HomeMy WebLinkAbout01-10-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF C~ U'~'~ 1~~1-~~ ~ 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 Informa con ,{~-~ ~"~ K ( S
Name: P~ I STd ~ ~'
a/k/a:
a/k/a:
a/k/a:
Date of Death:
File No: ~ j ~ ~~~ _ ~1~'~-~ /
(Assigned by Register)
Social Security No:
Age at death:
County, ~~
~t~_.~,nlr~<l~.~tl~i
Decedent was domiciled at death in ( ct.l~l ~~.
principal residence at ~'l1 ~ ' ~ ~M Woot~ ~'
Street address, Post Office and Zip Code
Decedent died at
Street address, Post Office and Zip Code
City, Township or
~{ A-rv t ~s.~
City, Township or Borough
22c~ - 5~ -- 3s ~~
~~ C
o(Stare) with his/her last
C"~tM~
Countys~
County State
Estimate of value of decedent's property at death: $ ~~'~ ~1 ~
If domiciled in Pennsylvania ................. • • . • • • • • • • .All personal property
/f not domiciled in Pettnsylvania ........................ Personal property in Pennsylvania $
!f not domiciled in Pennsylvania ........................Personal property in County $
.............. r
Value of real estate in Pennsylvania .............. • • • • • ' ' ' • ~ • TOTAL ESTIMATED VALUE.... $ _, D
Real estate in Pennsylvania situated at: Count
Street address, Post Office and Zi Code City, Township or Borough >'
(Attach crdditionnl sheets, if necessary.) p
A. Petition for Probate and Grant of Letters Testamenta ~ ~ Z~ t (-/ ~/ and Codicil(s)
Petitioner(s) aver(s) he/shelthey is/are the Executor(s) named to the last Will of the Decedent, dated
thereto dated
State relevant circumstances (e.g. renunciation, death ojexecutor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divoand d d not ha Pe a child bom og
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g),
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
~NO EXCEPTIONS ^EXCEPTIONS
:7 ~~:.
~~' _ ,-
B. Petition for Grant of Letters of Administration (lf applicable)
c. t. a., d.b.n., d.b.n.c.t.a., pendente life, durmttea~s~tia~duraite mina•i;ctte
,.
If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete tis'~'~rtteirs~-:
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 -,
Petitioner(s), after a proper search has/have ascertained that Decedent left no W ill and was survived by the following sptRise (if any) andh2irs (uftuch =~ ;
~~drlirinnal sheets, if necessar7r):
Page 1 of 2
F-rrnr aw-nz rev. l nill:'~nll
Official lisc Only
Oath of Personal Representative
CO~[~IONW"EALTH OF PENNSYLVANIA }
} SS:
COt'NTY OF C~J~(h~'A ~-~~~ }
Petitioner(s) Printed Name Petitioner(s) Printed Address
I ~~0 5
Tl1e 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 De~a3ent, he Peti io 1er(s) will well and truly administer the estate acc~rding to law.
Date_ ~L~ ^~ ~"
Sworn to or affirmed and subscribed before ~a..~~'~- ~-c l Date
me thi )L~r~day of ` c'~ ,~~
Date
~Y~ i ~ T ~-~ ~ ~ "~, ~ti"y'~- Date
Fir the Register
BOND Required:~YES ~NO
FEES:
t ~,,
$ ~ C/
Letters ....................
( ~ ~) Short Certificate(s).... ..
.. '` ~ ~-'t%
( )Renunciation(s)....... . .
( )Codicil(s) .......... .. .
( )Affidavit(s)......... .. .
Bond ..................... ...
C0111mIS$1011 . .............. .. .
~
[
. .
~ .....
... I - ~ `
Automation Fee .............. .
JCS Fee . .................... ~--.
TOTAL ..................... $_~?
;,, ~~
tJ _..
