HomeMy WebLinkAbout03-31-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND COUNTY, PENNSI'LVANIA
Estate of Joan E . Damey
also known as
Deceased
~,
File Number ~ ~ " ' ' ~ ~-} -1
Social Security Number 1 8 6- 2 8- 4 61 6
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 Testamentary and aver that Petitioner(s) is / ache EXE3CUtriX ___ named in the
last Will of the Dece ent da ed June 1 1 2 O O 3 and codicil(s) dated November 4 2 01 0
Codicil o~ ovem erL4; 2010 change a Persona Represen a ive
(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: '' GG~ ~c~..- ~°~--
n
B. rant of Let ers o A mtnistratio ~~ ~ ~~ ~ ~~ ~-~ `~ ~ ~~ -~-~~~~• 1
(If applicable, enter: c. t. a.; d. b. n. c.t.a.; pendentelite; durclnteabsentia; duranteminoritate)
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
Ad17l1111StYal10t1, c. t. a. or d.b.n.c.t.a., enter date. of Will in Section A above and complete list of heirs.)
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ,~ `•~~' ^~~ .... -~
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Decedent was domic~led at death in Cumberland County, Pennsylvania with hts / er last principal resi~i~ at ~~~ ;..
550 Criswe~l Extension, of ing Springs, PA 1707 ~. ; ~ ~.~
(List streetuddres.r, town/city, township, county, state, zip code) 550 Criswell Extension ~-~
Decedent, then 7 4 years of age, died on 3~ 2 4~ 1 1 at BO i l l ng Springs , P A 17 0 0 7
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled iti PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
situated as follows: 550 Criswell Extension, Boiling Springs,
$ 2,000.00
$ --
~ 1 90, 000.00
PA 17007
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 t:he appropriate form to
the undersigned:
~_ Si nature T ed or rioted name and residence ~
~tl/~~ ~~ ;~ ,~ Karen S . Toper
550 Criswell Extension
Boiling Springs, PA 17007
Form RW-02 rev. !0.13.06 Page I 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.
Sworn to or affirmed and subscribed
a~~'~o
before me the day of oignar/tre o~ rersonat Kepresentative
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March 2011
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For the Register Signature of Persona! Representative ' t ~~ ~~ ._,
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File Number:
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Estate of Joan E . Damey
Social Security Number: 1 &~ - 2 8 - 4 61 6
Deceased
cc ff _ Date of Death: March 2 4, 2 01 1
AND NOW, _ ~ (''a ~ ~ ,~ 1 ~ -~` `~" 2 01 1 in considerati
on of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Karen S . Loper --.
and that the instrument(s) dated June 1 1 , 2 0 0 3 Arid Novem er __ in the above estate
r
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) ....... , $ ~ jJ
Renunciation(s) , .... , .. , . $ `"
... $
... $
... $
... $
... ~
TOTAL .............. $ `'~~~ ~:90
Register of Wills ~/i~' L ~ ,~~w`~~: ; ~~ ~~
Attorney Signature: ~ ~ ~
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Att Anthon L : DeLuc , ~
orney Name: y a r ~SG111rCr
Supreme Court LD. No.; 1 8 0 6 7
Address: 113 Front StreF~t ..__
P.O. Box 358
Boiling Springs, PA 17007
Telephone: 717-258-6844
Form RGV-02 rev. 10.13.06
Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF E."~~I~-~
VVAf~NING; It is illegal to duplicate this copy bra phatcastat o~ photog~~ i~°
[~r:e tin- this c•ertii~i~at~, `~(~?.4?(1
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H105-143 REV 11/!006
TYPE !PRINT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
~SeF± instructions and examples on reverse) ~r.T~ CII C 611 1610 0 0
1. Name d Decedent (Flrel, middle, last, sulfoc)
Joan E. Damey 2. Saz
Female 3. Soda) Serxxigr Number
186_ 28_ 4616 4. Date d Death (Month, day, year)
March 24, 2011
Age (Last BiMday)
5 Under 1 ar Under 1 da 6. Date of Birth Month, da , ear 7. ~ and state or fore coon 6a. Place of Death Check on one
.
