HomeMy WebLinkAbout02-09-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COLINT~.', PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for betters as specified below, and in
support thereof aver(s) the following and respectfully request(s) the grant of Letters iri the appropriate form:
Decedent's Information
Name: DOROTHY M. GROUP File No: ~~ I _ _~ ~ !0 ~ ~~
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security N
Date of Death: ~ 2 l 2 Age at death:
Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (Stare) with his/her last
principal residence at 24 SMITH ROAD, GARDNERS, PA 17324 SOUTH MIDDLE'TON TOWNSHIP, CUMBERLAND
Street address, Post Office and Zip Code City, Township ar Borough County
Decedent died at24 SMTI'H ROAD, GARDNERS, PA 17324
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 $ 30,000.00.
If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ .
If not domiciled in Pennsylvania ........................ Personal property in County $ 100.000.00
Value of real estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VAL[TE.... $ 130,000.00
Real estate in Pennsylvania situated at: 24 SMITH ROAD, GARDNERS, PA SOUTH MIDDLETON TOWNSHIP,. CUMBERLAND
(Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township ar 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 :-ANUARY 6, 2000 and Codicil(s)
thereto dated NIA
State 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, was not divorced, was not a party to a pending
divorce proceeding wherein the grounds far 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.
O NO EXCEPTIONS ~ EXCEPTIONS SPOUSE, JACK R. GROUP IS DECEASED
B. Petition for Grant of Letters of Administration (If applicable)
c. t. a., d.b.n., d.b.n.c.t.a., pendenre lite, durante absentia, durante minoritate
If Administration, c.t.a. or db.n.c.za., 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 person.
Q NO EXCEPTIONS Q EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived bytlie following spouse (if any) and heirs (attach
additional sheets, if necessary): rya
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FormRW-02 rev. 10/11/2011 P3g0 1 Of 2
Uath of Personal Kepresentative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CjJ~ERI-AND
vauciu vac vuay
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Petitioner(s) Printed Name Petitioner(s) Prin
ACK R. GROUP JR. 20 FISHER DRIVE, YORK PA 17404
' COURT
~lf~nRF~'.At~f~ .,
The Petitioner(s) above-named swear(s) or affirm(s) the statements ' foregoing Peti ' aze true and correct to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the edent the 'tioner ) well an administer the estate accordirrng~~to~~law.
Sworn to or affirmed an subscribed b fore .~ Date /~O. 1
me this y o ~ Date
$y; Date
For the Re inter Date
BOND Required: ~ YES Q NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters ...................... $ '"
(~ )Short Certificate(s)...... ~' ---
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( .)Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ` ~~~ ........ ~---
Automation Fee ............... ''
JCS Fee . .................... oZS~
TOTAL ..................... $ 311 , .SO $"
Attorney Signature:
Printed Name: ROBERT G. FREY
Supreme Court
ID Number: 46397
Firm Name:
Address:
Phone:
Fax:
Email:
FREY AND TILEY
717-243-5838
DECREE OF THE REGISTER
Estate of DOROTHY M. GROUP File No: ~ ~ - ~ ~ ~ ~ ~~
a/k/a:
AND NOW, -~4i.~-~ ~ , in consideration of the foregoing Petition,
satisfactory. pro f ha ng been p esented before me, IT IS DECREED that LettersTESTAMENTARY
are hereby granted to JACK R. GROUP, JR.,
in the above estate and (if applicable) that
the instrument(s) dated JANUARY 6, 2000
described in the Petition be admitted to probate and filed gf~record as the last Will (and Co~icil(s)) of Decedent.
Form RW-OZ rev. 10/11/2011
of W lls y '
2 of 2
OATH OF SUBSCRIBING WITNESS(ES)
CUMBERLAND
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
Estate of DOROTHY M. GROUP ,Deceased
ROBERT G. FREY , (each) a subscribing witness to
(Print Names)
the ®Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same
and that she / he /they signed the same and that she / he /they signeci as a witness at the request of
the Testator /Testatrix in her /his presence and in the presence of each other.
