HomeMy WebLinkAbout10-02-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA 'J
Estate of AI RcRT P eMll`I l[`C`I bile Number 21 11 1 ~~?T_.
also known as ALBERT PASQUALE AMICUCCI
Deceased 'Social Security Number 181-16-6981
Petitioner(s), who is/are l8 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 FYFt=UTOR named in the
st19~1~n10 and codicils dated AIr1AIC
last Will of the 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 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
(lfapplicable, enter: c. t. a.; d. b. n. c. t. a.; pendente life; 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: (If
Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) r-~ _
(COMPLETE !N ALL CASES:) Attach additional sheets if necessary.
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Decedent was domiciled at death in Cl IMRFRLAND County, Pennsylvania, with his /her last principal residence at
PORT A DST.. MECHB BOROUGH MECHANICSR! lar Po 17n55
(List street address, town/city, township, county, state, zip code)
QI9.r,/9011 at enonu n rnnn MFMnR1Al H ME
Decedent, then 89 years of age, died on - pq 17013
O T ' T CARLISLE
Decedent at death owned property with estimated values as follows:
(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
17 E. PORTLAND STREET, MECHANICSBURG, PA 17055
situated as follows:
$ 7.000.00
$ 80.000.00
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 appropriate form to
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Signature Typed or printed name and residence
_ _ FRANK A. AMICUCCI
Page 1 of 2
Form RW-OZ rev. 10.13.06
f.
C7 -,-.- -~-,
Oath of Personal Representative `~~ ° ~-~ ~ `~'
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COMMONWEALTH OF PENNSYLVANIA ; `-` ~' rn
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COUNTY OF rIIMRERLAND `~ ' J'
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are tnEe ~d correcft"tb the~best 6~f
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the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well ~d truly
administer the estate according to law.
Sworn to or affirmed and subscribed
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be~ m/e the/ ~ ~ ,-~ `day rof
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FOr the ReglSter Signature of Personal Representative
File Number: 21 - ~ ~ / L' '°"
Estate of A~ RFRT P- OMICII(:C`I ,Deceased
Social Security Number: - - Date of Death: Q/251~011
AND NOW, /~1 ~ ,~, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DEC D that Letters rceTeiucniTeay
are hereby granted to ~oe~i~t a niui~~ i~~~
Signature of Personal Representative
S
in the above estate
and that the instrument(s) dated 812512010 -
described in the Petition be admitted to probate and filed of record ~s t~ last Will (anal Codicil(s)) of Decent. ,~ i~
FEES
Letters .........................
Short Certificate(s) ~•.~
e unci~tion(s) •••••••~••••
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Register
Attorney Signature:
Attorney Name:
Supreme Court I.I). No.: ~aRag
Address: ~a F MoiN STREET
Telephone: 717-697-4650
Form RW-02 rev. 10.13.06 Page 2 Of 2
Signature of Personal Representative FRANK A. AMICUCCI
L.OCA~ REGISTRAR"S CERTIFI~aATION OF DEATH
WARNIN(a: It is illegal t0 d(uplicate this copy b±~ photostat c,r pno~.lc~i'apl~,..
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P .176.4523..1_.__
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATIH
reap instructions and examples on reverse) CTATF FILE NUMBER
H105-143 RE`z 112006
TYPE 1 PRINT IN
PERMANENT
BLACK INK
bN ra[ result'rg h the untlerlylrg cause given in Part 1. ^ Yes ^ Probaby
^ No ^ unknown
P4.1:s1't~frp~y_ Jr1Td+wirz7 V~~. 29. If Female'.
^ Not pregnant wahin past year
^ Pregnant at Nrw of math
^ Nol pregnant bM pregnant wimin 42 mys
gf death
^ Not Dregnanl, bN pregnant 43 days to 1 year
before math
^ Unkrwwn it pregnant whin the pazl year
32C. Place of Inryry'. Home, Ferm, Street, Factory,
OHice Buikkrg, etc. lSpeah)
of Cause of Death? 32g. loptbn d injury (Street cM I town, state)
,y ^ Apimnt ^ PerMing Investigation 32tl. Time d Injury 328. Injury al Work? 32f tf Trartspodatbn Injury /Speedy)
^ Yes LJ Np ^Ves ^ No ^ Suiam ^ CoWtl Nol be I7elennin d M ^Ves ^ No ^ Dmrerl Opetala ^ Passenger ^ Pedestrian
corer ~ specry
335. Certifier lohock anry one) 33b. Sigreture~ YV • •l
• CertMying physician (Physiaan pRify'mg pose of deem when anomer physldan has ivo~rked mom and completed Item 23)
To the best of my knowledge, mom oceurted due to tM cause(s) arM manner as ebwd _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ t 33c. Licerue Number 33tl. Date Signetl IMOnm, day, year)
• Pronouncing and eertllying PhYSlydan (Pnysicon boor pronouncing mom ant prtiMn9 to cause of dpmj a ~~ L Ft 1..L V / t,
7o Ins beat oy my knowledge, Nam orxurred at me dme, date, and place, and due to Me pupae) and manrwr ere statetl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ;u ~-- (~ ¢ L~ 5
• Medk:al Examkwrl Carorur
On the bash d examinetian ant I a Investigation, In my opinion, death occurred at tM time, date, end place, and due to 1M poses) and manner as stated. 34. Name and Address of Person YAp Camplelatl Cause of Deam (tom 2'!) Type /Print
1Aw'sl. L-f Y4'i~Vl Sn_ I~r"N.LI"'"Yt'I IYAi G~22tl
36 r ~ wre and 's . r ~ , ~ ~ 36. Date Fiktl (Honor, der. year) Y• 1 1lU 1
~ I' I•- I I I~I SC .~~...~ ,17 fl I t21 .('f'~.~~: (t~f/~ cr~t2t.s'~ i~'~
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who pmnources mom.
