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HomeMy WebLinkAbout01-26-12Reset PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNT'i', 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 ixi the appropriate form: Decedent's Information Name: GEORGE W. DeWALT JR. a/k/a: a/k/a: a/k/a: Date of Death: 01/16/2012 File No• _~ '_I ~_~ I (Assigned by Register) Social Security No: 208-28-6637 Age at death• 74 Decedent was domiciled at death in CUMBERLAND County, pA (ware) with his/her last principal residence at 277 Meadows Rd. Newville PA 17241 Mifflin Cumberland Street address, Post Office and Zip Code i_~„ J City, Township oir Borough County Decedent died at Harrisburg Hospital 205 S. Front St. Harrisbure PA 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 Pennsy[vania ............................ All personal property $_ 100,000.00 If not domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsy!vania ........................ Personal property in County $ Value of real estate in Pennsylvania ................................ 'i00,000 nn TOTAL ESTIMATED VALUE.... $ 400 000 00 Real estate in Pennsylvania situated at: 273 Meadows Road Newville Cumberland (Attach additional sheets, ijnecessary.) Street address, Post Office and Zip Code City, Township or Borough County ® A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated 12/21/2006 and Codicil(s) thereto dated n/a C~ C H f'a h ~^4. n D k h G ~~ Mate 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, wa.s 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 born 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, durance absentia, durance minoritate If Administration, c.t.a. or db.n.c.~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 p<;rson. ® NO EXCEPTIONS ®EXCEPTIONS Form RW-02 rev. 10/11/20/I Page 1 of 2 Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs (attach additional sheets, if necessary): 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 Decede he Petitioner(s) will 11 and ly administer the estate according to law. Sworn to or ffirmed d subscribed before ~ ~ Date ~'o~o -/a me this day of 2 ~ Date i Y~ Date For the Re ister Date BOND Required: ®YES ~NO To the Register of Wills: FEES: Please enter my appearance b;y my signature below: Letters ...................... $ - ( I b )Short Certificate(s)...... ( \ )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ~T ~'~ 1 ~ , , .. , .. Attorney Signature: `~11n Printed Name: ROGER W. MORGENTHAL, ESQ. Supreme Court ID Number: 17143 Automation Fee. JCS Fee ..................... TOTAL ..................... $ ~~b_Jv Form RW-02 rev. 10/11/2011 Deputy for Register of Wills Form RW-06 rev. 10.13.Ob Firm Name: SMIGEL, ANDERSON & SACKS, LLP Address: 4431 N. FRONT 4T , 3RD FLOOR HARRTSRTTR(. PA 171 10 Phone: 717-234-2401 Fax: 717-234-3611 Email: ~tMnRC.RNTHAT n4ACT T P CO1\~ C7 C ~ ~ ~~,' ~~ t , - `- ~V)~ ~ C7`t r r ~. ;;~ C~~ .~ ~ ~ ~ D .. - ~.= 1~ ~ l`~S GI^ t Page 2 of 2 purposes states wltnln on irnls -L r~ ~ of ~ w~, ~_d ~ 2 Notary ublic My Commission Expires: y~ G ~ Zo/ y (Signature and Seal of Notazy or other official qualified to administer oaths. Show date: of expiration of Notary's Commission.) COMMONWEALTH OF PENNSYLVANIA Notarial Seal Roger M. Morgenthal, Notary Public RW-~ Susquehanna Twp., Dauphin County My Commission AprN 6, 2014 Member, Pennsylvania Assodatlan d Notaries Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } COUNTY OF } SS: ~ } Printed Name The Petitioner(s) above-named swear(s) or i of Petitioner(s) and that, as Personal Repres Sworn to or affirmed and subscribed me this day of By: - For the Register BOND Required: Q YES ~ NO FEES: Letters ...................... $ ( )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ........ Automatio ee....... ........ JCS Fee .................... TO L ..................... $ 0 00 '7'o the Register of Wills: Please enter my appearance by my signature below: At rney Signature: Printed Name Supreme Court ID Number: Firm Name: Address: Phone: Fax: Email: DECREE OF THE REGISTER Estate of ~ a/k/a: File No: ~- I l 1 AND NOW, ~~~ satisfactory proof having een presen d before me, IT IS DECREED ~ ~ ' m con idf;ration of the foregoing Petition, are hereby granted to that Letters the instrument(s) dated in the above estate and (if applicable) that described in the Petition be admitted n nrnhofA .,.,a ~:,_~ _,. - Y---~~~~ ullu rricu or record as the last Will ~,,, , ster a correct to the best of the knowledge and belief truily administer the estate according to law. -~_ Date --~_ Date -~_ Date --~_ Date Official Use Only itioner(s) Printed Address ;s) the statements in the foregoing Petition are true ve(s) of the Decedent, the Petitioner(s) will we11~a (s)) of Decedent. Form RW-02 rev. 10/11/2011 ~~ ~ ~~ ~J'~~ Page 2 of 2 H 105.805 REV (9/1I) - - - - - - - LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for t14~c~ificafF? $6.00 ~.~. o ~~ ?:,;, ', ~ u.. ~C ~-/ C~ C~ ~ L!.1 i~~ ~ ~~~ (~ .. _. N ~., ~ __.r IC.7 z/-~S cati _ umberp~ - 1 D Type/Print In l~~ ~- •V-/~ Permanent t`~r T^7- De Walt 74 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. ~.~~, ~ 2 za12 ~ Id4~ ~/ Local Reg(strar Date Issued GOM MONWEALTH OF PENNSYLVANIA . DEPARTMENT OF'HEALTH .VITAL RECORDS CERTIFICATE OF DEATH 0 2. Sex 3. Social SecuNty Mumber5tate Flle Number: Jr . a. Date of D 5 U s 1 D Male 7AO _ eath (MO/Day/Vr) (Spell Mo) Hou M~ Ir`ruta~ f Birth (M /D y/Vear) (Spell Monthl T~ n8~_.___6637 Jan' ~ 6 • 2p ~ 2 Residence (State or Foreign Country) Bb. Residence (Street and Num~beGr `_jnclude Apt M~p 37 ?A c (c Resld n 277 Meadows Rd. ctie fi°; -1"and er In US Armed ForcesT Ba, Residence (Zip Code) ~ 724 Ves ja{Np ~ Vnknown 10. Marital Status at Tlme of Death ~ Divorced 0 Never Marrle O Married ~ Wido~ Father's Name (First, Middle, Last, Suffix) ~ Unknown George W _ De Walt • Sr. 13. n . Informant's Name 0 1~arrell W _ De Walt 14b. Reletlonship to Decedent 14c Inf G ........ ............ f . Brothe 37 O S _ _ _ _ I Death Occurred In a Hospital: ~~ ~ ~~ ~~ In Patient . Emergen t-y Room/Outpatient a. ate o eat ...., r .......... ............ =1f Death Occurred Somewh e ~ Z n Arrival lSb. Facility Neme (If not institution, give streOet aD d er Ot ~ Nursing Home/Long-Te • n nu Harrisbur HOS tuber; ltal rr lSC. City or Town, State, and Zip [ ~, 16a. Method of Disposition ~ Burial Harriskxyr F '-~ Cremation Q Removal from State 0 Donation Other (Specif ~ 16b. Date of Dlsposltlon 16c. I y) 16d. Location of Disposition (City or Town, State, and Zip) 1/~020 ~ 2 F a NeLJV111e r PA 17241 11a. Signature o7 F octal service I Ei ~ 1]c. Name and Complete Address of Funeral Facility ~~ Brothers F~1-ler l a 1B. Decedent's Education -Check the box chat b ee~ no ~ 630 S . Hanove I- est highest tlegrce or level of school completed t h vibes the r 19, Decedent of Hispanic O 1 1 dettden[ eyed In _ Upper Miff tin decedent Ilyed within limits of 1. Survives ing Spouse's Name (If wife, g prlo Name Pr Narrlage (First, Middle, Las[) s Elva .Jr~hy~~,-.... 17241 Hi11 n In Ghar twp. 2633 L Q 8th grade or less a t e time of death. JQ'NO tliploma, 9th - 12th d box that best describes whether the decedent Is Spanish/Hi gra e ~ High school graduate or GED compl eted s panic/Latino. Check the "NO" box If decedent is not Spani h ~ Some college credit, but no degree , / s /Hispanic/Latlno. Yo No, not Spanish/Hispanic/L i ~] Associate degree (e.g. Aq, q5) at no ~ Ves, Mexican, Mexican Am N Bachelor's degree (e.g. BA, qB BS) e can, Chicano 0 Ves, Puerto Rican , ~ Master's degree (e.g. MA, MS, MEng, MEd, MS W, MBA) Doctorat ~ yes, Cuban 0 V e (e.g. PhD, EdD) or Prpfesslonal de Hree es, other Spanish/Hispanic/Latlnp . MD DDS DVM llB JD (Speclly) 21. Dettden['s Single Rece Self-Designation -Check ONLY ONE to In White di Black or African American cate whet the dettdent considered hlmsel/ or Q la Panese ~ Samoan Q Kor fi ~ American Indian or Alaska Natlye .7C ~ Asian I d ean Q Vietnamese ~ Other Paclflc Islander n ian ~ Chinese Q Other Asian ~ D°n't Know/Not Sure 0 Refused ~ Filipino Natlye Ha ~ wallan 0 Other (Specify) ~ Gua ITEMS 23a - 23 MUST BE COMP ED manian or Chamorro gY PERSON WHO PRONOUNCES q CERTIFIES DEATH 23d. Data Signed /M..ir,.,,n._, 23a. Date Pronounce Dead Mo Day 2g Q f IHnaturc o Person Prc l G ~ ~ o! ~ r - - to indicate what r decedent considerctl h mOSelf or hersOelf t b ' White Black or African e, o ~] Korean American Q Vietna AmeNcan Indian A i mese or Alaska Native 0 Other ASla s an Incllan Chinese n Q Natlye Hawaiian Filipino ~ Guamanian or Chamorro Japanese O Samoan Other 5 reel ( [ fY) O Other Pacific Islander during most of working life. DO NOT USE RETIRED. ~.vey Ol/ ~ - d 25. Was Medical Examiner or Goron 26. Part 1. Enter the [halo of _ CAUSE OF DEATH ~~ di - -1~3 G ` nta~`ted7 ~ Y°: N respiratory arrest, or y seases, Injuries, or complications-that directly caused the death. DO NOT entricular fibrlllatlon without showing the etl enter t l o ~ A o o er HY. DO NOT ABBREVIATE. Enter only one cause IMMEDIATE CAUSE -_________ Q ~1-i-- -_~ /~~ (Fi l s a ~E ~ PProxlmate minal events such as cardiac arrest ~ i Interval: on a Ilne. Add additional li . na disease or condition ~ ~ Y /-~- ~/ nes if necessary = Onset to Death resulting in death) D t ( s quence of). ¢ Off,`! T -7-.-- J-s-. ~ Sequentially list conditions, b P If any, leading to the cause Due to (or sequence of): as a con listed on line a Ent ~ ~~l . er [he UNDERLYING CAVSE Y .aj F (disease or injury that Due to (or sequence of): as a con Initiated She ev E ~ ents resulting d in death)LAST. Due to (or as a consequence of): 26. Pact 11. Enter other slan(fl ~cpnditl ~ ~ t ib [I _jr/~~~ ~- ~ ---~5_5_ but not resulting in the underlying cause given In Part 1 £~ ~_ '~ - 2]. Was an autoPZY Perfor d? 29. If F male: gnant within past year Q Not Pro 30. Did Tobacco V Ves o 2B. Were auto PSY findings ayallable to com Pbte Me cau se of~ieathT ~ r se Contribute to Death? Q Pregna [ at time of death Q Yes Q'Pf66ably Pregnant but r _ ~ Yes B"F 31. Manner of Death F- , p egnant within 42 days of death ~ No Q Unknown O Not pregnant but pregnant 43 d ~-~f rsl Q Homicide fe ays fo 1 year before deatF ~ Unknown If p gnant within the past year 32. Date of Injury (MO/Day/Vr) (Spell Month) [] Accident ~ pending inyestlgatlon C~ Suicide ~ Could not be determi d t~ _ V 34. Place of Injury (e.g. home; construction site; farm; school) ne 33. Time of Injury 35. Location of Injury (Street and Number, GI LY-. State, 21p Code) 36. Injury at Work l T 3]. If Trans O Yes Portatlon Injury, Specify: '~ ~ Driver/Operator 3H. Describe How Injury Occ red: 0 pedestrian ur O No J] Passenger O Other (Specify) 3 - 3 9a. Certlfler^Check only one); ~~ o C If SD YI g PhYSiclan - To the best of my knowled Be death ~ l ~ , ~V , ouncing ffi Certifying ph occu red due to the cause(s) and m stated ysiclan - To the bestTf my knowledge, death occurr 0 Medical Examiner/Coroner - O d h e n t at the time, date, and place, and du e basis of exa ination, a d or Inv Sfgnaturc of ttrtiFler n / estigatlon, in a [o my opinion, death occur d the cause(s) and manner stated Z re at the time, Ttle of certifier: 39b. Name, Address and Zip Code of Parson CompletirlH Cau ~ f D ~ 3 date, nd place, and due to the /t/ cause(s) and manner stated eath (Item 26) oe+ ~ 'f)J 40. Registrar's District Number ~ K y3~ y /Q ~e3 ucen:e NumDEr:_~ ^ ~/c ~ ~' / S' e 39c. Gate Signed (M /D 41. Registrar's ature ~ O O ay/yr) rj~ ~ ~ ~ ~'a ~ 43. Amendments 42- trar Flle ate Mo Day _ _ ) ~~~ >....~~ tYl ~, L S t 'C~~lh~ Dlsposltlon Permit No. O ~ ~ ~ ~ a q - - - - _ _ _ _ H105-143 - - - - - - - - REV O]/2011 LAST WILL AND TESTAMENT OF ~ ``'_y GEORGE W . DEWALT ~ QTR , ~ ~ % . n ~~m ha ~~~c ~' C~~ ~ © ~• I, GEORGE W. DEWALT, JR., of 277 Meadows Road,- ~ ---~ Newville, Cumberland County, Pennsylvania, being of sound and rn 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 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. 