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Home My WebLink About06-08-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of N;rn~laG inn Ma;errhik _ ,Deceased ESTATE N0: 21- ~~- L~>7 a/k/a: a/k/a: a/k/a: SS N 0 : 175-44-1510 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 G rant 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 Testamentary under the last Will of the above-named Decedent, dated February 2a, 2007 and codicil(s) dated ~_.-. (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 af~~ecution~f the ~ instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated ,and not party to a pending divorce proceeding at the time of death wherein grounds for divorce had been e~ ~tl a fine~~n 23 Pa. C.S.A. § 3323{g): ~ ~~~'~'._ _~~ :% cn ~ ~ , .: r ^ B. G rant of Letters of Administration a Q ~~ (If applicable, enter d.b.n., pendent lite, durante absentia, durant ~I~Orltate) ._._ c~ ; T ~~ Cj 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:- Name Aaaress rselauonsm to ueceol USE ADDITIONAL SHEETS IF NECESSARY nt THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At iG4 !"'nrnl C*rcn1F Nc~wi ('umF+crlnnrl DA 17!17!1• Rnrn~~n F. of I~Ic~wi r"~~mF~nAnnrl (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 5$ years of age, died May 25, 2011 at New Cumberland, PA (Month, Day, Yeaz of death) (City and State where death occurred) Estimated value of decedent's property at death: If domiciled in PA All personal property $ 75,ppp If not domiciled in PA Personal property in Pennsylvania $ If not domiciled in PA Personal property in County $ -Value of Real Estate in Pennsylvania $ Total Estimated Value $ 75 cx~n Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature(s) Name(s) & Mailing Address(es) ~ { f isa Ann Majerchik, 168 Carol Street, New Cumberland, PA Interim Form RW-U2 revised 1226.10 by Cumberland County pending action by the Court Pase 1 nt2 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 me this ~ rfl day of 1'l r- c.. _ - ~-~ -T , r' ~_>>'--' For the Register `' ~= v~ ~ `~' :moo-,-, -~. DECREE OF PROBATE AND GRANT OF LETTER~'~ :: ~ ~ -: Estate of NiCgnlac lnn MaiPrrhjk ,Deceased File Number: 21- ~ ~ -~~j~ ._ ~_ . , -, r:= _ ;:,, --r-; ~~ o AND NOW, this ~ day of , in consideration of the Petition on the reverse side hereon, satisfactory proo awing been presented before me, IT IS DECREED that Letters X Testamentary of Administration are hereby granted to: (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) the above estate and that instruments(s) dated ~ti~~~, ~ ,~~~ described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbaugh;~ ~`~ (s: ~ ~-~~ ~,~~ y ~' ~~~, ~~ ~' Register of Wills ,'~ FEES: . ~ ~'~~L Letters ....................$ . Will ........................ I h: C^ -r- Codici I(s) ................. (15) Short Certificates l I'(; . L ~~ ( )Renunciations....... Bond ............................ Other ............................. Automation. FEE......... 5.00 JCS FEE ................... 23.50 ?~ ~c~ TOTAL ................$ ~ . Signature of Counsel Required to Enter Appearance Atty's Signa re PRINTED Name: T;r,,nrn„ D Hnlmac Supreme Court 1D No.:g7~su Address: , ~~ ~ i f;rn ~rr~t Phone: 717-343-3256 Fax: Interim Form KW-02 revised 1226.10 by Cumberland County pending action by the Court Page 2 oft ,<>, . , LOCAL REGISTRAR'S CERTIFICATION OF ~AT WANING: It is illegal to duplicate this copy by photostat or photr,~,dl~ Ip:~`1. Fee Yl;I~ tlltti Lc)i1;~.,1t ~. 5s1.0U ___ P___17556307 43 REV 11Y2W6 E / PRIM IN RMANENT LACK INK ,~~~;'L~w Jf Pfy~ ~. 7~ sa :~ •~ .: a. * ._ ~F ~ ~~'° A~~~,~tt hT ~F~~~~ I~hi. iti i• .: ~ ~ , Lt It L~)'. -,t . .. „ Litt( i1i~ t, :, .. .. ~ ( l li,.... .... z .. ~Z.. t~ L1~ (,•.. /_Gn.,z. ~~ ~~.