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HomeMy WebLinkAbout03-05-12PETITION FOR GRANT OF LETTERS REGISTER OFD WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named belowl, who islare 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: Q~ssdent's Information Name: Mary B. Morri$on File No: 21-12 a/k/a: (Assigned by Register) a!k/a: a/k/a: _ Social Security No: 184-12424 Date of Death: 02/01/12 Age at Death: 87 Decedent was domiciled at death in Cumberland County, pA (State) with his/her last principal residence at 34221 Bedford Drive, Camp Hill 17011 Camp Hill Cumberland Street ddress, Post Office and Zip Code City, Township or Borough County Decedent died at Hol Spirit Hospital Camp Hill Cumberland PA Street addr ss, Past Office and Zip Code City, Township or Borough County State ^ ~1>3 Estimate of value of decedent's property at death: oa v~.,>7 If domiciled in Pennsylvania ...................... All personal property $ 100 /.,.~ '~•'Oe If not domiciled in Petjnsy/vania ................ Personal property in Pennsylvania $ Ifnot domiciled in Pe-lnsylvania ................ Personal property in County $ ~~'I' ~S;noo. ~.a Value of real estate in IPennsylvania ................................................................... $ ~" ® TOTAL ESTIMATED VALUE $ mot/ Oro ,~ ,I„flD1F,ACA,99 Real estate in Pennsylvania situated at, 3422 Bedford Drive Camp HIII oy Cumberland (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough County ® A. Petitioner(s) aver(s) that ~e/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated 12/29/2010 and Codicil(s) thereto dated State relevant circumstances (e.g., renunciation, death of executor, ehx) 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 wher~'in 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 q EXCEPTIONS ^ B. Petition for Grant of (Letters of Administration (If applicable) c. t. a., d.b.n., d. b.n.c.t.a., pedente life, durance absentia. durance minoritate If Administration, c.t.a q'r d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs. ~ „,~' Except as follows: Deced nt was not a party to.pending divorce proceeding wherein the grounds for divorce hadestablisl{~ as do in 23 Pa. C.S. § 3323 (g) ~nd was neither the victim of a killing nor ever a ludicated an incapacitated person. -p ~-~ r-1 ® NO EXCEPTIONS ~ EXCEPTIONS ~ ~ r ~ Petitioner(s), after a prop$r search haslhave ascertained that Decedent left no Will and was survived by the f~ additional sheets, if nece$sary): t~tncys~tse (ifG~lily) anii hek_s-a '7 CJLn ~"' ' , ~ C _. -r-i Name Relationship Address ~ ~ = r-r=i ~ ~. .fi - -T'' Form RIN-02 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 tt, G r ~ ~~ ~_ ~ ~'V~ ~f\' 'V,7 ~~~ ,~~ 1 ~,+'. l ~, ! Oath of Personal Representative '~~l~, , COMMONWEALTH OF PENNSYLVANIA } r, ~ ~~ COUNTY OF Cumberland } Official Use Only " ,,,5 ~}'( t~' ~~ Petitioner(s) Printed Name Petitioner(s) Printed Address ~„~ Theresa Brady 22912 Linden Drive O~{P~ i~~ ~, `~ C~ Q~, Lewes, DE 19958 Cllr{.~R~I-S`.. ~\~>>r The Petitioner(s) above-nam d swear(s) or attlrm(s) the statements In the roregotng re^^on arC uue arw wriv~i <~ .~~~ ~~~~ ~~ ~~~` ~„„••.....y.. ~~~~ belief of Petitioner(s) and tha , as Personal Representative(s) of a Decedent, Petitloner(s),w~ill`weJll and ruly administer the estate according to law. Sworn to or affirmed an ub$cribed before ~ ~~ O1~` Dafe 3 - ~ me this ay of ~ LZ Date Date By: For th egister Date BOND Required? ~ YES /'~ FEES: Letters . .................................. . ...... (~ )Short Certificate(s)......... ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ... .......................................... Commi ssion .................................. Other ~.) ~ I ~ Automation Fee ............................ JCS Fee ...............................:....... TOTAL .................................:....... J NO $ ~t./ f~ $ ~ `-f ~. S7~'- To the Register of Wills: Please enter my appearance v m srgnaiure oervw: Att rney Signa re: t~ Printed Name: Michael L. Bang Supreme Court 41263 ID Number: Firm Name: Bangs Law Office, LLC Address: 429 South 18th Street Camp Hill, PA 17011 Phone: 7171730-7310 Fax: 717/730-7374 E-mail: mikebangs~verizon.net DECREE OF THE REGISTER Date of Death: 02/01!2012 Social Security No: 184-12-6424 Estate of Mary B Morrison File No: 21-12 ~~~ a!k/a: AND NOW, ~U\ .