HomeMy WebLinkAbout08-25-09PETITION FOR PROBATE AND GRANT OF LETTE
RS
REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA
Estate of Paul E. Fought ,
File Number ~ ~ ~- (..~" ~~ 7 /
also known as
,Deceased Social Security Number 191-26-6813
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 Petitioners is /are co-execut
last Will of the Decedent dated December 4, 2007 O the ors named in the
and codicil(s) dated
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
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Except as follows, Decedent did not m '~?
arty, was not divorced, and did not have a child born or adopted after execution of ~~trument~offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ "~
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B. Grant of Letters of Administration (~~' ~°~
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(If applicable, enter.• c. t. a. ; d. b. n. c. t. a. ; pendente liter durante absentia; durante- xn`jn,tdte) -p_
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followin sous ' ~r. '
Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) g p _~ ~~~ any) an'i~leirs: ; (If
C.J
Name _ .L`
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Lo alton of Creekview 1100 Grandon Wa Mechancisbur PA 17050
(List street address, townlcity, township, county, state, zip code)
Decedent, then 90 years of age, died on August 1, 2009
Mechanicsbur PA 17050 at Loyalton of Creekview, 1100 Grandon Way,
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) $ 80,000.00
Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania $
$ 140,000.00
situated as follows: 303 Allendale Road, Mechanicsburg, PA 17055
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 a
the undersigned: ppropriate form to
~ ea or anted name and residence
"~
~~ %~ ~ ~ ,, C~~ Mary J. Wilson 100 Mountain View Road, Shermansdale, PA 17090
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Form RW-02 rev. 10.13.06
xonatci K. Wilson 100 Mountain View Road, Shermansdale, PA 17090
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 t
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioners he best of
administer the estate according to law. ()wall well and truly
Sworn to or affirmed and subscribed <~ ~
_ ~~ ~
l.~ ~-~ Si ature of erso Representative
before me the.. // -day of n
~m~
~ ~~ . r~
'` ., ignature of Personal Representative `~ '`
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For e Register ~ ~~-~ ~ ~ ~ + ~~
Signature of Personal Representative :.
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File Number: ~ - 0 7 ,~
Estate of Paul E. Fought
Deceased.
Social Security Number: 191-26-6813
Date of Death: August 1, 2009
AND NOW, ~1
~~--~~.~L_, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECR D that Letters ~~
are hereby granted to
and that the instrument(s) dated ~'C{~ ~ - in the above estate
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) ........ $
Renunciation(s) ....... $
...
... $
~...$ ^.Q
... $
... $
...
... $
... $
... $
TOTAL .............. $ e=96-
Form RW-02 rev. 10.13.06
Register of Wills `_ r -
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Attorney Signature: - l
Attorney Name: John akin
Supreme Court I.D. No.: 6351
Address: Market Square Building
Mechancisburg, PA 17055
Telephone: 717-766-3172
Page 2 of 2
' ~ _ (~~ ~' _ C1~7 ~ _
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LOCAL REGISTRAR'S CERTIFICATION OF DE ~M,'~" ~~
WARNING: It is illegal to duplicate this ropy by photostat or phatogr~ ~~~.
Fee for this ~:ertifir~tte. $~i.(}~O
P ~.5~5_9_64.3
Certification Nurnht~r
HtDS-143 HEV 11Q006
TYPE r PRINT IN
PERMANENT
BIACK INK
[ 1 Names of Decedent (Post, middle, last, sutlix)
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+~or~rcL~tl~ ~l~t~iccl f~# ~#e~ ,#n (illy=ins; i:`er)i(#4~~~#tc of Death
:lulr Cileci t,tiitl; lay : ~ I~ ~~ii Re~Yistl:u~. The ol-i~inal
e.rtif)catt`~ ~~ili ~~, [llt~~ti:#;-(!ed t'r~ tht~ Mate Vital
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS C,oy
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
2 Sex 3 Social Security Number 4. Date of Dead (Month, day, Pearl
5. Age (last BiMdaY) Under 1 ear Under 1 des 6. Dale of &M Montle, des , ear - -
Munlns Days Hours Minutes 7. & u Ci end State a fore cant ga. place d Death Check
one
•90 Jul 26 1919 Hospital. Other: --
"S Y , Mechanicsburg, PA
9b. County ul Death 8c Cily, Bcro, Twp. of Death ^ Inpatiem ^ ER / Outpatierd ^ DOA [~ Nursirg Home ^ Residence ^ Gther - Specify:
gd. Facility Name QI not institution, gne street and ntmber) 9. Was Derxrdent of Hapamc Origin?
