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HomeMy WebLinkAbout04-04-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of JOHN L. PROKOP ,Deceased ESTATE NO: 21- ~ '~ ~ ~~, a/k/a: a/k/a: a/k/a: SS NO: 193-12-8916 Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: ~ 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/are entitled to the aforementioned Letters Administration c.t.a. under the last Will of the above-named Decedent dated 3/10/1988 and codicil(s) dated •= ~~ ~_, . ~ , Aphrodite (Freda) Prokop has renounced her appointment as Executrix under the Last Will dated ~~ 10, 1988, -f-F, by Renunciation dated April 1, 2011. `~ ~ "' ~ w:~ ^'~~ '-~ ? (State relevant circumstances, e.g. renunciation, death of executor, etc.) ~=~? y r ';'~ - Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after exe~~t~~~i~.f the ,~„- --- instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person,;d ~ not a party to a pending divorce proceeding at the time of death wherein grounds for divorce had been establislr~c~~s~i~efine~n F 23 Pa. C.S.A. § 3323(8): NO EXCEPTIONS '_'' , =~- C: i .... . . _~~ r ~ ...~_ t s ^ B. Grant of Letters of Administration ~..' (If applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate) 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 ([f Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section A and complete list of heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(8), except as follows: NO EXCEPTIONS Name Address Relationshi to Deced~ Aphrodite (Freda) Prokop 119 W. Clearview Drive, Camp Hill, PA 17011 Sister USF, ADDI'1'IONA1., SIIF.E'1'S F NL.CE:SSARY ant THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 119 W. Clearview Drive, Camp Hill, Pennsylvania 17011, Hampden Township (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 85 years of age, died 3/9/2011 at (Month, Day, Year of death) Estimated value of decedent's property at death: If domiciled in PA If not domiciled in PA _If not domiciled in PA _Value of Real Estate in Pennsylvania 100,000.00 $ 170,000.00 Total Estimated Value $ 270,000.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 119 W. Clearview Drive, Camp Hill, PA 17011 ignature(s) Name(s) & Mailing Address(es) ' Steve C. Nicholas, Esq. 2215 Forest Hills Drive, Suite 37 Harrisburg, PA 17112-1099 Intenm hbrm KW-U2 revised 12.26.10 by Cumberland County pending action by the Court Page 1 of 2 Camp Hill, Pennsylvania (City and State where death occurred) All personal property Personal property in Pennsylvania Personal property in County OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania - SS County of Cumberland The Petitioner(s) herein named swear or affirm 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 C ~• be re me,this ~~ day of ~? ==- ;~? ~ ; '~ - T ... .~_; - ~Z ~, ~~; ~~~i-~ ~//f'~- -r tT7 1 i -- ~,__~ --i . For the Register %;-~' ~~' .. ;_~ .~ , ._~ ..... ~. 1 . ._: _~ DECREE OF PROBATE AND GRANT OF LETTERS =~ (~~~ `~~'``~.-{ Estate of e~ ~. ~ ~l 1~ ~ ~,,. r '~,~ (.` ~ C; ~) ,Deceased File Number: 21- ~. ~ - ~- '> ~~ - i ~: AND NOW, this day of ~~~)r l ~ ~ ~` I ( , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters y ~ Testamentary of Administration are hereby granted to: ` l (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) the above estate and that instruments(s) dated "~j - (C -- I ~t SS `~ described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbaugl~, " Y~ , ~ ~V~,~~/y~:~, 1~ ~~t ~~ ~- Re ister of Wills g FEES: Signature of Counsel Required to Enter Appearance Letters ....................