74
Yrs. Mondls Days Hours AGnubs
December 12, 1936
Mechanicsburg, Pa. Hospital:
^ Inpatient ^ ER /Outpatient ^ DOA Other: I~
^ Nursing liortre ®6Residence ^ other - spedly:
County of Math
Bb
8c. City, eoro, Twp. of Death ~pr~
6d. FedFty Name (If not institution, give street and rwmber) 9. Was Decedent of Hispanic Origin? I~Ng ^ ygg 10. Race: Arrericen Indian, Blade, Whde, etc.
. (lf yea, aPed+y caftan, (~'M White
Cumberland Monroe Mexican, Puerto Rican, etc.)
5 5 0 Cri sore 11 Fxt .
11. Decedents Usual Kind d work d one dun most d world Ffe. Do not state refired 12. Was Decedent ever in the 13. Decedents Education (Specify any highest grade oorttpleted) 14. Modal Status: Married, Never Married, 15. Survivkxf Spouse (If woe, give maiden name)
Divorced (SpecilY)
Wxkrved
KinQd Wop~ Kindc,~ysi /Igdust
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c~ U.S. Amted Forces? ElemenUry / ry (0-12) College (1.4 or 5t) ,
Widowed
Senior buyer rlca
tle ^ Yes '~NO
16. Decedents Mailing Address (Street, city /town, state, zip cdde) Decedents Did Decedent Mon roe
Twp.
PA Live in a 17c
Decedent lived in
^ Ves
550 Criswell Ext. _
.
,
Actual Residence 17a. State
Cumberland T°I""~'p? ,7d. ^No,DecedentLivedwithin
Boiling Springs, PA 17007 ,7b.County Actuall.imRSgf cdy/f3org
18. Fathers Name (First, middle, last, suffix)
Earl Zeigler 19. MoMers Name (Frst middle, maiden surname)
Grace Roller
20a. Informant's Name (Type /Print)
Karen Sue Loper 20b. Informant's Mailing Address (Street, ary !town, state, zip code)
550 Criswell Ext. Boiling Springs, PA 17007
21 a. Method d Disposition r ^ Cremation ^ Donatbn 21 b. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, aematory w other place) 21 d. Location (Ci~l /town, state, zip code)
Uwrl=ed
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;~-B„rial ^ RemovalfromState i wascremffia April 4, 2011 Rolling Green Memorial Park Camp Hill, Pa. 17011
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^ Yea^ No
^ other . by
~ 22a Funeral Service '- as such) 22b. License Number
FD-012662-L 22c. Name and Address d Fadkty
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
~
dams 23a when certifying
physician is not availebk at time of deaM to 23a. To best d my ,death occurred at the tl to and tad. (SkfpaNre and tills)
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~v 23b. License Number
~ /_ /~) ~ 23c. D (Month, y, year)
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cerMy cause d deadr. 1J (Q V C
Tune d Death
24 th, day, year)
25. Da 26. Was Case Refert Ito Medical Examiner I Crooner fora easan than Cremator w Donation?
horns 24-26 must be completed by person
• wfa pronounces death.- .
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CAU E OF DEATH (See Instrvctlons en examples) r Approximate interval: Pert II: Enter other significant conditiwu contnbutind to death.
iven in Pan: I
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lti 28. Did Tobacco Use Contribute ro Deady?
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Item 27. Part I: Enter the chain of events -diseases, injuries, w compFcatbns - Mat directly caused the death. DO NOT enter terminal events such as cardiac artest, r Onset to Death
r g cause g
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but not resu
ng yes
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respkatory arrest, w ventricular tbriltation without showing the etidogy. List ony one cause on each line.
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IfiWEDU1TE CAUSE (Foal dsease w
condition resulMg in death)
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29. If Female:
^ Nd pregnant within past year
_~ a
Due to (or as a consequence oq: ~ ^ Pregnant ai time d death
baps kst cwrditioru
H arty - 42 d
ithi
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~to the cause fisted on Foe a. Due to or as a con uence o r
Fster UNDERLYING CAUSE ( ~ fl~ r
ays
Nd pregnant, MA pregnant w
n
of death
(disease or kyury that initiated the ~ _
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ear
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nant 43 da
^ Nd
avenLS resulting n death) LAST. c. r y
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Due to (or as a consequence of): r
~
- before death
^ Unknown A nt within the t
pregna Pas Year
~ d.
