HomeMy WebLinkAbout01-13-12PETIT ON FOR GRANT OF LETTERS
REGISTER OF WII.LS OF C MBERLAND _ ______ COUNTY, PENNSYLVANIA
Petitioner(s) named below, who is/are 18 ye rs of age or older, apply(ies) for Letters as specified below, and in
support thereof aver(s) the following and re pectfully request(s) the grant of Letters in the appropriate form:
Decedent's Information _
Name: DEANS D_ CLARK _.._ _ File No• ~ ~a~J ,~I
a/k/a• (Assigned by Register) '~
a/k/a•
Date of Death: 1212 8 / 2 011
Decedent was domiciled at death in C U M B R L A
principal residence at 2912 MERION ROAD
Street address, Posl Office and p Code
Social Security No: 17 7- 2 4= 5 4 0 8
Age at death: 83 YEARS
County, PENNSYLVANIA (State) with his/her la
CAMP HILL CUMBERLAND
City, Township or Borough County
Decedent died at _HOLY SPIRIT HOSPITA 17025 East Pennsboro Cumberland PA
Street address, Post Office and Zip C City, Township or Borough County State
Estimate of value of decedent's property at death:
lvania
If domiciled in Penns ..
All personal property $ _ 5 2 , 0 0 0 • 0 0
,__
.....................
y . ......
.. _
..
lvania
If not domiciled in Penns . ....Personal property in Pennsylvania
.
.. $
...............
.
y ..
.
If not domiciled in Pennsylvania .................. . ..........Personal property in County $ _
Value of real estate in Pennsylvania ............... .. ............................................. $ _ 15 5 , 4 0 0 • 0 0
TOTAL ESTIMATED VALUE.... $ _ 2 0 7, 4 0 0. 0 0
RealestateinPennsylvaniasituatedat: C7LC rierio Roao yruyy ~amN nisi ouruu~ri ~umuerianu
(Attach additional sheets, i/ nerevsnrv.) Street address, Pos Office and Zip Code City, Township or Borough County
® A. Petition for Probate and Grant of LE
Petitioner(s) aver(s) he/she/they is/are the Executor(s)
thereto dated -~_._~
State relevant ei cumstances (e.g. renunciation, death ojexecutor, etc.)
Except as follows: after the execution of the instrument( )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 een established as defined in 23 Pa. C.S. § 3323(g), and did not have a child born or
adopted; and Decedent was neither the victim of a killin nor ever adjudicated an incapacitated person.
® NO EXCEPTIONS ^ EXCEPTIONS _____. ___.-___ . _
^ B.
If Administration, c.t.a. or d.b.n.c.t.a., ente!
Except as follows: Decedent was not a party to a pendir
in 23 Pa. C.S. § 3323(g) and was neither the victim of a
^ NO EXCEPTIONS ^ EXCEPTIONS _
Petitioner(s), after a proper search has/have ascertained
additional.rheet.r, if necessary):
Name
in the last Will of the Decedent, dated • 1 / ~ l ^ ~ 4 and Codicil(s) ~
Address
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Page I of 2
Form RW-02 rer. 1 011 1 2 01 1
(If applicable) ~.
c. t. a., d.b.a., d.b.n.c.t.a., pendente file, durance absentia, durance minoritate
divorce proceeding wherein the grounds for divorce had been established as defined
fling nor ever adjudicated an incapacitated person.
Decedent left no Will and was survived by the following spouse (if any) and heirs (attach
Oath of Personal
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND - ___ }
Petitioner(s) Printed Name
VC I~--_--- -Official Use Only
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Petitioner(s) Printed Address
17 Val ley Street (~ "~ ~` "` `'
orhnni r~hi~nn Or~~~~~',i`~ t' ~.i._i ~_~~~.`I
The Petitioner(s) above-named swear(s) or affirm(s) the state
of Petitioner(s) and that, as Personal Representative(s) of the
Sworn too affirmed and $Cu~bncri ed_ before ;
me th' da of ~ ~i~i'
By: ~-
For the Register
Letters ....................... $
(6 )Short Certificates(s) ..... .
( )Renunciation(s) ......... .
( )Codicil(s) ............. .
( )Affidavit(s) ............ .
Bond .........................
Commi ssion ................... .
Other W i 11 ... .
BOND Required: ^ YES ~ NO
FEES:
us in the foregoing Petition are true and correct to the best of the knowledge and belief I
:edent, the Petitioner(s) will we~ll~an~d~truly administer the estate according to/l~a~w.
~~~-C~~~~%4~i`s'~ Date !L ' ~~°~ ~ I
Date
Date ~_
_ Date .
