HomeMy WebLinkAbout10-04-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
Estate of Francis L. Gustina ~
also known as Francis LOUIS GUStlna File Number ~ l ! ` "' I Z~~
Deceased Social Security Number 095-07-5504
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW.)
a A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the executor
last Will of the Decedent dated 9/13/2OO 1 named in the
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 instrument(s) offered
for probate, was not the victim of a killing, was never adjudicated incapacitated, and was not a party to a pending divorce proceeding at the time
of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g):
^ B. Grant of Letters of Administration
~Ifapplicable, enter: c. t. a.; d. b. n. c. t. a.; pendente hte; durante absentia; durante minoritate)
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: (!f
Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.)
Name D C'~ __;,.
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(COMPLETE INALL CASES:) Attach additional sheets if necessary. ?a _,....
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Decedent was domiciled at death in Cumberland L`
100 Mt. Allen Drive Rm 28 Meehaniesbur PA u 1~7055sylvania, with his /her last princi al residence at _________
(List street address, town city, township, county, state, :ip code) ~ er Aleen Townshl
Decedent, then 95 years of age, died on 9/15/2011
1701 Linalestown Rnarl .. at Carolyn Croxton Slang Rco;.~l~...,..
Decedent at death owned property with estimated values as follows: rr1 t' 1 1 U
(If domiciled in PA) All personal property
(If not domiciled in PA $ 411 000.00
~ Personal property in Pennsy]vania $
(If not domiciled in PA) Personal ro e
Value of real estate in Pennsylvania p p ~' to County $
22 Farm House Lane, Camp Hill, PA $ 199 900.00
TOTAL: $610,900.00
situated as follows: _
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the a
the undersigned:
ppropriate form to
SlHn afore
~l ~Z`E~ ~ Lh~
Typed or printed name and residence
by Linda J. Lundberg, VP
Form RW-02 rev. 10.13.06
PNC Bank, National Association,
Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
CVUNTY OF Cumberland SS
The Petitioner(s) above-named swear(s) or affirm(s) that the statements
the knowledge and belief of Petitioner(s) and that, as personal representatives of th
m the foregoing Petition are true and correct to the best of
administer the estate according to law. ) e Decedent, Petitioner(s) will well and truly
Sworn to or affirmed and subscribed
before me the ~'~{l
I ------- day of
~~ ~1 ~ ~.
~~C~ ~r
-_
F r the Register
Signature of Personal
Signature of Persona! Representative
Signature of Personal Representative
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File Number: ;~ ~ - ~ ~ -. ~ lit ~ r' __
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Estate of Francis L. Gusting
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Social' !Security Number: 095-07-5504 ,Deceased
AND NOW, `'I ~~ E' ~' ('~ ~ ~~ ~ Date of Death: 9/15/2011
having been presented befor me, IT IS DECREED that Letters Testam
in consideration of the foregoing Petition, satisfactory proof
are hereby granted to PNC Bank National Assocation b LindatJ. Lundber
VP
and that the instrument(s) dated 9/13/2001
described in the Petition be admitted to probate and filed of record as the last Will
(and Codicil(s)) of Decedent.
FEES < Ia . _ A ,.
Letters ......................
Short Certificate(s) .......... $ ~ ~ ~~~
Renunciations ~~ $ ~ ~ t~
.... $ ~_
.... $ ~_
.... $ ~_
.... $
TOTAL ....................... -~'-~'-~-~-
..... $ -.-~.i.L
orm RW-02 rev. 10. /3.06
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.:
Address:
in the above estate
Page 2 of 2
PA
17070
Telephone: 717-774-7435
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LOCAL REGISTRAR'S CERTIFICATION OF pEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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PMANEM
/ pRINr IN COMMONWEALTH OF PENNSYLVANIA .DEPARTMENT OF HEALTH .VITAL RECORDS _
ACK INK CERTIFICATE OF DEATH
1, Name ofDecedenl(Rrt,middle,lest suffix) (See Instructions and examples on reverse)
STATE FILE NUMBER
Francis L. Gustina z. sex 3. Social sec,xhY Member
5, Age (Last SirMtle Male 4. Date of Deets (Momh, Bey, Year)
Yl Underl ear UMerlda 6.DeteolBerth Manlh,da, w 095- 07 - 5504 September 15, 2011
Mo~lhs Days Hours MMUIes 7~ B ~~ C' and state or tore coon
95 Ba. Place of Death Chock on one
Yre' September 15, 1916 Waverl Hospital: Other:
8b. County of DeaM &. Ody, Boro, T y a NY ^ In trent O 3 p C e
wp, of Deets 8tl. Faclfity Nana (I! nd instllutian, give street arts number) ~ ~ ^ ER / DmPetient ^ DOA ^ Nursing Home ^ Residence e i de n C e
Dauphin 9. Was Decedem of H' ®Omer -~:
Susquehanna 4Wa"z Ongfn? ®No ^Vey 16 Rats: Amencan Indian, Black. White, etc.
