HomeMy WebLinkAbout03-15-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
,- r /~}
Estate of Leah May Atticks File Number ~~ a ~ 1 ~~ 1.~~~~
also known as
Leah May Atticks ,Deceased Social Security Number
Jan L Brown aka Jan L Moberg
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW.)
^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ExeCUtrIX named in the
last Will of the Decedent dated 1 /24/2006 and codicil(s) dated
Elizabeth G Atticks is the named Executrix. Elizabeth G Atticks died on 10/16/2007. Jan L Brown (aka Jan L Moberg) is the
named continaent Executrix.
Continued on a Separate Page
(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, was never adjudicated incapacitated, and was not a party to a pending divorce proceeding at the time
of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g):
B. Grant of Letters of Administration
(If applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente liter durante absentia; durante 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: (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.)
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his /her last principal residence at
4905 E Trindle Road Mechanicsbura PA 17050 Hampden Township
(List street address, town city, township, county, state, zip code)
Decedent, then 94 years of age, died on 2/27/2011 at Country Meadows
4905 E Trindle Road Mechanicsburg PA 17050
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 500.000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
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
Jan L Brown aka Jan L Moberg
845 Sir Thomas Court Suite 12 Harrisbur PA 17109
Page 1 of 2
Form RW-02 rev. 10.13.06
,: ..~
(COMPLETE INALL CASES:) Attach additional sheets if necessary. ,-` ' ~ - `~~~ ~=~'
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, Petitioners} will well and truly
administer the estate according to law. _
Sworn to or affirmed and subscribed
before me the 15 ~. day of y v v U
n ..._..._ , y i--~
Signature of Personal Representative ~~~ ~ ~ .
1
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For the Register Signature of Personal Representative •._r ,
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File Number:
Estate of Leah MaY Atticks ,Deceased
Social Security Number:189-09-1614 Date of Death: 2/27/2011
AND NOW, March 15 , 2011 , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Jan L Brown aka Jan L Moberg
~. in the above estate
and that the instrument(s) dated January 24. 2006
described in the Petition be admitted to probate and filed of record as the last Will hand Codicil(s)) o~Decedent. ,~ ~
FEES -.V
..
Letters .......................... 410.00
$ Registe i s ,~
Short Certificate(s) ~~
'~y$ 40
00
~~
~
.
.
. . Attorney Signature:
Renunciation(s) •••.•••••••••••• $
Will .... $ 15.00 Attorney Name: Jan L Br
Automation Fee .... $ 5.00
Supreme Court I.D. No.: 67993
JCS Fee ..., $ 23.50
..,, $ Address: 845 Sir Thomas Court Suite 12
"" $ Harrisburg
.... $
.... $ PA 17109
.... $
$ Telephone: 717-541-5550
TOTAL ............................. $ 493.50
Form RW-02 rev. 10.13.06 Page 2 of 2
H105.805 REV (01/071
LOCAL REGISTRAR'S CERTIFICATION OF DEAt~'H
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.0(1
P 17296436
Certification Number
This is to certify th~.t the information here given is
correctly copied frcyn~, an original Certificate of Death
duly filed with me ati l~tx~a:l Registrar. The original
certificate will he for~rarded to the State Vital
Records Office t(~r ~~~1-rnane:nt tiling.
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Loc~x1 Registrar Date Issued
H105-143 REV 1(/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE /PRINT IN
PERM/WF_N'T CERTIFICATE OF DEATH
BLACK INK
(See InstrUCtlons and examples on reverse) STATE FII F NIIMAFR
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1. Name a DecedaM (First, mlddb, lest, wl6x) 2. Sex 3. Social Secaity Number 4. Dab d Death (Month, day, year)
At icks Female 27/2011
- 5. Aga (Last BIMdsYI Urxbr 1 UMer 1 da 6. Date a Birth Morttlt de , 7. Bi and sbb a sun fia. Place a Deaat Check ate
IAor~s Days Hours Mirrubs Hospital: Other t~lJal
Yom. 29 191 Hauls PA ^ Inpaaera ^ ER / Ou~atient ^ DOA ^ Nurahlg Hans ^ Residence ®oa,er - SpeayLl
- 6b. CounN a Death fic. City, Boro, Twp. a Death tlU. Faa7ily Name (a nd iratlatdorl, gMa street and number) 9. Wes Decedent a tispanlc Origin? ~] No ^ Yes 10. Ras: Arnedcan Inden, Blsdt,lVlrib, etc.
