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HomeMy WebLinkAbout07-26-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of WALTER A. BROWN also known as Deceased COUNTY, PENNSYLVANIA File Number ~ ~ - ~ ~-~ ~ ~ ~ ~~`~ Social Security Number 140-30-9448 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 J are the EXECUTRIX last Will of the Decedent dated 05/31/1996 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 (If applicable, enter: c. t. a.; d. h. 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 mouse (if ~any)iapd heirs: (If Administration, c. t. a. or d. b.rz.c.t.a., enter date of Will in Sectzon A above and complete list of heirs.) ~.~ ~ ~ .,r , ;~. Name Relationshi Res' ',~"eC7 ~ ~~ -- --~-~. ~ ~ ~ L .._ ~r r.,_, ~, ~.~. ~ ~ ~ . _ t ..J • --~ ~.,_ .J `'.7 . .....t ~ ~ . =::~ =r (COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ ,_,7 C~ CUMBERLAND Count ~.,~ .~ ~ Decedent was domiciled at death in y, Pennsylvania with his I her last principal residence a~- 1 SHEELEY LANE BOILING SPRINGS SOUTH MIDDLETON TWP., CUMBERLAND COUNTY, PA, 17007 (List street address, to~a~n/city, toia~nshrp, county, state. zip code) Decedent, then 70 years of age, died on 711J2010 at PENN STATE HERSHEY MEDICAL CENTER 3:53PM 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: l SHEELEY LANE, BOILING SPRINGS, PA 17007 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: ~ Sianature 't'yped or printed name and residence 1 .~~/l ~(~1~~1~'~--- r/ 1 ~ KATHLEEN BROWN 1 SHEELEY LANE, BOILING SPRINGS, PA 17007 $ 15,000.00 $ 168,570.00 :named in the Form RW-02 rev. 10.13.116 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, Petitioners}will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the r; '~ day of Signature of Personal Representative ' ~ i_, I _ Signature of Personal Representative C7 For the Re ~ ter Signature of Personal Representative ~~~ ~ ' ~ ~ t"~ ~ _~; .._, _.~ ,--. File Number: ,~ ~ _ ~ L ' ~ ~ ~ ~ ~ ~ : J- , -' ~`> ,_ ~ ~ _ Estate of WALTER A. BROWN ,Deceased C~a ~`'' Social Security Number: 140-30-9448 Date of Death:07/01/2010 L, ~ ~' ~~ ~(~ 1(.~ , in consideration of the foregoing Petition, satisfactory proof AND NOW, having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to KATHLEEN BROWN and that the instrument(s) dated 05/31/1996 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. ~~ FEES ~'~~~ t 1~C~ (~,`~1'~s2~-7 ~:J ~ C. ~~.~„'~ Letters ............... $ ~~1 Short Certificate(s) ........ $ ~ ~ ~~ Renunciations} .......... $ ... $ ... $ ... $ ... $ ... ~ ... $ TOTAL .............. ~~ 7 ~~ 9-98 in the above estate Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: ~~ ~ ,~~~ J~ ~~~ Register of Wills ~ C Telephone: Form RW-02 rev. !0.13.06 PagE' 2 Of 2 )05905 )3EV.(3/09) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. Linda A. Caniglia State Registrar 5682693 H705.144 REV 112006 TYPE !PRINT IN PERMANENT BLACK INK 1. Name of Decedent (Pest, middle, lass, suHiz) Walter A. 5. Age (Last Birthday) Under t t nbnns 70 Yrs Bh. County of Death ,,, ~ ~ Dauphin ,,..~ ,~ 11. Decedent's Usuai Occupation (Kind of work Q ~~ w w w 0 n i No. ~uL 1 ~ Zoo CGINMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH -VITAL RECORDS CORONER'S CERTIFICATE OF DEATH Date (See instructions and examples on reverse) STATE FILE NUMBER 2. Sez 3. Social Security Number 4. Date of Death {Month, day, year) Brown Male 140 - 30 - 9448 July 1, 2010 aar under 5 day 6 Di:!e of 0irth (Monet, da ,year) 7. Blnhplace (City and state or foreign country) ea. Ponce of Death (Check on one ~ i Gays Hours Minulea Hospital: OtMr'. October 16, 1939 Kearny, NJ ® Inpatient ^ ER 'Outpatient ^ DOA ^ Nursing dame ^ Residence ^Olhar - Speciy. 