HomeMy WebLinkAbout05-06-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of FRANCES W. CROCK
also known as
COUNTY, PENNSYL`~ANIA
File Number ? 1 ~~=-'"
,Deceased Social Security Number 579-10-C-850
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 /are the Executors named in the
last Will of the Decedent dated 2/13/01 and codicil(s) dated None _
(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):
Not applicable _
B. Grant of Letters of Administration
(If applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente liter durante absentia; durante mir7oritate)
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
1000 Claremont Road Carlisle PA 17015 MiddlesexTwp.
(List street address, town/city, township, county, state, zip code)
Decedent, then 92 years of age, died on 2/8/11 at Claremont Nursing & Rehab Center
1000 Claremont Road Carlisle PA 17015
Decedent at death owned property with estimated values as follows: t
(If domiciled in PA) All personal property $ ~~~~' ~ ~ ci
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ '~'~~ C ~~~'
South Middleton Township
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
-~ .~ "" ~ "
~~
~
~'' William A. Crock, III 142 Lyndale Avenue
~~
~~
~ Nottin ham MD 21236
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Pamela Hendrickson 16579 John Rowland Trail
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Milton DE 19968
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Form RW-02 rev. 10.13.06
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Page 1 of ~k
(COMPLETE INALL CASES:) Attach additional sheets if necessary. ~- 1 ~ ~~~ ~
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
be ore e the ' t ~ day of
Cc,U
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Si ure o rsonal_Represe alive /William A.- rock, III
/^~ ~ ~ ~/ ~ J r/
Signature of Personal Representative Pamela Hendrickson
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Si ature o Personal Re resentative :--:-~ ~~_) .-. , ~
Far the Regater ~~ l p r^ ~- '~'
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File Number: ~ ,.
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Estate of FRANCES W. CROCK , Deceased ~'.. ~:.•~~ ~.~
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Social Security Number: 579-10-0850 Date of Death: 2/8/11
AND NOW,
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to William A. Crock III and Pamela Hendrickson
in the above estate
and that the instrument(s) dated 02/13/2001
described in the Petition be admitted to probate and filed of
FEES
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Letters ....................... $
Short Certificate(s) •..•.. $ ~~~
n n lion(s) •••••••••••••
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$ ~ ~~l~~
$ 'U
$ x
TOTAL
2011 , in consideration of the foregoing Petition, satisfactory proof
as the last Will ( nd Codicil(s)) of
Attorney Signature:
Attorney Name:
Supreme Court LD. No.: 29943
Address: 10 E Hi~Lh St
$ Telephone
Carlisle,
PA 17013
717-243-3341
Form RW-02 rev. 10.13.06 Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF D~A,~I•I°°I.
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS -~
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CERTIFICATE OF DEATH ~' u.:
(See instructions and examples on reverse) STATE FILE NUMBER
H105-143 REV 11/1006
TYPE /PRINT IN
PERMANENT
BLACK INK
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1. Name of Decedent (Fret, middle, lest, suffoc) Frances Crock 2. female 3. sw;ial Security Number 4. Date of Death (Month, day, year)
579 -10 - 0850 February 8, 2011
5. Age (Last arn,day) Under 1 Under 1 de 8. Deb d BMh Month, de , 7. Bi and state w tour Ba. Place of Death Check one `
92 ~"'~ rya ""'~ '"~"°° May 9, 1918 Fairfax, VA Hospital: Other:
Yrs. ^ Inpaeant ^ ER I Outpetlent ^ DOA ~ Nursing Home ^ Residence ^ Otlar -Specify:
86. County of Death Bc. Ciry, Boro, Twp. of Death fid. Feclltly Name (If not insUhabn, give street orb number) 9. Wes Decedent of Hispanic Origin? ~] No ^ yeq 10. Race: American Indart, Bieck, WNte, etc.
Cumberland Middlesex map. Claremont Nursing & Rehab. Ctr. Al
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, alp.) White
11. Decedents Usual lion Kirb of work d one Burin most of wo life. Do rat state retl 12. Wes Decedent ever m the 13. Decedents Education (Spedry only highest grade comp leted) 14. Madtal Status: Monied, Never Married, 15. Surviving Spo use (I} wife, give maiden name)
Kind of Work Kind of Business/Industry U.S. Artred Forces? Elementary /Secondary (0-12) College (1-4 w 5+) Wbowed, Dn'O~ ISpeciy)
DE ^ Yea ~l Na 4 Widowed
16. Decedents Meiling Address (Street city /town, state, zip code)
1000 Claremont Drive Decedents
Actual Residence 17a. Stale Did Decedent r~tl
PA Uve in a 17c. L3 Yes, Decedent Lived in _ M1ddleseX Twp.
