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HomeMy WebLinkAbout03-02-12PETITION 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 requests the grant of Letters in the appropriate form: Decedent' Informs ion Name: Florence M. Fasick a/k/a: a/k/a: a/k/a: Date of Death: 02127/2012 Decedent was domiciled at death in Cumberland County, principal residence at Maplewood Assisted Living, Mechanicsburg File No: 21 + ~ O~ ~I (Assigned by Register) Social Security No: 190-26-6600 Age at Death: 101 PA 17055 Lower Allen T (State) with his/her last __ _ __ _ Cumberland ~~~ `~`" ~°°° City, lrownship or Borough County Decedent died at Bethany Villlage, Mechanicsbur 17055 Lower Allen Township Cumberland PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: !f domiciled in Pennsylvania ...................... All personal property $ If not domiciled in Pennsylvania ................ Personal property in Pennsylvania $ 690 000.00 If not domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................... $ --- 0.00 ~ TOTAL ESTIMATED VALUE $ 690 000.00 Real estate in Pennsylvania situated at None ' (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough Count y ® A. Petition for Probate and Grant of Lette Te -ment~~ Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated 08/0512011 thereto dated and Codicil(s) 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 mar 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 ~ EXCEPTIONS ^ B. Petition for Grant of LeffQrs of Admini tration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., ,oedente lite, durante absentia. durante minontate If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above ~nd omol list of heir, Except as follows: Decedent was not a party to pending divorce proceedin wherein the grounds for divorce h~ been establ~ed as defined in 23 Pa. C.S. § 3323 (g) and was neither the victim of a killing nor ever ad9udicated 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 fol f~ouse 'any) and' ` ~ (attach additional sheets, if necessary): Vi ~ fV _ ~: r ~; Form RW-02 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Petitioner(s) Printed Name Petitioner(s) Printed Address One West Main Street Shiremanstown, PA 17011 The Petitioner(s) above-named swear(s) or affirm(s) the statements in belief of Petitioner(s) and that, as Personal Representative(s) of the ~ Attor gnature: Printed Name: Jam . Bagar Sworn to or affirmed and subscribed before ~~ Date Z Z me this ay o ~.~ o~G 12.. Date By: Date For the is er Date BOND Required? ~ YES NO To the Register of Wills: FEES: Please enter my appearance by my sianaturp harnw• Letters .......................................... ( ~ © )Short Certificate(s)......... ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ............................................. Commission .................................. Other ~,J`~ ~~ i>~ Automation Fee ............................ JCS Fee ....................................... TOTAL ......................................... $ S ~l ~- 5+~- Shiremanstawn, PA 17011 (717) 737-8761 jbogar@bogarlaw.com DECREE OF THE REGISTER Date of Death: 02/27/2012 Social Security No: 190-26-6600 Estate of Florence M. Fasick File Na: 21 !6~-~ ~... a/k/a: AND NOW, v~ d~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to James D. Boger in the above estate and (if applicable) that the instrument(s) dated 08/0512011 described in the Petition be admitted to probate and filed of record as~i I,gst WTI (and Codicil(s)) of De ent. I Supreme Court ID Number: 19475 C_l/li~`ii.'