HomeMy WebLinkAbout06-29-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
Martha R Kenned ~~ - f ~ - L -~~(.(
Estate of y File Number ~ I~,
also known as
Martha R Kennedy ,Deceased Social Security Number 173-07-9162
James W Kennedv II aka James W Kennedy
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW.)
Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EX2CUtor _ named in the
last Will of the Decedent dated 9/25/2001 and codicil(s) dated
James W Kennedy II and Carol Ann Kennedy Tagye are named Co-Executors. Carol Ann Kennedy T~~gye has renounced
in favor of James W Kennedy II (aka James W Kennedy).
Continued on a Separate Page
(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 procf;eding at the time
of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g):
B. Grant of Letters of Administration
(If applicable, enter.• c. t. a.; d.b.n.c.t.a.; pendente liter durante absentia; durante minoritate)
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 West South Street Carlisle PA 17013 Carlisle Borough _
(List street address, town/city, township, county, state, zip code)
Decedent, then 94 years of age, died on 11/9/2010 at Sarah A Todd Memorial Home
1000 West South Street Carlisle PA 17013
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 5.500.00
(If not domiciled in PA) Personal property in Pennsylvania $ _
(If not domiciled in PA) Personal property in County $ _
Value of real estate in Pennsylvania $ _
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:
James W Kennedy II
Form RW-02 rev. 10.13.06
Typed or printed name and residence
aka James W Kennedy
2011 June 29
~~Itl'I I \N~ ~:C)l'R'l'
Page 1 of 2 ~ ~' ~~
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF DAUPHIN
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
.-~ ~.
before me the day of
June 2Q11
For th~~Regis er
-, / ,/
of Personal Representati James W Ken
~-;rt-----_
,,~f~~
i z~-f
II aEca .James W Kennedy
Signature of Personal Representative
Signature of Personal Representative
File Number: _ ~ j - ~ ~ - ~ 7 .~
Estate of Martha R Kennedv ,Deceased
Social Security Number: 173-07-9162 Date of Death: 11 /9/2010
AND NOW, June r'~~f ~1 ~ 2011
in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary _
are hereby granted to James W Kennedv II aka James W Kennedy
_ in the above estate
and that the instrument(s) dated September 25. 2001
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters .................. $
.;
~ 45.00
Short Certificate(s) .~
.~.~ $ 16.00
Renunciation(s) .... • • .......... $ 5.00
Will ,... $ 15.00
Automation Fee .... $ 5.00
JCS Fee ..., $ 23.50
.... $
.... $
.... $
.... $
.... $
.... $
TOTAL ............................. $ 109.50
Form RW-02 rev. 10.13.06
~r~'`.
Re
Attorney Signature:
ells
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Attorney Name: Jan L~e~Wn ~_
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Supreme Court I.D. No.: 67993
Address:
Telephone:
845 Sir Thomas Court ~~uite 12
Harrisburg -
PA _ 17109
717-541-5550
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2011 June 29
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Page 2 of 2
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2011 June 29
(:~.~~;RI~ O-r
t REV 11/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
/PRINT IN
CK INKT CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
1. Name of Decedent (First, middle, IasL suNix) 2. Sex --
3. Social Security Number 4. Date of Death (Month, day, year)
Martha Ruth Kenned Female 173 - 07 r- 9162 November 9, 2010
5. Age (Last Birthday) Under 1 year Under 1 day 6. Date of Birth (Month, day, year) 7. Birthplace (City and slate or foreign country) 8a. Place of Death (Check only one)
Months Oays Hours Mlnules
9 4 Hospital: Other:
' Yrs. September 8,1916 St. Albans, WV
^ Inpatient ^ ER /Outpatient ^ DOA ®Nursing Home [] Residence ^Other - specity:
' 8b. County of Death 8c. City, Boro, Twp of Death 8d. Facility Name (II not institution, give street and number)
