HomeMy WebLinkAbout03-22-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF ~U(Y1~PC~C.InG~ 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• ~ F~arr~ C ~ C) ~~U 1.
a/k/a: ~ILMISt(a 000(ell (aiZAuC
a/k/a:
a/k/a:
Date of Death• ~i 1 ~ { ~-
Decedent was domiciled at death in CUmh~f fend
principal residence at ~O~S ~7eCla•4C V't
Street address, Post Ofnfice and Zip
Decedent died at ~ ~~ ~~~ AJP_., ~11--~d ~~
Street address, Post Officeand Zip Code
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania .................. .
If not domiciled in Pennsylvania .............. .
If not domiciled in Pennsylvania .............. .
Value of real estate in Pennsylvania ............ .
File No: ~ I ~ /~ ~~
(Assigned by Registe
Age at death: - 61
County, }~~~} (ware) with his/her last
Township or Borough
City, Township or Borough
connty
connty state
All personal property $~ ~ ~ ~
Personal property in Pennsylvania $
Personal property in County $
TOTAL ESTIMATED VALUE.... $ , T~~
Real estate in Pennsylvania situated at: Coun
(Attach additional sheers, if necessary.) Street address, Post Office and Zip Code City, Township or Borough tY
® A. Petition for Probate and Grant of Letters Testamentary /~'
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named m the last Wr11 of the Decedent, dated ~/~~ ~ ~ ~~ 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(8), 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 Letters of Administration (If applicable)
e.t.a., d.b.n., d.b.n.e.t.a., pendente lite, durunte absentia, durance minoritate
If Administration, e.t.a. or d.b.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 W ill and was survived by the following spolnse (if any) and J~e'rs (attach
additional sheets. ifnecessury): ~~ r.;a„
Name
Relationshi fTj 1
Address `~ z" C"~
r-
moo`
:
-; ~
-
_
~,
-~ ~_
o
c~~
Form RW-02 rev. lo~lvznll Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF ~U marl ~r,d }
-fir-;._;` v~i4~y~a
r'~ r-
~` ZL
Petitioner(s) Printed Name Petitioner(s) Printe ~ r
u u5 c ~' ~ ~ A7 d
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 Dece nt, the Petitioner(s) 11 well and truly administer the estate according to law.
~ .L
Sworn too ffirmed a subscribed b fore ~~ (.W ~2~~'ltll Date .i .~ /
me ~ d o Date
By: ~ ~ Date
F e Register Date
BOND Required:~YES/~NO
FEES: ~
Letters ...................... $
(~) Short Certificate(s)......
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ~( ........
Automation Fee ............... ,5'-
JCS Fee ..................... a -
TOTAL ..................... $ 9 ~ SZT-
To the Register of Wills:
Please enter my appearance by my signature below:
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate f! C1~ "`~ ~ G'~e~ File Nq~// - / ~ ~~ ~T_
a/k/a: . 1
AND NOW, ~OZ , in c nsider tion of the foregoing Petition,
satisfactory proof hav ng been presented before me, IT CREED that Letter
are hereby granted to~ i C l
in the above estate and (if applicable) that
the instrument(s) dated
described in the Petition be
to probate and filed o,~r,~cord as the Iast1Wi11 (and Codicil(
Fonn RW-02 rev. 10/l 0201! ~ 1 ~ ~~~ Page Q Of 2
HIOi$05 RH~'19'll)
LOCA~ GISTRAR'S CERTIFICATION OF DEATH
WARNINQ~'~~) t` i ~licate this copy by photostat or photograph.
i
~ ~.z`v i L 7 .~'~ ~, t1 i C
~,,~
Fee for this certificate, $6.00
P 18331683
Certification Number
TYPe/Print In
Permanent
This is to certify that the information here given )s
~~ ~~ ~~R ~ correctly copied from an original Certificate of Death
2 ~~I~~ Q3
duly filled with me as Local Registrar. The original
C~~RK ~~ certificate will be forwarded to the State Vital
Records Office for permanent Tiling.
