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HomeMy WebLinkAbout07-25-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ~~~ ~ ~ V 6 i~ ,Deceased ESTATE NO: 21- ~ ~" f~G' a/k/a: a/k/a: ~~3 ' ~ ~" ~ '~~~ a/k/a: SS NO. Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as a icable: A. Probate and Grant of Letters Testamentary or p 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 under the last Will of the above-named Decedent, dated ~ ~ ~ as ~ U 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 23 Pa. C.S.A. § 3323(g): ^ 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 pa to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(8 ept as fows: r.~~ ~ ~ ~ , -Y-, C.«. rrY ~--~ Name Address I~18 ' to D ent ='~= M~ -. ~ ` t'rt N ;J r~-, ~ .:? ~ -."i .. USE ADDITIONAL SHEETS IF NECESSARY Cr. ,.. _.~C f~f t"~-1 •7 Q THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cpu~mberland /County, Pennsylvania, with his/her last family or principal residence At ~~ ~ GU/},L„~G t _~'Uff OM l~u /} l~ ~,~i /~l~.e /YS /3 U•C-4 ~iQ. / 7d.S7 (Street address with Post Office and Zip Code, Municipality: Toy/nship, Boro(u~g/h, City) Decedent, then ~ years of age, died ~ Q/ at ~Jei / c d /j ~ 9 / ~ S7 (M th, D , Year of death) (City and State wher death occurred) Estimated value of decedent's property at death: '~ 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 $ Total Estimated Value $ ~ `~ Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature(s) Name(s) & Mailing Address(es) ~cu.~C7,w R~% E. ~3~-~~~r~~, l 3 i , Lk l~~ ~~ i l~, ~ u~ ~~ I ~- tntenm Norm Kw-U1 revised IZ.Z6.IU 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 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 ~ ~,~ be a me thhis ~,~ ~ __ da of =p c~ ~~ ~-~ w ^', ..,A..~ ~ ~ ~'~' ~_ ~1 IV ice/ +'~ ti ~~ ~ ~. • ~ .r the Register ~ ~ -~ c~ t c-~ '~ ~ DECREE OF PROBATE AND GRANT OF LETTERS Estate of I L~ !.~/~ I`'',[,, Deceased File Number: 21- ~ ~ ~ ~~ AND NOW this J'~ da of ~~ ~~~ , in consideration of the Petition on ~~ Y t reverse side hereon, satisfactory proo Navin een presented before me, IT IS DECREED that Letters Testamentary of Administration are hereby granted to: ~ (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) ~ L GC- ~ ~ G!C /~ • in the above estate and that instruments(s) dated ~ ,~ described in tire- petition be admitted to probate and filed of record as the last W 11 a _ codicil(s) of Decedent. ~ _ . G1encTa Farner Strasbaugh, Register of Wills FEES: Letters ....................$ ~a • ~ t~ Will ....................... D b Co~cil(s) .............. . ( Short Certificates r. ( j) Renunciations.... ... ,~- ~d Bond ........................... . Other ............................. ................................. Automation FEE......... 5.00 JCS FEE .................. 23.50 TOTAL ................ $ ~t~ L~ Signature of Counsel Required to Enter Appearance Atty's Signature PRINTED Name Supreme Court ID No.: Address: Phone: Fax: Interim Form RW-02 revised 12.2G.10 by Cumberland County pending action by the Court Page 2 of 2 .. LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. '• .. - _ ~'ee tl)I` ~:hlS Certlhcate, ~h.~~(~ rrrrrur~~"""'%. ~'~115 15 1-O Cf'. rt)t `v th~lt tale lnf(~rl7latlOn Mel't' .!IVe(1 l1 tt,,ttl ~ZH OF p ' ~,P~------_ Eiji =: cr~)•re~~tly ct~pied fry+n~l ~(r~) Original Certificate ~If~ Death n~ ~i hf'- /,~~`~~o~ ~r ; r duly filed with n)e ~)s LOCaI Re~~istrar. The ~~ri~~inal . `~1; ~ ~~iz certificate w~il i~,r~ tilr~c;_irded to the Stake Vaal v -v ~~ ,ia~ Records Mfr ~ ~ - nel~t tiling. ,r ~_ _ _ ~~ _ ~ P~t~t~ P 17263435 `=°`'q -?~; ~~~ ~ _ LOCa Re~~istr.j~~~ ~~ate Issued ~~_..~ ~~ r . ~ ~ _ C . _ r.,.•. .._ ...r~ • ~~ _ T _ f j...~ 1~ } VJ~ r H10S143 REV 11/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH a VITAL RECORDS .