• 11. Decedent's usual lion Kind of work done Burin moat of w ~ rde. Do not a~ ; ,2~. wee ODaceaem avar~;rn,ex t onSrn add ~Re s i de tie a iAaziecsa~n, Pre o Ri~p~, aro.) ~~~
~ of W0"t Knd of Business/ Industry U.S. Armed Faces? (SPacilY only highest grade completed) 14. Madtal StreWe: Married, Meyer Martied, 15. Suniving Spouse (II ~, 9 R ~ Been name)
Deputy Chief of Staf FederalGovernmen eleme"1~1/saconaan(0-12) cull
® Yes ^ No eQe (t d or 5+) Wed, Dh'omed (SCea'N)
16. Decedent's Malting Address (Street city /town, state, tip coda) [ Wi Bowe d
32 Farm House Lane Decedam'a
Actual Residence 17a. State Pennsylvania Did Decedent
Camp Hi 11, PA 17 011 Live in a 17c. g] Yes, Decedent Lived in Fairview
176. County York Township?
18. Father's Name (First, middle, last suffix) 17tl. ^ No, Decedent LNetl within Twp.
Acual Limbs of
Francis Samuel Gustina 19. Homers Name (Frst middle, maiden surtreme) CirylBpro
20a. 1"'ormant's Name (type/Pnnp Hazel R. Beeman
Mi c ha e 1 B . Gustina 2gh. InlortnanYs Mailhg Adtlress (Street city /town, slate, zip code)
21a. Methotl or oieposaion 10405 Hudson Road
®Cremaeon ^Donatbn 21 b. Date of DI6POSNOn (Manor, da, BeaVer Dam 1
^ Bunal ^ Removal from Stale i Waa Crcmatbn or Donadon Authorized Y Year) 21 c. Place of Disposkbn (Name of cemetery, crematory or other place)
^ Other ~ S ~ by Medial Ezamlrwr/Coroner? C -~-. 21d. Location (City/town. stale, zip cotle)
~ 27a. gig ®Yes^ Np aJ Zd ZOI 1 Evans Crematory
see (or parson eding as such) 22b. licence Number S C ha e f f e r S t own
• - 22c. Name a~ Address of Facility PA 17 08 8
ComDlme he 23ec only when certifying 23a. 7° the best of my knowledge, deaM
FD 012 848 L arthemore FH & CS, Inc., P.O, Box 431, New Cumberland, PA 17070
physraan is not available at time of death to al Me fime, Bet d place stated. (Signature and title)
artily cause of deaM. ~` ~ 23b. Uanse Numberr ' `_ 23c. D/a~te Signed (Month, day, year)
Items 24-26 must ba completed by person 24. Time of DeaM ~N 3 (V ~ $g L (.} . I ~ _ C.'
wtro Pronounces deem. ~ ~ 25. Datq Pronou Deatl (Momh, deY, Year) C L 1.
P M, v(1 1_ ~ '~ 1 t 26 Was Case Refe~ to Medical Examiner /Coroner for a Reason Other Man Crematlon or Donafion?
hem 27. Pan P Enter Me CAUSE OF DEATH (See inatructlona end xampka) CJ Ty'1 p?V+ ~~ ^ Yes ~
f~ of evenh -diseases, injuries, or canplicatbns ,Mat directly caused hie deaM. DO NOT order terminal events such ss cardiac artest r
respiratory artest, or ventricular fibnllatlon without showi Ma etiol i Approximate interval: Pan II: Enter other ~s ~„ .
n9 ogy. List ony one cause on each line. Onset to Death but not resulting in Me undo m~ t0 M 29. Ditl Tobacco Use ConMbute to Death?
