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HomeMy WebLinkAbout01-26-12PETITION 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 ~~ l.,_- ~ ~ _ )' Name: EVELYN MCDONNELL File No: I I a/k/a: EVELYN M. MC DONNELL (Assigned by Register) at'k/a: a/k/a: Social Security No: 179-30-5353 Date of Death: 1 /11 /2012 Age at death: 86 Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (State) with his/her last principal residence at 10 VICTORIA WAY CAMP HILL BOROUGH CUMBERLAND Street address, Post Office and Zip Code City, Township or 13orough County Decedent died at HOMELAND CENTER 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 If ttot domiciled in Pennsylvania .............................Personal property in Pennsylvania If not domiciled in Pennsylvania .......... ....................Personal property in County Value of real estate in Pennsylvania ............................................................. . $ _ 3.500.00 TOTAL IrSTIMATED VALUE.... $ 3.500.00 Real estate in Pennsylvania situated at: NON E (Anach additional sheets, if necessary. j Street address, Post Otf;ce and 7.ip Code City, Townslup or Aorough County ® A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/aze the Executor(s) named in the last will of the Decedent, dated !6/18/1986 and Codicil(s) thereto dated NONE FRANCIS L KINER PREDECEASED THE DECEDENT, HAVING DIED ON -- L~-" State relevant circumstances (e.g. 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(8), 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.h.n.c.t.a., pendente lite, durance absentia, durante minoritate If Administration, c.t.a. or db.n.c.l.a., enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent was not a parry to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ^ NO EXCEPTIONS ^ EXCEPTIONS Petitioner(s), after a proper seazch has/have ascertained that Decedent left no will and was survived by the following spouse any) and heir~ittach additional .[heels, if necessary): ,,.,_ t.a ~~ Name Relationship _ _ .. _J _____ ~._ _ Address r•t C7 _ __~ ,~ _ ~ _ -- --- - -- - . _ _ ~ ~ ~._t ~ - ------ --- ---- Y -_ ~.. ~..__ - ~ .~ -_* ~ r~ ~7 rn Form nw-oz rev. 70/]IILOII Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Official lJse Onl ~'t~.~~~ ~r< _ ~.'s''ta.S 20 ~ 2 JAN 26 P~ 2~ 2~- r--- Petitioner(s) Printed Name ~ Petitioner(s) Printed Address ~I FRiC (~G 10 VECTORIA WAY I~VV~; 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 too affirmed and subscribed before me this w d ~ of ~~-UARY , 2012 By: - For the Register BOND Required: ^ YES ®NO FEES: Letters ....................... $ _ 30.00 (2 )Short Certificates(s) ...... 8.00 ( )Renunciation(s) ......... . ( )Codicil(s) ............. . ( )Affidavit(s) ............ . Bond ......................... - --- Commission .................... -- Other ......... WILL ......... 15.00 JCS _ ......... _ .23.50 AUTOMATION __ ......... 5.00 Automation Fee ................ . 7CS Fee ....................... - -- TOTAL ......................