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HomeMy WebLinkAbout08-30-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND RCYArP of ANN M. DYKSTRA also known as ANN MARIE DYKSTRA PAUL S. CRIBB Petitioner(s), who islare 18 years of age or older, apply(ies) for: (COMPLETE 'A' ~lr 'B' BELOW:) Deceased COUNTY, PENNSYLVANIA ~~; ~~ ~~ File Number~~~ v Social Security Number 528-64-7592 /© A. Probate and Crant of Letters Testamentary and aver that Petitioner(s) is /are the EXECUTOR last Will of the Decedent dated 8/13/2010 and codicil(s) dated (State relevant circumstances, e.g., renunciatio~i, 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 (lf applicable, enter: c. t. a.; d.b.r~.c.t.a.; pejulente line; durante absentia; durante minoritate) Petitioner(s) after a proper search has l have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs (~f Administration, c.t.a. or d. b.n.c.t.a., enter date of Will in Sectiorz A above anti complete list of~lieirs.) P°+.3 Decedent, then 5~ years of age, died on AUGUST l4, 2010 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (lf 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: $ 25,000.00 Wherefore, Petitioner(s) respectfully request(s) the probate Qf the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Si =nature T ed or Tinted name and residence ® ~ ~ PAUL S. CRIBBINS 1 ~-~l ~ _ 4110 CARRINGTON COURT WEST MECHANICSBURG, PA 17050 at HARRISBURG HOSPITAL named in the Form RW-0? rev. 10.13.06 Page 1 Of 2 :... ~ 1, ._) --~ l__ r J (COMPLETE IN ALL CASES:) AtCach additional sheets if necessary. - ~"~~ ~ ~ - Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his 1 her last principai:r~-sidence at--~ ~ .°> ,--, 4I I O CA~RRINGTON COURT WEST HAMPDEN TOWNSHIP MECHANICSBURG 17050 cx~ (List street address, town/city, township, county, state, zip code) Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF 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, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~+`~ ~`'" '~ ~.~c~ Sign tre of Personal Representative .-3 before rile tl~e ~,,,~ .~ day of i , ~'` ~ ~. ." 1 ~ ~ ~ Signature of Personal Representative ~--~ ~ (' r~/ rl,~ ~ ~Or t11e Reglster Signature of Personal Representative .,, ~~-- T"1 C.~7 ~ . , .~ C ~'..,h ~ ., c..ri -`~ ~; ~~ File Number: ,:~ '°r> ~,.~ ,- , Estate of `~~ 1'l V~ ~ ~ ~~ ~ ~~ ~~ ~'~~1 ,Deceased Social Security Number: Date of Death: ``~ ~ ~ ~ ~ ~-~ i ~..~ 4 AND NOW, ~~ V' C~~~,` ~ ~ t~ ~ ~~ ~ 1 , in consideration of the foregoing Petition, satisfactory proof having been presented be~fo^r~e me, IT IS DECREED that Letters ~~`1~ ~~l I~ l~l CAE t'~~- ~ are hereby granted to __T~ ~ ~~ ~ (~ i h ~ r ~ ~ in the above estate and that the instrument(s) dated ~~ ~ ~~ ' ~~ ~ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............... $ ~ .~' ~ ^l Short Certificate(s) ........ $ ~~~~ (~ Renunciation(s) .......... $ .$1~ L~ ~ . . ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ (~~ 3 - ~ i,~.oo Register of Wtlls ~ t ~' ~ ~~ ,~ ~ ~~.~ p ~, Attorney Signature: Attorney Name: BENJAMIN J BUTLER Supreme Court I.D. No.: ~ 1948 Address: 500 N 3RD ST FL 12 HARRISBURG, PA 17101 Telephone: 717-236-1485 Form Rw-o? r~ti~. 10.13.0< Page 2 of 2 ~~.:AL• REC~iSTRAR'~ t~ERTii=i+A1'it~i~i (~F 1~E,AT~~ ~N';t~~i1VING: !t i~~ illegal to duplit>7tEg this cl~~y bA~ ~:~hatos~:at Or ~hat~~~ra~:~~l.. , E"~l' jl~h ~~llti r~'t„1'il;?~~llt-'. ~',1) ''~! r;ir ~~ .. t„a'i~~~~~~ I~r ~~~C~~~'-,--- t :o ~, ~>} ~ :,; ~ ~ . k>: _ ~ ~~~ ~ ~~' ~`~4 t,`` ~ ~)`. 4~ (,> ;i`;1t"~ 1'i,t' 1~1;-" Ct'1~i11i11_lt1i111 ~lt ,-~: '..`E~I_`t1 ('~ I t tin{°~,~) I ",~, ~ I Lr ~ .I . I.. to )1. C'L rtifi~it~ i ~ (1~. ~ >I~~~tl~l L~tliO '.~t.E '~ „I E!]c I• # rtt7 ~~l't.