(Signature)
5 SOUTH HANOVER STR
(Street Address)
CARLISLE, PA 17013
(City, State, Zip)
Executed in Register's Off ce
Sworn to or affirmed and subscribed
before me this day
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(City, State, Zip) O
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
of Wills Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrum.ent(s) at time of notarization.
Form RW-03 rev. 10.13.06
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of DOROTHY M. GROUP ,Deceased
~ ~ S ~ L ~ ~ ~-S and
(each) being duly qualified ~~a//~~ccordin~g/ to law, depose(s) and say(s) that she / he /they was /were well-
acquainted with ~cJ I o ~ t~ ~ • G~'~ .. and am/are familiar
with the handwriting and signature of a decedent, and that the signature of L)OROTHY M. GROUP
to the foregoing instrument purporting to be the Last Will and TestamentJCodicil of
DOROTHY M. GROUP
is in his/her own proper handwriting.
h~
(Signature)
5 SOUTH HANOVER STREET
(StreetAddress)
CARLISLE, PA 17013
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before e this day
o ~ ~- .
for
of Wills
($ignature)
(StreetAddress)
(City, State, Zip)
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Form RW-04 rev. 10.13.06
LOC ~ ~ R'S CERTIFICATION OF DEATH
WAF# ~ t~is,Il , I~duplicate this copy by photostat or photograph.
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Fee for this certificate, $6.00 ~~ ~ ~ f ~B -g P~ ~~~ 2
c~RK o~
ORPHAN'S COURT
cI~MR~=R'
This is to certify that the information here given is
correctly copied from an original Certificate of 1-)cash
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
(_F+NO Cn . PA 2 2012
P 1~21062J_ ~~~~~, F~ /
Certification Number Local 1[~egistrar Date Issued
Type/PrIM In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
P°"'t'"°"` CERTIFICATE OF DEATH
Black Ink State Flle Number:
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1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Vr) (Spell Mo)
Dorothy Group emal 204-3C1-9698 January29,20'12
Sa. Age-Lest Birthday (Yrs) Sb. V nder 1 Year Sc. Under 1 D° 6. Date of Birth (MO/Day/Vesr) (Spell Month) 7a. Birtbplac}L(Glty r~rL StJte or Eocplgn Country)
l ar
L1 1E
YLi
.
•
Months Days Hours Minutes
7 1 March 4, 1 9 4 0 7b. Birthplace (County) um oer an o_
ga. Residence (State or Forel Country)
i gb. Residence (Street and Number -Include Apt No.) Bc. Dld Decedent Live In a Townshl T
Pennsylvan
a Bres,depedentuYedm 5'ou~h Middleton cwp
Bd. Reside~+ w (COtd~ty) 24 Smith Rd.
CumLler 1 and Se. Residence (21p Code) Q No, decadent IlYed within limits of city/boro.
9. Ever In US Armed Forces? 30. Marital Status at Time of Death Q Married ~' Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage)
[]Yes 4/NO QVnknown Q Divorced Q NeyerMarrled QUnknown Jack. Grou
12. Father's Name (Pint, Middle, Las(, Suffix) 13. M Char's Name Prior to First INarrlage (Fir Mitldle, Last)
Geor a W_ Miller Florence E_ E3ouder
14a. Informant's Name 14b. Relationship to Decedent 14c. Infor ant's Mailing Address (Street and Number, CI[y, State, Zlp Code)
~ Jack Group son 20 Fisher Dr..YOrk PA '17404
G
.
......................................................... ...•-•--•----------------------•---..... a. P awe o ---•`••`•,_o~,y,one
..................
.
..........ei.S... ...... ---.....-----
.
If Death Occurred in a Hospital: [~ Inpatient • z
..
..............rw _..----.........................._.. ..........................---......
