HomeMy WebLinkAbout12-06-11PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s) tht
following and respectfully requests the grant of Letters in the appropriate form:
Gregory M. Kerwin
Decedent's Information
Name: Daniel G Coury File No: 21 -11 _ ~ 6~ ~ \
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 193-14-3120
Date of Death: 11!2712011 Age at Death: 88
Decedent was domiciled at death in Cumberland County, pA
principal residence at Manor Care, Market Street, Camp Hill 17011 East Pennsboro
Street address, Post Office and Zip Code City, Township or Borough
(State) with his/her last
Cumberland
County
Decedent died at Holy Spirit Hospital, 503 North 21st Street, Camp Hill East Pennsboro Twp. Cumberland PA
Street address, Post Office and Zip Cade City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania ........................ All personal property $
If not domiciled in Pennsylvania ................. Personal property in Pennsylvania $
If not domiciled in Pennsylvania ................. Personal property in County $
Value of real estate in Pennsylvania........... $
Real estate in Pennsylvania situated at
(Attach additional sheets, if necessary.)
450,000.00
TOTAL ESTIMATED VALUE$ 450,000.00
Street adtlress, Post Office and Zip Code
City, Township or Borough
^X A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated
thereto dated
County
11/09/2010 and Codicil(s)
(State relevant circumstances, e.g., enunciation, death o/executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate, Decedent did not mar ,was not divorced, was not a party to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. ~ 3323(8), and did not have a child bom or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
^X NO EXCEPTIONS ^ EXCEPTIONS
^ B. Petition for Grant of Letters of Administration (If applicable)
c..a.; ..n.; ..n.c..a.; pe en e 1 e; uran e a sen la; uran a minon a e
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.
Except as follows: Decedent was not a party to pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa. C.S. § 3323 (g) and was neither the victim of a killing nor ever adjudicated an incapacltated person.
^X NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Deoedertt left no Will and was survived by the following spouse (if any) and heirs (attach __
additional sheets, if necessary): CC~7 ~~
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Official Use Only
Petitioner(s) Printed Name Petitioner(s) Printed Address
Gregory M. Kerwin 4245 State Route 209
Elizabethville, PA 17023 ~ jy
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~~~ rouuuncr~s~ above-names sweartsl or arrlrmtsl tne.stateme I the toregoi Petition are true and correct to the best of the knowledge and
belief of Petitioner(s) and that, as Personal Representative(s) of t e nt, P I ' Her(s) will well and truly administer the estate according to law.
J
Sworn to or affirmed a uescribed be ore Date
met 's ~ day of ti'1 C ~~ Date
BY: j ~ Date
For the Register / Date
BOND Required9 ~ Yes ~ No To th gisterofWills:
FEES Plea a nter my appearance by my signature below:
Letters ............................................ $ L . U Att n Sign •1
~
(~) Short Certificate(s).......... ~
( )Renunciation(s) ...............
( ~) Codicil(s) ......................... ~O ~
~
( )Affidavit(s) ....................... Print a Gregory M Kerwin
Bond ............................................
..
Commission ................................... Supreme Court
ID Number: 21222
Other
(~ t ~~ ~ ~ ~ U Firm Name: Kerwin 8 Kerwin
Address: 4245 State Route 209
Elizabethville, PA 17023
Automation Fee ............................. (~
~~ Phone: 717/362-3215
JCS Fee .........................................
Fax: 717!
TOTAL ........................................... $ E-mail: gmkerwina~hotmail.com
DECREE OF THE REGISTER
Date of Death: 11/27!2011
Social Security No: 193-14-3120
Estate of Daniel G Coury File No: 21 - 11 -- ~ ~ ~ \
a/k/a:
AND NOW, ( ~~ ~ , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Gregory M. Kerwin
in the above estate and (if applicable) that the instrument(s) dated 11/09!2010
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
Copyright (c) 2011 form software only The Lackner Group, Inc. ge 2
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17927927
Certification Number
U REV 112006
= I PRINT IN
AMANENT
IACK INK
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent fili
~ ~OV302011
~G~ ~ /
Local Registrar Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examoUAS on revnrnwY
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1. Name d DeptlerA (Ebel, mdde, iael, eu6iz) 2. Sss 3. Sodal Sewey Number 4. Date d Deem (Mash, day, year)
,.
Daniel G. Coury Male 193- 14 ,- 3120 ,
November ~7, 2011
5. Ape (Last BMdMey) Under 1 UMu 1 6. Dam d BIM 7, and etrde a 3e place d petlh Chock pl,
~a Days Hours knuwe HaDihl: Other:
88 vrs. a tember 23, 1923 Lansford, PA f7hpened ^~/~~ ^~ ^N~hai,ap ^Reaidence ^oma~speafy:
8b. Couiry d Deem Bc. CKy, 6oro, Twp. d Deem 9d. FscNKy Name (K nd hrtlnNon, pM eneel end resnber) 9. Wee Decedent d H4peMe OrigNi? ®No ^ Yea 10. Race: Amedpn In6eri, Black Wlde, etc.
