The URL can be used to link to this page

Home My WebLink About12-01-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Jean Kayser File Number 21-10 - ~1 ~ L also known as ,Deceased Social Security Number 483-62-9955 Peter Kayser Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or `8' BELOW.•) ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the last Will of the Decedent, dated ,~~CIl~'• ~,~~ ~ ~ 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, en er c..a.; .n.c..a.; pe en e i e; uran e a senha; urante moron a e Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spous-e (if any) and heirs: (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.) Name Relationship Residence ," C c _t: ~ ~~ ~_~~' ;,_-t -~- .~,7 Cl i'~r'? ~-_ .~ ~~ ~ ==fir ~ ~ c.M~_ • ~ i J ./ ~ r. _~ r ' ~_~ _ ~-~ ~.._J '-n ~ ~ i~~i (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ ~ ~ „c- ~ti-' ;=-v-e Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal re~ence at ~' ~. •~ 3536 Countryside Lane, Camp Hill, Cumberland, PA 17011 ~ (List street address, town/city, township, county, state, zip code) Decedent, then ~_ years of age, died on 11/17/2010 at ManorCare Health Services, Towson, MD Decedent at death owned property with estimated values as follows: (If domiciled in PA) $ 100,000.00 (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania 175,650.00 situated as follows: 3536 Countryside Lane, Camp Hill, Cumberland County, Pa 17011 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 residlence ~ • Peter Kayser 1301 110th street Bode, IA 50519 All personal property Personal property in Pennsylvania Personal property in County Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } 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. n ~~ Sworn to or affirmed and subscribed before me this I day of r ~~" / r' ~ ( f (~' ~ ~C \ l J ~ ~~ of Personal r Kayser Signature of Personal Representative ~ J/y~~aiu~c vi rc~uv~~a~ ~~c,.n cac~~~a~rrc For the Register ~ ~? ~-~~~n ~ c~ ~z~ ~~ ~~~ ~..~ ~.. File Number: 21-10 '~ ~ 1 ~`-- Estate of Jean Kayser ,Deceased r.s c~ C' ~- 1 .~' IV ,~-_~ .,x.. r ~f i J a'.3 S.,-~ ' .~...~ r t. i i ~._ _ _.~ •'7 ~; Y~ Social Security Numbeer: 483-62-9955 Date of Death: 11/1712010 AND NOW, ,- <~a ~i I ~ ~ { ~-~ I ~ ~ ~ ~ ~ ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Peter Kayser _ in the above estate and that the instrument(s) dated ~ - Z - ~(~ 1 ~~ __ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters .......................................... $ ~.~ Short Certificate(s).....~....i`...r,~..... $ Renunciation(s) ............................ $ Will $ JCP Automation Fee TOTAL ................................... 310.00 20.00 15.00 23.50 5.00 373.50 Attorney Signature: Carlisle, PA Telephone: 717-249-6333 Form RW-O~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Attorney Name: George F Douglas, III Esq. Supreme Court I.D. No.: 61886 Salzmann Hughes, P.IC. Address: 354 Alexander Spring Road, Suite 1 ~ / ~ .. , r ~\\~ ~ '~ 7 ,.~ 1~~ ~, ~\ i~ L , ~~ I1 I ,.