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HomeMy WebLinkAbout05-11-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Deceased ESTATE NO: 21- ~ ~ ~% ~~~' Estate of C• Edward Gregory a/k/a: Charles Edward Gregory Ewa' SS NO: a/k/a: Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: D A. Probate and Grant of Letters Testamentary or ^ Administration c.t.a., or d.b.n.c.t.a. (complete Part C a(so) '-A, and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary n udder -,- the last Will of the above-named Decedent, dated 10/27/1995 and codicil(s) dated `ry _ __ ;_ :7 - r- ____ -.; ::...; (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 exe~utjori,of the ;. `; instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person,_~ was note. , party to a pending divorce proceeding at the time of death wherein grounds for divorce had been establ'~I ed{as defined in ~: ~ Cry 23 Pa. C.S.A. § 3323(8): ^ 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 (If 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:-. THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 2121 Dou las Drive Carlisle North Middleton Townshi Penns Ivania 17013 (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 72 years of age, died Estimated value of decedent's property at death: If domiciled th PA If not domiciled in PA If not domiciled in PA Value of Real Estate in Pennsylvania 9/3/2010 at Cape Vincent, New York (Month, Day, Year of death) (City and State where death occurred) All personal property $ 195,000.00 Personal property in Pennsylvania $ Personal property in County $ Total Estimated Value $ 195,000.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 2121 Douglas Drive, Carlisle, Pennsylvania 17013 Signature(s) Name(s) & Mailing Address(es) Arlene F. Gregory, 2121 Douglas Drive, Carlisle, PA 17013 Page 1 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court 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 d^ before me this ~ (} ~'~ day of - r ~- ' L. ~ ~ _ ,, __. ~ --, ~~ h ~~ For the Register ~ { -y. ~...•:: ~~ DECREE OF PROBATE AND GRANT OF LETTERS ~:' ~r' Estate of C Edward Gregory a/k/a Charles Edward ,Deceased File Number: 21-~_- ~~ AND NOW, this I h 11 day of ~ C~ ~ ( , in consideration of the Petition on the reverse side hereon, satisfactory proof havir~ been presented before me, IT IS DECREED that Letters i'~Testamentary - of Administration are hereby granted to: ~ (IS applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) <,~ ~-- _ ir. ~~ ~ f' 1'1 ~ ~ t l/~ ~ ~ 1 l described in the petition be the above estate and that instruments ) da - ~-"~7 admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. `~ ~l~J it (( ~1-- ~~ ~ ' ~~_ _ ~1_k , ,' --~ ;~ Glenda Farner Strasbau !" ~ .,~~1'~~~ 1.~~~_ Register of Wills ,"~ FEES: Letters ....................$ ~~j1 ~~. L`~~ Will ........................ I `~•C%Ci Codicil(s) ................. (~) Short Certificates ' ~~' ~ ( )Renunciations....... Bond ............................ Other ............................. ................................. Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ 28.50 Signature of Counsel Required to Atty' s S PRINTED Name: Patricia Carey Zucker' Supreme Court ID No.: 37334 Address: Phone Fax: 1035 Mumma Road, Suite 101 Wormleysburg PA 170Q3 (717)724-9821 (7171724-9826 Page 2 of 2 )nterim Form RW-02 revised ]2.26.10 by Cumberland County pending action by the Court i_V,....