HomeMy WebLinkAbout10-14-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Hazel L. Smith File Number ~ f - ~ ~ ~' (,1
also known as
ecease Social Security 192-3-1-5039
Petitioner(s) who islaze 18 yeazs of age or older, apply(ies) for:
[X] A. Probate and Grant of Letters Testamentary and aver that the Petitioner ecutor, Kreig L. Smith
named in the Last Will and Testament of Hazel L. Smith
state re evenat ctrcumstances, e.g. renunctatton, ea o 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 and was never ad~udicated an incapacitated person:
f}.4-c1 ~ u>~ //~U 7~ r~- ~'.d,~ ~ - ~i ,U- ~ ~~Y~ci ~ ~~~~c~/°1-~ ~/',.?,~ ~ ~c-,-~'~ /1r~ y2,« 51.r .~~~ ~; C"~ ~~f ~? ~
[ ] B. Grant of letters of Admtmsration
(If applicable enter: c.t.a.; .n.c.t.a.; en ente ite; urante sentia; c urante minoritate
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the foilowing spouse (if any) and heirs: (If
Administration, c.t.a. or d.bn.c.t.a., enter date of Will in Section A above and complete list of heirs.)
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COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ ~ ' _'
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last principal residence a1E
86 E. Main Street Newville Pa 17241 ~ ~ -• - ~~'''
ist street ress, town city, towns ip, county, state, zip co e~-^
Decedent [hen
69 years of age died on 9/29/2011
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) ~~~'`" ~ ~~`%~'' ~'
(If not domiciled in Pa.)
(If not domiciled in Pa.)
Value of real estate in Pennsylvania ~.;~~, <<, . ;
situated as foll 86 E. Main Street, Newville, PA 17241
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Page 1 of 2
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 anorooriate feirm to the undersiened~-~
OATH OF PERSONAL REPRESENTATIVE
COMMONWEATLH OF PENNSYLVANIA
couN'rY of CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peitio~n are true and cone
to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate according to law. ,~ ~~
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Sworn to or affirmed,and subscribed
before the ti is ; ~ ~" day of October, 2011
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For the Register = r-> =~ x~
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File Number: a ~ ~ ~ ~ ~ 1 C~ ~ ,3 = ?' ~-
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Estate Of LEROY D. SMITH , Decease <:~ ~,
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Social Security Number:
192-34-5039
Date of Death 29-Sep-11
AND NOW
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to KREIG L. SMITH
in the above estate
and that the instrument(s) dated ~` - 15 - ~(;('( f
described in thte Petition to be admitted to probate and filed of rec. as the Last Will (and Codicil(s)) of
Decedent
Register of Wills ~~ r ~`~ F~3~dCdGLG2SG~~ ~~=h
FEES `J
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Signature , ~ ~ ,~~2.` ~'' ~ ~ ~
Attorney Name Stephen D. Tiley
Letters ~?j~ _ (jG
Short Certificates ~ ~. (3 ~ _ Sup. Ct. I.D
Renunciatio
(;~+, ~\ ~ 5. p0 Address:
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Telephone:
No 32318
5 South Hanover Street
Carlisle, Pennsylvania 17(113
(717) 243-5838
TOTAL... ICI~a 5~
Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEA1rIH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee Tin thi~~ certificate. S6.f?4)
_ P 17?26~
Certilicniiun Numlxx
~tlu, i., t.' ~r_`!'I,(`t U).r t!~c infiinnali(~n here s;fven i~
t.nrn°~tiy ir.~(>teL!~ ,art .n: t,rj~inal Ccriilicatc (1f Dcath
(lulu lilcei v.iih n:~L~ (- R.crc,tl IZer~i,tr(r. The rarix~inal
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N10fi~143 REV 112006
ttPE /PRIM IN
PERMANENT
BIACK INN
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COMMONWEALTH OF PENNSYLVANIA .DEPARTMENT OF HEALTH .VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reversal
1. Name of Decetlenl (First, mitlde, lest, sua'a) 2. $ex 3. Serial Scanty Number - ~ _ ~ __ _~~~ 4. Dale of Death (Monts, day, Year)
Hazel L. Smith Female 192 _ 34 _ 5039 ,
5. Age (Last Binheayl Under 1 ear Under 1 der 6. Dek d Bkth Month, tle ,
r 7. Bi tare CI end stale or lor e' n mu Ba. Plece of Dea1n Check onl erne
Months Days Maros M'rrwbs Hospltai: O
lber
69 vrs. 3/21/1942 rlisler PA ^Mpatlent ^ERIOulpetrmrl ^DOA y
DSPQgaaagHnme ^Readaree ^aber-spear:
Bb. County of DeaM Bc. City, Bono, Twp. a Death Ad
Facility Nana (II nq iredlulbn, glue street entl number) 9, Wes Decadent of Hlepank Origin? ®No ^ Yes 10. Race: Marken Indian, Black, White, etc.
