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Home My WebLink About03-28-12Reset 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: Nancy Hazell a/k/a: Nancy W. Hazell a/k/a: Nancy I Hazell a/lc/a: Date of Death: February 29.2012 File No • ~~ ~ ~ ~aC. " ~ J ~~ (Assigned by Register) Social Security No: 203-24-8541 Age at death: 79 Decedent was domiciled at death in Cumberland County, pennsvlvan;a (Stare) with his/her last principal residence at 103 Manchester Road Camn Hill. PA 17011 Lower Allen Townshin Cumberland County Street address, Post Office and Zip Code City, Township or Borough County Decedent died at _103 Manchester Road. Camn Hill PA 17011 Lower Allen Townshin Cumberland County Pennsylvania Street address, Post Office and Zip Code City, Townsiup or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania ............................All personal property $ 40.000.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsylvania ............................... ......... $ 149,000 00 ................. TOTAL ESTIMATED VALUE.... $ 189 000 00 Real estate in Pennsylvania situated at: 103 Manchester Road, Camp Hill PA 17011 Lower Allen Township Cumberland County (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 August 15,2003 and Codicil(s) thereto dated n/a. RenunciatinnrlatPrllVTarrht2 ~m~ „fn.,...:,.:,.rr u,.~,.,,:_r_____ ,-,-., __ .. .. State relevant circumstances (eg. renunciation, death of executor, etc) '- O ~~ : ~ y -~~ ~ ~1 a; -~ Except as follows: after the execution of the instrument(s) offered for probate Decedent did not "~ ~ ~" p ~~ ~ ~ ~ marry, was not divorced~~a party a eifdin divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), and d~gtrltave mild bam off: adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. '^ ~,-~ ~ Cp _ --, . X -, NO EXCEPTIONS ~ EXCEPTIONS -~ c:~ C~ ~ ;: ~_ _ ;-, B. Petition for Grant of Letters of Administration (If applicable) J ~ b ` m c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante~isentia, dura~ifL'minontat 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. NO EXCEPTIONS ~ EXCEPTIONS Forrn nw-oz rev. ~oillizol~ Page 1 of 2 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): Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: C'nUNTY OF ~'~~~Ir nC~ } Official Use Only The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the oesr or me x,iuw.cug~ a•=u ~~--~- ofPetitioner(s) and that, as Personal Representative(s) of the Decedent, the Petitioner(s) will well an truly administer the estate a3ccordin~to 1 Date > ~~ Sworn to or affirrzled and subscribed before Date me this 2 ~ day o1~ '~~ ~` ~ ~' ' ~ ~-z Date By: (~ 1M1 I,~i~,.~ ~ ~- '~l.l ~ ~~ ~ ~~~ Date Fcr the Register BOND Required: ~ YES ~ NO FEES: 260.00 Letters ..................... • $ 24.00 ( 6) Short Certificate(s)..... . ( 1) Renunciation(s)......... 5.00 ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other " " " ' • 15.00 Will •~•••••' ........ 5.00 Automation Fee .............. . 7CS Fee .................. • ~ • 332.50 TOTAL ..................... $ To the Register of Wills: ,,._..-......«o,. ,,,., ~,nnearance by my signature below: Attorney Signature: Printed Na John R. Beinhaur, Esquire Supreme Court ID Number: 55631 Firm Name: Curcillo Law, LLC Address: ^^`^ T ~ ^`^^ street u ' chnra P A 17109 Phone: 717-651-9100 Fax: 717-651-9200 Email: i7 = . ~ l L7 ~~ ~ ~ :a:, ~ , ~ ~» - _. , ,. . -,, J -n - _,-, :~ ~ = ~ ~ as r-r ~ _~ ~~ 4.7 Page 2 of 2 FormRW-02 rev. !0/I!/2011 Oath of Personal Representative CO~I~IOV~FE:~LTH OF PEV~ISY'tVA~IA } } SS: Official Use Only I i- ~ ; re~ s ~'r. -'ei ~a:r:e i'e:itionzri s Pru;:_c .~dd:ess The Petitioner(s) above-named swear(s) or affirm(s) a statements in the foregoing Petition ar rue and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) f the Decedent, the Petitioner(s) w~ well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this day of , By: For the Register BOND Required:QYES ~NO FEES: Letters ...................... $ ( )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ........