Loading...
HomeMy WebLinkAbout09-22-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENN REGISTER OF WILLS SYLVANIA PETITION FOR PROBATE AND GRANT OF LETTERS Estate of--~~l~r~L~~~ ~ ~y~/f~~i27`" a/k/a: ,Deceased ESTATE NO: 21- a/k/a: a/k/a: Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AN a plicable: . Probate and Grant of Letters Testamentary or ^Administration c.t.a., or ci.b.n.c.t.a, ~ D "C" as nd aver that Petitioner(s) is/are entitled to the aforementioned Letters ~'~ the last Will of the above-named Decedent, dated ~_ (°mPlete Part Calso) e Gl rC L 1 ~2ao~ and cociicil(s) date under (State relevant circumstances, e.g, renunciation, death ofexecutor, etc.) Except as follows, Decedent did not many, was not divorced, and did not have a child born or adopted after execution instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person and party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as def ne ' 23 Pa. C.S.A. § 3323(g): was not a dm ^ B. Grant of Letters of Administration (Ifapplicable, 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 w;ts 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 com let ' heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a endin proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(g~ except as followsf _ P g divorce Name Address `"O "" '~' ~ ' ~ -_~ fir, USE ADDITIONAL, SHEETS IF NECESSARY ~7 THIS SECTION MUST BE COMPLETED: iv ~ ~ ~~ <..-; Decedent was d_i2rrticiled at death in F~ At 3 Z ~ Cv ~ ~berland oun~y, Penn~lvani with his/her last farm] or ~ CL ~ =5 3i Y p Ilcipal residence. (Street address with ost Office and Zip Code, Munici li ~~~~ ~C 5~`/--~ ,~ ~y_,~ ~ 7~.5 _ ~ n pa ty: Township, Borough City) ----_ Decedent, then~f3~~-' years of age, died ~ - j ~ _ ~ 1 ~ at ~5~1/,/~'j . //,~ Estimated value of decedent's roe (Month, Day, Year of death) ~ ' p p rty at death: (City and State where at occurred) If domiciled in PA _If not domiciled in PA Al] personal property .~~'o _If not domiciled in PA Personal property in Pennsylvania $ - 7 ~~~~~ _Value of Real Estate in Pennsylvania Personal property in County $ $ ----~_ Total Estimated Value $ Location of Real Estate in Pennsylvania: (Provide full address if $ ~ `T- possible.) ignature(s) _ Name(s) & Mailing Address(es) J ~L~ ~ ~ ~ r Interim Form RW-02 revised 12.26.10 by Cumberland Cowl / L LZ... ~ 1 /~ / ,r~ ty pending action by the Court ~'v ~G ' ` /" ~/ '~~/~ Page I of 2 OCAL REGISTRAR' ~ l1 '~~ ~ S CERTII=iCAT10N O~ DEATH WARNING: It is illegal to duplicate this copy by photosf~lt of photogr,~ph Fee tin this certificate. `~ft.U(i Certifiratl at,~ hum}:3er /'' NTH OF sl~ ~ a - ~ ~ PF ~ , ~ _ ~p ~~ ,y A~i/' ~ ~, ;~ ~ r , ~, ~ ~: :r #'` x;i \~q9j ~P1?~ ~ , ~:-,Mf NT aE ~ .I.,. I'hiti r. ,,, _~I `~1;1? 1~IC IllfOhllIllCl(111 hell' °_f V'e 11 ctln~eu:k i„1,ic i jn~nl;ll~,~ii~rinal C~crtihc,tte f~f~(le~ tlul~~ (j ,~tl °~ i 1, j))~~ ,l, I.f,caY Re~~i.(rar-. l~he ul)~ii ccrlifi, r ~ h; f~1r~c,tr~lcd lu the ,Stifle' Vil Re~cnri ),~~it,. ~,,;~ ~~+,~(ntancnt J~ilin~. °~~~. ,/~ D`~ EP 2 0 11 ---- __ --- =---- I.uc,_II K f.;,i..l,- -- --- __ _-- [) rlL 1,>u ELI ~_ -:z~ --.. C7 --_ ,_, ~.r-, ~7 " . - _L ~ 1 _ ,.r __ .~- r` =° m r~.:j D -; ci, ~ -`U 3 REV t,rmos - ,~ r.~-) L~ ---,• - -- ! PRIM IN r ~_ -,~_ ~ iMANEN7 COMMONWEALTH OF PENNSYLVANIA . ~~?