~ VIII ~~" li illrl °p~~l' ~, ~~M~~' .~i ~,~ „r.~ II.~II~ I I III 1 s, - ~ I I b ' l'~ !Ir s ,yl r, II s,. ~ I ~ I ~ ~'~i III : ,i ~. r. , L . i it q Ip. 1 ..s~". III °~, ., :~ VIII y.... .,~':~ ` ItJI l ~ ~~~~ ~. ~ : 1 s, i - In JI .i -~, ~': ,..: I. ~ ~ r"41 : ~`.~ _ ~., III I .. ,.i,:` ":. 41111 i ~-~~~. : e ~~.. hill ice. t~1. {J. 4i :~ 11 I r i~ ~. II d n - i~ CAI' ~`Y - +~~~ _;_, n Ipi~~I (, ICI T! ~ .a:?ti. f ll11 s sci . _.?'.,_ IIi~JII '~' 'iii. --~~.. bull. i=_~~~` '' ~ - ~i . r e r _~ ° ' ~~~ s ,... ~. ;,~'~. P. I .;__~~~ I~~.,I 'ice^,```.~.~ 11~.~~/y '¢-.-y~~~`~ - I n. t!i ~:~~ llll iii ~~v ,.,\\11111 i~ ~i~~4. i ~1 ~ ~,ff I `~ti r lil - ally ~~ _ -- _ ~ ~~ .~ _ .. ~. - - ~ " ~~'~- .~ s ~ - - . - ~ .~ ~ r '. .:Y ,~~ta~~ ~a:adG'X;, '.~,~~Jia z. ."~~~.'1~$~~~`~' ,. 6a~~'~.' b .~,~,'r~v ~~ °r T.'~"r ,i ~~ ~ = I 4 i6~ ~~ lurl! ~~~~h h / .Y .. ...°° r` w4. My _+ J ~ " rI s~` i'-. :f ~. - ~~/i d C ~.~ ~Fi''`~lr~'~~ ~~hly~l I ~fl~ 3 r ..~~ ~ ~; I l 'L! j (`` __ ~ I~~~~ I i I ~~i I~~~ ~ ~ ,, sZ ~ j ~~i~~u r ~~, pll~ i ~~i 11 11' .... ._ r.J _.1 i v) I~4I I_.:."J ~ ~ 11`14\\ ~ !/RI ~~~„ ~~ ~~,. II I , ~~- TAT' E ~ F ~ A RY _~ IV D ~ ~~~~; ~~~: a~ = - ~ " pe ~-t~tfi~~"t of Heallrh and Mernta~ Hlygien~y try ,,, ~- ~~~~~~ Division of Vital Records `:; ~ ~ ~ . ~ ~~C~~~o ~,~f; ~ ' e or Print in Black Indelible Ink. Ensure All Copies Are ~e~gible. : ~ ~~~>?? /';;1 ~i~ ~ ~~~; ~ `~ f Maryland /Department of Health and Mental Hygiene '~'~~'~~~~ ;4 w44 ~ For R _ 1 ~ii~dy ,~~,! ~ state CU ~ f Death ~ . N°. :;;~- .. ~~ .- ~~'`W' ~`~~ Certificate o ~ :"~, a ~ Registrar - 3. Time of Death '° 1. Decedent's Name (First, Middle, Last) 2. Date of Death Month Day Year ~ * O ~ M ~F ~`~ ~e r loo r 1 '? X010 ~f _. ~;. ~~~~.~, 4d. Far~lity Name (lf not institution, giros street and number) 4b. City, Town, or Location of Death 4c. County of Death j ~~\~z~ . ,, ~,,,, %'% ,, (ire HIaalth S \~j,~\ 5. Social Security Number 6. Sex 7. Age (In yrs. last birthday) If Under 1 r f nder 24 rs. 8. Date of Birth 9. Birthplace (State or Foreign ~,,fG ~~; 1 ^ M Yrs Months Days Hours Nlut. ~(M~oynth, Day, Year) Country) / i~~s. ~ 983-fit-'~55 61 - ~';/ i$/19~9 IQnTci - ~1~, . Usual Residence of Decedent _~ v 10d. Inside City Limits -- y 3 10a. State 10b. County 10c. City, Town or Location :~°, .:~~/ ~ ~ ~" ~ Q~YI~ C~[C>p H~ 11 1 ^Yes ~No y :,, ~~i~ ~ ~ ~ ~ ~ 10e. Street and Number tOf. Zip Code 10g. Citizen of What (:ountry? ~r~ ~; ~~~`` ' r M ~ 3535 (Jcxalrittyside Lame 171011 t~niteci Stags - I,iy,~ " ~ ~ a d 12. Was Decedent Evar in U.S. 13. Was Decedent of Hispanic Origin? (Specify Yes or No- 14. Race -American Indian, ~;% `~~~ ; .o ~ ` ~ 11. Marital Status Armed F ? If Yes, specify Cuban, Mexican, Puerto Rican, etc.) Black, White, etc. `_ _,~ m 3 F. 1 [Never Married 2^ Married 1 ^Yes No ' ,_ ~ o ~ If Yes, Give 1 ^Yes ~No Specify: Specify: ~1~ ~'~ ~ L ~ 3 ^ Widowed 4 ^ Divorced Yearor Dates: ia~~ ~ ~ t\~C~i ~yy~~!; .c° ° ~ 15. Decedent's Education 16a. Decedent's Usual Occupation 16b. Kincl of