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HomeMy WebLinkAbout02-11-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Dorothy J Stevens also known as COUNTY, PENNSYLVANIA File Number 21 - 11 --- ! t ~~ ,Deceased Social Security Number 169-24-5256 Mary Shorter and Evelyn L. Witman _ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' i3ELOW.•) Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executors named in the last Will of the Decedent dated 05/24/2001 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 instruments} 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 sen ~a; uran a minon a e Petitioner(s~ after a proper search has /have ascertained that Decedent left no Wil! and was survived by the following spouse (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~ ~D r-. ~ ...... ~ '. i"T «`~ c.,,, i ~ ~~ ~, ~~, -~ , ~. - ~ ~ : y~`~ (COMPLETE /N ALL CASES:) Attach additional sheets if necessary. -~ C.."`? `-'~ Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 3709 Rosemont Avenue-, ramp Hili, PA 17011 (List street address, townlcity, township, county, state, zip code) Decedent, then $p years of age, died or. 02/03/2011 Decedent at death owned prope;t;; with estimated ~;21ues 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 $ situated as follows: 110,000.00 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 Mary Shorter 3709 Rosemont Avenue 1 ~~G~-c.-- Camp Hill, PA 17011 J ` '1 Evelyn L~IVitman 402 Wren Court rr ~ Mechanicsburg, PA 17050 G~.~C~ ~ / at Manor Care Form KW-UL Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page ~ 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. Sworr; t0 or ditLirmed a4zd subscribed before me this / day of ~ '~ For fihe Register Signature of Mary Shorter i .~ Evelyn L. Witman Signature of Personal Representative File Number: 21 -11 - (C~ ~ Estate of Dorothy J Stevens Social Security Number: 169-24-5256 Date of Death: 02/03/2011 Deceased AND NOW, t , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Mary Shorter and Evelyn L. Witman in the above estate and that the instrument(s) dated 05/24/2001 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. {^' ~. J h.. mom.. r..rw ••.~ +~ ? ~? om- ~' ~ FEES ,. ~ l ' ~ F ~ : ~ t ~~ ~ ~7 r ~• ' ' Letters ............................................ $ ~ . G~ j ~! ' ~ ~~f ( ~(,~ I ' -'~ r ~ i -~ .. Short Certificate(s) ........................ $ ~ ~ ~ l J ~ ~ ~ . z Register of Wills ^~ : ~ C'~ -~-;< -, ..-_ '.~ . :. ~. Renunciation(s) ............................. . $ Attorney Signature: I~,~,,` k , ~~~. ..a e,.__ -~-i ~ ~ w ; ;.... =--= ~, L' ' ~ ~ $ ~ t ~ ~ ~t J Attorney Name: Debra K Wallet ~~~ ~~ ~, ,, ~ ~ ~ ~ ~ , $ `~ ~ `~ ~ Supreme Court I.D. No.: 23989 ~~ ,-~ C; 1..~ l C~ fi t~ l ~ $ ~ ~ CZi , Law Offices of Debra K. Wallet $ Address: 24 North 32nd Street $ $ Camp Hill, PA 17011 $ Telephone: 717/737-1300 $ TOTAL .................................... $ ~ ~ C~ '~7 Form RIN-02 Rev. 10-13-2006 Copyright (c} 2006 form software only The Lackner Group, Inc. Page 2 of 2 ~ f~ ~:~~~ ~; ~~ ~~, ~!ec~~~~ ~~~ tl~ap~iic:a~.~' ~~~ c~~.)~ ~")'4F p~~t~~~~,:~~t ~.-)' ~~c~~€~c#rw-~~~~ '~ ~ - { , ) ,. ~~tt))~ l~lllc~~i) plc 9w_' t'_atil'll Iti ; ,. ,. , ~1 Qf ~~' ` ~~ ~ ~ '~ a r ~ t ~ .. la ;;~ ~~ ><--. . ~~~ ~. t: ) _ ~ , II r~t~r~.l~(3 tl~ ~~ ~)t.~ ;}((t~~r,,~ll - ti ~ K.. i ~ ~~ - ~.> -` ~ ~ t 1 t . (i.. t ~ I k ~ i { 1 G. ' ~ (. (, t ~ 1 ~ 4..~ ;~t I l I x ~. tw f 4. t 1 1 ~ ~ '~ ~ ~ ~~ ~~~ ~~ ~~ #~ ~; i ~~~ .. l ~' k l , a 4c•3li ! 11 i tl.° ~ FEB 0 7 2011 , ~ ~ 0 4 7 3 9 ~ ~ P ~ ~ J ~ ,~;~ , ,;~ ~ ;o; ~ _~. 7 - ~ ,~ ~ ~~ _ _ _ _ __ ~ _ _ ____. _. _ - --- - . r j.~ ~~ ~t:1 r " t'"z't ~ ~ J ~ j _~ ..,,~ ~~ Q~ C r`.. i., „+ ..A~ ~ ~ t ~~ ~ ~~ ~yyy 3 REV 1112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS RMANENTI" CERTIFICATE OF DEATH ACK INK ~~ tnctructions and exarttoles on reverse) cr.rc r.. c sn u.oco 1. Name o} Decedent (First, middle, last, suffix) 2. Sex 3. Social Security Number 4. Date of Geath (Month, day, year) 2011 3 5256 Feb 24 169 f l , . ,- - e ema Dorothy J. Stevens . 