HomeMy WebLinkAbout09-29-11IN RE:
ESTATE OF ROMAYNE F. BRETZ,
DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
NO. 2011- I D~. (o ^.~
__
ORPHAN'S COURT DIVISIfl '
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PETITION FOR SETTLEMENT OF SMALL ESTATE ~ -~ `~'
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To the Honorable Judge of said Court:
The Petition of Charles Lee Bretz and Linda Marie Crum respectfully requests:
1. Your Petitioners are Charles Lee Bretz and Linda Marie Crum, who were
appointed the Co-Executors of the Estate of Romayne F. Bretz, deceased.
2. Romayne F. Bretz died on April 15, 2011, and at the time of death the Decedent's
last principal residence was 801 North Hanover Street, Carlisle, Cumberland County,
Pennsylvania. H dea-+h Ce~--h-~'~ ~~-i"C i S ca~l~~l'lec~
3. The above-named Decedent died testate and Letters Testamentary have not been
issued. Decedent's Last Will and Testament is attached hereto and incorporated by
reference herein as Exhibit A.
4. The names, addresses and relationships of all persons having an interest in the
estate of the Decedent as beneficiaries are as follows:
a. Charles Lee Bretz
b. Linda Marie Crum
c. Kathy Bretz
401 Heisers Lane Child
Carlisle, PA 17015
105 Woodlawn Lane Child
Carlisle, PA 17015
221 N.E. 19t" Avenue Child
Ocala, FL 34470
~~
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5. The total value of the Decedent's personal estate is less than $10,000 and consists
of the following assets which have the following values:
a. Checking account at Members 1St FCU $ 310.52
b. Savings account at Members 1St FCU $ 5.15
c. Second checking acct at Members 1St FCU $ 1,720.00
d. Second savings acct at Members 1St FCU $ 5.00
Total Assets $ 2,040.67
7. The following is a list of paid expenses and the amount of their claims:
a. Hoffman-Roth Funeral Home, Inc. $ 247.94
b. Carlisle Brethren In Christ Church $ 262.50
Funeral Service and Reception
c. Church of God Home, Inc. $ 15.26
d. Law Office Of Andrew H. Shaw, P.C. $ 500.00
Attorney Fees (actual and estimated)
e. Filing fees $ 58.50
8. The following is a list of unpaid creditors and the amount of their claims, which
claims are proposed to be paid from the assets of the Decedent:
a. Department of Public Welfare (Class 3) $ 20,129.52
b. Department of Public Welfare (Class 6) $ 71,369.07
c. Carlisle Memorial Service $ 1,298.50
Grave marker
d. Howard's Accounting $ 100.00
Final income tax return preparation
9. It is proposed that the following distribution of the Decedent's remaining estate be
made to the following creditors, heirs, or next of kin:
2
a. Howard's Accounting $ 100.00
b. Carlisle Memorial Service $ 856.47
c. Department of Public Welfare (Class 3) $ 0.00
d. Department of Public Welfare (Class 6) $ 0.00
10. Because the total gross assets of the Decedent's estate are less than $2,400.00, the
Department of Public Welfare is not seeking repayment. A copy of the release letter
from the Department is attached hereto as Exhibit B.
WHEREFORE, Petitioner requests your Honorable Court to decree the
distribution of the Decedent's remaining personal estate to the persons entitled thereto as
set forth in Paragraph 9 above.
Respectfully submi
~~ ~~
Date: ". By:
Andrew H. Shaw, Esquire
Sup. Ct. ID No. 87371
200 S. Spring Garden St., Suite 11
Carlisle, PA 17013
(717)243-7135
Attorney for Petitioner/Estate
3
VERIFICATION
I verify that the statements made in this Petition are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to
unsworn falsification to authorities.
Date: ~-o~~ `//
~QQ ~
Charles Lee Bretz, Execut r
of the Estate of Romayne F. Bretz
LAST WILL AND TESTAMENT
OF
ROMAYNE F. BRETZ
I, ROMAYNE F. BRETZ, Social Security Number 178-16-6247, of the
State of Pennsylvania, declare that this is my LAST WILL AND TESTAMENT
and I revoke all other wills and codicils previously made by me.