9. Was Decedent of Hispanic Odgin? ~ No ^Yes 10. Race: American Indian, Black. White, etc.
• (If yes, specity Cuban,
Cumberland Carlisle Sarah A. Todd Nursin Home ) (specrr~
Mexican, Puerto Rican, etc. Whit e
11. Decedent's Usual Occu anon Kind of work done Burin most of workin life. Do rwt state retired 12. Was Decedent ever in the 13. Decedent's Education (Specify only highest grade completed) 14. Marital Status: Marred, Never Married, 15. Surviving Spouse (If wile, give maiden name)
Kind of Work Kind of Business /Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specify)
Clerk State Government ^Yes C~No 12 2 Widowed
16. Decedent's Mailing Address (Street, city /town, state, zip code) Decedent's
Did Decedent
1000 S. West Street Actual Residence 17a.State Pennsylvania Liveina 17c
Township? ^Yes, Decedent Uved in __ Twp.
Carlisle, PA 17013 17b.County Cumberland 17d.[~No,DecedenlLivedwithin ('arllsle
Actual Umils of City i eoro
18. Father's Name (Frst, middle, last, suffix) 19. Mother's Name (First, middle, maiden surname)
Roland G. Gru an Luc P. Niediffer _
20a. Informant's Name (Type /Print) 20b. Informant's Mailing Address (Street, city /town, state, zip code)
James W. Kennedy 12 Haines Terrace, Merrimack, NH 030'i4
~ 21a. Method of Disposition ^ Cremation ^ Donation 21b. Dale of Dispositbn (Month, day, year) 21c. Place of Disposition (Name of cemete cremato or other lace
® Burial ^ Removal Irom Slate ry ry D 1 21 d. Location (City /town, slate, zip cotle)
Was Cremation or Donation Authorized
^ Other-specity: byMedicalExaminerlCoroner? ^Yes^No November 12,201 Resurrection Cemeter
22a. Sign ure of rat Servic Licensee (or person acting as such) 22b. License Number 22c. Name and Address of Facility
W. Hanover Twp., PA 17112
- •~-;.--~- FS 012 849 L Parthemore FH & CS, Inc. P.O. Box 431 New Cumberland, PA 17070
Complete Items c ly when certitying 23a. To the best of my 1nowledge, death occur at the time, dale and place stated. (Signature and title)
physician is not a ble at time of death to 23b. License Number
ceni cause of death. ~r .~ ~ ~''~ 23c Date Signed (Month day year)
~ 24. Time of Death `t'Jn ~ ~ ~.: V ..~ ~~ _~ / rr;~ iL ~ _."~.,.,~~~: y ,~' - )~.,
~ Items 24-26 must De completed by person l• / ! r . ' ~ "?tCl.~('u 25. Date Pronounced Dead (Month, day, year) 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Crematwn or DOnaDOn? '
who pronounces death. / ,
(,~'-f /C.' .rr'pf M. /l1c y"~ia•h...,G.'Z.... ~l, ~C'rCr ^Yes ^No
CAUSE OF DEATH (See instructions and examples) r Approximate interval: Part II: Enter other sianiUcant condition. ontdb 4in to
Item 27. Part I: Enter the chain of events -diseases, injuries, or complications -that directly caused the death. DO NOT enter terminal events such as cardiac arrest, , 9 ath, :?8. Did Tobacco Use Contribute to Death?