..L. , ,; Iarfi,rSal Als ~~?E~, ~ ~ __ z,tr CLERK LF ORPHAP~'S CC~JRTd17a37-s761 =-r"=-ate)-~1 are true and correct to the best of the knowledge and ill well and truly administer the estate according to I w Firm Name: Boslar & Hipp Law Offices Address: One West Main Street Phone: Fax: E-mail: Re~'isfer of Will V `~ Form RW-02 rev. 10/11/101 > Copyright (c) 2011 form softwa my The Lackner Group, Inc Page 2 of 2 H105.805 REV (9!111 LOCAL REGISTRAR'S CERTIFICATION OF DEATH ~~~~1~:~~[~II~I to duplicate this copy by photostat or photograph. Fee for this certificate, $6_.00 This is to certify that the information here given is ~~~ ~ ~~R -2 ~t~ $~ ~ J correctly copied from an original Certificate of Death Certification 1~lumber Type/Print In Permanent pFS O t~s duly filed with me as .Local Registrar. The original (~~~ ~~ _ certificate will be forwarded to the State Vital Records -Office for ermanent filing. oR~-~Nrs couRT P 1~ 3 0 0 7~~~N~F~f r~,n,~~ r~. PA _ ~ Loca Registrar Date Issued GOMMONWEALTN OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH .VITAL RECORDS CERTIFICATE OF DEATH _. _ _ :- ABe-Last BIRhd•y (Yrsj Sb. Under 1 ••r Se. Under 1 D• !QO- ~6- G'~fl>,o f" .,.virn f~pen Mo) } 6 0 ~ ~~f ~ . •b o Birth (MO/D•y/Year) (spell Month) 7.- Birth 1•u ! Q ~ Months Days Hours Minutes r P ( Ky and stag or ForNgn Country) Tam ~I '~~~ 7b. BlrthPlau (County) ~. Residenu (state or Forelgn.000ntry) 8b. Residence (street and Number -Include Apt Ne.j 8c. Did DeudeM Uw In a Tow ? I~/oI A/A hi iv L R.ale.ne• fcounty> S2S (~/E ns p Yes, d•e•dene Iwed In dM1fA ud~- ~_ g4LtJ~/ a CV JIJ Be. Residenu (ZIP Code) Ev In us Arcned Foroesa J trop. f ?~-iti' Q No, decedent Ilved within Ilmib w city/DOro 10. .ntal stag, at nme of Man Married cal owed u. survwln s ( s p Y•a No Q Unknown Q Dworua Q Never MaMetl Q Vnknown B Pouae's Name 11 wH~, Iva name Nor to Ant m•rrlage) . Father's Name (FIM, Middle, Last, Su x) ~ i.LU-/M -T-ANN /+ ~'N r r 13. Mother's Name Prior to Flrat Marcl aBe (First, Middle, Last) NEu/E n orman a Name 14b. RelaNOnshlp to Decedent 14c. Informs 's Malling Address (S[reK and Number, Glry, state, 21p Code) rER r •/-a f i L .................................................... .................. Ieieh O¢urrad in a Hospital: .u..in . .................... Patient a au o to ° ..............:........................ ~£..on.. one r H Death ................................ w ... ..... Occurred somewh~ Oth Th ~ Ems • nay Room/Out atNnt Dead on Arrival b~F Nsma (H not InstKUtlon ive st ~ ....~ ..............~ r• er an s Hospital: 1-I HOSPIU FacIR •••• ••••.••••••••••••••••••-••••..• Nuraln Home/Lon Term Gre Faeillry Other 5 D~cetlent's Homa ee ( ~ , g reet and number; gg VI LL P 1St. City or Town, state, and ZIP Co e • 15d. County of Death s. Method of Disposltlon Burls Cremation Q Removal from stste Q Donation Other (specif ) 16b. Oeq W Dlapoait en 16e. Plau of Ols ' Position (Name of umetery, crematory, or other place) t9li y d. Loudon of Dls OSitl Ci R ~. roNS c(e~rw.T,Osta s~.'x.:,« on ( P ty or Town, SUte, and 21PI ~ e i7a. slgnatu of Funeral servfu Uuns•e or Person in Cha rge of Inter ` ~ ~70~` ment I7b. Llunse Number ~ c. N~m~ and Complete Addreu of Funeral F„-:I:r.. ~/_.~ 11. t. ighest degree or level of school completed at [M time of death. Q 8th grad. or less box that best describ•siwhet)Iler the decedent Q No dlPloma, 9th - 12th grade Q Hi h h is SPenlsh/HISPanle/Latino. Check the "NO" box M decedent is not SPenlsh/Hls i L sc i ool graduate or GED completed Q Some coliep credit, but no degree pan atino. 