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HomeMy WebLinkAbout12-28-11PETITION 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) the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information ~ I _ I I _ 12~~% Name: MAXINE R. ANTONICELLI File No: 1 J a/k/a: (Assigned by Register) a/k/a: a/iva: Social Security No: 188-32-4653 Date of Death: 12/17/2011 Age at death: 70 Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (State) with his/her last principal residence at 5023 LENKER STREET 17050 M CHANICSBURG, HAMPDEN TWP CUMBERLAND Street address, Post Office and Zip Code City, Township or Borough County Decedent died at HARRISBURG HOSPITAL HARRISBURG DAUPHIN PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania ................................All personal property $ 236.000.00 If not domiciled in Pennsylvania .............................Personal property in Pennsylvania $ /f not domiciled in Pennsylvania .............................Personal property in County $ 7. Value of real estate in Pennsylvania .............................................................. $ TOTAL ESTIMATED VALUE.... $ 423.000.00 Real estate in Pennsylvania situated at: 5023 LENKER STREET 17050 MECHANICSBURG, HAMPDEN CUMBERLAND (Attach additional sheets, ifnecessary.) Street address, Post Office and Zip Code City, Township or Borough County ® A. Petition for Probate and Grant of Letters Testamentary Petitioners) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated 10/4/2011 and Codicil(s) thereto dated NONE State relevant circumstances (eg. renunciation, death of executor, etc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, 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(g), and did not have a child bom or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ® NO EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durante minoritate If Administration, c.ta. or d.b.n.c.i:a., enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent 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(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ^ NO EXCEPTIONS ^ EXCEPTIONS ___ ~ m t`J c"-~ r -"-- -_c -- b ,-, ~ ,'~ Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heits'(attach additional sheets, if necessary): C~ ~"s ~? ..=~ -~~ 17 -t7 f' ~ ~ _~ Name Relationship Address ~~ -,-- C7 ~-, - t,:'. ~,=, Form RW-02 rev. 10/11/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Official Use Only ~.i _ ,. Petitioner(s) Printed Name Petitioner(s) Printed Address FRANK J. ANTONICELLI III 1804 BRIDGE STREET r ~~% ''= ~~ ~`,~, E C BER D C ;i~,'.'~' `;~r'~• !~~T P 17070 TINA L. ANTONICELLI 5267 MEADOWBROOK DRIVE C(}A i( (~ I' ,`` ( h MECH NI SBURG PA 170 0 The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Decedent, the Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before 3 ~ ~ Date 12/28/2011 me this ay of ~~" ~~ , ~~ Date 12/2812011 By: g; ~,~ ,~.~[~ L:e.~ ~~ Date For the Register Date BOND Required: ^ YES ^ NO FEES: Letters ....................... $ ( ~) Short Certificates(s) ...... `'~ ( )Renunciation(s) ......... . ( )Codicil(s) ............. . ( )Affidavit(s) ............ . Bond ......................... Commission ................... . Other ~ ~ I I ......... } 5 Automation Fee ................. S JCS Fee ....................... ~ L TOTAL ......................