5. Age (Last Birthday) Under 1 ar Under 1 da 6. Date of Birth Month da 7. BI ace C and state a tae coon Be. Place of Death Check on one Mcllhs Days Hours Minutes Hospital: Other: • 8 0 Yrs May 3 0 ,1 9 3 0 W e S t Fairview , PA ^ bfpatient ^ ER / Otrtpatlent ^ DOA Nursing Home ^ Residence ^ Other -Specify: 8b. Canty of Death 8c. City, Boro, Twp. of Death 8d. Fadlity Name (If rrot ktadlutlon, glue street and ntarfber) 9. Wes Decedent of Hispanic Ork)In1 ~ [] yrfs 10. Race: American Indian, Black, White, etc. ~ Cumberland Camp Hi 11 (11 yes, specify Cuban, I sp~M Manor Care Mexkan, Puerto Rican, et°.) white i i. peoadenYs llsuel tlon Kind of work d ate dud most of wodd INe. Do not state retl 12. Wes Decedent ever in the 13. DecederrPS Educatbn (Specity only highest grade completed) 14. Marital Status: Marled, Never Married, 1 ~~. Surviving Spouse (If wde, gNe maiden name) Divorced (Speary) Widowed wnddwork KvWotBusinesa/Industry U.S. Armed Faces) Ek~ttary /Secondary (0.12) College (1-4 or 5+) , widowed bookkeeper insurance ^ Yea No -~ s. Daa,aanra Mailing Address (slrea,, city novm, orate, zip rxxle) Decedents Pennsylvania Did Decedent Twp. Live in a 17c Decedent Lived in ^ Yes 3709 Rosemont Ave. ~ . , Actual Residern;e 17a. Shta Township? Cumberland 17d.~,°, Decedent Lived within Camp Hill Cam H i 11 PA 1 7 0 1 1 17bca,nty Actual Limits of coy/ Boro 18. Fathers Name (First, middle, last, st>f8x) John W . Buser 19. Mother's Name (Frst, middle, maiden aumame) Gertrude Kramer -r~ 20e. InlormaM's Name (Type / Pdnt) Wendy Grumbling 20b. InlamanYS Meiling Address (Street, °hY !town, stale, zip code) P.O. Box 573 Tonto Basin, AZ 85553 21a. Me of Disposition r ^ Crematbn ^ Donaton 21b. Data of Dlspositlat (Month, ~Y, Yid 21c. Place of Disposkion (Name of cemetery, crematory or other piece) 21d. Location fCity /town, state, zip code) uthorimd a Donetlon b Buda) ^ RemovalfromShte ~ Feb. 8, 2011 Stone Church Cemetery Enola,PA 17025 ^Y~^~ l~ ~? ~~ F ~ • lure of Fu Lirxarfsee (a person acting as such) 22b. License Number -013163-L 22c. Name end Address of Facility &CS,324 Hummel Ave.,Lemoyne,PA 17043 F H Musselman plate Items 23a•c only when certflying th to t ti f de k bl i Y 23e. T o the st of my knowledge, death occurred at the tlme, date and place stated. (Signature and title) ~ /~-1 C/- ' ' C/( /'~. I ~ ~ ~j d J 23/b.~ License Number 2~ to Sign d (Month, day, Year) // me o a e a cien is rat ava e phys certify cause of death. /V ~ ~~ I "1l/-'~ -/ ~ ~ ~ ~y~J 3 ,/ • 24, Time of Death 25. Date Pronounced Dead (Month, day, year) 26. Was Case Refe tc Medal Examiner /Coroner Mems 24.26 moat be completed by person ^ ^ Y for a Reason Other than Crematlon or Donation? • ~ ' es o who txaaunces death. O ~ Q M. ~L., CAUSE OF DEATH (See Instroetlons end exempts) r Approximate Interval: Part II: Enter other sionfOcant condtlions caftributlnq to death, Nen in Pad L nden in cause in th h b t t Po 26. Cid Tobacco Use tribute to Death? - [] Y P b g g ng y u no resu e u Item 27. Pen L Eller the chain of events -diseases, injuries, or canpCrcatbns • that drectly caused the death. DO NOT enter terminal events such as cardiac arrest, ~ Onset to Deat roba y es respiratory arrest, a ventricular 8brilialion witlwut showing the etiology. List only one cause on each line. r No ^ Unknown r IM~M~~ ~CNAUSE (FI ~ disease a n /~ r~ G r ~ ~ S rig oea / (ti /~~ V^ f r ~ r _ 29. If Fem nant within past year [ of pre _~ a, Due to (or as a consequencr of): g [] Pregnant at time d daatfi SSee~~uentlelly Ilat condtliorxs B arty b r i hi 2 d ] , , , leadi to the carree tleted on line a. p~ to (a as a consequence oQ: i Eller UNDERLYING CAUSE t Not pregnant, but pregnant w n 4 ays of death (disease a injury that inideted the [] Not re nt but re nant 43 da s Io t ear c everfta resutling m death) LAST. r y y gna , p g p • Due to (a as a consequence ot): r i " before death ] Unknown if pregnant within the past year • d. 30a. Was an Aulapsy 30b. Were Autopsy Findings 31. Ma Death 32a. Date of Injury (Month, day, year) 32b. Describe How injury Occurted 32c. Place of In}ury: Horne, Farm, Street, Factory, 13ffae Building, etc. (Speri/y) Pedomred? Available Prbr to Comple f C f D ths afore) ^ Homicide ause o ea o ^ Accident ^ Pending