~ 81.50 To the Register of Wills: rlease enter-;p„y appearance uy,ny s,gna,urC ucwvv: Syfpreme Court ~D Number: 52653 Firm Name: WIX, WENGER & WEIDNER Address: 508 NORTH SECOND STREET P.O. BOX 845 HARRISBURG PA 17108 Phone: .(717234-4182 Fes; ,(717) 234-4224 Emait: sdzuranin ~wwwpalaw com DECREE OF THE REGISTER Estate of EVELYN MCDONNELL a/k/a: AND NOW, satisfactory proof having are the instrument(s) dated J l1 N E 18 1986 described in the Petition be admitted to probate and f led of record as the last Wil (and Codicil(s)) of D ent. , f (NV R gister of Wil Fonn RW-02 rev. 10/11/2011 J~" Page 2 of 2 File No: ~~~ - ~ ~ i I t^b 2012 , in consideration of the foregoing Petition, before me, )CT IS DECREED that Letters TESTATMETARY ereby granted to SHIRLEY KINER in the at)ove estate and (if applicable) that ..~-Nt /'~`^~-~" Date 1 ' ~ ~ _ f a _____ Dace Date Date H 105905 REV.(8/11) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital S tatistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. tom. C,.7 ~ ~ N ~ ~ ,~~Qntiv~~.. ©r ~~ ~~ ~~_= ~ _ ~ C ~"'' ~" Marina O'Reill Matthew ~_ ~ .: ~~ :,~_ ) i ~ ~ v~ ~ State Registrar ~~ i~. , CV ~~ ~ ~ e 20~~ 6 370 -_~,IJ f~ o. Date type/Print In _. __ _ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VRAL RECORDS Black lnkt CERTIFICATE OF DEATH Sbb FII N M g~3 3 1. Decedent's Lepl Name (First, MIddM. Last, Suffix) 2. Sex 3. Sodal Security Number a 4. Dab N Death (MO/Day r) (Swll Mo) MRS. EVBLY M. Mc DONNELL tg- ~ a. AEe-Last Birthday (yn) Sb. Under YNr Sc. n er 1 Ds B. D.te N BIRh (MO Dey qr) Spell Mont ) 7e. Blrthp .u (CRy and St.te or FeM n Ceu ) S~ Months Dori Noun Minutes ~I ~ ^ ~ ~ gr t Pi t t n P8. O( ~ yr5 L i 7b. BlRhpl.u (County) Ba. Resldenp (Stets or Forolgn Country) gb. Msidenu Street and Number -Include Apt NPJ 8c. Dld Decedent Lhre In . Townahlp7 Panne 1Vania Yes, decedent lived In Penn Hhora Twn. trop . sd.R.a~ --.•.o(co~r,tY) 10 Victoria Wa Cain Bill be 'and. N. Resaenu (ZIP Code) _ (NO, deaden[ IMd within Ilmks o1 _ _ tity/boro. 9. Ewr in US Armed FOrasT 1 M artial Strtus at Time N Death McMe WI 11. SYMNr,g Spouw's Name (H wlh, giro name prior to flat maMge) y-- r Q Yes 0 Ne Q Vnknown p.,r Dlwrud Q Newr Married Q Unknow 13. Father's Neme (First, Middle, las4 u xl 13. Mother's Name Prior to Firrt MsMge First, MIdd4, last) William Morgan Mabel Sisad 14a. Interment's Name 14b. RNatbnship to Dec en[ 14c. In rmant's Malling Addrou (Street an NumWr, CRy, StNe, Zlp Gods) Mrs. Victoria way, C+3mp Shir4a iilai.-~-' ~~"'-:r -~- Daughtaa K O Hill, Pa. 17011 n - . . .................... ......... ye ....................................... ............~:......f e.....eet... .............. ..e..M .............................. ....... ......... .. H Death Occurrod In • NmPlbl: L.1 Inpatlent If Dea Occurred Somewhere Other Than • Nos ~~~~ p ~" pltal: I~NOSpI F IIRy ~Deude is Neme••• Em Room/OUt tNnt Deed on ArtNal Nunln Home/LO -Term Gro Faell Other iSb. Facility Name (H not Inrtitutlon, g street end number] lSC. or Town, Sbte, and Zlp Cede 15d. COUntY o1 Death 16a. Method DlspaHlon B rlal CromaNOn Sgb. Dab of Dispaltlon 1 . Plau N Dlipos n (Neme o cemetery, crematory, or other place) Q Removal M1om State 'Q Donation oener( ) 1-14-2012 Mountain View CaJnatery 16d. Loutlon o/ DlapwHlon (City or Town, Sbb, end Zlp) 17e. gnaturo of Funeral Service LlansN or Perron In Charge Interment 17b. LkxrnN NumMr Hardin Pa. 1 643 FD-D14594=L 17c. Neme and Complete Address N F rectal FacllRy H. MERRSTT HUG S FUNERAL HOME 2NC. 211 Lu2arne Avenue, W. Pittston, Pa_ 18643 ffi lg. Decedent's Eduutbn - Chec the that Mst describes tM 19. Decedent N Hispanic Origin - Gheek tM 20. DeaMnt's Rau -Check ONE OR MORE raps ro Indicate what highert dgroe er lawl N athoel eompNted at the time of death. box that best describes whNher tM decedent the decedent ansiderod hlmwlf er heneM to be. Q ant grant or leu la Spanlsh/Mispanic/Latlno. CMek the "NO" WhHe Q Korean 1!)~ No diploma, 9th - 12th grade box If decedent is not Spanish/Nispanic/latlno. Q Bieck or AMun /unerlcan Q VNtnemefe Q High sel,oel groduab or GED urr~PletW ~ Ne, net Spanish/NISPMic/LatMO Q Amerlun Intllan M Alaska Natve Q Other Asian Q Seine ullge wedn, but no dgrN Q YN, Mexican, Mexlun Amerlun, Chlune Q Aalan Intllan Q Native Newalbn Q. Assoclab dgree (e.t• AA. AS) Q Yes, Pwrto Rlun Q ChlneN Q Ouamanlan or Chamorto Q Bachebr's tlgree (e.g• BA, AB, BSI Q Yes, Cuban Q FIIIPIno Q Samwn Q Marten dgroe (e.i. MA, MS, M~ng, MEd, MSW, MBA) Q Yq, other Spanish/Hlspanlc/latlno Q JapaMw Q Other PaclRc Islander Q Doetonb (e.g. PhD, Ed D) or Pref}isbnal degree (SpeeHy) Q Other (SpeNfy) _ . MD DDS DVM LLB JD 31. DetedenYS Single Reee SeH-Designadon -Chock ONLY ONE to Indlub Whet tM decedent conslderod himself or heneM to W. 22a. GCWent'a Usual Occupation -Indicate tyro N work Whlb Q Japanese Q Samoan dom during most N working INe. DO NOT USE RETIRED. Black orAMun Amerlan Q Korean Q O[MrPaclRc Islander HOYIBCWi£® Q AmeNUn Intllan or Alasb Native Q Vietnamese Q Don't Know/Not Sun Q Asian Indian Q Other Asian Q RNusad 22b. Kind of Busines Industry Q Chinese Q Native Nawallan Q Other (SpeN1y) Q Filipino Q GuamenlanerGhamorro Homelnalcing CERTIHtli ONMO PRONOUNCES OR a. Oet I r I I n o V r gE~netun O E at ~ P~~ ~.y\~u/n_~w/~/y G ryrt 23d. Dab Signed Mo Day/Yr) 34. Time Death \ ~ ^ nC~:' ' c~ "~ R / ' ( u t{ 1 I ! 23. Was Medlin Examiner er Coroner ContactedT Q Yes No CAUSE OF DEATH Appro,Am.te 26. Pan 1. Enbr tM chain of events«dlaesaes, Injuries, or umPlleatlena--that dlrectN uugd Me death. DO NOT enter brminal event suth as urd4c arteM Inbrval: respiratory artest, or wntrlcularflbrillatlon wkhout s g t/» etlolo { y . DO NOT ABBREVIATE. Enbr only one uute on a Ilne. Add addRlonal Ilma If neaspry Onset to DeNh ~ ~ / w IMMEDIATE GUSE ---> ~~Cr~I/.C~ ~ j (Final disease or condnlon Dw to (or as • antequena of): rawltlM In death) b. SequentlalH Ilst condRlons, Due to (or u a eonbquence of): H any, leadln[ to the cause listed on Ilne a. Enter the UND[RLYING GUSE Due to (or as a consequence of): F (dlaeav or Injury that InRlatad the events resulcing tl. }K In death) IABT. Due To (or as a cpnaequenta o•): 26. Pan 11. Enter other bu! not resuhing In the underlying cause {iron In Part 1 27. Was an autopsy parlor Ves No ~/s. ~ ~ ~ / ~ f~ ~/~/ ~ !