Business/Industry ~ ~~w, ~ ! ~ ~ ~ ~j (Specify only h/ghest grade completed) (Give kind o/ work done- during most o/ working ~~\~ f ~ ;dI c fills. DO NOT use redred) F~-IC1J~ ~1' ~~, ` ~~ ~{I ~ ~ E Elementary/Secondary (0-12) Collage (t-4or b~) ~ ° ,~ x~~ `~ ~ 17. Father's Name (First, Middle, Last) 18. Motheds Name (First; Middle, Maiden Surname) ,~ ~~~ ~ O \ s ~ E ~ ~ t9a. Informant's Name/Relationship (Type. Prrrrt) 19b. Mailing Address (Street and Number or Autal Route Number, Ciry or'Town; State, Zip Code) ?`~~ ,~ a ~ a ~ Y~~~~. Ave.. Sla~c Falls, : ,r ;; ~~~~~,~ ~ ~ N ~ w~llialn F 26'991 9oiutYmsbl~n SD 5ii1.08 ~~ ~~,~ 11~, ~ ~ •- z ~ ~ 20a. Methotl of Disposition 20b. Place of ~ Disposition (Name o/ ~ Date ~ 20c. LoG~tion -City or Town, State ~ „~,( o, r s c 1 ^ Burial 2~ICremation 3 ]~[Ramovat from state ~;ye ~~~ 11/19/014 ~ LBOlld,r PA '~/~,' ~ I ~~ a ~ ; 4^Donation 5 ^Other (Specify} 1 =- •€ ~ ~5 21. Sig of Funeral Service Licensee 22. Name and Address of FacAity~,;,,,,,r ~ ~~~1 ~~ I~• ~ ~- ~, ~u ~ 23a. Part1. Enter the disease, or c:ompticatkms that.caused the death. Do not enter the mode of dying, such. as cardiac or reoprratory arrest, In~tervcal Between 1 ~~; ;,(pi%;;; shock, or CaQart failure. List orWy one c~uee~~ each Iln®. Onsetsnd Death ~ 11. j' ~ I Immediate:Gauss (Final ~* /~ "' ~~ ~ ~ ,~.~* ~" ~~ ~`,I ~ d~9ea ~or dconea~)dttign . a. J ~ ~fi~ ~ ~ ~ .S ~., ~ ~..L ~-~7x.~.,A ~ b ~ ~ w` tom' ~ ~~ ~ ~ ~1~~ a resultl ~n h Due to (ores a consequence of): ~ % ~;.; ,,~ -\ ~, Sequentially list conditions, b• 6 if any, leading to immediate Due to (or as a consequence of}: •- ,~ cause. Enter Underlinng r'f ~. ~ ,~ ~ ~ sertiateroNsnlury c. t j`\,. i~ r/ ~~ ( ~ ~ •` ~ itln iii death Last v~ ~/~ .,; x ~o >K reeu 9 ) Due to (or as a consequence of): »> ~~, ~`~~;c ~ ~ ~ lp j ~~r ~ r ~ L ~ \ ~ ~ ~ IF FEMALE: ~ v w 23c. If rimes, outcome pf ~regnancy 23d. Date of delivery '- +_ ~ ~ 23b. Was decedent pregnant ^ %'. ~ m ~ W t Live birth 2 Fetal death 3 ^Ectopic pregnancy :. m ~ o in the past 12 months? 4EIPregnant at time of death 5 ^ Other (specify) Month Day Year s~ v m m .~ 1 ^Yes 2^ No 90Unknown 'd~ '~ r ~ .~ ~ 9OUnknown (, '~ ~ Part II.Other significant conditfona contributing to death but not resulting in the underlying cause given in Part I. 23e. Did tobacco use contribute to the. cause of death? ~ ~ 1 ^Yes 2~~No 3^ Probably 4 ^Unknown g ~> m ~ h ~ r-~QX~S l~ ~ 24a. Was an 24b. Were autopsy findin s available _- g ~ a fl autopsy prior to completion o~ cause of ' t $, ~ performs ? death? ~` ~, ~ ~ ~ . / ~ m m O 1^ Yes 2 No 1 ^Yes 2 No '~(j ~~ c '' 0 25. Was case referred to medics! 26. Place of Death Check oM one ~~~~~ 9 ' ~~~('ff~~ M ~ ~ ~ examiner? Hospital; Other: ~~~,~ , "< ru ~ ~, ~ ~ 1 Yes 2^ No 1 ^ Inpatient 2 ^ ER/Outpatient 3^ DOA 4 Nursing. Home 5 ~ Residence Ei ^Other (Specify) ~~~ ~\ `,~ t ~ ~ t o. .