HomeMy WebLinkAbout07-15-11 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of ~n+l''~E~ ,Deceased ESTATE NO:
a/k/a: J
a/k/a: ~ ~
Petitioner(s) who is/are yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
A. Probate and Grant of Letters Testamentary or O 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 setters ~E~' under
the last Will of the above-named Decedent, dated lti ~ I ~ ~G~c 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 after execution of the
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person, and was not a
party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in
Pa. C.S.A. § 3323(g): N A
O 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 Pa. C.S.A. § 3323(g), except as follows:
Name Address Relationshi to Decedent
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USE ADDITIONAL SHEETS IF NECESSARY
THIS SECTION MUST BE COMPLETED: ~
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family ~ pt~ncipal re
iden~~
At ~ w 't~>< c,h~ n tc IGl 1`lc'~
(Street address with Post Office and Zip Code, Municipality: Township, ugh, City)
Decedent, then 5 7 years of age, died Q'7 - 0 3 - ~ 1 at t,)1~ ry1C5
(Month, Day, Year of death) (City and State where deat curved)
\ -Estimated value of decedent's property at death:
V_If domiciled in PA All personal property $ ~.rJ' ~(OC~~
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 Yalue $
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s) Name(s) & Mailing Address(es)
Interim Form RW-02 revised by Cumberland County pending action by the Court Page l oft
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 Petitioners} 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
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DECREE OF PROBATE AND GRANT OF LETTERS` ~-~
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Estate of /~~ ~~~~ 1: ,~.G/~ nl ~ ~ ,Deceased File Number: 21- ~ ~ - U 7~
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AND NOW, this ~~day of .Tu ~~ fj // , in consideration of the Petition on
the reverse side hereon, satisfactory proof having en presented before me, IT IS DECREED that Letters
"Testamentary _._.. of Administration are hereby granted to:
~ / >> (If 6k, enter cta., d.hn., d.bac.La., etc.)
the above estate and that instruments(s) dated described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
Glenda Farner St
Register of Wills
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Letters ....................$
Will ........................
C cil(s) ...............
( Short Certificates _ ~
( )Renunciations.......
Bond ............................
°t,eriipjiFPd . ~o~~C....~ . o_
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.50
r p 9 s"D
TOTAL ................$ --
Signature of Counsel Required to Enter Appearance
Atty's Signature
PRINTED Name:
Supreme Court ID No.:
Address:
~.nn~
Phone:
Fax:
Interim Fotm RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
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ROBERT L. BENNETT r=~= ~
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I, ROBERT L. BENNETT, Deer Path Road, Harrisburg, Dauphin County,'"'
Pennsylvania being of sound and disposing mind, memory, and understanding,
do hereby make, publish and declare this as and for my Last Will and Testament,
hereby revoking all other Wills and Codicils heretofore made by me.
First
I direct payment of my debts and expenses of my last illness, funeral and
administration from my residuary estate as soon after my death as conveniently may be
done. I wish to be cremated.
Second
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.
Third
I give, devise, and bequeath all tangible personal property, not otherwise
specifically bequeathed and owned by me at the time of my death, together with all
insurance policies thereon, unto my wife, VALERIA L. BENNETT, if she survives me by
sixty days. In the event she fails to survive me by sixty days, I give, devise
and bequeath said tangible personal property thereon unto my Trustee.
Page 1 of 5
I authorize my Trustee to deliver such articles to which a minor may be entitled
under this paragraph to the guardian of the minor or to the person having custody of the
minor, or to retain such property until an age at which my Trustee considers it
appropriate to deliver the property to her, provided in no event shall such personal
property be retained by my Trustee beyond the time the minor attains her majority. The
receipt of such of the above enumerated persons as may be selected to receive
delivery of such property shall be a full and complete discharge to my Trustee. In the
event my Trustee at any time decides it is desirable to sell any item or items of tangible
personal property held hereunder for a minor, the proceeds of such sale or sales shall
be delivered to the Trustee of the property appointed in paragraph Fifth hereinafter to
be held under the terms and conditions thereof.