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CAUSE OF DEATH ( Inesructlone and examples) r App'oxlmate Inten
Item 27. Pan I'. Enter the era n of events -diseases, 'mjrsies, or pnlplicatiore ~ coal direGly Caused me mom. W NOT enter terminal events such as cardiac arrest, Cmsel to Death
respiratory anent, a ventricular fibnllaaen wilhaA showkg me etiology. List onN one cause on each fine.
IMMEDIATE CAUSE IFInal disease or ~N~cS.TZJ r= ~ CH~i YhyH^K-~ t~Z `~
conditim restating m deem) __~
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Due to (or az a carseguerxe oq~.
$aguen0atly IsI mndilians, X aM'• b. -
laatlxp mthe use Isted m fine a. pus to la as a consequence op:
Eller me UNDERLYING CAUSE
(dwesse a aryur( Inert Inhietetl me c. -
events resulting m mom) UST. Due to (or az a conseguerKe 00
tl.
308. Was an Autopsy 30b. Were ANOpsy Froirgs 31. Manner of Deam 32a. Date M Injury (Manor, my, Year) 32b. Desedm How Injury Oaurred
Performed? AveiMbk Pdor to Completkm ~ Nawral ^ liomipde
Name w oepmnt (Rm1, middle. lazl. aulhx; ^/ ~ ~ ~~(,?S '!mil G(l e A~tf'1 ~ Cu L' C~ L
J 2. Sex
~ 3. Social Security Number
/ 81 - / (v - (~ ~~ ~ / 4. Dale of Death IMonm, day, year)
9 :~z 5 ~z U i /
Under I m 6. Date of Birth M
5 Age (Last Birthday) Under 1 arer mm, m , ear 7. BIRh ce and state a Me count 68. Place of Deam Check On one Omer
Hospital:
f, ~ MontM Days blurs Mv'ulas
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(, ~j /~/ ~` /;
~/~ /~~ /~ L~ I ~~ (i ~ ~"' 1 ~~~ ^ InpatbM ^ ER / OutpahenL ^ DOA ~ Nursing Home ^ Resdence ^ Oma - Spectly:
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~. County of Deam Ile. CM. Boro Twp. of Deam
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Bd. Fackiry N e (lf not slitNion, give sweet antl number)
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rr 10. Rate. American Irgian, Black, While, etc.
9. Was Decedent of Hispanic 0 9 ? ~ No ^Ves ,
{1-{IY (II yes specs Cuban (Spealy) I ~ , I
I I L71 Yi ~ Mexican P Ro fliran at I W Y1 I
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DecetlenYS Usual Occ tkln Kux1 M work done tlw rtasl of work' Me. W na state retired
11 .
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12. Was Decedent ever m me 13. pecetlenYS Education (Spei ry only highest gram ampletad) 14 MdrRal Slat s. M led, N r Marred 16. Surviving Spouse (d wile. give maitlen name)
Wxfowed Dlvorcetl (Spaaly)
.
Kill d Work K;rd of usirwss/Industry
verr~r>?eYlt
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h U.g. Amwd Forces?