9c. Ciry. Born, Twp. of Deam 8d- Fadkty Name (if not institvtbn, give street and number) 9. Was Decedent o! Hispanic Origin? No ^ Yes 10. flace~ American Indian. Black, White, etc. (If yes. speedy Cuban, is°~d» White Derry Hershey Medical Center Mexican, Puerto Rican, etc.) bne Bunn most o1 workin life. Do not sta'a retked t2 Was Decedent ever in the 13. Decedent's Education (Specly only highest grade urompleted) 14. Marital Status: Married, Never Maried, 15. Surviving Spouse (If wife, give •naidan name) o - Widowed Divorced (Specify Kind of Wont Training Co-ord. Kind dBusiness /Industry Utilities U.S. Amtetl Forces. Obas ^No Elementary /Secondary (0-12) 12 College (1-4 or 6+) 1 ' Married Kathleen Parker 16. Decedent's MaikngAddress (greet. city! town. state, zip code) 1 Sheeley Lane Boiling Springs, PA 17007 Decedem~a Pennsylvania ° e~caede"t Actual Residence 17a. gate Towr~txpz nb couny Cumberland ~F] South Middleton 17c. Yes, Decedent Uved in Twp. 17d.^ ~valts~IVedvnmin GrylBoro 18. Famer's Name (First, midde, WsL stAfizl Alexander Brown 19. Mother's Name (Frs[, middle, maiden surname) Flora Thomson 20a- InfonnaM's Name (Type /Print) Mrc_ xarhlppn P_ Rrntrm 20b. Informant's Mailktg Address (greet, dry "own, slate, zip cods) 1 Sheeley Lane_ Boilin¢ Snrin¢s_ PA 17007 2} a. o! D~sposilion ^ Crematkm ^ Donatia~ 21 b. Date of Disposition (Month, day, year) 21 c. Place o+ Disposdion (Name of cemetery, crematory or other place) 21d Location 'ry /tam, state, zip code) , ~ Bunal ^ Removal horn gate ~ Wee Crematbn or Dotaetlen Authxiad ^ other - spea/y: I by Medal Examfner/Coroner'! ^ yes ^No July 6 , 2010 Mt . Zion Cemetery / ~ 22a. Nrn d F tson acting as such) 22b. License Number 22c. Name and Address of Facliry Coc klin Funeral Home ,Inc . - - - - -L 30 N. Chestnut Street Di.llsbur PA 17019 ~orrylete name z:ia~ onry wren cemryxg physician s trot avaitabte at time o1 deem to c;sa. io ore oast m my zrww~-aye, uean„n.,:u,w ar uro unro, care -w w.w s~arw. t~,ya,~,o a,.. ,,, ,or .,.~.- ~•,~ • N„.V.,• - --.- -.n..-- ,...-.._., --,. ,--., certify ~:ause d deem. hems 24.26 must be competed by person 24. Time of Death 25. Date PronW need Dead (Month, day, year) 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Danatbn? who Pronounces death. 03:52 P M. July 1 , 20i 0 ®Yes ^ No CAUSE OF DEATH (Ssi InslrucUone and examples) r Approximate interval: Part II: Emer other siarrficant conddipns contdbutinp to deem, 28. Did Tobacco Usa Contribute to beam? Item 27. Pan C Enter the Phan xevents - dseases, injixies, or complicatans -that diretNy caused the Death. i7p NOT enter lerninal events such as carliac arrest, r Onset to Deem Dut not resulting in me undedying cause given m Pan L ^ Yes ~] Probably respiratory erresL ar venMcular fibrillation wnhoit showing me etiobgy. List Doty one pose on each line. ~ ~ No [] Unkrown IMMEDIATE CAUSE (Fnal disease or condition rixiAting in rleetn) _~ a. Head Trauma t r 29. If Female: t ithi ^ N t Due to (w as a ansequence oft: sequentieMy list cortdalons, d arty, b. Fal I From A Bicycle r i t r o pregnant w n pas year ^ Pregnant al time d death leetling le Me cause fisted on line e. nter me UNDERLYING CAUSE Due to (or as a consequence of}: E i r ^ Not pregnant, bN pregnam within 42 days ~~ ~e ar injury That initialed the c. l LAST b i d h r i of death - _ _ _- v ante resu ng m eat ) t Due to (or as a consequence of): ^ Not pregnant, but pregnant 43 days to 1 year d. ~ r before death ^ Unknown it pregnant within the pest year 30a. Was an Autopsy 30b, Were Auopsy Findings 31. Manner of Death 32a. Data pt Injury (Monet, day, year) 32b. Descdhe How Iiyury tDccuned 32c. Place of Injury- Home. Farm, great, Factory. Perforated? AvailaWePriorloCOrtpleuon June 26 2010 Fall from bicycle o~wad~'ato.