~-r-+rtt-.zCrlaIld (B yes, specity Cuban, ~ f'I0 ^Yes 10. Race: American Mdian, BWck Wlwe. etc
er] I,O alton of CreekvieW Mexican, Pwno Rican, etc) rl~rlN
11 Decedent's Usual Occ anon Kind of work duns dwin most of waki life. Do nut stale retired 12 Was Decedent ever n the 13 Drtcedent's Education t'tfl tl to
Kind of Work Kind of Business/Industry U.S. Armed Faces? (SPeGN only highest grade canpleled) 14. Marital Status: Married, Never Marrie4 15 ;surviving Spouse (If wde give maiden name)
Elementary !Secondary (p.12) College (1-4 or 5~) WitloweQ Divorced (Spedly)
F rmer ^Yes Ii7 No 1 2 Widowed
~ 16 Decedent's Maikng Address (Street, city! town, state, zip code)
Decedent's Did Decedent
1100 Crandon Way Acbial Residence 17a State PeI'lY]S~i'1 Va_rT 7 a Tow stu ? 17c ®Yes, Decedent Laved in _ Harntx'3Pn _, Tw
M2chanicsbur PA 17050 17b.County r~>ImhPrl?Y1l~ P = v
- - t 7tl. ^ No, Decedent Uved within
18 Father's Name (First. middle, Wsl suffix) Actual Llrmis °i .City / Buro
Earl FOUC~ht 19 Mother's Name (First, midde, marilen surname)
20a InlJrmanl's Name (Type / PnN) Sarah Fisher
20b. IMamant's Maikng Address (Street, city! town, state, zip code)
Wilson
2fa MetnodclDispusiucn ~- 1 PA 170gn _
ra l ^ Cremahun ^ Donation 21b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, cremat a other ace
^ Removal Iran SLtie I Was Gemation or Donation Authoruad
t1Y Bunal l orY W 1 21d. Locaton (City/town, state, zips cotle)
^ Other - S ~~ - r by Medkal Examiner/Coroner? ^Yes No St ~ 1
22aSxywture FneialSarvicelicensee ~ Augli ~ 2009 Rollin Green Cemete Cam Hill, PA _
yx person acting as such) 22b License Number 22c. Name and Address of Faciiy
~ ~~ ~ FD-13 63 8 Market Plaza Way --
Complet ems '23ec arty when ceni 23a. Tu the bey m 1 ZZ (
,death red at the k Fed. (Signatwe and tale)
pnyiwi is not available at tine of ih Iv 23b License Ntxriber
cenity cauw of dualh 23c. Date Signed (Month, day, year) -
Itruns 2426 must bn completed by pei sun 2a T f Death ' 25. Date Pronounced Dead (Month, day, year) ~ts Jr / .~
who pruriowices death ~ s ~- ~/ ~~ ~ / ` 26. Was Case Referred b Medical Examiner / Coroner for a Reason r N:vi Crefia or Donation?
• M ~ ~ ^Yes ~NO
' AUSE OF DEATH (See instructlone and exa es) I Approximate interval. Part II: Enter other i9011Kd0LS4Dgl1l~
Ilan 27 Part I Fnlva File tita,ull y4 dv ~ i - Jisna~es. intones or ~omplicauons -that directly caused die death. DO NOT enter terminal evenly such as cardiac erred r
Onset to Death ~~~ 28 Did Tobacco Use Corrinbute b Death?
ro,puatory arrest. or venincular hbi illuuon wnriaul sluiwiny the ntiobyy. l isl only a>a cause on each line. I Dut not resulung in the undedyiny cause given n Pan I
^ Yes ^ Probably
' IMMEDIATE CAUSE 1Final disease of I
condition resulung N death) ~' . 1~ w~ i ^ No Unknown
-- Y i ~ "~. ~v e t ~. G4C1~~p i/n~''e~-}y i / Y1p 29 If Female
Due to (or ~ copse nonce of ~"~ ~ ~ ~ ~ l T .~ f-~
Se uenuallyy use conJturxis if any /~ ~ i - ^ Not pregnant wthin past year
lea to the cause ksted ai krie a b_ r"1aL--~~~ t~(,~j,~~ I
Enter ra UNDERLYING CAUSE Du I to for as a c xisaquence oQ ~ ~~ Y~ ^ Pregnant al tune of death
(<kx,.,i~e ur uyixy di;e ueiirdnd ihu I - ^ Not pregriani, but pregnem witlhai 42 Jays
avum8 iusulW nl ui dn.ill i) LAST. ~
-..__ .___ _ ___~_ r
ul rkr:ith
Dun lu (ur as a i:unsnyunni:e till i --.
