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HomeMy WebLinkAbout08-10-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF COUNTY, PENNSYLVANIA ,-- ~ /~ Estate of ~~ ~ ....~ ~ ~ '~ ~ l'~' k-~--"_ File Number - r'.) ~l.' also known as Deceased Social Security Number _~~ l Z- i'( 2,•~ `-f 4, 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 l ~ ~ E' ~. -~'rL < `~ named in the last Will of the Decedent dated C~ ~~_ ©( 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. b. n. c. t. a.; perzdente liter durance absentia,, durance mina•itate) 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. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~°-.:~ J ~ - Name Relationshi Resicfen = - r--t-~~ ..._._ __, . _. _. -, ~ ,. _ i e ~e ~ r ~ ~~ (COMPLETE L'V ALL CASES:) Attach additional sheets if necessary. ~ ; h~'' - ~- ~..{ t ~ .. T~ f Decedent was domiciled at death in ~ J ~ ~' T(~,.,,, d, County, Pennsylvania with his /her last principalT~idence at t ~l 2.~ > ~ ~ " ;:: '~ 11~ r.v (E L.~ ~ ~_ W~-4-C~ H.Gti.-..c r ~ k~ a i..~ ~o ~~ 1 "7 ~ -$ --s - -- - - _~ (List sd•eet address, totiwi/city, township, cozznt)~, state, zip code) ~^ ~ Decedent, then ~_ years of age, died on S ~ ~ ~-~t at 1 SI ~. ~ t Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $_ ~ {.~~~ L~ (If not domiciled in PA) Personal property in Pennsylvania $_ • (If not domiciled in PA) Personal property in County $_ Value of real estate in Pennsylvania $____ ~ r ~. C y~ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters its the appropriate form to the undersigned: Signature Ty ed or tinted name and residence ~- , ~ :~. ,~ . ~ a,-,,., ~ Form R6V-0? rev. /0.!3.06 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA l~ ~ t ~ ~ • ~ ~~~-tL4 SS COUNTY OF ~ `~ `^'` b~ :t..l c:_.~ ~ The Petitioner(s) above-named swear(s) or affirnz(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 - ((7 *L' day of _~r ~ o t f ~ (r For the:~R~gister ~,s ;~ Signata~re of Persona! Representative Signature of Personal Representative ~~ ,, r"'-, c.,:.:~ ( _~ G:~J . Signatz~re of Personal Representative ~' Ca ~;; ~, -~? c; ~ _~ ,, ~ .~ "~ - , File Number: ~ ~ - ~ ~ - ~~(~ ~ ~~~~ ~ '~ - -i l^~? . ~' ~ Estate of ~ . J e ~ 1J c3 '~" ~ ~' ,Deceased t_F~ !~ `~ ~~' i- h Social Security Number: ~ ~ ~ Z`t Z S `~ ~' Date of Death: ~ ~' ` ~ ~ ~ ~ ~ AND NOW, ,%t y~<.; S 1' iE~ Z'~ ~ ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters u ~ `TCST ~ w~c +-~~~ ~~ ~( _ are hereby granted to L ~ ~~ ~ ' ~~ U «a+1L t~ in the above estate and that the instrument(s) dated >Nl iA~-1 1 ls~ 2 by 1 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. ~•~ , ~,. FEES ~`~`,~) ~~~rl~t ~,~r~``-..)~=-_l ~~- ~~(' ~1 ~ - C: ' v ~ ~ r \ , ~ Register of Wills ~ -i • %`~ e Letters ............... $ ;- CJ V~ -{ >~ ~~(~- ~- f~c~' C~..~~~ S ~. Short Certificate(s) ........ $ ~ ~Z- Attorney Signature: Renunciation(s) ....... ... $ ~~ ~ ~ 1 ... $ i ~ l ~~ Attoi-~zey Name: ~~ ~- ~ • ~ • $ C ~~ • "".7'~-' Supreme Court LD. No.: 1~L~ ~C.