HomeMy WebLinkAbout09-23-11PENNSYLVANIA
IN THE COURT OF COMMON REG SOTER OF WILLS ND COUNTY,
PETITION FOR PROBATE AND GRANT OF LETTERS jj j %1~
Estate of MARY ANN O'BRIEN ,Deceased ESTATE NO: 21- 1 ~~ 1 [.~
a/k/a:
tea' SS NO: 191-24-7275
a/k/a:
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
l7 A. Probate and Grant of Letters Testamentary or ^ Administration e.t.a., or d.b.n.c.l:.a. (complete Part C under
and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary
9/23/2010 and codicil(s) dated __ __
the last Will of the above-named Decedent, 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 adapted 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(8):
^ B. Grant of Letters of Administration
(-f applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate)
_L~
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USE ADDITIONAL SIIN:N.~t 5 tr rv~~.c~~r~n. -~-,
n
THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal reside~hce
At 15 Circle Drive Camp Hill East Pennsboro Township Cumberland County, Pennsylvania 17011 _
(Street address with Post Office and Zip Code, Mumcipahty. Township, E3oroubh, Cuy)
81 ears of a e, died 9/14/2011 at 15 Circle Drive, Camp Hill, Pennsylvania
Decedent, then Y g (Month, Day, Year of death) (City and Slate where death occurred)
Estimated value of decedent's property at death: All personal property $ 140,000.00
If domiciled in PA
If not domiciled in PA Personal property in Pennsylvania $
_If not domiciled in PA Personal property in County 120,000.00
-Value of Real Estate in Pennsylvania Total Estimated Value $ 260,000.00
Location of Real Estate in Pennsylvania: (Provide full address if possible.) 15 Circle Drive, Camp Hill, East Pennsboro Twp.
i.
Signature(s)
Name(s) & Mailing Address(es)
Peter ]. Ressler, 3401 N. Front St., Harrisburg, PA 17110-0950
_' i tl
Page I of 2
Interim Form Rw-02 revised I _'26.I0 by Cumberland County pending action by the Cow't
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 e.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
nrncPedinA wherein :?rounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(8), except as follows:-
;--~ _ ~_i
,. , __
OATH OF PERSONAL REPRESENTATIV cy -
~~~~
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Commonwealth of Pennsylvania SS ~; ; ~? c,~.:
County of Cumberland ~ ' '_ ~ `\
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The Petitioner(s) herein named swear or affirm thaPte htioneres and that as personal PepresentaQiv (s) of t}ie ` ,f ``~
correct to the best of the knowledge and belief of ( )
Decedent, Petitioner(s) will well and truly administer the estate according to law.
!'~ ;-.
Sworn to or affirmed and subscribed ,'-u~ ~ ~;~~~,~~ ~~
~ ~~d f
be re e this ~~
- _ ~~1
Ei~r the Register
DECREE OF PP
Estate of MARY ANN O'BRIEN
L~E'~.~
AND NOW, this day of _
the reverse side hereon, satisfactory p~
f Ad 'nistration
:OBATE AND GRANT OF LETTERS
,Deceased File Number: 21-_~_' V /
' 1?~l' ~ d ~ ~ , in consideration of the Petition on
a mg been presented before me, IT IS DECREED that Letters
are hereby granted to:
x Testamentary - o mi
Qf applicable, enter e.t.a., d.b.n., d.b.n.c.t.a., etc.) In
PETER J. RESSLER -
described in the petition be
the above estate and that instruments(s) dated 9/23/2010
admitted to probate and filed of record as the last Will and Codicil(s) of ecedent. ~
~~~ ~
~, j~^ ) C
Glenda Farner Strasbaugh,t ~ ,~
Register of Wills
FEES:
Letters .................... $
310.00
Will ........................
15.00
Codicil(s) .................
(a) Short Certificates 16.00
( )Renunciations.......
Bond ............................
Other .............................
.............. .
Automation FEE.........
5.00
JCS FEE ................... 23.50
TOTAL ................$ 369.50
Cianatt,re of Counsel Required to Enter Appearance
...b._~_~_ -
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~~
Atty's Signature o ~~,"\ '~ ~"~ ~'~"
PRINTED Name: PETER J. RESSLER
Supreme Court ID No.:. o6saa
Address: 3401 N. Front Street PO Box 5950
Harrisburg PA 17110-0950
Phone: 717-232-5000
Fax: 717-236-1816
interim Porm KW-OZ rerised 13.~6.I0 by Cumberland County pending action by the Court
Page 2 n f Z
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
H,ost43 REV tl2q(IG CERTIFICATE OF DEATH
TYPE I PRIPR IN
PERMANENT (See instructions and examples on reverse STATE FILE NUMBER
BVrCK INK 4. Dale M Deam (Month, day. Year)
z. sex 3. saai~ Security Norther 14 2011
,. Name of Decedent (Frst middle, last, samxl Fet[Iale 191 _ 24.7 275 9 / /
Ann ~ a Brlen 7. &nh lace C' antl state a tar ~ aum mo. Place d Deam Check and are OtMr
6. Age (Last Bxtnday) under 1 ear Urber 1 mo 6. Date of 8iM IMOnm, mo . ar S0utl1 W1PlAlaRLS}J0rt Hospaar.
Miwas ^ DOA ^ Nursing Home ~ Residence ^ Omer - Speciy'.