PA 17013
Carl isle
17b
County Cumberland Township?
17d. ^ No, Decedent Lived within
, . Actual Limits of Ciry/Bore
t8. Father's Name (Frst, middle, last, suffix) 19. Mother's Name (Rrst middle, maiden surname)
George P. Wolf Belle Graham
20a. Inlonnant's Name (Type /Print) 20b. Inhxmam's Mai9ng Address (Street city /town, state, zip code)
William Crock 142 Lyndale Ave., Nottingham, MD 21236
21 a. Method of Diapoeitbn r ®Crernetbn ^ Donalbn 21b. Date of Dfsposi0«r (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory w other place) 21d. I.ogfion (City /town, state, zip code)
^ Burial ^ RemovalfromState ~ wascremetlonorDOrwtlonAuthorized Feb
10 2011 Hoffman-P.oth Funeral Home & G3rlisle, PA 17013
^ Oyu - r by Medical Examirkr/Cerarer7 lal Yes^ No ,
.
22a of Funeral Service ' rase (w person acting es such) 22b. License Number 22c. Name and Address of Facility Hof furor-Roth Funeral Home & Crematory
~ 01.3144E
Complete N 23a~ only when cert6ying 23a. To the best of my inowledge, deatlt occuned at the 6me, date end place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year)
physician is rat avallatde at tlme d death a
rertlry cause of death. /1 ^ / 1n -~1 ~
k1L.Q,~li! .Gl ~ r l.G~~-'1:~(,~l.l ~'Ll n ~ I y / ~1
~ / ~ ~.:~ 'T/~~ ~C ~r '7 ~ ~{ - ~~- j ~~
Items 24-28 must ba completed by person 24. Time of Death 25. Date Prortouraed Dead (Month, day, year) 26. Wes Case Referred to Medxxrl Examiner / Groner for a Reason Other than Cremation or Donation?
who prproteaes death. U Y 4~~~ ~ M. ~~
1~Ut~,~ l_<_. Y , / ~ ^ Yes ~No
CAUSE OF DEATH (See Inetntctlons and examples) ! r Approximate interval: Pad II: Enter other ' 1~, 26. Did Tobacco Use Contratute to Death?
Item 27. Part I: Enter dre chain of events -diseases, injuries, w compkcatbns - tlret directly caused the death. DO NOT enter terminal events such as cardiac arrest, ~ Onset to Death but not reautling N the unrlertying rarxte given in Part I. ^ y~ ^ p~bly
respiretery surest w ventricular fibrfllation witlaut stowing the eddogy. List only one cause on each line.
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^ No ^ Unknown
IMMEDIATE CCAUSE (Fxtel drsease or ~
condition resulti m death) / y , ~
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29. If Female:
^ N
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Due to (w as a consequerce of):
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pregnan
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year
^ Pregnant at time of death
S$eaqquentiaNy list rnrtdtforts, it arty, ,'~ -Q ;~
jd
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lead to tla cause listed an line a.
Eller 9ie UNDERLYING CAUSE Due to (w as corrsequerae of):
'
r Not pregnant, but pregnant wiCtin 42 days
of death
(disease w irry
ury that Initlated the
evems resuldrr
m death) UST
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Due to (or es a consequence of): i
r - ot pregnard, but pregnant 43 days to 1 yeer
before Beall
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Unknown tl pregnant wtlhin the past year
30a. Wore an Autopsy 30b. Were Autopsy Findings 31. Manner of Death 32e. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred 32c. Place of Injury: Horne, Farm, Street, Factory,
Perfomted? Available Prior tc Completion
of Cause of Death?
atural ^ Fbmkade Office Building, etc. (SpeciryJ
^ Y
N _
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^ Y ^ Aatidem ^ Pendkg Imrestigation 32d. Time of Injury 32e. Injury at Work? 321. If TrensporWtran Injury (Specify) 32g. Location of injury (Street, city /town, state)
es
o es L7 rvo
^ Suicide ^ Could Not be Detamnined
^ Yes ^ No
^ Driver/Operator ^ Passenger ^ Pedestdan
M. ^ Other -Specify:
33e. certifier (check arty ore) 33b. signature and Tale of Certlfier
• CsnKying phyaklan (Physician certihdng cause d Beall when arather physician has pronounced death and completed Item 23)
TothebutofmyleawNdga,deaMoccurradduetofhecaws(s-andmarrneruatatad---------------
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• Prorauncktg snd certilying physkisn (Physician both Praraundn9 death and ceNlykg to cause d death) -------
_ _ - - _ _ - - - - ~ License Number ~ 33d. Date Si
grad (Mourn, day, year)
To the best of my knowledge, death oauned ri the time, deb, end place, and due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ Q S -^- L~:~ ;,~ ~~ - [_ ~ / ~ /
cal'
• MWkalExamkrr/Coroner ~
A /'
On the bash of examinatbn and / w Imestlgetion, M my opinion, death occurred at the time, Brie, end place, and due to the ease(s) and manner as stated_ ^ 34. Name and Address of Person Who Completed Cause of Death (Item 27) Type /Print
D
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Registrar lure and District~lumlfeh ~ l~ A I ~ I ry. I ( 1 Q
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~ Filed (Month, say, year) r.
