HomeMy WebLinkAbout02-08-12PETIT/I~ION FOR GRAINY OF LETTERS
REGISTER OF WILLS OF C, U ~ l J F' Y' I G VJ ~ COUNTY, PENNSYLVANIA
Petitioner(s) mined 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
Name: ..~Q r>'l t_S I T/ tZ c~ I
a/k/a:
a/k/a:
a/k/a:
Date of Death: ~ - 12-ao / ~ rr
Decedent was domiciled at death in u YYl ' PY ~ Q~l C
principal residence at / ~-.o h ~~ nom- I.c.Ja ~ ~Gi -^ 1 t~
address, "Post Office and Zip
.sle T2Py~rvnolMr~
Decedent died at
Street address, Post Office and Zip Code
Estimate of value of decedent's property at death:
If dontieiled in Pennsylvania..........'. .
If -rot domiciled in Pennsylvania....... .
If not domiciled in Pennsylvania....... .
Value of real estate in Pennsylvania..... .
Real estate in Pennsylvania situated at: ~ ~ /
(Attach additional sheets, ijnecessary.) Street ads
File No• ,,~ ~ - ~ ~ _ L `1 ~
(Assigned by Register)
Social Security No: f y~ - ~;~ '8~ // ~-
Age at death: ~ /
County, ~ (ware) with his/her last
I ~~~~~ ~:~„tG, Mtn 1~ tovl Curn1~luhd
.Glty, Township os-Bereegh Counl
~~,CE6•li5~e /~~/3~.mt ~~P Ic~~l,~jln~ Yk~r )anG r I"
(~ly,Townshipu~B~arengh County State
................ All personal property $
................ Personal property in Pennsylvania $~/~~ U C~ O
................ Personal property in County $ ~
TOTAL ESTIMATED VALUE.... $w.~ ~ r,?~ Z~ <7
'-t ~~ Ilto~n l~d,~Ctana~l-~(1 /7~1/-~uw~v~ll~t9 - ~u t-l~~jf't'~C•tr~l
Iress, Post Office and Zip Code lrE' y, Township oc=Bet•6Ggh 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 ~" ~~ ' ~~' ~~ and Codicil(s)
thereto dated
State relevant circumstances (e.g. renunciation, death ojexecutor, etc.)
Except as fol lows: 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(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 ^EXCEPTION'S
^ B. Petition for Grant of Letters of Administration (If applicable)
c.t.u., d. b. n., d.b.t:.c.t.a., pendente lice, clurante absentia, duranteminor•itate
It Administration, r. i.u"". Ul' [~ D.il.C.l.u., eittrt diitC of v4:'iii in .CiECtitiil A aba.,, and ccmi3lete list 9f !:eir ~.
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 ari incapacitated person.
^NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent lefr no 1~'ill and was survived by the following spouse (if any) and heirs (attach
additional sheets, i/ necessa>7~):
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Lfi~f~~88FfRAR'S CERTIFICATION OF DEATH
~h~~~. #t ~~"fil.I~gal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.ttE~+~~ ~~s -$ P~ ~~' a~
CLERK 0~
ORPHAN'S CO~~R~
CUMR~R~. AND t~:~~.. PA
P 19159903
Certification Number
Type/Print In
Permanent
Rlack Ink
~_
This is to certify the the info(-mation here given is
correctly copied from an original Certificate of Death
duly tiled with me ,a~~ Lora] Registrar The original
certificate will be t~l_)rw~arded to the State Vital
Records Office for p(°rmanent filing.
JAN 21 2p11
_/--_._1_-_____
Local egisCrar Date lssuod
COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
CERTIFICATE OF DEATH
1. Decedent's Legal Name (Fl rst, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Dale of Death (MO/Day/Yr) (Spell Mo)
James B_ Titzel Male 198 - 22 - 8892 January 17, 2012
Sa. Age-Last Birthday (Vrs) Sb. Vnder 1 Vear Sc. Untler 1 Da 6. Date of Birth (MO/D ay/Year) (Spell Month) 7a. Birth lace (City antl State or Foreign Country)
~
Months Days Hours Minutes Iarrisbtlr PA
81 August 11 , 1 930 76. Birtnplaoe Icpl,nty) Lau hin
8a. Residence (State or Foreign Country) 9b. Residence (Street and Number -Include Ap[ No.) 8c. Did Decedent Live to a Township?
Penns lvania
1437 B
d
R
d Ves, decedent Ilyed in LOWE!r Allen ty,p,
Bd. Residence (copnty) ran
ton
oa
Cumberland 8e. Residence (Zip Code) ]- 7 05 Q No, decedent IlYed within Ilmlts of city/bore.
