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HomeMy WebLinkAbout01-19-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF Petitioner(s) named below, who is/are 18 years of age o o aMBERLANG COUNTY, PENNSYLVANIA following and respectfully requests the grant of Letters in the appropriate form: pply(ies) for Letters as specified below, and in support thereof aver(s) tht WAYNE A. GOOD Decedent's Information Name: MARY A. GOOD a/k/a: a/k/a: a/k/a: Date of Death: 01!06/2012 Decedent was domiciled at death in Cumberland principal residence at y10 BIG SPRING ROAD, NEWVILLE 17241 County, Street address, post Office and Zip Code Decedent died at 210 BIG SPRING ROAD Street address, Post nsr~o ~.,a ~:_ ,. WF File No: 21 - 12 - (~'y-~ ~ ~ (ASStgned by Register) Social Security No; 168-14-3600 Age at Death: gg SPA ~~~ West Pennsboro City, Township or Borough City, Township or Borough County (State) with his/her last Cumberland County PA State Estimate of value of decedent's property at death: /f domiciled in Pennsy/vania ........................ All personal property if not domiciled in Pennsy/vania ................. $ /foot domiciled in Pennsylvania......•••••• Personal property in Pennsylvania $ Value ofrea/ estate in Pennsy/vania.........•. Personal property in County $ Real estate in Pennsylvania situated at (Attach additional sheets, if necessary.) Street address, post Office and Zio r„,~e "------- 121,000.00 TOTAL ESTIMATED VALUE$ 121,000.00 -- City, Township or- qh A• Petition for Probate and Grant of Letters Testamenta county Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated 01/02/1986 and Codicil(s) Except as follows: after the execution of the insUument(s)aoffered for probate, Decedent did not mar was not divorced, w;3s not a a divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C Secu3323c/ adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. p rty X^ NO EXCEPTIONS ~ ~ (g). and did not have a child bon orending EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above and com lete list of heirs. .n.c..a.; a cote fte; uran e a sentia; uran a mfnontate Except as follows: Decedent was not a a in 23 Pa. C.S. § 3323 P rtY to pending divor9 proceeding wherein the grounds for divorce had been established as defined (g) and was neither the victim of a killin nor ever a udicated an incapacitated person. ^X NO EXCEPTIONS ~ EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that additiona! sheets, ifnecessary): Deoedertt left no Will and was survived by the followin souse if an a`~ ..._.- 9 P ( Y) n$ ~s (attach -~" Name ,._.., PATRICIA A. HOCKENSMITH Relationship Address -~ Daughter ~'~• 1601 WALNUT BOTTOM ROgp .,,. WAYNE A. GOOD NEWVILLE, PA 17241 Son ~ w 12724 STONEWALL ROAD , t, », SHIPPENSBURG, Pq 1757 .» , f..., [:; Form RW-02 reg. to-f r_2of~ Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } COUNTY OF Cumberland } ss: Petitioner(s) Printed Name } WAYNE A. GOOD Petitioner(s) Printed Address 12724 STONEWALL ROAD Name as listed in Will: WAYNE A. GOOD SHIPPENSBURG, PA 17257 The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct t belief of Petitioner(s) and that, as Personal Representative(s) of the Decedent, Petitioner(s) will well and tr I adm' Sworn to or affirmed and subscribed before o the best of the knowledge and Y mister the estate according o la me this day of ~] j ~(~ ~ gy. mrto- ~ Date ~ ~~ ~~ For the Register Date Date BOND Required? ~ Yes No FEES Letters ............... . i _L) Short Certificate(s)......... ~ ~ )Renunciation(s) .............. ~ )Codicil(s) ......................... I )Affidavit(s) ....................... Bond .............................................. Commission ................................... Other .. $ ~- y