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HomeMy WebLinkAbout02-14-12Reset PETITION 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 Name: Mary Jane Trego a/k/a: a/k/a: a/k/a: Date of Death: February 1, 2012 File No: ~~~ ` ~ r` r 1 (Assigned by Register) Social Security No: Age at death: 91 Decedent was domiciled at death in Cumberland County, pennSYlvania (state) with his/her last principal residence at 828 Hamilton Street. Carlisle. 17013 Carlisle Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Carlisle Reeiona] Medical Center. 361 Alexander Snrinsr Road. Carlisle. Cumberland County, PA Street address, Post OfLce and Zip Code City, Township or Borongh County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania ............................ All personal property $ 200,000.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ If not domiciled ue Pennsylvania ........................Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ 15n,nnn_nn TOTAL ESTIMATED VALUE.... $ 350,000.00 Rest estate in Pennsylvania situated at: 828 Hamilton Street, 17013 Carlisle Cumberland (AUach additional sheets, if necessary.) 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 _November 10, 1981 and Codicil(s) thereto dated State relevant ©rcumatances (eg. renanciation, death of execator, erc) 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 (lf applicabte) c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durante minoritate If Administration, c.t.a. or db.n.c.t.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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. NO EXCEPTIONS ~ EXCEPTIONS ,~~ '- Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (ilnd heirs ~ach m additional sheets, if necessary): ,~7-p t'f'! ;.;,~ -1 Name Relationshi Address ~ ~- ~ t ~~t7 A ~ ~ ~ ~ C~ t ti...• r~..i -.._3 C! z ""T'"t ~~ C~ T . ~.n Forn xw-oz rev. 10/11/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } } SS: } ~i2 ~µ~B 14 ah~ $~ ~+ 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 }mowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Decedent, the Petition) will well and truly administer the estate according to law. Sworn to or affirmed d subscribed before Date - / ~ ~~ me this day U la- Date Z a Z Date By' Date For the egister BOND Required: Q YES ~ NO FEES: Letter ................... $ r- ( ~ Short Certificate(s)...... ~~= ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)............ ` Bond ........................ Commission ................. . Other ~ll~V~ •••••••• ~~~ Automation Fee .............. . JCS Fee . .................... ~~..~ TOTAL ..................... $ --$99 To the Register of Wills: Please enter my appearance b;y my signature below: Attorney Signature: Printed Name: Bradley L. Griffie Supreme Court ID Number: 34349 Firm Name: Griffie & Associates, P.C. Address: inn ~.r,,.it, u~n„~,Pr etreet rlisl ., PA 17013 Phone: 717-243-5551 Fax: 717-243-5063 Email: h~riffie,~~ ffi ~av^~ ~nm ~ '~a 3 . ~- DECREE OF THE REGISTER Estate of Ma Jane Tre o File No: ~~ I - ` a/k/a: AND NOW, ,~~, in co sideration of the foregoing Petition, satisfactory pr f ing be n prese ted be ore me, IT IS DECREED that Letters are hereby granted to ~ ~ ~ "~ in above estate and (if applicable) that r the instru n (s) dated ~ ~ described in the Petition be admitted to probate and filed of record as the last Will (and Codic' )) o Decedent R gister of W' s ,, i FormRw-oz rev. ~oi~lizo» Page 2 of 2 HIOS.ROS RBV (9/III L RAR'S CERTIFICATION OF DEATH :~~i~ al to duplicate this copy by photostat ar photograph. Fee for this certificate, $6.0~~~~ ~~B ~ ~} ~]~} 8: ~~ This is to certify that the information here given is - _ correctly copied from an original Certificate of Death ~ER~ ~ duly ?filed with me as Local Registrar. The original certificate will be forwarded to the State Vital ~}~}~'~" ~D~j Records Office for permanent filing. CUt+~BEF~~ AND ~0 , PA P 18.2__ 10 6 4 J_ ~R~~ Fps ~ Zo~2 Certification Number .D TYP¢/Print In Permanent Black Ink ~- ~~ v ~g a Local Registrar Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL fIECOROS CERTIFICATE OF DEATH _____ _.._ _..._____ 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. 