HomeMy WebLinkAbout11-24-10PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Jacquelyn A. Roberts
also known as
COUNTY, PENNSYLVANIA
File Number 21-10 ' ~ f ~ ~~
Deceased Social Security Number
303-48-6529
PNC Bank National Association
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 Executor Warned in the
last Will of the Decedent, dated 11 /14/2007 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
app ica e, enter. c.t.a.; .n. c.t.a.; pe ente ate; urante a sentTa-, durance minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) andheirs: (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.)
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(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
130 Millers Gap Road, Enola, Silver Spring Township, Cumberland County, PA
(List street address, town/city, township, county, state, zip code)
Decedent, then ~~ years of age, died on 10/07/2010 at 130 Millers Gap Road, Enola, PA 17025
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 100,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 385,000.00
situated as follows: 130 Millers Gap Road, Enola, Silver Spring Township, PA 17025
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:
Signature Typed or printed name and residence
Qv L S~J ~.. ,+.~ '~ PNC Bank, National Association 4242 Carlisle Pike
' ' ~ Linda J . Lundberg , Camp Hill, PA 17011
3~, _~~\~~~~ Vice President
~ ~
Forrn RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2
Oath of Personal Representative
COivI~10N~VEALTH 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 con~ect 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 e the ~ Ch day of
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For tl~e Register
Signnture ojPerso„nl Represe ntlve U ~ V ?~. L~,,~r~y' '-~Z.£.~---
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AND NOW c:~'T ~ ~l ~ ~, in consideration of he foregoing Petition, satisfactory proof
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Navin been resented befo e me IT IS DECREED that Letters `~'~'~tGc~C~ ~~/"' '
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are hereby granted to /~ ~- ~ ~ ~~ • ~ ~ ~e
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and that the instrument(s) dated /~~ ~ ~ ~ ~~
described in the Petition be admitted bate and filed of recor a th last Will (and C dicil(s)) of Deced
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H705.144 REV 11/2006
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS "" ;;: j ~--~
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CORONER'S CERTIFICATE OF DEATH `) `~ ~~ 'r7
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1. Name of Decedent (Frst, mitldle, last, suffix) 2. Sex 3. Social Secuay Number 4. Da a bl atFi Monty, day, yeau) ""~ _~ ,'~-_T^
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2010
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6529
Jac uel n A Robe Female 303
5. Age (Last eirmday) Under 1 year Under 1 day 6. Date of Birth (Month, day, year) 7. Birthplace (City and state a foreign rxxmtry) Ba Plr of Deam (Check any one) ;
iAO~xfss Sys ~~ Minutes Hospdal. Other:
Ma S 1944 Peru, Indiana ^ Inpel~ent ^ ER /Outpatient ^ DOA ^ Nursing Hortte Residence ^Omer - Speciy:
66 Yrs
.
Bor of Deatn 8d. Fadfiy Name (M not institution, give street and number) 9. Was Decedent of Hispanic Ongn? ~ No ^ Yes S0. Race: American Indian, Black, White, etc.
City
d Death 8c
Coun
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(If yes, speay Cuban, (:iperihl
• Cumberland Silver S tin s 130 Millers Ga Road Mexiwn.PuertoRican,efc.} White
71. Decedent's Usual Oa lion Kind d work done du ~ most a life. Do rat state retired 12. Was Decedent ever in the f 3. Decedents Education (Seedy only highest grade completed) t a, Marital Status: Married, Never Married, 15. Surviwng Spouse (11 wile, give maiden name)
Divorced (Specil}~
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Kind a Work Kind aBusiness /Industry U.S. Amted Forces? Elementary 1 Secondary (0-72) College (t-4 or 5+)
Widaaed
H ^Yes ($No 12
16. Decedent's Marling Address (Sheet, cdY I irnvn, state, zip code) Decedent's Dd Decedent
Pennsylvania Live k, a , 7c. ~ Yes, Decedent Uved in S T~1 V~ ~~L~ r1 T _rwp.
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130 Millers Gap Road a.
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Actual
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Township? 17d
Decedent Uved within
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bola, PA 17025 .