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as
1830 Good Hope Rd . , Enola ~ :PA 17025
Disposition Permit No. ~ G-`T ~ ~ ~ 3 p
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I, Frances W. Crock, of South Middleton Township, Cumberland County, Pennsylt~iania, declare ~`
this to be my last will and revoke any will previously made by me.
ITEM ONE: I direct that all my debts and funeral expenses, including my gravemarker shall be
paid from my residuary estate as soon as practicable after my decease as a part of the expense of the
administration of my estate.
ITEM TWO: I give, devise and bequeath my entire estate to my son, William A. Crock, III, and to
my daughter, Pamela Hendrickson, equally, share and share alike, per stirpes.
ITEM THREE: I appoint my son, William A. Crock, III, and my daughter, Pamela l~endrickson,
Co-Executors of this my last will.
ITEM FOUR: All estate, inheritance, succession and other taxes, imposed or payable by reason of
my death, and interest and penalties thereon, with respect to all property comprising my gross estate
for tax purposes, whether or not such property passes under this will, shall be paid out of the
principal of my residuary estate, without apportionment or right of reimbursement.
ITEM FIVE: I direct that my person representative or guardian shall not be required to give bond
for the faithful performance of their duties in any jurisdiction.
ITEM SIX: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this
will, I give to my Executors during the full time necessary and for the administration of my estate
the following rights and powers to be exercised in their sole discretion.
A. To retain any real or personal property which may at any time form a part of my estate so
long as he or she deems it advisable.
B. To invest in any real or personal property without restrictions to legal investments.
i. i v ic~~di, duet, ttitprUVe (uT iedSC IUr utiy period of time any real or personai property and to
give options for leases.
D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to
partition real or personal property, and to give options for leases.
L~. l;-~
Frances W. Crock
PAGE ONE OF THREE PAGES
E. To make distribution in kind.
F. To compromise claims.
a~
IN WIT S WHEREOF, I have hereunto set my hand this ` ~ day
of ~ . 2001.
~,`,~
°-~c~~~
SIGNED ~ ~2= ~
Frances W. Crock
The preceding instrument, consisting of this and two other typewritten pages each identified by the
signature of the Testatrix was on the day and date thereof signed, published and dec;Tared by the
Testatrix therein named as and for her last will, in the presence of us, who at her request, in her
presence and in the presence of each other have subscribed our names.
l ~ "f
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss
We /`~~ ~t~~' (fir ~t2a and .;~.,~~^_ y-t ~~. .~~;~~'~c.' ,~r,~ ~~~1~.
witnesses whose names are signed to the attached or foregoing instrument being duly qualified
according to law, do depose and say that we were present and saw the Testatrix sign and execute the
instrument as her last will; that she signed willingly and executed it as her free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the
will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more
years of age, of sound mind and under no constraint or undue influence.
J
PAGE TWO OF THREE PAGES
Sworn and subscribed to
before me this I~~ day
of , 2001.
~ ,~
Nota Public
r~c3taria! Sea!
~ F±+itigtt t~.nr- C;crc,~~-.~r"-: I`.ot~iryy F'ub!it;
x~3.~F~i~i~. k3o-"t~; (-srr~bt~~rtar-d Co-~nty
I',11~ ~vri"ill'115Si~;~7"i ~:Xp~iiBS .lUti~ 1(t, ~?{}1)..
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
I, Frances W. Crock, whose name is signed to the attached instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed the instrument as my last will;
that I signed it as my free and voluntary act for the purposes therein expressed.
.2~..~~.~/ _
Frances W. Crock
Sw rn d affirmed to and acknowledged before me this ~ day of
2001.
_ C~ c.~5
Notary Publi ,
~~ ~Jotarial Seal
C';"idg;~t Rnn Corcoran, Notary Public
:;ar!3s!e Eoro, G~~mberland Co~-nty
~Vi'~r ~c,n~missi:?r- Expires June 10, 1002
PAGE THREE OF THREE PAGES