Fourth
Should my wife, VALERIA L. BENNETT, and I die in a common disaster within
the next ten years from the date our wills are executed, we wish to pay for the
college tuition of Heather Danielle Shaw, Alpine, New Jersey and Harold Duncan Shaw
IV, Alpine, New Jersey. We give, devise and bequeath the rest, residue and remainder
of our estate unto our daughter, Carrie Elizabeth Landis, to be placed in trust under the
conditions outlined in paragraph Fifth.
Should my wife and I die in a common disaster after ten years from the date
our wills are executed, if our combined estate is valued at or less, then we
give, devise and bequeath eighty percent of our estate to our daughter, Carrie
Elizabeth Landis, and ten percent of the estate each to Heather Danielle Shaw
and Harold Duncan Shaw IV, Alpine, New Jersey. If our combined estate is valued at
or greater, the Shaw children are to receive each. We then
give, devise and bequeath the rest, residue and remainder of our estate to our
daughter, Carrie Elizabeth Landis.
To all else, we leave nothing.
Page 2 of 5
Fifth
I give, devise and bequeath all the rest, residue and remainder of my estate unto
my wife, VALERIA L. BENNETT, if she survives me by sixty days.
In the event my wife, VALERIA L. BENNETT, does not survive me by sixty
days, I then give, devise and bequeath all the rest, residue and remainder of my estate
unto my sister-in-law, KAREN KOSAREK, to act as Trustee upon the following terms
and conditions:
A. To pay the income and so much of the principal as may, in the discretion
of my Trustee, be necessary for the maintenance, support, medical
expenses, and education of my daughter, Carrie Elizabeth Landis.
B. To pay three equal installments of one-third of the accumulated income
and principal then remaining in said Trustee's hands to my daughter,
Carrie Elizabeth Landis, at ages thirty thirty-five and forty
Sixth
In addition to the powers conferred by law, I authorize my Executor in her
absolute discretion:
A. To retain in the form received, and to sell either at public or private sale
any real or personal property.
B. To exercise any option or rights arising from ownership of investments.
C. To compromise claims without court approval, and without the consent of
any beneficiary.
D. To join with my wife, VALERIA L. BENNETT, or her Executor in the filing
of any federal income tax return for any year for which I have not filed
such return prior to my death, and to consent to the treatment of any gifts
made by her as being made one-half by me for gift tax purposes
notwithstanding the fact that such action may result in additional liabilities
for my estate. Any income or gift taxes due on such returns and any
deficiencies, interest, penalties, or refunds thereon, shall be allocated
between my estate and said wife or her estate, or all to any of them, in
such manner as my Trustee and my said wife or her Executor may agree.
E. To give options for sales, exchanges, or leases, for such prices, and upon
such terms and conditions as it deems proper, for any real or personal
rty.
Page 3 of 5
F. To engage attorneys, accountants, agents, custodians, clerks, investment
counsel, and such other persons as deemed advisable, to make such
payments, therefore, as deemed reasonable, and to charge the expense
thereof to income or principal as equitably determined, and to delegate to
such persons any discretion deemed proper.
Seventh
Any and all payment or payments of any sum or sums whether in cash or in kind
and whether for principal or income payable to any beneficiary shall be free from
anticipation, alienation, assignment, attachment, and pledge and free from control by
the creditor of any such beneficiary. All shares of principal and income given shall be
free from anticipation, assignment, pledge, or obligations of any beneficiary and shall
not be subject to any execution or attachment.
Eighth
In the event my wife, VALERIA L. BENNETT, shall predecease me, I appoint my
sister-in-law, KAREN KOSAREK, Streetsboro, Ohio, guardian of Carrie Elizabeth
Landis, if she is a minor at the time of my death. In the event that KAREN KOSAREK
shall predecease me, I appoint JAYNE KIETER, guardian of Carrie Elizabeth Landis, if
she is a minor at the time of my death.
