HomeMy WebLinkAbout08-30-10ESTATE OF IN THE COURT OF COMMON PLEAS
ANNA MAY SCHROEDER :CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS° COURT DIVISION
No. ~ i ~ I(~ - v8~ ~
PETITION UNDER SECTION 3102 OF THE PROBATE (-~c7 ~~
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ESTATES AND FIDUCIARIES CODE FOR ` =r~ "
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SETTLEMENT OF SMALL ESTATE ~- F~ _
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TO THE HONORABLE JUDGES OF SAID COURT: ~:~~; ~~"'
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Roger B. Irwin and Marcus A. McKnight, III, your Petitioners, file this Petiti~ for
Settlement of a Small Estate under the provisions of Section 3102 of the Probate, Estates and
Fiduciaries Code and in support thereof avers that:
(1) Your Petitioner, Roger B. Irwin, is a competent adult residing at 233 Avon Drive,
Carlisle, Pennsylvania 17013, and is the legal representative of the above decedent.
(2) Your Petitioner, Marcus A. McKnight, III, is a competent adult residing at 120
Clearview Place, Carlisle, Pennsylvania 17015, and is the legal representative of the
above decedent.
(3) Anna Mae Schroeder, died on March 23, 2010, at the age of 98 years, but prior
thereto lived and was domiciled at 770 South Hanover Street, Carlisle, Pennsylvania,
Cumberland County, Pennsylvania. A copy of decedent's Death Certificate is
attached hereto as Exhibit "A."
(4) Anna May Schroeder died without a Will and no Letters have been issued. A copy of
decedent's Will is attached hereto as Exhibit "B."
(5) Anna May Schroeder had no probate estate when she died other than the following:
Life Insurance with Metropolitan Life Insurance Company, Group
No. 0142695, Claim No. 21005005834. The value of the life
insurance policy with Metropolitan Life Insurance Company is
$5,000.00. Correspondence from MetLife is attached hereto as
Exhibit "C."
(6) The sole heir and relationship to the decedent are as follows:
Chapel Pointe of Carlisle
(7) Your Petitioners aver that there are no creditors of the decedent and no claims unpaid
known to your Petitioners.
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WHEREFORE, your Petitioner respectfully requests that an Order be made authorizing
Metropolitan Life Insurance Company to complete the outstanding claim and issue payment to
Chapel Pointe of Carlisle, pursuant to Section 3102 of the Probate, Estates and Fiduciaries Code.
By i'~- `'3- ~-
Roger .Irwin, Esquire
Supreme Court I.D. No. 6282
IRWIN & McKNIGHT, P.C.
60 West Pomfret Street
Carlisle, PA 17013
(717) 22353
By
Mar,~us A. K fight, III, Esquire
Supreme Cou .D. No. 25576
IRW1N & McKNIGHT, P.C.
60 West Pomfret Street
Carlisle, PA 17013
(717) 249-2353
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Roger B. Irwin and Marcus A. McKnight, III, being duly sworn according to law, deposes
and says that the facts contained in the foregoing Petition are true and correct to the best of their
knowledge, information and belief.
(SEAL)
Ro r .~n, Esquire
`- / A
A.
Sworn d subscribed before me
this day of August, 2010.
Notary Public
Esquire
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(SEAL)
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photogre~ph.
Fee fi:~r thi, certif~cttte, 56.~ti
P 16245627
Certifi~auon tiumber
This is t:, celtif~~ that the. Ll~fcx-)natiur) here ~.I~cn is
COrreC[IC 4(i~ll'Ci ]'e1171 :lit )r;~T117i1'! tc'r[?rh:2i[e OI Death
duld~ (-ifed ~ ith r :~ as L<3c,~1 R~ ~I~,n-ar, "I~he orit*inal
certifieatE U~ill !>e [orti~ardctl ?:1 tht~ State Vital
Reckn-d~, Offil.~:~ 'r r i?~)-tnt,nent tihn,~.