• (ayes, spedly Ctlbert. (Spedly)
la,,,.] ('.O~1Tltry ~ad(~g Mexican. Puerto Rican, e1cJ
11. Deadea's Uallal aan KrW a work dab d u ' mat a life. Oo rat stab red 12. Was DecakM ever in the 13. Decedent's C•ducatim (Spsdy only ltigyRSt grade oom peted) 14. Marital Status: Married, Never Married, 15. ;surviving Spo use (a wife, g'we maiden name)
Kind a Wak Kind a Buair•ss/ Indrsrry U.S. AmrW Forces? Elementary / Secadary (0.12) Cdlege (1-a a 5+) waON~' ~~ (~M
Executive Secre Bankin ^veayyNo 4 Never Married
6. DecedertYS Mldlktg Address (Street cAy /tam, sbb, zip code) Decedents
Penn C~]
AcNal Residence 17
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4905 East Trindle Road a.
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Mechani.CSbur , PA 17050
17b.cdunty ClrrnhE'rla ,7d. ^ No, Decedent Lived within
nr~ ActualLimitsa ~/~
16. FeltleYs Name (Rrst ntidde, last, slrltst) 19. Moarefe Name (Fist midde, maiden wrrtame)
20e. InfortrbnYa Name (Type /Print) 20b. Inkxniartts kleikrrg Addreae (Street dry /town, state, zip code)
Att .Jan L. Brawn 845 Sir Thomas Ct. Suite 12 Harrisburg, PA 17109
21a. Method of Dbpoaiam r ~ Crematbn ^ Donation 21 b. DaDe a DtaDoaNor+ (Mash, day, year) 21c. Plaa a Dispaition (Name a almetery, cranwory a attar place) 21d. Locetkxt (City /bwn, stab, zip code)
• ^ ttud~ ^ RamovallromSbte ~ waCramatlon«13antlonAutlwrizad
^ Oar. ~ I by ExarnlrtsrlCorotrrt ®Yes^ No 3/1 /2011 Evans Cremation Service LeO:la PA 17540
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2za. siptaaae q ( as suds) 22b. Litxnae Nunrbar 2zc. Nam. and Addreac a FacNly Nei 11 Funeral Home, Inc
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Campbea a ony when oatayuq
physician ' waBabb at time a decal b 23a To the best d my k, death occurred at the lima, dab and place sbbdt(Sigrwure and tltle)
° 23b. License Number 23c. Date Signed (Month, day, year)
arory a death. ~ ~Zof.~x,~~..' /~/V ~~ off- S~1' d'~ ~ l L- ~ k:c v ~ U ! %
• Itertls 2426 must he oargbbd b/ pareon 24. Tme a Death am 25. Dale Praramad Dssd (Month, day, year) 26. Was Case Referred 1o Medical Examiner / CAroner fa a Reason Oarer Cremeaon a Donetion9
"'''° pronaxtces deatl,. f : ~ ~ I~ rfc. ~ '~ a 0 ~ ^ Yea
CAUSE OF DEATH (Sse Inatructlone and axamplas) , Approxkreb imerval: Pen II: Eller oMar ' 26. Did Tobacco Use Cortenbrae b Death?