$ To the Register of Wills: Please enter my appearance by my Attorney Signature: // below: Printed Name: MURREL R. WALTERS, III Supreme Court ID Number: 24849 Firm Name: MURREL R. WALTERS. III. ESQUIRE Address: 54 E. MAIN STREET MECHANICSBURG PA 17055 Phone: 717-697-4650 Fax: 717-697-9395 Email: DECREE OF THE REGISTER Estate of MAXINE R. ANTONICELLI a/k/a: AND NOW, 4~~~C ~P~~~ ~ ~ ~ ~y ~ l , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to FRANK J. ANTONICELLI. III AND TINA L. ANTONICELLI in the above estate and (if applicable) that the instrtunent(s) dated 1014!2011 described in the Petition be admitted to probate and filed of record as the last Will (and C icil(s)) of Decedent. 4 -(~- egister f Will /~ ~ Form RW-01 rev. 10/1l/10/1 ~`~C g Of 2 File No:~'~ ~1 ~ ~ °~- HIOS.ft(15 REV 101/(17) 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 17927520 Certification Number 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 filing. ~~, ~ ~ DEC 0 20.11 Local Registrar Date Issued . .- ~ ' - -~ -z r -. ,~ .. ~ ~ r - ----------- ~ ~ ~ y ' - h~ ~" ? -~ _.<- __. _ _ _ _ ~ ~ --1 .. ._.. fTs D .• , " l-~! 43 REV nnae COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS . .. ~i RIN CERTIFICATE OF DEATH n (See ineVUCtions and examples on reverse) aaaFA 1. Name d Decedent (FYsI, nedde, la,t, wlPoc) 2. Sex 3. Sadal SecaitY Nuniba 4. Dde d Drew (Mmm, day, year) ~vt5'ohi~\l. MaXit~2 R. 188 -31 !}-C~53 ~z- I~_ zo11 5. Age (tent IiemMy) tAMar 1 t)mrer 1 8. Dale a ant 7. end elate a teal mum M. Place d Drew Check ae Maee [hya Fh„ Aaixae6 Hospital: Other: ~ p 7 - 2q - j q 4-1 Harrisburg, PA ® ^ ^ ^ ^ ^ Residence Oter - spedty: ER! Ollpelient DOA Nursbg Home Irpedam vin. - llb. Csudy d Drew Bc. CMy, Soro, Twp. d Drell Bd FeWky Name gf nd YetitrNOn, give street and marcher) 9. Wee DeaMnt d Hbpedc Origin? ®No ^Ves 10. Race: Americen Indian, &ack While, dc. n' ( ( Dauphin Harrisburg Harrisburg Hospital ~waro Wi , eroa White it. DeadrCa )laud dasak done moat d ire. Do rot aWe 12. Wes Decedarll ever m the 13. Deatlwn's Edrealbn (Spedly my Ngfed grad. mmpbred) 11. MdiW Status: Monied, Never Monied, 15. Survmng Spouse (N wife, give maiden name) IOrltld Wak IOMdSuskerelkrdudry D US. AmeO Faas7 Elementary I SemnMry (0-12) Colege (1-4 or 5,) Witbwed, DNOrced (Spedly) ~uic~iasin Directo Student Loans ^rre ®Na 12 Divorced 16. DecadsnYS Melirlg Aaarres(SlreeL dryltavn, dale, zip code) 5023 Lenker Street D•e•Mm'a Penns lvania ~°p,,, l° ems' ,7e. Hampden 1kTp. T Adel Residerce 17a. Slate y ®Yes, Decedent Lived in wp. Cumberland T0N9~7 17d.^NO, Decedent Livetl wimm Mechanicsburg, PA 17050 17b. cPlady Adud Umitsd CirylBoro 18. Femafs Name (Fttd, rddde, rest suffix) 19. Momer's Name (Ftrst, mitltlle, makren surname) - John David Evans Henrietta Pauline Stemler 20a Irdaned's Name (Type! Prkd) 20b. Inbrmam's Makkq Address (Shed, coy! brm, etee, zip mM) Frank J. Antonicelli III 1804 Bridge Street, New Cumberland, PA 17070 21a MdhM d Dlspositlan ^ Cremeem ^ Dorellan 21b. Dent d Diapodtlon IMmm, MY, Year) 21c. Plea d Dispositim (Name d amerery, cremaMy or omer prece) 21d. Location (Citylrown, slate, zip rode) • ^ ~&"°l ^ R.mIXwfremslare ; aMedk.l a.