Clunberland West Pennsboro
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l~ 1'Y~-n ~ ~/~ ~ lit. ~ F~ of rap, apadly cnban, (spy
Mmdcan, Puerto Rican, ekJ
11. Decedent§ llsuel Oc fion KuW of woM done dots most d worts Me. Do not stele reli 12. Was Decedent ever in Ibe 13. Decedent's Education (Speaty only hghest grade mmpbled) 1d. Memel SIeNS: Married, Never Marred, 15. Surviving Space (II weer, give maiden name)
Kind of Wak Klntl of Business/IMumry U.S. Ambd Forces? Elements /Secondary (D-12) College (1-0 a 5+) Witlowed, Divorced (Speedy) -
Stitcher Shoe Indust ^yaz ®Na 1~ Never Married -
- 1fi. Decedents Maikng Address (Street, city /town, state, zip codel Decedents Oid Decedent '
PA
86 E. Main St . AcNal Residence 17a. Stale Live in a 17c. ^ Yes, Decedent lived in _ T
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coanry CLUnberland Township? rid. S~u+o, Decedem Lived wimi
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ill
Newv
1 e PA 1 241 . ewv
Aaaal omits a
e ciryrBaa
18. FeMats Name (First, mk~e, Iasi suffix) 19. MoMer's Name (First, mitltlle, maiden 511rtrame)
Laurie Frederick Smith Bertha Viola Arcmld
20a. Informants Name (Type / Prinq 200. IMormant's Meiling Address (Sweet city /fawn, stare, zip rode)
Krei L. Smith 152 Springfield Rd., Shippensburg, PA 17257
218. Mmlwd d D'oposilbn ^ Cremaam ^ DonaOOn 21 b. Date of DlSposilion (Monts, day, year) 21 c. Plum of Disposition (Name of amalery, crematory or other place) ltd. Caption (Ciryllown, stale
zp code)
BUnai ^ Removal from Stale r Wu Crematbn or Donation Auarodred ,
^ Omer- ' by Medksl Ezamkrar/Coroner? ^ Yes^ No
- estminster Mgnorial Gardens ~~ar11SlE? r PA
22a S'rgnalure a F ice Licensee (or as 22b. Uanse Number 22c. Name aM Adtlress of Facairy
- - FD 012633 L Fleeing Brothers Funeral Herne, Inc., Carlisle, PA 17013
Complele items 23a~c only when anlrylnq 23a. T bell of my know Ih occurred al Me
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and INaj
te+++aM place stet 23b. License Number ?3c Dele Signed (Month
tley
year)
physipen is na avaiWbk al tlme of death to
prory caaae of eaam, ///
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Items 2428 muss be mmpletetl by person
- wno
mrmancea deem 2<. Time of DeaM 26. Date Prmamced Deatl (Monts, day, year)
A ; CY yM !+?/
~ 26. Was Case Referted to Examiner /Coroner for a Reason Other Nan Cremation a Donation?
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M. S¢ }~M he~^ D29 o2C/! ^Yaa l~
CAUSE OF DEATH (See Instructlona and examples) , Appraxenafe nlerval:
Item 27. Pan I: Enter Me chats of evems -diseases, injuries, a canpliretions - Mal dredty arlsetl the dpM. W NOT enter terminal events such as cardiac enact Onset to Death Part II: Enter ollrer:on'frant mn_ dim= lyy t deep,
but not resuhing in tbe urMertying pose given in Part I. 28. Did Tobamo llse Canlribure to DeaM?
^ Yes h
^ P
h
respirelory errasi or venlrkular IibriAation wahad stxwdng iha etiology. List o `one cause an each line.
IMMEDIATE CAUSE 1Final disease or
ra
ty
a
^ No ^ Unknown
mrldi8on resureng In deethl
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Q~ 29 II Female'
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Due to (er az a consequence o~~.
list pMitbns, it any, b - ut pregrrenl wiNin pall year
^ Pregnant at time a tleeM
fo aloe Asled on line a.
