the entire instrument by signing this page on the ~ day of 200_, at ,tea. 1 a) O ~,.. .~ seph A. Kovalcik Attestation and Statement of Witnesses Each of us declares under penalty of perjury under the laws of Pennsylvania that Joseph A. Kovalcik, the Testator, signed this instrument as his Last Will in our presence, all of us being present at the same time, and we now, at the Testator's request, in the Testator's presence, and in the presence of each other, sign below as the witnesses, declaring that the Testator appears to be of sound mind and under no duress, fraud, or undue influence. ~~ . _ [Witness Signature] [Witness Signature] [Print Name] [Print Name] Residing at /~,~ ~ - ; ~~;~ Residing at 1.~.~j (c~or-f ~ ~1 ~ Will of Joseph A. Kovalcik Page 6 of 6 Initials: Date: OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Joseph A. Kovalcik ,Deceased Mark A. Kovalcik (Print Name) and ~ ~ ~-~ (~ I%vale ~ Iz - ~e.~/c~~, , (Print Name) (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were welly acquainted with Joseph A. Kovalcik and am/are familiar with the handwriting and signature of the decedent, and that the signature of Joseph A. Kovalcik to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Joseph A. Kovalcik is in hislher own proper handwriting. :~.. ~/~ . (Signature) Mark A. Kovalcik Post Office Box 396 (Street Address) Chaptico, MD 20621 (City, State, Zip) Executed in Register's Office Sworn to or affirmed an~ subscribed befo me thi ~ day of ( c~201 C~. Depu~y for Register o~/ills r (Streetddres~ ~ ~~ ~ A ~ M alp ~;~ ~•b C.~ .^' (City,~StJate, Zip) / ~ 'l. W Lam'' ~.][I`~l ~r`tlt / l `~ I ~ ~ ~ V ev fL' '3 - . ~ . i r;.~ :~ -~ r ~ -- ~- ~~' +~ ' ~ L~:~ W w.7 Form RW O4 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.