IMMEDIATE CAUSE (Final disease or ~ nyirig ause gNen in Pan I. ^ Yes ^ Probably
contlitim msutling in ant) 'T~~N/ ; !~
~ a. 1 fi ~~ ^ No u.Mnknown
gequentlalry list conMtlons, h any, Dua I° O as a consequence o() ~ ~~~- 29. If Female:
karRng to the cause Ilsted on line a. 6~ ~ ~~G `V+Q{9Q,QP p~ ~~G,~,.v~ i ^ Not pregnant within pass year
Enter the UNDERLYING CAUSE wnsequerxxi o r
~1 (disease or injury Mat inifiaMd Me
y events resulting in deaM) LAST. c ~ ^ Pregnant at time of deaM
~ ^ Not pregnant bm
~ pregnant whNn 42 days
e to (or as a conseglrerH:e ot)~ of deem
d. ~
~ ^ Nol pregnant but pregnant 43 days to I year
30e. Was an Aul ~ before deaM
7 oPsY 30b. Were Autopsy Findings 31. Ma r of Death ~
-~ Pedortned? Available Prpr to Completbn 32a. Date of Injury (MOmh, deY, year) 32h. Descdba How Injury Occurted ^ UnNnown if Pregnant within Me
~ of Cause of DeaM? NaNral Pasf year
~y/~ ^ Homicide 32c. Place of Injury; Home, Ferm, Sheet, Factory,
^ Ves ICI No ^Ves ,~ /o ^ Accident 32d. Time of l ' Office Building, etc. (SpecilyJ
l(11V ^ Pending Investigation Mury 32e. Injury at Worko 32f. h Transportation Injury (SpeciyyJ
^ Suicide ^ Count Nof ba Determirred 329. Loalbn of injury (Street city /town, state)
M ^Ves ^ No ^ Driver/Operator ^ pa„eng„ [~ pedestrian
33a. Certifier (check any one) ^ Other - ~~'
• Cendying jxhyalcian (Physician certifying cause of tleaM when anoMer physiaan has pronounced deaM antl completed Item 23) . Signaure and Tdle of Cenfier
To the beat of my knowledge, death occurred due to the auee(a) and manner es atated_ _ _ _
• Prorqundng ant certdyfrg phyelclen (Physician both pronoundng death and artltying to cause of deaM) - - - _ ~ _ _ _ - - ~ •"~"~'~/71~~LC..~'r~(~ 1 „
To the beat of my knowledge, death occurted M the Bore, date, end place, and due to the auae(s) end manner as etated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~C~' Liense Number
• Madkal Examiner/Coroner _ _ _ _ _ _ _ _ _ _ _ _ ^ / ~ ~D ~~~ ~~ 33tl. Data Sgned (Month, day, year)
On Ne baala of ezaminallon and / or Inveatlgatlon, In my oplnbn, deMh occurred at the Bore, ate, end place, and due to the auagp end manner a atated_ ^
34. Nerve and Adtlress of Person Wlw Co OQ '/ ~ J /
Registrars Signet re and Dishim N bar ~ A' mpletetl CaCause of DeaM (Item 27) TYPe I Pnn
I(~,Z I ~ I a I ~ I ~ I 38. Doh Bled (M M, tlay, ) ~~'+~` ~"QG~ ~C13,~..SH
9~i~o~~` <oo ,ir1TAu.6a~L1 xarLivd rv,>FCr-r<-~rs~~eti
Dlapositlon Permh No, n~ e ~ ~ ~-~ (~ /
ep\wills\gustina.fl\9-01
LAST WILL AND TESTAMENT
OF
FRANCIS LOUIS GUSTINA
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I, FRANCIS LOUIS GUSTINA, of Fairview Township, York County,
Pennsylvania, declare this to be my last will and revoke any will
previously made by me.
ITEM I: I direct that my Executrix hereinafter named shall pay
all my just debts and funeral expenses as soon as conveniently may be
done after my decease.
ITEI`'I II: All the rest, residue and remainder of my estate,
whether real, personal or mixed, and wherever situate, I hereby give,
devise and bequeath to my wife, MARY GLADYS GUSTINA, if she survives
me by thirty (30) days.
ITEM: Should my wife, MARY GLADYS GUSTINA, fail to survive
me by thirty (30) days, then I hereby give and bequeath the sum of
Five Thousand ($5,000.00) Dollars unto ST. THERESA'S ROMAN CATHOLIC
CHURCH, New Cumberland, Pennsylvania.
Page 1 of 6
ITEM IV: Should my wife, MARY GLADYS GUSTINA, fail to survive me
by thirty (30) days, then I hereby give and bequeath m
y tangible
personal property unto my hereinafter named Executor for sale or
distribution, as he has been otherwise instructed.