- 27. Manner of Death 28a. Date of Injury 28b. Time of 28c. tn'urryy at 28d. Describe how injury occurred _g ~ ~ p 1 atural 5 ^Pending (Month, Day Year) Injury ~oric? ~° ~ ¢ " ~ 2~Accident investigation M 1 ^Yes 2 ^ No ° V 6 (]Could not be E $' 3 ^ suicide 28e. Place of injury - At home; farm, street, factory, office 28f. Location (Street and Number ar Rural Route Number, ~~~ ~ ro ~ ~ = 4 ^ Homicide determined building, etc. (Specify) Glty or Town, State) i9 ~~ ~ ~ ~ m (~ ~ Off~p~(g~'I $~ ~ ~ 29a. Certifier 1 Certifying Physician: To the best of my knowledge, death,occurred at the time, date and place, and due to flue cause(s) andmanner as stated. r '~11\I a\~ , ;I = ~ ~ ro ~ (check oMy fl/sdlloai Examiner. On the basis Of examination and/or irnsstigation, in my opinion, death occurred at the time, date and place, and due to the cause(s) (/, ~~ ,) ~ ~ m ~1 and manner stated. ~. 3 ~ c~ E = ~ ~ ~ $ ~ 29b. Signeture.a title of certifier. 29c. License number 29d. Date signed (Month, Day, Year) _, .. .. ~ , - D ? 8' D~~Ire o ~ .'p ~ 0. Name an of completed cause of (Item 23a) (T pe, Print) `•~~~ ~ BSI ~3't _ Date tiled ( SZ s Sifynatuce ....w,.,. ~~ ,~ .' HMH 17 Rev 1/2001 ORIGINIppHEREBY CERTIFY THAT THIS DOCUMENT IS ', A~RUE COPY OF A RECORD ON FILE- IN THE ~ _\\ ,,. s/~1 III ___ . -- wa~~~~~~~gtt ~8t@ ~SSl1,@d: ~~~..w~~~~~~~q~ri F I,~1),r , ~~ _ ,~~~~~~ ntWu.. za !; November 19, 2010 ~~~~~ wl,lfl ` ~~ /~~~ STATE REGISTRAR ~; ~ >,b ~ ~ ~ ' '. ' y ~ ~ DO NOT ACCEPT UNLESS ON SECURITY PAPER WITH SEAL ~ o ~,, _ OF VITAL RECORDS CLEARLY EMBOSSED. - LAST WILL AND TESTAMENT OF JEAN KAYSER f? ns ~ C_ t~ o ~, -~~, ~ ~ = _ _ T' / /'~ i...+ ~ k E.. _: :::' .. . 'ry ~_~7y ~ . ~ ., „"' N "",~ I, JEAN KAYSER, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making voici any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I direct that my remains be cremated and that the expense of my cremation be paid from my estate as soon after my death as conveniently may be done. SECOND: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral and crematory expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. Further, to the extent that sufficient assets exist in my estate, any and all inheritance or other estate taxes, whether to non-charitable or charitable beneficiaries, shall be paid by my Executor or Executrix from the residuary of my estate prior to distribution and no part of the taxes paid shall be prorated or apportioned among the persons or beneficiaries receiving the taxak~le property regardless of tax rate applicable by law to each such persons or beneficiaries. THIRD: I give devise and bequeath my interest in a business known as Nutri-Innovations, located in Minnesota to RUSSELL STEELE, per stirpes, who lives in Martinsburg, Pennsylvania. FOURTH: I give, devise and bequeath my interest in our family farm, located in Iowa, to four of my brothers, PETER KAYSER, WILLIAM KAYSER, JEROME KAYSER, and HOWARD KAYSER, in equal shares, per stirpes, all of who are co-owners of the said farm. FIFTH: I give, devise and bequeath sixty (60%) percent of the remainder of my estate, both real and personal, which includes my interest in a business known as