Item 27. Pan I: Enter the flap, - dbeasas, ijudea. a conptications • that direcriy caused the death. DO NOT enbr IarrikluJ wards such as cerdac arrest, ~ Onset ro Death but not resulEng b the atderlyirrg cause given in Pan 1. ^ Yea ^ Probeby
r~spirat
ory sweat a ventriuYar Abr~kation without showing the etiology. Ust
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y one cause on each line. r
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resaang in dead d•IeOYe a ~~ . ~ ~ ~~ f1
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min Peat year
^ Pregnant a, lime d death
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Eater bUNDERLYNrG CAUSE a Due a (a as a consequence a): ~ ^ Na pregrtaM, but pregnant wilFwr A2 days
(dlseasa a that ktRiabd the
sveres resultlirg In deaM) LAST
a r
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i)trs ro (a as a consequence oQ: r
r Nd pregrwrt, but pregrwM 43 days ro 1 year
hetore death
• d. i ^ Ur*nown a pregnaa wilhm tM pa9t year
30a. Wa en Aubpay 30b. Were Atdapay Fxrdrps 31. Manner a Death 32a. l)ab a tttNy (Month, day, year) 32b. Deacnbe How irtpsy oocurred 32c. Plan a Iryury: florae, Fenn, street Facrory,
Performed/ Avaibbb Prior ro ComPteaon rte(
^ Cafice Buildng, etc. lSpea'ly)
a Cause a Daetlt7 aturel
homicide
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^ Yea
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^ Yes ^ N ^ Acddant ^ Pending Inveatige6an 32d. Txne a Injury 32e. IrMUry at Work'J 321. a Trsnsponation Injury (SPec~y) 32g. Locatbn a irgay (Street cat !town, state)
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' \ o ^ Suidde ^ CouW Na be Debmined
M ^ Yes ^ No ^ DmrerlOpsrator ^ Passenger Pedestrian
. Otlter - Speedy:
33a. CeNaer (deck any one) SgnaNre and T r
CenayMg phytidan (Physiden ceRilYin9 ~• a death when anodter physaiart hec P death and cmlpbbd hem 23)
TotMbastamykltowladga,dastltoceumddwtotl(aquas(s)andmannerustatad--------------------------
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• Pronotsairg and artllyfrg pftyakMn (Physician both proraunckg death and anilyirg ro cause a loth)
To the that a my krgaAadpe, dad( ecourrad n tM tlme, dabs. and Pbce, and due to the cause(s) and msnnsr u rrtNad_ _ _ _ _ _ _ _ _ _ _
• fAsdicali:xamkrx/Coranr
_ _ _ _ _ _ _ ^ 33c. Lice r
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Gii 33d. Date Signed (Mon ,day. year)
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r)n the f>tsls a examination and / «imaatlgatton, In my opinion, dmth oauned at the nme, data, and place, end due to the eauaa(a) a+d manner as atetecL ^ 34. Name and Address of Person Who Com
leted Cause of Death
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`~ Disposition Pertnh No. Q ~~ /•~jl ~ ~ '
I, LEAH MAY ATTICKS, 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.
4 R ~
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Article III
I give, devise and bequeath in accordance with any memorandum which I have either
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.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my sister, ELIZABETH G. ATTICKS, of Cumberland
County, Pennsylvania. In the event that ELIZABETH G. ATTICKS predeceases me or fails to
survive me by thirty (30) days, I give, devise and bequeath the remainder of my estate, of whatsoever
nature and wheresoever situate to the MARKET SQUARE PRESBYTERIAN CHURCH, or its
successor(s), of 20 S. 2nd Street, Harrisburg, Pennsylvania, to be used at its discretion..
Article V
I nominate, constitute, and appoint my sister, ELIZABETH G. ATTICKS as Executrix
of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any
reason whatsoever of my Executrix, I nominate, constitute and appoint my attorney, JAN L.
BROWN of JAN L. BROWN & ASSOCIATES, or its successors, or an attorney of Jan L.
Brown & Associates, or its successors, currently of 845 Sir Thomas Court, Suite 12,
Harrisburg, Pennsylvania, as successor Executor of my Last Will and Testament. I dil-ect that my
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Executrix or successor Executor be permitted to serve without bond and in addition t:o those
powers granted by law, I grant them 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 Executrix or successor
Executor shall receive reasonable compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executrix and successor Executor,
in his/her 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,
(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
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interest in at time of my death, and
(j) to receive reasonable compensation in accordance with their standard schedule of fees in
effect while their services are performed.
IN WITNESS WHEREOF, I, LEAH MAY ATTICKS, hereby set my hand to this my Last
Will and Testament, on l'' o~ y 2006.
o~ <-k. ~
LEAH MAY AT ICKS
In our presence, the above-named LEAH MAY ATTICKS 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
01 ~ ~..~ 5~2~,rvt '~ ('!l ~n, n ~'l ~ T~
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I, LEAH MAY ATTICKS, 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
LEAH MAY ATTICKS, the Testatrix
on ~ "v~ `k 2006.
No ry blic
OF
l~QUaNNE w. IiELLX NO~IIIK MISt16
~p
1M oowwsm9N FI~PMES Off. l~ 1910'
LEAH MAY ATT KS
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
instrument 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) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
by ~fi V ~~ ~L~L~e ti~~~~~~
and~1.7E , rS'~~i.~~.B~' ~
witnesses, on j - ~ ~ , 2006.
^ ~.
N tary blic
COMIMONYPEALTH of PENNSYLrAINA
NOTARIAL SEAL
1A000EUNE A. KELII~ NOrAIK PUBIlC
i~INER PAXTON TMIP., DAUPHNI COUNTY
~ COIMAi1SS1ON DfPIRES DEC.11, 2001
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Witness ,/
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Witness