ITEM V: Should my wife, MARY GLADYS GUSTINA, fail to survive me
by thirty (30) days, then I hereby give, devise and bequeath all the
~ rest, residue and remainder of my estate, whether real
personal or
mixed, and wheresoever situate, unto such of the following named
persons as shall survive me, in equal shares to my nieces and ne h
p ews:
DONNA ELIZABETH GUSTINA, FRANCES ANN GUSTINA KRAGLE, AMY JOS
EPH
GUSTINA RYAN, and MICHAEL BERRY GUSTINA.
ITEM VI: Should any person entitled to a share of my estate not
have attained the age of twenty-one (21) years at the time of distri-
bution to him or her, I devise and bequeath the share of each such
person to my trustee hereinafter named IN SEPARATE TRUST to hold,
manage, invest and reinvest th;~ ~
~~ s~lare so recei~red and the accumu~.a-
tion of income therefrom and to use and apply the income or ri
p ncipal
or so much thereof as in trustee's discretion may be necessary or
appropriate for the education of the beneficiary or for medical
emergencies of the beneficiary after taking into account the sources
Page 2 of 6
of income and assets of the beneficiary including government
entitlements. Any principal or income not so applied shall be dis-
tributed to such beneficiary absolutely when he or she attains the a
ge
of twenty-one (21) years. If the said beneficiary dies before attain-
ing the age of twenty-one (21) years, the trust shall terminate and
such share shall be distributed to the other named legatees in Item VI
of my last will as are then living.
ITE-II: The interests of the beneficiaries hereunder shall not
be subject to anticipation or voluntary or involuntary alienation.
ITEM VIII: I appoint PNC BANK, N.A., Trustee of any trusts
created under this my Last Will and Testament.
ITEM IX: I appoint my wife, MARY GLADYS GUSTINA, Executrix of
this my last will. Should my wife, MARY GLADYS GUSTINA, fail to
qualify or cease to act as Executrix, I appoint PNC BANK, N.A.
Executor of this my last will.
ITEM X: I direct that an_y fiduciary named herein shall retain
the services of the law firm of Stone LaFaver & Stone in handlin
g all
legal matters in connection with my estate.
Page 3 of 6
ITEM XI: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of his/her dutie
s
in any jurisdiction.
IN WITNESS WHEREOF, I, FRANCIS LOUIS GUSTINA, have hereunto set
my hand and seal this ~ ~ day of ~` M~j~~
--._._ , 2 0 0 l .
FRANCIS LOUIS GUSTINA
SIGNED, SEALED, PUBLISHED and DECLARED by FRANCIS LOUIS GUSTINA,
the Testator above named, as and for his Last Will and Testament, and
in the presence of us, who at his request, in his presence and in the
presence of each other, have subscribed our names as witnesses.
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Witness
Address ~~
Page 4 of 6
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND :SS:
I, FRANCIS LOUIS GUSTINA, the 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
triis instrument as my last will; that I signed it willingly and chat
I signed it as my free and voluntary act for the purposes ther
ein
contained.
FRANCIS LOUIS GUSTINA
Sworn to or affirmed to and acknowledged before me by FRANCIS
LOUIS GUSTINA, the Testator, this ~, .:
day of .fJr~,,.~_,_., f'~t~„~ 2001 .
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Not ry Publ'c
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
We , ~ \~ -~~~ I-~~ ~ ~
~c and ~ ~'_ ~L~ _, ,~~_
the witnesses whose names are signed to the at tached or for
egoing
Page 5 of 6
instrument, being duly qualified according to law, depose and sa
y that
we were present and saw Testator sign and execute the instrument as
his last will; that Testator signed willingly and that he executed '
it
as his free and voluntary act for the purposes therein expressed; tha
t
each of us in the hearing and sight of the Testator signed the will
as witnesses; that to the best of our knowledge, the Testator was at
that time eighteen or more years of age, of sound mind and under no
constraint or undue influence.
4.,,~
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W' nes
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Witness
Sworn to or affirmed to and acknowledged before me by
~~ Ryrt ~ s' ~ \\\
and
~~~ - ~~
witnesses, this /~_ day of ~' -t '
~~~ 2001 .
~vorv~~,~ sue.
KAYE R, Lt1CK,E1; ~~, Fi-bllc
l+kw Cumberland Gu
~?' Cnmmissi~an E~ ~ ~ ~ Co.
Marcb27, 2Q~
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Notary Pu]~ is
Page 6 of 6