Loading...
HomeMy WebLinkAbout07-22-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Anita P. Pane also known as Deceased COUNTY, PENNSYLVANIA File Number 21 - 11 ~- ~ ~ I Social Security Number 122-32-1074 Tommy D. Pane _ 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 Le ers T stamentary and aver that Petitioner(s) is/are the EX@CUtOr named in the last Will of the Decedent dated ~ Z ~7 2 occ and codicil(s) dated (State relevant circumstances, e.g., renunciation, death of executor, etc.) After the execution of the documents offered for probate: Decedent did not mar ;was not divorced; was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. §73323 (g); did not have a child born or adopted; was not the victim of a killing; and was never adjudicated an incapacitated person, except as follows: B. Grant of Letters of Administration app Ica e, en er.• c..a.; ..n.c..a.; pe ente ate; urante a sen ia; urante mmontate Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived by the following spouse (iif any) and heirs (if Administration, c.t.a. or d.b.n.c.t.a., enter date of Will on Section A above 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 beE:n established as provided in 23 Pa. C.S.A. § 3323 (g), except as follows: Name Relationshi Residence _ ~ :.; C7E~ '°:~ .~, =~ _~ ~. ~. r-t ~ ; - -. ~~ `~ r-n f`J 'J ...T..t - - ,.J -~~ ...... '' ,...-~ (COMPLETE /N ALL CASES:) Attach additional sheets if necessary. _ -, ~ •-- ~_ Tiri Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residenc~t ~ ~ " `r~ ~j 1703 Brandt Avenue, New Cumberland, PA 17070 _ `~ (List street address, towNcity, township, county, state, zip code) Decedent, then g5 years of age, died on 07/03/2011 at Bethany Village, Mechanicsburg, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (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: 1703 Brandt Avenue, New Cumberland, PA 17070 108,000.00 150,000.00 c;opynght (c) 20t0 form software only The Lackner Group, Inc. 605 Grandview Circle Lewisberry, PA 17339 Page 1 of 2 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 they appropriate form to the undersigned: COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland Oath of Personal Representative } SS } 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 ill well and truly administer the estate according to law. r ,~' f ~'., - Sworn to or affirmed and subscribed -- ~,~ s~gnarure tx~ersonai rrepresenrauve Tommy D. Pane before me this day of _~~~ v t ~ Signature of Personal Representative ~ _:1 ~ ~ ~ ~~. y~-C,~~,~t!~ _. ~ ~ ~ _~ Signature of Personal Representative ~- f"" ~ _ r~, Fur the Register ,;_~ ;ice ~--- .- ?~ E~ ~ n __ File Number: 21 - 11 - C,J~ 1 Estate of Anita P. Pane ,~ _-~ --~ `~ - ., ,, ~. ~.: ~ ~.:;" Deceased Social Security Number: ~~ 122-32-1074 Date of Death: 07/03/2011 AND NOW, je~ (_T_:L,r~ ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Tommy D. Pane _ _ in the above estate and that the instrument(s) dated " ~ ~, ~ ~ ~~~i described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............................................ $ , ~ ~ (,% • - Short Certificate(s)...4.-`~-~..1............ $ ~~L , ~~ Renunciation(s)....... ~ .................... $ ~ ~ /~ - _, $ $ $ $ $ $ TOTAL .................................... $ ~ ~~ U ' ~~~` ~~ ~~ '~ ~, ~' Supreme Court I.D. No.: 17225 Address: 525 North 12th Street Lemoyne, PA 17043 Telephone: 717/761-5361 Form RVI~-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Attorney Signature: I~y Attorney Name: Samuel L Andes air"1~ RE~ISTRAI~~S' ~I~T~~A'I~I t v~°I~ V!"r~~~11NG: It is illegal to du~licata t~~s i.