To the Register of Wills:
Please enter my appearance by my signature below:
Atto ignature:
•
Pri Name: m a n P• S i n e w - ______ _~
Supreme Court
ID Number: 2 0 919 0 _ _ ____ _
Automation Fee ................. _ 5
JCS Fee ....................... 23
TOTAL ......................$ 377 -
DEC
Estate of DEANE D • _.CLARK
a/k/a:
AND NOW, ~'~~~... ~__ ~~
satisfactory proof having been presented before me
_ are hereby gran
the instrument(s) dated - ~ ~~ ~ GO `-{
described in the Petition be admitted to probate anc
Form RW-02 rev. 10/I !20/ 1
Firm Name: Shumaker Williams, P.C__ _
Address: 3425 Simgson Ferrer Road __
C a m~__H i 11 .___ P A 17 011
Phone: 717-763-1121 ____-_
Fax: 717-763-7419 ____-
Email: siney5lshumakerwilliams•com
OF THE REGISTER
File No: o~ ~ " ~ ~ - U~~~
07U ~ ~ , in consideration of the foregoing Petition,
IT IS DECREED that Letters T~S~~~-'iyt-p-~_~~___- ~~'~~
~d to ~OIOp C-4- ~ -~~n 11~~~r -l- --- - -
in the above estate and (if applicable) that
filed of record as the last Will (and Codicil(s)} of Decedent.
Register of Wills
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H1US.ROi REV r0/In7+ _ _ I _
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal t~ duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17927995
Certification Number
113 REV 11f2006
PE! PRINT IN
>El,MANENr
BLACK INK
__-r
COMMONWEALTH OF PE NSYLVANIA • DEPARTMENT OF HEALTH • YRAL RECORDS c "
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
This is to certify that the information her given is
correctly copied from an original Certificate of Death
du]y filed with me as Local Registrar. T~~ original
certificate will be forwarded to the St~te Vital
Records Office for permanent filing.
~~
~IMM. ~~ D 310 011
Local Registrar Date I sued
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1. Noma of Decades (Brat. nNdda, meL auBN) 2. Sex 3. Sadal Secudly NumhM 4. Dam d Desch (Mpah, day, yea0
Deane D. Clark male 177 ~4 _5408 Dec. 28, 2011
s. Aga (Lest &MrmYl Ihltla 1 Urder 1 fi. Dam d BirNt 7. C aritl stem es ro M. Place d Deets check on one
8 3 Mahn Dan Hues Minuma
Yrs. June 7 , 19 2 8 H~cJey{ Nel: Uther:
Phi 1 ads 1 ph i a , PA IiJ ,npetled ^ ER ! DutpatieM ^ DDA ^ Nursing Homo ^ Residence ^ OMer - Spea7y
Sb. Coumy d Deelh Bc. City, Bao, Twp, d Deets Bd. Pettily Name (N nal i ,glue sheet ~d number) B, was Decadent at Hispardc Odgin? No ^ Yes 50. Race: Amearen 1ntNan, Black . ek.
Cumberland East Pennsboro Holy S irit Hospital (Mlax~ n'~.aroa wh ~e I~
51. UBCSdMN'e Ueial Kintl dwark d one ngetd Nm. Do not emm 12. Wes Oecedad ever Nis 13. Deuded's Edrallon ISP~i odY higheatt P•de ~nP ml•dl 74. Marital Smlus: Merced, Never Marred, 15. Surviving Spo use Qf wile, give maiden name)
Kintl d Work IOrd d &mMSe/ Inamoy U.S. Amted Forces? Elementary ! SecdWery (0.121 CoNega (1-4 or 5+) Widowed, Divorced (Speafy)
warehouse mgr. old storage ^vea Na 12 3 widowed
18. Deceder8a Meiling Address (Street, ciyltown, smm, zip code) Decedent's
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na. XsNa, Decedent Lived wlmin Camp H i 11 wp.
Cam H111 PA 17011 t7b Actaal umimd /ego
18. FeNmfs Name (Post, nYddm, mat, sutNx)
Harry H. Clark 18. kbiMfs Name (Fist, riddle, nmNen aurreme)
Katherine Lyons
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209. InlesmenYS Name (Type f PrIM) 20b. Idamiard's Msihig Address (Street, dty /town. smm, ziD code)
Robert D. Brillhart 17 Valley St, Mechanicsbur PA 17055
219. McOpd d DmpalNai ~ ^ Cremation ^ DmeNm 27h. Dale d d (Monts, day, year) 21 c. Place d DisDOSllbn (Name d cememry, cremalay a other place) lid. Location (City/mwn, stain. zip wde)
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~ Jan 2012 Rolling Green Cemetery PA17011
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D-013163 L 22c. Name end Address d Fadkly
Musselman FH&CS,324 Hummel Ave. ,Lemoyne,PA17043 ~
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Dompmte imma 29ec ony wMn cergyktg 23a. ToMa d my a<the Nina, dam aM place . (SlQmmre end Ndel 23h
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phyaiGan is nd aaalehm at Nine of areNi to
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~ Pmtouiced ,day, year) 26. Was Cesa R m Me6cel Examiner ! Coroner fa a Reason Otlrer Man Crarnagon a
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who pranoumsdeath. M.