6oclal 6ecurlry N b r 4. Date of Death (MO/Day/Vr) (Spell Mo) Mary Jane Trego Female 177-16-0188 February 1, 2012 9a. Age-Last Birthday (Yrs) Sb. Under 1 Ysar Sc. Under 1 Da 6. Date of Birth (MO/Day/Vear) (Sp¢II Month) ]a. Birthplace (City and Stat< or Foreign Country) t gl Months Days Hours Minutes OCt 27 ~ 1920 7b. Birthplace (County) l.]1L1 8a. Residence (State or For¢Ign Country) Bb. Residence (Street and Number -Include Apt No.) Hc. Dld Decedent Live In a Township? PA 828 Hamilton St . QYes, decedent lived In _ twp. Sd. Residence CountyY]j Cumber5.ana Se. Residence (Zip Code) o, decedent lived within limits of Carlisle city/boro. 9. Ever In US Armed Forces? 10. Marital Status at Tlme of Death Married [~ Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Y¢s No Q Unknown Q Divorced Q Never Married Q Unknown 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to Firs[ Marriage (First, Mlddle, Las!) G_ Frank Sadler Rose E. Smyse>r• 14a. InformanYS Name 14b. Relationship to Deced<nt 14c. Informant's Melling Adtlre s (Street and Number, Clty, State, Zip Code) JoAnn ECe11y daughter 16 Mt. View Dr3.vef Carlisle, PA 17013 _ ~ ¢~¢ p , ~~.. on.y one , _ ...... .. a•"c in a Hospital: [Inpatient ; If Death Occ rred If Death Occurred Somewhere Other Than s Hospital: Hospice Facility Decedent's Home ~ Emergency Room/Outpatient ~ Dead on Arrival Q Nursing Home/Long-Term Care Facility Other (Specify) e~ 16b. Facility Name (If not institution, give street and nu mb¢r; 36c. City or Town, State, and Zlp Code 15d. County of Death Carlisle R Tonal Medical Center Carlisle PA 17013 Cumberland 16a. Method of Disposition ~ Burial Q Cremation 166. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) p RempYal frpm stare p Donation Feb 6 , 2012 Westminster Cemetery Other (Specify) 16d. Location of Dlsposillon (City or Town, State, and Zip) 1]a. 51gn of Funeral 9erv e n n Charge of Interment 1]b. Ucense Number ~ ~ Carlisle, PA 17013 138504 1]c. Nam and Complete Address of Fun<ral Facility ~ 18. Decedent's Education - Check the box that best describes the 19. Dece ent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to indicate what r- highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. ~ Bth grade or less Is Spanish/Hispanic/Lallno. Check the "NO" Whibs 0 Korean Q No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. [~ Black or African American Q Vietnamese g'] Hlgh school graduate or GED completed [C}}NO, no! Spanish/Hispanic/Latlnp ~ American Indian or Alaska Native Q Other Asian Q Some college credit, but no degree Q~Ves, Mexican, Mexican American, Chicano Q Asian Indian p Native Hawaiian Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chint:se Q Guamanian or Chamomo Q Bachelor's degree (e.g. BA, AB, BS) Q Ves, Cuban Q FIIlpino Q Samoan )~ Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispa nlc/Latino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Specify) . MD DDS OVM LLB JD 21. Decedent's Single Race Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work White Q Japanese Q Samoan done during most of working Ilfe. DO NOT USE RETIRED. an Q Other Paclflc Islander i K l k f i A mer can Q ore B ac or A r can Receptionist Q American Indian or Alaska Native ~ Vietnamese Q Don't Know/Not Sure Q Asian Indian Q Other Azlan Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) _ =nsurarice Company Q FIIlpino Q Guamanian or Chamorro ITEMS 23a - 23 MUST BE COMPLETED 23a. Date Prono ced Dead (MO Day 23 Signaturo of Person Pronouncing Oeat Only w en appl ca 23c. License Number BY PERSON WHO PRONOUNCES OR ©/ ..tl .... / /~ _ o CERTIFIES DEATH lXN l~~ ~ ~ `' I Mp4 ~ /'a r~ ~ 23d. Date Signed (M /Day r) 24. Time of D <a h j p ~ ©/ r ,I ~~- ~ t~cv 25. Wa Medical E aminer or Coroner ContactedT 0 Ves No CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of events--diseases, InJuries, or complications-that directly caused the death. DO NOT enter Terminal events such as cardiac arrest Interval: OT ABBREVIATE. Enter only one cause on a Ilne. Add additional lines if necessary Onset to Death o l y. D N respiratory arrest, or ventricular flbrlllation without showing the e ti o g O ~ ~ t . ~ t r- r IMMEDIATE CAUSE > I>~V f~ 1 D 1 r a Due to (or as a consequence of): (Final disease or condition ~ ~1 resulting In death) ~" t_t~ Q N Petty ~_ ,r n ~ ~S ~ y... ~~ b. 1 T~ l) - Sequentially Ilst conditions, Due to (or as a consequence of): ~ if any, leading to the cause D ~~p V ~1 N Trr t~ hr~ p oS IS ~~- Ilsted on Ilne a. Enter the c UNDERLYING UUSE 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): ~ ,j 26. Part 11. Enter other sl Iflcan 1 nt tin th but not resulting In the underlying cause given in Part 1 2]. Was an autopsy performed? 