Cumberland E. Pennsboro ("~B6''P"~''~1B"' (
2wyp. Holy Spirit Hospital Meaipn,PwrbRipn,ew.) White
• 11. Depdem's llwd d wok done moeld 91e. Do nd eteae 12 Wee Depderd ever h the 13. Depdxd'e Edupptlon (SDW y Wy NpMat pads mnpbled) 14. MMW SteWe: Married, Never Mertied, 15. SurvMng Spouse (0 Wife, phre maiden nertie)
Kind d Wok Klnd d Buelpesl kMuary U.B. Aymed Forces? FJemenmry / Secarrdery (U72) Cdkge (1 d a 5t) ' Dharoed ISP•oYi'1
Accountant State Gove
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vee ^Na 12 2 Widowed
• 1e.oB~eaemaMaahpA~areealso-eet,dynoWO,amce,ap~oae) oe~aem~8 East Pennsboro
1103 Yverdon Drive, Apt. B1 Aclwi Reaiderlce na. stete_ Pennsylvania L~°Na l°~dB1d nc.®rea, Depdenl lhredh T
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Camp Hill, PA 17011 17b. Counry Cumberland T°~i1pP na.^NO, Decadem livetl wimin
Acbel LknOs d Ciry I Boro
16. Femefs Name (Fast. mlddk, lest, srmx) 19. Motlrle Name (Fkst, mbdM, nleitlen eaname)
Albert Coury Bahia Saleh
20a. Inkvmed'e Name (Type / Pdnt)
Sharon Madden 20b. Inlormera'a MaMrp Address (Sheet, pY / tavn, etero, ziP pde)
1280 Rosstown Road, Lewisberry, PA 17339
21e. Mdhod d Dlsooeitlon ~ ^ gapnon ^ Dpatlon
® a,rol ^ Removelfransfate . w 216. Date d DiePpinp (MOmh, day, year) 21c. Place d Dlepoeltlori (Name d caplery, asma0ory a Mrer plepl 21d. Loption (City I town, state, zip code)
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~ ?2e. S lkames (a perap aNrg m sorb) 22h. Lkeme NaMer Yh. Name end AdAaee d Fray
• - FD 012 848 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
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Kern 27. Pan I: Enter me Nlloot.emah - tlMeeeae, injuries, a prnpliptlors -met ~ ~o~e
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LAST WILL AND TESTAMENT
OF -c~ `-- :a~,
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DANIEL G. COURY ~''`~'
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I, DANIEL G. COURY, of 1103 Yverdon Drive, Camp Hill"`7011, CQinty of -~`~"
Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and
understanding, do make and publish this, my Last Will and Testament, hereby revoking and
making void all former Wills by me at any time heretofore made.
FIRST: I direct my hereinafter named Executor to pay all my legally
enforceable debts, funeral expenses, administration expenses, and inheritance, estate,
succession or excise taxes, which I owe or may become due on account of my death, as soon
as may be convenient after my decease.
SECOND: I give, devise and bequeath all of my estate, be it real, personal and
mixed, whatsoever and wheresoever the same may be situate at the time of my death to the
following:
1. Fifty percent (50%) of my estate to be divided equally as follows:
A) One third to my nephew, ROBERT GRAY.
B) One third to my brother, JOSEPH COURY.
C) One third to my niece, BARBRA SCOTT.
In the event any of the aforesaid beneficiaries, should predecease me, I direct that
~nc.ir sham; of my estate shall pass to their issue per stirpes.
2. Fifty percent (50%) of my estate to my sister-in- law, KATHLEEN A.
GREGORY M. KERWIN
TERRENCE J. KERWIN
JOSEPH D. KERWIN
HOLLY MCCLURE KERWIN
ATTORNEYS AT LAW
DEMETOR.
Page 1 of 2 Pages
Daniel G. Coury
THIRD: I nominate, constitute and appoint GREGORY M. KERWIN, as
Executor of this, my Last Will and Testament, authorizing and empowering him to sell and
convey any and all real estate of which I may die seized and possessed.
In the event GREGORY M. KERWIN, is unable or unwilling to serve, I nominate,
constitute and appoint, JOSEPH D. KERWIN, as Executor of this my Last Will and
Testament.
I further direct that my Executor or personal representative shall not be required to
post bond to act in said capacity.
IN WITNESS WHEREOF, I, DANIEL G. COURY, have hereunto set my hand and
GREGORY M. KERWIN
TERRENCE J. KERWIN
JOSEPH D. KERWIN
HOLLY MCCLURE KERWIN
ATTORNEYS AT LAW
seal, to this my Last Will and Testament, this ~~ day of November, 2010.
SIGNED, SEALED, PUBLISHED and
DECLARED by the above-named
Testator, DANIEL G. COURY,
as and for his Last Will and
Testament, in the presence of us,
who at his request and in the
presence of each other, have
hereunto set our names as
witnesses:
Residing at. DANIEL G. COURY
~'~ ~1~ :
:
esiding at: ~ ;
//-I _ _ .