To the Register of Wills: ~ t -~ -
Please enter my a earance by my signaCp~e~b!low: --
Attorney Signature: ~/"~~ `
,.
r
/~,~ c,°
Printed Name: ~ ~ty,~ ~
Supreme Court ~ ~ Z
ID Number:
Firm Name: ~r~-~L~_ d/L l (~ CvLC
Address: 0 f ~ S, UGC
' >~
T ~'i y
Phone: '? ~ ? ~ 3 .L ~j 7c~ 6
Fax: .j 4' Z
Email: ~f~. ~ B/G _~" '~ 'O~ . t_~•"-~
t
DECREE OF THE REGISTER
~~
~ L~~ ~S File No: .~ (" ~ . ~` ~~' ~'.~
Estate of -
a/k/a:
AND NOW, ~(~ ~ ~~ ~~ I *~~ -t~ ~ ~t- ~~ '' ~ ~~ in consideration of the foregoing Petition,
satisfactory proof having been presented before.me IT IS DECREED that Letters
are hereby granted to ~ ~ ~ ~ S 1~1 ^-~ G K l/ ~-~ k ~
in the above estate and (if applicable) that
the instrument(s) dated
described in the Petition be admitted to probate and filed of record asl!the last Will (/and Codfficil(s)) of Decedejnt.
Register of Wi 1 Wit/ {'~ ~ ~ 1~-( ~. .-.,.~ ~~' a > __.,
~. .,,~ Page 2 of. 2
Farm RW-t)2 ,•w. tninizou
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograp;~.
Eee for thl> c~:rtificite. ~t~.{I{)
P__ 1764__5012
C'crtifica[i;~n ~ulnher
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H1O6 114 REV 1112006
TYPE I PRINT IN
PERMANENT
BUCK INK
1133-096
t. Name of Deceanl (First, rttidtlle. last. sNfix)
Hristos K
B-Ruda llrxler 1 year
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
p. Se, 3. Social Security Number 4. Date of Deam (Room, day, year)
Kanelakis Male 220 - 58 - 3569 Se tember 6
>ay 6. Data of BiM (M^nm. daY Year) 7 &rmpuce (City aM Sure «I«n n country) Ba. Place of Deam (Check Dory one) Omer.
5. Age (last i yl Hospital.
Nomow Days Hvas Ninvlea ^ OOA ^ Nursi Home Resdence ^Other - Speory
^ Inpatient ^ ER / Outpet nt n9
70 Yrs Januar 1 1941 A inion 9wasDecedentdHispanicorigin? [~Np ^Ye5 ,o Race.AmerianlManBlack.wneeetc.
8c. Ci Bo Tw . f Death fis. FadMy Name (H not mnnunon, give nren and ruroerl (Il yes. speciN Cuf»n. (Sp~iM
• fib. County d Death ry~ p Mexlcari Puerto Riau, etc.)
White
hi h sr atle eted t/. Manul $reras: Marred, Never Martied. 16. Survbeg Spouse Q5 wife. give maroen name)
Cumberland U er Allen 477 East Elmwood Avenue
11. DecedxKs Uwal Occu Iron Klnd of work done tl most d Me. Oo rid slate reli 12. Was Decedent ever in ale t 3. Decedent's Etlucaeon lSVecih' Doty g e gr ariW 1 Witlowe4 Divorced (SpeciM
Kud d Business / Insustry U.S. Armed Forces? Elementary I Secondary (0-12) College (1-4 or 5+)
Kud dwork ~ ~1r1St1ne $COTO S
^ Ye5 1
DN par;edenl (fn~j(r D~ 1 en Twp
Dapeanl'S lvania Lrve in a 17c. ~ Ves. Decedent (Ned in •CL"
16. DeredenYS Maitinq AtlhesS (Street, city I tam. stele, Zip code) peal Residence 17a. Sure P~Sy Township?
477 E . E1tilNx~od Ave. rid. No, Deeeaent l;.ee wttnn cM 1 R«p
.._..t,...,. PA 17055 17°-D°"mry C`tTmharl ~ Adpalunn5d
`•~ ~ ~CSb~g r 19. Mom«'s Name (Frst. midde. maiden surname)
tfi. Earner's Name (First. middu, un, wffix) Marla i
n 20D. Informant's Mailing Address (SUeet. dry I town, state, zip code)
208. Idormant's Name (Type / Pant)
477
Monm. daY. Year1 2t<. Place of DisppsitKn (Name d cemetery, «ematory «omer place) 21
Christine Kanelakis
Date of D'aposimn
21 b
d. Location ICM I town, slaw, zip code)
.