resgratory arrest, or ventricular fibrillation without showing the etiology. List only one cause on each line. r Onset to Death but not resulting in the underlying cause given in Pan I. [] Yes ^ Probably
IMMEDIATE CAUSE (Final disease or ^ I ' ` ~ r
r No ^ Unknown
condition resulting in death) 11 J l~ r ,,,I --
_~ a r V r >th(~, .5. It Female:
Due to (or as a consequence of): r
r ^ Not pregnant wilMn past year
Sequentially Nst conditions, if any, b r
leadingg to the cause listed on line a. , ^ Pregnant al time of death
Enter the UNDERLYING CAUSE Due to (or as a consequence off:
r
(disease orinryrythatinitiated the ^ Nol pregnant, but pregnant within 42 da s
r y
events resulting in death) LAST. c r of death
' Due to (or as a consequence of) r
r ^~, Not pregnant, but pregnant 43 days to ~ year
~ d, r
t before death
30a. Was an Autopsy 30b. Were Autopsy Findings 31. Manner of Death ^ Unknown it pregnant within the past year
Pertormed? Available Prior to Completion 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred
32c. Place of Injury: Home, Farm, Street, Factory,
of Cause of Death? ~~ Natural ^ Homicide Office Building, etc. /specity)
^ Yes ~No Yes No ^ Accident ^ pending Investigation 32d. Time or Injury 32e. In'u al Work? po j ry (p ty) 32g. Location of Injury (Street, clty /:own, state)
^ ^ 1 ry 32f. If Trans nation In u S eci
^ Suicide ^ Could Not be Determined ^Yes ^ No ^ Driver /Operator ^ Passenger ^Pedestrian
M. ^Other ~ specity:
33a. Certifier (check only one) _
33b Sin a and Ttle of Certifi ~- "-- -- ---~-
• Certifying physlclan (Physican certitying cause of death when another physician has pronounced death and completed Item 23) (~ -^)
To the best of my knowledge, death occurred due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ® ~ ~+ ~(Vy~.~~ JC `.~
• Pronouncing and certifying physician (Physician both pronouncing death and certifying to cause of death) u ~ ^ \J (T~
To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33c. license Number 33d. Date Signed (Month, day, year) _
• Medical Examiner I Coroner ^ rl"~ D b ~ ~ Z ~ ~ ~. p ~) v ~ I ~a I Q
On the basis of examination and / or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as stated_ ^ __
34. Name and Address of Person Who Completed Cause of Death (Item 27j Type! Prirt ~~~~-~~~r~~_-__.._..._,
35. Registra ' nature and D' 36. Date Fil d (Month day, year) ~ 6 d ~ ~. p ~' (~ L^ ~ Q,~,~ r(~ I)•,f°~
__ _._ ? "'~ I l b 15
Disposition Permit No. ~ ~ ~-~" 1 ~ ~ L ~ 4J yx~~J~~_` ry`~.y~~~
~ ep\wills\KENNEDYmartha\9-Ol
i
LAST WILL AND TESTAMENT
OF
MARTHA R. KENNEDY
°J
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~~~~
~~
4
I, MARTHA R. KENNEDY, of the Borough of New Cumberl~~nd, Cumber-
land County, Pennsylvania, declare this to be my last will and revoke
any will previously made by me.
ITEM I: I bequeath my automobiles, household and ~~ersonal
effects and other tangible personalty of like nature (not: including
cash or securities) together with any existing insurance thereon to my
children, JAMES W. KENNEDY, II, and CAROL ANN KENNEDY TAC7YE, if they
are then living, to be divided among them by my Co-Executors with due
regard for their personal preferences in as nearly equal shares as
practical.
ITEM II: I devise and bequeath all the rest, residue anal remain-
der of my estate, of every nature and wherever situate, as follows:
A. 30% thereof to my son, JAMES W. KENNEDY, II, if he is
living, and in default thereof to his issue, per stirpes.
B. 30o thereof to the then living children of mm~r deceased
son, ROBERT S. KENNEDY.
Page 1 of 5
2011 June 29
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~ )K PI 1 1'~:`~ ~ :~ >t 11Z'l'
C. 30% thereof to my daughter, CAROL ANN KENNEL>Y TAGYE, if
she is living, and in default thereof to her issue, per :~tirpes.
D . 10 o thereof to my brother and his wife , R0~3E'RT LEE
GRUGAN and EULA FAY COOK GRUGAN. If neither ROBERT LEE C~R.UGAN nor
EULA FAY COOK GRUGAN are living at the time of my death, their share
shall lapse and be added to the other shares created in t=his Item II
in the same proportion as they now bear to each other.
ITEM III: I appoint my Co-Executors and their succE~ssors guard-
yL
J~
ian of any property which passes, either under this will or otherwise,
to a minor and with respect to which I am authorized to ~~ppoint a
guardian and have not otherwise specifically done so, provided that
this appointment of a guardian shall not supersede the right of any
fiduciary in its discretion to distribute a share where ~~ossible to
the minor or to another for the minor's benefit. Such gL~a:rdian shall
have the power to use principal as well as income from time to time
for the minor's support and education (including college education,
both graduate and undergraduate) without regard to his or lzer parent's
ability to provide for such support and education, or to make payment
for these purposes, without further responsibility, to the minor or to
the minor's parent or to any person taking care of the minor.