4RPH,q~is COUAr
Cl1MRF~l ANA r~ , pq _ ~ /~.5~
Local R tistrar Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH st>te Flle Number: _, ^__ ti Iwn.elDav/Yr) (Spell Mo)
_.~2.0 ._ ! S~ o l 3 t
3
xga-use o,r.....~r .••-. 'Months Days Noun Minute ~ L / t t~~
87
Residmca (State or Foreign Country) Bb. Rasldlnca (Street and Number - Include Apt No.)
pA 208 Senate Ave, Apt. 707
Raald.nee(eounty)
Cumberland a!. Raaldence (21p Cod!) 70
vet In US Armed Forces? 30. M>rRal Status at Tlme of Death Mauled W
V!s Q No Q Unknown ®Divorced Q Nwer Married Q Unknown
Father's Nam. (First, Midtlla, Last, Sufflz) ~ 1
Jose h C. Graul fah w.latlpnshio to Daudent ]
E
August :6`• '-
]b Blnhpl (C tY) Mercer
c. Dld D!cldent Llv! In !Township?
®Yes, daeedMt Ilved In Past P nn t]O twP'
lNO. a«adent eyed wthin (limits of cltY/bore
Q Removal from State .__. Q Donation ' 3-15-2012 I Cremation Society of PA
d. Locatioh of Dlspoaltton [City or Town, axav, sr... ...r. ~~i ~ t~~ ~
C r , _
~-~J i pq 138312
Harrisburg PA 17109
l Faclllty Auer Cremation Services of Pennsy
f F lvania Inc.
unera
G Hama and Complete Address o ck ONE OR MORE races to Indlut! what
Ch
'
cation -Check the box that bee[ descrl !s tM
Ed
' 19. Decadent of N{sp>nlc Origin -Check the
t
d e
s Raee -
20. Decedent
~
tM deudlnt considered himself er her
u
s
. DeeedMt
thee[ dKru or level of school completed at the tim! of death. en
box thlt best describes whether the dece
anish/Hlspanit/Latlno. Cheek the "NO"
Is S O
Korean
®White
Vhtn>mese
8th grad! or less p
box if decedent is not Spanish/Hlspanle/Latino. Q
Q Black or Afrlun Amarlcen
Native Q Other Allan
Al
k
Q No diploma, 9th - 12Ch grade
l
d No, not Spanish/Hispanlc/Latlno as
a
Q American Indian or
Q N>tlya Hawall>n
ete
Q Hlgh school graduate or GED comp 0 yes, Mez)ean, Mexican Amlrlun, Chicano Q Allan Irvdlan
Q Guamanian or Chamorto
® Some college cradl4 but no degree
Q Associate degree le.g. AA, AS) Q yes, Puerto Riun Q Chlnlsa
Q FIIIPino Q Samoan
nder
I
l
ifi
Q Bachelor's degru (e.g. BA, AB, BS)
MEng, MEd, MSW, MBA)
MA
MS
(e
d
' Q Yls. Cuban
Q Yes, other Spanish/Hbpanic/Latino s
a
c
la Panes! Q Other Pac
Q
if
,
,
egru
.g.
Q Master
s
Q Doctoraee (e.g. PhD, Etl D) or Profeaslonal dagraa (Specify) y)
Q Other (Spec
. MD DOS DVM LLB JD
-Check ONLY ONE to indluta what the dacadant considered himself or h
i
erself to be. oT work
nmos[ e7aworking'LNe^ DO NIOTt U E RETIRED.
