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HomeMy WebLinkAbout02-23-12 ~ rcesei 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 fdllowing and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information Name: MARGARET B. PHILLIPS a/k/a: a/k/a: a/k/a: Date of Death: February 6 2012 File No: ~I - ~ ~ ~ ~o~ i-~'d (Assigned by Register) Social Security No: 184-18-7818 Age at death: 96 Decedent was domiciled at death in Cumberland County, Penn.ylvania (state) with his/her last principal residence at 2100 >~ent Creek Boulevard Mechanicsburs, 17055 Silver Shrine °Cwn Cumberland Street address, Post Office and Zip Code City, Township or Borou gh County Decedent died at 2100 Bent Creek Boulevard Mechanicsburs. 17055 Silver Snrin¢ Twn Cumberland 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 $ 140,000.00 If not domiciled in Pennsylvania ...................... ..Personal property in Pennsylvania $ 0.00 If not domiciled in Pennsylv4nia ...................... .. Personal property in County $ 0.00 Value of real estate in Pennsylvania .................... ..................................... $ 0.00 TOTAL ESTIMATED VALUE.... $ 140.000.00 Real estate in Pennsylvania situated at: N/A (Attach 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 February 12, 2009 and Codicil(s) thereto dated 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 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 0 EXCEPTIONS B. Petition for Grant pf Letters of Administration (If applicable) 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(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. Q NO EXCEPTIONS ©EXCEPTIONS 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): n ~ Name Relationshi Address~~-'~~ -*~ `' ° ~~ ' J~~ t?J r:., ~ i't'1 N ~ i i i' ' '; ? -~ n i ~ ~ _; 3~ -tom :~ ~ '. _ =' i:~a W -~ L~ Form RW-02 rev. 10/11/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Official Use Only n t,r ~~~ ~, ~ ;r ~~'v~ '~~" `" ~,r~ ~ C 1i~ Petitioner(s) Printed Name Petitioner(s) Printe:d Addres r Elizabeth F. Shaffer 417 Cherokee Drive Mechanicsbur PA 17050 QNf~~~ v~~~T c«M ~ , .. -~~~ ~~:., ,~.• 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 to or affirmed sulbscribed before Date ~- a~'-~ / ~- me this ~ day , o ^ ~ Date By: ~ Date For t ie Register Date BOND Required: Q YES Q NO FEES: Letters ...................... $ ~~U '` ( 4) Short Certificate(s)...... i 6 - ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s) ............ . Bond ........................ Commission ................. . Other (,LJ, ~. ..••.••• ~' Automation Fee ............... JCS Fee . .................... S~ TOTAL ..................... $ To the Register of Wills: rtease en[er my appearance cry my srgnarurc uc,uw: Attorney Si nature: ~' Printed Name: Andrew H. Shaw Supreme Court ID Number: 87371 Firm Name: Law Office of Andrew H. Shaw, P.C. Address: Inn c Ski; (', rrl .n Street, Snite 11 Carlisle, PA 1701 ~ Phone: 717-243-7135 Fax: 717-243-787:2 Email: anrlrP~ achawlaw cem 31G ~ - DECREE OF THE REGISTER Estate of MARGARET B. P~-IILLIPS File No: ~~~ - ~ ~ ~~ 1~ a/k/a: AND NOW, - ~ , O~J ~ ~- , in consideration of the foregoing Petition, satisfactory pr f h ing be pres ted before me, IT IS DECREED that Letters Testamentary rare hereby granted to Elizabeth F. Shaffer in the above estate and (if applicable) that the instrument(s) dated FeblXuary 12 2009 described in the Petition be admitted to probate and filed(r~ecord as the la t Will (anal Codi '1(s)) of Decedent. ~ 11 i n >~ n ~~ G ~~n 0 ~ n ~ ~ ~.