FIRST: I appoint my children, CHARLES LEE BRETZ and LINDA MARIE
CRUM as my Personal Representative concerning this Will.
a. I request that my Personal Representative be permitted to
serve without bond or surety thereon and without the intervention of
any court, except as required by law. I direct that my Personal
Representative act in unsupervised administration so as to administer
my estate with a minimum of court supervision. If it becomes necessary
to have ancillary administration of my estate in any jurisdiction where
my Personal Representative is unable or does not desire to qualify as
ancillary legal representative, I appoint as such ancillary legal
representative such individual or corporation as my Personal
Representative shall designate, in writing.
b. I direct my Personal Representative to pay the expenses
of my last illness, the expenses of a funeral appropriate to my station
in life and custom of living (including a suitable monument or marker
for my grave), and written charitable pledges which I have made. I
grant my Personal Representative the power to extend or renew any debt
for such time as my Personal Representative shall. deem appropriate.
c. All estate, inheritance, succession and other death taxes
with respect to all property passing under this my Will shall be paid
from and borne by the principal of my residuary estate, without regard
to reimbursement, as if such taxes were administration expenses. My
Personal Representative may pay such taxes at any time deemed
advisable, whether or not then due and payable.
d. My Personal Representative is requested to settle my
estate as soon after my death as may be practicable, and to pay or
deliver every legacy or bequest to my beneficiaries without waiting any
time that may be believed to be customary in probate matters.
PAGE 1 _~~~~ ~'~'/
'' ~•~..~ ~ OF 4 PAGES ~~~ ~`
e. I may leave a letter of intent with the executed copy of
this Will for the purpose of giving guidance to my Personal
Representative concerning the distribution or sale of certain items of
my property. I request, but do not require, that my Personal
Representative honor my wishes therein expressed.
SECOND: I give, devise and bequeath, absolutely and forever, all
of my estate and property of which I may be seized or possessed, or to
which I may be entitled, at the time of my death, wherever situated or
of whatever nature, be it real, personal, or mixed, to my children,
CHARLES LEE BRETZ, LINDA MARIE CRUM and KATHY EILEEN ULSH and to any
child or children that have been or may be born to or adopted by me, in
shares of substantially equal value to be divided as they may agree.
a. If any of my children shall not survive me, then the
share of that deceased child shall go to the descendants of that child,
who are to take per stirpes and not per capita. If any of my children
shall not survive me and shall not be survived by any descendants, then
the share of that deceased child shall be distributed to my surviving
children and the descendants of any of my other children who fail to
survive me, in the manner set forth above.
b. If they are unable to agree, the division among my
children and the descendants of any of my children who fail to survive
me shall be made by my Personal Representative, in that person's sole
and absolute discretion. I empower my Personal Representative to sell
any or all of such property, if such property is not distributed in
kind hereunder, and to distribute the proceeds among my said children
in substantially equal shares. Any determination of my Personal
Representative as to what should pass or be sold under this paragraph
and to whom it should pass or be delivered or at what price it should
be sold shall be conclusive.
THIRD: Except as otherwise provided in this Will, I have
intentionally failed to provide for any other relatives or other
persons, whether claiming to be an heir of mine or not. Insofar as I
have failed to provide in this Will for any of my issue now living or
later born or adopted, such failure is intentional and not occasioned
by accident or mistake.
FOURTH: Any beneficiary who fails to survive until one hundred
twenty (120) hours after my death shall be deemed to have predeceased
me, and the gift to that beneficiary shall be disposed of accordingly.
PAGE 2
~~ ~~~ .~ ~~" OF 4 PAGES ~ ~ ~Z~
FIFTH: Definitions:
a. The term "children" as used in this Will includes adopted
and afterborn persons. The term "children" as used in this Will shall
not include step-children, the natural born or adopted children of a
person's spouse who are not the natural born or adopted children of the
person. A relationship by or through legal adoption shall be treated
the same as a relationship by or through blood for purpose of
succession to property under this Will.
b. The term "descendants" as used in this Will means the
immediate and remote lawful, lineal descendants by blood or adoption of
the person referred to who are in being at the time they must be
ascertained in order to give effect to the reference to them.
c. The term "Personal Representative" as used in this Will
means Executor, Executrix, Independent Executor, or any other title of
like import which is used to describe such a fiduciary.
d. The term "per stirpes" as used in this Will means that
whenever a distribution is to be made to the descendants of any person,
the property to be distributed shall be divided into as many shares as
there are (1) living children of the person, and (2) deceased children,
who left descendants who are then living, of the person. Each living
child (if any) shall take one share and the share of each deceased
child shall be divided among his then living descendants in the same
manner.