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CAUSE OF DEATH (Sae InaWCBone and exampke) i ApproxNnem IdervaV: Ped IF. Einar osier 2B. Did Tobacco Use Cormi~Ae to DeaM?
Nam 27. Pad I: Elder de diem d evenm- , kQudee or cesrofnaaare - Met dr•a+N mimed dm deeM. DD N0T enter I evenm such as rerdiac enesl, r Onset m DeaM but rat resuMng in Me uMerlying cause gNen in Pan 1. ^Ves ^ Pn>baNy
readratesY erred. a ventdaNer IRrdNeNon wiUad showkg the eNOhgy. Lill mty are tales m each Ikie. '
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RL~YM~G CMISE ~ Due N (or as a wnsequence oQ: ; Na pregiam. but prepwtl wkhm 42
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Due tc (vr es a coreequerim d): ~ ~ ~M•gr~am, but pregnam 43 days t o year
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30a. Wee en Autopsy 30b. Were Auropny Firdrps 31. Manner d Death 32a. Dam d (Month. day, year) 32b. Descdhe How Injury Occuned 32c. Platy d M)txy: Hone. Farm, Street, F
Perrormed't AvaNelNe Prior m Canpmlbri
d Cause d l7eeM? }r.~~
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^ N ^ Aaid°^t ^ Pend'ng NmesaligaN°^ mod' Tine al I M ry 32a. InMey el Wak? 321 N Tranapatalian htjury (Spec%r) 32g. Laelian of injury (Street, cRy! rown, slam) ~i
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es ^ ~~ ^ CoiNd ~ ~ ~ ^ Vac ^ ~ ^ Drhrer/Operates ^ Passagar ^ Pedestrian
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33e. CertlNar pitack only are) 93b. Sipmture entl TNk d CerNNer ~ ,.
CarlNying PM~mn (~yNC~ ~h+tg muse d dMdi when amUar P has protwiawed deadt and ampbbd
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To the Mx d my Iniowmtlgs, death occurred rt the dine, Mta, ens phm, arts due m the cause(s) erid mratrmr ae
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LAST WILL
OF
I, Deane D. Clark, of 2912
being of sound and disposing mind
Will and Testament, hereby revokit
DEANE D. CLARK
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anion Road, Camp Hill, Cumberland County, Pennsylvania,
id memory, do make, publish and declare this to be my Last
all Wills and Codicils by me at any time made.
1. I direct that all inhe tance and estate taxes becoming due by reason of my death,
whether such taxes may be payable b my Estate or by any recipient of any property, shall be paid by
my Executor out of the property p sling under this Will, which is not specifically devised or
bequeathed, as an expense and cost f administration of my Estate. My Executor shall have no duty
or obligation to obtain reimburseme t for any such tax paid by my Executor even though on proceeds
of insurance or other property not p sing under this Will.
2. I hereby exercise all p wens of appointment which I may have at the time of my death
in favor of my Executor, and all pro erty subject to all such powers shall be included in my Estate.
3. I hereby give and beq eath all of the rest, residue and remainder of my property, real,
personal and mixed to: Robert D. B 'llhart of 417 Valley Street, Mechanicsburg, Pennsylvania.
4. In the settlement of my Estate, my Executor shall possess, among others, the
following powers to be executed for he best interest of the beneficiaries and in my Executor's sole
discretion:
(a) To sell either at
Executor may deem a~
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c or private sale and upon such terms and conditions as my
ivantageous to my Estate, any or all real or personal estate or
1
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4~ '
interest therein, whet er owned by me severally or in conjunction with other persons
or acquired after my eath by my Executor, and to consummate said sale or sales by
sufficient deeds or of er instruments to the purchaser or purchasers, conveying a fee
simple title, free an clear of all trust and without obligation or liability of the
purchaser or purchas rs to see to the application of the purchase money or to make
inquiry into the valid ty of said sale or sales; also, to make, execute, acknowledge and
deliver any and all eeds, assignments, options or other writings which may be
necessary or desirabl in carrying out any of the powers conferred upon my Executor
in this paragraph 4(a~ or elsewhere in my Will.