~ M ~ Y 2 7, 2011 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NLIMBFR ~ ~ D ~~n ~~~ ~ I `,>: r- Cia ~ ~ , - ~~ Y ~ - j ' ~;-y ~~ o ~- 1. Name of Decedent (First, coddle, last, sulRx) 2. Sex 3. Social Searitv Number 4. Gate d Death (Month, day, year) Nicholas "Nick" Jon Majerchik Male 175-44-1510 Ma 25, 2011 5. Age (Last 0inhdsy) Under 1 year Under 1 day 6. Date el Birth (Month, da ,year) 7. Birthplace (City aM state or laeign canlry) Sa. Place of Deflth (Check only one) MAims Days nmurs MNNae Hospital: Omer. 58 yrs May 29, 1952 Sewiekly, PA ^lnpanem ^ER/ompatbnl ^DOa ^NarSing Home [Residence ^Other 9jecity. Bb. Count' of Death Bc. City, Boro, Twp. of Death ed. Faciiry Name QI nd inaWwion, give street and nurtoer) B. Wes Decadem o/ Hispanic Origin? (~ No ^ Yes I o. Rxe American tntlbn, BIacN, write, etc. Cumberland New Cumberland 168 Carol Street jMa ~a,~ oRean `5pPC1~ ~ > rl e ,ala) White 11. DersdenYS Usual tbn Nind oI work done tl ~ moat d waMln Me. Do not stele retired 12. Was Decedent ever in me 13. DecaknYs Etlucefion (Spetlly only highest gentle completed) 14. Mortal SIGNS: Monied, Never Monied, 15. Surviving Spouse (II wife, give maiden name) Kind of Wark KIM of Business /Industry U.S. Ambd Forces? Elementary /Secondary (412) Cdlege (1 ~4 or Sr) Wldowad, Divorced (Speary) Pro'ect En ineer Glass Manufacturing I~Yes ^Na 1z a Married isa A. Custard 16. DecedenYS Malnng Address (Street, coy /sown, stele, rip code) DecetlenYS DId Decedent 168 Carol Street AcWel Residence nor. sale PA LNe ^ a nc. ^ vas, oecedem uved m rwp. New Cumberland, PA 17070 Townshp7 t>ti. county Cumberland 17d. ~ No. Deoetlent uvM wimin Aclualumdsd New Cumberland City / Boro 16. Famer's Name (Frsl, middle, last, suffix) 19. Mother's Name (Fxsl, midde, maiden suname) Geor a Ma~erchik Julia D'Antonio 20a. Informant's Name (Type / Pnd) 20b. InlamanYS Maikrlg Address (Strad, city /Town, slate, by code) Lisa A. Custard Majerchik 68 Carol Street New Cumberland, PA 17070 21 e. Method d Disposition I Cremation ^ Donation 21 b. Dale al Disposition (Monti, day, year) 21 c. Place d Dhposinon (Name of cemetery, aematory or other place) 21 tl. Lpcallon (City I sown, stale, riD code) ^ a,ral ^ RamovdlromState ~ WasCremadonorDOnatlonAUtharteetl~ May 27 2011 Evans Crematory Scheafferstown PA 17088 ^~ ^ Other ~ Specly: ~ by Medical ExarMrbr /Coroner? Yes , , 22a. Signature d Fune I see (a R sm actlng as such) 22b. Llcerlse Number 22c. Name and Address d Fedfy FS 012 849 L Parthemore Funeral Home 8 Cremation Services, Inc. P.O. BDX 431, 1303 Bridge Street, New Cumberland, PA 17070 CompMe Items 23o-c Doty tern 23a. To the bast o my knowledge, deem Occuned d me Ilene, dab aM place elated. (Signatixe aM tNb) 23b. Lcense Number 23c. Dale Signed (Hoorn. day, year) Dhy5lden is nd evaieble al N Beam to cedfY pose d death. Items 2426 must be compldM by person 2a.1 ime of Death 25. Dale Pranourx:ed Dead (Month, day, year) 26. Was Case Retened to McMCeI Examiner / Comrrer for a Reason Other loan Cremation or Donation? wM pronounces death r ~~ M~ Mo. 2 5 2a 1 i ^ Yes ^ No CAUSE OF DEATH (See instmetlons end examples) t Approximate interval: Pan Ih Enter othereimitlcant .