`n
d
on
L. Decedent's Singie Raca SeN-Designat
anes!
l Q Samoan g
u
done
ap
® White Q
Q Korean
i Q Other PaelHc Islander Fiscal Technician
can
Q Bla<k or African Amer
Q AmeACan Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure
d
f 22b. Kind oT Business/Industry
Allan Indian Q Other Asian
Q Q Natve Haw>u!n use
Q Re
Q Other (Specify) Commonwealth of PA
Q Chlnase
Q FIIIPIno Q Guamanian or Chamorro
Pro
P
nouncing Dea
a
t n V w ln
>P
P
c
23c. L tense Num er
MS - 23 MUST 6E MP ETED arson
23a. D!t! Pronounce Dea o Day r 23 .Signature
"~~ ~ ~
~,
,
)
-~ ~ L , ~-~ S ~'( .~ g
~v
Y PERSON WNO PRONOUNCES OR ~. -~ ~ ( ( pZ L s
/L•/r ~ ,
3 - i t - ( L ° • ~ - - -- APProximate
r complicati
l CAUSE OF DEATH
ons--chat directly caused the death. DO NO one t
r _ Interval:
nald llnesrlf necessary 1 Onset to Death
dditi
!
n
t
es, o
26. part 1. Enter the ~heln of !vents-diseases, In}ur
n wlfhout showing tM
lll
tl
f
b uuse
etloloEy. DO NOT ABBREVIATE. Enter one o
Add a
ll e
on
i
~
~ ~
respiratory arrest, or ventric r
a
o
i
ular ~
i- •- p 1 )
IMMEDIATE CAUSE ---------------
l disease or condition
Fi ~ >~
~1
` s a consequence of):
Due to
r
~ ` /~ yE~A
~
~
/
na
(
In death)
lti (,~
1
'T
~
' ~GI 4'~ ~ W r~^~
'
I S
C
( e
/
,~
~ ` "' '~~--
ng
resu b `
S
r~n /I1x. t l
~ t~'~ L
t
1 L
Dw to (or as s consequence of). ~
Sequant1a11Y Ilst conditions,
{f any, leading to the Cause
Tested on Ilne a. Enter the Du! to (or >s a consequence of):
VNDERLYING GUSE
(disease or Injury that i
Inltlated the events resultlnE d• Dua to (or as a consequence of):
(
In death) LAST. _ _ autoosY oerformed7
~~ call en
to complete the uus! of death?
Vea No
30. Dld Tobacco Use Contribu[! to DlaM] 31. Manner of De>th
l
t
Q Homlclde
' Female:
ear
t
hi Q Ves ]~ Probably ura
~.[ N>
Acddent Q Pending Inyastifatlon
n Pas
Y
Q Not Prcgn>nt wit
th
1 d Q No Q Vnknown Q
Suicide Q Could net be determined
ea
Q Prcgnlnt at clme o
Q Not prcgnlnt, but pregnant within 42 days of death
Dat! of Injury (Mo DW/Yr) (Spell Month)
32
Q Not pregnant, but pregnant 43 drys to 1 year before death . 33. Time of Injury
Q Unknown if Pregnant within Che Past Year _ _ _._ -__-- _'_ J_`
Q Yes Q Driver/Operator Q Pedestrian
Q N Q p g Q Other (Specify)
CeRifter (Check only one):
'~ GrtiHing phYSlclen - TO the best of my knowledp, d;ath occur~e, dpth occurred ai ine cme, e. land place, and dw to the cause(s) and manner stabd
Pronouncing a Cartlfying Ysieian - To the best of m knowled date, and place, and tlue to the cause(s) d manner stated
Medical Examiner/COron - On the balls of examinatlon, and/or Inyestiptlon, In my opinion, death ocfc1urred at the time, ~~/ f ~~ ~~
Title of certlfler: '~ A =r' Lleense Number: 'T
Signature of certifier: 39c. Oat! Signed (MO/Day r)
b. Name, Address a 21p Coda of Person Compllting Caul! of Death (Item 28) _ C ~^ / 7p/ Q /!l
JtJ f ~ S m O ') M.D - 79 Pp (ySf2G~~UfZL~ : C,~+v1 P ITT G ~ 4 . g strcr I e to Mo r
eg attar s Dlstrlct er 41. lgistrar s ^OISM^! '. ~ /'1 A , , ~` 1 i ^ (~ 3 I tS ~ao f pL
/'~ /7 H1O5-143
Disposition Permit No. v ~~ ~~ L ~ REV 0]/2011
r
x
LAST WILL AND TESTAMENT
OF
RICHARD C. GRAIIL
I, RICHARD C. GRAUL, of Camp Hill, County of Cumberland,
State of Pennsylvania, being of sound mind and memory, do make,
publish and declare this my Last Will and Testament, hE
revoking and declaring null and void any and all Wills
Codicils by me at any time heretofore made.