~. ~enrr ~ ~ - I I ~C~L~(~ -~~ ~ ~ ~ DEPARTMENT OF HEALTH STATE FILE NUMBER REGSTERNUMBER CERTIFICATE OF DEATH RESIDENCE Q i ~ 1. NAME: FIRST MIDDLE LAST 2. SEX: 3A. DATE OF DEATH: 138. HOUR: MALE FEMALE MONTH DAY YEAR CHARLES ~ W~QRD GREGORY Lit ^2 09 03 2010 ~ 4:30 A m NcHs 4A. PLACE OF DEATH: HOSPITAL HOSPITAL HOSPITAL NURSING PRIVATE HOSPICE OTHER ~ 48. IF FACILITY, DATE ADMITTED: (Check one) DOA ER OUTPATIENT INPATIENT HOME RESIDENCE FACILITY (Speciry): i MONTH DAY ^ ^ ^ ^ ^ ~ ^ ^ ' NA 4C 4C. NAME OF FACILITY: (II not facility give address) ~ 4D. LOCALITY: (Check one and speciry) ~ 4E. COUNTY OF DFATH: I CITY VIUAGE TOWN i 6007 RIVERVIEW DR. ' ^ ^ [~ CAPE VINCENT ~ JEFFERSON 4G 4F. MEDICAL RECORD N0. ~ 4G. WAS DECEDENT TRANSFERRED FROM ANOTHER INSTITUTION? (1l yes, spearyinstitution name, ary or town, counryand sfatel i NO YES NA ' ~ ^ 5. DATE OF BIRTH: 6A. AGE IN 68. IF UNDER 1 YEAR 6C. IF UNDER t DAY 7A. CITY AND STATE OF BIRTH: (1/not USA, Country and 17B. IF AGE UNDER 1 YFAR, NAME OF HOSPITAL OF BIRTH: ' l RepiorVProvince) i ENTER: YEARS: I ENTER: ' ~ MONTH DAV YEAH ' monNs days ~ hours minutas - { iT~ ~~R+S' r PA i NA i 12 20 1937 72 yrs. ' 6. SERVED INU.S.ARMED 9.DECEOENTOFHISPANICORIGIN7CMcklMOoxestMroastoast,ibewheurerroedecedenrisSpardsMtiswniutatiro. T 10.DECEDENT'SRACE:CMdoneamorerxesroirrdA•ananar rcauidendlNmsWgausedrob:-,-, ~~ ~ f-0RCE57 (Spaciry years) A ~ No, net SpanishlHispanirRauno B ^ Yes, Mexican, Mexican American, Chicano A ®WhitelCaucasian B ^ Black or Aldan American C~ ~ Indian D ^~-CNnese ~ 1A ^ 0 Y~1 C ^ Yes, Puerto Rican D ^ Yes, Cuban ,,~~,,J1 E ^ Rlipirro F ^ Japanese Gt~f Ka~r~ H ^~AlfAamese .., - ~ . 5~ 1 Q ~ E ^ Yes, Other SpanishlHispaniWtino (speciyJ . , ,tom 1 _. , J ^ Nadve Hawaiian K ^ Guamanian or Chamono MII samwil~ .- 78 11.DECEDENT'S EDUCATION: Cnxk Me box WrDesf desaibes the highest deproe or kmrl olsdrool roar dre tine oldealh. '~~~ N ^ American IMian or AWska Naliue (spedhl ~I 1 ^ 5 8th grade 2 ^ 9th-12th grade; no diploma 3 tp,r High school graduate or GEO ~ ~ Islander /speatyl R '. P ^ ONer Asian (sprNtilyl ^ ~ ' ~ 4 ^ Some college credit, but no degree 5 ^ Associates degree 6 ^ Bachelor's degree B ^ Other (spedyl -~ ~~~ .""~ ~ ;-r{ 7 ^ Master's degree B ^ DoctoratelProfessional degree ,.. , - r h ~ `' ~ ~,~ 12. SOCIAL SECURITY NUMBER: 13. MARITAL STATUS: 14. SURVIVING SPOUSE: Entername M U NEVER MARRIED MARRIED WIDOWED DNORCED SEPARATED mamedorseparated. dsurvivingspouseis ~p 056-32-8764 ^ 1 I~ z ^ 3 ^ 4 ^ 5 rWfa' enter maiden name' ARLENE MCGUIRE C: 15A. USUAL OCCUPATION: (Do not enter refired) i 158. KIND OF BUSINESS OR INDUSTRY: 115C. NAMfiAND 1.01;A11TY~ CODIB4DLYI ~RrFJR1~AA ~A /k ~ w~ ~ MANUFACTURING/RETAIL GLASS ~PITTSBURG PLATE GLASS ~JIJ~j 1 ~~ ~ } SI 16F. IF CITY OR VILLAGE, IS RESIDENCE • 16A. RESIDENCE: 168. County or RegioNProvince 16C. LOCALITY: (Check one and specify) 'WITHIN OR VILLAGE LIMITS? CITY VI LAGE TPWN ~ (State orCouN^~ „ N nol hA -C OYES ,~10 IF N0, SPECIFY TOWN: )) ~~ yya ~ / ~ ' l rl not USAJ `~ ~ n iu ~ ~ r+ a /kf ^ ] v j• G E : l 16E. ZIP C^OD SI DE NC E ANO NUMBER OF RE T 16D. STREE ~ 25 ~f w y , ^ ) , ~ % ~L' s ~ ~''~ ~ ,~~tJ'~S ' lV1 ~ '1 "f /'a J[JifiJ~.,C. 17. NAME OF FIRST MI LAST 1B OF MOTHER: E FIRST MI IAST 3o FATHER: CHARLES