>YV~~t ~~1G v~1 ... $ ~L,1 (~. ~~ $ Address: ... $ ... $ ... $ ' ' ' $ Telephone: ... $ TOTAL ........... ... ~~_ ~, r-~r~n, RNV-(IZ rw ~o.r3.or> Page 2 oft LC~~~AL REGISTRAR'S CERTI~ICA,TION OF DE~~'TH 1t''~/p-RNING: It is illegal to duplicate this copy by photostat ar photograp~ih. Ft:e 1~1~r thi. certiri~~lte, ,r, r,~„%, ,'++(~.t)~) t'r;,~,t~N ~~P~ ~ I his 15 to ~tl•t~fe _ht~t the ir)t~~rr.~~atic~n here g~ve~ is ~'' F,, ~ ~"~ ~ url-e~rly~ w(~piecl rru)~t an ori~r)nal Ceriifieate of lleath ;~;+~o'~/ \.~ ~ ~1ulti- 1•ile~ ti~~ith 111 r: a~ I t)cal Re~,)strar. The original (, ~i ~. ,,~~ a~rtll•)~~~aie ~~~11 he I~(Ir~a~ar~~ied to the State Vital __.. ~~°' a~ 1~erorcis Uttlc~~' ityr }~ieunane'nt filling. ,t~~, ~r~ ~~~ °~ --- ----- --__ _ _---- __.._---- __-- - \~A1' ENT ~`~,~~'"'' -- ---~L- ltd ,. Cert)~)c~<(~11)n ~~la~~~,~~ ~ ,,,,,,,_rr~,- ;cal Rc«i~;tr~)). r~_, l~~te I.SSUCd .__,. ... r ~ .... i. 1. i f C.G ~ .? r ._w - ~_, °r-•r \ j v T°wtPerPalNTir~i~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS __`_~ r~ti; ; ,-i PERMANENT CORONER'S CERTIFICATE OF DEATH ' ' • • - -~, BLACK INK (See instructions and examples on reverse) { ~ ~ ~'~ CTATC GII G Nr ILIRCO "~~ ! r n t1 r r V U; f. Name of DecpdeM (Prat midrte, last, sulfa) 2. Sez 3. Social Beatify Number a. Date or Death (Month, day, year) D. Jean Boake Female 1.71. - 24 - 2546 ~t.x.<< ti $ Zo ti ~ 5. Age (Last Birthday) Under t year Under ~ day 6. Date d Birth (Month, day, year) 7. Birthplace (City and stare or for eign country) 6a. Place d Death (Check only one) 8 O v bloMns nays Hours Miw~as May 13, 1930 Altoona, PA Hospital: Odrer. ,,,,....~~//'~ rs ^ Irrpafrent ^ ER i Outpatient ^ DOA ^ Nursing Horne LrlResidence ^Other -Specify: r 6b. County of Daalh 6 iyy~aw.Twp. o`. Death BC . 8d. Facoryy Name (If not i nstitufion, ¢ve slreH and number) 9. Was Decedent of Hispanic Origin? ~ No ^ Yes 10. Race: American Indian, Blerk, While, etc. - . rL ~ y • ~ (If yes, specify cubarr, (Saecly) ( ~ Z ~' "~ ~ ~ ~ r ~ ~ eV\ • r"~-- r'Cr- lJl S O tr1 dJ o 0. Mexican, Puerto Rican, etc.) l t e o ' M o0 2. i 1. Decedent's Usual Oca Iron of wak done du' of woddn life. Do not state reM1red 72. Was Decedent ever in the 73. Decedent's Education (Spedty only highest grade completed) 14. fAarita4 Status: Martied, Never Married, 15. Surviving Spouse (If wife, give maiden name) Knd of Work Kind of Business I IMUStry U.S. Armed Forces? Elemenffiry /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (SpetiQg Nursing Education Healthcare ^Yea [~NO 5+ Widowed 16. Decedents MaAitg Address (S:reel city /town, state, zip code) Decedent's Did Decradem 922 Allenview Drive Actual Residence t7a. sate Penn vlvania Live ~ a 17c. ^ Yes, Decedent Lived in _ Tw p Tamsnlp? Mechanicsbur PA 1.7055 17b c~~nn Cumberland ,7d.~ No,DecedeMLivedwiMin Ntechanicsbur ActualUmitsnf ~ Gry1Boro 18. Fa~fs Name (Prat, middle, tasL sutlix) Waldren Corcelius 79. Mother's Name (Flrst, middle, maiden surname) Adah Weber 20a. IntormanCs Name (Type /Print) 20b. IMormaM's Mail~g Address (Sbeet, city! to•.m, stale, zip erode) .Edith A. Boake 3002 Broadmoor Lane, State College, PA 16801, 2ta. Method of Disposition [~Crematbn ^ Dorre6on ~ 21 b. Date of Disposftion (Month, day, year) 2tc. Place of Disposition (Name d camel ery, aemafory ar other place) 21 d. Location (City / ~wrr, state, zip code) ^ Burial ^ Removal from State merlon ar Donatlon Authorhed ^ Other- ~ yM al Examiner/Coroner? Yes^No July 19, 2010 Oakwood Crematory State College, PA 3.6801. 