FI T
I direct my Executors to pay my just debts, the expense of my
last illness and my funeral expenses from the property passing
under this Will as an expense and cost of administering my estate,
~as soon after my death as may be found convenient.
SECOND
I give my Howard Miller Grandfather Clock to my daughter,
PATRICIA ANN JENDRZEJCZAK.
THIRD
I give my Broyhill China Closet, excluding the contents,
my son, RICHARD CHARLES GRAUL.
FODRTH
LAW OFFICES
PATRICK F. LAVER. JR.
Attorney N Law
2108 Merkel Street
Aztee Building
Camp Nill, PA 17011
(717) 763.1800
48 South Duke Strset
York, PA 17401
(717) 846.17eti
I give all my tangible personal property, including but not
limited to any and all automobiles, furniture, furnishings, china,
silverware, jewelry, ornaments, works of art, books, ~icturea:~ an
r-• , J
d
r7 ~ ~ .. (; f"~
J'_G7~ N _ (`::
Page One of Six -~~i;; "; '~ _
~JL ---- ~_- `CJ
~~ .. _. ~ - tT1
C.
wearing apparel, .but excluding cash on hand, to my children,
PATRICIA ANN JENDRZEJCZAR and RICHARD CHARLES GRAUL, if they
survive me by thirty days to be divided equally among them as they
may agree or in the absence of agreement as my personal
representative may determine in her sole discretion; provided that
articles which may be sold and the proceeds thereof added to my
residuary estate.
FIFTH
All the rest, residue and remainder of my estate I give,
devise and bequeath, as follows:
a. One half of my net residuary estate to my daughter,
PATRICIA ANN JENDRZEJCZAIC, per stirpes.
b. One half of my net residuary estate to RICHARD CHARLES
GRAUL, per stirpes.
SITS
I hereby nominate and appoint PATRICIA ANN JENDRZEJCZAK as
Executrix of this my Last Will and Testament. Upon her death,
resignation or inability to act for any reason, I appoint my son,
RICHARD CHARLES GRAUL, Executor of this my Last Will and
uw OFFICES Testament .
PATRICK F. LAUER. JR.
Attorney et law aS
2108 Merkel Street
Artee Building M Executor and Trustee s shall have the followin owers in
Gmp Hill, PA 17011 g p
(717) 763-1800 y
48 South Duke street addition to those vested in them by law and by other provisions of
York, PA 17401
(717) 846.1799
Page Two of Six
this Will, applicable to all property, real, personal and mixed
and wheresoever situate, whether principal or income, exercisable
without court approval, and effective with respect to each item of
uw OFFICES
PATRICK F. LAUER. JR.
Attomay at Law
2100 Market Street
Ariae Building
Camp Hfll, PA 17011
(717) 763.1800
48 South Duke Street
York, PA 17401
(717) 846-1769
said property, until actual distribution thereof:
A. To retain, as investments, any and all assets of my
estate, real, personal or mixed, without regard to any principal
of diversification, and to purchase and acquire real or personal
property, and to hold any and all of such real and personal
property retained or acquired without making the same productive
of income;
B. To permit occupancy of any real estate retained or
acquired upon such terms and conditions as they shall deem proper;
C. To pay all taxes, charges and expenses of
maintenance, upkeep, improvements, development, protection,
preservation and investment of any retained or acquired real oz
personal property, such payments to be made from either principal
or income, as my Executor shall determine;
D. To retain or invest any and all funds, whether
principal or income, in any real or personal property without
restriction to legal investments; to purchase investments as
premiums; to exercise all rights of a security holder or
shareholder in any corporation; and to lease, mortgage, pledge,
give options upon or sell, at public or private sale and without
Page Three of Six
approval of any court and without any responsibility to the buyer
or buyers to see to the application of the purchase price, any
real or personal property, or portions thereof, irrespective of
the manner of means by which the same was acquired by my said
IExecutor.