4 No, not spanlah/Hlspanlc/Latino Associate degree (e.g. qA, qs) Bachelor's degree (•.g. BA, AB, BS) Q Yea, Mexlun, Maxiun American, ClHUno Q Yes, Puerte Rlun n Merter's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, Cuban Q Yea, other Spanish/His anl /L l Doceorab (e.g. PhD, Ed D) or Professional degree p c at no e. . MO ODS DVM LLB JD (specify) DeudeM's single Race self-Designation -Cheek ONLY ONE to Indiwh wMt the deutlent considered himself or typs~White Q Japanese S O Black or African Amerlcsn Q Korean Q American Indian or Alaska NaHVe Vietnamese A g Q amoan Q Other PacMe Islander Q Don't Know/Not sur Q llan Indian Other Asian Q chlnese Natlw Hawaiian Q FIRPino G i e Q ReRlsed Q Other (SPeciry) uaman an or Cham orro ~ a~ /~' _ I ~ ~°~~ 2s w M dl 1 E Q~ ~>SS SF () 26. Part 1. Enter the chain f even •-di w CAUSE V F DEATH u Y N ~t sea s, InJurles, or compliutlons-chat direct! Approximate Mspiratory arrest, or wntrlcular fibrillation wKhout shovel the etlolo V eauud the death. DO NOT enter terminal .vents such as urdlac arrest. j InMrval; n8 N• DO NOT ABBREVIATE. Enter only one cause on a Iin•. Add addltlonM Ilnes If neussary : Onset to Death IMMEDIATE CAUSE > GO N '~ ~+ ~ 'r" l V~ y.}-~~Fj 2-r ~ ~ r L- [ (Final disease or condltlon U (Z ~' 1 Z, /Yt Oh ~" resulting In tlpthj Out to (or as a conNquenee of): E b. SegwnHally ilst condlNOna' Due to (or as • eons. Mce o n .ny, I.seing to the cause qu fl: Ilsted on Ilne a. Engr the } VNDERLYIN6 UUSE c Du• to (or as a eons•gwnca of): (disease or Injury that 1 inltisud the evems resulting d. ) In death) LAST, Dua to (or as • conssquenca of): r ' to eompleb the rouse of death? Female: 30. Did Tobacco Use ContribuN [o Death? Q Y No )(~NOt Pregnant within past year 31. Manner of MaTh Q Pregnant at time of death Q Yes Q ProbsblY ~j~latursl Q Homlelde Q Not Pregnant, but Pregnant within 4,2 days of deatt ~NO Q Unknown Q Accident Q Pending Inveatigatlon Q Not Drains M, but pregnant 43 days to 1 year before deatF 32. Date of In u Q sulelde Q Could not be determined Q Unknown H pregnant wlMln the pasT year J ry (MO/DaY/Yr) (spell Month) Yes - ~--Kr~~. r,ew In)ary oee~rr.d: Q No Q D,aver/Operator ~ Pedestrian Q Q P senger Other (SpeeMy) rtiR (Ch k .^ ) Grtlfying Phyald - To the beat o} my knowledH, death oeeurcetl dw to the uuae(s) and manner stated ~ Pronouncing i GrtNylon :physician - To the best o} my knowledge, death occurred at the time, Bete, and plea, and due to the cau»(a) and manner stated ~ Medlin Examiner/CO r - On the bests of examinetlon, and/or Inwstlgetlon, In my opinion, death occurred at the time, daN, sold place, and due to the cause(s) and manner staid signature of o+rtiRer: ~---fit.--s~t f{1/~ nele of urtlner Fit 1~ Name, Address and ZIP Code of Person Com Nti ueens. Number:_. M O 4 21 ~+ fr'J ~Q.YYY~L~Jh `I _-+ P ng Guse of Math (IteT 26) 39c. D to slg ed (MO/Day/Yr) R g District Num ~ liter G "r77 V'fp( f.(. ~ i,.Y1 lam' / ` /1G ( e~~ ~ ~ K ' Igna r et itrar F e Date Mo DaY r 1 ~ ~~ ~ ~ .. it _ r 3~~ Dlspositlon P•rmlt No. O HIOS-143 REV 07/2011 1 dsudsnt ronsidered himself or herself to be. to Indicate what White Q Korean Black or Airlun American Q Vletnam•se Amerlun Indian or Alaska Native Q Other Asian Aalan Indian Q Native Hawellan Chinese Q Guamanian or Chamorro Flliplno Q Samoan Japanese Q Other PaelRC Islander Other (SpecHy) 'to be. 22n. Mgdent s Uau•1 Oecu Patton - Indleab ryPe of woH done during most of working Ilfe. DO NOT VSE RETIRED. r -~ . ,_;~ ~ , ~~.. . , , _ ~.v ~~62 BAR -2 ~ $~ 4~ OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS Estate of Florence M. Fasick Deceased James D. Bogar and Lauren E. Bogar , (each) a subscribing witness to (Print Name/s) 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 signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence of each other. (Signa e) James D. cJar One West Main