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17b~'"y Ctmberland AdualLimitsd City;Bao
18. Father's Name (First, middle, last, suffix) 1g. Matter's Name (Rrst, middle, maiden sraname)
Donna Hi. k
20a. Informants Name (Type /Print) 20b. Infamtant's MaiNng Address (Street, lily I rown, state, ziP coda)
IN 46526
Goshen
1305 Copley Court
Thorrlas Rose ,
,
21 a. Method d Disposition ^ Cremation ^ Donation 27 b. Date of Disposition (Month, day, Year) 21 c. PWce d Disposition (Name of cemetery. crerttatory a abet place) 21 d. Location (City I town, state, ziP ~1
• ® Burial ®Removal tram State ;Was Cremation a Donation AtltlaAzed pot
15
2010 West Goshen Cemetery Goshen, Indiana.
^ Other - Spscily.~ by Medical Examirtar /Coroner? ^ Yes ^ No ,
.
• 22a. Signature F Licensee (a as slxlt)
22b. License Number
22c. Name and Address of FacilRy $ Mar et P aza Way
. - F'D-138630 Mal zzi Funeral
Complete tt 3a-c any when certifying 3a. To the hest d rrry knowledge. am occurred at the time, date aM place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year)
physidan' avaJade at tkne d death t
certttY cause of death.
• Time d Death
24 25. Date Pronounced Dead (Monet, day, year) Case Referred to Medical Examiner / Coroner tnr a Reason Other than Cremation or Donation?
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26.
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Items 2426 must be cort>plefed bf person
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Yes ^ No
who prortowices death. M.
CAUSE OF DEATH (See Instructions and examples) I Approximate interval. Pan II: Enter outer iii ~t ce tuon~ t+~+tdbutinq to death, 4:8. Did Tobacce Use Contribute to Death?
kern 27. Part L Enter the gyg0g -diseases, injuries, a canplications -that directly caused the death DO NOT emer tertnlnal events such as cardiac attest, t Onsa to Death ba nor resulting in the underlying cause given a Part I. ^ Yes ^ ProbalNy
respiratory arrest. w ventricular fibrillation wahax stowing the etbagy. Last any ate cause on each line. r
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^ No ~ Unknown
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IMMEDUTE CASE /Rnaj disease w r
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Due to (or as a consequer of): r
SequeMiaMy list coridilioris, if any, b r pregnan
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^ Pregnant at time of death
to the cause fisted on fine a ~
Enter UNDERLYING CAUSE Due to (or as a consequence of): r
^ Not pregnant, but pregnaa within 42 days
of death
(disease or injury that initiated the r
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events resulting In death) LAST
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• Due to (or as a consequer of): ^ Not pregnant, DN pregnant 43 days to 1 year
berae deem
• d. r ^ Unknown tl pregnant within the past year
30a. Was an Autopsy 30b. Were Autopsy Rndrys 31. Manner of Deem 32a. Date of Injury (Monet, day, year) 32b. Describe Few Injury Oaurred 32c. Place d Irtjtay: Fbrtte, Farm. Street Factory,
Office Buildng, etc. (SPeci(y)
Pedormed? Available Prat to Completion
a Cause a Deem? Natural ^ Homicide
^ Yes ~NO
[] Yes ^ No ^ Accident ^ Pending Investigation 32d. Time d Injury 32e. Injury at Work? 32f. If Transportation Injury (Specify) 32g. Location d Injury (Street, dty /town, state)
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^ Suicide ^ Couk1 Na be l~termined
^ Yes ^ Na Driver /Operator ^ Passenger ^ Pedestrian
^
M abet - spedry:
33a. Certifier (check tiny one) 33b. Signature and 11Ae'ohBeltM
• Certlfyirtg physcian (Physician certifying cause of death when anotner physician floe Praauncetl deem and completed Item 23)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
To the Dest a my krtowhdge, deattl occuned due to the cause(s) and manner as sated. _ _ _ _
_ _ _ _ _ -
_
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• Pronouncing and certifying pfryslcisn (Physician both proroundrig deem and certifyirrg to cause d deem)
^ 33c. Ucense Number 33d. Date Signed (Month, day, year)
To ttN best of my knorrbdge, death oceurced at the time, date, and place, and due to the cease(s) and manner as sated- - - - - - - - - - - - - - - - - -
/ October 11 2 010
. Medical Examiner
Coroner
On the basis a examination and 1 w investigation, in my oplnbn, death occurced at the time, date, and plaice, and due to the carue(e) and mamtar as etatad_ ~ ~ Name and ass f Person Completed e~waee d beam (Item 27) Type / P~~int
To~~ G'. Ec~Cenrode, Coroner
35. R is Signature and District N 3s. Data Filed (Maim. day, year) 6 3 7 5 B as e ho r e Rd . , Suite ~~ 1
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LAST WILL
(~F
.TACQUELYN A. ROBERTS
Jeffrey R. Boswell, Esquire
Boswell, Tintner, Piccola ~ Alford
315 N. Front Street
P. O. Box 741
Harrisburg, Pennsylvania 17101-0741
(717) 236-9377
LAST V~ILL AND TESTAMENT
OF
JACQUELYN A. ROBERTS
Introductory Clause. I, JACQUELYN A. ROBERTS, a resident of and domiciled in the
Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, do
hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all
Wills and Codicils at any time heretofore made by me.