To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: Printed Name: Hamilton C Davis Supreme Court ID Number: 10264 Firm Name: Zullin er Davis, PC Address: 20 East Burd Street Suite 6 Shippensburg, pq 17257 Automation Fee ............................. Phone: 717/532-5713 JCS Fee ......................................... TOTAL ........................................... $ ~ Fax: 717! -~ E-mail: hdavis @Zullinger-Davts.com DECREE OF THE REGISTER ~- Estate of MARY A. GOOD a/k/a: AND NOW, satisfactory proof having be present before me, IT IS DECREED that Letters are hereby granted to Wq NE A. GOOD in the above estate and (if applicable) that the instrument(s) dated described in the Petition be admitted to probate and filed of record 01/02/1986 -~'- ill and Codicil )) of Decedent. -"-'- , - ~r~hcw Copyright (c) 2011 form software Date of Death: 01/06!2012 Social Security No; 168-14-3600 File No: 21 -12 ~ , in consideration of the foregoing Petition, Testamentary Lackner Group, Page 2 or 2 RENUNCIATION REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of MARY A. GOOD Deceased ~' PATRICIA A. HOCKENSMITH (Print Name) , in my capacity/relationship as Daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to WAYNE A. GOOD /a~ { _, ~ ~Jl~~ ~ ~ , _" ". (signature) PATRICIA A. HOCKE MITH .., , ,~,,, -_ i i .~ C. .. .' _~. `J . L Executed in Register's Office Sworn to or affirmed and subscribed before me thi-`----day of Deputy for Register of Wills 1601 WALNUT BOTTOM ROAD (Street Address) NEWVILLE, PA 17241 (CKY State, Zip) Executed out of Register's Office Ba fore the undersigned personally appeared the p rty executing this renunciation and certified that he or she executed the renuncia ' n for the purposes stated within on this ~da .rr~~.., __ Y Note Pu lic `~ `- My Commission Expires: ~~51 i~/aO`5 (Signature antl seal of Notary or other official qualified to ` administer oaths. Show date of expiration of Notary's commission.) Form i~tly-vs Rev. 10-132006 Copyright (c) 2008 form software only The Lackner Group, Inc. QOMMONWEq~TM pF PENN Notarial Seat S1'LVANI/~ Angela M. Schauer Nary Publk ~t~eoi'o, G+mberland County ~NSri.v rot M iS 2015 ~oa~noN of Nor~r LOCAL REGISTRAR'S CERTIFICATIOIV OF DEAT WARNlNC: It is illegal `t~ duplicate this co f'I pY by photostat or photograph. Fee for this certificate, $6.00 P 18150;12_ Certification Number Type/Print In Permanent n~.I I Ci '~~ ~ ~~ ~~ .~~ Mary A. GOOd al ~~ I `I S >~ a E _ 8 8 ' months R Id (State or Forei PA gn count 1. Residence (County) Cumberland Ever in VS~q_rnoed Forps7 ]Yes QVnk 1 F th N me (First, Middle, Last, James G. Strale •. Informant's Name Wayne A. Good lest/. oceurrea i~ : "tiosi.CP: •-••---°° This is to certify that the information here given correctly copied from an original Certificate of Dea dul~/ filed with me as Local Registrar. The origin certificate will be forwarded to the State Vit: Records Office fo e anent filing. ~~ ~p al Registrar Date Issued COMMONWEALTH OF PENNSYLVANiq . pEPARTMENT OF HEALTH . VIT4L RECORDS eat, suffix) CERTIFICATE OF DEATH 2. Sex 3. Socla Securl Num STata Flle Number: Sc. Under 1 D• F e m a 1 ~ bar 4. Date of Death Mo 6. Date o1 girth (Mo Day ~ 6 8 _ ~ 4 _ ~' 6 O O ( /Day r) (SI Deri Hours Minutes ear) (SPell Month ( January 6 2 O 1 2 1")aY 2l 1923 ) ~.. aiLhp~t C es dse to gn CO t Bb. Resi anee (Street and Number _ ~ O W n , P A un ry) Include Apt No.) gc, 1 mob. Blrthplap (County) 2 l 0 ~ D•pdent Llw In • TewnshlP? Adam s gig Spring Road s, depdent llyed In West Be. Residence (Zip Code) P e n n s b o r o stirs) Status at nme f ~ 7 2 4 l Q No, decedent IWed within IImRS of DNOrced ° Death Q Man d CI Never Married Q Unknown 1 owed 11. Surviving Spouse's Name If w ( Ife, ghre ham el 33. M other's Name prior to First Marria a Prior to Rrst manage) 14b. Relatlonshl to Mar A . W O 1 f 8a (First, Mitldle, Laat) P Decedent 14e, Informant's Mailing gddr•ss (Street and Number, CRy, State, Zip Coeiej .................. '12724 St npatlent ................... o n see o eat onewal l Rd. t Sh ,........... e:..... ..... . Death "' ' ~ D~~w .._._ :If otturrea GTE,. •._!.._onyon!