~1~7~ 1~ ~I Form RW-02 rev. 10/11/2011 ~J Fage 2 of 2 H 1(IS,eO~ REV ~, 9111 LOCAL R ~, ,+;.t;~`ri~'~CERTIFICATION OF DEATH WARNING: It if~G~g~t4 dr~~~ate this copy by photostat or photograph. Fee for this certificate, $6.00 ~~ ~ ~ rJ~~ 23 A~ ~ (~ J J h P 181?')1982 ~Ilprd"""~~~..,~ Th1S 1S t0 CE1-City lhat the lIltOrllldh0^ ere glVe^ IS n'' a~~H OF pE'' correct.] co led from an on final Certificate of Death ~~'~ w Ny=_ y p g (/`~~R}( ~j~ t,,t`°o`Z~' - `fir`, duly filed with me as Local Registrar. The original ~~~'~ ~U ~ ~ °~ ~ z certificate will be forwarded to the State Vital ~~~~~~'~.~~-~~~ ~ ~ ,,4 ~ ,n~ Records Office fo permanent filihg. *~ 'q F ~P 1 ~~j o~ ~ 7 ~'-=9lMENT 0 ~ ~`7-- ""'°"""'1JIIj111111 Local Registrar Date Issued COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RE(DRDS c Ac a'1,CATgJ Certification Ivfumber Type/Print In Permenen[ ' ^N ` i 3 lack In k Oeced•nt'a LePI Name (First, Middle, 1 --- - - -- - -- - - - - - ~•~~ Ust, Suf/lx) ~ 2. Sex 3- Seelal Security Number 4. D•N of Death (MO/Day/Yr) (Seel] Mo) . P h'~ t~. s ~ l8 ~- ~.8 8 t 8' ~. zo ~-Z Sa. Age-Last Birthda (Yrs) Sb. Vnder 1 Year Se. Under 1 D 6. Date of Birth (MO/Day/Vear) (Spell Month) 7a. Birth Ice (City and SG or For•IBn Coun ry) ~ Months DaK Hours Minutes ~ ~ t ~, ~ th lau (Coun ~ 7b Bl Q / p . r ¢a. Resl ca (Stag or Foreign Country 8b. Residenu (Stye i and Number - Include Apt No.) Be. Did Decedent Llw In a Townsl ~7 tw ~j1~~e ~~ ~~~\~k~ P. . E w,OOa_w~~`-~-a/ R`v l\_ Ves, deudentlMdin_ /~ Pas. C-`~~~ ~ V ~i gd. Resldenu (County) '.. G' s.1 y,/`~r~ 6_y~~, ~ Be. Realtlenu (Zip Code) < 0 O No, decadent INetl within limits of city/born. 9. Ever in US Armed Forus7 10. Mar ital S4tus at Tlme of Oath Marrlad WI owed 11. Surviving SDOUae's Name (If wife, gWe name prior to first marriap) Q Yea ~ No Q Unknown Di vorced Q Never MarrNd Q Unknown 12- Father's Neme (First, Middle, Vat, 5 13. Mother's Name PNOr to First MarriHe (First, Middle, Last) ) ~~ ~ L fo m w ` '~ Informant's Nama 14a ant's Mailing Address IStreN and Number, City, State, Zip Gods) 4b. R•INlonshlp to Deud•nt 14e. In . Z Ch¢r ~jC ac caw ~z g ` .. -.-.. .,t . . - t - e'~e ............................................... •--- If Death Occurred In a Hospital: ..-. .. ~ -...-. .-..... ......................................... ........~:... Inpatient ~ 11 Death Occurred Somewhere Other Than a Hospital: ~( Hoaplu FaeI11tV ~ Oeeedent's Home $ Em•r enry Room/Out tlent Deed on Arrival Nunln Mome/1-on -Term Gre Facility Other (Specify) lSb. Fac11Ry Name (If not Instltutlon, ilv street and number; SSC. City or T;wn, State, and 2 Code 15d. County of Death V\ O ~~u o., ~ ~, \ Method f DlsposRlon Bu 16a emetery, crematory, Or other place) e o1 c laposltlon (Na m IN Cremation 16b. Date of Disposition 16c. Place of ~- . Q Removal ham SCeu . ` \ ` Donation ~•j ~ ~~ ~ ^ ,7 `7\,~ r Qi~ R\~` ~,Q~A'~'~ l Other (Specify) 16d- Loudon of Disposition (City or to i n, Suta, and Zip 17a. Slgna of Funeral Servlu Lice or Person in Ch rp of Interment 17b. Uunse Number nee .