~ ....~. Firm Name: Address: ,,,.., Phone: Automation Fee .............. Fax: JCS Fee . ... ................ Email: TOTAL..1 .................. $ DECREE OF THE REGISTER ~', r, Estate of ~~ ~ File No: ~ ~ - ~ ,~ ~ L'v "~ ~ 1 a/k/a: ~Q flf L1 1l, E- d7 P (Z i'1(' l l _ ~- AND NOW, ~ ~1 ~,1~~,~~-4~i C~' , ~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that L tters ~ ;. `' ~ ~!~-~ are hereby granted to f 'C~.1 _l ~U'1 ~ ~~(~ 2 ~ _'~ in the above estate and (if a.pplicab!e) that the instrument(s) dated described in the Petition be Fm'm R4P-q1 rev. 10/!1/2011 Date Date Date Date To the ister of Wills: Please ent my appearance by my signature below: Attorney Si Printed Name: Supreme Court ID Number: to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Register of Wills ~ ~~, ~. ~ ~ SYf~ ~/~~'~~ i ~~=~1 t .1 ~/ Pa e 2 of 2 l111A~if~V'~~~f itt~~a~~ `r~ I.ap9~±;~~e: t~(~, (w'"~~%~' fsy ~h+~to:~~d~ ~~ ~#-,-; ( _P_ ~81~Q~a0 Type/Print In Permanent IVAn~ Age-Last Bi ~q G ~d Z Is F s E Residence Pe Residence r in U~A Ves 48 '.fie, `` r ~ •li ~a i t ( l9 i ~ i CLERK CIF ~: ~~ / ~ ~_ ~ , ~ {, }.,, J T ~~~ ~~ ~~~ ~~ •• - ~,~%~;,~ ~, :e~~`~~ MAC 0 2 ?012 r >a ,,'~ --- - COMMONWEALTH OF PENNSYLVANIA. DE PARTMENT OF HEALTH ~ VITAL RECORDS CERTIFICATE OF DEATH 'le, L t, S ff ) 2. Sex State File Number: ~~Z~ ~ t 3. Soc' I Security Number 4. Date of De h (MO/pay/V r) (Spell M° f= -7 C',-~--emu _c~~1 ( r-.--~_-, ~3t ~ _ ) _._._-__ ) ' 13~- --•-iiEa ergn cp~ntry) A (~ 1 a3 i Lion pA (state or Foreign Country) 8b. Residence (Street and Number - Inclutle Apt No.) 8c. Did Decedent Livebn al Towlnsh p? unry) YO rIC nns lvania (cpunty) 103 Manche Yes, decedent lived in Lower A11en star Road wp u Et and 8e. Residence (tip Code) 1 7 Q 1 1 ~ No, decedent lived within limits of t mad Forces? 10. Marital Status a[ Time of Death ~ Married ~ Widowed city/born No Q Vnknown ~ Divorced Q Never Married 11. Surviving Spouse's Name (If wife, give name prior to £rst m me (First, Middle, Last, Suffix) 0 Unknown arriage) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Leslie E1woo i e shame 14b. Relationship to Decedent 14c. Informant's Marlin Address (Street and Number, Ci A. Haze 1 on g tv, state, np cpdel 'etl in a Hospital: ~--•-•----• ...................... iSa: P ace o Deat C ec_ on y one In Patient ....................... . _ 51f Death Occurred Somewhere Other Than a Hospital: _ _ -Y Dom Outpatient - r] Hos --"-"-"---""" O Dead on Arrival Q pice Facility ~ -Decedent's Home ~-- me (If not institution, give street and number' s c^ _ Nursing Home/Long-Term Care Facility ~( Other f5nnrir.,l ~ Removal from State u ~ ScYleafPerstown, PA 17088 I ~ (~ /~ -- _ -~~~ ~.~~,r,ee° 2 N d C pl t Add f F I F Ility di-1- Parthemore FH&CS inc. P Bo x 9. Decedent's Education -Check the bo that best describe he '~ he t d 1 New C mba 1 p 19. Decedent f H g s egree or level of school co ~ 8th mpleted at the time of death. rade l o is Pa me Origin -Check the box that best tlescribe h g or ess Q No tliploma, 9th - 12th grade s w ether the decedent is Spanish/Hispanic/Latino. Check the "NO" Q Hlgh school graduate or GED completed box if decedent is not 5 panish/Hispanic/Latino Q Some college cretlit, but no de gree . (,~ No, not Spanish/Hispanic/Latinp ® Associate de gree (e.g. AA, q5) ~ Yes, Mexican, Mexican American, Chicano ~ Bachelor's degree (e.g. BA, AB, B6) Q yes, Puerto Rican Master's degree (e.g. MA, MS, MEng, MEtl MS W MBA ~ Ves, Cuban , , ) 0 Doctorate (e.g. PhD, Ed D) or Professional degree ~ Yes, other Spanish/Hispanic/Latino . MD DDS, DVM, LLB Jp (Specify) ..r ~D-~ cedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent con White id W ~ Japanese ~ Black or African America s ered himself o ~ Samoan r n Q Korean Q American Indian or Alaska Natlye ~ Vietnames ~ Other Pacific Islander e ~ Asian Indian 0 Other Asian ~ Don't Know/Not Sure Chinese p ryative Hawaiian Filipino ~ Refused ~ Other (Specif ) ~ Guamanian or Cha mo y no EMS 23a - 23d MUST BE COMPLETED ' 23a Date P PERSON WHO PRONOUNCES OR . ronounced De ad (MO/pay Vr) 23 b. Signa[u re of Person Pr. 12 ' 24 AM 25. Was Medical Examiner or C 26. Part I. Enter the chain of CAUSE OF DEATH respiratory arrest, pr ven t --diseases, Injuries, or complications--that direct) sed the death. DO OT en c u tr cular fibri llatf ' a `''ilt ~u on h f show h a eti logy. DO O AB EVIATE. Ente y pn IMMEDIATE CAUSE ___________ ~ ~ ( / ____~ a (Final disease or condition / ~ 'j resulting In death) /`/~ s' r cv r 1/ to (or as a consequence ). () ',~//~y~y~/. /)~ b. l/ ~ Sequentially list conditions, I if any, leading to the c e Due to (or as a consequence of): Ilsted on fine a. Enter the UNDERLYING CAUSE (disease or Injury that Due to (o as a <onsequ nee of): initiated the events resultin8 in death)LAST. d. Due to (or as a consequence of): 26. Part 11. Enter other ssS~nific a nt d't t 'b t' t d h b t ut no[ res ulCing in the underlying cause ¢IVen ir. I t{Trvot pregnant within past year - cno ooa co Use Contribute Q Pregnant at time of death ~ Yes c ~ Probably Q Not pregnant, but pregnant within 42 days of death ~ No n Uyy.,.rrrsF Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In l~ ~~~~~~~~~~' Q Unknown if pregnant within the past year Jury (MO/Day/Yr) (! ~ Yes I events such as ca rtllac arrest Approximate line. Add additional lines if necessa Interval: ' A , ' ry Onset to Death ~ t~ to co plete the cause of death? 31 M ~ Y ~ N Bath Q Homicide Q Accident 0 Pending Investigation 0 Suicide 0 Could not be determined Yes 38. Describe How Injury Occurred: Operator ~ Pede t i O i r s r an No ~ ger ~ Pa sse n p orner (specify) 39a. er (Check only one): Certifying physician - To the best of hoc d due to the cause(s) and m rn Y ~jsi~eat curre anner st Q Pronouncing $ Certif in h t _ y g p a etl i i now ~ y k ledge, tleath occurred at the time ~ Medical Examine-'^--- y ~ dale a d l ~ , , n p ace and due to the cause(s) and m r stated ~d/dr investigation, in my opinion death o , a t the time, date, and place, and due to the taus Signature of certifle ( ) d 3 Title of ce rtifler: 96. Name, Atltlress and Zip Code of Person Completing Cause of D License Number: ~~f ~~ ~ __ eath (Item 26) Dr _ Eric Binder 890 Po Jar Chur 39c- Date sl nea (M h 4 g p/pay/Yr c Rd. Cam H 0. Registrar's District Number 1- PA ]- 701 ] ' s Si ~y~ 41. Registrar ' Februar 29 c pz ~ -a / / ~ 42. Registrar File Date (MO/D 4 3. Amendments ~J' ~l /.-.~ ame of Cemete ry, crematory, or t 17b License Number FD 012 848 L to indicate what the Decedent considered himself or herself to b White ~ Black or African American e 0 Korean ~ Vietna ~ American Intlian or Alaska mese Native ~ Other Asia Q Asian Indian ~ Chinese n Q Native Ha walian ~ FIIIpi^° 0 Guamanian or Chamorro Q Japanese Samoan 0 Oth Q Other PactRC Islander er (Specify) self to be. 22a. Decedent's U sual Occupation -Indi done during most cate type of wort of working life. DO NOT USE RETIRED- Le a1 Secretary Disposition Permit No. ~~ / LJ ~ ` n NSpS-143 r ~1 ~ ~~ ~C ~ ~~>~j ~ y O '~ t ,,~ -- ._ ~,~. _~~ T ~ - ~. r'-1 r LAST WILL AND TESTAMENT ~ _~ ~ ~ ~ c~ t _. ,r ~' ~ 1 _ Z ,r cx~ _ OF ~~ t . _ ~ ,~ -, rte? _-~, -~--. _ , -;, NANCY HAZELL - - ~ ~ -== '~`~ ...~ -'-i .. .. ~_... rr ~,~ CJ c, I, Nancy Hazell, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. ARTICLE I The expenses of my last illness, cremation, and administration of my estate may be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. My cremation arrangements have been pre-arranged with the exception of a marker. It is my desire upon my death to be cremated and my ashes mixed with those of my deceased husband. It is also my desire to have a funeral service held at the Grace Lutheran Church in Camp Hill. ARTICLE II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of i~ly residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. ARTICLE III I give, devise and bequeath all my property, real and personal, and mixed, as follows: 1. To my son, Edwin A. Hazell, I leave my home and all its contents located at 103 Manchester Road, Camp Hill, Pennsylvania; 2. To my daughter-in-law, Patricia M. Hazen, my second burial plot at Rolling Green; 3. To my granddaughter, Jessica E. Hazen, all my jewelry, wherever located; 4. All the rest, remainder and residue of my estate shall be disposed of as follows: A.) Divided equally between my Granddaughter, Jessica E. Hazen, and my Grandson, Ryan W. Hazen, in accordance of the provision set forth in Article IV hereof. ARTICLE IV If my grandchildren are entitled to take under Article III hereof, then I give my grandchildren their shares of my estate in the following manner: If a grandchild has reached the age of THIRTY-FIVE (35) years at the time of my death, then I direct my Executor to distribute each such grandchild's pro rata share of my estate to such grandchild at the time of my death. If any grandchild has not reached the age of THIRTY-FIVE (35) years at the time of my death, then each such grandchild's pro rata share of my estate shall be placed into a trust for each such grandchild's health, education and welfare as provided in Article V hereof. If any grandchild of mine fails to survive me by thirty (30) days, or dies before receiving all property passing into a trust for his or her benefit as provided for herein, then I give, devise and bequeath each such grandchild's pro rata share of my estate equally unto such of his or her issue as shall survive me. If any grandchild shall predecease me leaving no surviving issue, then such predeceasing grandchild's pro rata share of my estate shall .pass to my surviving grandchild or his or her issue, as the case may be. 2 ARTICLE V I hereby create the Nancy Hazell Testamentary Trust (hereinafter the "Trust") for any property passing into trust under Article III hereof. I appoint my daughter-in- law, Patricia M. Hazell, as the Trustee of any property passing into the Trust (hereinafter the "Trust Property") for the benefit of my grandchildren, Jessica E. Hazell and Ryan W. Hazell. The Trustee shall administer the Trust Property in his sole discretion for the health, education and welfare of my grandchildren, in accordance herewith. The Trust established herein is for the health, education and welfare of my grandchildren above named for whom the Trust is created. In addition to the powers given by law, I authorize the Trustee (a) to use such amounts of both income and principal of the Trust Property as he in his sole discretion deems proper for the support, education and welfare of any such child without leave of any Court, and (b) to invest any Trust Property. The Trustee shall not be required to give bond or furnish sureties in any jurisdiction. In addition to the aforesaid, the Trustee shall distribute the Trust Property as follows: upon each child reaching the age of TWENTY-FIVE (25) years, the Trustee shall distribute to that child ONE-THIRD (1/3) of the remaining share of the Trust Property to said child, and upon each child reaching the age of THIRTY-FIVE (35) years, the trustee shall distribute to that grandchild the remainder of that grandchild's pro-rata share of Trust Property to said grandchild, absolutely and without reservation. All principal and income shall be free from anticipation, assignment, pledge or obligation of beneficiaries or remaindermen and, while in the hands of my Executrix or Trustee, the same shall not be liable to any levy, attachment or execution. 