9. Ever In VS Armed Forces? 30. Marital Status at Time of Death Q Married ® Widowed 11. Surviving Spouse's Name (If wife, give name prior [o first marriage)
Q Yes (~ No Q Vnknown Q Divorced Q Never Married Q Unknow
12. Father's Name (First, Middle, Last, SufFlx) 13. Mother's Name Prior to First Marriage (First, Middle, Last)
James A. Titzel Sevilla Bo d
14a. Informant's Name 14b. Relatlonshlp to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code)
~ John T. Titzel Brother 1437 Brandton Road, Mechanicsbur ,PA 17055
lsa. ace o eat ec on y one --°- -° - --...... .° --- °--- --------- -•• ---•--- .....-- •----
If Death Occurred in a Hospital: ~ Inpatient ;If Death Occurred Somewhere Other Than a Hospital: Hospice Facility Decedent's Home
® Emergency Room/Outpatient Q Dead on Arrival Q Nursing Home/Long-Term Care Facility Other (Specify)
156. Faclllty Name (If not instituflon, give street and number; SSC. City or Town, Stag, and Zip Code SSd. County of Death
Carlisle Re ional Medical Cente S. Middleton PA 17013 Cumberland
16a. Method of Disposition Q Burial ~ Cremation I6b. Data of Dlspositlon 16c. Place of Disposition (Name of cemetery, crematory, or other place)
O Removal from State O Dpnatlpn
Other (SpecHy) Jan11$~y 20 , Evans Crematory
16d. Location of Dlspositlon (City or Town, State, and Zip)
Schaef£erstown, PA 17088 1]a. SI natu of F Servic nsee or Person In Charge Of Interment 1]b. License Number
FD 013 340 L
~ 1]c. Name and Complete Address of Funeral Facility
.
§ Parthemore FH & CS Inc. P.O. Box 431 New Cumberland PA 17070
~' 18. Decedent's Education -Check She box that best describes the 19. Decadent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE ra s to Indicate what
~ highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent consideretl himself or herself to be.
~ 6th grade or less is Spanish/Hispanic/Latino. Check the "N O" $( White Q Korean
® No diploma, 9th - 12th grade box If decedent Is not Spanish/Hispanic/Latino. ~ Black or African American Q Vietnamese
Q High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native O Other Asian
Q Some college credit, but no degree Q Yes, Mexican, Mexican American, Chicano 0 Asian Indian Q Native Hawaiian
Q Associate degree (e.g. AA, AS) Q Ves, Puerto Rican Q Chinese Q Guamanian or Chamorro
Q Bachelor's degree (e.g. BA, AB, BS) Q Yes, Cuban ~ F71lpfno Q Samoan
Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) ~ Ves, other Spanish/Hispanic/Latino ~ Japanese Q Other Pacific Islander
Q Doctorate (e.g. PhD, EdD) pr Prpfessional degree (Specify) ~ Other (Specify)
. MD DDS, DVM, LLB, JO
21. Decedent's Single Race Self-Designation -Check ONLY ONE [o indicate what the decedent considered himself or herself to be. 22a. Decedent's Vsual Occupation -Indicate type of work
White 0 Japanese Q Samoan done during most of working life. 00 NOT USE RETIRED.
Q Black or African American Q Korean O Other Pacific Islande
Q American lntlian or Alaska Native QVletnamese QDOn't Know/NOt Sure Printer T esetter
Q Asian Intllan Q Other Asian ~ Refused 22 b. Kind of Business/Industry
Q Chinese Q Native Hawallan Q Other (Specify)
0 Filipino Q Guamanian pr Chamorro Print Media
ITEM 23a - 23 MUST BE COMPLETED 23a. Date Prone need Dead (MO Day Yr 23 b. Signature of Person Pr n nctng Deat (On y w en applicable 23c. License Number
BV PERSON WHO PRONOUNCES OR
CERTIFIES DEATH ; t rY _
T / ~ ~ D
~! O
23d. Da a Sig tl ( o/Day/Yr)
24. Time of peat O ~
~
J(P O
~-- ~ ~ 25. Was Med cal Examiner or Coro r Contacted] ~ Ves 0 No
CAUSE OF DEATH Approximate
26. Part 1. Enter the chain of a ants--diseases, InJurles, o mpllcatlons--that directly causetl the death. DO NOT enter terminal a ants such a ardiac a est Interval:
r
respiratory arrest, or ye ntrlcular fibrillation without sho
w
ing the etioi
y. DO
N
OT ABBREVIATE. Enter only one cause on a line. Add addi[lonal Itn es
o
g
tf necessary Onset to Death
1f
~
r
~
~
~
.