(b) To pay all costs,
my Estate. My l
(c) To distribute my
they shall be
distribution.
(d) To retain any inve
it advisable to my
(e) To vary investments,
expenses and charges in connection with the administration of
• shall pay expenses of my last illness and funeral expenses.
in kind or in money. If any assets are distributed in kind,
~d at their respective value(s) on the date(s) of their
I may have at my death so long as my Executor may deem
deemed desirable by my Executor and to invest in such
bonds, stocks, notes, oney markets, real estate mortgages or other securities or in
such other property, eal or personal, as she or he shall deem wise, without being
restricted to so-called "legal investments".
(f) To mortgage real
C~ (n~
l.~C:~~r
e and to make leases of real estate.
2
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(g) To borrow money fitom any party to pay indebtedness of mine or of my Estate,
expenses of administ ation or inheritance, legacy, estate and other.
(h) To vote any shares o stock which form a part of the Estate and to otherwise execute
all the powers incide t to the ownership of such stock.
(i) In the discretion of y Executor, to unite with other owners of similar property in
carrying out any plan for the reorganization of any corporation or company whose
securities form a part of the Estate.
(j) To distribute my per onal property directly to the Guardian of the person of any
minor beneficiaries h reunder.
(k) To elect such settlem nt options as deemed most appropriate by my Executor with
respect to any perso ,profit sharing or other retirement plan in which I am a
participant.
(1) To do all other acts in udgment of my Executor necessary or desirable for the proper
and advantageous m agement, investment and distribution of my Estate.
5. Any person who shall ave died at the same time as Testator or in a common disaster
with him, or under such circumstanc s that it is difficult or impossible to determine who died first,
shall be deemed to have predeceased him.
6. I nominate, constitute d appoint Robert D. Brillhart to be my Executor. In the event
of the death, resignation, refusal or inability of Robert D. Brillhart to serve as my Executor, I
nominate, constitute and appoint Ant ony J. Foschi, Esquire to serve as Executor. My Executor is
specifically relieved from his duty or obligation of filing any bond or bonds.
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IN WITNESS WHEREOF, $, the said Deane D. Clark, hereby set my hand to this my Last
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Will, typewritten on and consisting of these four (4) sheets of paper, at the bottom of each of the
preceding pages of which I also
placed my initi , on this L 3 day of November, 2004.
J
Deane D. Clark
4
On this 2.3 day of Nove ber, 2004, Deane D. Clark declared to us, the undersigned, that
the foregoing instrument was his La t Will, and he requested us to act as witnesses to the same and
to his signature thereon. He thereu on signed said Will in our presence, we being present at the
same time. We now, at his reque t, in his presence, and in the presence of each of us, hereby
subscribe our names as witnesses t ereto and have placed our initials at the bottom of each of the
preceding pages. By so doing, each f us declares that he believes this testator to be of sound mind
and memory.
~ residing at (~E'~ ~ J~
residin at ~
~ ~~ ~~ l~-~wr
residing at ~~~~~~ ~p ~.
172139
.\ .
COMMONWEALTH OF PENNS LVANIA
SS.
COUNTY OF
I, Deane D. Clark, testator, hose name is subscribed to the attached foregoing instrument,
having been duly qualified accordin to law, do hereby acknowledge that I signed and executed such
instrument as my Last Will, and th I signed it willingly and as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and a knowledged before me, by Deane D. Clark the testator, this
23 day of November, 2004.
Deane D. Clark
1
otary ubli
My Commission Expires:
ANTHONY JO. FOSCHISN L
Lower Allen Twp~~ C~;,~~~ Cobulic
M Commission Expires A ust 11, 2(li]5
.ti
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ',
SS.
We, ~ ~~ ththe witnesses
whose names are signed to the attac ed foregoing instrument, being y qualified~a[ccording to law,
do depose and say that we were pres nt and saw Deane D. Clark, the testator, sign and execute such
instrument as his Last Will; that suc testator signed such instrument willingly and executed it as his
free and voluntary act for the purpos s therein expressed; that each of us in the hearing and sight of
such testator signed such Last Willa witnesses thereto; and that to the best of our knowledge, such
testator was at that time 18 or more ears of age, of sound mind and under no constraints or undue
influence.
' l Sworn or affirmed to an subscribed before me by ~b~~ ~~ ~~~,~~-.
V~~i cam. ~G~CeL„~~ ~ / witnesses, this z z dayof November,
2004.
WITNESSES:
l
Notary
My Commission Expires:
:17213 9 '~"' ""'""' "`
ANTHONY J. FOSCHI, otary Public
Lower Allen 7w ., Cur erland County
My Commission Expires u ust 11, 2005