°oi`"°lDeren."'z°"°d^ Y.e^ Na December 21,201 Rolling Green Cemetery Lower Allen Twp. , PA 1701 ~ 22a. la perem eclkig re such) 22b. Lianee Number 22c. Name end Address d FecNry ~ FD 012 848 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Conpbk grey wfen adrykrg 23a. To the bed d my lorowledrp, drew aavrred Mme thee, deb ell place dared. (9gnakae and title) 23h. Lxxeee Number 23c. Data Signed (Mmm, day, year) physkien'e nd awrLble M tlme d deem to oerdly ease d deah. Items 2428 moat ha mrnObled M person 24. Time d Drem 1 ye~r) 25. Deb Prmu er ce d ~y , d Dead (Marc1h - 26. Was Case Rderred to Medical Examiner I Caaer br a Reason Omer man C,rernatim w Donatim7 ^ • ale Prena•xws deem. ' I, /1 q. ~•'I 0.M. ~ 7 , ~ ~ ~ ( ~ ~ LJ~-L IJC.X ~ 1 201 ~ Yes ICI No CAUSE OF DEATH (Sae Irsatruoelofa erM nremples) ~ Apprexhare interval: Pad II: Emx omer ' 28. DiU Tobacco Use Cmtrfiule ro Dedh? Item 27. Pad I: &irer tlfe fb9¢! - 6aea,re, Nyudes, a mmpeatioM - met dhrdy sued de deem. DO NO'F enter temihud evems such a ardec erred, r Onset m Deem dd not resuhing In Be uMertying Huse given in Pad I. ^Ves ^ Probably feBQharely erred, or ventriwhr 1lbdlre8on wMrad ehwMp mB elebgy. Usl sly ore muse m tech IYe. r ^ No ^ Unkmwri I~MF.d1AlE CAUSaE IFhdl~re w r rs•slis9 deem _~ a R{,S bI Vq -f'~V~ ~v('lr.e5~' i 29. If Female: ^Nd nam wihin ant ear re . Due b la re a mnsequena o : ' i b ~ ~ ' , . a e. ZvtklX'S>fi-F~ a~ Ot~wtwDVt~~i S ' ' o i p y p g ^ PregaM d time d deem ^ ne a. re msfetetl c R Dare (or re a mreegance dl: i hirer UTAERLVNG CAUSE Nd pregnan4 bd pregnam within 42 days d deem (deeax a hy'"1'tMt hxliNed me c t 43 d ro 1 ^ N t t b evems resYlhg n deem) LAST, i pregen ut Dregnan ays year o , Due to (a es a mnseguence Dry: r ~ d betas death ^ Unlaevm 4 pregnma wihin tle Pad year . 30e. Was en Adopey 30b. Ware Adopsy F'Nidrgs 31. Manner d Deelh 37a. Dale d Irjury (Month, My, Year) 3ffi. Dsembe How kdury Occurred 32c. Plain of Inryry: Hans, Fenn, Sheet, Factory. Office Bi,Mmg, dc. (SpeaYy) Pedaned7 Avairebl• Pdor re Conpretbn a ca•ee d Deem? ^ Nemral ^ HpNdda ^ Yes ^ No ^ Yes ^ No ^ AaaMm ^ PeMMg IrwedlPtian 32d. Tine d reN•Y 32e. h'N•Y at Wak? 32f. If Treapoddion Iryray (SpecNyl xada ^ Passen er ^ Pedestrian ^ Driver/O 32g. Lmetion d injury (Sheet, city / lawn, side) ^ Suidde ^ Count Nd Da Delsrmied M ^ Yee ^ No g l . Omer- SpeNly: 33e. CertlBa (deck ady ae) 33b. Signature ell file d Cadlfler • CeslMyhg phYaldef (Plryeiden adHying ease d deem when erislter phyeidan tae praarced drew and mnprered hem 23) deem omumd dfeto the aesse(a)eM lanma ae dared--------------------------------- ^ ro ell beetamYloaa4edge . ~ ~ ~_r , 33c. Lkenre NuMer 33d. Date Signed (Month, day. Y••d • PfaftalalBYtg ant arlNYklg phrgdan (Phyaitien hors pronandrp Mdh ofd graying re rase d deem) TolMteadmy bfaadrlge, MOm omuned e<th~ Bme,Mre, end Plea, end memthe alm(a)aM mennernateled__________________^ MDN3~88Co Iz-17-~-011 • Madlal ExamNalCmonx On tlfe lwre d examinegal and I a Imredlgation, m my opinion, deem occurred al the tlme, dare, ant plea, ell ea to the ease(s) ant roamer a aretal. ^ rron YVho Completatl Cause of Dears (item 27) Type! Pdm 34. Na ll Ad d re s~ d P e e e m , 1 ~ - '/ ~ ~ ~ ~ ~ l / d Dkei R ' r 38 Dale F