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Home My WebLink About07-07-10 (2)PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER. OF WILLS OF CUMBERLAND Estate of HAZEL M. MASSEY also known as Deceased COUNTY, PENNSYL~IANIA ~7 File Number C~~ l ~~ ' ~ ~' ~- Social Security Number 202-20-7167 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 EXECUTRIX last Will of the Decedent dated APRIL 3, 2007 and codicil(s) dated rya teamed in tl ~; ,:: ~ +~ - _..., i .:.~. (State relevant circumstances, e.g., renunciation, death of executor, etc.) ~ ~ ~ ~•.1 r s~ . ..-". ~"~ --~-~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution a'l~~h~~nstrume>~) offex'e~i:--'~ :: i..`r, for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~'~- ~ ; a { ~ - G.'- : i C~ B. Grant of Letters of Administration (If applicable, enter: c. t. a. ; d. b. n. c. t. a. ; pendente liter durante absentia; durante minorrtate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) anal 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.) (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 _ 141 N. BEDFORD STREET CARLISLE CUMBERLAND COUNTY PENNSYLVANIA 17013 (List street address, townlcity, township, county, state, yip code) Decedent, then 86 years of age, died on JUNE 30, 2010 at CARLISLE REGIONAL MEDICAL CENTER, CARLISLE CUMBERLAND COUNTY PENNSYLVANIA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 9,000.00 (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $~ 70,000.00 situated as follows: 141 N. BEDFORD STREET, CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA 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: or printed name and residence ~~ / ~ I MARLO STOFKO, 83 REGENCY WOODS NORTH, CARLISLE, PA 17015 Form RW-02 rev.10.13.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNT' 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 the ~~~ day of (..J the Register (/ ~. Signature of Personal Signature of Personal Representative Signature of Personal Representative File Number: ~' Estate of HAZEL M. MASSEY ,Deceased Social Security Number: 202-20-7167 Date of Death: JUNE 30, 2010 ! -~ ~>r AND NOW, ~'~~ t~ , in consideration of the foregoing Petition, satisfactory proof having been presente before e, IT IS DECREED that Letters TESTAMENTARY are hereby granted t MARLO STOFKO and that the instrument(s) dated APRIL 3, 2007 described in the Petition be admitted to probate and filed of FEES Letters ......... ...... $ Short Certificate(s) ........ $ Renunciation(s) .. ........ $ JCP ... $ AUTOMATION FEE $ WILL $ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ Form RW-02 rev. 10.13.06 in the above estate 210.00 12.00 23.50 5.00 i s nn Attorney Signature: Attorney Name: ROGER B.`-~kWIN, ESQUIRE Supreme Court I.D. No.: 6282 Address: 60 WEST POMFRET STREET CARLISLE, PA 17013 Telephone: (717) 249-2353 265.50 Page 2 of 2 I(li;;l)S IlI:V ctrl/~I~~ i~-cam ~~j ~.OCAL REGISTRAR'S CERTIFICATION OF DEATH `4N~,RNiIVG: it is illegal to duplicate this copy- by photostat or photograph.. I ~cL~ tt~~. this c;~rtit~iL_~t~L•. `ti(~ (1tt :~.~~" (_'~~rtiliciititlt~ Ni)-t)ix't --- _ ;~,~,,,,/r/~///= ~ ~N Qf P ~ '~"lus I~ to t~ertlh, that the n~torn~atlon h~:re given IS ' ' ,~,y ~,~cP ,,;~' \ `" y ~ - ;~~or~-ectl~ c(1~ied ~ rl.~n~ ttn ori,~il~a1 ( ~`e~rtific~ate of Death , 11 J . ,~ ~~;,~ \~ z,, s~! 1iu{y I~iied ~~~ith 1ne as Local Re~zistrar. "C'he original ~ertific.a;e ~~i)1 t~t:° Ic~rw:)rded to the State Vital i ~j . ~~ . gay ~' ~ t~ecord~ (>l~ficc )t1r Eat<~~rmanent fi]irig. ~_ - - * , ~_ 9~ ~. , \` `~'"q P ~ ~~~''`'' ~!~"+ L ~J~-ir(e.. -~` +'~ ~`'~~ ~ `~~'~ ~ 1 2 010 ~ ~ MEI~~ 0~ ~ ~ t.t~cal Re~'IStt'~!I- Date' Issued ~ c~ ~...