+rvuRm to alh 26. Ditl Tobacco Use Conlnate to Death? - Item 27. Pan I: Enter the chain of evenx -diseases, injures, or canplitatbns -met tllrecny caused the death. DO NOT enter terminal events such as cardiac areal, r Onset k Death but not resugng in the underlying cause given m Pan t. ^ yes ^ Probady respiratory areal, or venlMular fibniatlon without showing the eliobgy. List Doty orb cause an eadl line. r or i NiMEDIATE CAU E 1Fn l dise ^ No ~ Unknown S ase a mMNim resulting n thl M Y ~ c-A-~ O ~ tiu- t ~ F qr.C 1 UJ ~ 29. If Female _,~ a. Due to (a as a consequence off: ^ Nol pregnant within past year Sequellnally list mMNicns, N any, b. r=G v\ V +~ /-v~ " Q, n T(~ 'i IJ 1 7 arR SC ~ MadlrW to the cause listed m line a ^ Pregnant al time of tleam . Due to or as a con ) Enter a UNDERLVMG CAUSE ( sequence of : r r ^ Not pregnant, brt pregnant wA6n a2 days (tllseasa a inryry that initiated the t events resanilg n deem) usr. ~ 01 seam Oue to (or es a consequence off: ^ Not pregnant, Mtl pregnant 43 days to t year d r belora death ^ Unknown II pregnam within me past yezr 30a. Was en ANOpsy Sob. Were Autopsy Endings 31. Manner of Death 32a. Date of Irqury (Mmlh, day, year) 32b. Describe Haw Injury Oaurted 32c. Place of Injury. Honre, Fann, SYreel, Factory. Perbrmed? Avdube Pita to ComPlatian {{{~~~irr g(1 NaNrel ^ Horradde OKce BuilAing, etc ISM'tilyJ of Cause of Death / - ^ Yas No ^ Vas ^ No ^ Acctdenl ^ Pending mvasbgatom 32d. Tme d Injury 32e. Injury et Work? 321. II 7renspMelbn Injury (Spedtyi 32g. Locatpn of Injury lSireel, city I town, stale) • ' ^ Suicide ^ Could Not be Delermirbd ^ Ye5 ^ No ^ O^'er /Operator ^ Passenger ^Petlestrien M. ^Other- SpeGry: 33a. Certifier (check only oral 33b. Sgnature aM TAIe of Cenitier • Crsrtitying Dhysiclen (Physician cerntying pose of death when another physician nos Dronouncetl death and completed Item 23) ~ To the best of my knowledge, death caned due to the cause(s) and manner es sieted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (~ ~ , • Pronowteing and centlying IMyslclen (Physidan both pronandng deem aM tallying to pose d death) To Na bed of m kno kW e d th at t th ti d d t d l M d t th d ^ 33c. License Number 33d. Dale Signed (MOnm, day, year) _ _ _ _ _ _ _ _ _ _ y w g , tune a ea a e me, e, an p ace, a ue o e cause(s) en manner es etatetl_ _ _ _ _ _ _ _ sm9p U4 2C: ~ r'f~ L_ ~ 3 7. / / • Medical Examiner/Corona On iM basis d examinelion end / ar investlgelion, In my opinion, deem occunad at Ura Ilene, date, and place, and duo fo the cause(s) and manner se smled_ ^ ~ (~ and Address of Person Wto Completed Cause of Death Qtem 27) Type / Print 35. RegidraYS s re and Dtstnd r ~-/ 7 ~ / v/ ~ ~i ~ i ~1 I I I r 36. Dy/~rod (MOn~ aay~ A aT ~ °,• u3 T •'-v . ,~~ s~~ ~'•' i- ;~~a /~,l ~~c 7 . iv3 S/ /°l z , ~d3V Gov %~ ffOF~C ~O G Disppdmn Parmn No. D ~ I~0 =~~_;,: r ~.: LAST WILL AND TESTAMENT OF NICHOLAS JON MAJERCHIK I, NICHOLAS JON MAJERCHIK of New Cumberland, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, and revoke any and all previous Wills and Codicils I have made. ITEM I: I direct that all of my just debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my death, as a part of the expense of the administration of my estate. ITEM II: All federal, state, and other death taxes payable because of my death with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the residue of my estate, without apportionment or right of reimbursement. ITEM III: I give, devise, and bequeath all the rest, residue and remainder of my estate, wheresoever situate, to my wife, Lisa Ann Majerchik on the condition that she survives me by a period of thirty days. ITEM IV: If my wife, Lisa Ann Majerchik, does not survive me a period of thirty days, I then give, devise, and bequeath all the rest, residue, and remainder of n ~1.~ my estate as follows ~~ _ .... T,~ fx'J ~;_. ~ : ~; . , ~. ~ ~ - - ~ ~.. , .:.- 1) My nephew, Mark Wentz, should receive my Admiral pocket watch with gold moose chain. This was my grandfather's watch. 2) My nephew, Mark Wentz, should also receive the Valley Forge grandfather clock. 