_~ ACN INK DEPARTMENT OF HEALTH .VITAL RECORDS ~ ~~{ T''n• :..._ ;=r~r CERTIFICATE OF DEATH '~ c • % L~ 1 Name or Decedent (First, midme, feet sarrix) (See Instructions and examples on reverse) '~' Isabelle Florence ~- Omme rt 2, Sex STATE FILE NUMBER 5. Age (Last Birthday) Under 1 3. Sacrel Secunry Number a` unmr 1 6. Date of Berth Monet da , a Fema 1 e 19 5 4. ° a ~ (Norm, ley, year) 8 7 Maglhs Deye Hpara kkmrtea ~. ei laps era orate Pr roe copn - 16 -- 3 9 61 Yrs. fie. Place of DaeM Check on one ~/ Bb. Coumya Deam 10-5-1923 illersburg "oapilee Sc. Ciry, Boro, Twp. a Deem r Pa . r~~ Other: Bd. Facllly Name (If not msdMbq ~d7npatianl ^ ER / Ou¢atienl ^ IbA Dd u h l n gve strew and number) ^ Nursing Home ^ gesidence Ha r r i s bu r 9 Wes Deretlenl of HlsFanic Ongin'+ ^ Other -Specify; r r. Decedents u~,,1,~alodyt WoLrikon Kind or work dare ludo ,opal a 5 Harrisburg HO S p 1 t a 1 (Ir Yes, sv~Y a6an, ~ ~ ~ .vas to. Rare: American lnryan, Black. whoa, em. COO e C a C e n IHe. Do rpt state retiretl 12. Was Mexican, Puerto Rican, etc.) (Specify) Kind of Business/Intlust Decetlenl ever In me 13. Decedent's Education (Speciy only highest reae ry U.S. Armed Forces? g compbted) 14, MerXel Status: Memel Wh 1 t e ' Element! /2Secnndary (B-r2 Never Married, 15. Surviwn S re. OecederMS Mailing Address Istreet clry/town. state, vp code) ^ vas ®No ) calege (1-a or s.) Wkkaved, Divorcetl Isperyfy) g Posse pf wire. gwe maiden name) 325 Wesle Decedents Widowed Y Drive Aaual Residence , 7a. state P e n n a . Did Decedem Mechanicsbur Pa. 17055 ,m. c~,ny Llvema 18. FameYS Name (First, middle, tst, suffix) Cumber 1 a n d TPwnaMp? "`~cYeS. Decedent LiYed in Lower A 1 ~ P n Harr rid. ~ No, Deceaem uYad wimin Two. Hoverter r9. MomeYS Name (First, mitlNe, maiden sumamel Aauel Umds of 20a. Inlormanps Name (Type / Prim) Ciry/Boro James Keys Florence E. 21a. Methotl of DisposiXOn 20b. laonnent's MeiXng Address (Street pity /town, stele, zip cotlai Barrel ~ Removal hom State i ~ Cremation ~ Donation 21b. Dale of D" Y Year 21C 3 D e v e n s h i r e S u a r e ® Omer . Wea Cremation or yunxrn:ed ,sposilpn (Monet, de , ) Ptre m M e c h a n i c s bu r E t o e d l br Medkel Exa ~n (Name a cemetery, premamry pr peter uada Pa . 17 0 5 0 mreaF ^Yes^No -20- • ~~ S~ 2 011 ) 27d. Location (Ciry/town, state, zip cede) ~ (a Person acting ass o11in Green 22h. License Number C e m ~ C a m 22c. Name arM Adtlress of Fecrllry [~ H i l 1 r Pa . 17 O l 1 items 23a.c Dory when rertityin9 23a. o 1 ,; 3 4 bier u net avaNahle at sine of deem to ~' or my kranv , deem occurred et me time, date eM F n H m N • 2nd S t r e e t cerXA' cause or deem. Weca slated. (Signature and title) n 236. License Number Items 24-2fi must he comiNetetl by person 24. Time of Deem 23c. Date Signed (Month, da woo pronounces deem. q 25. Date P Y year) "' 'road d (MmM, ay, Year) Y / M' ~'7r Q/ 26. Was Ceee Relened to Matlical Examiner /Coroner for a Reason Omer Than Cramefion or Donation? Item 27 Pan I. Enter me CAUSE OF DEATH (See Instruetlons en axe plea) ~ / ~~ Gt n of v tits -diseases, injures, a rompliceXOris -that di ^ Yes Dry arrest, or vemncuWr fibrillation wimoW showing ma elblogy. List only one cease on each Ilne. r•spret n~Y ceased me deem. DO NOT enter terminal events surh as ca~ac arrest, I Approx,met interval: Pan II; Enter Omer Nmlfl~°tm IIIMEDUTE CAUSE !Final disease or Onset tp Deem but not resWXng In me urde Inm ceu 2S. Did Toby cerMXion resuldrg in deem) / `~(~ ` ~ ~ g cce Use Contribute to Death? -~ a. : 5 ,~ given in Part L ~ ye ~ Probably tlalN Irst Due to (r as a con uenca ~ i l~ No ^ Unknown the contlisons, X any, G/ P, Emer b °~ luletl °n hoe a. b. `I'~.pS ~ S , -~---- -~~- 29 It Female: UNDEgLYIND CAUSE Due to (or as a conseq ence oq ~ ~'------- n~ (dsease or xyury that mmeted the , of pregnant wimin past year ~ events resuPong m deem) LAST. c , ----.