~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Theresa Brady in the above estate and (if applicable) that the instrument(s) dated 12!29!2010 described in the Petition be admitted to probate and filed of record as t~(~ast 111 (and `Codicil(s)) of Deceden . Register of Wills Form RW O2 rev. 1 0/1 12 0 1 1 Copyright (c) 2011 form software y T e Lackner Q,TbQp, Trio Page 2 of 2 U - HIOSBOS REV i9illi LO AR'S CERTIFICATION OF DEATH W~ ;`~t,I; i to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ~~~~ ~~~ _~ ~~ 8; ~~ This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original C~~E( (~F certificate will be forwarded to the State Vital ~~~~~(~ ~~~1Rj Records Office for ermanent filing. P 1816 0 2 91~~~1 rR~MC) C~ PA ~d~1~ FE 0 3 011 Certification Number Local Registrar Date Issued Type/Print In Permanent 'JG Q ~_ 02 ~- ~• 7 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH • VITAL RECORDS ~`C OT~C~!•ATC AC r1C ATI.A lack In k 1. Decedent's Legal Name (First, Middl ,Las[, Suffix) 2. Sax 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) n' F 184-12-6424 Februar 1 2012 Mar B. Morriso Sa. Age-Last Birthday (Yrs) Sb. Under Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Vear) (Spell Month) 7a. Birthplace (City and State or Foreign Country) E11Za thtOWn Months 87 Days Hours Minutes Ma 20 1924 7b. Birthplace (county) 8a. Residence (State or Foreign Count ) Sb. Residence (Street and Number -Include Apt No.) Bc. Dld Decedent Llve In a Townshlp7 en lvania 3422 Bedford L7r . QYes, decedent nYed in _ ~p~ Bd. Residence (County) Cumberland Be. Residence (Zip Cade) 1 (~NO, decedent lived within Ilmits of ~"'F~ H~-1-~- city/born. 9. Ever in US Armed Forces? 1 .Mar ital Status at Tlme of Death Q Married ~ Widowed 31. SurvWtng Spouse's Name (If wife, Hlve name prior ip first marriage] Q Yes ~ No Q Unknown Q Di vorced Q Never Married Q Unknown Father's Name (First, Middle, Last, uffix) 12 13. Mother's Name Prior to FI t Marriage (First, Middle, Last) . Christo her A. B'schel Rose Coo er Wri ht Informant's Name 14b. Relationship to Decedent 14a 14c. Informant's MailinH Address (Street a d Number, City, Sbte, Zip Code) ~ . Theresa Brad Cousin 22912 Linden Dr. Lewes, DE 19958 G ......• If Death Occurred in a Hospital: Inpatlen[ 5 a~ep oat '..".' ec on y one .. ......... .'...... ... ... ..."'... W '.. "' '. ....... ..'.. 1f Death Occurred Somewhere Other Than a Hospital: ~ Hospice Facility L..I Decedent's Home S Emergency Room/OUtpatieni Q Dead on Arrival NurslnH Home/long-Term Carc Facility Other (Specify) ISb. Facility Name (If not Institution, gi a street and number; ISC. City or Town, State, and 21p Code iSd. County of Death Hol S irit Hos i al Cam Hill PA 17011 Cumberland 16a. Method of Disposition ~ B Aal Q Cremation S6b. Date of Dlsposltion 16c. Place of Disposition (Name of cemetery, crematory, or other place) Q Removal from State Q Donation Other (Specify) 02/07/2012 Indiantown Ga National Cefneter 16d. Location of Disposition (City or To n, State, and Zip) 17a. Signature of Funeral Service Licensee or Perso Charge o Interment 17b. License Number ~ Annville PA 170 3 014819 ~ 17c. Name and Complete Address of F n ral Facility 1903 Market t. Hill PA 17011 o nc . ~' . - e e SB. Decedent's Education -Check the x that best describes the 19. Decedent of Hispanic Orlgln -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate what r highest degree or level of school comp etad at the time of death. box that bast describes whether the decedent the decedent considered himself or herself to be. Q 8th Hrcde or lass Is Spanish/Hispanic/Latino. Check the "NO" Whl[e Q Korean Q No diploma, 9th - 12th Hrade '~ b x If decedent Is not Spanish/Hlspanlc/Latino. Black ar African American Q Vietnamese Nigh school graduate or GED corr)pleted $$~J No, not Spanish/Hispanic/Latino ~ American Indian or Alaska Native Q Other Asian Chicano Q Asian lindian Q Native Hawaiian Mexican American Mexlca n ~J Ves ~ , , , e Some college credit, but no degr 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, B ) Q Yes, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, M ng, MEd, MSW, MBA) Q Vea, other Spa nlsh/Hispanic/Latino Q Japanese Q Other Pa<iflc Islander Q Doctorete (e.g. PhD, Ed D) or Prosslonal degree (Specify) Q Other ISpeclfy) . MD DDS DVM LLB JD II 21. Decedent's Single Race Self-DeslHn tlon -Check ONLY ONE to Indicate what the decedent considered himself or herself fo be. 22a. Decedent's Usual Occupation -Indicate type of work ~~hi[e Q Japanese Q Samoan done during most of working life. DO NOT USE RETIRED. ~ Q Korean Q Other Paclflc Islander i -B • can lack or African Amer n L lerlcal Q American Indian or Alaska Nativ* Q Vletnsmase Q Don't Know/Not Sure Q Asian Indian Q Other ASlan Q Refused 22b. Kind of Business/Industry Q Chinese ~ Q Native Hawallan Q Other (Specify) once CO lth I H . nsur ea Q FIIIpIno Q Guamanian or Ghamorro il'EMS 23a - 23 MUST BE CO PLETE 23a. Date Pronounced Dea Mo Day 23 ignature of Person Pronouncing Death Only when applicabb 23c. Ucense Num r BV PERSON WHO PRONOUNCES OR ~r~1 R ~ itA ~ a oia. CERTIFIES DEATH ~~•J /r/~' 23d. Date Signed (MO/Day/Yr) 24. Time of Death ' ~ Q (~ /f/~ 25. Was Medical Examiner or Coroner Contacted? Q Yes No CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of eyents~-diseases, InJ rtes, or complleatlons-that directly caused [he death. DO NOT enter terminal events such as cardiac arrest. Interval: respiratory arrest, Or ventriculs{ fibrlllatlon without howing the etiology. DO NOT ABBREVIATE. Enter only ono cause on a Ilne. Add addi[Ipnal lines If necessary Onset to Death ~ -7~~ ~ ~ ~ i ~/AL ~~~jc,r~ nl~I 4 IMMEDIATE CAUSE --------------> a. ~~t~~ c-/~ O~. Wi-/~ / (Final disease o onditlOn ~ Due to (o as a consequence of): resulting In death) b. Sequentially Ilst condltiOns, ~, Due to (or as a consequence of): if any, leading to the cause '~. listed on Ilne a. Enter the UNDERLYING CAUSE Due to (or as a consequence of): (disease or Injury that F Initiated the events resulting '. d. a con In death) LAST. Due to (or as sequence of): Enter other ifl t c but not resulilOH In the underlying cause given in Part 1 27. Was autopsy performed? Part 11 26 . . ~. Q Yes ~•.No ~ 28. Were autopsy Flndings available ~. to complete the cause of death? Q Ves Q No 29. If Femab: 30. Dld Tobacco Use Contribute to Death? 31. Manner of Death Not pregnant within past yeart Q Yes Q Probably ~ U k )~ Natural Q Homicide Q Accident Q Pending Inyestigation $' Q Pregnant aT time of death but pregnant v~^.'~~Ithln 42 days of death Q Not pregnant n nown Q No $ Q Sulcldc Q Could not be determined , but pregnant 49 days to 1 year before death regnant Q Not 32. Date of Injury (MO/Day/Vr) (Spell Month) ~ , p Q Unknown If pregnant within t(ie past year 33. Time of Injury 34. Place of Injury (e.g. home; constru Jon site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transport tlon Injury, Specify: 3B. Describe How Injury Occurred: Q Yes Q Driver/Oper~etor Q Padestrlan Q No Q Passenger Q Other (Specify) 39a. Certifier (Chock only one): Q Certlfying physlclan - To the bas of my knowledge, de th o curved due to the cause(s) and manner stated and due to the cause(s) and manner stated rred at the time date and lace l d d th 9 k p , , , now ge, ea occu y e ]~ Pronou ncing 6 Cartlfying physic an - eat o stated e(s) dm a n s red at the time, date, and place, and due [o th u oc Q Medical Examiner/CO - On he basla of atlon, and/or Investigation, In my opl nion, death ~/ / / \ - 6 ~r ' Oh 7 SL ~, ` ~j Llcensa Number: /J ) r . Signature of certlfler: Title of certifier: / ~I 39b. Name and Zip Code of son Completing Cause of Death (Item 26) S.T 39c. Date gned o/Day/Yr) iVG-- /~/M er /1027 2I T~E~ % ~~1~'J/~h~/LL '~-' Z 40. Registrar's istrict Num er 41. Registrar's 5 cure -ter ~/ / 42. Reglstrer le Dace (MO DaY r) cal i ~ ` e1 d a o Z B 43. Amendments c H105-143 Disposition Permit No. OtJ 70808 REV 07/2031 LAST WILL AND TESTAMENT I, MARY B. MORRI$ON, of 3422 Bedford Drive, Camp Hill, Cumberland County, Pennsylvania 17011, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills hehetofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon ass convenient after my decease. I direct that all inheritance taxes imposed or payable by reasoh of my death and interest and penalties thereon with respect to all property, whether or not such) property passes under this Will, shall be paid by my personal represe~~iative out o~ niy estate. 