__._. -~~Pen`_..bVr9. PA ~~o~-. L;reen Ridge Vi11a street anc •- Method of DlsPOSltlon e Q Remwsl from state oriel L7 oth~..<___._ . 17 oomatlon Newyille, pq-~~~ " . Dace of Dbposltlon ~ 7 2 16e. Plate of 1-10-20'12 5 h i p P e n s b u r _.~. ~••° ~IP7 g va. sgnature °f F„_e 5 t i n ' rsl l .7c. Name and Complete Ad s 7 Fu rv ~ f ~' Licensee c d ress of neral Fa Il ri Fo elsan ricke ' l/ ~'*~ - r F u n e r a l a. oeceaent•a Edueac on B lgneat de Cheek the o m e Inc . ~ ~ 2 Wes t box that best tlescrib Brae or lev l p e es tt of school tom letetl at the time of death 8th grade or less 19. Decedent of Hb Kin S i 0 l . Q No diploma, 9th - 12th grade Q Hl h box that beat descHbes wh •th ar the decedent Is Sp•nlah/H g sch°ol graduate or GED completed Some colle ispanic/Latino. Check the "NO" box N decedent Is n ge credit, but no degree [] Associate degree (e.g, qq AS) ot 5 Panish/Hispanic/Latino. ENO. not Sp•nlah/HlsPanl4Latino Q Bachelor`s tlegrea (e,g, BA, qB, BS) Q Mast ' xican American, Chl<ano Q Yef Puert er s degree (e.g. Mq, MS, MEng, MEd, MSW, Q Doctorate (e MBA) g Ph O , o Rican Q Yes, Cubsn . . , Etl0) or Professional de . Mp DDS OVM tree B D Q Yes, other S Panish/Hisp•nlc/Latlno (SPecl/y) . Decedent's Single Race Self` ~'Whge Dealgnation -Check ONLY ONE t o In Q Blracek or^ friean American Q J oPan ese CIA rice I Q K e dleste what the deptlent considered himself or Q Samoan a n ndian or Alasks Native Q Aslan l ndian - _ Q Vietnamese ~ Q Other Paelfle Islander s e Q Chine Q Other Aalan Q Don't Know/Not Sure Q Flllplno tive Hawaiian Q gefused Q Gu Q ether S MS 23 shish or Chamorro ( Peclfy) MusT erlan FD-0'12984-L et Shi ensbur . Decedent's Race -Check ONE OR P A 1 7 2$ 7 s decedent considered himself or herself to be, to Indicate what 'White Black or gfrlcan gmerlpn Q Korean Amem'ean Indian or Alaska Native Q Vietnamese Asian lndlan Q Other ASlan Chlna:te O Native Hawai'•n Flllplno Q G ^!maa; lan o Cham Japanese 0 Sa o orro Other (Specify) Q Other Pacific Islander to be. 22a. Decedent's Vsu•1 Occupation -Indicate type of wort done during most of working life, p0 NOT VSE RETIRED. Inspector ~ ~ 23d. Date d o/paY/Vr) --- a,O(A ~F 6o'?O~ar/v.). z .signaeuree ars n Pronoun i Hoffman Mi11s / Gi ~ !7 ~fO ~f r c ng Deat On Y w e 24. Time of Death ~ / `n ~ ~ r o _ ^ aPP Ica 23c. License er / 535 r~- // ( r c ( e ~ 26. Part L Enter the chain f . ,. . .. . • 2S- Waa Madlcal Examiner °r coron ---- ~,Lf j l2~lJ ~°/~f X007 ej p 8 respiratory arrest, or Yentri er --dlaese:, In)urre:, or oompupe OF oenT-i cul ~ dtr ~ O contatted~ Q Yas IMMEDIgTE CAVSE I on,__t arflbrilla tion without showing the etlolo Y pus d the death. DO NOT enter ter BY~ DO NOT ggB Q No i _ _ __ (Final disease or conditi REVIATE. Enter onl ` Y one pose o s a ~~ r' m nal evenb such as cardiac a ! APProxlmate treat n a fi on resulting In death) S ne. Add additio . Interval. nal lines If necessa 3 Du to (or as on se ry On set to Death Sequentially Ilst conditions, if a b ~, ~ quence of): t~ ~ ~_/ - Ie - ny, leading to the pus listed on Ime a Ent a ( - ~= Dua to (or L~ ~ ! as a co ~ . er rhe V NDERLYING CAUSE n sequence oT): c' ~ (disease or in )u that -~ F e ^ Initlatetl the a is resulting in d Du d e to (Or segue a p~: as a con ,tc i `~ eath) LAST. 26. P•R It. Enter othe rsi nifl sa • con Due to (or sequence of): ; --- ~ e' n 1 n rl 1 h but not resulting In the under) I ' ~~- a