2ta. Metlad d Disp~sdion ^ Cr«afion ^ Donation
[~ Renal ^ Removn from 'Wes Cramalbn or t3«utb^ AIM«Ized
~ H111 Carnet
4 ^Yes ^ No 9 ~ 9I 2O1
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R
2 Ha erstOWLl MD 21740
^ DVlef - SpecrYy Medkat Examirwr / Dorat«
IT1C
Fad
c Name antl Atltlreu d
Neill ]:'17T1era1 Herne,
2
22a. Sgarure d nice L' ~ u sum) 22b. license Numb«
- 3401 Market St. Hill PA 17011
_ ,
23b. License Number 23c. Date Sgned (Hoorn. ay. Year)
r e rd tree(
cerelyiig 23a. To me best d my kmwledga, darn occurred at s,e erne, dau and P~ ~~. 155na « a
c od
tt
y
e
Campkre
plrysldan ~ avaaable n tlma of deem ro
ceun/ ease dBeam. 26. Was Case Referred rp Metlkal Ezaminer -
I Coroner for a Beeson Other man Cremation or Donation?
Time d Death 25. Date Pronanced Dead (Hoorn. Oay, Year) es ^ No
24
.
items 24-26 mat 0e competed by Parson 2O 11
7 : 2 2 A. Nt. S e tember 6 , M mr~eiuon: c ~~a ,
seam
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o deem, z6. Da Tpbaao use conmbma ro Deem?
.
woo pronounces
u
r Appmximau imerval: Pad 11'. Enter , y
y,s PmOabl
CAUSE OF DEATH (Sea InstruMlons and examples)
set to Deam but rM r85uXing'n me undedpng cause 9~ven n PM I. ^
t
O
r
.
«canp~catxx¢ -mat dreary eased me dam. 00 NOT enter terminal evens such u ardac artes
injuries
- d'eeases
f
M ^ No ^ Unknovm
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,
eve
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item 27. Pan I: Fnrer me chain o
a StwwM9 aw ebdo~ Lai odY ^w cruse on eeCn line.
im
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respirafay arten. «vedfp tar fdriAe6on w 29. d Femak~.
IMMEDIATE CAUSE FuW dsease« Me tastic Lung Cancer
tt
'n ~) ^ Nd lxegrem within past year
m
ng
condtion rew
~ a.
Due to (or u a consequence Dry:
Pancreatic Carcinoma
d ^ Pregnant err Mre of dee
^ Nd pregnant bpt pragna°` whin 4z av5
any. b.
sagden,;aay liar c«wnron5,
~~dxq to me cruse listed on brie a. Duero 1« as a consequence of):
Emer me UNDERLYING CAUSE d deem
^ Nd pregnant, WI pregnam 43 ays m 1 year
(disease or inryry mat initiates me c.
evens resdtlrg n deem) LAST. Due to (or u a consequence of)_
r before deem
^ Unknown it pregram wiaan me pen year
d. 32c. Puce d Inry7'. ~. Farm. SUeel, Factory.
Oars d Inryry (MOnm• aY• Year) 320. Desuibe Her Injury Ocwrted
32a Office Rwldng, etc. (Spedryl
.
33a Wu an ANOpsy 300. Were Adopsy RMlrgs 31 Harrier of Deam
PeROrmetl? Ava9abb Prior w Canplelbn ~ Nmural ^ Homicide
Ir4uN n W«k? 321.11 Trensponation Injury ISy,ednrl 329. Location d In'
d Cause ol0eam? ~,
Street. dry I rown, sole)
.
^ Ac itlenl ^ Penyng lmastigabon 32d. Tme of Inju7 ^ pnuer I Operat« ^ Passm9er ^Peannan
^ Yes ~NO ^Yes ^ No ^ yes ^ Np
^ Sukide ^ Caukl Nd 0e Dererminetl H. Omar -Specify
33D. Sgnature and die of Cen
~~
33a' ~"~` l °~ one) aaam and comprerea nom z31
se d death when andher physkxan f s proraixwed
il
^
r one r
prq ea
• Certllying physician (Physidan arl
To fhe beat of my kllowbdge, dwm occurred due to dw ausets) and manner u staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
33c. Licenss NurtBe 33tl. Date Sigied (M«m. ay. Year)
• Pronouncl^g end pertdyhlg physlden IPMsidan both pronax ing dam and ceniying ro cruse d deem) ""'
and place. and due to me pause(s) end manner u sbted_ _ _ _ _ _ _ _ _ _ _ _ _
date
O
N o~rted n Me time S E tember 6 , 2O 11
.