22a Signature Funeral ee (a son adi ) 22b. License Number 22c. Name and Address d Facility . - ~ 03.0338-•L ooh Funeral Home 2401. S Atherton St State College PA 16801 Complete Items 23a-c only when cerdtying 23a. To the best of my kneel e, death oxurted ai the time, date and place stated, (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year) physician is Trot available at time of death to ceAdy cause d death. ~ Items 2426 must be completed by person ~ 24. Time of DeMhL1 Q r 25. Dale Pronounced Deapd (Nbnth, day, year) ~ 26. Was Case Referred to Medical Examiner / Coroner for a Reason Other tlran Cremation a Donation? who Prorrourrces death. T J ~ ~ M. t~~ ' p Z.d ~ *~ ®a`ES ^ No CAUSE OF DEATH (See instructions and amples) r Approximate interval: Item 21. Part 1: Enter the chain cf everxs -diseases, injuries, acomputations - That drectly caused the death. DO NOT enter tarmirr0l events such as cardiac artest, r Onset to Death PaA IL Enter other sionificarit conditions contribulino to dea(ti, but nd resulting in the underlying cause given in PaR I. 28. Did Tobacco Use ContnbrAe to Death? ^ Yes ^ PmbaWy respiratory arrest, or ventricular ribdllaGon without stgvrirg the etiology List only one cause on each line. r r ^ N lnk IMMEgpTE CAUSE (Fnal 6sease a r rroam o ~A rxxtditian resuRitg in death) _~ a ~ ~ ~ Q.,L ~ 5 ! ~ v' w~.~ a. i ~f~ ~ ~ov\ eve j1~ri'~/ ~ ~ty~„4 9. I1 F ale: Du ro (or as a consequence of) ~ ~ - P Not pregnant wilftin past year Sequentially list condlions. tl any, b. t 0.G k 5 u ` \ ewe c~.-j i laedng to the cause listed on line a. ~ ~ 1C.~ /C_ { 0.Zt rat ~"'" ^ Pregnant at time of death Enter the UtiDERLYg/G CAUSE Due to {or as a consequence ot): r ^ Not pregnant, but pregnant within 42 days (disease or injury that initiated the r ~ events resuksrg in death) LAST. o. ~ C ~ ~ of death Due to (or as a consequence of): , - ^ Not pregnant, but pregnant 43 days b 1 year ~ d r I r/~, ,y before death ^ Unknown if pregnant wtltrin the past year 30a. Was an Autopsy PeAormed? 30b. Were Autopsy Firstlings Avaiahle Rion to Completion 31. Man of Death 32a. Date of Injury (tdamh, day, year) 32b. Descrbe How Injury Occurred 32c. Place al It µ' rry: Home, Farm, sreet, Factory, 016ce Building etc (Specfy) of Cause of Death? Natural ^ Fbmicide , , ^ Yes No ^ Yes ^ No ^ Acrident ^ Pending Investigation 32d. Tsne of Injury 32e. Injury at Work? 321. H Transportation Injury (Speciy) 32g. Location of Injury (S7eel city/town, slatel ^ Suicide ^ Could Nat be Dalermined ^ Yes ^ No ^ Onver f Operator ^ Passenger ^Pedesldan f"' Other • Speciy: 33a. CMifler (check only one) 33b. 