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HomeMy WebLinkAbout11-17-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of PEGGY JEAN FOLEY also known as PEGGY J. FOLEY Deceased COUNTY, PENNSYLVANIA File Number •' Social Security Number 212-32-8191 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 last Will of the Decedent dated - ~i and aver that Petitioner( is are the SUCCESSOR EXECUTOR sand codicil(s) dated AND (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.; pendente liter durante abseruia; 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) and heirs• ~~r Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) J „ ~ _ ~ (COMPLETE INALL CASES:) Attach additional sheets if necessary. ..a ~ Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at ^ ~ p - ~ 27 ABBEY COURT, CARLISLE, PA 17013 "' ~ _ `; . ! N (List street address, town/city, township, county, state, zip code) `_ Decedent, then ~ ~ years of age, died on NOVEMBER 1 S, 2010 at CARLISLE REGIONAL MEDICAL CENTER, w x 361 ALEXANDER SPRING ROAD CARLISLE~PA 17013 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 147,600.00 situated as follows: 27 ABBEY COURT CARLISLE, PA 17013 named in the -~ J 'J n :~ f .^_, ~~~ ~^ x ,. x ., Form RW-01 rev. 10.13.06 Page 1 of 2 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: Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 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 ~ ~ before me the ~ ~ ~ day of .~ Fort Register Sr e o Personal Representative ---- - Signature of Personal Representative Signature of Personal Representative File Number: ~ ' ~ ~ ~~ / 7 ~Tt Estate of PEGGY JEAN FOLEY ,Deceased ~~`'~ ~x O "„„ :. :L -r. _^, Z O x i ~ f ~ `% „-.. N . _. ,~J, ~./ A7 ~ xi = ~ l V J Social Security Number: 212-32-8191 Date of Death:NOVEMBER 15, 2010 AND NOW, f r ~J~~~ ~~ ,~ ~~ ~~ in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to ALLEN TAYLOR FOLEY and that the instrument(s) dated DECEMBER 2002 described in the Petition be admitted to probate and filed of record as the last Will (and FEES ,? ~~~ Letters ............. $ ' Short Certificate(s) .... ~ .. $ ~ ~'~~ Renunci tion(s) .......... $ _ ... $ ~~'~ ... $ 0~ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ --9:6@ in the above estate s)) of Decedent. Attorne Si ature: R'~gister of i-Gills ~;/ t ~~~°R"x""'~~~~~- Y l~ Attorney Name: KATHLEEN K. SHAULIS Supreme Court I.D. No.: 37445 Address: 1633 WALNUT BOTTOM ROAD CARLISLE, PA 17013 Telephone: 717-243-6655 Form RW-02 rev. 10.13.06 Page 2 of 2 ,y c f ,~ L{~AL REGISTRAR'S ~ERTIFICATIC)I~ )F` ~~~ .I 1nl~~NNNr. It is illegal to duplicate thiscopy ~~ ,phc~'kos.tat ~ ~hc) t_c,;r{ ~ k ~'L'L t(1)~ Ihl1 +•~~'1'IIIIL~t~C. `'~{~ {~( P ---16- 8 5 _~_~ ~ ~ _ ftr{i,r~r`rZ ~ 17C Pl~C 11 ' rrur E: ~ i~('4 ) tl+ ~ "I ` ~ l)i ll)t'` i7)li~t1)~ c`L'l'11}~l,l ~ltt 1)f)l~f.'ilt~l ;,l' ~,P - r"I~,f,=: t ,1I._'l t t ids "l C i ; ~ir d~~, ~~" ,~ '~~ ,+I~ ' '~i ~ I~~ (rl ' ~ (I~,af Re~~i~~;tr~(r. ~I-t~~• ~;~ri~inal ''g' ~' ~i ~rt)1~; .~t~ r ; l .. ~ 1 ~~ .:Y-(iL.~(_1 to the `il~ike vital 4 ~ ., ~~~ ;~r --, -~ :. /; ~; ~ -~ y~ ~ '-~ ! 1y .~ --J ~ •~ _ ly/ ^ v -_ r~ v r"` O .i ~, ~ ..i ~ ~_' v N ^ x ~~ ~; z ^'~ J ~... H105.143 REV 11/1006 TYPE /PRINT IN PERMANENT BLACK INK if) Q) .,~ a 0 U N r J 1~ ~i `~ w COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) .._.__ _.. _ ... .. 1. Name of Decedent (Flrel, middle, last, sufix) 2. Sez 3. Social Security Number 4. Date of Death (Month, day, yea') OV 5. Age (Last Birthday) Under 1 ear Under 1 da 6. Date of Bi Month, de , ar 7. Binh C and state a forei coon 6a. Plop of Death Check one Months Days Haura Minutes H o spital: Other. 