E. GREGORY ALICE GARRETT 19A NAME OF INFORMANT: i 198. MAILING ADDRESS: (include np code) ARLENE GREGORY ' 6007 RIVERVIEW DR.r CAPE VINCENT, NY 13618 31 20A. t O euRIAL 2 t~DREMATION 3 ~ REMOVAL 4 O HotD 5 ^ Dorunon l 208. PLACE OF BURIAL, CREMATION, REMOVAL OR OTHER DISPOSITION. l 20C. LOCATION: (City or town and state) MONTH DAY YEAR 6OENi0MBMENT ~ pip r BROOKSIDE CREMATORYrINC. ' TOWN OF WATERTOWNr NY 1218. REGISTRATION NUMBER: • 31B 21 A. NAME AND ADDRESS OF FUNERAL HOME: ' 00390 CUMMINGS.FUNERAL SERVICE,INC.r 320 JOHN ST.r CLAYTON, NY 13624 2?A. NAME OF FUNERAL DIRECTOR: ~ 228. SIGNAT E OF FUN RAL DIRECTOR: i 22C. REGISTRATION NUMBER: DR '- a\ - ~ X00790 WALTER P. CUNNINGS Ygp , 24A RIAL OR REMOV PERMIT ISS D BY: 124M~ ISSUED r TEAR e~ FILED: REGIST R: l 23 ATURE OF 23A a t . DAY ITEMS 2tS THRU 33 COMPLETED BY CERTIFYING PHYSICIAN -- OR -- CO NER/CORON 'S PHYSICI NOR MEDICAL EXAMINER CERTIFICATION: To the best of my knowledge, death occurred at the time, date and place and due to the causes staty . 25A "~ OCOD . Certifier's Name: License No.: /~ Signature: ~ - ~ ~/ /~ e rear ~ ~ ~i '/ ~ ~ ~ ~ ~ ~ ~ ~ V CANCER Certifier's Trtle: 0 Attendin Physician 0 Physician actin on behalf of Attending Physician Add~~ ,• L r1~ 9 ^ g . ~ (/ lyg' ~1 c.~!'~l (} IJl/f'i / - 1 ~ ~[~ D J ~ ~ ~~' ' ~ ~ 1 ^ Coroner 2 ^ Medical Examiner I Deputy Medical Examiner Monet D rear 258. If coroner is not a physician, enter Coroner's Physician's name 8 title: License No.: gnat 25C. If certifier is not attending physician, enter Attending Physician's name b title: License No.: address: S 26A. Attending physician th D Year Manor D Year 268. Deceased last seen al'we Year 26C. Pmmounrbd Momh D rear attended deceased: N1OM TD fY try attending physician: ~ O D°ad pN ~ ~ AT M WERE FINDINGS USED TO DETERMINE IF YES AUTOPSY? 298 v - O . , 28. WAS CASE REFERRED TO 29A. 27. MANNER F DEATH: UNDETERMINED PENDING CORD E R MEDICAL EXAMINER? O YES REFUSED i CAUSE OF DEATH? NATU USE ACCIDENT HOMICIDE SUICIDE CIRCUMSTANCES INVESTIGATION 1 ^2 ^3 ^4 ^5 ^6 0 NO 1 ^YES 0 ^1 ^2 ' 0^NO 1 ^YES CONFIDENTIAL SEE INSTRUCTION SHEET FOR COMPLETING CAUSE OF DEATH CONFIDENTIAL y~ ~j ( aaaROxiMAtE INlenvu (r 30. DEATH WAS CAUSED BY: (ENTER ONLY ONE CAUSE PER LINE FOR (A), (Bj, AND (Cj.) EN oNSEr Axo DEATH (y PART I. IMMEDIATE CAUSE: /j ' ~ I OUE TO OR AS A CONSEQUENCE OF: r `j o o . DUE TO OR AS A CONSEQUENCE OF: I S ~C ~ fC) DID TOBACCO USE CONTRIBUTE TO DFATH7 \~^~ PART II.OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH BUT NOT RELATED TO CAUSE GIVEN IN PART I (A): 0 ENO t ^YES 2 ^ PROBABLY 3 ^ UNKNOWN w re 31 A.IFI U ~ ` MONTH 0 o= 31F.IF LOCALITY: (City or town and count' and state) ~ 31C. utxnrot nuw muunr ur,wnnau: I ' m' INJURY, SPECIFY: 32. WAS OrCEOENT 33A. IF FEMALE: em . vcnw .,n vcc _I"1... .... . f1. ... .. .. .f1.. N YES 0 ^1 R: YEAR I DO HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY FROM THE ORGINAL COMPLETE REGISTERED RECORD AND THAT SAID LICENSE WAS DULY RECORDED AL`TD FILED IN THE TOWN CLERK'S OFFICE. A CLERK THE OF CAPE VINCENT, NEW YORK, p,ND STRAR OF VITAL RECORDS THEREOF. Warning: Any alteration invalidates this certificate. LAST WILL OF C. EDWARD GREGORY -,. ~"~ ~7 C~ ~ :: -:; --, ~___ (` 7 -_ r., , . I, C. Edward Gregory, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will. 