--~ ~n„~. ~, ~- -1' ~? PERMANENT TYPE /PRINT IN CERTIFICATE OF DEATH ~ C - ~'~ ~ BLACK MIK (See instructions and examples on reverse) ..t.r. ~„ ~ .,,,...,~7 M~ ~J w v w w 0 0 w a Z t. Name of Decedent (Fast, rttiddle, lest, atdTa) 2. Sex 3. Serial Security Ntmiber 4. Date o1 Death (Montlt,~yur) `~ Rita Mary Teresa Moore female 063 _ 14 _ 7321 March 6 Zf?i-} 5. Age (Last Batldey) Under 1 r Under 1 de 8. Date of Birth Month, des , 7. Bi C' and state or br ' n carat 8e. Place of Duth Check ate ~ 14mMs aye Hours kanatea ~ 13 1920 ~ • t ~ Hospflal: Other: Yrs. t ^ Ir>petient ^ ER ! Oulpetient ^ DOA ®Nuroing Home ^ Hesider>ce ^ Otlter • Speaty: 8b. County of Death Bc. City, Bono, Twp. 01 Death 8d. Facility Name (It not ir>stittdian, give street end number) 9. Was Decedent d Hispanic Origin? ~ ^Yes 10. Rxe: American Indian, Blade, White, etc. Ctmberland Shippensburg Ztap. Shippensburg Health Care Mg~~ ~r>n', etc.) ( white 11. Decedent's Usual lion d work done duri most o1 Me. Do not state ro9red 12. Wu Decedent ever in the 13. Decedent's Edurstbrt (Speclly Doty highest grade exxnpbted) 14. Marital Status: Herded, Never Herded, 15. Surviving Spouse (6 wile, give maiden name) Kind d Work Kind Busaress/aMus ,~ aY U.S. Amted Feats? Widowed, Divorced (Speaty) erv Elemenf I Secor>dary (0-12) College (td or 5+) ~~ ~ ~ i ~ ^ Yes Ll No 1~ WZdOIJ~ - 16. Decedent's Ma6ing Address (Street, city I town, slate, zip code) Decedent's Did Decedent Actual Residence 17a State PA Live in a ~p~~""` ~ ® i21 ~3lilllt BOttt;lit Rd • Fri 17257 - Ship ensburg . 17c. Yes, Decedent Lived in Twp. Cu<[1~,1.8I1~ Township? 17d. ^ No, Decedent Lived within 17b. County . , p Actual Limits o1 CitylBoro 18. Patter's Narne'~~sl, rttidde, last, strMx) ll F 19. MoMer's Name (Fast, middle, melden surname) J~ph arre T:illianSrhnrr 20a. IMarrtard's Name (type /Print) Rita E Buchter 20b. Inbnnant's Malin Address (Street, sty /town, state, zip cola 131 Milk ~ia ensbtu- Sh Pa 17257 . y ipp g, y . _ 21 a. Method o1 Disposflion r ^ Cremation ^ Donetbn 21 b. Date of Dispos4ion (Month, day, year) 21c. Place of Disposition (Nsme o1 cemetery, aemetory or other place) 21d. Laation (City (town, slate, zip code) ^ Burial ® Rerttoval from State r Was Cranutfon or Donstbn Authorized r ' Breslau Cemetery Lindenhurst NY 11757 ^ Oybr. r by Ikdkal Examiner/Corona 1 ^Yes^ No • 3 ~- 1 V ~ 1 • 22a. Signature o1 Funeral Licensee (a person ac8ng es such) 22b. License Nanber 22c. Name end Address of Fedkty - - ~ i FD-012884-L Dugan Ftu>.eral Home & C~amtory, INc. Shippe~sburg, Pa. 17257 Complete creme 23a-c sly when ng 23a. To the best of my knowledge, death aaxsred et the time, date end place staled. (Signature and Utle) 23b. License Nurrteer 23c. Date Signed (Month, day, year) physician is not evalable at time of d~th to i ~ cen y cause d deem. ~ hems 24-26 must be cortytleted by person 24. Time o th 25. Dale r>ced ad (Mmth, day, year) 26. Was Case Refaced to Medical Examiner / Coster for a Reason Other than Crornatbn or ion? who pronounces deaM. ~ M. ^Yes ^ No CAUSE OF DEATH (See Instructions sod xampl s) r Approximate interval: PaA II: Eller other ' 28. Did Tobacco Use Contribtae b Death? Item 27. Pan L• Enter the ~16.~1s -diseases, atjuriea, a trorr>pkcetions • Ihet efirocty caused the death. DO NOT enter terminal events such as cardiac arrest, ~ Onset to Death but not restating in the urdertying reuse given kt Pan I. ^ yu ^ p,a,~y respiratory arrest, a ventricular Iibri9ation w81rou1 ahowir>g the etiobgy. List a,ty ate cause on each kne. % ^ No ^ Unknown i IMMEDIATE CAUSE (Final disease or ~/ ~ ( cor>dArort resulting kt death) J / r 29. II Female: _~ a N Due to (or as a rxx>sequer>ce ol): i ot pregnant wiMin pest year ^ Pre nant et tkrte of de th ueMielry list cardilions, fl arty, b i le to 9>e cause iiled on Me a g a ^ ' Due to or as a uence of r Enta UNDERLYING CAUSE ( cen~q Y r (disease a atjury that kadated the c r everts resulting n death) LAST. ~ Not pregnant, but pregnant wMhin 42 days of death ^ Due to (a as a ax>sequence ol): r Na pregnant, but pregnant 43 days fo 1 year beloro death • d. r r ^ Unknown M pregnant wkhin the past year 30a. Was