If Death Occurred Somewhere Other Than a Hospital: LJ ~HOSpice Facility Decedent's Home
Q Emergency Room/Outpatient Q Dead on Arrlyal 1 Nur Ing Home/Long-Term Care Facility Other (Specify)
35b. Facility Name (If not ins[Itution, glue street and number; 15 c. City or Town, State, and Zip Code iSd. County of Death'
of
16a. Method
Disposltlon ~ Burial Q Cremation 16 b. Date of Disposition 16c. Place of Disposltlon (Name! of cemetery, crematory, or other place)
p Remo~herr (Specify) o Don.tlon 2121201 2 Mt _ Ho1lySpr3.ngs, PA'I 7065
C Ct=_metery )
16d. Location of Disposltlon (City or Town, State, and 21p) 17a. Signature of Funeral Service Licensee or Person In Charge of Interment 17 b. License Number
Mt_Holly Springs,PA 17065 011589E
17c. Name and Complete Address of Funeral Facility
Ho111n erFH&Cremator 50"IN_BaltimoreAve_ Mt Holl S z•in s 1
1H. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE rcces to Indicate what
~ highest degree or lav°I of school completed aY the time of death. box that best describes whether the decedent the decedent considered himself or herseH to be.
Q 8th grade or less Is Spanish/Hispanic/Latino. Check the "NO" White Q Korcsn
No diploma, 9th - 12th grade box if decedent Is not Spanish/Hispanlc/Latlno. Q Bieck or African American Q Vietnamese
High school graduate or GED completed No, not Spanish/Hispanic/Latlno Q Amerlcain Indian or Alaska NetlYe Q Other Asian
Q Some college credit, but no degree Q Ves, Mexican, Mexican American, Chl<ano Q Asian Indian Q Na[iye Hawaiian
Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamanian or Chamorro
Q Bachelor's degree (e.g. BA, AB, BS) Q Vas, Cuban Q Flliplno Q Samoan
Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) 0 Yes, other Spanish/Hispanic/Latino Q Japanese Q Other Paelflc Islander
Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) _ Q Ocher (': 1
_pec fy)
. MD DDS DVM LLB JD
21. Decedent's Single Race Self-DeslgnaHOn -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work
)$1 White Q Japanese Q Samoan done during most of working Ilfe. DO NOT VSE RETIRED.
Q Black or African American Q Korean Q Other Pacific Islander
Q American Indian or Alaska NeHYe Q Vietnamese Q Don't Know/Not Sure
Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry
Q CMnese Q Native Hawaiian Q Other (Specify)
Q Flliplno Q Guamanian or Chamorro
ITEM 3a - MU BE COMPLETED 23a. DKe Pro ounce Dead Mo Day r 23 . Slgnaturc o Person Pronouncing Death On y w en applies a 23e. License Num er
BY PERSON WHO PRONOUNCES OR /e~ ~/~ --->
CERTIFIES DEATH d 1 ~+/ GsCJ Z '~
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23d. Date gned ( p/Day/Vr) 24. Time
/ P h ~I/L{
KN
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y
/ (~-E7 •-t • . s 25. Was Medical Examiner or Coroner ContactedT Q Yes No
CAUSE OF DEATH A
roxim
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pp
a
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26. Part 1. Enter the chain of events--diseases, Injuries, or compllcatlons--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval:
respiratory arrest, or ventricular fibrillation without sh
Owing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add adtllNOnal lines If necessary Onset to Death
LL
IMMEDIATE CAVSE -------------> a. ~~\~ Q~l'~-tl~. C~ ~ LtV y. ~ V h k
(Final disc ondition Due to (o as a consequence of):
eswang In death)
b.
Sequentially list conditions, _ Due to (or as a consequence of):
If any, leading to the cause
listed on line a. Enter the
UNDERLYING GUSE Due to (or as a consequence of):
~ (disease or Injury that
F initiated the events resulting d.
~ in death) LAST. Due to (or as a consequence of):
26. P°r[ 11. Enter other si nifl nt 1 1 t h but not resulting in the underlying cause given In Part 1 27. Wss s autopsy ertormed7
~
D
~ Yes
No
2B. Were autopsy findings available
to complete the cause of death?