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. Page One of Five Article III I give, devise,- and bequeath, all my property, real, personal, and mixed, to my beloved wife, Arlene F. Gregory, provided she survives me by thirty (30) days. If my wife fails to survive me by thirty (30) days, I give, devise, and bequeath any real estate that I may own to my two beloved children, Brian A. Gregory and M. Karen Lickle. Any guns that I own at the time of death I give, devise, and bequeath to my son, Brian A. Gregory. All the rest, residue and remainder of my estate, real, personal and mixed, I give, devise, and bequeath in equal shres to Brian A. Gregory, M. Karen Lickle, Kimberly M. Dailey, Michele R. Gibb and Melissa M. McCurdy, provided they survive me by thirty (30) days. In the event that any beneficiary fails to survive me by thirty (30) days, his or her interest shall be paid to his or her living children. In the event that any beneficiary who fails to survive me by thirty (30) days does not have living children his or her interest in my estate shall be paid to my remaining living beneficiaries . Article IV In addition to the powers conferred by law, I authorize my Executor, in his absolute discretion: Page Two of Five ~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, fib) 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, fig) 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, and ~ i ) to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death. Page Three of Five Article V I nominate, constitute, and appoint Arlene F. Gregory Executrix of my Last Will and Testament. In the event of her renunciation, death, resignation, or inability to act for any reason whatsoever as my Executrix, I nominate, constitute, and appoint M. Karen Lickle to act as my Executrix. I hereby relieve my Executrix, whether original, substitute, or successor, from the necessity of posting security in connection with her duties as such in any jurisdiction in which she may be called upon to act so far as I am able by law to do so. My Executrix shall receive reasonable compensation for services rendered to my estate. IN WITNESS WHEREOF, I, C. Edward Gregory, hereby set my hand to this my Last Will, on this -~ ? day of C; at Harrisburg, Pennsylvania. C. Edward Gregory, es ator In our presence, the above-named Testator signed this and declared this to be his Last Will and now at his request, in his presence, and in the presence of each other, we sign as witnesses. i Sri `l' 3e Four of Five I, C. Edward Gregory, Testator, 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 beforethe Testator, C. Edward Gregory, this ~ day,. of 19Q). C. Edward Gregory, T to r NOTARIAL SEAL PATRICIA A. PATTON, Notary Public L,&~r Pax~r~~p.. g~p~~q ed witnesses who signed the foregoing M omfnission x es une OSe and Say instrument, being duly qualified according to law, dep that we were present and saw the Testator sign and execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary act for the purposes therein expressed; that each of us in his sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that he 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 subs e t bef e e by ,L- and ' witne ses ~ ,hai 19 41 daY/1 f/ ~ L - NOTARIAL SEAL age Five of Five PATRICIA A. PATTON, Notary Public Lower Paxton Twp.. Dauphin Co. Av Commission Fxpues June 20. 199Fi