3 ARTICLE VI In addition to the powers conferred by law, I authorize my Executor in his absolute discretion: 1. To retain in the form received and to sell either in public or private sale, any real estate or personal property except that which I specifically bequeath herein, and pursuant to my directions set forth in this Will. 2. to manage real estate; 3. to invest and reinvest in all forms of property without being confined to legal investments, and without regard to principal of diversification; 4. to exercise any option or right arising from the ownership of investments; 5. to compromise claims without court approval and without the consent of any beneficiary; 6. to file any federal income tax return for any year for which I have not filed such return prior to my death; 7. to make distributions in cash or in kind, or in both, and to determine the value of any such property; 8. to employ any attorney, accountant, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all of their services; and 9. to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death. ARTICLE VII I nominate, constitute and appoint my daughter-in-law, Patricia M. Hazen, to act as the Executrix of my Last Will. In the event of her renunciation, death, resignation, or inability to act for any reason whatsoever as my Executrix, I nominate, constitute and 4 appoint my son, Edwin A. Hazell, as my Executor. I hereby relieve my Executor whether original, substitute, or successor, from the necessity of posting security in connection with her duties as such in any jurisdiction in which she may be called upon to act so far as I am able by law to do so, My Executor shall rPrP;vP rPa~,,,,~~,~„ compensation for services rendered to my estate. IN WITNESS WHEREOF, I NANCY HAZELL, hereby set my hand to this my Last Will, on this /-~~ day of August, 2003, at Hershey, Dauphin County, Pennsylvania. ~/ NAN HAZELL In our presence, the above-named Testatrix signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other we sign as witnesses. Name Address ~' C~u`~1 5 I, Nancy Hazell, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Last Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Nancy azell COMMONWEALTH OF PENNSYLVANIA ) ss: COUNTY OF DAUPHIN ) On this, the ~ day of August, 2003, before me, a Notary Public, the undersigned officer, personally appeared NANCY HAZELL, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~. NOTARY PUBLIC Notarial Seal Michele L. Pritchard, Notary Public Derry Twp., Dauphin County My Commission Expires Mar. 22, 2004 Member, Pennsylvan~aASSOC,r+~~n! ?!NO4ars8s 6 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that the Testatrix executed this instrument as her Last Will; that she signed and executed it willingly as her free and voluntary act for the purposes herein expressed; that each us in her sight and hearing signed the Last Will as witn es; and that to the best of our knowledge, she was at the time eighteen (18) r ore ag~f sound mind, and under no constraint or undue influence. Sworn to and subscribed before me a Notary Public this j ~ day of ~Uy;,~{-~ , 2003. No ary Public Notarial Seai ~~~! fv1ichele L. Pritchard, Noiary Public Derry Twp., Dauphin County My Commission Expires Mar. 22, 2004 Member, Pennsylvania Association oT Nn+aries 7 r.- RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA ~2i-1~--~~71 ~ti~ f~iR 28 ii' 8: ~.,8 CLERK ~~F pRRNP,~'c +~:~URT Estate of Nancy Hazel), a/k/a Nancy W. Hazel), a/k/a Nancy L. Hazel) ,Deceased I, Patricia M. Hazel) , in my capacity/relationship as (Print Name) Executrix of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Edwin A. Hazel) ,---- ~~ /)~ ~~ -f 3, t Z ~ (17ate) (Signature) 3814 Dawn-Mar Street (Street Address) Harrisburg, PA 17111 (eir~, state, zp) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ day of ^M,- ~~ ~," Deputy for Register of Wills COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL JOHN R. BEINHAUR, Notary Public Lower Paxton Twp., Dauphin County My Commission Expires March 13, 2015 Form RK'-06 rev. 10.13.06 Rw-os Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this ~ 3 ~ day of M w--r~- oho ~ ~ Not Public My~ommission Expires: ~ !3• /~ (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.)