,
u
To die but d mY laawud9e•
• MedkN ExamNer /Coroner 34 N me d P la Cause d Deam (Item 271 TYDe I Print
arp 9dd a-gs
in my ppmlon, death atoned at the time, data, and place, end due to me causetp and rrunner es sated- _ ~
Yff°^~enr ol~e
Corona r
and / « Irnesdgetion
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On the basis d exem
yean 6375 Basehore Rd. , Suite 111
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0 36. R ' trafs Signature and DLnMd Nu t ~ t J t t ~ I ('~ Se. t , (~ (t M
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Disposition Permit Np.
~~ ~'
I, HRISTOS K. KANELAKIS, of 477 East Elmwood Avenue, Mechanicsburg, '
Cumberland County, Pennsylvania, being of sound mind, memory and ~''
understanding, do hereby make, publish and declare this as and for my Last Will
~_ ` and Testament, hereby revoking all other Wills and Codicils heretofore made by me. ~~
~~
FIRST
--~ ~ ~'~l~.direct the payment of my debts and expenses of my last illness and funeral
-= frorrk~-~r estate as soon after my death as conveniently may be done. If there be no
_.
~_~:: c:;
cemetery lot available for my interment, owned by me at the time of my death, I
authorize my personal representative to purchase such cemetery lot with a contract
for perpetual care, using therefore funds from my estate, in such amount as my (^''
personal representative shall consider necessary and desirable and I authorize my
persona! representative to cause title to or ownership of such lot so purchased to be
vested in such person as my personal representative shall designate.
Further in this connection, I authorize my personal representative to expend
funds from my estate, in such amount as my personal representative shall consider
necessary and desirable for the purchase, erection and inscription of a suitable
marker for my grave.
SECOND
I give, devise and bequeath all my estate, whether the same be real,
personal or mixed and wheresoever situate, unto my spouse, Christine L. Kanelakis,
provided my spouse survives me by sixty (60) days.
THIRD
!n the event my spouse fails to survive me by sixty (60) days, I give, devise
and bequeath my entire estate, whether the same be real, personal or mixed and
wheresoever situate, unto my three children, namely Kimon Christos Kanelakis,
Demetzios Christos and Stefanos Christos Kanelakis, in as nearly equal shares as
practicable, per stirpes.
FOURTH
In addition to the powers conferred by law, I authorize my personal
representative, in his or her absolute discretion:
A. To retain in the form received and to sell either at public or private sale,
any real or personal property; and
B. To manage real estate; and
C. To invest and reinvest in all fc~ms of property without being confined to
legal investments and without regard to the principal of diversification; and
D. To exercise any option or rights arising from ownership of investments;
and
E. To compromise claims without court approval and without the consent of
any beneficiary, but not limited to claims by the Commonwealth of Pennsylvania with
respect to inheritance taxes on any future interest passing under this will.
F. To continue the operation of any business that I may own at the time of
my death for the period of time and in the manner that he, she or it considers
advisable and to be in the best interest of my estate, or to sell, or to liquidate the
business at the time and on the terms and conditions that he, she, or it considers
advisable and in the best interests of my estate.
FIFTH
All shares of principal and income herein given shall be free from
anticipation, assignment, pledge or obligation of any beneficiary and shall not be
subject to any execution or attachment.
SIXTH
I direct that any and all inheritance, estate and transfer taxes imposed upon
my estate passing under my Will or otherwise, shall be paid out of the principal of
my residuary estate.
SEVENTH
AI! benefiiciaries taking under this Will must be at least 25 years of age at the
time that any bequests come into their possession.
Up to the age of eighteen (18) years I appoint the bank fisted in this ~°
paragraph as the Guardian of any property that passes to such person or persons. ~~
In addition to the powers given by law, I authorize the Guardian to (a) Use
such amounts of both income and principal as it, in its sole discretion, deems proper '
for the support, education and welfare of such minor without leave of any court; and
(b) to invest in any property without restriction to legal investments.
Between the ages of eighteen (18) years of age and the time that a
distribution is to be made in accordance with this Will, I appoint the bank listed in
this paragraph as the Trustee of any property that passes to the person or persons.
In addition to the powers given by law, I authorize the Trustee to (a) Use such
amounts of both income and principal as it, in its sole discretion deems proper for
the support, education and welfare of such minor without leave of any court; and (b)
to invest in any property without restriction to legal investments.