~ ~ ~ ~ I I )-'. , ._t ~,~ ~ _ .i....r f:_t:..1 ~ ~ ~ ~ H105.143 REV 1112006 TYPE I PRINT IN PERMANENT BLACK INK 4J Q- w 0 w w 0 0 Z COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) CTATF FII F NIIMRFR 1. Name of Decedent (First, middle, last, suffix) Hazel M. Massey 2. Sez Female 3. Soda) Security Number 202 _ 20 _ 7167 4. Data of Death (Month, day, year) June 30, 2010 5. Aga (last Birthday) Under 1 ar Under 1 de 6. Dad of Binh Month, ar 7. Bin lace Ci and state a fa re n count Ba. Place of Death Check on one 8G v Monms Days Hours ~"'~ ~y 30, 1924 Gettysburg, PA Hospital: Other: Yrs ®InpaUent ^ ER (Oulpatiant ^ DOA ^ Nursing Home ^ Residence ^ Other • Spedty: 8b. County of Death tk. Ciry, Boro, Twp. of Deam 8d. Fadliry Name (If rat Institution, give street and number) 9. Was Decedent of Hispenk Ongln? ~ ~ ~] Yas 10. Race: Anwrican Indian, Black, Whfie, etc. w Cumberland S. Middleton Twp. Carlisle Regional Medical Center a+yea'apadrycaban, (spec//,q Mexican, Puerto Rican, etc.) White 11. Decedents Usual Occu tion Kind of work done B urin rrrost of wo Iffe. Do not state retired 12. Was Decedent ever in the 13. Decedent's Education (Specity ony highest grade comp leted) 14. Mental Status: Married, Never Married, 15. Surviving Spo use (If wife, give maiden name) Kind of Work Kindol Businessllydustry U.S. Armed Forces? Elementary I Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specify) Owner Cleanin Co. ^ vea ®No 12 Widowed w 16. DecedeM's Mailing AddressiStreet, dly /town, state, zip code) Decedents Did Decedent PA Live in a T t Li d i ^ Y D d 141 N . Bedford Street PA 17013 li l C Actual Residence 17a. State „~ ~„nry ve n _ wp. 17c. es, ece en Cumberland Township? 17d.I~No,DecedentLivedvrithin Carlisle s e, ar , Actual Limits of Ciry/Boro 18. Fathei s Name (First, middle, last, suffix) 19. Mother's Name (first, middle, maiden surname) Gu Kauffman Marie Harman 20a. InfonnaM's Name (Type / Pdnt) 20b. Infornant's Mailing Address (Street, dty /town, state, zip code) Marto Stofko 83 Regency Woods North, Carlisle, PA 17015 21 a. Method of Disposftion r ^ Cremalbn ^ Donation 21b. Date of Dispositon (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory a other place) 21d. Loption (Ciry/town, state, zip cafe) w ~] Burial ^ RertavelhomState ~ wascrerwtbnarlxxretlenAuttari:ed July 6, 2010 Cumberland Valley Memorial Carlisle, PA ].7013 ^ Other - S ' by Medkal Examiner/Coroner? ^ Yes^ Ne Gardens ~ 22a. Sgnature of Funere or parson acting as ouch) 22b. License Number 22c. Name and Address of Facility Hof fman-Roth Funeral Home & Crematory, Inn. . _ ~ 138425 219 North Hanover Street, Carlisle, PA 17013 Complete items 23a-c only wften certilyirg 23a. To the my knowledge, death occurred at rite time, date and place stated. (Signature and tltle) 23b. License Number 23c. Date Signed (Month, day, year) physcian Ls not available at time of death to ceniry cause of death. w Items 24.26 must be completed by person 24. Time of Death 25. Date Pronounced Dead (Month, day, year) 26. Was Case Referred to el Examiner /Coroner fa a Reason Other than Cremation or Donation? who pronouraes death. 5 ~ 4$ ~ M, _ ^ Yes No CAUSE OF DEATH (See Instructbns and examples) r Approximate interval: Pert II: Enter other sianifk;ant conditlons contribubngJg death. 26. Did Tobacco Use Contdbute to Death? Item 27. Pan I: Enter the chain of events -diseases, injuries, or complications • that directly caused the death. DO NOT enter terminal events such as cardiac arrest, ~ Onset to Death but rat resulting in the undedying cause given in Pan I ^ Yes ^ Probably '- respiretory arrest, or ventricular fibrillation without showing the etiobgy. L+sl Doty one cause on each Nne. r r ~ ^ Nc nknown IMMEDIATE CAUSE (Final disease or r' (~. corndtion resulfmg in death) ~ ~L' Y~ ~S -~ a. r , r 29. If Female: nant within ast ear ^ Nol ro Due b (a as a consequence of): t / ~~ < r r p g p y , ^ Pregnant et time of death e ! Y/ c/~ ~, J SSs~qpuuendallky~ fiat conditions, if any, b ~~ I,cQ., D 1a1 r ^ leading to dte pose listed on line a y ( Enter Bre UNDERLYING, CAUSE Due to (a as a consequence ot): i Not pr~nant, but pregnant within 42 days o1 death (disease or injury that initiated the c' r t 43 d t 1 ^ N t b t events resuking in death) LAST. Due to (or as a consequence of): i r pregnan ays year o pregnant u o before death w d i ^ Unknown if pregnant within the past year . 