Street (Street Address) Shiremanstown, PA 17011 (city, stare, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills Shiremanstown, PA 17011 (City, State, ZipJ Executed out of Register's Office Sworn to or affirmed and subscribed before me this C~9fh day Notary Public ~ a lea / ~S My Commission Expires: (Signature and Seal of Notary ar 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 instrument(s) at time of notarization. Form RW-03 rev. 10.13.06 CUMBERLAND COUNTY, PENNSYLVANIA CLERK C~ ORRHAN'S COURT CUM~f`f?! ;~~f4i? C~, PA ignature) L wren E . One West Main Street (Street Address) BETH B. tENt~EL, NOTARY PU81JC EHIREMANSTOWN BORO, CUMBERUIND CDUNR MY COMMISSION EXPIRES DECEMBER 12, 2015 J ~ i LAST WILL AND TESTAMENT OF FLORENCE M. FASICK I , FLORENCE M . FASICK, Of ~~ .ter'', r ~ cry ~ ` N ~ ~` ~~' Y T ~ .. C7 _ , ~ ~. ~-' , C ~ A -, ~ -i ~ : r -.~ .~ p ~:~ >,: Mechanicsburg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore. made by me. F RST: I give and bequeath the sum of five thousand dollars ($5 , 0 0 0 . 0 0 ) to my f riend, VIRGINIA BONE, of 126 Clearview Drive, Camp Hill, Pennsylvania 17011, provided that should she predecease me, I direct that this specific bequest be made to my sister-in-law, MARIANA DAVIS, of 8717 Valleyfield Road, Lutherville, Maryland 21093 . S COND: I give and bequeath the sum of ten thousand dollars ($10,000.00) to my sister-in-law, MARIANA DAVIS, of 8717 Valleyfield Road, Lutherville, Maryland 21093, provided that should she predecease me, I direct that this specific bequest be made to her son, THOMAS DAVIS, of 2300 Dulaney Valley Road, Timonium, Maryland 21093. T IRD: I give and bequeath the sum of ten thousand dollars ($10, 000.00) to my friend, MARCIA M. MONTGOMERY, of 6 Redwood Court, Camp Hill, Pennsylvania 17011, provided that should she predecease me, I direct that this specific bequest be made to her 2 son, PETER MONTGOMERY, of 660 Bomberger Road, Etters, Pennsylvania 17319. FQURTH: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance poli cies thereon, as follows: (A) Five percent ( 5 % ) thereof to BETHESDA MISSION, of 611 Reilly Street, Harrisburg, Dauphin County, Pennsylvania 17102, to be used for general purposes as the governing body of said organization deems appropriate. (B ) Ten percent (10 % ) thereof to ELIZABETHTOWN COLLEGE, of One Alpha Drive, Elizabethtown, Pennsylvania 17022, to be used for general purposes 3 as the governing body of said organization deems appropriate. (O ) Thirty-five ( 3 5 % ) percent thereof to the NURSING FOUNDATION OF PENNSYLVANIA, of 2578 Interstate Drive, Suite 101, Harrisburg, Pennsylvania 17110 , f or the purpose of est:abl i shing The Florence (Madden) Grady-Fasick Scholarship Fund to be administered in accordance with the provisions of a Deed of Gift to be established with the NURSING FOUNDATION OF PENNSYLVANIA and, in the absence of a Deed of Gift , to be used for general purposes as the governing body of said organization deems appropriate. (D) Fifty ( 5 0 0 ) percent thereof to my fiend, PETER MONTGOMERY, of 660 Bamberger Road, Etters, Pennsylvania 4 17319, provided that should he predecease me, then to his issue per stirpes by representation. F FTH: Should any of the children of PETER MONTGOMERY (hereinafter ref erred to as "children" ) not have attained the age of twenty- f our ( 2 ~ ) years at the t ime f. or di s - tribution to him or her, I give, devise and bequeath the share of each such child to my hereinafter named Trustee or Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and reinvest the shares so received, and to use and apply from time to time such portion of income and principal