$ ~ 1 ~ Will ....................... ~~- Codicil(s) .............. . ( )Short Certificates '~;~ .~''L~' ( )Renunciations....... ~`~~ ~,~L~ Bond ............................ Other ............................. Automation. FEE......... 5.00 JCS FEE .................. 23.50 TOTAL ................$ C.'~). ~~~_ Atty's Signatur ~~ ~~--~' PRINTED Na ]ames ~. Walsh _ Supreme Co rt ID No.: 16676 Address: 2215 Forest Hills Drive, Suite 37 Harrisburg, PA 17112-1099 Phone: (717)540-7746 Fax: (717)541-1527 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 r'l' ~-~.>>1 ise *aaer ~ ~ ~ ~w \A' ~ ^ ^ ! r~ ^ ^' n f~ 'he~N . ~ '~sm~°" ~ , ^~i y~ s~ ~'.. vu~~~,Nl~~: !t !s illegal i<n va~licat tai<~ ~-~rrg-~w,3 ~~ I~,iak;~tM~ :~~ ~~ ~r. ~~°i~~ ~$ x ~. ~"~ti' Iif1~ ti1,~ i~'p 3~ is ~a(s:'. `~t~ . ,. P 172145220 - /~ /~ -- .. / ~C • ~ ~~ t a.~ ~ - ~~ ~~ s t,~ aEV nrzoD6 COMMONWEALTH OF PENNSYLVANIA .DEPARTMENT OF HEALTH • VITAL RECORDS T1 PE PRINT IN Pf3L.1CK NKT i ~ ~, CERTIFICATE OF DEATH ( (See instructions and examples on reverse) ;~f r-- crerc cu r C7 ~-~: : ~ ,,.._ ... -- _~~, o z., ~I -t( Y S ~ ~ ? I--n ~ ,, ` _~ ~- - __ -- ~,.,J l-..... _...y,. F . - - I Yuarrr d Decedern (First, mrdde, last. whiz( ToHN ~ P eol'~OP 2. Sex .... _ ..__ .. .-. 3. Soual Seventy Number _ 1". _~.... - s, fS~of Dears (Month, day, yep{..., ~,,, r - ~ . . l i 93 - i Z - 89 i 6 ~ oi/ ~ r~RC~ 5. Age (Last eknldayl Under t ear Undo 1 da 6. Date d Birm IMOnth, da , earl 7 e Ci and stale a la coon Ba. Place d Death Check one S Y MorNfu Days Hours R4nWp /~ /~ Q .s ~ K ~~ ~ rH-OlSprWl: Other: rs. " - V• i • •A'7 GO Inpatient ^ ER i pulpabsnt ^ DOA ^ Ntxsng Hans ^ Ras~dence ^ Other -Spear 6b. Caunry d Death & Ciry, Bor Death !b. Faakry Name llf na rcutiNtion, qve stre6t and number ( 9. Was Decedem d HSpanrc Orign? m ~ ^ y~ tD. Ran: ArgpnCarl tndurt Black. Wire, et[. /! C ~Aw~D E• P[NKf 40R • ~0 ~ S ) 2 i T ~0 f ~ fi4` In yes, spay dean, Mexican, Pusno RKan, aC 1 Isv~M W~~E t t Derwdenrs Usual Ooh IKvW d work done d u most d sgrfu Nfe. Do not sofa reaed 12. Was Decedent ever n the 13. Decedent's Education jspeury oNy highest grade cattpleted) t a Manta Status Marred Never M r d t5 S S 11 d Kindd Work Ci E KinddBusvtessllridustry i ~ ' U S Arrtud Faces? Elementary / Secotwary (412) College (1d a 5.) . . . ie ar , wdOM~~' DNOrceO ls~hl urvmrtg pouse ( w e, gh'e maiden narrrl e vNs t o IW v t A f T1t p c T il3t Yee ^ rro Sr KE~ER /ylARn2i t6 Decedent's kAaikrg Address (Street, ary ~ town, state, np code) r / 9 WEST l (~/~ 2 ~/~ E~,ef ~/Q L /E Decedent's Actual Resdence 17a SUU ~A • Did Decedent ~ ,t,/AMPDEN T T ve i t 7c Yes Decedent Lned m PA l 7 0 / ! ~~¢M t*lf /L L ~e t 7b. Counry 1. ~I~I{J~.~ x ~' . , ey ede n aLnred rntlun ~. A /~~ t 7d ^ ~ t . l u Cry ~ Bom t 8. Petits Name (Fksl mrdde. last. wtful %OS PRo KoP NA I9. MdhW s tdartte IFrst nsdae, mardart surturrr) T ANA T i 20a InfortruM's Name (Type r Peru) TfivE NitNa~AS 200. Irnamant's Address ISUeet ary /town, stau, zp code( ~Z~S '~,~ T ,/ D • ~ ~1 Sf N/ yR• !//f~ . /~AR1~IS vICC~ `i•. /7irt 2taMethoddDisposrbon t ^ Cremation pd r ^ Danalan llJ Burtel ^ Removal Iran Sat 21b Dated DtsPosNOn (Mon nt. day, Yearl 2tc. Placed Dulposrtion Warne d certterry, crematory «onur place) ltd. t.antxn ICiry/ bwn, state, np code) e r Wp Crwytetbrt a Oorrtlon AtAhaltW ^ ^ orlw - r w wave E,aminar/Carorrr? ^ Yes ra ^ O t /Y(,±~~tleµ 1 / i EAfr .1/t.