I appoint Keystone Financial of Carlisle, Pennsylvania to act as Guardian and ~
thereafter as Trustee of any property that passes to any beneficiary who is effected
J
by the terms of this clause.
EIGHTH .
I willfully and voluntarily make it my desire that my life shall not be artificially f
prolonged under the circumstances set forth below and do hereby declare: ~ ,_r
A. If at any time I should have ar. incurable injury, disease or illness certified
to be a terminal condition by two physicians, and where the use or application by
any person of artificial, extraordinary, extreme or radical medical or surgical means
or procedures calculated to prolong my life would serve only to artificially prolong the
moment of death and where my physician determines that my death is imminent,
whether or not life-sustaining procedures are utilized, I direct that such procedures
be withheld or withdrawn, and that ! be permitted to die naturally and with dignity.
B. In the absence of my ability to give directions regarding the use of such
life-sustaining procedures, it is my intention that this directive be honored by my
family and physicians as the final expression of my legal right to refuse medical or
surgical treatment and accept the consequences of such refusal.
C. I execute this directive with the understanding that any person, hospital or
medical institute which acts or refrains from acting in reliance on and in compliance
with this directive shall be immune from {lability otherwise arising out of such failure
to use or apply artificial, extraordinary, extreme or radical medical or surgical means
or procedures calculated to prolong my life.
D. I understand the full import of this directive and I am emotionally and
mentally competent to make this directive.
NINTH
I nominate, constitute and appoint my spouse, Christine K Kanelakis, as
persona! representative of this my Last Will and Testament. In the event of the
renunciation, death, resignation or inability to act for any reason whatsoever of my
said spouse, I nominate, constitute and appoint my son, Kimon C. Kanelakis, of Ann
Arbor, Michigan, as personal representative of this my Last Will and Testament. I
hereby relieve my personal representative from the necessity of posting security in
connection with duties as such in any jurisdiction in which my personal
representative shall be called upon to act insofar as ! am able by law to do so.
IN WITNESS WHEREOF, I, Hristos K. Kanelakis, have hereunto set my
hand and seal to this my Last Will and Testament, consisting of seven typewritten
pages, the first four of which bear my signature in the margin for the purpose of
+' nn
identification this ~_ day of k~e c~~.~ e~ 1999.
~j _'
__ ~ _ _`_~
RISTOS I
SIGNED, SEALED, PUBLISHED AND DECLARED BY THE ABOVE NAMED
HRISTOS K KAN~LAKIS as and for his Last Will and Testament, in the presence of
us, who at his request, in his presence and in the sight and presence of each other,
have hereunto subscribed our names as witne/s~ses.
of (Qp 1 iS1P ~~ l 741 ~
.S ~ 2 of ~ X70, jJ
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF Y~ - K SS
HRISTOS K. KANELAKIS, the Testator, whose name is signed to the
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed this instrument as my Last Will and
Testament; that I signed it willingly and that 1 signed it as my free and voluntary act
for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by Hristos K Kanelakis,
the Testator, this I ST day of ~e ~e r. ~c, p - , 1999.
Testator, HR13'f`~ K.~I~A~NELAKIS
Nota Public
Notarial Seal
Ronnetta S. Rider, Notary Public
Dillsburg Boro, York County
My Commission Expires Feb. i 2, 2001
Member, Pennsylvania Association of Notaries
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF y~= ~ ~ SS
We, hex ~ ~ ~a,~ ~e ~ and ~JGLS/9-r~ IS'~/2,~g T ~' e. ,
the witnesses whose names are signed to the foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw the
aforesaid Testator sign and execute the instrument as his Last Will and Testament;
that he signed willingly and that he 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 eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
Sworn or affirmed to and subscribed to before me, this 1 , ~ day of
e~~.. hQ r , 1999.
~ - / )~_ Notarial Seal
v'-a' Ronne r, Notary Public
Nota PU~J~IC s urq oro, York County
ry My Commission Expires Feb. 12, 2001
Member, Pennsylvania Association of Notaries
Ronnettr, Notar:; ;;r,a;
S• RiJr r l,i.~±a, °ublic
Dillsbi:rg 6orc. Y~,.K `•i~unty
MYCommis~;on Exp;re^ Gib, 1,,
,mbQ~ per"" P``;_---- .. 2001
„f ~intaries