SIXTH: In addition to any powers granted by the laws of the state
in which this Will is probated, I hereby authorize and empower the
fiduciaries named in this Will, to the extent of the discretion herein
granted, to sell, exchange, convey, transfer, assign, mortgage, pledge,
lease or rent the whole or any part of my real or personal estate, to
invest, reinvest, or retain investments of my estate, to perform all
acts and to execute all documents which my fiduciaries may deem
necessary or proper in regard to my property. If any of my fiduciaries
elect to receive compensation for services, such compensation will be
that allowed by law.
SEVENTH: If any part of this Will shall be invalid, illegal, or
inoperative for any reason, it is my intention that the remaining
parts, so far as possible and reasonable, shall be effective and fully
operative. My Personal Representative may seek and obtain court
instructions for the purpose of carrying out as nearly as may be
possible the intention of this Will as shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
PAGE 3
~~o~,-~.~-,,,,.. ~ OF 4 PAGES ~.
IN WITNESS WHEREOF, I
!:~~
~~ - day of ~~~~A,~~
this my LAST WILL AND T
each page bearing my ha
This document was
section 1044, and impleme
by Robert P. Formichelli,
of New York.
~~~•--- ~ _ ~ ~ ( SEAL )
ROMAYNE BRETZ
The foregoing instrument was, at Carlisle Barracks, Pennsylvania,
this ~_ day of ~?~~~ ~ , 19~, signed, sealed, published
and declared by ROMAYNE F. B Z, the testatrix, to be her LAST WILL
AND TESTAMENT in the presence f all of us at one time, and at the same
time we, at her request and in her presence and in the presence of each
other, have hereunto subscribed our names as attesting witnesses, and
we do so verily believe that the said testatrix is of sound and
disposing mind and memory at the date hereof.
have at CC~~arlisle Barracks, Pennsylvania, this
19/(C , set my hand and seal to
rAMENT, consisting of 4 typewritten pages,
written signature.
prepared under the authority of 10 U.S.C.
nting military regulations and instructions,
who is licensed to practice law in the State
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COMMONWEALTH OF PENNSYLVANIA
CUMBERLAND COUNTY
ACKNOWLEDGMENT
I, ROMAYNE F. BRETZ, testatrix, 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; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
~~-,-, ~_,~,e ,~• ~a ~ ( SEAL )
ROMAYNE BRETZ
AFFIDAVIT
We, ,/~~~=~ f~/~~r/~IiC, ~G~~ ~ ~~.`; ~ V~ ~ 1 ~ t" , and
tS ~E ~ ~E~~ ~ ~= the witnesses _ si an n„r namac i-n tt,; ~
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 the testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testatrix signed the will as a witness; and that to the best of our
knowledge the testatrix was at that time 18 or more years of age, of
sound mind and u der no constraint or undue influence.
` ~ .=cam ,,~' ~, ~u
Witness Witness Witness
Subscribed, sworn to and acknowledged before me by ROMAYNE F.
BRETZ, the testatrix, and
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subscribed and sworn to before me by
~~( yL vtu r L 1 ~ , and
.the witnesses, this ~~ - day of
Y FSLIC /I My Commission Expires:
Notarial Seal
Kim C. Guyer, Notary Publ(o
Carlisle eoro, Cumberland Cou~
My Commission Expires Nov. 10,1 97 I
n K am~r, ennsyMania /assodahon of Note
~~ Pennsylvania
~.
DEPARTMENT 4F PUBLIC WELFARE
September 21, 2011
LAW OFFICE OF ANDREW H SHAW
ANDREW H SHAW, ESQUIRE
200 S SPRING GARDEN ST
SUITE 11
CARLISLE PA 17013
Re: Romayne Bretz
CIS #: 110205359
SSN: ###-##-6247
Date of Death: 04/15/2011
Dear Mr. Shaw:
Pursuant to your correspondence dated August 26, 2011, regarding the
above-referenced estate, the Department recognizes the estate to be insolvent. Please
notify us of any change in circumstances which may affect the insolvency of the estate.
Thank you for your cooperation in this matter. If you have any questions, please
contact me.
Sincerely,
Tina M. Wise
TPL Program Investigator
717-214-1204
717-772-6553 FAX
Bureau of Program Integrity ~ Division of Third Party Liability ~ Recovery Section
PO Box 8486 ~ Harrisburg, Pennsylvania 17105-8486
h. - ~, .r
LOCAL REGISTRAR'S CERTII=ICATIOlV OF C~EATFI
WARNING: It is illegal to duplicate this copy by photostat or photoyr~iah.