~` ~jp t.Z2.t Z - L Z~ 17c. N me and Com late Adtlrea of Fu er I F•c1llry `1 / • 7w L ~ Decedent's Education -Check the x that best deferibes tM 19. Decedent of Hispanic Orlgln -Check She 20. D edent's Rau -Check ONE OR MORE taus to Indicate what 18 . highest degree or level of school comp) Nd at the time of death. box that best descNbea wMther the decadent the decedent considered himself or herself to W. Q 8th grade or less '. Ia Spanish/Hlapanic/Latino. Check the "NO" WhKe Q Koran Q No diploma, 9th - 12M grade '~ box If decadent Ia not Spanish/Hlspanlc/Laclno. black or AfNean Amerlon Q Vietnamese A i O h er s an t High school graduate or GED comlpleted No, not Spanish/Hlspanl4Latino Q American Indian or Alaska Native Q Q Asian Indlen O Native Hawaiian i Chi A Q mer can, cano Some college credit, but no degree Ves, Mexican, Mexleen Puerto Rican Q Ghinu• Q Guamanian or Chamorro Q yea AS , Q Associate degree (e.g- AA. ) Q BacheloYa degree (e.g~ BA, AB, BS Q Ves, Cuban Q FIIIPino Q Samoan Q Marter's degree (e.B. M/1, MS, M g. MEd, MSW, MBA) Q Ves, other Spanish/Hlspanic/Latino Q lapane:te Q Other Pacific Islander ~ sslonal degree (Specfy) Q Other (:Specify) Q Doctorate (e-g- PhD, Etl D) or Prof . MD DDS DVM LLB JD Decedent's Single Race Self-Designs ion -Check ONLY ONE to indlcab what the decedent considered himself or herself to be. 22a. Deudent's Usual Oecupatlon - Indicate type of work 21 . Whlta ~, Q JaPan•se Q Samoan done during most of working IIf•. DO NOT USE RETIRED. r Q Black or Afrlun American Q Korean Q Other Pacific islander j.~O K~, Q ~f( d. Ker I-r ' t Knew/Not Sure Q American Indian or Alaska Natve'. Q Vietnamese Q Don i I d t d f ness/ n us ry o Bus Q Asian Indlen )~ Other Asian Q Refused 22b. Kin Q Chinese ', Q Natlw Hawaiian Q Other (Specfy) ~~ Q Filipino I Q Guamanian or Chamorro ITEMS MUST BE COM D 23 ate Pronoune Dea Day 23 . Signature o Person Pronounc nL eat On y w en app ca le 23c. L unse Num er by PERBON WNO PRONOUNCES OR A w/ aJ ' /~ ~ ~s - ' r) • I }'+-Jh-7 ^~~ L^s F/_A_J fC(V a [ lc7V CERTIFIgg DEATH L~~sc~ 7 2 to Signed M Da ~ 24. Time of Deb t Q 2S. Waa edtul Examiner or Coroner Con4ctetl Q Yes • Approximate CAUSE OF DEATH ~ 26. Pert 1. Enter the f -~dlseasea, Injuries, or compllcatlons-thK directly caused the death. DO NOT enter terminnl evenb such as cardiac arrest. Int<rval: 1 Onset to Death N n s a dditi l Il I dd ry ona nes ece s lne. A a respiratory arrest, or ventricular Rbrlllatlon wKhout showing the etioloN. DO NOT ABBREVIATE- Enter only one cause on a G s ..~ ¢ a~S Ti tier .r/ ~ka• T G~ i ~rf ~-~ i IMMEDIATE CAUSE ---> - f ~ ): (Final disease or condition Due to (or as a consequence o resulting In death) b. i Sequentially Rst conditions, Dw to (or as a consequence of): If anY. leading to the cause Ilrted on Ilne a. Enter the i VNOERLYING GUSE Due to (or as • eons•gwnce on: arc (disease or Injury that initiated the evenb resulting d' con in death) LAST.. Dw to (or as a sequenu of): y p n 26. Pert 11. Enter other 1 but not ruulUnB in the underlying cause given In Pert 1 27. Waa a autoPSy Performed? ~ u es I D` _1 -A4 28- Were s SoPSY findings weilable sT~' .~- to complete the cause of death? Ves No 29. 11 Femai•: 30. Did Tobacw Uae Contribute to Death? 