HomeMy WebLinkAbout03-02-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOffR PROBATE AND GRANT OF LETTERS ++
Estate of O O~ ~L ,Deceased ESTATE NO: 21- ~ l '~~
a/k/a:
a/k/a:
a/k/a: SS NO•~~ ~ - l ~ - `7~'CD 3 `.~
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND °°C" as
ap cable:
A. Probate and Grant of Letters Testamentary or ^ Administration c.t.a., or d.b.n.c.t.a. (complete Part C also)
and aver that Petitioner(s) is/aze entitled to the~aforementioned Le ers ' i under
the last Will of the above-named Decedent, dated ~ d codicil(s) date ~~
(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, was never adjudicated an incapacitated person, and was not a
party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in
23 Pa. C.S.A. § 3323(g):
^ B. Grant of Letters of Administration
(If applicable, enter d.b.n., pendent life, durante absentia, durante miaoritate)
C. 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 (If Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section A,~rtd completst of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a pa a pend divorce
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proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323~~~t as ows:~.., ,--
Name
Address
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(Street address with Post Office and Zip Code; Municipality: To~nship, Borough, City)
Decedent, then ~ ~S years of age, died ~~= ~ 0 /U at ~_ 141y1 p f -/ / L [, _ ~i4
(Month, Day, Yeaz of death) (City and State where eath occurred)
Estimated value of decedent's property at death:
_If domiciled in PA All personal property $ (~ QOO. D O
_If not domiciled in PA Personal property in Pennsylvania $
_If not domiciled in PA Personal property in County $
_Value of Real Estate in Pennsylvania $ ~
Total Estimated Value $ J _,d Q~}', dd
Location of Real Estate in Pennsylvania: (Provide full address if possible.) "'-
D Signatur~ ~ „ Name(s) & Mailing Address(es)
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THIS SECTION MUST BE COMPLETED:
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
1,, ~, SS
COUNTY Ol~~ ,(~'Yl I J~~ I (~ .~ (~
The Petitioner(s) above-named swear(s) or affinn(s) that the statements in the foregoing Petition are true and conect 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
~~
For Register
Signature of Personal Representative
Signature of Personal Representative
Signnture of Personal Representative
File Number: ~ ~ ~ I ~ V ~~~
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Estate of _~r~ I V t U ~ ~,~ 1_.~ ~ ,Deceased ~
Social Security Number: ~I ' ~ (I/ ~ `~'~ D 3s Date ofDeath: /T _ ~ Co "- ~ r/
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AND NOW,~~ ~~r(~,r1 ,inconsideration of the foregoing Petition, satisfactory proof
having been presented b~~ef~~or~~e'~m',e, IT IS CRE hat Lette s ~ ~~f(~,1~ ~QI%~
are hereby granted to ~„~ZCA/ ~ ~ • i ~~ '~
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 Decec~nt
FEES
Letters ............... $
Short Certificate(s) ........ $
Renunciation(s) .......... $
L~
~r! ... $
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Register of
n iw~'
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Fa•m RW-U_' ,-ev. 10.13.06 Page 2 of 2
105.805 REV 101/07)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17047943
Certification Number
3 HEV 11lNOB
l PREIT Ei
FIAIAIEIff
acFC Sec
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will he forwarded to the State Vital
Records Office for permanent filing.
LGwn~ ~ ~ FEB 7 2 11
Local Registrar ~' Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORD3
CERTIFICATE OF DEATH
(Sse Instructions and ezamplee on roveree)
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Dorothy F. Black Female 201 _16 ~ 4635 February 26, 2011
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LAST WILL AND TESTAMENT
OF
DOROTHY F. BLACK
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I, DOROTHY F. BLACK, now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may
have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum I have handwritten or signed, located with my will or with my valuable papers and
found within 30 days of the probate of my will. Gifts may only be to persons who survive me or
to organizations which exist at my death, and if there is a conflict, the memorandum having the
latest date shall govern. To the extent no such memorandum is found, or all of my tangible
personal property is not disposed of pursuant thereto, my tangible personal property shall be
added to my residuary estate and pass under Article IV hereof.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my son, STEVEN D. BLACK, of Adams County,
Pennsylvania, Per Stirpes.
Article V
Except as otherwise provided in this Will, I have intentionally failed to provide for any
other persons or relatives, whether claiming to be an heir and/or relative of mine or not. Insofar
as I have failed to provide in this Will for any of my relatives, and/or issue now living or later
born or adopted, such failure is intentional and not occasioned by accident or mistake.
Specifically, my sons, DAVIDSON M. BLACK and JEFFREY L. BLACK, are not to inherit
any monies or property, personal or real, under the terms of this Will.
2
Article VI
I nominate, constitute and appoint my son, STEVEN D. BLACK, of Adams County,
Pennsylvania as Executor of my Last Will and Testament. I direct that my Executor be
permitted to serve without bond. In addition to those powers granted by law, I grant my
Executor the power to distribute in cash or in kind, in like or in unlike shares, and to file any
qualified disclaimer I could have filed if living. My Executor shall receive reasonable
compensation for services rendered to my estate.
Article VII
In addition to the powers conferred by law, I authorize my Executor, in his absolute
discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any
beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
3
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Executor and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
(j) to receive reasonable compensation in accordance with his standard schedule of
fees in effect while his services are performed.
IN WITNESS WHEREOF, I, DOROTHY F. BLACK, hereby set my hand to this my
Last Will and Testament, on ~ °d.y ~ p'7 , 2007, at Harrisburg, Pennsylvania.
DOROTH .BLACK
In our presence, the above-named DOROTHY F. BLACK signed this and declared this
to be her Last Will and Testament and now at her request, in her presence, and in the presence of
each other, we sign as witnesses.
Name Address
2000 Linalestown Rd Suite 202 Harrisburg PA 17110
2000 Linglestown Rd Suite 202 Harrisburg PA 17110
4
I, DOROTHY F. BLACK, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my
Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
DOROTHY F. BLACK, the Testatrix
on /~ DEC.' ~ a~ ~ , 2007.
`--~
Notary ublic
` --
DOROTHY F. LACK
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Melissa M. Kain, Notary Public
Susqueharura Twp., Dauphin County
My Commission E~ires Aug.11,2010
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute
this instruunent as her Will; that she signed and executed it willingly as her free and voluntary act
for the purposes therein expressed; that each of us in her sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) yeazs or
more of age, of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to before me
by S
and ~\ILir1_.l~_= - D~C~AL nr~ la,
witnesses, on ~. ~ / ~ ~ , 2007.
~_~
Notary Public
Witness
i`n fi? ~-~rY~
Witn s
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Naives M. Kain, Notary Pubic
~ ~P•. Dauphin Courny
My Canxr~eeiar Atra.11,2010