2. I authorize and empower m~ personal representative to sell any realty and/or personalty owned by me at my'~,death and not specifically devised or bequeathed herein, at public or private sale or sales and to~,give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I hiay be engaged at my death, for such period of time after my death as seems expedient to'said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: n ~:~` .O ~ -~, -- . ;~ :x~ A. The hum of $10,500.00 to Theresa A. Brady; ~ ~ , v Y~;' B. The hum of $10,500.00 to Vickie J. Smith; 4>cr; ~ ~ .._~, ~~~r `<< .. Svv.Ov tC ~2Sliz~..ce. ~i anBC~iC; Th.^. ~U^'. of yQi1 v ...J~-~ ~7~~j ~. ~_.J C 'l r-~ , `3c~ ' :~: ..._~ D. The hum of $1,000.00 to Benjamin Morrison Taylor, ~ ~ c~ E. The hum of $1,000.00 to Andrew C. Smith, ,~ `~ F. The hum of $500.00 to Good Shepard School Library for general purposes; G. My sump and coin collections to Andrew C. Smith, and all the H. Resth residue and remainder to Andrew C. Smith to be held in trust by the hereinafter-mentioned trustee according to the following terms and conditions: The trustee, as well) as my personal representative, is hereby authorized to retain, unconverted, any property, real olr personal, that I may own at my death and shall be under no duty to convert it into legal investments. The trustee shall have the power and authority to sell, transfer, convey, invest and rleinvest and to pay over the net income of the trust property, to or for the use of Andrew C, Srnith or to accumulate it in the sole discretion of the trustee. My primary object is to insure the support, maintenance, education and medical care of Andrew C, Smith until he reaches the gage of thirty (30) years. However, the trustee shall make the following distributions to Andreew C. Smith: A. The hum of $3,000.00 at the beginning of each school year he is in college, for a period of up to four years; B. The sum of $2,000.00 on his 21st birthday; C. One-half (1/2) of whatever remains of income or principal of the trust estate when he rejaches the age of twenty-five (25) years; and D. Wha~ever remains of income or principal of the trust estate when he reaches the age bf thirty (30) years. 4. In the event ,that Andrew C. Smith does not survive me by a period of sixty (60) days or if he predeceases thei termination of the trust provided above, then I give, devise and bequeath his share of my estate, or whatever remains thereof, to Vickie J. Smith. 5. I appoint Susquehanna Bank, or its successor, to be the trustee of any trust created herein. 6. I nominate alnd appoint my cousin, Theresa A. Brady, to be the personal representative of my estate, to serve without bond. If she cannot or does not serve, then I appoint Vickie J. Smith to the substitute personal representative, with the same powers and also without bond. 7. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHE~EOF, I have hereunto set my hand and seal this ~ day of December, 2010. `_ t,~'', (SEAL) A B.I RRISON Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as-subscribing witnesses. ,i / J ~ ~ n 1~ ~~~ ~ ~~,~ ,~ _ ACKNOWLEDGMENT AND AFFIDAVIT WE, MARY B. MOF~RISON, HAVEN H. ANDREWS and AMY J. MAZUTIS, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act fob the purpose herein expressed, and that each of the witnesses, in the presence and hearirhg of the testatrix, signed the will as a witness and that to the best of their knowledge the testaltrix was, at that time, eighteen years of age or older, of sound mind and under no constraint'ior undue influence. COMMONWEALTI~ OF PENNSYLVANIA as: COUNTY OF CUMBERLAND . Subscribed, sworn' to and acknowledged before me by MARY B. MORRISON, the testator herein, and subsc ibed and sworn to before me by HAVEN H. ANDREWS and AMY J. MA2UTiS, witness s; this ~~'"day of December, 2~1'i ~. Notary `~Q py~ ~A~ F pENNSYL,VANIA~ NOTARIAL SEAL }ltd S. Irwin Iii; Esq, Notary Public Carlisle, Cumberland County My commission expires Febmary 06, 201 ].