Monms Days Hoas ^ In Mnt ^ ER I OutpaOent
2 / 14 / 1930 ~ to. Race Ameacan Indian each, wnne. em
81 Yrs. sveet and number) 9. Was pecedent M Hispank Origin? ~] No ^ Ye5 (SpeahJl
Bc. City. Boro, Twp. of Deatn Bd. Facility Name (If rot mstitNion, give (H yes, seedy Gin, White
• W. Caxay of Deam Mervran, Puerto Rican. etc.)
a sI de cortpleled) 14. Martial Sktus Mam84 Never Marred. t6 Surmnng Spouse IIt wge, give maitlen name)
Clunberland East Pe~bOro 15 Circle Dr
Wdcw.e'd~Dworcetl (Spealyi
1t. Decedarrrs USUd Occu bon K'ud of work done Burin rtastdwo' tae. DO not slate reared t2. WS ~e~orces~ln~ ElemD emir ryrl SecondaryrlO-ceN 4College (1-4 or 5«1 wYUVYV~+
Kintl Of Work Klnd of Busiressllndustry
EC1llCatl0n ^ vas ~ No Did Decedent
Teacher Deaedern'a Pp Li.a in a nc. ~ van, Daoadem ~~~ad in East Penrisboro rwp.
t6. Dc edam's Maikng Address (Street, ny I tavn, state, Lp cotle) Actual Resbence t 7a. State TownshW?
,-,, ~,,,y„~~..1~ t id- ^ N~o,~ adento vetl wrtMn Cly I Born
15 Circle Dr. nD. ca,ny l,wuuc+
Hill PA 17011 ,q kbCaraNFlora ,mabenaa (i7navailable)
t8. Fathers Name (First middle, last sumxl
Ch2rles Crawley zoe. mmrmanre Madlrg Address (street asr 1 ~^^, ~~ :ip coda) PA 17110
zoo. mtananra Name (TYPe/Print) 3401 N. Front St. PO Box 5950 Harrisburg,
Peter J. Ressler eta Laaaon lciyllwm, state, tip coact
^Gemaaon ^Donatbn ztbDateaaw^~aonlMonm,dav.vearl zm.PlaceolDisposNOnlNameotcenaterv,cremaroryamMrp~e) HugheSVlllee PA 17737
z,a.nkmodofDxspoaiDon 9/20/2011 Pleasant Hill Cemetery
eaMl ^ Removal ban seta ~ was cramaaon a oonalian Authorimtl Inc
r erMedkalExaminmYCOronaR ^ vee^ No zza Name andAddrassaFackily Neill Funeral Herne,
^ Omer ~ ??D. License Number
ua. sgn d Funeral service Lxrensee I« person acting as such) ket St. Hill , PA 1701 1
- ~~ it/~ 12122 L 3401 Mar zx Date signed IMOnm, eery. yeah
a , 23b. License Number
Con'91ete sems 23a<onN wtan ceratyirg 23a. To me Mst of my knowledge, beam ocwnetl at me time. date and dace stated. (Signawre orb Idle)
physiaan s nw available al titre of deem m
cerMy cause of Deam 26. Was Case Refened ~o Madica~ E.amirer I Canner fa a Reasm Other man Gamatim a Donanon.
24. Time of Death 25. Date Pronouxed Dead IMmm, daV. Yrer) ^ Yes N
toms 2a-26 must M mmpated W Verson H• ~(,~ n M. 9 / 14 / 2011 ---• _-.,~
wM pramixrces Deem. / r Approamate interval: Pan II' Enkr other t a rrro t de th 28. Db Tobacco Use ContribMe to Deam?