n Y 8 cause given in Part 1 29. If Fema le: 27- Was an autoPSV Perfor ed? o 0 N t pre^g^a^t wlthi^ Past Year 30. Dltl Tob Preg t 28. Wer Yes Y flndln o t l ~ at time of deeath Q Not pregnant, but pr gnant ac o Use Contribute to Death? Q Yes c Q Prob i bl h O GOt^PI ~e She cause of death T yes Ma 3'1 Q Not pregnant, but pregnant w a t y in 4 2 days of death ~~ •~~ Q Vnknow 43 tl ~~ n~~tar of Death No L~'N•tur l [] Unknown If pregnant within a n the ys to 1 year before death 32 a 0 Homicide Q Aetld 34. Place Pest year . Date of Inlury (Mo/DaY/Yr 5 ) ( pall M ent Q Suicide 0 Pending Inyeatigatlon _•• onth) of Inlury (e,g, home; construction sine: fnr... ._~_ - ~] Could not be determined Q Vas __-___..e...~n mJUtY. SPecify: .. ___ °• P c.ode7 Q NO Q Driver/Operator O Pedestrian 38. Describe How In u [] Passenger Q Other 5 7 tY Occurred: :Ia-~Ce~rtifi~e ~r^Check onl ( PecHy) Q P°f"TYI C Physician one): '-~~ To the bast of my knowledge, death oecurre ^ Ing 8: CertHying physicla - To the bast of my knowlad d due t0 the cause(s) and manner sated (] Metlical Examiner/Coroner - On the b ge, death o si f examination, antl/or Invest) red at the time, data, nd Place Signature of ceKifler: gatlonr In my opinion, death oecurretl at the timeod tom`, nA (twee d ~ •^^er s b. Name, Address and ZI ~ tared P Code of P Title of cerHfler:_ ~ P a d due to the cause(s) and manner stated Qr m ~" r--• S ` ` ompleting Guse of Da th (Item 26) _ ~ ~ R ~TaA•~ ria- ~ ~~,_ a ~~ ~` License Number: O~ (('S ~ ~ f.~ gistr District Number S 1 41. Ragl ,~-ry ~ l 39c, Date 51 ~~ ~- ~~ gnatu/ ~ ~ ~ /-/~ 1 7Zy 1 / / G7(MO/Day r) ~_ ~_ _ - DisPOSftIOn Permit NO._~_ H105-143 REV n~r~n. twp. ,. LAST WILL AND TESTAMI3NT OF MARY A. GOOD I, MARY A. GOOD, of the Borough of Shippensburg, Cumberland County, Pennsylvania, being of sound and disposing 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 thereto, heretofore, made by me. FIRST I direct the payment of my debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. In the event I am not the owner of a cemetery lot at the time of my death, I direct my Executor to purchase such lot with a contract for perpetual care and to improve the lot and have erected thereon a suitable monument and `\^r\` marker, using therefor funds from my estate in such amount ,.~.s she V ~... r-~ in her sole discretion shall deem advisable. ~' .::3 r- SBCOND ' `-~ ,.,~., I give, devise and bequeath all my property, whether real~br personal, tangible or intangible, together withh all insrtrance ...~. ''~ policies thereon, unto my husband, RALPH E. GOOD, provided he shall survive me by thirty (30) days. In the event my husband fails to survive me by thirty (30) days, I then chive, devise and bequeath all my estate whether real or personal property, tangible or intangible, together with all insurance policies thereon unto my children, provided they shal]_ survive me by unto my children, provided they shall survive me by thirty (30) days, in as nearly equal shares as possible. In t:he event any of 1 my children fail to survive me by thirty (30) days, I give, devise and bequeath my deceased child's share unto said deceased child's spouse and children, in as nearly equal shares as possible. THIRD I give, devise and bequeath all the rest, residue and remainder of my estate unto my husband, RALPH E. GOOD, provided he shall survive me by thirty (30) days. In the event my husband fails to survive me by thirty (30) days, I then give, devise and bequeath all the rest residue and remainder of my estate, in as nearly equal shares as possible, unto such of my children as shall survive me by thirty (30) days, provided that the share my oldest child, Gary Good, shall receive, shall be reduced by the sum of Thirteen Thousand