IMMEDIATE CAUSE > Q /~n I J ~ Sy'~"N-t _~~
(Final tlisease or contlitlon Due to (or as sequence of):
resulting in death) ~ ~
~
`
_
~ v
b -
'
`~
~
Sequentially list conditions,
r
o (o as a
quence of):
If any, leading to the cause
listed on line a. Enter the
UNDERLYING CAUSE Due to (or as a consequence of):
(disease or Injury that
Initiated the events resulting d.
~ In death) LAST. Due to (or as a consequence of):
s 26. PaK 11. Enter other si¢nlflcant c ndlLions coniributlna fo death but not resulting In the untlerlying cause given in Part I 27. Was a utopsy perfo ed7
Q Ves No
26. Were autopsy Flndings available
to complete the cause of death?
Q Yes Q No
' 29. If Female: 30. Did Tobacco Use Contribute to Death? er
31. M~~^ of Death
Q Not pregnant within past year l--t~
~ -- Q Probably [$'Ndtu ral Q Homicitle
Pregnant at time of death ~ No ~ Unknown 0 Accident 0 Pentling Investigation
~( Q Not pregnant, but pregnant within 42 days of death Q Suicide Q Could not be determined
~ Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Vr) (Spell Month)
0 Unknown if pregnant within the past year 33. Time of Injury
34. Place of Injury (e.g, home; construction site; farm; school) 35. Location of injury (Street antl Number, City, State, Zip Code)
36. Injury at Work 3]. If Tra nsportatlon Injury, Specify: 38. Describe How Injury Occurred:
Q Yas 0 Driver/Operator Q Petlestrlan
~ No Q Passenger Q Other (Specify)
39a- C r (Check only one):
Certifying physlcia - To the best of my knowledge, death o ed due to the < e(s) and m ed
- Q Prpnouncing 8a Certifying ph I -TO the best of my knowledge, death occurred at the time, date fa nd place, and due fp the cause(s) and m tad
~ Medical Examiner/COronar nth basis of exa atlon, and/or Inyestigatlon, In my opinion, death
I
red at the time, date, and place, and due to the
c
a
use(s) and manner stated
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Signature of certifier: Title of certlFler: /fJ
~ License Number: (/V In ~~ S _ L
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39b. Nirita'A antl Zip Co Completing Cause of Death (Item 26)
- ar=o~
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~° 39c. Date 5 d (MO y/Y
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40. Registrar 5 Istrici er 41. Registrars ature 42. Registrar File Date (MO Day r
of -al ~~~~ ~ o / 3-
43. Amendments
`\\
Dlspositlon Permit No. ~i_0 ~/~~
H105-143
REV 07/2011
4/
-;
LAST 61ILL A1QD TBSTAMEIIT OF JAM88 B . TIT'ZBL
I, JAMES B. TITZEL, A RESIDENT OF 2014 MILLTOWN ROAD, LOWER
ALLEN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECLARE THIS MY
LAST WILL AND HEREBY EXPRESSLY REVOKE ALL PRIOR WILLS AND
CODICILS AND WRITINGS IN THE NATURE THEREOF, HERETOFORE MADE BY
ME.
I. I DECLARE THAT LINDA HOERNSR, OF CUMBERLAND COUNTY,
PENNSYLVANIA, IS A SISTER OF MY DECEASED WIFE ESTHER, AND THAT
ALL REFERENCES IN THIS WILL TO "MY WIFE'S SISTER LINDA" ARE
REFERENCES TO HER.
II. I DSCLARB THAT JOHN T. TITZEL, OF CUMBERLAND COUNTY,
PENNSYLVANIA, IS MY BROTHER, AND THAT ALL REFERENCES. IN THIS WILL
TO "MY BROTHER JOHN" ARE REFERENCES TO HIM.
III. I DECLARE THAT HELEN TITZEL, OF CUMBERLAND COUNTY,~~,
PENNSYLVANIA, IS THE WIFE OF MY BROTHER JOHN, AND THAT '"''
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REFERENCES IN THIS WILL TO "MY BROTHER'S WIFB HELEN" AR]
~V7~ ~
REFERENCES TO HER. '=-?c~>~-~ ..,~
--
IV. I DECLARE THAT JOHN T. TITZEL, JR., AND ARTBi~~ N. {:~
y c
TITZEL ARE THE CHILDREN OF MY BROTHER JOHN AND HIS WIFE HELEN, `t'
AND THAT ALL REFERENCES IN THIS WILL TO "MY NEPHEW JOHN" AND "MY
NEPHEW ARTHUR" ARE REFERENCES TO THEM.