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Due to for as a
EE
DERLYING CAUSE ronsegxrrrce oil:
-
^ Nd pregnant, der pregnant w11hm 42 days
(& ease a injury Met initialed d1e
c of tleeM
everd5 rasularg rn tleeM) LAST. ^
Due to
(or as a mreequenp oq: -
Nd preganl, bN pregranl a3 tlays to 1 year
d
- belae de91h
^ Urkrrowm a pregnant wiMln Me pest year
30e. Was an Aulapsy
Penomrem 30b. Were Amopsy F dings
Avertable Prior to Completion 31. Ma eM 32a. Date of Injury (Monts, day, year) 32b. Describe How Injury Occurtetl 32c. Place M injury: Home, Farm, Street Factory,
'
m cueae of Dpm+ Netuml ^ Homkide Off a BuiM
mg, etc. (SPearyJ
^ Yes No
^ Yes ^ NO ^ Accidem ^ Pandirrg Invesagalion 32d. Time of Injury 32e. Injury al WaM? 321. II Trensportelbn Injury (SpecityJ 32g. Laation of injury ISimel, city /town, stale)
^ Suicide ^ Could Nol be Delermmed
^ Ves ^ No ^ DriverlOperetOr ^ Pd.53ellgBl ^ PBdee(nan
M ^ aher spazy:
33a. Gnifler (check only one)
• ~raMn9 phyaicien (Phyaiden anlying pose of tleeM when arwMar physktian has pmmrnceG dpM end car
letetl It
23 33b. S' nelu of CanlNar \
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To tlsa Oast of my kugwledgs, deem occurred tlue[otM Uwe(s)entl mammasaWatl________________ _________________ .
• Prorwurrcing end cartltying phyelclen (Physiaan bats prwpuntlrg tleeM and artilyirp b pose of death) 33c. Li an r 33d. Date Signed (Mmih, day, year)
Toth twMdmy knowledge,dwM Omurred mthe time,dNe, and plett, mddue to are auae(a)and mannerualeted_ _________________ ^ _
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• Metliul Exemirxx/Coroner
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On the heeia of eaaMnmbn and / or Inveatigatbn, in my oplnlon, death occunee N the time, date, and plop, eM due to era auee(s) arts manner n s1aNd_ ^ y,, Maitre ddress of Per~Spn Canp
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{tl Cause of Deets p
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Disposition Permit No.v ~~ ~,S I -1.~ ~n
RENUNCIATION
Cumberland
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
Estate of Hazel L. Smith
I Denise L. Shimkanon
(Print Name)
Executrix
Deceased
in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Kreig L. Smith
October 14, 2011
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this (y day
of ~` ~-C~ b~ r C'
r ~ u.~L L.~" ~~ ~ Cla,c.~ ~ESc rl
Deputy for Register of Wills
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(Signature)
1200 Mainsville Road
(Street Address)
Shippensburg, Pa 17257
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the remanciation for the
purposes stated within on this _ day
of ,
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
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Form RW-06 rev. 10.13.06
RENUNCIATION
Cumberland
COUNTY, PENNSYLVANIA
REGISTER OF WILLS
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Estate of Hazel L. Smith .Deceased
I Urgan J. Smith , in my capacity/relationship as
(Print Name)
Executor of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Kreig L. Smith
October 14, 2011
(Date)
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(Signature)
86 East Main Street
(Street Address)
Newville, Pa 17241
(City, State, ZipJ
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this 1 ~ day
of CiC~-Ei1~P 1"
~ ~cJ~ti1,~..~ ,~,r .r ~pC~.(,cGi 1 ~p
Deputy for Register of Wills e
Executed nut of Register's Ofjrce
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this _ day
of _
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
LAST WILL AND TESTAMENT
OF
HAZEL L. SMITH
I, Hazel L. Smith, of the Borough of Newville, (86 East Main Street), Cumberland
County, Pennsylvania 17241, being of sound and disposing mind, memory ar~d
understanding, do hereby make, publish and declare this as and for my Last'V1i~t,~nd :..
Testament, hereby revoking and making void any and all Wills and Codicils he~~t~fore ~ -.
made. =,'=?
__- r-r r _.._.
_~ ..
FIRST
~;
_,
direct the payment of my just debts and funeral expenses as soon afi:er my
death as may be convenient. I desire that me body be interred in the plot that I have at
Westminster Cemetery, Cumberland County, Pennsylvania.