I was married to RICHARD E. ROBERTS. My husband, RICHARD E. ROBERTS,
died on May 10, 2006. I have no children.
ITEM I
Direction to Pay Debts. I direct that all my legally enforceable debts, secured and
unsecured, be paid as soon as practicable after my death. If at the time of my death any of the
real property is subject to a mortgage, I direct that the mortgage debt be paid at the time when
my Executor sells the real property.
ITEM II
Direction to Pay All Taxes from Residuary Estate. I direct that all estate, inheritance,
succession, death or similar taxes assessed with respect to my estate herein disposed of, or any
part thereof, or on any bequest or devise contained in this my Last Will (which term wherever
used herein shall include any Codicil hereto), or on any insurance upon my life or on ar~y
property held jointly by me with another or on any transfer made by me during my lifetime or on
any other property or interests in property included in my estate for such tax purposes be paid
out of my residuary estate.
ITEM III
Direction to Sell Tangible Personal Property. i direct that all of my tangible personal
property shall be sold by my Executor as expeditiously as can be done in order to receive the
highest price obtainable for the sale of each item within the time deemed reasonable by my
Executor. The proceeds from the sale of each item shall be added to my residuary estate to be
distributed as set forth in ITEM V.
ITEM IV
Direction to Sell Real Property. I direct that my Executor shall sell my real property,
including my residence and any real property that I have acquired during my lifetime, as
expeditiously as can be done in order to receive the highest price obtainable within a time
deemed reasonable by my Executor. The proceeds of the sale of my real property shall be added
to my residuary estate to be distributed as set forth in ITEM V.
Last Will and Testament of Jacquelyn A. Roberts Page 1
ITEM V
Outright Gift of Residuary. After payment of debts, taxes, and expenses of
administration, Igive and bequeath all the rest, residue, and remainder of my property of every
kind and description (including lapsed legacies and devises) wherever situate and whether
acquired before or after the execution of this Will, to If my husband shall not survive me, then I
give bequeath to THE COLONIAL WILLIAMSBURG FOUNDATION, Williamsburg,
Virginia, One hundred (100%) percent of the rest and residue of my estate, my net estate. If the
gift property meets the requirements for establishing a named endowment fund at Colonial
Williamsburg, then it shall be designated as the Jacquelyn A. Roberts and Richard E. Roberts
Endowment Fund (the "Fund") in the books and records of The Colonial Williamsburg
Foundation. The property comprising this gift may, for investment purposes, be merged with the
general endowment fund of The Colonial Williamsburg Foundation. The investment and
spending policy for the Fund shah be the same as that for tree general Ci:i.duwilicnt fand of Tii~
Colonial Williamsburg Foundation. The amount spent from the Fund each year shall, insofar as
is practical, be used for the support and maintenance of Colonial Williamsburg's gardens in the
Historic Area. If, in the opinion of the Trustees of The Colonial Williamsburg Foundation, or
their successors, the need for funds for the purposes described above no longer exists at some
future date, the Trustees, or their successors, are authorized to use these funds in the best interest
of The Colonial Williamsburg Foundation.
ITEM VI
Naming the Executor, Executor Succession, Executor's Fees and Other Matters.
The provisions for naming the Executor, Executor succession, Executor's fees and other matters
are set forth below:
(1) Naming the Corporate Executor. I hereby nominate, constitute and appoint as
Executor of this my Last Will and Testament PNC BANK, N.A. and direct that it shall serve
without bond.