~_ -'---- ~__ ~ Pregnant at time of tleam '~ Due to (or as a consequence °~: ~'~---- r ^ Nol pregnant but pregnant wimin 42 tlays ° i ~'~ -~,~ of death 30a. Was an AWOpsy 306. Were Aut , -'~- ^ Nol pmgnanl, bW -^ Pedomgd7 nPsY Findings 31. Manner of Deam , ~_ Pregnant 43 days to 1 year ~ Available Prpr to Cortpletbn ,~--,~ ~~ 32e. bete of Injury (Month, ley, year) 326. Deecnbe How In u --- before death of Cause pl peam? ~ANatural ^ Homicide 1 7Occurted --- ^ Unknown if pregnant within the pest year Yes ~ ^ Ves ^ No ~ Accitlent 32c. Place of Injury: Home, Fann, Sheet, Factory, ^ Pending Investlgadan 32d. Time of Irqury 32e. Injury al Work? Office Building, etc. /SpaciyJ ^ Suicitle ^ Coultl Not be Determined ~~ tt Trensportalion Injury (Spemfyl 33a. Certifier (check Doty one) M. ^ Yes ~] No ^ Dover/ Operetor [] Passe 32g. Localbn of injury (Street city /town, state) Other ~ Speciy: n9ar ~ Petlesman • To Ne Itxst of my knowlad~n ~~g ce~ of deem when s'ome' Physician has pronouncetl deem end competetl Item 23) 6 g ge, death Dawned due to Me cause(s) end manner roe a i nature and Title of CertXler Pronwncing and cenllying physlctn (Physician bom pronounang death and ce ' fated To the beat of my knowledge, deem Detained tl the d reMng to cause of deem) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - /'t ' X4edkal Examiner/Coroner men data. and Place, antl due to the ease(s) and manner as efatad_ _ _ _ _ _ _ - _ 33c. License Number 7~~-(/ "Y / at Signed (Month, day, year On the beau of exemina6on end / or Inveatlgetlon, in my oplnbn, death occurred al the time, data, arM plea, and due to me cause(s) and manner roe stated. ~ ~ ~--~- - ' 35. Regisbars Signature and DLStnct Number ~ ~ a/f ~ I ~~me ~{AQdrass or.P$reon Who ppp~~~ ~~e I /y~~ / ~~~ QQQ FFFppp r IY~ ~~ ~ m em 27) tit Diapasmon Permk Np. 0 6 5 0 8 5 2 ~' OATH OF PERSONAL ~pRESENTATIVE Commonwealth of Pennsylvania County of Cumberland SS =-= o ---: :~~ ~. ~~ ~`,~ . r-- -' ~ r`,, The Petitioner(s) herein named swear or affirm that the statements in the fore oin • ~ ~ r 4 correct to the best of the knowledge and belief of Petitioner(s) and that, as personal re l Decedent, Petitioner(s) will well and truly administer t g g Petlta;°ri a're true and p~~antativ~(~) ofrthc s~, he estate according to law. _ c, Sworn to or affirmed and subscribed `~ ~~ me this da of For the RPgistei~- DECREE OF PROBATE AND GRANT OF LETTERS Estate of ~_~;~ t' ~ I C }_ Urn ~~ )Ni ~` ,Deceased File Number: 21-•=_ ~~?~] AND NOW, this ~ day of the reverse side hereo ~ r n, satisfactory proof ha ing been presented before me, IT IS DECREED that Letters n Testamentary _ of Administration ---~ are 1!~ereb (If'applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) Y granted to: s~ ~ the above estate and that instruments(s) dated admitted to probate and filed of record as the last Will and Codicil(s) of Decedent ribed in the e+1~+; p ~ .tor. be Letters .................... Will .............. $ ,3 Ut? ......... Co icil(s)......... . ( ~) Short Certificates ( )Renunciations..... Bond ................ .. ............. Other ............................ . ......................... Automation FEE....... .. JCS FEE . 5.00 ................ 23.50 TOTAL ................ $ '1 Glenda Farner Strasbaugh, Register of Wills m Signature of Counsel Required to Enter Appearance Atty's Signature- 7 ~~ ~ L PRINTED Narri, Supreme Court ID No.: '~ Address Phone: Fax: hiterim Form RW-02 revised ] 2. `- 26.10 by Cumberland County pending action by the Com-t ~~ 2 ~ 3~~"~~ ~ -~~~~ ... G-~y-- Page 2 of 2 n __ _ - -r, JJ1 __ LAST WILL AND TESTAMENT ~ T?~-n ~•.~r -- ISABELLE F. OMMERT I, ISABELLE F. OMMERT, of Cumberland Coun ,Penns I „ ~r be my Last Will, hereby revoking all prior wills and codicils. ylvania, declare this to FUNERAL EXPENSES FIRST: I direct the payment of my funeral expenses, including my gravemarker as soon as may be convenient after my death. PAYMENT OF DEATH TAXES SECOND: I direct that all taxes that may be assessed in consequence of m death of whatever nature and by whatever jurisdiction imposed, shall be paid from m resid Y uary~ estate as a part of the expense of administration of my estate. PERSONAL PROPERTY THIRD; I bequeath those items of my household furnishings, personal effects and personal property as I may set forth in a separate signed memorandum to the ersons named in that memorandum. p DISTRIBUTION OF RESIDUE FOURTH: I give the entire residue of my estate to JAMES A. KEYS and PAUL R. KEYS, JR., equally, providing they shall survive me for a period of thirty 30 da s. JAMES A. KEYS shall not survive me for a period of thi ~ ~ Y If be distributed to his spouse. If JAMES A. KEYS has no spous0e) then his share shall shall distributed to his issue, per stirpes. If PAUL R. KEYS, JR., shall not survive me fora e period of thirty (30) days, then his share shall be distributed to his spouse. If PAUL R. KEYS, JR., has no spouse, then his share shall be distributed to his issue, per sti es. rp PROTECTION OF BENEFICIARIES (Spendthrift Provision) FIFTH: No interest in income or principal shall be assignable by a beneficia or available to anyone having a claim against a beneficiary before actual payment to the beneficiary. TRUSTEE OF ESTATE OF MINORS AND INCAPACITATED BENEFICIARIES SIXTH: If any income or principal shall be payable to amy person who shall be a minor I appoint their executor, as trustee to hold such income and principal durin minority and shall be entitled to apply such income and principal to the health, g maintenance, support and education of such person during minority without the appointment of any committee or any authority of court. My trustee shall be entitled to make direct application hereunder or to make application b principal to the parent or other person in charge of such minor orrto his or hermuardian to a custodian under the Uniform Transfers to Minors Act. Trustee may, in dischar e of r all the Trustee's duties, pay any minor's share deemed impractical of administrationg parent or other person in charge of the minor or to his or her guardian or to a custodianthe for the minor under the Uniform Transfers to Minors Act. Any rennaining income an principal to which such person shall be entitled shall be distributed to such person u o such person reaching the age of 21. My Trustee shall have the same