(spe~iry~ - R ot Cause of Death? ^ Natural ^ Fb~~ iode , a y ®Arxdent ^ Pending Investigatbn 32d. Time of Injury 32e. Injury at Work? f M Trensportelion Injury (Specd~! 32 32g. Loptian o! Iryury (greet. cRy /town, slate) ^ Yes ~ No ^ Yes ^ No uidN tbeDetertnned ^S id ^C ^'Yes ®No ~ ( ~Dnver/Operator ^Passa•,ger ^Pedestrian 535 Park Drive, Boiling Springs, PA o wc e o 09:03 AM. - ^~~ - sPe«fr 33a. Cemlfer (check tiny one) ~ 33b. Signetur~d; nle e~`\dier ~ I \_ , , CeAlfylnp physician IPhysicwn cemying cause of deem when another physkia,r has pronounced death and wnpleteo hem 23) • 7o the best of my knowledge, death oaurred due to the uuna(s) and manna as smed_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ____----____ ~ - i ~ ~ L` ~~-Y~ _ .. p ~ ! % -' i[ Lisa A. Potteiger, Chief Dep • Pronouncln and art' n h aleian Ph sician both rvnounc death turd ee " to cause d death) 9 dN 9P Y l Y D mg niMn9 t h d ^ 33c. License Number '33 . Date Si ed (Monet, da ,year 9n Y I e cause(s) end manner as ata e _ _ _ _ _ _ To the best w my knowledge, death occurred at the time, data end place, amd cue to t • Medfal Examiner /Coroner _ _ _ _ _ _ _ _ _ _ _ _ JUIy 2, 2010 0 the basis of examinatbn end / or investigation, In my opt n, dash ocrurred at the Ilme, data, and plea, and due to the ease(s) and manner ea a[ated_ ® 34 Name and AtMress of Person Who Completed Cause of Death (Item 27) Type /Prim Pottei Lisa A er - 35. R ar s Signature and D' riot Nu ~ 3fi. ate Feed (Monet, day, year) g . 1271 South 28th Street - a ~D Harrisbur , PA 17111 ~,, Disposition Permit No. ~ ` ~ t ".~ ~ C~"D ,t. .) . ;-a. \..J ~~ ' ~ ~ ~• + l ~ (, - 6_i ry"_ ~ ~.~ f -/ -'t ._ _ r- ... ~ "- - ~ U ., _,I .- .. ., r..- W t IN THE NAME OF GOD, AMEN ~'~ r ~' , :~J ~:~ G,..., ::i . - ~. _ ti / ~-~ ~ i_,... _ ^A 3 t` _. .., ~ s`: a' ~: T ~ii _ ~_~ .,. _ ..,. ,_ °" _ ~~, ~_ ,..~ . , _. C.,r ' ` ~, I, WALTER A. BROWN, residing at 42 Lakewood Road, i.n the Borough of Manasquan, in the County of Monmouth and State of New Jersey, do make, publish and declare this my Last Will_ and Testament, hereby revoking any and all former Wills and Codicils by me at any time heretofore made, in manner following: FIRST: I order and direct the payment of all my just debts and funeral expenses as soon as convenient after my decease. SECOND: All the rest, residue and remainder of my estate, real, personal and mixed, wheresoever situate, I give, devise and bequeath to my wife, KATHLEEN BROWN, to her, her heirs and assigns forever. THIRD: I authorize and empower my Executrix, hereinafter named, to sell and dispose of any and all of_ my real estate at public or private sale whenever she, in her judgment, deems it most advantageous for my estate so to do, and to~ make, execute and deliver good and sufficient conveyances in the law for the same. FOURTH: I hereby nominate, constitute and appoint my said wife, KATHLEEN BROWN, sole Executrix of this my Last Will and Testament, and I direct that she shall not be required to give any bond for the f aithful performance of her duties in any jurisdiction. FIFTH: In the event my said wife, KATHLEEN BROWN, shall predecease me, or in the event my said wife shall not survive me for a