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Home My WebLink About07-25-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ~ c~3 R A ~~- ~~ c._ L ,Decease a/k/a: 3 C R. a/k/a: a/k/a: ESTATE NO: 21- ~ ~a SS NO: ~~~ "" 2~' ~~~ Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: I~ A. Probate and Grant of Letters Testamentary or ~1 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 `~~ ~s-~x- ,, ,, L N ~r~ ~~ under the last Will of the above-named Decedent, dated 1 ~ - 19 - 2d 0 ~ and codicils da ed _ (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 life, 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 completet of heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a parl~o a pending3livorc~z ~; roceedin wherein rounds for divorce had been established as rovided in 23 Pa. C.S.A. 3323 t as follows: ~".~:..~ ` - r' P g g p § (gam ~ p ~ ~~~".~_- Name Address R to D~lent t- - '~ . ~ _, ~~~ ~ ~~ ~ ~ ~. _ ~ .. ~, USE ADDITIONAL SHEETS IF NECESSARY THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal At :J~3 ~ /~. fl G A fc n ~. ~ C. t~ c~ C" ~ P~4 1 '7 dL S- ~ps,-- eQ~ ~P (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) ~~., t~ ~' v o.9 - t~! Decedent, then ~_ years of age, died 7° ' ~ U t ~ at ~ (Month, Yeaz oiuiea~) (City and State where death occurred) Estimated value of decedent s property at death: ~~JJ 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 $ ~t Total Estimated Value $ , O C7 C7 { 70 ~ Oc7 ~ Location of Real Estate in Pennsylvania: (Provide full address if possible.) ~~~ ~~ /~~G~/~'~ ~~ ~ ~ OG"'~ ~ ~~ ~ ~ s Signature(s) ~~ Name(s) & Mailing Address(es) t ._ t.--ri ~~ O --r1 Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Nage t of 2 r..� 'n ��..'• -� OATH OF PERSONAL REPRESENTATIVE �� `�" �`' , � L_ m� � � � 4y�'� \...'�..•. ...i.{ � �y �+ r..'�� _ ..�./ 1 � .._' ,...I � Commonwealth of Pennsylvania � SS �� ' f��'�� County of Cumberland : '`�a� -� `_ � --��„ --�-� �� W �� The Petitioner(s) herein named swear or affirm that the statements in the foregoing Pet�f'ion are tr�ie 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 th state according to law. Sworn to or affirmed and subscribed � bef e me this �� da�of // r^' � ( `�i!� r the Regist�r �ECREE OF PROBATE AND GRANT OF LETTERS f Estate of c�� v G ,Deceased File Number: 21- - �� AND NOW, this �-!�D day of � , in consideration of the Petition on the reverse side hereon, satisfactory proo havi been 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.) G�J//� "(� in� the above estate and that inst ments(s) dated !3D escribed in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. �'�� Glenda Farner trasbaugh, , � Register of Wills � � � FEES: Signature of Counsel Required to Enter Appearance Letters. ..................$ ��'�� Will....................... � Atty's Signature Co 'cil(s)... ............ ( � Short Certificates PRINTED Name: ` ( )Renunciations....... Supreme Court ID No.: Bond ............................ Other............................. Address: Automation FEE......... 5.00 JCS FEE.................. 23.50 Phone: � Fax: TOTAL................$ � �"Jr' lnterim Form RW-02 revised 12.2G.10 by Cumberland County pending action by the Court Page 2 of 2 I(h.tith hE~~ irll'!1'~ LOCAL REGISTRAR'S CERTIFICATION t~F DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 17557886 Certification Number ~,,,,r~~%%%%-. This is t~~ ~:ertit~y that the information here given is t,trr'' ASH Of p ~ ~ -(n ori«inal Certificate of Death ~,P - Fiyj; ._ correct ~y copieel i~rum ~ ~, ,~~~ ~~r ~ duly filed with me as Local Registrar. The original ~ ~sa certificate will tie forwarded to the State .Vital ~ ,_. °v( .