Dollars ($13,000.00)~to reflect sums paid by me for his college education. In the event any of my ~~hildren fail to survive me by thirty (30) days, I give, devise and bequeath my deceased child's share unto said deceased child's spouse and children, in as nearly equal shares as possible. FOURTH I give, devise and bequeath any minor child's share to be invested in an interest bearing account at Dauphin Deposit Bank & Trust Company, Shippensburg Office, until such child is eighteen (18) years old. FIFTH I hereby direct that all inheritance, estate or transfer taxes imposed upon my estate, whether passing under this my Last Will and Testament or otherwise,. be paid out of my estate. 2 SI%TH Any and all sum or sums, whether in cash or in kind and whether for principal or income, payable to the :beneficiaries, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made and free from anticipation, alienation, assignment, attachment or pledge and free from control by the creditors of such beneficiary. All shares of principal and income herein given shall be free from _ / anticipation, assignment, pledge or obligation of` any beneficiary ~\~'~/ and shall not be subject to any execution or attachment. S$VENTH I nominate, constitute and appoint my husband, RALPH E. GOOD, Executor of this my Last Will and Testament. In the event of the death, resignation, renunciation or inability to act for `~-~-as~y reason whatsoever of my said husband, I nominate, constitute and appoint WAYNE A. GOOD and/or PATRICIA A. :HOCKENSMITH Co- Executors of this my Last Will and Testament. My executors may be compensated for their services up to three (3) percent, in total of my estate, to be divided equally between them. I hereby relieve my Executor from the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act, insofar as I am able by law to do so. 3 T IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, consisting of three (3) typewritten pages, the first two ( 2 ) of which bear my signature in the margin for the purpose of identification this ~_ day of 1981( . ..~~' rr~ Ma A. od Testatri SIGNED, SEALED, PDBLISHED AND DECLARED by the above named Testatrix, MARY A. GOOD, as and for her Last Wi:11 and Testament, in the presence of us who at her request and :in her sight and presence and in the sight and presence of each other have hereunto subscribed our names as witnesses: ~~,;. ~ ~,L._..~ CO!lMONWEALTH OF PENNSYLVANIA SS COIINTY OF FRANKLIN I, MARY A. GOOD, the Testatrix whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the 4 .~ instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~~ Mary A. G d Testatrix Sworn or affirmed to and acknowledged before me by Mary A. Good, Testatrix, the ` _ day of 198. r ~, Notary ublic JOYCE A. CRO(~SE, ROTARY PUBLIC -~ S11U71~lPTQy T'elP., F~'4s?;~.!R COUNTY .~~ ~; ~ MY COlN~91SSiO!,' c~~ •~ 5, 197 M~r~bcr, P~-~~tsYdt&~,r~ >i,::, . - ~ "sa3~ri~g CO1rIIYiONf1BALTH OF PENNSYLVANIA SS COUNTY OF FRANKLIN we , ~ yes 7` /1~ ~ ors and ~o ~~'s i~~u.~n 6 witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw MARY A. GOOD, Testatrix, execute the instrument as her Last Will and Testament, that she signed it willingly and that she executed as her free act and voluntary act for the purposes therein expressed; that each of us in the 5 hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen or more years of age and under no constraint or undue influence. ~~~ ~D ~ qo i~ Sworn to and subscribed before me by ~~re~s f" /~/. N7 ytrs and J~~~s ~~um6 ,witnesses, this ~hcL day of lLnu.cc~ 198 ~ . ~~~ ~ _~ Notar P blic My Commission Expires: JiYCt A. E.'RGi~r£, NOTARY PUBLIC SOUTI•AMPTOfI TCIIP.. FRANKLIN COUNTY MY COMkI1SSlON E%PIRES JAN. 5, 1987 Member, Pennsylvania Association of Notaries 6