~l~~l~;fi'. ~'1C' a?Ci'31~;11 11i;,a t_~ ". '}4 ~ 1' 1~;~~'i3 it'I IZ,t.' ``~lEll~~.' ~v'9lit ~ +,ltYl, °~ ~ii.l,_ 1, f i'l11i,_131 ~i~lfi!F. ///~~ V • / Y - I l'; i 3 tIr .... l~iiit' ~ `: l ll'l~ _ -- -- - P -16.8 2__0_ ~ ~ 4 _ _ ~~L'i'litl~;t'3t.)11 '`41li31?'c" Rlps-t4,1 REv moos TYPE PRINT IN PERMANENT 9tACK iNK ~---y „`~ _._ ~,,? c,.;.~ , - C'"J ~ r . C,:) - -- r,.... ., , - ; ; c;.,, .~_ ,- , .., ~; ~ ~ 1 I t. k ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH .VITAL RECORDS ~ ~ - ' ~ ; ~ . _r r -- -- i CERTIFICATE OF DEATH :.11 ~ ; .-~; ,,- (See Instructions and examples on reverse) eTete ee c tar rucco' ~ ~ f.,'"t : . t Wattle d Decedent iFirat, nWde. Last. suffix) 2. Sex 3. Socw Sewrily NurtlDer 4. DaM Oedh (Mortal, dy, O Ann Marie Dykstra (=ernale 528 -64 - 7592 ~ /O 5 Ape tLast &rthday) Under 1 Under 1 da S Da4 a 8iM Month. da . 7 C and sUts a Bor. Place a Death CMCk aria AbnOrc Dap Roars kknaec Sa 1 t Lake City HosWtal: Dthe/'. 57 vrs. ~e b 28 , 1953 UT ~/ t],/tnpatixn ^ ER ~ outpatamt ^ DOA ^ tJuraag Wome ^ Rrtsdana ^ Odw • SpeclY• 9o Counry a beam & Crry. Roro. Twp a DeaN 8d. Facaily Name III rat alsuauon, give street and nrurWer) 9. Was Decedent a Hispana Orgm? ~ No ^ Y~ ip. Rea: Amerran lti6an, Blsck WIkN, rllt • baup}tin Harrisburg Harrisburg Hospital (11 yac, spr>Gly Cuban. Mexaan,PwrtoRyan,etc.l (Spscyt White • t t Decedent's Usual Occ tan IKind of work c one d ui moss of ide Do rat stale reared) 12 Was Decadent ever m lM 13. Decedent's Edutatan jSpeuy Dory hgnesl grade Comp leted) t4 Manta Status: Mamed, Never Marrx;d, t5. Survnulg Spe w (N wde, qw maiden rlanr) Co 1 1 egeicad a wont Z) i CK~1-Tt I irtdutry - U.S. Amwd Forces? Elementary ~ SemrWary lo-t2) CoAege (t-3 a 5.) widowed. Dworrxd ISDeGhI Administrator Cone e ^Yes ®No 12 4 Married Paul Cribbins • t 6. Dscedents Matlirg Address ISUeeI, cdy /town, stale. zip code) Decedent's Od Decedent P '~ ¢ 1 10 Carrington Court West Actual ResirieraB 1 Ia. State ' ~ +' 17c ^ Yes, Decedem Lrved n Twq. ri Uvedvndrt ~7oe e d nd ~ C b l Mechanicsburg, PA 17050 a . Li m um er an t?o.cota,ly js Mechanicsburg CiIYlBoro 18 FatMfs Name )First, rtedde. Iasi. suffix) 19. MotMls Narrw (First, nadds, mardert sumarnel ban%e1 b kstra Lil ale 20a tntamant's Name ITypB ' Pnntl 20D Informant's Markng Address ISVwL crry r IOwn, slate, tip Code) Paul Cribbins 41L0 Carrin ton Court West Mechanicsbur PA 17050 • to Hatred of Dlspos~txm I ®Gren4aon ^ Donatan 21D_ Date a Orsposttan (Month, ear, rear) 21c. Place d DrsposrWn IName of nrneNry, aema a other lory place) 21d. Location ICmy I town, stale, z'P ODde) ^ Banal ^ Removal from $IalB ~ w.. cretnatton or Dantbrt AWhawd ^ Oeler - I Dy 1lediuY Esamirtet/Cononer7 ~Yes^ No 8 - ! 8 -2 010 Cremation Society o f PA Harrisburg , PA I7109 >za Sgrut a Furreral Servxx nsee la pe ac as sucltl zee. License f4lxrtber 22c. Name and Address a FaWity A u e r Cremation Services o f Pe n n s y I va n i. a , Z n e . - fb 138312 100 onestown Road Harri bur Cargrle ~1amc 23at any when 23a To 4w bast a my krawNdge. death occured al the Wrw, date and plea staved I Sgnature and title) 23D. Lcense Number 23c. bats Signal (Mortar. dy, Year) pnysrcaan rs not avatlaote x tine d den b artty cause d dellh. • • ~te~ 2i-26 must a competes try person 24 Time abeam ///~ / ~ 25 Date P Dead (Month Y Year) 26. Was Case Referred b Examaar -Coroner for a Reason Oewr than Crertwon ar Dmaeori? woo pronaarces deem. ~ . fy M. / ~ ^ Yes CAUSE OF DEATH ( i~atructlo~s uld e: Nor) r Approxxnata ~nbrval: S» Pan II Enter otMr 2B. Did ToOatto Use CantriDrM b Dee01? Item 27. Pan I: Enia 1hB dual aevents - dseases, vtpaws, a COrrlplaall0rla - dtat duecMy eased tM deatli- DO enter termnat events such as cardac arrest ~ Onset to Dsatn put not resulhg m dte underlyaq cause gwen n Part I. ^ Yea ^ PrdnDy