'mature of Certifier • Certilying physician (Physkdan cerdtyirrg cause of death when another physician has pronounced death and completed Item 23) /~ To the l»at oa my knowledge, death oeeurred due to the eau,e(s) and manner as elated_ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ - ~-+~ .. \ r • Pronourx:ing and certHying physician (Physician bah pronourrcirg death and cenifykrg to cause d dealt) To the beat of my knowledge, death occurred at the time, date, and place, and due to the ease(s) and manrter as elated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 330. License Number 33d. sae Srg (Llglth, da year) ,r~ , h • INedialExaminer/Coroner On the baste of erpminalion and 1 or Imesti atlon in m de th o Mnlon d et th d tk t l d d h / / ~ ~Q ~ U g , y , a occurre e rra, e, an a p ace, an due to t l e cause(s) and mamer as stated. acct Address of Pe~sop~ Completed Cause d Deem (Item 2~ Type Print ~ 35. tar's 3igrratrxe and isl ~ Nu r I ~ I ~' I I 11 ~ 36. Date Feed (MOmh, dm/, year} ` ~`~ ~\ L "" ~~ 5 Y2p i~o/ACS S~rtt•~ 'f- I ! I •.7u1 i ~, c;20i4 ~ PA S (,sr 1Dispnatlion Permh No. 0 4 9 4 3 9 2 LAST WILL AND TESTAMENT OF D. JEAN BOAKE I, D. JEAN BOAKE, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. ~, ~.: -~ ~»F. -- - c7 ~,. ~ . _ __ l1'~ A rti rl P TTT I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. ArtirlP TV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to my children, FELIX J. BOAKE, III, of State College, Pennsylvania; GREGORY W. BOAKE, of Williams Bay, Wisconsin; and EDITH A. BOAKE, of Bensalem, Pennsylvania. If one of my beneficiaries predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath the share he/she would have received to my remaining beneficiaries who survive me by thirty (30) days, PER CAPITA, NOT PER STIRPES. Arti~1P V I nominate, constitute, and appoint my daughter, EDITH A. BOAKE as Executrix of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executrix, I nominate, constitute and appoint my sons, FELIX J. BOAKE, III and GREGORY W. BOAKE, as successor Co-Executors of my Last Will and Testament. I direct that my Executrix or successor Co-Executors be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in lik;e or in unlike shares and to file any qualified disclaimer I could have filed if living. My Executri~s: or successor Co-Executors shall receive reasonable compensation for services rendered to my estate. Arti~1P VT In addition to the powers conferred by law, I authorize my Executrix and successor Co- Executors, in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed. such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, -3- (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, D. JEAN BOAKE, hereby set my hand to this my Last Will and Testament, on %~.c.~/ /~ ~ 2001, at Harrisburg, Pennsylvania. -~ ~ ~ ~ ~ tc n ~~.~~-~-~ D. JEAN BOAKE In our presence, the above-named D. JEAN BOAKE signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address ~, `~- '~~~ _J- -4- I, D. JEAN BOAKE, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by D. JEAN BOAKE, the Testatrix on `~ ~~ ~ (p 2001. /~~.____ ( ~J ~`;Nota~Public NCT~1RtAL SEAL ., JI,iV L BROUVt~, R~2~~ P~~~ic Lowa~ P~«~iar~ To~+~a., ~~~ Cou ~y Commiss~~n Ex~r ~ ~, ~ C..Q/~ /O .,~.t/ D. JEAN BOA We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and volunta.~y act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ~ "~` C r . ~ Il(~ and ,~ `, - ~. ~ ~ ~.,-, ,.~ witnesses, on ;r ~' ~ ~~~ , 2001. f~,, J~ ----~ r =~L-.-- o Public N~TA~AL SEAL. . . ,1k~11.6flOWN, Notary PIS Lour P~ctan T~-~., pin Co ~y Gomm r~s Mares ~~ -5-