an Autopsy 30b. Wore Autopsy Fir>dir>gs 31. Manner of Death 32a. Dale of Ir>jury (Mexdh, day, year) 32b. Describe Haw Injury Occurred 32c. Place of Irryury: home, Farm, Street, Factory, Pedamed? Available Prior to Cat>plelion ~ atonal ^ hbmirtide Office Building, etc. (Specify) of Cause of Death? ^ Yes ~ No ^Yes o ^ Aceidenl ^ Pending Invesligetbn 32d. Time of Injury 32e. Injury et Work? 32f. M Trenspetnetion Injury (Specify) 32g. Lacetgn of injury (Street, sty /town, state) ^ Suicide ^ Could Not be Delemtirred ^Yes ^ No ^ Driver/Operates ^ Passenger ^ Pedestrian M gher - SPacyl': 33a. Certifier (check oMy one) 33b. Sgneture and Title of Caliber • CortHyfng physkfen (Physician ceditying cause of death when anMher physiden has pratour>ced death and completed Ilan 23) To the best of mykrtowkdge,daethoccurredduetothecsuse(s)andrrtenrtaustatad--------------------------------- • Pronouncatg and certMyYg phyNclan (Physician both pronourxing dulh and ceAHyatg b txiuae of death) To the tteN of m knowed e death occurred al the time date and hce and due to the caus ( end m l t d ^ 33c. L~n~/e Nu r A ~~ 0 " 33d. Date S' d (Month, day, year) y g , , , p , e s) anner u e a e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medical ExuMner/Coroner ~ ~ ~ ~ ~ ~ lll..J//~~~ f\ ~ ~ ~ V ~ ( I On the twin of examinatbn and / or investigstlon, In my opinion, death occurred N the time, date, sod place, and due to the cause(s) and manner ee atsted_ ^ 34 N e~me end Address of Person Who~Co mp/le~ted Cause of Death (Item 27) Type /Print Registrars Si nawre a Number 36 ~ ~ ( ! ~ `~X~ r ~ ~ ~ r t t`'~~ g I Z I / I 7 I / ~ ~ Date Filed (Month, day, Year) o g za ~r -- ~ ~ I vd ~ ~° ~~ ~ I ~5 a / Disposkion Permd No. 'y~ ~ t^` ,,. ~;, ~_ ~ ~' ~ .. ~~ (,., - ~ ~ :.'~ ~ ~y t`~ ~. , ~ :r .., `"' ~ CSI CJ3 ~ _,., c_:.~ _ ._- LAST WILL AND TESTAMENT ~~~p ~ ~ y~'~-.~ of -v ~~ i ~~ C7 ~ ~ . .~- RITA MARY MOORS I, RITA MARY MOORS, residing at 574 Fulton Street, Farmingdale, in the County of ~~~ '~offalk and State of New York, being sound mind and memory, do make, publish and declare th' ~ my Last .Will and. Testament, hereby revoking all other and former Wills and Codicils by me ` at any time heretofore made: FIRST: I was married to DONALD P. MOORS, who died a resident of the County s~.-1 of ~`arffof~on February 3, 1997. There were no children born of that marriage, but my husband and I adopted two (2) children, to wit: MARY ANN SECONI, who died a resident of the County ~- of Suffolk on March 13, 2004 and WARREN JOSEPH ho• died a resident of the ,~ County of Suffolk on August 6, 2009. Neither of my children had children. SECOND: I hereby direct that all- my just debts, funeral expenses, costs of administration of my estate and all taxed payable by reason of my death, be paid out of the general assets of my estate as soon as conveniently possible. THIRD: I GIVE all the rest, residue and remainder of my property and estate, real, personal or mixed and wheresoever situate at the time of my death, belonging to me and subject to my disposal by Will, in equal shares to the following, or the survivor or survivors of them as follows: - to my grandniece, VERONICA DENNIS; - to my grandniece, ERIN JOYCE; - to my grandnephew, JOHN JOYCE; - to mygreat-grandniece, MADISON MASSA; and - to mygreat-grandnephew, ROBERT MASSA. FOURTH: If, pursuant to any provision of this Will, ali or any part of my estate shall vest in absolute ownership in a person under the age of twenty-one (21) years, l authorize my Executor in his sole and absolute discretion-and without authorization by any court: A. To defer, in whole or in part, payment or distribution of any or all property to which such minor may be entitled, holding the whole or the undistributed portion thereof as a separate share for such minor with all the powers and authority conferred by the provisions of this Will, including, without limitation, the power to retain, invest and reinvest principal without being limited to investments authorized by law for trust funds. 