rsspratay arrest, a venlriprlar fiarxWfxn wMout ihowarg dal eWbgy. List ony one Cause on each line. t O Lkelrgwn ~~ ~aru~alI ( condi0on 1E~dealh) Osease or ~~ 1 wI Osl Q ~h S Gl • i CX. HA'A; _~ a ~Gl 29. If F N t e ta la as a ~ r ` , ` a~ pregner o w rn peat year ^ ~~ G ~ i noaW Hst canOOOru. A arty, u Seg rw e the Q I r'' ` a Pregnant at hoe d degh ^ g ~ Due to for as a conseQuw>ce al Enter tM UNDERIYMIG CAUSE Nd pregwa, Du preQunl wArt 52 deye ,dre915e a wyury That xrOatW tM C r events rasuttay n death) LAST. ~ d Osatlt ^ Ow b for as a consequence ol)' Nd pregtent, IKt pregtvte 4J dye b t YMr before death • d r r Uraua+wt 1 pregrwe wxrxn Ile paM yeY 3t)a_ Was an Autopsy 30a. Were Autopsy F~adxgs 3t r a Deem 32a. DaU a Iryury IMontn, day, year) 32b. Descnoa Fbw lnlury Occurred 32c. Ptaa d trytay' Fton+e. Fares, SAree~ factory, Penamed? Avadaae Poor to Competxxl Nat l ^ li Office Blaldifg, eft. (SyedyJ a cause d Dsatn~ ura arracde ^ YBS No ^ Yes ^ No ^ Accrdertt ^ Psrtdktg InvestigaUDn 320. Tine d tryray 32e. Iryury at Work? 321. II Traneponapon IrMWy ISD•MY! 32g. Locates a ayury ISlrosl, Ch I bwn, stale) ^ SuKde ^ Could Not be Detarrtwwd M ^ Yes ~ No ^ DrnNrOperatp ^ Passenger ^ Pedeshun otrbr _ Specrh: 33a. CBNtaN (CMCx Dory ones 33D S are and Tilk • CMrfYwW pnyaician I Physx:Nn ceroryng cause ~1 Oeatn when arnrMr pnysx:uat nos pronoratced deaN and corrglated Item 23) TotMDnlamYknowl•Oge.deathauurrWdwtotMUwe(e)andmanneraestabd--------------------------------- ^ r (, ~ ~~ • Prortowtcup and nrtitYing pnyaictan IPnysKan Dom ormouncu,g aeatn and ceroryarq to cause of oath) To tM Wet a my lutowteage, death occurred at tM date, and plan. and dw to tM uusge) and manner ore scud _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ License Numoer 1 rt D - ~ 3 ~ ~ 7 Z 33d Da Sgrrd Month, day. Yen S~ ~ b ZQ / O • NadiulExamewrlCoroner On tIN examination and I a inwsttgat y opinion, death ocoumd at dw tlme, date, and place, and dw to tM cauays) and manner ore aWed_ ^ 34 N~rM and Andre a Per~y^ Who ComWered Cause a Oe inem 27) TYDe ~ Pont ~j ~ t=ct~ :N C ~ ~ r ~ ~' ~'N k ~4 s5 Regisuar a and N r le FiNd i N, day, year) / ~ - A - . vt7v. C , . c2di b ( N , [Z r ru ~~ 17 1 ~ O `• - / Oisposdan Perms No ~ ~~ J `~'~ :J LAST WILL AND TESTAMENT OF ANN M. DYKSTRA t-, -.~ t c~°a - ~---- , ~ + ~~ ~•^Y~ r ~ i _.~..~ . ~ 'Yys= .. \.} ~: , i.r7 C.~J ~ ~ 1 _ C,:J ~; .... \ _ ~ ,„.5~.j ~ , - {_ -! ~W~. I, ANN M. DYKSTRA, of Hampden Township, C~miberla~ld Co~mty~, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revolting all Wills and Codicils by me at any time made. ITEM 1. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes play be payable by my estate or by any recipient of any property, shall be paid by my Executor out of my residuary estate, as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Executor, he may pay such taxes immediately or may postpone the payment of taxes on filture or remainder interests until the time possession thereof accrues to the beneficiaries. I also direct my Executor to pay the expenses of my last illness and funeral expenses from the property passing under this Will as an expense and cost of administration of my estate. ITEM 2. I am in the process of gifting the sum of Thirty Thousand ($30,000.00) Dollars to DICKINSON COLLEGE of Carlisle, Pennsylvania. If the funding of this charitable gift has not been completed as of the date of my death, I instruct my Executor to cor3lplete the 1~unding with assets fi-om my estate. ~,.. ITEM 3. I give, devise and bequeath all the rest, residue anal remainder of my estate of any kind whatsoever, real, personal or mixed, and wheresoever situate unto my husband, PAUL S. CRIBBINS, if he survives me. In the event that my husband, PAUL