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 direct that my Executor shall pay all taxes that are incurred by reason of my death, including both federal and state, from the remainder of my Estate. i't cy ~` `. .:"~ rn f- :.~ Q 3i THIRD All the rest, residue and remainder of my estate, of whatever nature or wherever situate, I give, devise and bequeath unto my brother, DARRELL W. DEWALT, should he s~~.rvive me by a period of thirty (30) days. Should my said brother predecease me or fail to survive me by thirty (30) days, then I give, devise and bequeath all the said rest, residue and remainder to my nephew, DUSTIN K. DEWALT. FOURTH All income or principal held for the use and benefit of the beneficiaries of this Estate shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the posses:~ion of my Executor, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. If any beneficiary of the Estate shall, in the sole opinion of my Executor, be or become mentally or physically incapacitated, by reason of illness, accident, minority or other circumstance, my Executor may apply either income or principal for the support and welfare of such beneficiary directly or to the pe=rson who has the care and control of such beneficiary, without the intervention of any Trustee and without obligation to supervise application of 2 said amounts in any way. FIFTH I authorize my personal representative to carry on any business owned or controlled by me at my death f_or whatever period of time he shall think proper, and he shall have the power to do any and all things he deems necessary or appropriate, including the power to borrow and to pledge assets contained in my estate as security for such borrowing, and the power to close out, liquidate or sell the business at such time and upon such terms as to him shall seem best. SIXTH I nominate, constitute and appoint my brother, DARRELL W. DEWALT, as Executor of this my Last Will and Testament. Should my said brother fail to qualify or cease t,o act as Executor, I appoint my nephew, DUSTIN K. DEWALT, as Substitute Executor of this my Last Will and Testament. I relieve my personal representative (as well as any substitute) 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. SEVENTH In addition to the powers conferred by :law, I authorize my Executor (and his successors) in his absolute discretion: A. To retain in the form received, and to sell either 3 at public or private sale any real or personal property. B. To manage real estate. C. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversification. D. To exercise any option or rights arising from ownership of investments. E. To compromise claims without court approval, and without the consent of any beneficiary. F. Should any beneficiary, in the opinion of my personal representative, be incapa~~itated, said beneficiary's share shall pass to -she appointed trustee to be held and administered in the same manner during the period of incapacitation. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, on this Sf- the u day of December, 2006. .,ro ' ~~'` _" .-' ~ ( SEAL ) GEORGE W. DEWAL JR. 4 Signed, sealed, published and declared by the above named testator GEORGE W. DEWALT, JR., as and for his Last Will and Testament, in the presence of us, who, at hi.s request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~~y " 2 515 N . Fron t Street, Harrisbur /tom" 2515 N. Front Street, Harr:isbur PA 17110 PA 17110 5 COMMONWEALTH OF PENNSYLVANIA: ss COUNTY OF CUMBERLAND We, GEORGE W. DEWALT, JR., ROGER M. MORGENTHAL and DEBRA R. MEHAFFIE, the testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument of his Last Will, and that he signed willingly and i~hat he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witnesses, and that to the best of their knowledge, the testator was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this LI S~"day of December, 2006. NOL1RMt ~iAl DNO~AN A Cpu~ 1 ~ OOM~Y ~t !I. X0/0 6