E . To make any payment or distribution herein provided'
for in cash, kind, or partly in cash and partly in kind, at
valuations fixed by my Executor at the time of said distribution.
SEVENTH
I direct that no Trustee, Executor or Executrix, or other
fiduciary named, nominated, or appointed in this , my Last Will and
;Testament, shall be required to post any bond or give any security
of any type for any purpose whatsoever, any law or rule of court
of the Commonwealth of Pennsylvania or any jurisdiction to the
contrary notwithstanding.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
)2~ day of ~cf~ ~-- , 1992.
LAW OFFICES
PATRICK F. LAUER. JR.
Attorney at Law
2708 Market Street
Azac Building
Gmp Hill, PA 77011
(717) 763.1800
48 South Duks Street
York, PA 17401
(717) 846.1789
Page Four of Six
SIGNED, SEALED, PUBLISHED and DECLARED by the above-named
Testator, RICHARD C. GRAUL, as and for his Last Will and
Testament, in the presence of us, who, at his request, in his
presence and in the presence of each other have hereunto
subscribed our names as witnesses.
~r1 S ~c~~'~"~,ioe P~- I-to~Z
WITNESS ADDRESS
I~ p 9 ~ (~
S ADDRESS (701
LAW OFFICES
PATRICK F. LAVER. JR.
Attorney et Law
2108 Market Street
Aztec 8uildiny
Camp Hill, PA 17011
(717) 763.1800
48 South Duke Street
York, PA 17401
(717) 846.1798
Sworn and affirmed to and acknowledged before me, by
RICHARD C. GRAUL, the Testator, this ~ day of ,
1992.
( c^w' J
Martlta L Morrow, ivorary l'~~b6c
Carlisle eoro, Gxnberland County NO ARY P L I C
My Commission F~pirtzs Sept.18,1995
MembEr, PerxtsyNania Assot~abolt of IVofaries
Page Five of Six
EALTH OF PENNSYLVANIA
• SS.
OF CUMBERLAND
We , ~e t-L'~ ~,,, ~ rrn .nC ~ , and
1 ~I
the)
tnesses whose names are signed to the attached or foregoing)
t, being duly qualified according to law, do depose and)
ay that we are .present and saw the Testator sign and execute the
instrument as his Last Will; that he signed willingly and that he
ted it as his free and voluntary act for the purpose therein
sed; that each of us in the hearing and sight of the
stator signed the Will as witnesses; and that to the best of our
knowledge, the Testator was at that time eighteen (18 ) or more
are of age, of sound mind and under no constraint or undue
influence.
:~
~utJ'~ ~
Sworn or affirmed to and subscribed to before me by
LAW OFFICES ,I / ~
PATRICK F. LAUER. JR. ~ `~-1 ~ ~ p !- m D n d and T~~~ Gi~c ~ [c r J _ ,
Attorney at Law `-~
s,oe Market Street the witnesses this ~ ~ da of ~6 1992 .
Aztec Building 1 y
Gmp Hill, PA , 701 t
(717) 763-,8110
48 South Duke Street X13 ~. AlIOrrOYV, NOf2ty Pi~biD
York, PA ,740, CarisleBOro,GxrltJerlarxlCounly NOT Y PURL
(717) 846.1789 ivyConvnission Expires Sept,18,1995
iv~er„ber, Pert„5yivertia Aseodation of ^iaa"asP age Six o f Six