31. Manner o1 Oasth ~NOt pregnant within past year Q Y•a Q Probably O~Natural Q Homicide Q Preg^ant at time of death D~NO Q Unknown Q Accident Q Pending Investigation $+ but pregnant wl hin 42 days of death Q Not pregnant Q Sulclde Q Gould not be determinatl , but pengnant 4 days [0 1 year before death nant ) Not re 32. Data of InJury (MO Day/Yr) (Spell Month) 1 ~ , ~ p g Q Unknown If pregnant wl[hin t e past veer 33. Time of Injury 34. Plsu o1lnJury (e.B. home; constru ion site; farm; school) i 35. Location of Injury (Street and Number, City, State, Zip Cod•) 36- InJury at Work 37. If Transport lion InJury, Specify: 38. Describe How Injury Occurred: Q Yea Q Driver/Opar for Q Pedestrian Q No Q Passenger Q Other (Specfy) . Grtlfler (Cheek only one): 39 a ~ / I certifYing physician - To the best f my knowledge. dpth occurred due to the cause(s) and manner stated tr _ Q Pronouncing i GKHying Physlcl n - To the best of my knowledq, tl•ath occurred at LM time, date, and plan, and due to the cause(s) and manner stated Q Medical Examiner/Coroner - On t a basis exa ton, and/or investigation, In my opinion, death occurred at the lima, date, and place, snd tlue to She Cause(s) and manner stated Signature of certifier: Title of certifier. ~Fd License Number. M~ - G' ./J B y 4/• L 39b. Name, Addreu and Zip Code of P rson C p InB Guse of Death (Item 26) ~ p p G FYb /•L~' ICfi 39c. DaN Signed (MO Day/Vr) _ . Reglrtrar s IatNCY Num • ~. 1. 42. Re Istrar FI a Date Mo Dsy 43. Amendments ~ J~ £ ~ 9 ~ r~S ~+..,~ ~ J ~ B H306-143 DlsposiClon Permit No. ~~,~ REV 07/2011 Last Will of ~ ~.~, ~ o ~° r*~ ~., ~"J v - rn n ' w : _~ t_' - ~~ MARGARET B. PHILLIPS ~ ~ `=~ ~,Y r~~ <- - .,_, . -~, . ~, ~ _ , I, MARGARET B. PHILLIPS, of Cumberland County, Pennsylvania, mai~'e this c.~ `" Will and revoke all of my prior wills and codicils. ~ Article One Distribution of My Property • Section 1. Pour-Over to My Living Trust All of my property of whatever nature and kind, wherever situated, shall be distributed to my revocable living trust. The name of my trust is: MARGARET B. PHILLIPS, Trustee of the MARGARET .B. PHILLIPS LIVIP~IG TRUST, dated February 12, 2009, and any amendments thereto. Section 2. Alternate Disposition If my revokable living trust is not in effect at my death for any reason whatsoever, then all of my property shall be disposed of under the terms of my revocable living trust as if it were in full force and effect on the date of my death. Section ~. Testamentary Trust If my spouse survives me, I authorize my personal represenl:ative to establish, • with the a$sets of my probate estate, if any, or with any property distributed to my Page 1 personal representative from my Trustee, a testamentary trust I or trusts) for the benefit of my spouse and my other beneficiaries under the same terms and conditions of my revocable living trust as it exists at the date; of my death. I appoint the Trustee and successor Trustee named in my revocable living trust as the Trustee and successor Trustee of my testamentary trust(s). The Trustee of my testamentary trust(s) shall have all the administrative and investment powers given to my Trustee in my revocable living trust and any other powers granted by law. My Trustee shall be under no obligation to distribute property directly to my personal representative, but rather may distribute such property directly to the Trustee of the testamentary trust(s). Any property distributed tc- my testamentary trust(s) by the Trustee of my revocable living trust shall be distributed by the Trustee of my testamentary trust(s) in accordance with the terms and conditions of my revocable living trust as it exists on the date of my death. Article Two Powers of My Personal Representative c: My personal representative shall have the power to perform all acts reasonably necessary to administer my estate, as well as any powers set forth in the statutes in the State of