I direct that all federal and Pennsylvania estate taxes, Pennsylvania inheritance
taxes, and generation-skipping transfer tax payable as a result of my death, rrot limited
to taxes attributable to property passing under this Will, shall be paid by my Executor
from my residuary estate, including any part of my residuary estate that otherwise
qualifies for a deduction for federal estate tax purposes. I direct my Executor not to
seek reimbursement for any tax so paid from any beneficiary under this Will, heir of
mine, or other transferee of property included in my gross estate.
'~i
1 SECOND
~,
r~ I declare that I am unmarried. I have three (3) children, to wit: Kreig L.. Smith, of
v 152 Springfield Road, Shippensburg, Pennsyivania 17257, a son born Ai;gust 7, 1Q66;
Denise L. Shimkanon, of 1200 Mainsville Road, Shippensburg, Pennsylvania 17257, a
~, daughter born October 6, 1970; and Urgan J. Smith, who resides with me at .66 East
~~' Main Street, Newville, Pennsylvania 17241, a son born September 13, 1978.
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THIRD
.,,~
Y All the rest, residue and remainder of my estate, real, personal and mixed, and
wheresoever the same may be situate, I give, devise and bequeath, in equal shares,
per stirpes and not per capita, unto such of my children as shall survive me bey ninety
(90) days, but should any of them fail to so survive me then the share such deceased
child of mine would have received shall pass to such of his or her issue as shall survive
me by a period of ninety (90) days, per stirpes, and if there be no such issue the same
shall lapse and be added to the remaining share or shares. At the present time I have
three children, as aforementioned.
FOURTH
I hereby nominate, constitute and appoint my three said children (Kreig L. Smith,
Denise L. Shimkanon and Urgan J. Smith) as Co-Executors of this my Last VVill and
Testament, or the successor(s) or survivor(s) as Co-Executors, or alone as Executor or
Executrix, as the case may be. I further direct that no bond or other security shall be
required of any Executor or Executrix appointed in this Will for the performance of his,
her or its duties in any jurisdiction in which he, she or it may be called upon to act. The
terms Executor or Executrix may be used interchangeably in this Will and shall refer to
any Executor or Executrix appointed in this will, or any other Administrator appointed by
a court of competent jurisdiction.
.Y7
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Last Will and Testament of Hazel L. Smith Page 1 of 3
FIFTH
In addition to, and not in limitation of, the powers conferred by law or by other
provisions of this Will, my Co-Executors shall have the following powers, each of which
may be exercised from time to time by my Co-Executors in their sole discretion:
(a) To retain in the form received, and to sell either at public or private
sale, or to distribute in kind, any real or personal property.
(b) To manage both real and personal property.
(c) To invest and reinvest in all forms of property, notwithstanding the
fact that any or all of the investments made are of a character or size
which but for this expressed authority would not be considered
proper for an Executor.
(d) To exercise any option or rights arising from the ownership of
investments.
(e) To compromise claims without court approval and without the
consent of any beneficiary.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last
Will and Testament, written on three (3) pages (including notary page), this 15th day of
September, 2006.
,Q
Hazel L. Smith
Signed, sealed, published, and declared by Hazel L. Smith the Testatrix above
named, as and for her Last Will and Testament, in our presence, who, in her presence,
at her request, and in the presence of each other, have hereunto subscribed our names
as attesting witnesses.
-~f
~~~~
Last Will and Testament of Hazel L. Smith Page 2 of 3
COMMONWEALTH OF PENNSYLVANIA )
SS:
COUNTY OF CUMBERLAND )
We, Hazel L. Smith, the Testatrix in, and Stephen D. They
and Robert G. Frey ,the witnesses, to the Last Will and
Testament, the attached or foregoing instrument, who have signed the instrt,iment,
having been duly qualified according to law do depose and say:
a. that I, the Testatrix, do hereby acknowledge that I signed and executed
the instrument as my Last Will and Testament, that I signed it willingly and
as my free and voluntary act for the purposes therein expressed; and
b. that we, the witnesses, were present and saw the Testatrix sign and
execute the instrument as her Last Will and Testament, 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 thie Testatrix
signed the Last Will and Testament as a witness and that to thE; best of
our knowledge the Testatrix was at that time eighteen (18) or rriore years
of age, of sound mind and under no constraint or undue influence.
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Hazel L. Smith
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Subscribed, sworn to and acknowledged before me by the Testatrix and the
witnesses above-named, this 15th day of September, 2006.
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Notary Public
NOTARI SEAL
TRISHA A. LIESS, Notary Public
Borough of Carlisle, Cumb. County. PA
My Commission Expires May 20, 2010
Last Will and Testament of Hazel L. Smith Page 3 of 3