~ 3 ia: ~2ecords Office ft:>r permanent filing. ~* ~~ = '' *,,~' ~ ~UL 1 1 1011 o , ~,, ~ .9 ~_---~ +~t>t ~' / '-9rMENT,O,; ~ - Local Re~~l~trar Date Issued REV 11/2008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS PRINT IN CORONER'S CERTIFICATE OF DEATH (ANENT .K INK ~~33-070 (Brae Instroctlons and examples on reverse) STATE FILE NUMBER C? r- ~' ~ ~ ~ ~ _ t..... ~ ~ ~ ~., a .) {...i ~~~ ~~ -~. /'~ '^~ ~- R' 1. Nerve of Decedent (First, mkk>fe, Iasi, sulAz) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year) John J Rakoc Male 208 - 24 '- 4684 Jul 19 2011 5. Age (Lest Blyd>day) Under 1 Under 1 da 8. Date of &rlh Matth, de , ea 7. C end able a f 8a. Place of Death Check on are Derys Flotxe Mkzxae Hosphal: OtMr. 77 Yrs. Se tember 25 1933 Ltxust Gap, PA ^InpetleM ^ERloutpatler>t ^DOA ^NureingHane Residence ^other-SP•dA': Bb. County of Death 8c. CIry, Bo Twp. Death Bd. FacNlry Name (h not Instltutlon, glue street arb number) 9. Was Decedent of Hbpen~ Origin? ^ No ^ Yes 10. Race: AmerKen Irdlan, Black, While, etc. (If Yes, >lpedly Cuban, (SpecNy) Cumberland East Pennsboro 539 Magaro Road Mexican,PuenoRic~rt,eto.) 11. Decedent's Usual Kind of work d ata du ' most of We. Do rat state retl 12. Wes Decedent ever In the 13. Decadence Ed>xxdbn (Spectly only hlghsst grade cort>p bted) 14. Merttel Sbtue: Martbd, Never Married, 15. Surviving Spo use (Ii wife, give maiden name) Kind of Work Kind of Buslnesa /Industry U.S rtned Forces? Elementary I Secondary (b12) College (1-4 or 5+) Widowed, ~~ ( Clerk po al ~ Yes ^ No 12 Divorced 16. Decedents Matiing Address (street, cny /town, slate, zip code) Decedent's pp, Did Decedent East PennsbOTO Adual Residen e 17a Slat 17 (Y d I D d t U ~ re 539 Magaro Rd. c . en c. es, ece ve n Twp s T o wrohip? Enola, PA ] 7025 17b. County Cumberland 17d. ^ cruel rnUtred wlthln ~ / Boro 18. Father's Name (First, midde, lest, su(fbc) 19. Mother's Name (Flrst, middle, maiden sumeme) somas Rakocv Mildred E. Scheuren 20a. InbrrtrenCs Name (Type / Pdnt) 20b. InformanYa MelMrg Addreee (Street, cky /town, state, zip code) David A. Rakocy 3 Grant Street Enola PA 17025 21 a. Method d Diepoeniort ~ Crematbn ^ Donation 21 b. Date of Dfepositiat (Month, day, year) 21 c. Place of Dispoenbn (Noma of cemetery, crematory a other place) 21 d. Lacetlort (City I town, state, zip cods) ^ Burial ^ Removal from State ^ Other - Sped/y: Was l:rematlon a Donator Autltorized by nladial Examirar 1 Corarterl Yes ^ No July 22, 201 1 Cumberland Crematory LLC Carlisle, PA 17013 22a Signature of Funeral Service Licerreee (a person acting as such 22b. Uoenee Number 22c. Name and Address of Fadlhy - ~ FD 012774-L Richardson F1m~eral Home Inc. 29 South ETlola Dr. Enola, PA 17025 Complete Ibrt>s 23ec orty when certlying 23a. T bast of my knowledge, death occurred et the tlme, dab and place stated. (Signature end title) 23b. Llcenee Number 23c. Date Signed (Month, day, year) pftysicbn is not available at tlme of death to oertily cause of death. name 24-28 moat be con>pbted by perecn 24. Time of Death 25. Date Pronounced Deed (Month, day, year) 28. Wee Case Rebored to Medcal Examiner / Cororrer to a Reason Other than Cremation a Donation? """~'~'~BBdB°"'~ A rx. 3:30 A.M~ Jul 19 2011 Q~Yea ^"° CAUSE OF DEATH (Ssr Inrtructlonr and exemplar) r Approzhnate Interval: Pert II: Enter otirer 28. Dkl Tobacco Use Cattrlbule to Death? hem 27. Part I: Enbr the dtel[t of evems - diseases, Inlurbs, a can>pticetlans -that directly cawed the death. DO NOT enter bnnlnal events such es csrdlac arrest, ~ Onset to Death but not resulting In the undedying cause given in Part L ^ Yes ^ Probably respiratory artest, a ventrkx>br flbdtletlat witltait showlr>g Ne etblogy. Usl only one cause on each tine. r r ^ Na ^ Unknown ~mt)de' a. Atherosclerotic Cardiovascular Disease ~ Hyperlipidemia 2s. IfFemeb: ^ Due to (a as a consequence of): ~ Not pregnant within past year ^ Pregnant at tlme of death ~ ~ti~ tl ~ri b. ~ ~ ~A~ a' Due to (or as a consequence oQ: ~ ~ ^ Not pregnant, but pregnant wkhln 42 days ~ k~av lit d~ealJtdS~ o~ _ ~ truants res Itlh of death g Due to (or as a consequence ot): r ^ Not pregnant, but pregnant 43 days to 1 year d. i before death ^ Unknown N pregnant withkt the past year 30e. Wes an Autopsy 30b. Were Autopsy Flndr>ga 31. Manner of Death 32e. Date of Injury (Month, day, year) 32b. Deecrlbe How Injury Ocarred 32c. Place of Injury: Fbrtre, Fenn, Street, Factory, Perfamed'I AvallaMe Prior to Campletlort ~ Mural ^ Homk~We 01flce Bulldk>g, etc. (Specity) of Cause of Deeth7 ^ Yes ~ No ^ Yes ^ No ^ Acadent ^ Pending Inveatlgetbn 32d. Time of Injury 32e. Injury at Work? 32f. M Trenepodatlon Injury (SpedtyJ 32g. Locefbn of Injury (Street, dry /town, state) ^ Suktide ^ Could Not be Determined ^ Yea ^ No ^ DrNer I Operetor ^ Passenger ^Pedestrbrt ~ M• Otlrer • Sperdly: 33e. Certifier (Grade sty are) 33b. Signature of Certlfier CaAllyhq physician (Physk;Iart cengying cruse G death when another physldan has prawunced death and completed hem 23) - To the I»st d my totowdsdys, daaBt occurtsd dos to the gase(s) and manner as statsd_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ Chief D e u t C o r o tie r • Pronourteing and artllying physiclart (Physidart bah prortocxxdng death and cxinlryddng ro cause of death) d t th ti d h d l d d t th ^ f k d d tl d d 33c. License Number 33d. Dab Slgtred (Month, day, year) t occurre a e me, o , an p ace, an ue To tlw bast o my nowb pe, ee o e ease(s) an manner d stta _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ rl.daN Etramkrer / Coroner On tM basis of etuunhtatbrt and I a Irnestlyrtlon, fn my opinbn, death oaunad et the time, deh. and ghee, and dos to the sup(s) and manner u sfaterL ,~ J u 1 19 2 011 34.N~rge end~i reae d P Completed Ceuee ofppetp (~ 27LType /Print e e uty Coroner Matthew ~. toner Preghtrar'ssigrtature ~ Number 35 Da { my y.a 38 , it ~~1 6375 B h R d S . ~ l ~I ~ I ~I ~ I ~ I - - - ~- . , } "f a- aOt ore u e ase oa , 1 0 0 _ l Mechanicsbur , Pa. 7 5 Dleposldon Pertnn No. ~~ (~, (~1 ~._~ ~+ ^ ~ C..T ~ LAST WILL AND TESTAMENT OF ~ ~ C '~ r7 ~.~,~ ~__ z `~'~ ~~ ~ ~:' . JOHN J. RAKOCY ~ ~ -F-~ ~~; -; _~ ~~: ~~ ~~ ~.. I, JOHN J. RAKOCY, of East Pennsboro Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking all former wills by me at any time heretofore made. ITEM I. I direct all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property shall be paid by my Executor out of the property passing under Item II of this Will, as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement of any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Executor, such taxes may be paid immediately, or the Executor may postpone the payment of taxes on future or remainder interests until the time possession thereof accrues to the beneficiaries. ITEM II. If at the time of my death, my son, Thomas M. Rakocy, is still residing in my household, he shall have the right to lease my residence for a period not ohn J. Ra Page 1 of 2 pages ~' To exceed six months at a monthly rental of five hundred ($500.00)dollars plus payment of all utilities associated with the property. All the rest, residue and remainder of my estate, of whatsoevel• nature and wheresoever situate at the time of my death, I give, devise and bequeath to my sons, Thomas M. Rakocy and David A. Rakocy, in equal shares. In the event either of my beneficiaries should predecease me, I give, devise and bequeath his share to his surviving children in equal shares, or if one, I give, devise and bequeath his share to my surviving beneficiary. ITEM III. I nominate, constitute and appoint my son, David A. Rakocy, as sole Executor of this, my Last Will and Testament. It is my desire that my Executor serve without bond. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, typewritten on one (1) other page, this ~ day of~(~~~ , 200 g. Witness: ~-~-_._, ~ .~ ohn J. Rak .~- Commonwealth of Pennsylvania County of Dauphin I, JOHN J. RAKOCY, 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 and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. Sworn o firmed to and acknowledged before me, by JOHN J. RAKOCY, the testator, this ~ day o~('~ ~U1~,r' , 2008 . ,. ~; ,~ . ., J n J. Rak ,...- I otary Public State of Pennsylvania County of Dauphin We, James H. Turner and Patricia A. Kreitzer, the witnesses, respectively, 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 testator sign and execute the instrument as his Last Will and Testament; that JOHN J. RAKOCY signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator was at that time eighteen or more years of age, of sound mind or under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by James H. Turner and Patricia A. Kreitzer, the witnesses, this )~'~ pie, ~lctary'~~blic Stacey A FoU luau ,E~.sn County Susquehanna ~'~v-~ , ~ - ~,~, ;?009 y cs~mn,e~>sion F ,n+~e: t it t,ti M __. .._..___:r~ j ',. _ y I +,t'. ~ StG1^ C' 7 ~ Y M,ln~•~' .?i!J!3i1L~`a~i41a ~ 1~ ''.. ~~ lll?'i11i1 r1 t 4~~ ?(`,'tlc~ MV C~rS11Si11S 1Q11 Fn ~1'r~`' ^ar,~}~14~~t....~ ».: Notary Public