~ ~ I'1'c.I i't~~` I 2g.ro eomPNtwe the udus~ evalathl7 Yes No - 29. If Fe Net Pregnant within Past War 30. Dld Toby Vae Contribute to DeathT Q Q ProMbly 31. Ma r of Death atvral Q Homicide Q Pragnant at time of death No Q Unknown Q Ao[IMnt Q Pendlq Investigation ~ Q Not PrgnaM, but Prgnant wlthln 42 day N death Q Sulrlde Q Could not M determined Q Not prognam, but pregnarR 49 dari to 1 year before death 31. Dab of Injury (MO Day/Yr) (Spell McMh) Q Unknown H Pregnant within tMe vest Year 33. Time d Injury 31. Place N Injury (e.g. home; wr,stru n site, farm; school) 3S. Location N lnlury (Street and Number, CRy, State, ZIP Code 36. lnlury at Work 37. If TnnsportrlHOn Injury, SPacIN: 38. Describe How lnlury Oaurred: Q Yes Q Driver/Operftor Q Pedestrian Q No Q PaasenNr Q Other (SpecNy) 39a. er (Check on1Y one): e.tlNing Dhysiclan - To tM beat Wf my knowledge, death oaurratl dw to the cause(s) end manner abted Q Pronouncing L Certifying phrilcly - To the best N my knowledge, death oceurted at the time, date, arM plan, and due to the cause(s) and manner sbted Q Medical Examiner/Coroner - On the Is of examin d/or Investigation, In my opinion, death t the tl ,date, and plea, a1W tlw to the UU w (s) antl manner stated ~ s A Signature N urtiRer. TitN of arGfNr: ~ Uanse Numbs: //l// ~G 6 Ja~L 39b. Nem , Addross and Zip Code N P n Comphtlrg (Ibm 36 39c. D Signed (MO Day r) esl : 1. .aura glstrar l e eb o ay a- JAN 1 43. M,a,drtrenb _ CORRECTED ITEMS: 8b,8c,8 _ 'd PER: FD DATE: O1/18/20~n ' ~ - ~" ~ ~~ ~~` ~ • , , ~. ~, 07 03 57 6 N103.1a3 oitpaitlorr PerrN[ Ns REV 07/2013 E _ ~~~~ i~~ ~xl~ ~~~~~~.e~~ o~ rn _x., ~V~LyN MCDONN~LL ~ti3 ~ rwry gn~ ~~~ ~ w I, ~V~LyN MCDONN~LL, a~ the banaugh a~ we~~ P~.~~~an, Caun~y ~ w na- a~ Luzenne and Cammanwea.2~h a~ Penn~y.2van~,a, da hereby mah.e, pub.-cash r and dec~ane ~h~ ~a be my La~s~ w~.2.~ and Te~~amen~, hereby nevaFz~.ng a.~.~ pn~.an G1.c,P.~~s and Cad~.c~..~~s hene~aUane made by me. FIRST: I d~.nec~ my ~xecu~an, hene.inab~en named ~o pay the expen~e~s a~ my .~a~~ -i.Q.2ne~~ and ~unena.~ a~ Gaon a~ pxac~~.cab.~e ~a.~.~aw~.ng my death. S~CUND: I gtive, dev~e and bequeath a.2.~ ab my pnapen~y, nea.~, pen~sana.~ and m~.xed, a~ wha~saeven na~une and whene~saeven ~s~.~ua~e a.t the rime o{~ my death to my husband, FRANCIS L. MCDUNN~LL. THIRD: In the event ~ha~ my husband ~hau2d nab ~sunv~.ve me, an ~.n the event ~ha~ we ~shou2d d~.e under such c~ncum~~ance~s a~ ~a render ~~ ~c,mpo~~~.b2e ~o de~enm~.ne wha d~.ed ~~.n~s~, ax ~.n the event ~ha~ we ~shou.~d d~.e w~.~h~.n ~s~.x~y (60) days o~ each o~hen, then, ~.n ~ha~ even, I gtive, dev.c~e and bequeath a~.~ a~ my pnapen~y, a~ wha~even f~~.nd and whenever .~aca~ed ~ha~ I awn a~ the ~t~c.me a{~ my death, ~o my ch~..~dnen, SHIRL~y KIN~R, NANCY yAL~TSKU, and ~RANC~S LANGAN, ~.n equal ~hane~, ~shane and ~shane a.~~.Fze. FOURTH: In the event ~ha~ any o~ my ch~..~dnen ~shau.2d nab ~unv~.ve me, bud ~hau.