30a. Was an Autopsy 30b. Were Autopsy Findings 31. Manrrer of Death 32a. Date d Injury (Month, day, year) 32b. Desaibe How Injury Occurred 32c. Place of Injury: Home, Farts, Street, Factory,
OMx:e Building, ek:. (Seedy)
Performed? Available Prior to Cwnpletbn
f C
of Deatlt? ~~rr
47LNaturel ^ Homicide
o
ause ^ Accident ^ Pending Inwestigation 32d. Time of Injury 32e. Injury at Work? 32f. If Transportatbn Injury (Specity) 32g. Location of injury (Street, city / hwm, state)
^ Yes
~.NO
^ Yes No
^ Yes ^ No
^ Driver/ rotor ^ Pedestrian
Ope ^ Passenger
^ Suicide ^ Could Not be Determined M Other - Specity: -~ ,/;
33a. Certifier (check Doty one) 33b. Signature a~ d T o ere'Re} /J/~~. ,
~~
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CartHying physician (Physician certifying cause d death when arather physican has proraunced death and completed Item 23)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
death oceurnd due to the cause(s) and manner as stated
Tothe best of my knowbdga , . '
GG/(~L~•
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• Pronoundng and certifying physician (Physician both pronourx;irg death and certrfying to cause of death)
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S~ / ~ ~ C 33d. Date Signed (Month, day, year)
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_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
To the best of my knowledge, death oceurred at the time, date, and place, and due to the cause(s) and manner as s , ~
~
• MedlealExaminsr/Cwomer
On the basis of examinatbn and I w Investigation, in my opinion, death occurred al the time, date, and place, and due to the cause(s) and manner as stated_ ^
34. Name and Address of Person Who Completed Cause 4f DeaN (Item 27)'fype / Print
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35. Reg gars Signature and pis ~ Number Date Filed (Month, day, year) ~ ~
J ~ Disposition Permit No. t-! ~~/_._/ ",~L~
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LAST WILL AND TESTAMENT -~~~~
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OF c ~~ ~ .~-~
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JOAN E
DAMEY `~ cri ~
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I, JOAN E. DAMEY, a resident of Boilin S rin s Cumberland
g p g ~ County, .
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Pennsylvania being of sound mind, memory and understanding, do hereby make, publish
and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils heretofore made by me.
ITEM 1: I direct that all my just debts, the expenses of my last illness and
funeral expenses be paid as soon after my decease as the same can conveniently be done.
ITEM 2: I direct that there shall be paid out of my residuary estate all estate,
inheritance and like taxes together with any interest or penalty thereon imposed by the
government of the United States, or any state or territory thereof, or by any foreign
government or political subdivision thereof, in respect to all property required to be
included in my gross estate for estate, inheritance or like tax purposes by any of such
governments, whether the property passes under this Will or otherwise, excluding,
however, any property over which I have a taxable power of appointment, provided,
however, that no residuary beneficiary shall by reason of this provision be denied the
benefit of any deduction, credit, favorable rate of tax or other benefit which by law
enures to such beneficiary.
ITEM 3: I give, devise and bequeath all of the rest, residue and remainder of my
estate, real, personal and mixed, of whatsoever kind an nature, and wheresoever situate
J AN E. DAMEY ,
1
LAST WILL AND TESTAMENT
OF
JOAN E. DAMEY
at the time of my death, in equal shares, unto my children, ROBERT E. DAMEY,
KAREN S. LOPER, RICHARD L. DAMEY, II, and JONI BETH DAMEY, provided,
however, that they survive me and are living sixty (60) days after the date of my death.
ITEM 4: If and in the event that a child of mine does not survive me and is not
living sixty (60) days after the date of my death, then and in such event, I give, devise
and bequeath the interest in my estate, which such deceased child would have received, if
living, to the issue of said deceased child, per stirpes.
ITEM 5: I hereby nominate, constitute and appoint my son, RICHARD L.
DAMEY, II, Executor of this my Last Will and Testament, with full power to do any and
all things necessary for the complete administration of my estate, and direct that no bond
or other surety is required of him in this or any other jurisdiction for his performance of
this office.
If and in the event that my son, RICHARD L. DAMEY, II, does not survive me
and is not living sixty (60) days after the date of my death, or does not complete his
duties as Executor, then and in such event, I hereby nominate, constitute and appoint my
daughter, K-AREN S. LOPER, Executrix of this my Last Will and Testament, with full
power to do any and all things necessary for the complete administration of my estate,
-~
r~~ ' ,
JO E. DAMEY ~` ~~
1
2
LAST WILL AND TESTAMENT
OF
JOAN E. DAMEY
and direct that no bond or other surety is required of her in this or any other jurisdiction
for her performance of this office.