Yes No
29. If Female: 30. Did Tobacco Use Contribute fo DeathT 31. Manner of Death
E ~B Not pregnant within pas[ year Q Ves Q Probably Natural Q Homicide
as
' Q Pregnant at time of death No Unknown
Q Q
Q Accident Q Pending Inves[Igatlon
$ Q Not pregnant, but pregnant within 42 days of tleath 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/Yr) (Spell Month)
Q 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 and Number, City, State, Zip Code)
36. Injury at Work 37. If Tra nspor[atlon Injury, Specify: 39. Describe How Injury Occurred:
Q Yes Q Driver/Operator 0 Pedestrian
Q No Q Passenger Q Other (Specify)
39a. Certifier (Check only one):
Q CartlfYinB Physician - To the best of my knowledge, death occ red due to the cause(s) and m stated
Q Pronouncing 6 Certifying physician - To the best of my knowledge, death o red at the time, date, and place, and due to the cause(s) antl m stated
Q Medical Examiner/CororylL~~_On the basis of examination, and/or Inyesilgatlonr in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner sbted
P
Slgnaturc of certifier. +-V
Title of certifier: License Number: ~~ O (~t Z ~ ~ L
39b. Name, Address and Zip Cade of Person Completing Cause f D th (Item 26) 39c. D e S d (MO/Day/Yr)
robe T r (`2 JW ~+. ,1 -. ••.O 7'7 N~l~f+, "lJ ~'~s~- L'Lt"4iva PA 1013 2 1 l~
40. Registrar's District Num er 41. Registrar's SI
~~ 42. Registrar FI a Date Mo Dsy
43. Amendments
Disposltlon Permit No. \J 12 ~4 \ c2`O t H305-143
REV 07/2011
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LAST WILL AND
OF
DOROTHY M,
TESTAMENT
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I, DOROTHY M. GROUP, married woman of South Middleton Township (mailing
address: 24 Smith Road, Gardners, PA 17324), 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 and making void any and all Wills by me
at any time heretofore made.
1. I direct my hereinafter named Executor or Executrices.to pay all of m:y just debts and
funeral expenses as soon after. my death as may be found convenient to do so. I further direct that
all inheritance, transfer, succession, estate and death taxes which may be payable o ^ account of my
death shall be payable from the residue of my estate regardless of whether the as~~ets upon which
such taxes are based are included in my probate estate.
2. I declare that I am married to Jack R. Group, Sr. and that I ihave three (3) children,
Connie Scherzer, Kimberly Miller, and Jack Group, Jr. I further decl~rre that :[ have no other
children.
3. All of the rest, residue and remainder of my estate, real, personal rind mixed, and
wheresoever the same may be situate, I give, devise and bequeath to 'my husband, Jack R.
Group,Sr., his heirs and assigns, to the exclusion of my child or children born and unborn,
provided my said husband, Jack R. Group, Sr., shall survive me by a period of ninety (90) days.
3 . Should my said husband, Jack R. Group, Sr. predecease me or :fail to survive me by the
aforesaid period of ninety (90) days, then in such event all of the rest, residue and remainder of my
estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and
bequeath in equal shares to such my children as shall survive me by a period of ninety (90) days,
the share any deceased child would have received is passed to his or heir issue per stirpes and if
their be no issue of such share shall lapse and be added to the remaining share or share per slirpes.
At the present time I have three (3) children as before mention.
4. Should any person less than twenty one (21) years of age be entitled to distribution from
my estate, in such event share that person would otherwise have received shall be paid to my
herein after named Executor, in trust. I authorize the herein named Trustee to receive and invest
the same, and to pay the income arising there from together with so much of the principal thereof
as in his or her opinion is necessary or desirable to be expended to the proper maintenance,
support, and education of such person, to and for the benefit of such person and upon such person
attaining twenty one (21) years of age to pay to him or her the then remaining principal together
with any undistributed income.
a. To invest any part of the trust corpus in such securities, investments, or other
property as may be deemed advisable and proper, irrespective of whether the same are authorized
for the investment of trust funds under the laws of any governing jurisdiction.