~d d~.e ~5unv~.ved by a ch.c,Qd ax ch~.2dnen, then the ~shane wh~.ch ~a~.d ch-c,~d wou.~d have ~af~en hereunder ~sha2.~ pa~s~s ~o h-vs oh hen ch.c,ed on ch.c,ednen ~.n equa.~ ~shane~s, share and share a.~~.fze. In the event ~ha~ any a~ my ch-i,Pdnen ~hau.~d d~.e w~.~hau~ ch.i,Pdnen, then the share he an she wau.2d have ~al2en hereunder, ~sha.~.~ pa~~a my rema~.n~.ng ~5unv~.v2ng ch-iednen, ~.n er~ua2 ~hane~, Shane and Shane a.~~.Fze. ~I~TH: I ram-~na~e, con~~ti~u~e and appa~.n~ my husband, FRANCIS L. MCDONN~L, ~xecu~ar ob ~h-vs, my Lcvs~t w.c,~2 and Te~S~amen~. In the event ~ha~ my ~a~.d husband ~shou.~d nod ~5urv~.ve me, an be unw-i,Q.~~.ng an unable ~a ~enve fan any rea~san, then I hereby nam~.na~e, can~s~~.~u.~e and appa~.n~ my daughter, SHIRL~y KIN~R ass can~~.ngen~ ~xeuc~tr~.x ab ~h-vs, my La~s~ w-i,P.~ and Te~S~amen~. Ne~~ther my ~xecu~ar ran my con~.%ngen~ ~xecu.~~;x ~ha.~.~ be requ~.ned ~o ~urn~h band an ~rvice~~.e~ ~.n ~ any%9wc.~dtic~on. IN (~ITN~SS GI~I~R~U1=, 1 have heneun~o ~e~ my hand and ~ea2 ~h-us day ab ~ ~c.~~- 1986 . ~~~ ~~~~L~~~ IS~aL1 ~VFLyN CDUNN~LL S~.gned, ~ea.~ed, pub.~.ushed and dec.~aned by the above named Te~~a~o~c, ~V~LyN MCDUNN~LL, ass and bon hen La~S~ w.c,P2 and Te~~a.men~, who, a~ hen neque~~, ~.n hen pex~sence and .in the pne~ence ob each a~theh, we have heneun~o ~ub~cn~.bed auh names a~ w~.~ne~~e~. .. xe~~.d~.ng a~ C~r- ~ ~.q.. _ ~ce~~.d~.ng a~ ~/11 ~ ~] -2- ACKNUGIL~DGM~NT UR TFSTATUR CUMMUNGI~ALTN U1= P~NNS~LVANIA CUUNTy U~ LUZ~RN~ SS: I. ~V~LyN MCDUNN~LL, Te~~a.~c~.x, wha~e name ~ r,.~gned ~o the bahega~.ng ~.n~~numen~, hav~.ng been duly qua.L~.~~.ed accond~.ng ~o .2aw, da hereby acFznow.~edge ~ha~ I ~~.gned and executed the ~axeoo~.ng ~.n~~.umen~ a~ and fax my La~s~ w.i,L.2 and Te~~amen.t; ~ha~ I ~s~.gned ~.~ w~.2.2~.ng.~y; and ~ha~ T ~~.gned ~~ a~ my knee and va.2un~aay act ion zhe pcvcpo~e~ ~hene~.n expne~~ed. ~V~LyN DUNN~LL Sworn an a~~~nmed ~a and acf~naw.~edged be~ane me, by ~VCLyN~~MC,D~UNN~LL, 7e~~a~aa, ~h~~~'~~ day o~ June, 1986. ,•-C~~ No~ta.ny ~.c ~os~r ~.ic My C~~n;~;::~rn c'.Yr,~;cs Aui:~.=st it~~ 187 -3- AFFIDAVIT OF GIITN~SS~S CUMMONG]~ALTH UP P~'NNSyLVANIA CUUNTy OP LUZ~RN~ SS: ~% ~ u` l~~O ~_~~. and /,~.,,,~ L~ , the w~.~ne~~e~ whose names ane ~ub~scn~.bed ~a the anego.~:ng document, be~.ng du.~y qua.~~.~~.ed acco~cd~.ng ~o .haw, do de~a~e and say ~ha~ we wexe ~ne~en~t and yaw the Te~S~a~n~.x ~~gn and execute the ~.n~~ic.umen~ ass hen L~a~~ w~~ and Te~~amen~; ~ha~ she ~~.gned ~~ w~..2.~~.ng.~y and ~ha~ she executed ~.~ a~ hex knee and va.~un~axy act bax the ~unpo~e~ ~hene~.n ex~ne~~ed; and .each ob u~ ~.n the hea~.~.ng and ~s.~gh~ a~ the Te~S~a.~c~.x ~~.gned .the w.ce.2 a~ w~.~ne~s~e~; and ~ha~ ~o the be~~ a~ oun h.naw:2edge, the Te~~ta~c~.x ways, a~ ~ha~ ~i,me, e~ghzee 1 ] 8) an mane yeah~s o{~ age, a~ sound m~.nd and undux nod can~~ca~.n~ a.a undue ~.n~.~uence. ,vim.,, a. ~- Swohn an a~~~.nmed ~a and ac~Znaw.~edged bebone me, by ,~~~ ,~ and ~ ~ h ~~ day o~ June, 19kd. /~ G/ "~ Na~a.~cy u tic 1Y~kcs-~..,ps. i_;~:.+9,D Ccurtty~ Re, MY ~.~rrs~,s;c rzzN.;~s At!gus't 10~ 1:~'/ -4-