~US apt G Cat /e•f T~ R yA /'~Ant2ff a { w / 7~0 22a d Furwal L~censes for oe big ass ) / J~ 22b. Lxanse Numeer 22c. Name and AdNess d Faduy , - lj j/ of . c. E~~~ < TAK. Aso I s~~~ sT 1,~ ~usw,~F Pa . «/- ~ Conpra Gems 23at only cerplyeg pnYSrtsart w rte avataole ar err d cream w 23a. To the best d my knowledge. death ocarred at tM time, date and pun (Signature and tiwl 23D. Lx:ense Number 23c. Date Srgrled (Moon, day, Year) arefy vets. d dean. ~ M~ M~~ 3 ~1 g S y o 3- 0 9- z o l J items 2426 mutt De te0 rson who prortotnces death. ~~ ~ ~ 24 rune d Deans! O 3 ~ ~ D P M. 25. Dau P ad IMontlt, da .Year -'1 0 3 - oq ' L d I ~ 26 ~ Yasa Relsrred,~ Mescal Fxarrxnw ; c«arr !« a Reason Onrr nun Crertuea, a Dataoon? `LI~/0 v CAUSE OF DEATH (SN Inetrractbns sod etcampNs) , Approxmar nrrval: uem 27. Part t: Enter nr chart devents - arseases, vyurbs, a camplrcanons -nut drecny caused nr death. DO NOT enter tertnetal events such as carauc arrest r Onset to Death Pan n: Enter other put na reslJGng :n the underryvg cause grvwr tit Part r pg. pb Topacco Use CorgraW to DeaN~ ^ V ^ P reapratory arrest, a ventncular kbnkatan wnn,a,t stgwry tM etalogy. List oNy ane Huse on each Ier. disease a ' ~ es ^ Nb unkrtoan ~~ 5 ~ ~ 1 S -> a ~ MALNVT1ZITtoN ~~ Due to la as a c1«-r~equence~ofl^ /' T' wyy list con6ebrls, d any, b r LJ- ~ tom" C~ d L ~ 1 ~ twls~ w tfr cause YstW on Ivr a r i ~ ~ L.V Q ~ I ~ ~~"f ICI V` G ~~~ ^ Pregnant at Ime d dears ptp to to as a Firer 3u tNWENLYINfi CAUSE consepuence o~ (aittease « irtjlry Inn heard me c ; G D L M E N T i A ^ Na pregrunt. do pregnary wM 12 deyt d atwn . events resulting n death) LAST. r r ^ Due to la as a consequertn dl: r Not prwpuru, etn pregrtaru 13 days b I ynr d. t ~ Delon death ^ UrJutown d pregrtarn wrtrrt rN peat Peer 30a. Was an Autopsy Performed? 3r3b. Were AWapay FuMrys AvaYibte Prpr to Canpletion 31 AAenner d Daant 32a. Dan d I rtpry (Month, day, Year) 32D. Dascrtbe Flow IMWY Oaurred 32c. Place d I xpry. rpurY' Mbnr. Farm, Street f d Cause d Deam~ L3~ Natural ^ Fbnaada ~r° &~t4 w- (SONY/ ^ Yes NO ^ Yes ^ No ^ AcciWnl ^ Pend,g hHeshgelp„ 32a rme d Irytry 32e. Inltry ar Work? 321. n Tgrtepbrtetton kyury ISP«'+h/ 32g. London d vyuy (strew, aY /town, stir) u SuKWa ^ Card Na W Datsrrrwtad M ^ Yes ^ No ^ Orrvwi0puator ^ Pa asargw ^ Peasstnan Onwr SPeati 33a. Cwher Idreat anyy art C il i 33D. Srgrunus arW tine d Cerufur • wrt y np pttpsician IPhysruan certryng cause of death when aranrr pnysKUn has prananced death and cornpletad hem 23) To tM bert d my knowedge, death occrxnd due to tlr cause(s) and nwuter a sand _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - ^ ----'-- - • Prarowtcwtq and artrl(my pltyrtician IPhysryan Ootlt ponaxtcn9 deans and cerbyeg to cause d dealhf 33C LKense Numoer 33d. DaM S,grrd IMmth, day. Year) Twdfw Eaantirwl Caarr ,death occurred u tM tMa, daa, and plan, and dw a tta cauee(e- and ma«ar as wad_ _ _ _ _ _ _ _ _ _ _ • _ _ _ _ _ _ _ rx ^ h _T ~, / I [~ ~,/ Y / ' ,J 7~ O ~ ~ o.Z O 1 1 , On tla treeN of esanlwrwion and / a in opinion, deetlt ocburrW w me IMtr, dw, and plan, and dw t0 tlr taus«s- aM mwrr u seed ^ ~. Nam ~ q~ ess d Person Who Compb tW Cause d Oeatn Iltem 27) Typo i Pmt Rugrstrar' Dar F (Mann dy ywl ~'=i, rn- l7 ~ Cli M~ /-~, / ( \~-~'W. n ~ Z/' Na , . il rlo! S ^,~r T l~os ~7a1 Sv3 ~V ~~ sr~ ~z~7 ~i~ 17G,~ ~/ Dispus.nor, Pemr No. _ y ~ / 7 dl U~_ t ~ ~~ r ~r ~ ~:..Y ~ ~~ ~ ~.zrc~e~t~ ~_ __..~ _:: .~;r.~ _ rX) -t7 .