Ninth
I nominate, constitute and appoint my wife, VALERIA L. BENNETT, Executor of
this my Last Will and Testament. In the event of the renunciation, death, resignation or
inability to act for any reason whatsoever of my wife, I nominate, constitute and appoint
JAYNE KIETER as Executor of this my Last Will and Testament. I hereby relieve my
Executor and/or Trustee 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 insofar as I am
able by law to do so.
Page 4 of 5
In Witness Whereof, I have hereunto set my hand and seal to this my Last Will
and Testament, consisting of five typewritten pages, the first four of which bear
my signature in the margin for the purpose of identification this day of July
RO E N E T
Signed, sealed, published and declared by the above named Testator, ROBERT L.
BENNETT, as and for his Last Will and Testament, in the presences of us, who, at his
request, in his sight and presence, and in the sight and presence of each other, have
eunto subscribed our names as witnesses.
of ~
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Page 5 of 5
Acknowledgment
Commonwealth of Pennsylvania
County of Dauphin
: SS
We, ~ ~~ 2A- 6 ~-r u Q . Qu~l~o and ro ar ~'. ,
and ~ ~1 ~ ~c~~ witnesses whose names are si ned to the
9
attached and foregoing instrument, being duly qualified according to law, do depose
and say that we were present and saw the Testator sign and execute the instrument as
her, 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 the time eighteen (18) or more years of age, of
sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by
i ~ h and CQTo ~ ~ c~G ~e-~ ~ and
~- ~ ~J~/}~ ' ,witnesses this s'~ day of
July 1999.
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Acknowledgment
Commonwealth of Pennsylvania
SS
County of Dauphin
I, ROBERT L. BENNETT, Testator, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; that 1 signed it
willingly; and that I signed it as my free and voluntary act for the purposes therein
expressed.
Sworn or affirmed to nd ackno dged before e b
' ,and ,the Testator, this
S'r day of July
ROBE NETT
t ry Public
I~OTAR~AI. SEAS.
il~AR.IOR}E i~~EAUG!i'tni~,1 Pub~C
Sus~t~ta~r~a dup., ~
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LIVING WILL
I, ROBERT L. BENNETT, being of sound mind, willfully and voluntarily
make this declaration to be followed if I become incompetent. This declaration
reflects my firm and settled commitment to refuse life-sustaining treatment under
circumstances indicated below.
I direct my attending physician to withhold or withdraw life-sustaining
treatment that serves only to prolong the process of my dying, if I should be in a
terminal condition or in a state of permanent unconsciousness.
I direct that treatment be limited to measures to keep me comfortable and
to relieve pain, including any pain that might occur by withholding or withdrawing
life-sustaining treatment.
Should I cease to have brain activity or I am in a state of permanent
unconsciousness, I am an organ donor and wish that my organs be removed
from my body and used for the benefit of others.
In addition, if I am in the condition described above, I feel especially
strong about the following forms of treatment:
I [ ] do [X] do not want cardiac resuscitation.
I [ ] do [X] do not want mechanical respiration.
I [ ] do [X] do not want tube feeding or any other artificial or invasive form
of nutrition (food).
I [X] do [ ] do not want hydration (water).
I [ ] do [X] do not want blood or blood products.
I [ ] do [X] do not want any form of surgery or invasive diagnostic tests.
I [ ] do [X] do not want kidney dialysis.
I [ ] do [X] do not want antibiotics.
I realize that if I do not specifically indicate my preference regarding any of
the forms of treatment listed above, I may receive that form of treatment.
Other instructions:
I [ ] do [X] do not want to designate another person as my surrogate to
make medical treatment decisions for me if I should be incompetent and in a
terminal condition or in a state of permanent unconsciousness. Name and
address of surrogate, if applicable:
I make this declaration on the ~ day of July,
Name:
ROB . BENNETT
The declarant, Robert L. Bennett, knowingly and voluntarily signed this
writing by signature or mark in our presence.
WIT ESS ADDRESS
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TNESS ADDRESS '