30a. Was an Autopsy 30b. Were Autopsy Endings 31. Man Death 32a. Date of Injury (Month, day, year) 32b. Desurbe How Injury Occurred 32c. Place of Inlury: Hans, Farm, Street, Factory, Performed? Available Prior to Completion of Cause of Death? n 1r" atonal ^ Hanidde Office Building, etc. (Specity) ^ ^ ^ ^ Accident ^ Pending Irnestigation 32d. Time of Injury 32e. Injury at Wont? 321. It Transponatfon injury (Specify) 32g. Location of injury (Street, city /town, state) Yes ~ No Yes No kid ^ CoWtl Not be D termin d ^ S ^ Yes ^ No ^ Driver/Operator ^ Passenger ^ Pedestrian u e e e M. - ^ Other - Specify: 33e. Certifier (check only one) 33b. Signature and Titk of Ce r t • CertMying physician (Physician certitying pose of death when anotfafr physician has proraunced death and completed Item 23) To the best of my knowledge, death oceurted due to the cause(s) and manner as stMed _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ) ~^--~ - ` '- l~~ • Pronouncing end eertlryMg physician (Ptysician both pronoundng death and certifying to pose of death) .License Number 3 ~ 33d. Date Signed (Month, day, year) To the bast of my krawledge, death occurred at the time, date, and pleas, and due to the eauae(a) and manner as stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Madkal Examiner/Coroner ,/(/(~ 3 ~ r ,3 ~ ' OG f ~, ~ p ~tp On tM bests o/ examinatbn and I or Investigation, fi my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as stated_ ^ 27) Type I Print 34. Nor erson Who Completed Cause of Death (Item m a and Address of P / ~ y~ ~ ~ istrar' re and Di trio Numbe?~ Re 35 ate Filed (bloom day year) 36 y f ~ ~ rf'~ ~ ~'/,l ~ ~M f 'v( `T' . g - ~~ r-e~.c'E~'`c I ~ I 1 l .~. I 1 I C) I , , . C/9f'L r'.S~:k' ~L ~Ioi/fl ~ 2t ~,/~%c~AG ~F/J"~c~ Disposition Permit No. ~ . v ~ v `ti ~~ r `F' HOC,/y LAST WILL AND TESTAMENT I, HAZEL M. MASSEY, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1. I direct my Executrix to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Executrix of my estate. 2. My Executrix may, at her discretion, compromise claims, borrow money, retain property for such length of time as she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. 3. I authorize and empower my Executrix to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My Executrix is authorized and empowered to engage in any business in which. I ~_ may be engaged at my death, for such period of time after my death as seems ex~nt to ~d _. -- Executrix. '~"' ~ r" ~ ,_ 1 ~ ~ ~.~ ' .~ w ~ ~ o~ 5798 4. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my granddaughter, JENNIFFER HOLLINGER, and if she is not living, to my granddaughter, MARLO STOFKO. 5. It is my desire that MARLO STOFKO tame care of my animals and that she be provided funds to do this. 6. I request that MARLO STOFKO oversee and assist JENNIFFER HOLLINGER with the management of her affairs and with the assets of the estate. 7. I nominate and appoint MARLO STOFKO to be the Executrix of this my Last Will and Testament. 8. No Executrix acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 9. I hereby suggest that my personal representative retain the services of Irwin ~& McKnight as attorneys in the settlement of my estate. 2 i . ~ ~ - _.~ IN WITNESS WHEREOF, I have hereunto set my hand and seal this ' day of l~~h, 2007. ,~~ ., ~ ~'" (SEAL) HAZEL M. ASSEY ,,. Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~ ~ ~ ., ,. f .~~ '~ ~ -~ \ ~y. " ~ ' 3 R ~ + ~ ACKNOWLEDGMENT AND AFFIDAVIT WE, HAZEL M. MASSEY, KAREN S. NOEL and SHARON L. SCHWALM, the Testatrix and witnesses respectively, whose names are signed to the 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 that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. HAZEL M. MAS ~~ t .., ~. KAREN S. NOEL SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by HAZEL M. MASSEY, the Testatrix herein, and subscribed aid sworn to before me by KAREN S. NOEL and SHARON L. SCHWALM, witnesses, this ' day of l~~h, 2007. ...., -G~ a Public COMA ~°~11M~. ~'H OP P~~}NSYLVaIVIA ,~o~~al deal Roder Ei.1~,n, tVo'~ry Public Carlisle eoro. Cumberland Gounty My Commission Ex~+res Oct. 3, 2008 Member, Pennsylvania Association Of Notaries