Pa e 2 of 2 Pages ~ ;
Z:1Maria\Wills\Coury, Daniel.wpd
OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Daniel G Coury ~p, Decea_sed -~~
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Terrence J. Kerwin _~_~ 11
Tina L. Lloyd ~ ~ ~:' ~ ~''
(each) a subscribin~w~ness to, ' ; ~ ~ ,_:,
(Pont Names) -'r'
the ^x Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same
and that she / he /they signed the same and that she / he /they signed as a witness at the request of
the Testator /Testatrix in his /her presence and in the presence of each other.
(Signature) Ter ce J. Kerwin
Signature) Tina L. LI d
276 Wagon Road
(Street Address)
Millersburg, PA 17061
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
Deputy for Register of Wills
177 Gary Drive
(Street Address)
Millersburg, PA 17061
(City, State, Zip)
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this 3°th day
of Novem her 201 1
~~ ~ ~~
Notary Public
My Commission Expires:
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's commissicn.)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Nancy J. Ligon, Notary Public
Washinp~on Tvvp., Dauphin County
My CommfaNon ~ 21, 2013
Member, Pennsylvania Aeeoclatlon of Nfrterlse
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW-O3 Rev. 10-13-2006 Copyright (c) 2006 ronn software only The Lackner Group, Inc.
CODICIL TO LAST WILL AND TESTAMENT
OF DANIEL G. COURY
I, DANIEL G. COURY, now of 1103 Yverdon Drive, Camp Hill, Pennsylvania
17011, being of sound mind, memory and understanding, do make and publish this Codicil to
my Last Will and Testament dated November 9, 2010, to provide as follows:
I give and bequeath all of shares of stock in Mid Penn Bancorp to my sister-in-law,
GREGORY M. KERWIN
TERRENCE J. KERWIN
JOSEPH D. KERWIN
HOLLY MCCLURE KERWIN
ATTORNEYS AT LAW
KATHLEEN`A~. DEMETOR a_nd~her daughter, {ATHLEEN BLE~""
Q.~i-(~ ; C7' ~'~-~C.JP~ f^' ~r :/~"~t-2, .C'~cr-ric./
All other provisions of my aforesaid Last Will and Testament are hereby reaffirmed.
IN WITNESS WHEREOF, I, DANIEL G. COURY, have hereunto set my hand and
._.--,-
seal to this Codicil this day of February, 2011.
WI'ESSES:
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UanielG. Codicil. wpd
(SEAL)
DANIEL~G: C URY
OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of
Daniel G Coury ,Deceased
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Gregory M. Kerwin ~ =, ~`, ~ t'''
Beatrice M. Kerwin L i ~ J -~
(each) a subscribi~{vdif~i~ss tip...
(Pont Name//s)
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the ^ Will Q Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and ~-
say(s) that she / he !they was /were present and saw the above Testator /Testatrix sign the same
and that she / he /they signed the same and that she / he /they signed as a witness at the request of
the Testator /Testatrix in his /her presence and in the presence of each other.
ignatu Grego Ke~ in
2001rish Road
(Street Address)
Lykens, PA 17048
(City, State, Zip)
(Signature) Beatrice M. rw'
200 Irish Road
(Street Address)
Lykens, PA 1048
(City, State, Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Sworn to or affirmed and subscribed
before me this day before me this 30th day
of of Novl:rn bcr 2t7 i f
°H'i`'Z
Deputy for Register of Wills Notary Public
My Commission Expires:
(Signature and seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notarys commission.)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Nancy J. Ligon, Notary Public
Washlrpton 7~vp., Dauphin County
M Commission Expires 21, 2018
smb~r, Pennsyivanla Asaoclation of Notaries
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW-O3 Rev. 10-13-2006 Copyright (c) 2006 font software only The Lackner Group, Inc.
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OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Daniel G Coury ,Deceased
Gregory M. Kerwin and
(Print Namels)
(Pont Names)
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well-
acquainted with Daniel G Coury and am/are familiar
with the handwriting and signature of the decedent, and that the signature of Daniel G Coury
to the foregoing instrument purporting to be the t/Codicil of .
Daniel G Coury dated 03/11/2011 is in his/her own proper handwriting.
Gregory M. Kerwin
200 Irish Road
(Street Address)
Lykens, PA 17048
(Cdy, State, ZipJ
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this ~ day
of ~l1C~S~U1~1~~`Y, ~C~I1.
`deputy for Register of Wi s
(Signature)
(Street Address)
(City, State, Zip)
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Form Rw ~ Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Daniel G Coury
Terrence J. Kerwin
(Print Names)
and
Deceased
(Pont Names)
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well-
acquainted with Daniel G Coury
and am/are familiar
with the handwriting and signature of the decedent, and that the signature of Daniel G Coury
to the foregoing instrument purporting to be the Codicil of
Daniel G Coury dated 03/11/2011 is in his/her own proper handwriting.
(Signature) T e ce J. Kerwin
276 Wagon Road
(Street Address)
Millersburg, PA 17061
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
befg+`e~me this~,...L~~_day
IIS
(Signature)
(Street Address)
(City, State, Zip)
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