7 9 vrs. Apr i 1 1 4 19 31 Sha 1 lmar Mar 1 a ~~ r l 61 lnpetient ^ ER /Outpatient ^ DOA ^ Nursing Home ^ Residence ^ olner • Spedty: Nb. County of Death Bc. City, Born, wp. 1 Death 8d. Fadliry Name (If not institution, give street end number) 9. Was Decedent of Hispanic Origin? ®No ^Yes 10. Race: American Indian, Blade, Whtte, etc. • (If yes, specify Cuban, (S,oeci/y~ Cumberland South Middleton C 1' Mexican, PuertoRicen,el°.) White • 11. Decedents Usual Otxu tan Kind of work done Burin most of wtxki life. Do not state reti 12. Was Decedent ever at the 13. Decedents Eduptbn (Specify Doty highest grade completed) 14. Mental Status: Marred, Never Monied, 15. Surviving Spouse (If wde, give maiden name) Kind of Work Kind of Business/Industry U.S. Amred Farces? Elements I Seconds 012 Cofl Widowed, Divorced (Spec/ryJ ry ry( ) ege(1.4a5+) Housewife Domestic ^Yes No i ow 16. Decedents MaiRrmg Address (SUeet, city 1 town, state, zip code) Decedents Did Decedent Vy~~-~ P a 27 Abbey Court Actual Residence 17a. State . Live in a 17c. 4?J Yes, Decedent Lived in T hi ? T`"~' Carli l P 1 owns p ve 17b. County Cumberland 17d. ^ Ac ei ~st d wnhmn s e a . 7 01 5 tu Lim of City / Boro 18. Fatfinels Name (First, middle, last, suffix) 19. Mother's Neme (First, middle, maiden sumeme) Soloman 20a. Informant's Name (Type /Print) 20b. Informant's MaRing Address (Street, city /fawn, state, zip code) 1 21 a. Method of Disposition r ~ Crerr~tion ^ ~~ • 21b. Date of Disposition (Month, day, year) 21c. Place of Dispostion (Name of cemetery, cremarory a otfter place) 21 d. Loptlon (City /town, state, zip code) ^ Burial ^ Removal hom State i Wes CtamMion or Donetlon Aldltodn.M ^ outer- rLryMedlcalExaminer/coronerT ®Yes^No n Nov. 19 2010 Hollinger FH/Cremator Inc Mt.Holl S s.Pa.17055 lure d Fu eral Servk~ L acting ) r% 22b. Ucense Ntxnber 22c. Name and Address of Facility 5 01 N . Ba 1 t i mo r e Ave . y ~C FD- 11 plate Rams 23ec Doty when prtirying 23a. To the best of m ,death occurred at the time, date and place staled. (Signature and tills) 23b. License Number 23c. Date Signed (Month day year) ysician Is not available at time of death to , , certiry cause of death. ~ Items 24-26 must be completed b'1 person 24. Time of Death 26. Date Pronounced Dead (Month, day, year) 26. Was Case Referred to Medical Ezaminer /Coroner for a Reason Other than Cremation or DonafionT • who prorwurxxs death. Ct ~ / J ~ M. ~~ ~ ~ ~ ~ '~ J L J ^ Ves ~ No CAUSE OF DEATH (See Inetructlons and examples) ,Approximate interval: Pan II: Enter other;;ienifipnt conditions conMb uLing to death. 26. Did Tobacco Use Contribute to Death? Item 27. Pan I: Enter the chain of events -diseases, in~ries, a complications • that directly caused the death. DO NOT enter terminal events such as cardiac arrest, r Onset to Death but not resulting In the undertying cause given in Pan L ~ Yes [_ Probabl respiratory arrest, a ventricular fibrillation without showing the etiobgy. List Dory one cause on each line. t IMMEDUTE CAUSE IF l di r y ^ No ~ Unkrwwn na sease a _ __ _ p ~,,,~ y condition resulting in death) _~ a. C'(9 ~ (p ~ S ~ ~ l ~ (~ j f ~L L /s~~J ~ C~ n n ,` 29. If Female: N Due to (or as a consequence of): i ot pregnant wRhin past year Bally fist conditions, if ant, b Gp-! T7 G /11'L /'~ ~ j7 Cr 5 /~~7L2y.~i S m ~~J'f~ ~ lee ' to the cause Nsted an line a. ^ Pregnant at time of death Enter UNDERLYING CAUSE Due to (a as a catsequartce oft: ~ ^ Not pregnant, but pregnant within 42 days (disease a injury that initiated the c t events resuttirtg m death) LAST. ~ of death ^ Due to (or as a consequence oft: Not pregnant, but pregnant 43 da to 1 ear Ys Y m • d. i before deFtth ^ Unknown if pregnant wRhin Me past year 30a. Was an Autopsy PedormedT 30b. Were Autopsy Find'mgs Available Prior to Completion 31. Manner of DeaN 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred 32c. Place of Injury: Home, Farm, Street, Factory, of Cause of Death? ~ Natural ^ Homicide Orfice Building, etc. (SpeatyJ ^ Yes ®No ^Yes ~ No ^ Accident ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 321. II Transportation Injury (Specify) 32g. Location of injury (Sheet, city /town, state) ^ Suicide ^ Coukl Not be Determined ^Yes ^ No ^ Dover/Operator ^ Passenger ^ Pedestrian M ^ soar - spa~lly: , 33a. Certifier (check Doty one) • CenNying physkWn (Physidan certifying puss of death when arwiher h sician has rortourtced d th d l t d It 33b. S' ore and TRIe Certifier ~ ~ ~ ~ p y p ea an corttp e e em 23) To the beat of my knowledge,Beeth occurred due to the ause(s)end manr»rta stated--------------------------------- ^ / / r .