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Local Rerlsa~al i~;):e l~;ued
Htaste3 REV nl2oD6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE / PRINT IN
PERMANENT CERTIFICATE OF DEATH
RucKmK (See instructions and examples on reverse) ~r.r<<
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,. Name d Decedent (Rrst mitldb, yst suffix) 2. sex 3. social Sacudry NunWr 4. Date of Deam (Monet. day. yead
Anna Ma Schroeder Female 142 - 10 -4237 3 23 2010
s. Age (Last timday) Untler 1 year Under 1 tlay 6. Date of SiM (MOrnh, aey year) 7. Bwhplace (City and stare ar foreign coumry) Ba. Place of Deam (Check onN one)
xlorxM ~ wars 1larwme H09Pkel: Omer
Yre. 2 26 1912 Walden tQY ^ Inpatant ^ ER / Oulpaaem ^ DOA Nursing Home ^ Residence ^Omer .Specify.
8b. Coumy of DuM ec. City, f3om, Twp. of Daam 8d Fapkry Name Ilf not mstlturan, give street and number) 9. Was Decedem of Hapank Origin? ~] No ^ Yu tg. Race. Amarxan Indian. &ack, Whew. etc.
Cumberland Carlisle (g yes. spedty CuWn, IScea~M
Chapel Point Mexican, Puerro Rican, etc.) White
f 1. Dxxdenl's Usual id of wdk done duns maw of Gfe. 0o not slate f 2. Was Decedent ever in dre 13. Decedent's Education (Seedy mN hghest gretle canplatee) 14. Martial Stems: Maned, Never Manietl. 15. Surwving Spouse Ilf wim, give maden name)
Kid d Work Kid dBusiness / Indusby
i~ecutive Secretar
Bankin U.S. Arme° Forces? Elementary 1 Secondary (Pt2) Cdlege (t-4 or 6«) Wklowed, Divorced (Spedyy)
1
y
g ^Yea ®No
2 Widowed
f 6. Decedent's Maeing Aomass (Street, city /town. state, zip code) Decedents Dkl Decedent
Pennsylvania
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itl
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770 South Hanover Street c
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ance t
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late
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Ves, DtCedent Lived in Twp
7v ~sha
Carlisle
PA 17013 r~a
y
1DCamy ~~-land 17d •'~
;ve0w~" Carlisle
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, pal
a
Cey / 8oro
78. Femer's Name (First mitldle, last, sumx) Ig. Mother's NarM (First, ntitlde, maiden sumarrie)
Andrew Schnieder Anna Dubois
20a. Informant's Name (TYDa! Print) 2GE. IMOmmnt's Maiing AddRSS (Street cAY I rows. state, zip code)
Ro er Irwin 60 W. Pomfret St. Carlisle, PA 17013
2ta. MNhod of DisPOwUan ^Crematan ^ Donakon 2tb. Date of Daposidon (MOnm, ear. Yaarl 2tc. Place of
Oispowfion Warne d cemetery, crematory a Omer pycel
2, d. Location ICiry I Town. state. zip code)
'~ 13niial ~ Removal from Stele ~ Wu Cremation ar D0r10dM Authorized
^ omar-sp«aM ; bykbdkalExamiMr,Corpwr7 ^vea^Na
3/24/201 0
Whitin Memorial Park
Whitin btJ OA759
22a. Sigre rn Service Licensee person acerig suUl 22b. License Wnber 22c. Name ant Adtlress d Faceay Neill Funeral Hone, Inc
- FD 012212 L k St Hill PA 17011
23a<oNy when ce '
aart9y raised at twwaeeamk 23e. Tome ,deem w dw mw. a~M.pl~ace~/s(mt~je~6~ISkytamre arA 6Ae)
~` a /_ Rif 23b. License Number
Q~(j 2Zy.~ ~/s" L 23c. Dam Signed (MOnM, da ,year)
c~3 /~ ~ JZl3 i e
lrems 2y26 ~w W con~etetl q, ~~ 24. Time d Dean 26. Dam Dead (Manor. say, year) 26. Was Case Relwretl m Medical Examiner /Coroner kr a Reason Other than Crematbn or Donetron?