Freckled Moose Fundraising to all five of my brothers, PETER KAYSER, WILLIAM, KAYSER, JEROME KAYSER, HOWARD KAYSER, and RICHARD KAYSER, in equal shares, per stirpes. The remaining forty (40%) to be divided between my nieces and nephews, JENNIFER SCHIELE, JACQUELINE KNORR, JACOB KAYSER, NICHOLAS KAYSER, CASEY KAYSER and KELLY KAYSER, in equal shares, per stirpes. SIXTH: In the event any of my above-named nieces or nephews shall not have attained the age of eighteen (18) years at the time of my death, I hereby give, devise and bequeath his or her share, be it real, personal or mixed, of whatsoever kind and wheresoever situate to their parents, IN TRUST NEVERTHELESS, for the use and benefit of my said nieces and nephews. The Trustees, authorized to act jointly or 2 ~ ~ k separately as the case may be, shall invest the funds in good and safe securities, legal for Trust funds in the Commonwealth of Pennsylvania and may use the income derived therefrom for the support, maintenance, health, education and general welfare of my said nieces and nephews. In addition, I hereby authorize and empower the Trustees to use as much of the principal as they in their sole discretion shall deem necessary ar~d proper for the support, maintenance, health, education and general welfare of my said nieces and nephews, and to distribute absolutely to them the principal and accumulated income, if any, upon his or her attainment of the age of eighteen (18) years. LASTLY: I nominate, constitute and appoint my brother, PETER KAYSER, to be the Executor of this my Last Will and Testament. In the event that PETER KAYSER shall be unable to serve as Executor for any reason, I appoint imy brother, WILLIAM KAYSER, as Executor. No Executor or Executrix shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~a -~ day of --z-., , 2010. '~ JE N KAYSER SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, JEAN KAYSER, 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 1 signed it willingly; and that 1 signed it as my free and voluntary act for the purposes therein expressed. Swo ~n~ or affirmed to and acknowledged before me, by JEAN K,AYSER, the Testatrix, this ~.. ~ day of ~~~,1,~,~,-~,i-t , 2010. ,'~ ) JEAN YSER, Testatri i ~~~ :c~eoaa~F oouous, m, No~raseuc ~~ CARLISLE 90ti0, CUMBERLAt~ 000NTY ~ . ~ COMMON ExP~ES'~tE2~ ~01t Notary Public 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We, George F. Douglas, III and ~a .,,~, , ~ ~_,: ,~~,~~ ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualifiE:d according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed i1t as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind ar~d under no constraint or undue influence. Swor or affirmed to and subscribed to before me by George F. Douglas, III and /~Q;.~ :~ /(~1~ ~ ~,-~~ this 2~'-~ day of ~._~-~_~,~.~, , 2010. ~,r~,- Ceorge F. Dougla ,III, Witness Witness __.__.._ NOTARW.8EA1. ,`+? DEORQEF. DOUQLAS, Iq, I~TAI~PU~JC ~' r CgRIl51.E 8~, CUMBEF~APID COUMY Notary Public MY COMMI5SI~1 DtPiHES JtMiE 26, 2011 5