3 Q Ves No ~ 28. Wer<a topsy Flndin vallable m to complete the cause of death] ~ Yes No $' 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death Not pregnant within past year Q Yes Q Probably ~Natu ral Q Homicide Q Pregnant at time of death Q No ~Vnknown Q Accident Q Pending investigation ~' Q Not pregnant, but pregnant within 42 days of death Q Suicide Q Could not be determined ~ ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of InJury (MO/Day/Vr) (Spell Month) ~ Unknown if pregna n! within [he 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, Zlp Code) 36. InJury at Work 3]. If Transportation Injury, Specify: 36. Describe How Injury Occurred: Q Yes O Orlv¢r/Operator Q Pedestrian Q No Q Passeng<r Q Other (Specify) 39a. CertlFler (Check only one): Q Certifying physician - To the best of my knowledge, death o red due to the cause(s) and m r stated Prgnouncing 8i Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, and due to the c se(s) and manner slated ~ red at the lime, date, and plat<, and due to the c se(s) and m stated Medical Examiner/Coroner - the bast f ¢ Inatlon, a d/ r investigation, in my opinion, death a r r ,{ ~ ,- 1' ~'~~ V License Number. Title of certifier: Signature of certifier: 39b. Name, Address and 21 Code of Pers Co plating Cause f Death (Item 26) 39c. D to 5 ned (MO/Day/Yr) M t;D ~- d 2 0( I ?~-- 40. Registrar s District Numb<r 41. Registrar s 51 ~ 42. Llser FI a Date Mo Day r a~-a o ~ ~~. ~ oia-- 43. Amendments Disposition Permit No. `1~~~~~~~ REV O]/2011 4, ' ~~ :. a r'• ^'i LAST WILL AND TESTAMENT ~ © s> ~-'; ~-.,.~,. I, MARY JANE TREGO, of the Borough of Carlisle, C ~ ~ rland~ou~~ ~~t~ Pennsylvania, being of sound and disposing mind and memory, do hereby mak~publisT~~" and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I give, devise and bequeath all of my estate, both real and personal property, to my husband, KENNETH E. TREGO, absolutely. 2. In the event my said husband shall predecease or fail to survive me, then I give, devise and bequeath all of my estate, both real and personal property, in equal shares, unto my daughters, JOANN ELIZABETH KELLY and TERRY ANN GLASS absolutely. 3. I nominate, constitute and appoint r~}y husband, KENNETH E. TREGO, as Executor of my estate. In the event he shall be unwilling or unable to serve in such capacity, I nominate JOANN ELIZABETH KELLY and TERRY ANN GLASS as Executrices of my estate. 4. I direct that neither my Executor nor my Executrices shall be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 5. LAW OFFICES ~I WILLIAM F. MARTSON. P. C. I authorize and empower my personal representatives in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die _._ Mary J Tr o Page 1 seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to. mortgage or pledge any real or personal property forming a part of my estate or to join in or secure' the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS WHEREOF I have hereunto set my hand and seal this 10~ day of T~?~V FMi3E;2 , 1981. (SEAL) ary J Tr SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of said Testatrix and of each other. LAW OFFICES ~I WILLIAM F. MARTSON. P. C. ~~ ~~ ~~~~ Page 2 COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, MARY JANE TREGO, Testatrix, 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 bef ' e me by MARY JANE TREGO, the Testatrix, this / 0 ~='' day of NovErnBF R , 1981. ~1 Notary Public WILLIAM L. EARP, Notary Public Carlisle, Cumberland Co., PA COMMONWEALTH OF PENNSYLVANIA ) My Commission Expires Aug. 13, 1984 SS. COUNTY OF CUMBERLAND ) We, ~~'RRI-J£ L . 1`(~~'E'RS ~``-t P41~'L~IS E , DEcNE1~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that. we were present and saw the Testatrix sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me this ~O~`~' day of NovEmB~~ , 1981. LAW OFFICES II WILLIAM F. MART$ON. P. C. Notary Public WILLIAM L. EARP', rY Public Carlisle, Cumberland .Co., P'A Page 3 My Commission Expires Aug. 13, 198rR