~cZ . ~ •'t-~ L [Tl7// ~. • Pronouncing and cettlfying phyalclan (Physidan both pranourtdng death and certirying to pose of death) 33c. se Number 33d. Date Signed (Month, day, year) To Nte beat of my knovrkdge, death occurred at the Nme, date, and plea, sod due to the cause(s) and manner es atated_ _ ~ ---------------- ~ ~~ a~, ~ // ~ .~ ~ 1 ~ `V • ldadkel Examiner/Coroner / _ V On Nte basis of examina6on and I or Investigelion, in my opinion, death occurred e[ the time, date, entl pka, and due to the auae(s) and manner ae steted_ ^ 34.J~ame and Address o_ j PgLsOn oiatad Causeof,Dea1~ (Item 27) Type /Print o'er . ~f ~~r(J JWl 2711 36. Registrar' Nre and Di biG ' ~ ~ ~ ~a I ( I d I I 16 I ( y year) ~ Dale Filed Month, da , ~ j :3 r£t! GuTL771W<,/ ~vJ ~~ Disposition Pennn Na. ~~ ~7 I_ ~ I ~c~ IIa~.~~ ~Il~l ~.ffid ~C~~~.~~~~ ~~ ~~~~ ~~~ffi ~~ll~~ I, Peggy Jean Foley, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. ARTICLE ONE PAYMENT OF DEBTS AND EXPENSES I direct the payment of the debts and expenses of my last illness from my estate as soon after my death as conveniently may be done. ARTICLE TWO DISPOSITION OF PROPERTY I give, devise and bequeath all my property, real, personal and mixed, of what nature or kind so ever, and wheresoever the same shall be at the time of my death, to my beloved husband Ray Lynwood Foley, provided he survives me by thirty (30) days not counting the day of my decease. In the event that my beloved husband Ray Lynwood Foley predeceases me or fails to survive me by the aforesaid period, I give, devise and bequeath all my property, real, personal and mixed, of what nature or kind so ever, and wheresoever the same shall be at the time of my death, to my son Allen Taylor Foley, provided he survives me by thirty (30) days not counting the day of my decease. In the event that my son Allen Taylor Foley predeceases me or fails to survive me by the aforesaid period, I give, devise and bequeath all my property, real, personal and mixed, of what nature or kind so ever, and wheresoever the same shall be at the time of my death, to my grandson Todd Allen Foley. ARTICLE THREE ,f -- ,., ,~ ~ , . ~~~ ~z TAXES _ I direct that any and all inheritance, estate and ~' -%~ ;~, V v transfer taxes imposed upon property making up my estate ~ N F~~ ~ ~: passing under my Will or otherwise, shall be paid out of ^~~",^z the principal of my residuary estate prior to its o ~._. ,., , distribution to my heirs . ~: '' cy ~ x N~ J Cr " ARTICLE FOUR EXECUTOR'S POWERS In addition to the powers and authority conferred by law or necessary and appropriate for proper administration, I authorize my Executor in his or her absolute discretion: 1. To retain in the form received, and to sell either at public or private sale any real or personal property; 2. To lease, mortgage or otherwise encumber any real or personal property that may be included in my estate, without order of court or notice to any beneficiary ; 3. To invest and reinvest in all forms of property; 4. To exercise any options or rights arising from ownership of investments; and 5. To compromise claims without court approval and without the consent of any beneficiary. ARTICLE FIVE NOMINATION OF EXECUTOR I hereby nominate, constitute and appoint my husband, Ray Lynwood Foley to serve as Executor, if living and able to serve as same. If my husband Ray Lynwood Foley is deceased or is otherwise unable to serve as Executor, I hereby nominate, constitute and appoint