CAUSE OF DEATH (See Instruetiona end exampka) in tM urbertying cause given m Pad 1 ^ Yes ^~Pyrobady
Onset b Death btR not resuakg ^ NO Lap Unkrwwn
Item 27. Pan I: Enter are Aa1n d events - diseases, mjunes, or comlNkat'lans -Mal 6remy wrsetl IM Beam. W NOT enter krminal events such as rabiac arrest
venmcular fbnllation wimaa stowing lee eadogy. List onN ore reuse m eatT line.
resgratory anent or 29. tl~ yFemale:
^ ~ LJ N01 Pregnant whin past year
IMMEDIATE CAl15E IFinal disease a ' T ^ Pregnant a1 fima d Beam
candtbn resulting m deem) _~
a Due to for ss a rmsequance oD. ^ Nd pregnant, but pregnant whin 42 tlays
of Beam
$$eepp~~~een list cabNars, d arty. p,
leadngg to ~e Cause anted on Gne a. pue to (or as a consequarrz of): ^ Not pegnant tM p29nant 0.3 davs to t year
Enbr Ito UNDERLYING CAUSE Mlare main
(dkvax or'mjury Cal initiated der
events resulting n deem) LAST. c Due to (or as a careequence off: ^ Unkrrown d pragnard within the pest Year
d r 32c. Place or Injury. Nome, Fann, Street, Factory,
32a. Date d Iryury (Monet, day, Year) 32b. DascnM How Injury Occurred Oftrz 9uiUing, etc. (SDealy)
• 30a. Was an AutapsY 30b. Ware ANOpsY FnM^9s 31~~. M~anrar of Deam
Pedametl7 Available Pita to Oompklwn CJ Nalurel ^ Hanitlde 32g. I oratim of InIaY ISVeet riy I town, stale)
of Cause d Deam? 32d. Time M Injury 32e. Irpury M Work? 321 It Transpodatbn Iny.xy (Speayy)
^ No ^ Axitlent ^ Panting lnvesigaaon ^ Yes ^ No ^ Grwerl Operate ^ Passenger ^ Pedestran
^ Yes ~NO ^ Yss
^ Suicide ^ Could Not ce Determirea M. ^ Omer -Speak'
33b. Sigret andTM Ot Cengier
33a. CeraMr IchBQ onN oriel main and comDbted Item 23) '--~ ~tl^ `~~ ~~
Certllying physician (PhYSitian cedgyin9 cause W deem when arotlar Physican has Taoa~ced _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33tl. Date S ed IMon day, year)
To1MbMdmY knowledge, deaM ottumetl due to lM Ceusa(s)entl manner tie stated---------------- 33c LKRnse Number r ^_
• Pronouneirg antl certirying Pnysicfen l~Ysiaan Oom prorwurring deem orb cenilykr9 to cause a deaM manner as stated' _ _ _ _ _ _ -' -"- --' '. "-
To tM heal of mY knawkdge, dmoth occurred at tM time, date, and Plsa, ant due to tM mousers) a
o • Medical EaamiMrl Cororer M Mce, end tlw to IM mou9e(e) and manner as staed_ ^ 31. Name and Atldress d Perstn Who Competed Cause of Death (Item 27) Type I Print
On tM bash of examinatbn and I or Investigation, in my opinion, death occurred at iM time, date, a P 7~-av- ~, ~ n Lr r }'11 ~
/; ~ f~~ 17nrr 3
w 3a Da Fled (M m, ear. marl ~ L V I,k.-` ~ ` ~ ~ S ~, k eii~ li / >
3s rev Di r Na ~ ,~y ~ j I ~. I ..~ I~ I ,$~; ~yj~j'y .I y •I ~ (u 5
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Disposition Permit No. ~--
~'iast ~iU attD TII
OF
MARY ANN C. O'BRIEN
I, MARY ANN C. O'BRIEN, of East Pennsboro Township, Cumberland
County, Pennsylvania, declare this to be my last Will, hereby revoking all prior wills
and codicils.
FIRST:
The expenses of my last illness and
funeral shall be paid from my estate.
SECOND:
I hereby give and bequeath in fee
simple all my property, real and personal, as follows:
(A) All of my jewelry shall be
divided in equal shares between STEPHANIE LYDEN B:ENTZ and
JACKIE LUMLEY.
(B) The watercolor painting
of Gray Run in Trout Run, Pennsylvania to DONNA WELSHANS if she
so desires the same; otherwise, to the Gray Run Club, Trout Run,
Pennsylvania in memory of Paul F. O'Brien.
(C) All the rest, residue and
remainder of my estate shall be liquidated to cash and paid to THE
HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA,
DEPARTMENT OF GYNECOLOGY/ONCOLOGY, Philadelphia,
Pennsylvania, for cancer research, in memory of ANN C;. O'BRIEN.
Page 1
l~F ~
THIRD: No provision of this Will is intended to
exercise any power of appointment, including any power of appointment.
FOURTH:
No interest of any beneficiary under
this Will or any codicil hereto shall be subject to anticipation or voluntary or
involuntary alienation, and the personal receipt of such beneficiary shall be the
sufficient and only discharge of my Executor unless otherwise provided herein.
FIFTH: All taxes, interest and penalties
thereon payable by reason of my death with respect to property comprising my gross
estate, whether or not passing under this Will, shall be paid from the principal of my
residuary estate.