V. I HEREBY DIRECT, THAT UPON MY DEATH, THE EXECUTOR OF
MY ESTATE PAY ALL MY JUST DEBTS AND OBLIGATIONS, AND ALL FUNERAL
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EXPENSES, FROM MY ESTATE.
VI. I GIVE, DEVISE, AND BEQUEATH 10$ (TEN PERCENT) OF THE
REMAINDER OF MY ESTATE TO MY WIFE'S SISTER, LINDA.
VII. I GIVE, DEVISE, AND BEQUEATH 90$ (NINETY PERCENT) OF
THE REMAINDER OF MY ESTATE TO MY BROTHER JOHN, MY BROTHER'S WIFE
HELEN, MY NEPHEW JOHN, AND MY NEPHEW ARTHUR, IN EQUAL SHARES.
VIII. IF ANY BENEFICIARY NAMED IN THIS WILL DOES NOT
SURVIVE MS, I HEREBY DIRECT THAT THS SHARE OF MY ESTATE WHICH
WOULD OTHERWISE HAVE GONE TO SUCH BENEFICIARY SHALL GO TO THE
HEIRS OF SUCH BENEFICIARY.
IX. I APPOINT MY BROTHER, JOHN, AS THE EXECUTOR OF MY
ESTATE. IF MY BROTHER JOHN DOSS NOT SURVIVE ME, I APPOINT MY
NEPHEW JOHN AND MY NEPHEW ARTHUR AS CO-EXECUTORS OF MY ESTATE.
X. NO BOND SHALL BE REQUIRED OF ANY EXECUTOR OR
EXECUTRIX APPOINTED UNDER THIS WILL.
XI. ALL ESTATE, INHERITANCE, AND SUCCESSION TAXES,
TOGETHER WITH ANY INTEREST AND PENALTY PAYABLE THEREON, PAYABLE
AS A RESULT OF MY DEATH SHALL BE PAID FIRST FROM THE REMAINDER OF
MY ESTATE PRIOR TO ITS DISTRIBUTION AS SPECIFIED HEREIN. ANY
RBMAINING ESTATE, INHERITANCE AND SUCCESSION TAXES SHALL BE
EQUITABLY PRO-RATED AMONG, CHARGED TO, AND COLLECTED FROM, EACH
OF THE BENEFICIARIES SHARING IN MY GROSS TAXABLE ESTATE,
INCLUDING BENEFICIARIES OF PROPERTY PASSING OUTSIDE OF THI5 WILL.
MY EXECUTOR SHALL TAKE WHATEVER ACTION IS NECESSARY TO COLLECT
SUCH TAXES AND CHARGES FROM ALL BENEFICIARIES SHARING IN MY GROSS
TAXABLE ESTATE AND MAC WITHHOLD SUCH TAXES AND CHARGES FROM ANY
PROPERTY THAT MAY BE DISTRIBUTABLE TO SUCH BENEFICIARIES.
Witness
Witness
r
ACKNOWLEDGMENT
Commonwealth of Pennsylvania
County of Cumberland
I, James B. Titzel, testator, whose name is signed to the attached
or foregoing instrument, having been duly qualified according to
law, do hereby acknowledge that I signed and executed the instrument
as my Last will; that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by J mes B. Titzel,
the testator, this ~ ~ day of ~ ~. ~ 19~.
~~ ~.
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AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
we , c-~/S~'!rt e.; /c ~ ~ i ~~ and ~~i"~j~4- ~ ~ -S'n c ~~ ,
the witnesses whose names are signed to t1Ye attached or foregoing
instrument, being duly qualified according to law, do depose and say
that we were present and saw testator sign and execute the
instrument as his Last Will; that James B. Titzel signed willingly
and that James B. Titzel executed it as a 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 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 by
and witnesses, this ly
day of ~' 199.
~~~
~ ~
Witness
W
7-L+L+TT7~~fTR1
Commonwealth of Pennsylvania
County of Cumberland
this, the ~ day of ~~~~~' O~D ~ o~,
~~5.!$~+~ef ore me the unders i ned
officer, personally appeared William H. Andring, known to me or
satisfactorily proven to be a member of the Bar of the Highest Court
of Pennsylvania, and certified that he was personally present when
the foregoing Acknowledgement and Affidavit were signed by the
Testator and Witnesses.
In witness thereof, I hereunto set my hand and official seal.
~Ja.wn 4~~u~v,
__ ~9MMpNV~4~TH OF PENNSYLVANIA
Notarial Seal
iDanna S. LuEes, Notary PubUc
mower Allen 7wp., Cumberland County
My r.Ammission F.~cpkeS June 2, 2015
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