Pennsylvania relating to the powers of fiduciaries. Article Three Payment of Expenses and Taxes and Tax Elections Section 1. Cooperating with the Trustee of My Living Trust I direct my personal representative to consult with the Trustee; of my revocable living trusC to determine whether any expense or tax shall be paid from my trust or from my probate estate. • Page 2 • Section 2. Tax Elections My personal representative, in its sole and absolute discretion, may exercise any available elections with regard to any state or federal tax laws. My personal representative, in its sole and absolute discretion, may elect to have all, none, or part of the property comprising my estate for i~ederal estate tax purposes qualify for the federal estate tax marital deduction as qualified terminable interest property under Section 2056(b)(7) of the Internal Revenue Code. My personal representative shall not be liable to any person for decisions made in good faith under this Section Section 3'~. Apportionment All expenses and claims and all estate, inheritance, and death taxes, excluding any generation-skipping transfer tax, resulting from my death and which are incurred as a result of property passing under the terms of my revocable living trust or through m'y probate estate shall be paid without apportionment and without • reimbursement from any person. However, expenses and claims, and all estate, inheritance, and death taxes assessed with regard to property passing outside of my revocabble living trust or outside of my probate estate, but included in my gross estate for federal estate tax purposes, shall be chargeable against the persons receiving such property. Article Four Appointment of My Personal Representative I appoint the following to be my personal representatives: ELIZABETH F. SHAFFER, or if ELIZABETH F. SHAFFER is unwilling or unable to serve, I appoint WILLIAM K. SHAFFER. I direct that my personal representatives not be required to furnish bond, surety, or other secuCity. Page 3 • • I have signed this Will on February 12, 2009. M RET B.~ HI, LIPS The foregoing Will was, on the day and year written above, published and declared by MARGARET B. PHILLIPS in our presence to be her Will. We, in her presence and at her request, and in the presence of each other, have attested the same and have signed our names as attesting witnesses. We declare that at the time of our attestation of this Will, MARGARET B. PHILLIPS was, according to our best knowledge and belief, of sound mind and memory and under no undue duress or constraint. WITNESS ~yrcG~_ WI ESS Page 4 • STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. We, MARGARET B. PHILLIPS, K ,~~ts ~, f}rrl~n.)5 and C•~nroau:u 1,,CN,,,A~r ,the Testatrix and the witnesses, respectively, whose names are signed to the foregoing Will, having been sworn, declared to the undersigned officer that the Testatrix, in the presence of the witnesses, signed the instrument as her last Will, that she signed, and that each of the; witnesses, in the presence of the Testatrix and in the presence of each other, signed the Will as a witness. _ .~.t~t a,.~ WITNESS Subscribed and sworn before me by MARGARET B. PHILLIPS, the Testatrix, and by Ti-/~.~r+s J. AH,~ivs _ and `'~e witnesses, on February 12, 2009. COMMONWEALTH OF PENNSYLVAMA NOTARIAL SEAL Aaron C. Jackson, Notary Public Upper Allen Township, Ctiunberland County My commission ex fires May 07, 2011 • Page 5