who praroiares deem. 7 5o R M. Q :i 2 3 2.O / a ^ Yu ~No
CAUSE OF DEATH (See MsW eslona and exemplea) r gpproxknam interval:
Imm 27. Pan I: Eller dw plain of events - tlaeases, injuries, or cemWNkadona - mat eiedy causetl me tleam. DO NOT enter termirull evenly such as wwac anasl, Onset m Deem
i
k Pan II: Enter Omer gg ' .~v eilinris lino I m,
dA rot restyling n me uMerlyalg reuse given's Pan I. pg. py Tobacco Uu Contriouk to Deam1
^ Vss ^ Probably
rup
ra
ry anew, or ventricular fibrilyeon wkput atwwirlg d10 9lbbgy. lJet a^N one Ouse an uCh Nne.
IMMEDIATE CAUSE IRnal duease or ~ No ^ Unkrown
/~~
mnddion re8W1'rg k deem) _~ .~ S C~ O r ~ r ~`~
a
~~~lll~~`
29. If Femare'.
Due to (or as a consequence d): ~ Nw pregnant wANn pal year
Seq~xiaW kw ce'dai°ns, rt anY~ b.
kadq m dw rJUae laced nll arl@ a. ^ Pregnant of lone of deals
Emer me UNDERLYING CAUSE Due to (or as a cronsaquer~ce ory: ~
^ pregnant but pregrew wttxn s2 days
(diaaase or iryiNy der ikWfed dw C.
sane resuMig n deem) LAST d deem
Due to (or as a consequence of):
Not
^ pregnant but pregnant a3 days l0 1 year
d.
r Wlore dam
^ Unknown if pregnant whin me past year
30e. Wu u Aumpey
PMomretl? 38h. Were Autopsy Findings
Available Prior m Comprekm 3t. Manner of Dum 32a. Dam d Injury (MOnm, day, year) 32b. Describe How Injuy Oaurretl 32c. Pyre d Injury: Home, Farm. Street Factory,
of Case d Oeam?
~aual ^ Homicide Ogice Building, etc (Speciry)
^ yeS f~l u„
~'" ^ Yss ^ ~ ^ Accitlern ^ PeMir~g Irnulgatpn 32d. Tore W Injury 32e. Iryury of Work? :321. g Transporlatbn Injury (SpeuNl 32g. t.oca(wn of Iryury (SlreeL city /town, syte)
^ Suicke ^ Cook NtN W Deremaied ^ Ves ^ No ^ Deter /Operator ^ Passenger ^Petlestrien
M Other - Speciy:
33a. Cerlilier (thank ally ore)
D•dgving Mra~aw, (Pnysmwn cam
Nkg cause d deem when andher ph
skian has fxonaxCad roam and mn
aled Imm 23)
33b. Gignemre nets a cenir
y
p
Ta the Wet M m
y knowledge
death occurred d
m tM
d
rered -
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,
w
manner a<a
oase(s) an
.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Proneund
d
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^
rq an
g
y
rg phyaklan IPtyaiaian both pronouncing dam antl cenilyvg m reuse d deem)
ro tlw WSidmy knowredge, deem acunad MtW time,dem, and place, snddw mile uusNal and marxwra eyled------------------ ^
• MMipl Exammar y canner 33c. Licenu Number
h°.O o l b 2 t't (C 33tl. Dam IMOnm, day. Yur)
M ar2c4. ~ 3
70
d
0 she Wale of uamlrutbn and / or investigetlon, in my opinbn, deem oeeurred n me ame, dne, antl place, and due to the cauaslel and menrwa as ayted
^ ,
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_ 34. Name and Pddress d Person Who Completed C
se of Deam (ge
]r m 27f Type / Pnnl
35. Rpg~Ear' naN Di Nu r
~~ I 1 I ~ 12 I ~I
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36. Dam Filed (Metro. uy, Yearl
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Dlsposnbn Permit No. 0 ~ Il ~ ~ ,~ ' 1
LAST WILL AND TESTAMENT
I, ANNA MAY SCHROEDER, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament, hereby expressly revoking all Wills
and Codicils heretofore made by me.