Page 2 of 5
ITEM IV: I appoint my children, JAMES W. KENNEDY, I7., and CAROL
ANN KENNEDY TAGYE, Co-Executors of this my last will.
ITEM V: No fiduciary acting hereunder shall be req~ui_red to post
bond or enter security for the faithful performance of t~~eir duties in
any jurisdiction.
IN WITNESS WHEREOF, I, MARTHA R. KENNEDY, have herei.~n.to set my
.~„
hand and seal this day of ~~~'~? ~ 2 0 01 .
4
' ti. ~~
MARTHA R . KENN ~DY t~
SIGNED, SEALED, PUBLISHED and DECLARED by MARTHA R. KENNEDY, the
Testatrix above named, as and for her Last Will and Testam~snt, and in
the presence of us, who at her request, in her presence .rid in the
pr e of eac of er, have subscribed our names as witnesses.
W ' tness _~,,° e.. Address
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..
__ ~`.
Witness f Address
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Page 3 of 5
COMMONWEALTH OF PENNSYLVANIA:
. SS.
COUNTY OF CUMBERLAND .
I, MARTHA R. KENNEDY, the Testatrix whose name is s:i~~ned to the
attached or foregoing instrument, having been duly quali_Eied according
to law do hereby acknowledge that I signed and executed t=:h.is instru-
ment as my last Vui ll_; that I signed it willingly and that I signed it
as my free and voluntary act for the purposes therein contained.
~~ J ~ 1
MARTHA R . KENTIEDY -
Sworn to or affirmed to and acknowledged before me key MARTHA R.
KENNEDY, the Testatrix, this ~~~ day of _ ~ 2001.
---
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Notary Public
Notarial Seal
Carol L. Troxstl, Notary Put>•+c
I~anon, Lebanon County
My Commission Expires Dn.;. 27~ 2(?01
COMMONWEALTH OF PENNSYLVANI~emeer, Pannsyivania Association ct Notaries
. SS.
COUNTY OF CUMBERLAND .
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We , and f~ ~i !~ ~- tit` ~ ~c'~ :~°'~ °~ s, ~ ~f
the witnesses whose names are signed to the attached or f~z-egoing
Page 4 of 5
instrument, being duly qualified according to law, depose and say that=
we were present and saw Testatrix sign and execute the i:n~~trument as
her last will; that Testatrix signed willingly and that ,she executed
it as her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testatri:~ signed the
will as witnesses; that to the best of our knowledge, thE~ Testatrix
was at that time eighteen or more years of age, of sound rr~ind and
under no constraint or undue influence.
Sworn to or affirmed to and acknowledg~,ed before me by
//
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~~~,~~ i .1 c~_ and ,~' -~~~ ~' ~~.~. ~- ` ~. -.'.~ ,
~:
witnesses, this _~_ day of ~ 2001. ~
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Notary Public
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Wi ness
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Witness ,,f`
Notarial Geai
Carol L. Troxell, Notary PubAc
Lelk.non, Lebanon County
My Commission Expires Dec. 27, 20(11
Memtzer, Psnnsytvanla AssoCiatlon of Notaries
Page 5 of 5
RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
~ -I~ -~7~
Estate of Martha R Kennedv _ ,Deceased
I, Carol Ann Kennedv Taave , in my capacity/relationship as
(Print Name)
Co-Executor and daughter of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
James W Kennedv II
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
2011 June 29
c;l.l lZh (~~~
~~~, ~
_~
(Signature)
2356 FauverAvenue
(Street Address)
Davton OH 45420
(City, State, Zip)
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 a rs,y. day
of June _ , 2011 _ „
w MARK C. FINNEGAN, po
~ r the State of ph ~Y public
Notary Publi MY Commission Expires Nov 1, 2012
My Commis on xpires:
(Signature ar~e+ Seal of i~ara~y c~ other official qualified to
administer ca~~~s. ~;no~;a date cr c.cpiration of Notary', Commission.)