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
1. Name of Decedent (Fret, midrib, last, wmx)
Romagna F. Bretz 2 Sex
Female 3 Social Secudy Number 4. Data of DeaU (Monet, day, year)
178 -16 - 6247 Aril 15, 2011
5. Age (Last &mbay) Under 1 err UMer 1 der 6. Dale of Birth Month, der , ) 7. Btrm lace and state or fa ' coon fie. Place al Death Check on aw
89 "'°""w °a" "°"' """NB6 Nov. 7~ 1921 Harrington, DE Hospdal: timer
YrS. ^ Inpalienl ^ ER / Outpetlent ^ DOA Nursiig Home ^ Residence ^ Omer ~ Spedy:
' Bb. Count' of Death Bc. Ciry, Boro, Twp. at Dam 6tl. Facing Name (II not Ins6ktien, gNe street and number) 9. Was Decedent of Hispanic Okpn? ~ No ^ yes 10. Race: American Indian, BWCk, White, eh.
• Ctmlberland
N. Middleton 7.'Wp.
Church of God Home (n Yes, seedy Cohan,
Mexican, Puerto Rican, ek.) (SP~M
White
11. Decedent's Uwal Oc tlon 1(eid of work done d un most d world Me. Do not state retl 12. Was Decedent ever in dw 13. Deadent's Education (Specity mty highest grade compl eted) 14. MerAel Skks: Clamed, Neuer Marred, 15. Survrvkg Spo use df wile, give maitlen name)
IGrM a Wok Mmd d Buskers /Irxkntry U.S. Armed Fates? Elementary / Secaldery (0-12) College (1-0 or 5+) W'd0~d' DNaced l~Nl
Bookkee r Hotel ^ Yea ®rro Widowed
- its. OecadanYS Malting Adtlreca (street, city sown,skk, zip code) Decedent's Ditl Decedem N. Middleton
PA
Atrial Residence 17
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801 North Hanover, Apt 502 en
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Cumberland 17d ^ No
Decedent LNetl wnMn
Carlisle, PA 17013 ,
„~ Coany
AaualGmika city/Brim
18. Father's Name (First, midde, la6t, wmx) 19. Mamas Name (F'rsL midtlb, maiden sumeme)
Millard Fitzgerald Romayne Marsh
20e. InfortnanYS Name (Type /Pant)
Charles Bretz 20b. Informant's Mainrg Adtlrees (Street, ciy / rown, state, zip cotle)
402 Heisers Lane, Carlisle, PA 1705
_ 21 a. Mre~m/od of Disposnbn ^ Cremation ^ p~ga 21 h. Dale of Dbposiom (Monet, daY, Year)
A
il 19
2011 21 c. Pkce d Dkaposinon (Name of carek , aemarory or timer place)
Cu
land Val~e
Memorial
b 21 d. Location (City/town, stale, zip code)
lT Burial ^ Remeeal form skk iwa cremetkn albatlon AWiaiad pr
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er Carlisle, PA 17013
^ ~ W ktedlul ExaminerlCOrona? ^ Yes^ No Gardens
wre a Funeral Service ~ (a person admg es cam) 226. Liwnse Number 22c. Name and Address of FeciAty Hof fman-Roth Funeral Home & Crematory
013144E
items 23ea my when remryin9 23e. To die beer of my . deem aaurred Una, dale end pbce skied. (Signakre and Mbl 23b. License NwMer 23c. Dak Signed IMonm, may, gar)
phyakien b not available at 6rta of deem ro
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game 2426 rout k completed by pamon 24. Time d Deem 25. Dak Pmnoasetl Deed (Monet, day, year) 26. Was Casa Ralaned ro Medal Examiner /Coroner fa a Reagan r man Cremedon or Donation?
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CAUSE OF DEATH (See Inatructlone and asmpke) ~ Approxlmak hkrval: Pat II: Fnkr timer ggsioram mridtkns contnhutinn to deem. 2fi. Oro Tobacco Use Cmmbae to Deem?
Aan 27. Pan I: Emer die dleb of evenk -diseases, injuries, a mmpncadau - met dredy reused the meet. W NOT enter bnninal evems wch as cardiac anasL Onset to Deem hW not resultlng in rile undedykig cause given in Ped I. ^ Yes ^ Probebty
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30a. Wes a Auropsy 30b. Were Autapry FlMlr~ 31. Manna d Deem 32a. Dak al Inpiry (Manor, tley, yam) 32b. Dacrihe How Irryury Oaunad 32c. Place a Injley: Home, Fartn, Sheet, Factory,
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