SIXTH:
In addition to powers given them by
law, my Fiduciaries and their successors and any guardian acting hereunder shall
have the following discretionary powers applicable to all real and personal property
held by him, effective without court order and until actual distribution:
(a) To retain all property received by them including the stock of any
corporate fiduciary acting hereunder, provided such property remains productive;
(',~) To Seii real estate for any purpose, publicly or privately, for such
prices and on such terms as he deems proper, without liability on the purchasers to
see to application of the purchase moneys;
(c) To compromise controversies;
(d) To distribute in cash or kind or partly in each at valuations fixed
by them;
(e) To hold investments in the name of a nominee;
Page 2
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i ~~
(f~ To assume continuance of the status of any beneficiary with
reference to marriage, divorce, illness, incapacity or other change in the absence of
information deemed reliable without liability for disbursements made on such
assumption;
administration of my estate or trust created hereunder; and
(g) To make income or principal distributions during the course of
(h) To undertake ary and all acts deemed necessary and proper by it
for -the proper and advantageous management of any trust and the settlement of my
estate.
SEV_:
Any person who shall have died within
thirty (30) days of my death shall be deemed to have predeceased me.
EIGHTH:
RESSLER as Executor of this my Will
I appoint my closE~ friend, PETER J.
In the event the said PETER J. RESSLER
cannot act' or continue to act for any reason, I appoint an attorney from the law firm
of Mette, Evans & Woodside who practices in estate administration to act in his
place. No fiduciary acting hereunder shall be required to post bond or enter security
in any jurisdiction.
IN WITNESS V~'HEREC~F, I have here:~~nto set. my hand ant? seal this
~'~ ~~_ day of ~ _ , 2010, to this and the preceding two (2)
pages, and I have also placed my initials on each preceding page for better
identification and greater security.
.~ ~.fi
~,. Cy , SEAL)
y C.O'BRIEN
Page 3
SIGNED, SEALED, PUBLISHED and DECLARED by the above-named
Testatrix, MARY ANN C. O'BRIEN, as and for her Last Will and Testament, in the
presence of us, who at request, in her presence and in the presence of each other,
have hereunto subscribed our names as witnesses:
,.~
~ ~_ ~ _
Residing at ' c n ~~~ ~'` ~~
Residing at ~s ~ ~ ~~ C~ ,s ~' C"^ 4
!I~„lQ~c. 0 e /~-~ mss'
Page 4
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA SS.:
COUNTY OF '
I, MARY ANN C. O'BRIEN, Testatrix, whose namE~ is signed to the
attached or foregoing instrument, having been duly qualified according to law, do
hex•eby 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 expressed.
~~ ~ /
MARY N C. O'BRIEN
Sworn to and subscribed
before me this day
of , 2010.
Notary Public
My Commission Expires:
(SEAL)
Page 5
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA .
SS..
COUNTY OF ~~-~~~~`/'"~'~`'~``' '
,7
We,_~ `"i~'s/~ ,and />~~ ~~. l~`' ' ' ,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
Testatrix, MARY ANN C. O'BRIEN, sign and execute the instrument as her Last
Will and Testament, that Testatrix signed willingly and that she executed said Will 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 Testatrix was at that time eighteen (18) or more years of age, of
sound mind and under no constraint or undue influence.
Witness
fitness
;1:. fv Pc.~,, ..1. ,¢~11u.,~
Sworn to and subscribed
before me this day
of ~.L~Md.-~ _, 2010.
-~
Notary Public
My Commission Expires: d - ~~- -t ~
C.. (3~1NiUN4VEALTFi OF PENNSYLVANIA
1 NotarEal Seal
SEAL) ~ loan E. Brothers, Notary Public
Susquehanna Twp., Dauphin County
M Commission Expires Feb. 12, 2014
Member, Pennsvlvanla Assodation of Notaries
Page 6
ATTORNEY CERTIFICATE
COMMONWEALTH OF PENNSYLVANIA SS.:
COUNTY OF DAUPHIIVT
h-,,~,~~ ~ , 20 ,i c ,before me, a
On this, the ,~ 3,~ day of
notary public, the undersigned officer, personally appeared PETER J. RESSLER,
known to me or satisfactorily proven to be a member of the bar of the highest court of
Pennsylvania, Supreme Court ID No. 06844, and certified that he was personally
present when the foregoing acknowledgment and affidavit were signed by the
Testatrix, MARY ANN C. O'BRIEN, and Witness, h'1~y ~- (~. ~~~, ~
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
No ry Public
(SEAL) CON~MI)f~1~V°~ACfH ~JE='~~NiVSYLVANIA
Notarial Seai
Joan E. Brothers, Nntary Public
Susquehanna Twp., Dauphin County
M Commission Expires Feb. 12, 2014
Member, Pennsvlvanla AssoCiatlon of Notaries
Page 7
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