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HomeMy WebLinkAbout06-20-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS P,~ITION FOR PROBATE AND GRANT OF LETTERS Estate of IOHN R. BEL~FONTI ,Deceased ESTATE NO: 21- ~ ~ - ~ - a/k/a: a/k/a: a/k/a: SS NO: 164-30-2073 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. and aver that Petitioner(s) is/are entitled to the aforementioned Letters TESTAMENTARY the last Will of the above-named Decedent, dated /(~ 10~~ and codicil(s) da (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 instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitates party to a pending divorce proceeding at the time of death wherein grounds for divorce had been 23 Pa. C.S.A. § 3323(8): ^ B. Grant of Letters of Administration (I[ applicable, eater d.b.a., peadeat life, duraate absentia, duraate adaoritate) 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:- I LCF THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At CLAREMONT NURSING HOME, 1000 CLAREMONT ROAD CARLISLE, PA 17013 (Street addrsss with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 72 years of age, died 6/5/2011 at CUMBERLAND COUNTY, PENNSYLVANIA (Month, Day, Year of death) (City and State where death occurred) 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 All personal property Personal property in Pennsylvania Personal property in County Total Estlmated Value Location of Real Estate in Pennsylvania: (Provide full address if possible.) s~F~ Fooo ~' 8D 1~.0®• ~ namets~ ac mawng waaresstes~ ~ ~ ~~ ~ ~' ( /l (JOHN R. BELFONTI, ]R., 516 SHIELD ST., HARRISBURG, PA ~I County pending action by the Court Page Part' also) ~' nnrle Q' ::i 7 '~J Ltof thg ` ~yts no's r`n a~ defi~tl, ~_ OATH OF PERSONAL REPRESENTATIVE ~FC~R~~~~FIC,~ ~F nC~7~J j C" ~, ~ }!~r~ Commonwealth of Pennsylvania SS County of Cumberland 2~ I E JllN 20 AM 9~ 3L The Petitioner(s) herein named swear or affirm that the statements in the foregoin a and correct to the best of the lalowledge and belief of Petitioner(s) and that, as perso _ , ~of the; Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed the ~` ~day(of I ~ /C i~ ~ / DECREE OF PROBATE AND GRANT OF LETTERS Estate of JOHN B. BELFONTI , Deceased File Number: 21-~~-~ (C% /~ AND NOW, this day of \ 1G~-' ~ pLU ~' , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters X Testamentary _ of Administration are hereby granted to: (If applicable, enter eta., d.b.o., d.b.n.c.G., etc.) JOHN R. BELFONTI, ]R. in the above estate and that instruments(s) dated 11/10/2003 described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbau , ~`~~ r Register of Wills FEES: 3~d ~ Signature of Counsel Required to Enter Appearance Letters ....................$ ' Will ........................ ~.~c ~' Codi~l(s) ................. ( )Short Certificates ~~" ( )Renunciations....... Bond ............................. Other ............................. Automation FEE......... 5.00 JCS FEE ................... -~~~ ~ TOTAL ................$~ 1 ~8'S0 Atty's PRINTED Name: ~ARyL J. Gi Supreme Court ID No.: 21372 Address: 46 East Main Street Palmyre, PA 17078 Phone: (717) 838-5411 Fax: (717)838-3047 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 105$p5 RF.V Qll /U7) LOCAL REGISTRAR'S CERTIFICATION OF DEATH '~~ ~~13 WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $6.00 P 17556649 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. Phe original certificate will be forwarded to the State Vital Records Oyffi.~ce for permanent filing. /Gyvrt. ~'l ~~--~ JI~N 0 82011 Local Registrar Date Issued r-.3 ~` C ~ .~ ,- Z f~- N 1 ' p 1~ o~ ~ ~ 1,. ,. ~ w . q ~v 112A06 CDMMONWEALTH OF pENNSYLVANfA .DEPARTMENT OF HEALTH • VITAL RECORD iIPPMN R CERTIFlCATE OF DEATH (ew InYtruclbm and numPNs on ravsraa) sure PsF NUAABER 1. N.ra araNrpa.e+ar, K alM z er z say 8n1p rasa 4. D1b a De1N1(wnn, M. YrA ohm R. eelfonti - - c,gllalalNd~ usrl Unlai e.araans r. a PYraDra a11• Nan Ibe11 NeePMa: Ohf. vn. June 4 19 Shartakin Pa ^ Np11atl ^ m 1 oupbl ^ DW Nan ^ nlaeenc. ^ oNr ~ eP1eM a. emh a orb ee Gry, saw, rea a D1an Na Fetal,Nar dmNelldlq yw 1N111ad iuro.rl N. wr Deelenlt a Nwwe De,InT No rr io. Pw. Nnabn 1id~ai. ee,dt 1NN^, ae. ism Cumberland Middlesex ~.i Claremont Nursi Home White 11. daaNe w had 6.01 ielalY 1E Wr Deellal hY h h ib OaiM1 EAcalr (agdl/ asY Igaa o1e1 aalhael 11. sWYa BWa 11nue. Nerx N1nbe. 15. 