Investlgation 32d. Tine of In}ury 32e. Irry'ury et Work? 32f. If Trenapodatbn Injury (Spedly) 32g. Location of injury (Street, city / tovvn, state) ^ Yes o ^ Yes No ^ Yes ^ No ^ Driver/r)peretor ^ Passenger ^ Pedestdan ^ Suicide ^ Could Not be Detertnlred M Other • Speclly: 33e. Certifier (dtacfc Dory one) 33b. afore and Title o r 1 ~ Certlfying physkhn (Physician °•rtltyin9 cause d death when another physician has pronanced death and completed Item 23) , life / ~/ v~ To 1M hest of my knowedge. death orxurrod due to the urge(s) and manner as shred _ _ _ _ _ -' _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ .. - - - - - - - ^ - - 33c. Llurrae Number .Date Signed (Month, day , year) • Pronouneing and rxrtNying physician (Physician both pronouncing death and certHykg to cause of death) To the best of my -mowlsd9e, death occurred st the lima, dste, and place, end dos to the cause(s) and manner as Mated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • ~ t!~ G G 3 ~ ~ ~ / '~ '~ ` • Medical ExaminerlCoroner On 1FN bmh o1 exemfnstion and 1 or inveadgetion, in my opinbn, death occurred M the dms, dsh, end pleee, end dos to gte eave(s) afM manner u satad_ ^ 34. N and of Person Who t~se of Death (It@m 27) Tyx i Pdnt ~~ r ,C/ ~ ,wN///] / '~ ' " year) da Date 36 / .• 6 ` 1 ~ / ~ , stud Nuribet ~J 35. Regishers Signature. +` ~ ~ ~0~~ ~ ~ y, , . 2 r 'Z~~ / ~~ ~ ~ ~ P. w l cJ V DisposNion Permit No. a/ -7 a`?~ aL 7 J ~ V.~ o ~ l~ ~ l~ ~1 ~ r .~ e~ ~~ ? `r'I ~ ~..7 ~ ~ ~..a _ `~ t: ~ _~:. ~ 1 ~,~ t... ~ L.^+ ~i ~ F ~:.j v `~ t ~, ~ I, DOROTHY J. STEVENS, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils, that I have made, including the Will dated December 4, 1990. FIRST: I give and bequeath my diamond wedding ring set to my daughter, ,~''~ENDY GRUMBLING, of Cedaredge, Colorado, so long as she shall survive me by thirty ~~~-~ ~,. r SECOND: All the rest, residue, and remainder of my Estate, of whatever nature and wherever situate, I give, devise, and bequeath as follows: A. Three fourths (3/4) to my daughter, WENDY GRUMBLING, so long as she shall survive me by thirty (30) days; B . One fourth (1 /4) to my granddaughter, SHERRY LYNN SAYL~;R, of Sun Valley, Nevada, so long as she shall survive me by thirty (30) days. Should any of these individuals fail to survive me by thirty (30) days, but be represented by children then living, these children shall take, per stirpes, the share to which my beneficiary would have been entitled if then living. THIRD If any portion of my Estate shall be payable to a beneficiary who is less than eighteen (18) years of age, my Executrix may pay such share to the beneficiary's parent or guardian, as custodian for said minor, who shall deposit such share in the minor's name in a Uniform Gift to Minors' Act account in a savings institution of the Executrix's choosing, payable to the minor at majority. FOURTH: All interests of any beneficiary in the income or principal of this Estate, ~'~ while undistributed and in the possession of my Executrix, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, ,~ contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to ~~ ,; pledge, assignment, conveyance, or anticipation. ~, ~ .~~ FIFTH: All inheritance, estate, and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally ..~ t the principal of my residuary estate without reimbursement from any person. SIXTH : In addition to all rights and powers conferred by law, I authorize and ver my Executrix and her successors, in her absolute discretion and without necessity of ing court approval: A. To buy investments at a premium or discount. B. To hold property unregistered or in the name of a nominee. C . To give proxies, both ministerial and discretionary . D . To compromise claims . E. To join any merger, consolidation, reorganization, voting trust. plan, or any other concerted action of security holders and to delegate discretionary duties with respect thereto. F. To lend to, and buy from, my estate. G. To borrow and to pledge real and personal property as security therefor. H. To sell at public or private sale for cash or credit or partly for each, to exchange, or to lease