Elemamary I Sewndary (P12)
~yaz ^Nt f,~.. College (1-4 or 5t) I ,V i ~ (; UV ~ ~i~
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CLC-Ke) Did Decedent
16. pecetlenYS Mailing Address (Street, city /town, state, ziE code)
} C.a~ (/o
-[ ~ ~C V I I Cl V1 L~ .J I V`( 1. ~
1 DecemnYS
Actual Resitlence 17a. State ~~ n n S y I ~ CL /1 f G
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Y I Li n ci
~ Live in a I7c I^~I Yes. Decedent I.ivetl in TwD-
Township? 170 ~NO, Decemnl Lived wrtYi `,, 1-
n l ~~ C /`~ i1 I (S I'l.i Y~ Cl
/ Boro
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170. County ry
AGUaI Limds W
19. Fameh Name (fiat, middle, last, sultix)
~h ~ t St I n s :!-~w~ i s 19. Mahers Name
U, [? C ~ (Flrsl, midde, maiden surname) /1 ~ ~' I Y) ~ ~ yn v} -/t] ~ a 1
.~ Ur) ylJ
20a. InfamanYS Name (Type I Pnnq _
~~ t~•~rT ~rvli C-u cc ~
~CtVll~ 20b. InformaMS Mailing Address (EVBaI, dry /town, state, zip axfe) rtit.~ c h . , ~~ I ~ p ~ ~
3-a5 V~.~st S~m~s~n St,~ee_t;
,
mod of Drsposilbn ^ Cremation ^ Donaton 2tb. Date of Dispositim (Honor, day year)
Me
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i 21c. Place of Disptnitio.}n ~(N.ame of cemetery, cremamry a mar pace) ~~j~J Q., ~ 21 tl. Location (City I sown, stet , i ~ ) --r
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W Cremation a Donation Aulhoriietl i (i / ~
I[y eunal ^ Removal Fran Stale
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No
Yes
t by Medkal Examiner/Cororwr4
^ Oth
er -
Si o urwral 'a pens az such)
228 22b License Number 22c. Name ant Address of Fadliry
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Complete Hems 23ac oMy when ceroH
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a 23a. To me best of my krwwletlge, deem attuned at Ire time, date end place stated. ISignalure and lalel 230. License Number 23c. Da/tie Signetl (Honor, daY. year)
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cert my, year)
Date Pronourvxtl Deatl (Month
26 26. Was Case Referred to Meticai Examiner I Coroner la a Reason Omer man Cremation a Duration
Items 20-26 must m aompleletl by parson ,
.
24. lime of Deam ^ Vas ^ No
Disposition Perms No. ~~ `--" 7 7 !O ~
LAST WILL AND TESTAMENT
BE IT REMEMBERED THAT
I, ALBERT P. AMICUCCI, a resident of Cumberland County,
Pennsylvania, being of sound mind, memory and understanding, do make,
publish and declare this to be my LAST WILL AND TESTAMENT, hereby
revoking any and all Wills and Codicils previously nnade by me.
I
I declare that I am not married, my beloved v~~ife, FRANCES J. AMICUCCI,
having predeceased me, and that I have four children, DEBORAH R. STEPHENS,
FRANK A. AMICUCCI, MARGARET L. STOY and JOHN P. AMICUCCI.
II
I direct that all my just debts and funeral expenses shall be paid from my
residuary estate as soon as practicable after my decease.
III
I direct that all taxes that may be assessed in consequence of my death,
of whatever nature and by whatever jurisdiction imposed, shall be paid from
my residuary estate as a part of the expense of the administration of my estate.
IV
I give, devise and bequeath all my property, whether real or personal,
wherever situate, including any property over which I may have a power of
V
I nominate, constitute and appoint my sore, FRANK A AMICUCCI, as
Executor of this LAST WILL, to serve without bored. If my son is unable or
unwilling to act in that capacity, then I nominate;, constitute and appoint my
daughter, MARGARET L. STOY, as Executrix of this LAST WILL, to serve without
bond.
IN WITNESS WHEREOF, I, ALBERT P. AMICUCCI, have set my hand to
this LAST WILL this 25th day of August, 2010.
_.,
' ~~- '? ' ,
ALBERT P. AMICUCCI
Signed, sealed, published and declared by the above-named. ALBERT P.
AMICUCCI, as and for his Last Will and Testament, in the presence of us, who,
at his request and in his presence, and in the presence of each other, have
hereunto subscribed our names as witnesses. '
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ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
I, ALBERT P. AMICUCCI ,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; that I
signed it as my free and voluntary act for the purposes therein expressed.
ALBERT P. AMICUCCI
Sworn or affirmed to and acknowledged before m~° by ALBERT P. AMICUCCI,
Testator, this 25th day of August, 2010.
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~~~~~~ C~'l fr~~~
Notary Public ~~ ~,,,_,,.
r~o;,aa~A~ s~€,~
p~ANE M SMiT4i
Notary Puhllc
MECIiANICSBURG BORG, CUMBERL4ND CNN
AFFIDAVIT My Commiss?an Ex~;ir~s Jun 22, 2012
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
We, U~ ~ ~~ ~~ L-;.~/~ ~~ /~ ~ and ~~ c- S[ rr-, :~ ~ ~ -c_ ~.:~ ~~li 4t ~ ,
the witnes ~s 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 Testator sign and execute the instrument as his LAST WILL, that
ALBERT P. AMICUCCI signed willingly and that lie 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 signed the Will as witnesses; and that to the best of our
knowledge, the Testator was at the time 18 years of ge r or , of found mind
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and under no constraint or undue influence. j /, ~
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