period of fifteen days, then and in either event, I give, devise and bequeath all the rest, residue and remainder of my estate, real or personal, to my two sons, namely, KEVIN A. BROWN and STEVEN J. BROWN, share and share alike, to have and to hold the same for their own use and benefit forever. In the event either of my said sons shall predecease me, then and in that event, his share shall go to his issue in equal shares, per stirpes, or -2- in default of issue, to my surviving son. In the above event, I authorize and empower my Executors hereinafter named, to sell and dispose of any and all of my real estate at public or private sale whenever they, in their judgment, deem it most advantageous for my estate so to do, and to make, execute and deliver good and sufficient conveyances in the law for the same. In the above event, I hereby nominate, constitute and appoint my said sons, KEVIN A. BROWN and STEVEN J. BROWN, Executors of this my Last Will and Testament, and I direct that they shall not be required to give any bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal thi s # =, ; ~~-~ day of May, One Thousand Nine Hundred and Ninety-six. WALTER A. BROWN. Signed, sealed, published and declared by the said WALTER A. BROWN, as and for his Last Will and Testament in the presence of us, who, at his request, in his presence, and in the presence of_ each other, have hereunto subscribed our names as witnesses this ,~„?,r~°~~day of May, One Thousand Nine Hundred and Ninety-six. ~ ~,. CHARLES V. MYERS ''~ - ~° ~ . ~.~v RUSSELL E. MILLS 1473 Whitty Road Toms River, New Jersey 08753 853 Glenwood Circle Toms River, New Jersey 08753 502 SE-WILL PAGE-SELF PROVED ~` 1' R V S T-1 ©1979 ALL-STATE LEGAL SUPPLY CO. (Simultaneous Execution) ONE COMMERCE DRIVE, CRANFORD, N..d. 07016 - 3- I, WALTER A , BROWN the testat o r , a;nd bein dul sign my name to this instrument this = ; ° ''~"' day of May 19 9 6 g y sworn, do hereby declare to the undersigned authority that I sign and execute this instrument as my Last Will; that I sign it willingly; that I execute it as my free and voluntary act for the purposes therein expressed; and that I am 18 years of age or older, of sound mind and under no constraint or undue influence. ,.. ---------- ---------------- ----~ ---------------------_-_--i"---------------------------- WALTER A. BROWN Testat or We, CHARLES V . MYERS and RUSSELL E . MILLS the witnesses, sign our names to this instrument, and, being duly sworn, do hereby declare to the undersigned authority that the testat or signed and executed this instrument as Yli s Last Will and that he signed it willingly; that each of us, in the presence and hearing of the testat or ,hereby signs this Will as witness to the signing thereof by the testat o'r ;and that to the best of our knowledge the testator is 18 years of age or older, of sound mind and under no constraint or undue influence. r ~ d>'" w ~ ~~' ~---~~ ~--- 1.47-3_-_Whitty--_Road, Toms River, NJ 08753 Witness CHARLES V . MYERS ~-' Address ~~ ~ ~~~~-~~---="---~'~-~-'~-~-----------------------------$5-~---~l~nylQod--Crcle,_.-Toms---River, NJ ------------------------- ------ -------- Witness RUSSELL E. MILLS Address 08753 STATE OF NEW JERSEY SS. COUNTY OF MONMOUTH Subscribed, sworn to and acknowledged before me by WALTER A . BROWN the testat or ,and subscribed and sworn to before me by CHARLES V . MYERS and RUSSELL E . MILLS ,the witnesses, this .~; ,~ `'' ~ day of May ~ 19 96 - r . ~' ; '` ~~~iet A. Cairney Notary Public of New Jersey My Commission Expires June 27, 2000