3) My niece, Lisa Scott, should receive the Nichols and Stone rocker. 4) My niece, Lisa Scott, should also receive a bench and small table. Both of these items are made of wood and are black in color. They were gifts from my mother. 5) My niece, Lisa Scott, should also receive my wife's quilt collection. 6) My great-niece, Allison Scott (daughter of Lisa Scott) should receive the Jewell Tea China Collection and all of the jewelry except the Admiral pocket watch previously devised to Mark Wentz. 7) Daniel Smith, should receive all of my tools albeit mechanical, woodworking, gardening, etc. 8) The remaining assets of my estate should be made part of the residual estate. The residual estate should be distributed as follows. A) Eighty percent (80%) of the residual estate should be given to my mother Julia Majerchik. If my mother should predecease me, eighty percent (80%) of the residual estate should be given to my sister Georgiann Wentz. If both my mother (Julia Majerchik) and 2 sister (Georgiann Wentz) should predecease me, forty percent (40%) of the residual estate should be given to my nephew, Mark Wentz, and forty percent (40%) of the residual estate should be given to my niece, Lisa Scott. B) Ten percent (10%) of the residual estate should be given to the Penn State University, Beaver Campus, College of Mechanical Engineering for a scholarship fund. C) Ten percent (10%) of the residual estate should be given to The Pymatuning Yacht Club to be used only for the installation of new windows in the main clubhouse. D) If Mark Wentz, Lisa Scott, Penn State University, Beaver Campus or The Pymatuning Yacht Club are in any way unable or unwilling to accept the portions of the residual estate specifically devised to them, the percentages of the residual estate that I have allocated to the person(s) or entity(ies) unwilling or unable to accept their share(s) should be made part of the general residual estate and equally distributed to the remaining aforementioned persons or entities willing and able to receive their shares. ITEM V: I hereby appoint my wife, Lisa Ann Majerchik as Executrix of this my Last Will and Testament. If my wife, Lisa Ann Majerchik should predecease me, 3 or otherwise fail to qualify as Executrix, I then appoint Daniel Smith as Executor. Mr. Smith resided at 388 W. County Line Road, Jamestown, PA 16134 at the time this Will was created. ITEM VI: I direct that no Executrix or Executor serving hereunder be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this a~ day of ~~ , 200. ""~~ (SEAL) NICHOLAS JON AJERCHIK The preceding instrument, consisting of this and three other typewritten pages, was, on the date thereof signed, published, and declared by, the named Testator, NICHOLAS JON MAJERCHIK as his Last Will, in the presence of us, who at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. residing at e2~ C.,,~ , - t i~ ~~,, (~,,~~~,,,,, , r,. ~~~'r~- ~i ,~-- residin at ~ ~ ~ ~ 2 ~ 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss: WE, NICHOLAS JON MAJERCHIK, ~~~ ~ i~ ~n ire-.r-s 7r ,and ~E-t1-e-E ~- ~ ~ v ~ ers the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament, and that he had signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. (~/'~~ NICHOLAS JO MAJERCHIK Witness Witness Subscribed, sworn to, and acknowledged before me by NICHOLAS JON MAJERCHIK, the Testator, and subscribed and sworn to before me by ~otl,ty ~ " oC'e~-s ~-~ and ;~~,r,~., t-- ~ o~er~ ,witnesses, this ,~~ day of `_~--~-~-- , 200. "v`- ~G Ui~~1NfUNwEALTr~ OF PENNSYL'vAfvi~: Public NOTARIAL SEAL BARBARA STUMP, Notary Public Camp Hill Boro, Cumberland County 9 My Commission Expires Nov. 12, 2010 - .~ - ~ -. My Commission Expires: ~ vU / ~ ,~C- ~ ~ 5