(2) Naming Corporate Successor or Substitute Executor. Except a;s otherwise
provided herein, if PNC BANK, N.A. or any successor as herein defined should fail to qualify as
Executor hereunder, or for any reason should cease to act in such capacity, the successor or
substitute corporate Executor shall be some other bank or trust company qualified to do business
in the State of my domicile at the time of my death, which successor or substitute shall be
designated by the court having jurisdiction over the probate of my estate.
(3) Fee Schedule for Corporate Executor. For its services as Executor, the corporate
Executor shall receive an amount determined by its Standard Fee Schedule in effect anal
applicable at the time of the performance of such services. If no such schedule shall be in effect
at that time, it shall be entitled to reasonable compensation for the services rendered.
(4) Change in Corporate Fiduciary. Any corporate successor to the trust business of
the corporate fiduciary designated herein or at any time acting hereunder shall succeed to the
capacity of its predecessor without conveyance or transfer.
Last Will and Testament of Jacquelyn A. Roberts Page 2
ITEM VII
Definition of Executor. Whenever the word "Executor" or any modifying or substituted
pronoun therefor is used in this my Will, such words and respective pronouns shall include both
the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply
equally to the Executor named herein and to any successor or substitute Executor acting
hereunder, and such successor or substitute Executor shall possess all the rights, powers and
duties, authority and responsibility conferred upon the Executor originally named herein.
ITEM VIII
Powers for Executor. By way of illustration and not of limitation and in addition to any
inherent, implied or statutory powers granted to Executors generally, my Executor is specifically
authorized and empowered with respect to any property, real ur persoitai, at a~iy tim;, held ~aniter
any provision of this my Will: to allot, allocate between principal and income, assign, borrow,
buy, care for, collect, compromise claims, contract with respect to, continue any business of
mine, convey, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate
any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect
to, take possession of, pledge, receive, release, repair, sell, sue for, to make distributions or
divisions in cash or in kind or partly in each without regard to the income tax basis of such asset,
and in general, to exercise all the powers in the management of my Estate which any individual
could exercise in the management of similar property owned in his or her own right, upon such
terms and conditions as to my Executor may seem best, and to execute and deliver any and all
instruments and to do all acts which my Executor may deem proper or necessary to carry out the
purposes of this my Will, without being limited in any way by the specific grants of power made,
and without the necessity of a court order.
Testimonium Clause. IN WITNESS WHEREOF, I have hereunto set my hand and
affixed my seal this the ` ~ day of November, 2007.
-
q'"' ' ~ ~' ' , " ,.SEAL)
.IAC EL,YN AA. I~.OBERTS
Attestation Clause. The foregoing Will was this the t ~" day of November, 2007,
signed, sealed, published and declared by the Testatrix as and for her Last Will and Testament in
our presence, and we, at her request and in her presence, and in the presence of each other, have
hereunto subscribed our names as witnesses on the above date.
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Last Will and Testament of Jacquelyn A. Roberts Page .3
PROOF OF WILL
COMMONWEALTH OF )
PENNSYLVANIA
Self-Proving Affidavit
COUNTY OF DAUPHIN )
We, JACQUELYN A. ROBERTS, and Jeffrey R . Boswe 11. ___ and
Diane E . Gr i s s incter ,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 bast 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 purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testatrix, and in the presence of each other, signed the Will as
witness and to the best of our knowledge the Testatrix was at that time eighteen years of age or
older, of sound mind, and under no constraint or undue influence.
,, _ ,y
JA~QUEf.YN A. IZOBERTS
Witness
Witness
Subscribed, sworn to, and acknowledged before me by JACQUELYN A. ROBERTS, the
Testatrix and subscribed and sworn to before me by Jeffrey R . Boswe 11 and
Diane E. Grissinaer ,witnesses, this the 14th day of November, 200?.
eal)
Notary Public for Pennsylvania
My Commission Expires: o~ G o1-d //
COMMC7NWE,~L'~H CF pENNSYLVANl,4
Connie L. H ~~ ~I
City p f ~ ~Y~ Notary Public
My Commisslp~n U~~ Oataphin Count),
Member, Penne Ivanl~ herb. ~~, x'11
~ AsaoCletlon o! IVotarlere
Last Will and Testament of Jacquelyn A. Roberts Page 4