ITEM 6: If any provision of this Will or of any Codicil hereto is held to be
inoperative, invalid or illegal, it is my intention that all the remaining provisions thereof
shall continue to be fully operative and effective, so far as is possible and reasonable,.
IN WITNESS WHEREOF, I, JOAN E. DAMEY, the Testatrix, have to this my
Last Will and Testament, typewritten on three (3) consecutively numbered pages,
subscribed my name and affixed my seal this /r- day of June, 2003.
PLC./ ~ 4~ JY SEAL)
Signed, sealed, published and declared by the above named JOAN E. DAMEY, as and
for her Last Will and Testament, in the presence of us, who have hereunto subscribed. our
names at her request, as witnesses hereto, in the presence of the said Testatrix, and. of
each other.
iding at -~,_~!~~~
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~ c-<~ ~ ~~~residing at ~ " ~ -~~~. /'?'c%c°.~
CODICIL TO ~ - _,:
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LAST WILL AND TESTAMENT ; h;'=~' ~ ` ~ ~ ,;
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JOAN E. DAMEY -_`~'-= u - - ~ ~-
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I, JOAN E. DAMEY, of Boiling Springs, Cumberland County, Pennsylvania, do make,
publish. and declare this to be the first Codicil to the Last Will and Testament executed by me on
.Tune 1 1, 2003, in the presence of Anthony L. DeLuca, Esquire and Marjorie A. DeLuca.
FIRST: I revoke and annul ITEM 5 of my Last Will and Testament executed by me on
June 1 1, 2003; and, in lieu and substitution thereof, I direct that ITEM 5 of my Last Will and
Testament executed by me on June 11, 2003 be set forth as follows:
ITEM 5: I hereby nominate, constitute and appoint my daughter, KAREN S. L,OPER,
Executrix of this my Last Will and Testament, with full power to do any and all things necessary
for the complete administration of my estate, and direct that no bond or other surety is required of
her in this or any other j urisdiction for her performance of this office.
If and in the event that my daughter, KAREN S. LOPER, does not survive me and is not
living sixty (6d) days after the date of my death, or does not complete her duties as Executrix,
then and in such event, I hereby nominate, constitute and appoint my son, RICHARD L,.
DAMEY, II, Executor of this my Last Will and Testament, with full power to do any and all
7 i ~ ~~,
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JOAN E. DAMEY
CODICIL TO
LAST WILL AND TESTAMENT
OF
JOAN E. DAMEY
things necessary for the complete administration of my estate, and direct that no bond or other
surety is required of him in this or any other jurisdiction for his performance of this office.
2003.
In all other respects I ratify and confirm all of the provisions of my said Will dated June 1 1,
,,.
IN WITNESS WHEREOF, I, JOAN E. DAMEY subscribe m n ~ ~~
y ame, this day of
November, 2010.
~.
JOAN , .
DAMEY -- '-
l
The foregoing instrument, consisting of this and one preceding typewritten page was signed,
published and declared by JOAN E. DAMEY, the Testatrix, to be the first Codicil to her Last Will
and Testament in our presence, and we at her request and in her presence and in the presence of
each other have hereunto subscribed our names as Witnesses this day of November, 2010.
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OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
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Estate of Joan E. Damey
_, Deceased
Anthony L. DeLuca, Esq./Marjorie A. DeLuca
(each) a subscribing witness to
(Print Name/s)
the ~ Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, de ose s and
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say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same
and that she / he /they signed the same and that she / he /they signed as a witness at the request of
the Testator /Testatrix in her /his presence and in the presence of each other.
,~ 7
( ignature) ~ ~ ~' '~ ~-~ L - ~ !~ L(..-C('-~-L,
(Signature)
113 Front Street
113 Front Street
(Street Address)
(Street Address)
Boiling Springs, PA 17007
(City, Stale, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this ~~ day
'+ `' ~ ~ ~"
Deputy for Register of Wills ~-
Boiling Springs, PA 17007
((.'ity, State, Zip)
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this 31st day
of March 2011
~~ ~r ~ ~- • ~~~~
rotary Public
y Commission Expires: ~! z7/z~~5
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Comm.ission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
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Form RW-03 rev. 10.13.06