day Yea "L~ l.f I I L(R.7r l t s an c 35. eg etra ~ I ~ i I dl / I ~ . , ia~aai~ ' iz~l t-}ctrriSb 7tz ~1 R ~ r l Pemrg Nd. Ol~,`i I O'~ I LAST WILL AND TESTAMENT BE IT REME11kIBERED THAT I, MAX~NE R. ANTONICELLI, a resident of (:umberland County Pennsylvania, I 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 made by me. I I declar$ that I am not married and that I have a son, FRANK J. ANTONICELLI,',III and a daughter, TINA L. ANTONICELLI. II I direct that all my just debts and funeral expenses shall be paid from my residuary estat~ 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 and' bequeath items of personal property to specific individuals that I have set forth in a list which I have prepared, signed and maintain with this Will. V I give, devise and bequeath all my property, whether real or personal, wherever situat~, including any property over which I may have a power of appointment, tc~ my children, FRANK J. ANTONICELLI, III and TINA L -, n :: ANTOINCELLI, ir'~ equal shares, per stirpes. ~-~:70 -- - ~ ; r~s 1. ~ ~ Gr? _.._- ~~ i--, / .~ .~ `~ r_~ _ __~_~ i rt :.~ . .. ~ ~' -z~ L.7 ~' i I nominrate, constitute and appoint my son, FRANK: J. ANTONICELLI, III, and my daughlter, TINA L. ANTONICELLI, as Co-Executors of this LAST WILL, to serve without bond. If either is unable or unwilling to act in that capacity, then the other may ;serve alone as Executor. IN WITN~SS WHEREOF, I, MARINE R. ANTONICELLI, have set my hand to this LAST WILL this ~?~~\" day of ©C~~©b~-'~' , 2011. MAXIN R. ANTONICELLI Signed, sjealed, published and declared by the above-named MARINE R. ANTONICELLI, las and for her Last Will and Testament, in. the presence of us, who, at her regilzest and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. v ~ ~ ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF (CUMBERLAND ss. I, MAXIINE R. ANTONICELLI, Testatrix, whose name is signed to the attached or fozregoing instrument, having been duly qualified according to law, do hereby ackno~bvledge that I signed and executed the instrument as my LAST WILL; that I ~igned it as my free and voluntary act for the purposes therein expressed. r ~~ MAXI E R. ANTONICELLI Sworn or affirmed to and acknowled d before me by MAXINE R. ANTONICELLI, Testatrix, this ;~ -~~, day of ~ ~~ , 2011. !/y'1 . Notary Pu ' Nor,~~;r,>_ sEA~ DiAN~ i~~ C%P.~iTN ~ Notnr;J ~'ubilc ~^~~~!.~'~ tiSBURG BC~kC), CUMBERlA1VD GNTY AFFIDAVIT ^~Y ~cmmissiori Ex~~irr~s Jun 22, 2072 TH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND the witnesses v~hose names are signed to the attached or foregoing instrument, being duly qual~fied according to law, do depose and say that we were present and saw Testa ~ sign and execute the instrument as her LAST WILL, that MAXINE R. AN'~ONICELLI signed willingly and that she executed it a s her free and voluntary ~ct for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our kno~lvledge, the Testatrix was at the time 18 years of age or more, of sound mind ands under no constraint or w Sworn or affirmed t and acknowledged before me this jf ~- day of ~C,~ b-~-- , 2011. ~~ . )~~ Notary Public NOTAR4.Al. SEAL_ ~~ DIA3~a~ Iv' ~t'.41TN Notary FLb!!c g~"~~:;': ~!i'SBURGEC;ri'~,CUMBERL~WDCN7Y :-7y Cc~rrmission Ex~Las Jun 22, 2012