6. To pay, distribute or apply the whole or any part of any net income or principal at anytime held for any such minor, to or for the support, education and general welfare of such minor, either directly or. by making payment or distribution thereof to the guardian or other legal representative, wherever such minor shall reside, without obligation to see to the proper application thereof, or to such minor pe~-so~~ally, or by distributing the whole or part of such share to a Custodian under the New York Uniform Gifts to Minors Act, and to pay or distribute any balance thereof to such minor when such minor attains the age of twenty-one (21) years, or, in case such minor shall die before distribution of all the property held under this Article, to the Executor or Administrator of the estate of such minor. C. The receipt of the person or persons to whom any such payment or distribution is so made shall be sufficient discharge therefor even though my Executor may be such person. D. My Executor .shall not be required to render and file annual accountings with respect to property so held under this Article of my Will. My Executor shall be entitled to receive compensation with respect to any property held for any minor pursuant to this Article at the same rate and in the same manner payable to testamentary trustees under the laws of the State of New York. FIFTH: I hereby nominate, constitute and appoint my niece, RITA BUCHTER and my niece, PATRICIA JOYCE, or the survivor of them to be Executor(s) of this, my Last Will and Testament. SIXTH: No Executor named herein shall be required to give any bond or security for the performance of his or her duties in any jurisdiction. All the powers, duties, privileges and immunities herein conferred or imposed upon the Executors herein specifically named shall devolve upon their survivor, legal successor or successors. IN WITNESS WHEREOF, I have ,r unto subscribed my name this 14t" day of May, in `~~~-r~.~` , the year Two Thousand Ten. WE, whose names are hereto subscribed, DO CERTIFY that on the 14t" day of May, 2010, Rita Mary Moore, the Testatrix above named, subscribed her name to this instrument in our presence and in the presence of each of us, and at the same time in our presence and hearing declared the same to be her Last Will and Testament, and requested us, and each of us, to sign our names thereto as witnesses to the execution thereof, which we hereby do in the presence of the Testatrix and of each other, on the day of the date of the said Will, and write opposite our names our respective places of residence. r Residingai Residinga' .. STATE OF NEW YORK) ss.: AFFIDAVIT OF ATTESTING WITNESS COUNTY OF SUFFOLK) Pursuant to SCPA 1406 STEPHEN W. KRETZ being duly sworn, says: I am over the age of 21 years and reside at 64 Riverside Avenue, Amityville, New York 11701. I make this affidavit at the request of the Testatrix. 14~' day of May, 2010 to be offered for probate as the Last Will and Testament of Rita Mary Moore, the Testatrix named in said Will. I saw the Testatrix sign her name to said instrument and such signature was made by Testatrix in my presence and in the presence of Stephen W. Kretz, the other attesting witness, on the 14~' day of May, 2010 at 574 Fulton Street, Farmingdale, New York 11735 At the time of making such subscription, the said Testatrix declared the said instrument so subscribed by her to be her Last Will and Testament; and this deponent and the other attesting witness thereupon signed our names as witnesses at the end of said instrument at the request of the Testatrix and in her presence. The said Testatrix at the time of executing said instrument was upwards of the age of 21 years and, in my opinion, in sound mind, memory and understanding, not under any restraint, and not in any way incompetent to make a Will. The Testatrix could read, write and converse in the English language and was suffering from no defect of sight, hearing or speech, or from any other physical or mental impairment. which would affect her capacity to make a Will. The propounded instrument was the only copy of such instrument executed on this occasion, and was not executed in counterparts. Will. The undersigned was acquainted with said Testatrix at the time of the execution of the 1 P r N :. y ~ 1.1 ~ ~ !.: ` ;..,., d ,.