S. CRIBBINS, predeceases me, I give, devise and bequeath said rest, residue and remainder to my brother, DANIEL .1. D~I~STRA, JR. ITEM 4. In addition to the powers conferred by law, my Executor shall have the following powers: (a) To retain in his absolute discretion and for such period as to him shall seem advisable, any and all assets constituting my estate, without liability for any loss incurred by reason of the retention of such assets. (b} To change investments and properties, and to invest and reinvest all or any part of the corpus of my estate, in such securities, investments, or other property as to him seem advisable and proper, irrespective of whether the same are authorized for the investment of estate fiends by the laws of the Commonwealth of Pennsylvania. (c} To sell all or part of the property which at any time may constitute a part of my estate, at such time, upon such terms, for cash or on credit, with or without security, in such manner and at such prices, either at public or private sale, as to him shall seem advisable and proper, and to execute good and sufficient deeds and bills of sale therefor. (d) To lease any property held by him and for the duration of the term, irrespective of the provisions of any statute or of the termination of my estate; and to mortgage, ~~ -z- pledge, collect, convert, redeem, exchange, or otherwise dispose of any securities or other property at any time held by kiln. (e) To bon-ow honey, whether to pay taxes, exercise subscriptions, rights, and options, pa}~ assessments or to accomplish any other purpose of any nature incidental to the administration of my estate, and to pledge any securities or other property held by him as security therefor. (~ To enforce any bonds, mortgage, or other obligations or liens held hereunder ; to enter upon such contracts and agreements and to make such compromises or settlements of debts, claims, or controversies as he may deem necessary or advisable; to submit to arbitration any matter or difference; to vote personally or by proxy any shares of stock which may at any time be held by him hereunder. (g) To consent to the reorganization, consolidation, merger, liquidation, readjustment of or other change in any corporation, company or association, or to the sale or lease of the property thereof or any part thereof, any of the securities or other property of which may at the time be held by him thereunder, and to do any act or exercise any power with reference thereto that maybe legally exercised by any person owning similar property in his own right, including the exercise of conversion, subscription, purchase or other options, the deposit or exchange of securities, the entrance into voting trusts, and the making of agreements or subscriptions which he may deem necessary or advisable in co~ulection therewith, all without applying to any court for permission to do so, and to hold, redeem, sell or otherwise dispose of -, - J - any securities or other property which he may so acquire, irrespective of whether the same be authorized for the investment of estate fields by the laws of the Commonwealth of Pennsylvania. (h) To cause to be registered in his name as Executor hereunder, or in the name of his nominee without qualification or description, any securities at any time held in my estate. (i) To determine the manner in which the expenses incidental to or connected with the administration of my estate hereby established shall be apportioned as between. income and principal. (j} To carry out agreements made by me during my lifetime, including the consummation of any agreements relating to the capital stock of corporations owned by me at the time of my death, anal including the continuation of any partnership of which I may be