~. :~'~ kt, ~~~~.~.~t~~$~~~.~t ,~(. ~1~a~f~~~~. I~.t~j I~k~L~ I:>j~ thi°~ ;.t~t~tif~ic,)tL~. ~,f~~ ~ r~ ) P _1.7 5 5__7.4.5..7. Ccrtilici(titlr~ ti~j)n~~i.~( ._ iii 'tldl;tEirT[l tlt~ '~'1~ 1i i~ .~ ,~ ~ r-"~ .. ~~~~e~ /r ~~ .- ~ .! (_ ~,~~l~ilir rt(a~ t)! I)~ )'i) '`~'~~ ~~ ~ ;' ~ ,~.~~tr~(r I~;i~a i,lf~ixt;.ff ~=~' ~~ ~ ,;~ t ' , ` ` ~'~ 1111 ~,') ~: ,C~ "`~~"~t ~~ + `'~ `~'" "'r~ ~ C7 C~ _._ .~ - ~TJ t_,., r~i Y.cZ- f:,~? r- ~-. ,-- -T7 ,~'.} ~ ` ,..- a ' "'~ • ~~ ~ ~ r 1 --1 ' ~ r __ r ~ ~ s w ~ o `I"i U~ 3 REV 11!2006 /PRINT IN RMANENT ACK INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) ~„ ~ ,,,,,.,,_„ 1. Name of Decedem (Fret, middle, last, suffix) 2. Sex 3. Social Security Number 4. Date of Deedh (Month, day, year) Anita P. Pane Female 122 - 32 ,- 1074 Jul 3, 2011 5. Age (Last Birthday) Under i ar Under 1 da 6. Date of Binh Month da r 7. Bi ace and state or n coun 8a. Place of Death Check on one rMBths Deys Hours Minutes Hospital: _ Other: - 95 vrs. January 20 , 1916 Altoona , PA ^ Inpatient ^ ER /Outpatient ^ DOA ®Nursing Hone [] Residence ^ Other - Speciy Bb. County of Death 8c. City, Boro, Twp. of Death 8d. Facility Name (If not institutlon, give street and number) 9. Was Decedent of Hispanic Odgin? ~] No ^ Yes t 0. Race: American Indian, Black, White, etc. • Cumberland Lower Allen Twp . Bethany Village (If yes, speciry Cuban, Mexkan, Puerto Rican, etc.) (gp~ White 11. Decedents Usual Occu bon Kind of work done d udn nest of wo Irfe. Do not state retired 12. Was Decedent ever in the 13. Decedents Education (Spectty onty highest grede comp leted) 14 Madtal Status: Married Never Marded 15 Survivin S o use (It Ae i id Kind of Work Kind of Business /Industry U.S. Armed Forces? Elements /Seconds 0.12 ry ry ( ) Colle ge (1-4 or 5+) . , , Widowed, Divorced (Speclry) . g p w , g ve ma en name) Homemaker Domestic ^ vea ®No 12 Widowed - i6. Decedents Mailing Address (SVeet, city I town, state, zip code) Decedents Did Decedent Penns lvania 1703 Brandt Avenue y Actual Residence 17a. State Liveina 17c. ^ Yes, Decedent Lived in - Twp. - N b C l d PA 17070 Township! 17b.Counry Cumberland 17d.®No,DecedentLivedwithin IVew Cumberland ew um er an Actual Limits of city/Bom 18. Father's Name (Prat, middle, last, suffix) t 9. Mother's Name (Fret, middle, maiden surname) George Bressler Hulda (unknown) 20a. Informants Name (Type /Print) 2qb. InfonnanYs Meiling Address (SUeet, city I town, state, zip code) Tomm D. Pane 605 Grandview Circle, Lewisberry, PA 17339 • 21 a. Method of Disposition r ^ Cremation ^ Donation 21b. Date of Dispositbn (Month, day, year) 21c. Place of Disposltion (Name of cemetery, crematory or other place) lid. Location (City I town, state, zip code) • ® Budal ^ RemovaltromState i WaeCremetionorDOnedonAWhorized ^ Other • r by Medical Examiner/Coroner? ^ Yes^ No July 6, 2011 Rollin Green Cemeter g y Lower Allen Twp PA 17011 , 22a. Signature Funeral rvice L n (or pe ng as such) 22b. License Number _ 22c. Name and Address of Facility - - FD 013 340 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Cortplele hems 23a-c Doty when certfying 23a. To the best of my kno ,death occurred at the time, date d place slated. (Signature and title) 23b. License Number 23c Date Signed (Month, day, year).. physician is rat available at time of death to ~~ cause of death. , ,e~/.S"~ /!