for the said child's education (including college, trade school or other similar training or education), as my Trustee or 5 Trustees, in their sole discretion, deem advisable. The Trustee or Trustees, in exercising their dis- cretionary authority with respect to the payment of income or principal of the within Trust to the children, shall take into consideration any income or other resources available to the children from sources outside this Trust. Any income or principal not so applied shall be distributed to each child when he or she attains the age of twenty-four ( 2 4 ) years . In the event any of the children die prior to the termination of this Trust established herein for their benefit, the interest of said child in said Trust shall cease with any income and principal. being 6 divided evenly between or among the remaining children of PETER MONTGOMERY or the separate Trusts established hereunder for their benefit . S XTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it . (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (c) To compromise any claim or controversy and to abandon any property which is of little or no value. (~) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, vuithout restriction to s investments authorized for Pennsylvania f iducia~'ies , as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, 'right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (~) To make distributions to my herein named beneficiaries in cash or in kind or partly in each. (H ) To borrow money f rom themselves or others in order to pay debts, taxes, or estate or trust 9 administration expenses, to protect or improve any property held under my will, and for investment purposes. (z) To select a mode of payment under a~.y qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent ithe plan or the law permits them to do so, and to exercise any other rights ~rvhich they may have under the plan, in whatever manner they consider advisab~Le . SEVENTH: I nominate and appoint LAURA A . MONTGOMERY, wi f e of PETER MONTGOMERY, as Trustee of the. hereinabove described trusts. In the event of the death, resignation or inability to serve for any reason what- to soever of the said LAURA A. MONTGOMERY, I nominate and appoint GRANT DIANDON~TO, brother of LAURA A. MONTGOMERY, as Trustee of the hereinabove described trusts. I direct that my Trustee shall serve without bond and shall receive fair and reasonable compensation. E GHTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoe~,rer, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the princi- pal of r~ny residuary estate . Notwithstanding, I specifically direct that there be no allocation of inheritance, estate, transfer, ~~ succession and death taxes, of any kind, whatsoever, to any charitable beneficiary designated by me herein. N NTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though crested or distributable, shall not be subject to attachment, execution or sequestration for any debt., contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. T NTH: I nominate and appoint JAMES D, BOGAR, Executor of this, my Last will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of 12 JAMES D. BOGAR, I nominate and appoint JENNIFER B. HIPP and PETER MONTGOMERY, Co-Executors of this, my Last Will and Testament. I direct that my Executor or Co-Executors, Trustee or Trustees, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties i.n any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~~ day o f ~,~-~ 2 011 . ( SEAL ) FLORENCE M. FASICK 13 Signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attestingf.~witne~ses. ~;. Address ~ ~' ~-- Address 14