my son Allen Taylor Foley to serve as Executor, if living and able to serve as same. I hereby relieve my Executor from the necessity of posting security in connection with their duties as such in any jurisdiction in which they may be called to act insofar as I am able to do so by law. ARTICLE SIX MISCELLANEOUS PROVISIONS A. Paragraph Titles and Gender. The titles given to the paragraphs of this Will are inserted for reference purposes only and are not to be considered as forming a part of this Will in interpreting its provisions. All words used in this Will in any gender shall extend to and include all genders, and any singular words shall include the plural expression, and vice versa, specifically including "child" or "children," when the context or facts so require, and any pronouns shall be taken to refer to the person or persons intended regardless of gender or number. ~.` ~~~ ~ .~ ~ B. Thirty Day Survival Requirement. For the purpose of determining the appropriate distributions under this Will, no person shall be deemed to survive me unless such person is also surviving on the thirtieth day after the date of my death . C. Liability of Fiduciary. No fiduciary who is a natural person shall, in the absence of fraudulent conduct or bad faith, be liable individually to any beneficiary of my estate, and my estate shall indemnify such natural person from all claims or expenses in connection with or arising out of that fiduciary's good faith actions or non-actions as the fiduciary, except for such actions or non-actions which constitute fraudulent conduct or bad faith. IN~~~TNESS WHEREOF, I have subscribed my name below, this ~'~day of December, 2002. ~, ~~ ~--~ ~ . Testatrix Signature Peggy Jean Foley We, the undersigned, hereby certify that the above instrument, which consists of five (5) pages, including the page which contain the witness signatures, was signed in our sight and presence by Peggy Jean Foley, the Testatrix, who declared this instrument to be her Last Will and Testament and we, at the Testatrix's request and in the Testatrix's sight and presence, and in the sight and presence of each other, do hereby subscribe our names as witnesses on the date shown abov . W ' ne s Si ature ~ '~-~- it s gn Name ' l~ n City, State ~ ' ~ Witness Signature Name City, State ~~~~- ~~ ~Gt rCrs lQ ~7~ l 7 L'r r ~ t ~w ~ AFFIDAVIT CONII~iONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I, Peggy Jean Foley, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will, that I signed it willingly and as my free and voluntary act for the purposes expressed in the instrument. Testatrix Signature %7 ~ -~ e can Foley Subscribed, sworn to and acknowledged before me by Robyn E. r Malone, the Testatrix, this day of December, 2002. .~ ~~,,~ Not Public ' lyli int.; ~,µ'~ i _ :R ~ {- ~ ' a:~°9;r f ~:1rr ~ ~~ ~ r ~ AFFIDAVIT ~~.~~~,~~,~.~`r `+~ , :_,,~~ ~, ~ s COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We , V G~ ~ ~ i-^ I e ~ ~ `~~ ` and ~G~ ~'y~~ ~ `~ ~ ~G~.t~ ~ 1 '~ , 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 Peggy Jean Foley signed and executed the instrument as her Last Will and Testament and that she signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of her witnesses, in the presence and the hearing of the Testatrix signed the Last Will and Testament as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen (18) years of age or ~' ; L,rl' iJ !/~ ,~ ~~ / ~ a a older, of sound mind and under no constraint or undue influence . /-, ~ ~ ~ residin at ~~'~- ~;'~ WITN~:SS l~-~~ ~ ~- 4 ~ ~ WITNESS ~: _ -,w.-~~-~~~ '' residing at ~ s ti~~ ~ ~ ~ ~~ ~ 3 Subscribed, sworn to and acknowledged before me by U ~ ~ ~ irrl ~- ~' (~ ~ ~ ~ , and T »~~~. ~ ~~ y~ 1 s , the witnesses, this day of December, 2002. ,, ~~ N tary Public KATHLEEN ~~ SHAULIS N to Carlisle Born, Cumberland Co Public MY Commission Expires Dec. 22~2~3 ., 7~~--~~ ` ,~ ~ ~~ ' , ~~ t~~