~d? G .,J clL ~ ~. ~O / /' - Items 24.26 must be completed by person 24 Time of Death 25. Date Proraunced Dead (Month, day, year) 26. Was Case Refen-ed to Medal Examiner I Coroner for a Reason Other then Crematon or Donation? who pronounces death. y, ~O M. ~ Q ~ / / ^ Yes CIQ No CAUSE OF DEATH (See Instructions end examples) r Approximate interval: 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 amest, i Onset to Death Pert II: Enter other siondicanl conditions contributing to death but not resulting in the undedying cause given in Part I 28. Did Tobacco Use Contribute to Death? ^ ^ respiretory arrest, or ventricular fibdltation without stewing the etlology. List only one cause on each line, , t IMMEDIATE CAUSE (Final disease . Yes Probabty ^ No ^ Unknown or ~ n ~ ~ ^ u , condltion resultlng in death) _~ a l v rv i a r ~ r~.~ O ~ ~ ~ 1 ~ U /' -~ V~._' ~ 1 1 29. If Female: ^ D to r as a consequence o i S ~ ~ Not pregnant wkhin past year ^ equentially Ilst condltkms, It any, b (~ 1 r T ~ leading to the cause listed on Ilne a. Pregnant at time o1 death Enter dte UNDERLYING CAUSE Due to (or as a consequence ot): i ^ Not pregnant, but pregnant wiMin a2 days (disease or injury that initiated the r of death - events resulting in death) LAST, c i r-~ Due to (or as a consequence of): i .~ Not pregnant, but pregnant 43 days to 1 year ~ d ~ r before death ~ Unknown N pregnant wfihin the past year 30a. Wes an Autopsy Pedormed? 30b. Were Autopsy Findings Available Prior to Completion 31. M ner of Death 32a. Date of Injury (Month, day, year) 32b. Descdbe Haw Injury Occurred 32c Place of Injury: Home, Farm, Street, Factory, of Cause of Death? Natural ^ Hanicide Office Building, etc. (SpecilyJ ^ Yes No ^ Yes ^ No ^ Accident ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 32f. M Transportation Injury (SpecilyJ 32g. Location of injury (Street.:ity /town, state) ^ Suicide ^ Could Not be Determined M ^ Yes ^ Ne ^ Driver/Operator ^ Passenger ^ Pedestrian Other -Specify: 33a. Certlfier (check anty one) 33b. Slgnatur d dla of Cerli6er Certifying physcian (Physician certifying cause of death when another physician has pronounced death and completed Item 23) • 1 ~ /'~ ~ ~ To the best o1 my Imowledge, death oceurrod due to the cause(s) and manner as stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ " ~ ~ _ • Pronouncing and cerlilying physkian (Physician both pronouncing death and certltykrg to cause of death) 33c. License Numbs 33d. Date ignad onth, day, year) To the best of my knowledge, deaM occurred et the time, date, and place, end due to the cause(s) and manner as stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ `` ^~ ~ 33 ~' ~ • Medical Examiner/Coroner ? i 1 On the heals of examination end / or Investigetlon, In my opinion, death occurred at the time, date, and place, and due to the cause(s) end manner as stated_ ^ erne and Ad} rso n~Who Comple ed Cause of Death he ~~~ ass[ o~f P~e ~ ~ ( ~~ ~ -E~ R i l f Si t d Di i t N +~ ` 1 ~ ~ ( ~ ~ ~ ( ~ ~ ~ eg a ra s gna u n str c r ~ ~ j I / I ~ I / I /' (/ ~:' 36. Date ed (Mo th, day, year) ~ ~~ -~ ~ - ~ 3 S~ I-} t C ~ i h C o ~ , . v n c oo . ~ Disposition Permit No. RENUNCIATION REGISTER OF WILLS OF ~ un~geRt^AN~ COUNTY, PENNSYLVANIA Estate of Anita P. Pane ~~ Linda A. Grosz Deceased in my capacity/relationship as (Print Name) daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Tommy D. Pane 07/12/2011 (Date) ~ ~ - _ ~? Q t , t = ~ ~ x.~ ~ ~... _ ~ -_. .~ . f L • ~'_ ~ _ J ~ ii..7.. 6...t...1 ~: ~:~ '~ ~.1.~ o ~Y _~- U Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Dep~rty for Register of Wills ::~ ~ ,~ :~ (Signature) inda A. Grosz _7 0 6 C o o t. t D s ~' S 'T'2~ee ~_ (Street Address) New GuMC3 e~2.LA-rvD ~i4 )'~_o~ o (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 ~Z~` daly of 3~~y Z° f ~ ~~. Notary=Public - My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) MM4NVUEALI''H OF PENNSYLVANIA CI1Y OF#~ EHRENFELDI NOTARY Pt1BUC LEMOYNE BOROUGH, CUMBERLAND COUNTY WIY COMMISSION EXPIRES FE8.1,1013 Form f~tN 06 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. P".,, 3 WILL ~o :.