1. I direct my Executors to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my Executors to sell any realty owned by me at my death and
not specifically devised herein at either public or private sale, and to give good and sufficient
deeds therefor, in fee simple, as I could do if living.
3. I give, devise and bequeath all of my estate of every nature and wherever situate to
Chapel Pointe of Carlisle, Pennsylvania, absolutely.
4. I nominate and appoint ROGER B. IRWIN and MARCUS A. McKNIGHT, III, to be
the Executors of this my Last Will and Testament; they are to serve as such without bond.
5. I hereby suggest that my personal representatives retain the services of Irwin &
McKnight as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this I ~T~`' day of
May, 2004.
SEAL>
ANN MAY SCHROEDER
Signed, sealed, published and declared by ANNA MAY SCHROEDER, the Testatrix
above-named, as and for her Last Will and Testament, in the presence of us, who, at her request,
in her presence and in the presence of each other have subscribed our names as witnesses hereto.
2
ACKNOWLEDGMENT AND AFFIDAVIT
WE, ANNA MAY SCHROEDER, MARTHA L. 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 Testament, that she had signed
willingly, 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.
~~/. ,, G,.', f
AN A ~Y SCHROEDER
MAR HA L NO L
7"'iI ~' ~ > L~ '~' ~'~~llc/~ Ciao i
SHARON L. SCHWALM
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
. SS:
Subscribed, sworn to and acknowledged before me by ANNA MAY SCHROEDER, the
Testatrix herein, and subscribed and sworn to before me by MARTHA L. NOEL and
SHARON L. SCHWALM, witnesses, this r87 day of May, 2004.
~3 . c~~
Public
N~?tarini Seal
12Uger Et. Irwin, Notary Public
Car{isle I3oro, Cumherland County
My Commission Expires Oct. 3, 2004
Member, i'onnsylvania Association of Notaries
3
MetLife
Metropolitan Life Insurance Company
Croup Life Claims
PO Box 6100
Scranton, PA 18505
August 23, 2010
THE ESTATE OF ANNA SCHROEDER
60 WEST POMFRET
CARLISLE, PA 17013
RE: Insured: Anna M Schroeder
Group No: 0142695
Claim No. 21005005834
Policy Value $5,000.00
Dear The Estate Of Anna Schroeder:
~~~~~
Al?G ? w ~i~~l~
iRi:'JIN ~ ;~1cY;Nl[~ri r
I..A.Iti' OEFICtS
We are writing in regard to the above-referenced claim for Group Life insurance benefits. Please
accept our sincere condolences at this time.
In order for us to continue reviewing this claim, we request that you please forward the following
documentation and/or requested information to this office. Please do not submit original documents
unless exp--essly directed to -original documents will not be returned:
r Certified Estate Papers issued by the Probate Court appointing an Administrator/Executor
for the Estate of ANNA M SCHROEDER.
- Small Estate Affidavit from the state in which ANNA M SCHROEDER resided. This
docl-ment must contain MetLife's naive, the policy number, and the dollar amount of the
policy.
- Provide the Tax Identification Number for the Estate on the enclosed W-9 Form, sign and
date the form.
- Complete the enclosed Claimant's Statement, sign and date the form.
The required information is necessary to further review the claim. If it is not received, additional
time may be required to finalize the claim.
Upon receipt of the above-requested information, we will continue our review of your claim. A pre-
addressed envelope is enclosed for your convenience.
If you have any questions, please contact our office at 800-638-6420 prompt 2.
Sincerely
Group Life Claims Operations
Enclosure
F3GP01