b. With respect to any corporation, the stocks, bonds, or other securities of which
may be held, to vote in person or by proxy on any shares of stock; to consent: to the merger,
consolidation or reorganization of such corporations; to consent to the leasing, mortgaging or sale
of the property of any such corporations; to make any surrender, exchange or sub;~titution of such
stocks, bonds or other securities as an incident to the merger, consolidation or reorganization of
such corporations; to pay all assessments, subscriptions and other sums of money which may be
deemed wise and expedient for the protection and maintenance of the proportionate interest of the
investment in such corporations; to exercise any option or privilege which may be conferred upon
the holders of such stocks, bonds, or other securities of such corporations either for the conversion
of the same nto other securities or fir the purcha~~e of ad:iitional securities, and to rnake any and ali
necessary payments which may be required in connection therewith; and generally to 1-iave and
exercise as to all such stocks, bonds and other securities, the powers of a.n individual owner who
is not under trust obligation.
c. To hold the trust corpus in one or more consolidated funds in whicL~ separate shares
shall have undivided interests.
d. To sell at public or private sale for cash or upon credit, or partly foi• cash and partly
on credit, and upon such terms and conditions as shall be deemed proper, any pa~•t or parts of the
trust estate, and no purchaser at any such sale shall be bound to inquire; into the expediency or
Page 1 of 2
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propriety of any such sale or to see to the application of the purchase move:ys arising therefrom.
e. To keep on hand and uninvested such money as may be deemed proper and for
such period as may be found expedient.
f. To compromise, settle or arbitrate any claim or demand in favor of or against the
trust estate.
g. And authorized in the discharge of fiduciary duties, to employ counsel and to
determine and to pay such counsel reasonable compensation which shall be charged against the
principal or income of the trust fund, and shall further be entitled to charge against the principal or
income such other reasonable expenses and charges as may be necessary and proper to incur for
the proper discharge of fiduciary .duties and for the proper management and administration of the
trust estate.
h. In making any division of property into shares for the pu~:pose of any distribution
thereof directed by the provisions of the trust, to make such division or distribution, either in cash
or in kind, or partly in cash and partly in kind, as shall be deemed most expedient, and in making
any division or distribution in kind may allot any specific security or property or any undivided
interest therein to any one or more of such shares, and to that end may appraise any or all of the
property so to be allotted and the judgment as to the propriety of such allotment and as to the
relative value for purposes of distribution of the securities or property so allotted shall be final and
conclusive upon all persons interested in the trust or in the division or distribution thereof.
i. And authorized to register any shares of stock or other assets of any trust in their
own names or in the name of a nominee.
j . To retain and invest in shares of stock of my Trustee.
k. To retain any investments including mutual funds which :[ may own at the time of
my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds
as may be deemed advisable or proper, irrespective of whether the same are authorized for the
investment of trust funds under the laws of any governing jurisdiction.
1. To determine from time to time whether alJ or some portion of realized r..apital gains
shall be treated as ordinary income for distribution to a beneficiary or treated as principal to be
retained as part of the corpus, and such designation need not be consistent from one year to
another.
5. I hereby nominate, constitute and appoint my husband, Jack R. Group, Sr. as Executor
of this my Last Will and Testament, but should he predecease me or fail to qualify or cease serving
as such, then in such event I nominate, constitute and appoint my sore, Jack R. Group, Jr., as
Executor, but should he predecease me or fail to qualify, then in such event I nominate, constitute,
and appoint my daughter, Connie Scherzer as Executrix and I further direct that none of them shall
be required to post any bond to secure the faithful performance of his or her duties in the
Commonwealth of Pennsylvania or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will
and Testament written on two (2) pages, this ~'~ day of ~a ~,~ J ~ ~ 20 ~ v.
.,_,,, (SEAL)
Dorothy M. Gr up
Signed, sealed, published, and declared by Dorothy M. Group., the Testatrix above named,
as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and
in the presence of each other, have hereunto
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