powers as m p n executor and shall serve without bond. y If any income or principal shall be payable to any person who shall be incapacitated for any reason, my executor, as trustee shall hold suchh income and ri during incapacity and shall be entitled to apply such income and principal to the heal cipal maintenance, support and education of such person during incapacity without t th, appointment of any committee or any authority of court. My TrusteE; shall hav the sam powers as my executor and shall serve without bond. e POWERS OF EXECUTOR SEVENTH: I confer upon my executor the right to sell or otherwise convert an real or personal property at public or private sale, at such time or times, in such mannery and for such price or prices, and upon such terms and conditions as my executor shall determine, and to execute and deliver good and sufficient conveyances, assi nment g sand transfers thereof, without liability of any purchaser for the application of an consideration; to borrow money and to secure its payment by mortgage of real or ers property, pledge of investments or otherwise, without liability on the part of the lende s to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, without restriction to so-called "legal investments;" to make distribution in cash or in kind; and to do all other acts and things necessa or a in the management, administration and distribution of my estate. ~ Ppropriate APPOINTMENT OF EXECUTOR EIGHTH: I appoint JAMES A. KEYS as executor of my will. If JAMES A. KEYS is unable or unwilling to qualify as executor or having qualified is unable unwilling to act, I then appoint PAUL R. KEYS, JR., as executor hereof. I direct tha executor shall not be required to furnish securi man t my h' ~ y jurisdiction. INTERCHANGEABILITY OF LANGUAGE NINTH: Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to i the feminine and neuter; the feminine may be read to include the rr~asculine and n nclude and the neuter may be read to include the masculine and feminine. euter; HEADINGS TENTH: The headings used on the various paragraphs of this will are included for convenience only and shall have no legal significance. I have signed this Will on March 13, 2008. ti~ .' 'i ,~ ~^ c~ ISABELLE F. OMIVIERT yy-~~ ~ . , ~Y~ ) ness ~ ~~ ~ ° • acL-"~, ~~ Witness ACKNOWLEDGEMENT and AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SS. ~ ~ I, ISABEiL j ~F. OMIv1ERT,an e testatrix/or in, and ,~ ~ , witnesses to the last ll,~the attache d~~~-~ ~~ ~ J ~"~ the d or foregoing instrument, who have signed the instrument, having been duly qualified according to law do depose and say: (a) that I, the testatrix/or, do hereby acknowledge that I signed and executed the instrument as my last will, that I signed it willingly anti as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix/or sign and execute the instrument as her last will, that she signed it willingly and 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/or signed the will as a witness and that to the best of our knowledge the testatrix/or was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ISABELLE F. OMMER'T ~, ~ , i , ~~~ ~~ .~ ~~~ ~_ f s Witness ~ -- i w ~~--_ Witness- .... 1 ; ._ _. C~ c~~°~~u~otJwEALT~ ~ „- ~~=wry: ~. NOTARLAL SLAB ~.,, T Aaron C. Jackson, Notary E'~:~d~, 1`~t~ii 1 Opper Allen Township, Cumberlanu Count; _- ' A4y commission ex tires May Q'', nP