9uMNp 90a w A Wb, N1• nWr nmel D8 MnNtl Faie111 1MOU•14 ~~ IeOaeN NW tl pak MNtlaBNaNr/Y1iary . 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DG /D rc 9 / !/-~~3 ~C~!?CcG lFFfCE ~F ~. 26! f JUN 20 AM 9~ 3Z ~~~x 3~i11 ~.rt~ ~P~~CimP o~ ~~ ~~.a~uo ro, ~ I, JOHN R BELFONTI of the Borough of New Cumberland, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, do hereby make this to be my Last Will and Testament, hereby revoking all Wills or Codicils by me at any time heretofore made. ARTICLE I I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. ARTICLE II I hereby make the following specific bequest: My M&T Bank account titled KAREN BELFONTI as Custodian for John R. Belfonti to KAREN BELFONTI. ARTICLE III I give, devise and bequeath all the rest, residue and remainder of my estate, after the payment of debts and expenses provided for in Article I above, whether real; personafior mixed, and wheresoever situate, which includes but is not limited to all .financial accounts, except those that I have jointly with Karen Belfonti, which include but are not limited to, an Annuity, Deferred Compensation Plan, Retirement Account, Savings Account, and Checking Account, and Checking Account, to my son, JOHN R BELFONTI, JR. or unto his issue, per stirpes. In the event that he has predeceased me leaving issue, that child's share shall be received by his issue, in equal shares, but in the event that he leaves no issue, that share shall be received by the surviving residuary beneficiaries of this, my Last Will and Testament. ARTICLE IV In the event my beloved son predeceases me, or in the event that hr and I die in a common disaster, then I give, devise and bequeath all the rest, residue and remainder of my estate unto my KAREN BELFONTI as Alternate Beneficiary of this, my Last Will and Testament. In the event that my has predeceased me then I give, devise and bequeath all the rest, residue and remainder of my estate unto my brother PAUL R BELFONTI. ARTICLE V I direct that my Executor shall not be required to enter security in any jurisdiction in which he may act. ARTICLE VI I nominate, constitute and appoint my son JOHN R BELFONTI, JR to be Executor of this, my Last Will and Testament. In the event that he is unable or unwilling to serve in that capacity, then I nominate, constitute and appoint KAREN BELFONTI as Alternate Executrix of this, my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this l~~ day of ~ ©~ w~be r , A.D. 2003. (SEAL) John R. Belfonti SIGNED, SEALED, PUBLISHED and DECLARED by John R. Belfonti the above named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, all being present at the same time, have subscribed our names as witnesses. Address: Pahnyra, PA Address: Palmyra, PA COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF LEBANON ) I, John R. Belfonti, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed the instrument as my Last Will; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affumed to and acknowledged before me by John R. Belfonti, Testator, on this the ~hday of ~Q'VZW~~PQr, 2003. froYYARIAL CAI. TM M. sirt, ~ PubNc My Car~io~„ oat. Belfonti Notary Public ' My Comm. Expires:/U /x,02 / a~ 7 COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF LEBANON ) We, Daryl J. Gerber and Penny LaFoe, the witnesses whose names are signed to the attached instrument, being duly qualified according to law, do depose and say that we were present and saw John R. Belfonti sign and execute the instrument as his Last Will; that he signed 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 that time 18 or more years of age, of sound mind and under no constraint or undue influence. `~` Sw^orn and subscribed before me by Daryl J. Gerber and Penny LaFoe, witnesses, the 1V''~ dayof~A~~'Z003. o~Public My Comm. Exp.:pa~labd7 I~IL ~. ~~ ~rlNr; 14~r~ ~ ea~1,