~ .tom O F v c~ n ANITA P. PANE ~ `~,~ r-,7 e r .:..3 `--~ ~ - I, ANITA P. PANE, of the Borough of New Cumberland, Cumberland ~~ nay, ~=' - ~'' Pennsylvania, declare this to be my last will and revoke any will previously~nade by~r~e. ~.-~ ~ ,~ , "T"1 "' ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments ~' imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give, devise, and bequeath all of my possessions and estate of every nature and wherever situate in equal shares to those of my issue, per stirpes, who survive ~ ~ my death by sixty (60) days. d! ,, ~ ITEM III. I appoint my son, TOMMY D. PANE, and my daughter, LINDA A. GROSZ, co-executor and co-executrix of this my last will. Should either my son or~ daughter ' predecease me or otherwise fail to qualify or cease to serve as co-executor or co-executrix O of this my last will, I appoint the survivor to serve individually as executor or executrix of this my last will. ~~ f ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. In addition to the other powers and authorities granted to my personal representative by Pennsylvania Law and by the other terms and provisions of this will, I hereby give to my personal representative the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim ~~. . or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representative may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other Page 1 of 4 securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representative deems proper, without regard to any principle of risk or diversification; to retain any or all assets of my "estate, real or personal, without regard to any principle of risk or diversification; to sell at j public or private sale, to exchange, or to lease for any period of time, any real or personal f: ~~ property and to give options for sales, exchanges, or leases, for such prices and upon such ~ terms or conditions as my personal representative deems proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VI. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this Z~ ~ day of c -~. , 2000. -- ~~ ~ ~ a~ v ANITA P. PANE Page 2 of 4 The preceding instrument, consisting of this and two other typewritten pages, each ~, identified by the signature of the testatrix was on the date thereof signed, published, and I~'!, declared by ANITA P. PANE, the testatrix therein named, as and for her last will, in the ~I~ presence of us, who at her request, in her presence, and in the presence of each other, f have subscribed our names as witnesses hereto. i, O L. An s ~.~.~~~ Amy H ins Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 1 SS.: The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing 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. ,.~ ,~ ~,/ ~ `' ~~ ~C l~ ANITA P. ANE ' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 1 1 SS.: 1 WE, SAMUEL L. ANDES and AMY HARKINS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it 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 testatrix 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. Sv~rorn or affirmed to and acknowledged before me this L~ ~' day of S~~PM6t~-, 2000. C NOTARIAL SEAL Notar Public LYNN fHRENFELD, NOTARY PUBLIC lEMOYNE 80R0., CUMBERLAND CO. MY COMMISSION EXPIRES AUG. 17 2004 Page 4 of 4 Sworn or affirmed to and acknowledged before me by the testatrix named above ~I this Z1 ~`' day of 5~,~,b ~ r , 2000. ,~ ~ ~~ i