i - ~ ~ Nut ru, I but iu Y Y
rl _. -_.__._. _ - 1 L' yw'i p ynunl 43 Ju a h. 1 uai
- - -....._..____-- 1 Iwh ~i a .krnlll
30a Was an Ate s i LJ Uirkixrwn H (xeyliaM wrlhei gin pa~sl year
oP V 30D. Were Autopsy Fiakngs 31 Manner of Death 32a. Date of Iii
Perlurrned? Avalable Pna to Curriplnuun ~~`777 Nry (Monty, daY. Year) 32b. Describe Flow Injury Occurred 32c. Piave of 1
ul Cause of Dt:ath? Iii NaWial ^ Homicide rqury~ Home, Farm Street, Factory,
I _ Office BuiWv,g, ek. (Speplyl
^ Yes [~ Nu ^ yes [~ No ~ ~ Acndent ^ Pendng Investigation 32tl Time of Injury 32e. Injury a1 Work? 32f. If Transportation Injury ($pea
hl 32g. Location of injury (SUeet, city /town state)
[ ~ Sux:rda ^ Could Not be Determined ^Yes ^ No ~ Driver l Operator ^ Passenger ^ Pedestrian
-- M. Other - Specily.~
33a Certifier (check ady one)
• Certifying physician (Physician ceni u 33b. Signature arb TAIe of Certifier
N ig cause d Jeatl, wt~en another physician nay pronounced death and completed Item 23)
To UN bast of my knowledge, death octurred due to the cause(s) and manner as stated _ _ _ ~
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• Pronouncin aMteAi '- ---------------------
9 fying physician (Physician lk>ttr prarouncing death and cenifyiny b cauw of death)
To Uw best of my knowledge, death occurred of the time, date, and place, and due to the cause(s) end manner es stated_ _ _ _ _ _ _ ~ Lii:ense Ntxilber a iStr'ed (MonUi, day, year)
• tilWkal Examines/Coroner _ _ _ _ _ _ _ _ _ _ _ ^ ~•~ p 2 .> ~ L~ ~ `/} ~~
On the basis of examinallon and I or investigabon, in my opinion, death occurred at 1M tlma, date, end pku, and dw to tfN utw(e) esW manner u e4lard_ ^ a77 r7\7 G
_ 34. Name and Address of Parson Who CompWted Cause of Death (Item 27) Type /Print
35 R rev's Siynutwa and Disbx; Number ~ ~,,/r/ ~ 1 /~_ - _ _ ~ ` ~-
l `~ 1 ~ ~ p~ ~ / I ~ I 36 Date Filed (Morxh, day, year) v f.'~{/~' S
. ~ 1 uia ~~6~tao NFL ~~~2,Fi~~ /~- /73to
Disposition Permit No. ~ - ~ ~ 9 S
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PAUL E . FOUGHT ~~:. -:
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I, PAUL E. FOUGHT, of Mechanicsburg, Cumberland County, i ~__ R:-
Pennsylvania, being of sound and disposing mind, memory and understandin , do ~
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hereby make, publish and declare this my Last Will and Testament, hereby revoking
and making void any and all prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after
my decease as the same can conveniently be done.
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 CTovernment of the United States, or any state or territory thereof, or by a.ny
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.
3.
I give, devise and bequeath my entire estate, real, personal and mixed of
whatsoever nature and wheresoever the same may be situate, to my wife, MIRIAM E.
-1-
..
FOUGHT, absolutely and in fee simple.
4.
In the event my wife predeceases me I give, devise and bequeath my entire
estate real, personal and mixed to my daughter, MARY J. WILSON, and. her
husband, RONALD K. WILSON, as tenants by the entireties and in the event
either should predecease me the other shall be the sole beneficiary.
5.
Lastly, I nominate, constitute and appoint my wife, MIRIAM E. FOUGHT,
to be Executrix of this my Last Will and Testament. In the event my wife
predeceases me, or should she be unable or unwilling to serve in such capacity, then in
such event, I nominate, constitute and appoint my daughter, MARY J. WILSON and
her husband, RONALD K. WILSON, to be Co-Executors of this my Last 'Will
and Testament and I further direct that no bond or other security be required of my
personal representatives to guarantee faithful performance of their duties.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this '~~
day of December, 2007
i ~ ~ ~d`Z~o~~ SE
( AL)
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COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND ' SS
I, PAUL E. FOUGHT, the testator, 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 same instrument as my Last Will and
Testament; that I signed it willingly, and that I signed it as my free and voluntary
act and deed, for the purposes therein expressed.
/~,~-~ ~ - ~' J (SEAL)
Sworn an bscribed to before au oug
me this ~~ day of December 2007 ..
~ ~ ~ ~ ~ ~Mt
C Yf t`rAY/r 1 l7 era r ~~
otary u is Mafa~-
MY Corkin ~ANri .iwt !T. ~1 i
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND SS
We, the undersigned, J. Robert Stauffer and John M. Eakin, the witnesses
whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw the'
testator, PAUL E. FOUGHT, sign and execute the instrument as his Last Will and
Testament; that the said testator executed it as his free and voluntary act for the
purposes therein expressed; that each of us, in the hearing and sight of the testator,
signed the Will as witnesses; and that, to the best of our knowledge, the testator
was, at the time, eighteen (18) or more years of age, of sound mind, and under no
constraint, dure or undue influence.
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Sworn and subscribed to before
me this; ~~f'J~? day of December, 2007.
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MY Corm ,h,N~ ~~~ t