~ OF ~ -` ``~ ~-`„ ' Y ~ ~ v .;e. ~ .c~ r. ~: ;,x; J~~i L. PAP ~~ 4~a c"'7 '.. , :.:7 _~ , . "L 7 j I. JOHN L. PROKOP, of Hampden Township, Cwnberland County, Pennsylvania, being of sound and disposing mind, rr~nory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all wills or codicils at any time heretofore made by me. ARTICLE I I direct the payment of all my legal debts, and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed., shall. be paid from my residuary Estate as part of the expense of the achninistration of my Estate. AI~ICLE II I give and bequeath my automobiles, .household and personal effects and other tangible personalty of like rsature (nct incl»di..~?y casr~ or sec~,zritio~ :) , together with any existing insurance thereon, unto my sister APHRODITE (FREDA) PROKOP, Camp Hill, Pennsylvania. ARTICLE III :~-~ -_ f~~ _~~ ;...~ ,.~~ w.~7 C ---.~ I give and bequeath all the rest, residue and reminder of my estate of whatsoever nature and wheresoever situate unto my sister, APHRODITE (FREDA) PROKOP. t 1 AR~IQ~ 1V I name, constitute and appoint my sister, APHRODITE (FREDA} PROKOP, Executrix of this mY Last Will and Testament. IN WITNESS WHEREOF I have hereunto set hand and seal this the ~-"da of ~ ~/ y ~-~~ 1988 . _~ --~, ,;, -k.R.... ' ;~:~, ~..~ > ._. ~-- ;~~-.~ (SEAL) JOHN L. PROKOP Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. ,,-- COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND I, JOHN L. PROKOP, Testator, whose name is signed to the foregoing 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. _. , ,.. , ~~ ~ ,. S X' ~~_; _ r, .,,, __. ... <~ JOHN L. PROKOP Swr~rn to or affirnled and acknowledged before me, by JOHN L. PROKOP, the Testator, this ~ ~ ~~ day of '~'1 c~,t,_ ~~ ~ 1988 . ,.iC.~ NOtary Publ. c My cc~r~nission expires (~SEAL~ My Commission Expires pec, ~1. 1'~8~ Lemoyne. PA Cumberland County i i AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND d~~~.. d a ~.. .,~~- '~J We ~ °~- . ,:. ~~ ~ ~ ~ 4.~-, and ~- ° ~v~~ ,.,;', ~~~~ ~. ~~. ~, the witnesses whose names are signed to the foregoing instnunent, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the foregoing instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the puY.~oses 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 that time at least 18 years of age, of sound mind and under no constraint or undue influence. ,e r ~~ S ,~' '~~~ Sworn to or of firnled and subscribed to before me by ,~ and .. - ~~ ~~ ~-. ~A_~, ~..,. ~ ~. ,r~- messes, this ~ 0 ~`~' day of '--.~.~ ~~.~- ~ ~~ 1988 . ~~. . - L Notary Public \~ MY corr~nission expires ~sEAL~ DIANNE LENIG, Notery Public My Commission Expires Dec. 21. 1989 Lemoyne. PA Cumberland County RENUNCIATION CUMBERLAND COUNTY, PENNSYLVANIA C'~ .--~- `:_ O ,=l _,~ ~~ .. ~1.~ ~ ~ ,._, ~ `.~ ~ , W,, ~~_ ~r.~ -~ _ ~, r ~ ~. .~~ ~ / 1 - `~,,.~ Estate of John L. Prokop REGISTER OF VVIL,LS --., .~: ".~'~ . .'~ F A I ` j ~"'° _.. --^r ~:..~ !~_ --~, Deceased I, Aphrodite (Freda) Prokop, sister of John L. Prokop , in my capacity/relationship as (Print Name) Executrix under the Last Will dated March 10, 1988 of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Steve C. Nicholas ~~ ~' April 1, 2011 (Date) (Signature) 4835 Trindle Road, Building 1, Room 39 (Street Address) Mechanicsburg, PA 17050 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this 15+ day of ~~~.~ 1 ~ G t ~ Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary'c Commission.;) Form RW-06 rev. 10.13.06 TM of r~MSmvwNiw NOTARIAL SEA! CF~tSTINA L. NiCHOIAS, Notary Public Loywr Paodon Twp., Daupt-in County Connrr~~ion June 20, 2013