for any period of time, any real or personal property, and to give options for sales, exchanges, or leases. I. To exercise any option permitted by law which she believes to be ii ~~7 advantageous from the viewpoint of overall tax reductions, including, without limitation of the v `, foregoing, power and authority to claim administration or other expenses either as income tax deductions or inheritance or estate tax deductions, without regard to whether they were paid ,, ~~` from principal or income and without requiring adjustments between principal and income for ='any resulting effect on income or estate taxes, and a deduction of such expenses for income tax ~, , --'purposes shall be given effect in computing the respective shares of all persons interested in my estate set forth herein, even though the effect is to increase the share of one beneficiary or .~~ class of beneficiaries hereunder at the expense of another; and to make such adjustments, if ,) ~ any, between beneficiaries with respect thereto as she shall deem appropriate in view of the ~~ nature of the transaction and the amounts involved. J. To distribute in cash or in kind or partly in each. The powers granted hereunder shall be exercisable with respect to all real and personal property, including, but not limited to, income and principal held for minors or disabled beneficiaries at any time, until the actual distribution of all property. All powers, authorities and discretion granted here shall be in addition to those granted by law and shall be exercisable without leave of court. However, nothing herein shall be interpreted or construed to encourage, authorize, empower, or permit the Executrix to act or cause anyone to act in a manner contrary to or inconsistent with accepted standards of portfolio diversification and risk management. SEVENTH: I nominate, constitute, and appoint my sisters, EVELYN L. WITMAN and MARY SHORTER, both of Camp Hill, Pennsylvania, as Co-Executrices of this, my Last Will and Testament. In the event of the renunciation, death, resignation, or inability of either of my sisters to act for whatever reason in this capacity, then I nominate, constitute, and appoint the other sister as sole Executrix. I direct that no representative named above shall be required to post security for the faithful performance of her duties in any jurisdiction insofar as I am able by law to relieve her of such obligation. Any of my representatives shall be entitled to reasonable compensation for the performance of the duties set forth here. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .Z*1'"'` day of tti-~{~1 , 2001, on this, the fourth of four typewritten pages. I have also signed the left-hand margin of the first three of these pages for purposes of identification only. ~.__. SIGNED, PUBLISHED, and DECLARED by the Testatrix, DOROTHY J. STEVENS, as 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 hereunto subscribed our names as witnesses. ,..-- ~Gh•-~ i GS b wrq ~ ~A 1 ~ oS's ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, DOROTHY J. STEVENS, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~~. C. ` ,. W ~ ti ,~y ~.. OROTHY J. S'I\ ~E Sworn or affirmed to and subscribed before me by DOROTHY J. STEVENS, the Testatrix, this ~ ~-r1 day of Y~'(1 ~~ , 2001. ~~ ~.,~, ; ~ ,~ Notary Pub c Notarial Seal Mary M. Loper, Notary Public C~utM HNI Boro, Cumberland County Member, Pennsylvania Association of Notaries AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Debra K. Wallet and `~~. I't ~ y?~C~, ,~ ~ ~ ,the witnesses v~rhose names are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that she executed it 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 years of age or older, of sound mind, and under no constraint or undue influence. ;,. ~~1~ -,~- _~ worn or affirmed to and subscribed to before me by ~.)~'kjt-~>~. ~:. ~ ,~ ~,~~ 'i ~ --, and ~ ~~,~~~,,~~~~~~~~~ }.~ ~~,~ ,witnesses, this `"~ ~~~' day of {r,~~~ , 2001. f , ~. 1 • ` ' r' ~- Notary Publi Notarial seal Mary M. Loper. Notary Public HN! Boro, Cumberland County My~Commission Expires Oct. 27, 2003 Member, Pennsylvania Association of Notaries