~ .f ~. 0 r~ ~~Y ISO 1 1 t.~ .~ I J l l V \I .s4. ~. STEPH N W. KRET ~._, ~ w+r~a ~~ ~ '~'{^~ 1 ~ ~ ~~ ~~ ~J l ,, t VA ~~ _.4 ~+ t_ i ..~.~ t .. ~.~ ~ ~;. "r"l ~~ ~ ` ~ f`'..} ~ Q STATE OF NEW YORK) ss.: COUNTY OF SUFFOLK) AFFIDAVIT OF ATTESTING WITNESS Pursuant to SCPA 1406 PAULETTE L. MOSES being duly sworn, says: I am over the age of 21 years and reside at 182 Oldfield Avenue, Amityville, New York 11701. I make this affidavit at the request of the Testatrix. I am one of the attesting witnesses to the instrument attached hereto bearing the date the 14th day of May, 2010 to be offered for probate as the Last Will and Testament of Rita Mary Moore, the Testatrix named in said Will. I saw the Testatrix sign her name to said instrument and such signature was made by Testatrix in my presence and in the presence of Stephen W. Kretz, the other attesting witness, on the 14th day of May, 2010 at 574 Fulton Street, Farmingdale, New York 11735 At the time of making such subscription, the said Testatrix declared the said instrument so subscribed by her to be her Last Will and Testament; and this deponent and the other attesting witness thereupon signed our names as witnesses at the end of said instrument at the request of the Testatrix and in her presence. The said Testatrix at the time of executing said instrument was upwards of the age of 21 years and, in my opinion, in sound mind, memory and understanding, not under any restraint, and not in any way incompetent to make a Will. The Testatrix could read, write and converse in the English language and was suffering from no defect of sight, hearing or speech, or from any other physical or mental impairment which would affect her capacity to make a Will. The propounded instrument was the only copy of such instrument executed on this occasion, and was not executed in counterparts. Will. (~~,~+,~ r~1 ~~ , ~. ~ ,, ~ .. t r ~ -, .-~r , irk The undersigned was acquainted with said Testatrix at the time of the execution of the _© ~~~ ~y'~, ,~~» ~ 7D :~' ~ ~` _~y~ ~~n /~ ~, r~ U"- ~` ,-~, ~~ ~'~~ °~ ~. -~~ t _~ , ; =., .~ .,. ~ - r-r7 ~~ Q ~..c- il~ U~/~ REGISTER OF WILLS COUNTY, PENNSYLVANIA ~, _~. -~, ~; - ~, ` JQ~ ~ , ~ r-- ~.~ p ~ ~ Estate of RENUNCIATION I~vQr~ Deceased I~ ~ ~~° ~~ ~ ~ C~ _, in m ca aci /relationshi as Y P ty p (P 'nt N me) ~v T of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~~~'~t << (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ _ !ia;~ of Deputy for Register of Wills Executed out of Register's Office Before the undersigned personally appeared the pa--ty executing this renunciation and cert«iec that he or she executed tr. renunciation for the purposes stated within on this o't ~ day of C~t..P ,~. ~ c { Notary Public t1 My Commission Expires: 1 ~,l 1,l (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 (Street Address) eca~6~ ~1'1~ C~~ (City, State, Zip) LAW OFFICES DONOHUE, KRETZ & GARABRANT 36 EAST MONTAUK HIGHWAY LINDENHURST, NEW YORK 11757 JOHN J. DONOHUE 1916-1987 STEPHEN W. KRETZ" MARK R. GARABRANT MEMBER OF THE NEW YORK AND FLORIDA BAR'S Ms. Rita Buchter 131 Milky Way Shippensburg, PA 17257 Re: 7'he Estate of Rita Marv Moore Dear Rita: July 12, 2011 TELEPHONE: (631)957-2000 FACSIMILE: (631) 957-3443 E- MAIL: DKGESQ36@AOL.COM As you requested, enclosed please find the original Last Will and Testament, as well as the Witness Affidavits for Rita Mary Moore. If you have any questions, please don't hesitate to call. SWK:fd Enclosure Very truly yours STEPHEN W. KRETZ r ~~ .w-R .`.'Vi ~y ~ ~ l"` ~_~ C'„~ m* y, ~ i Hsi V ~`-t^~ 'l_y~ I . ~~ t~ {''~ ' v~