a member at t11e time of my death whenever the terms of the partnership agreement obligate my estate or personal representative to continue my interest therein, and to enter into agreements for the rea-~rangement or alteration of my interests or rights or obligations under any such agreements in effect at the time of my death. (k) To apportion extraordinary and stock dividends received by him between income and principal in such manner as he may see fit; provided, however, that all rights to subscribe to new or additional stock or securities, and all liquidating dividends shall be deemed to be principal. -4- My Executor may freely act under all or any of the powers of this Agreement given to him in all matters concerning my estate hereby established, after forming his judgment based upon al] the circumstances of any particular situation as to the wisest and best course to pursue, without the necessity of obtaining the consent or approval of any court, and notwithstanding that he may also be acting as an individual, or as an agent for other persons as an individual, or as an agent for other persons or corporations interested in the same matters, or may be interested in connection with the same matters as stockholders, directors o-- otherwise. The powers herein granted to l~ny Executor maybe exercised in whole or in part, fi'om time to time, and shall be deemed to be supplementary to and not exclusive of the general powers of executors pursuant to law, and shall include all powers necessary to carry the Same into effect. T1~Ie enumeration of specific powers herein shall not be construed in any way to limit or affect the general powers herein granted. ITEM 5. I hereby nominate, constitute and appoint my husband, PAUL S. CRIBBINS, as Executor of my estate. In the event that he is unable or unwilling to serve in this capacity, I then nominate, constitute and appoint my brother, DANIEL J. DYKSTRA, JR., as Executor of my estate. My Executors are specifically relieved from the duty or obligation of filing any bond 0I' bonClS. My Executors are hereby authorized to disclaim any interest in property in accordance with Chapter 62 of the Probate, Estates and Fiduciaries Code or Section 6103 thereof and may do so without court authorization. ~. __.... -5- [TEM 6. For the convenience of my Executors, I note that this Will has been ~~repared by Ronald D. Butler, Esquire and the Butler Law Firm. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last W i 11 and Testament, this ~ ~ y~ day of ~~ e5 ,~, ~-~- , 2010. WITNESS: cx~, /~ ~/~~II residing at __ (SEAL) Ann ykstra residing at ~~',~ fr ~. / 7 I ~3~rss~ ~~ 5~.,.~-- ~~~~~w i ~i~~ f~ -6- COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF DAUPHIN We_ ANN M. DYKSTRA . ~ ~~:~~ ~ D . V o~ ~{.. , end K,~,~~}t_D ~ _ ~~~~~2. ,the Testatrix and the witnesses respectively, whose names are signed to the attached or 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 (or willingly directed another to sign for her) and that she executed it as her free and voluntary act for the purpose therein expl-essed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of their knowledge, the Testatrix was at that time eighteen years of age and older, of sound mil~~d and under no constraint or undue influence. --.~, ~~ ~ Ann M. D stra W1tIleSS Witness Subscribed, sworn to and acknowledged before me by ANN M. DYKSTRA, the Testatrix, and subscribed and sworn to before me by L~sc:c ~ ~, . ~ oG~ L ar d ~c~ w p~~ p ~. ~v~,~G~'- _, the witnesses, this (~'~'` day of v~,~., T-- , 2010. c~_ tary Public My Conlmiss~on Expires. COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL CHERYL L. FERGUSON, Notary Public City of Harrisburg, Dauphin County My Commission Expires April 6, 2012 -7