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HomeMy WebLinkAbout04-12-12PETITION 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 , request(s) the grant of Letters in the appropriate form: Decedent's Information Name: Dorothy M Crouse / I ~ I ~ ~ ' . File No: `J ! ~ ~ - `~ a/k/a: (Assigned by Register) a/lc/a: a/k/a. Social Security No: Date of Death: March 18, 2012 Age at death: 98 Decedent was domiciled at death in Cumberland County, Pennsylvania (stare) with his/her last principal residence at 206 East Burd Street,Apt. 1C Shi ppensburg PA 17257 Shippensburg Borough Cumberland Street address, Post Office and Ztp Code City, Township or Borough County Decedent died at Episcopal Home 206 East Burd Street Shippensburg PA 117257 Shippensburg Borough 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 dotniciled in Petnsylvania .......................... ..All personal property $ 500 00 + If not domiciled in Pennsylvania ...................... . .. Personal property in Pennsylvania $ If not domiciled its Pennsylvania ...................... .. Personal property in County $ value of real estate in Pennsylvania .................... . , , .. $ TOTAL ESTIMATED VALUE.... $ 500.00 + Real estate in Pennsylvania siritated at: (Attach ncldrtionnl sheets, iJ'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 November 13, 1979 and Codicil(s) thereto dated n/a -' Clarie M C'r~uce hnahand of the n ed n died ianuar~ 31 1980 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 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 ~ EXCEPTIONS ® B. Petition for Grant of 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 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 stablish~s defer in 23 Pa. C.S. § 3323(g) 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 Will and was survived b the foalowin s of ~ ~r ~ t~"! additionalsheetr. if~,ecp~.~n,-„t• y g P ~)andheirs(atlachr=-_, Name Form RW-02 rein. 10/11/20/l Relations Z Address -+ ~? ~, Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland To the Register of Wills: Please enter my appearance by my signature below: Petitioner(s) Printed Name Petitioner(s) Printed Address Robert C. Crouse 3346 St. Andrews Drive Chambersbur PA 17202 ~ ~ ~, ~~r cuM~ i ~~vn , . ~~ 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 t/o ]aw. Sworn to or'~affirnled and subscribed before / ~t ~ - Date '-~(~ a ! l ~a rile t ~ ~,/~rjn ~o~ i ,o~~ ~ Date u i i~' /y ~.r - Date Date BOND Required: ~ YES Q NO FEES: Letters ...................... $ a~.~ (5) Short Certificate(s)...... ~~ ~' ( )Renunciation(s)......... ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commissi n .................. _ Other •••••••~ Automation Fee ...... . ........ 5.00 7CS Fee ..................... 23.50 TOTAL ..................... $ Attorney Signature: Printed Name: Courtney J. Graham Supreme Court ID Number: 23685 Firm Name: Sponseller/Graham LLC Address: ~~~ r ~ ^^~^ Malay Fact - r'~^~mhPrch,~g PA 1701 Official Use Only ~~~ - ,"Iii 717-264-1100 717-264-1880 ~Ca7ci pncPllarg am ~nm Phone: Fax: Email: DECREE OF THE REGISTER Estate of Dorothy M Crouse a/k/a: e AND NO / o~ ~ (~ ~ , in consideration of the foregoing Petition, satisfactory pr of ing been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Robert C. Crouse in the above estate and (if applicable) that the instrument(s) dated November 13,1979 described in the Petition be admitted to probate and filed r~cord ~s the }a~ Will (and C i~il(s)~ of of W-lls File No• ~~~ ~~~~~~3~ } } SS: } Form RW-n1 rev. ~miii2n~t U ~ Page 2 ~f 2 H 105.805 REV (9/11) LOCAL ~~~~~ CERTIFICATION i0F DEATH WARNING~?~t ~S; illegal t©'I,~d~t~licat~e this copy by photostat or photograph. Fee for this certificate, $6.00 ; if ~7 ~~~ ~ ~ ~~ 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 /'~~1^ certificate will be forwarded to the State Vital ~RP~ ~ vlJUrl~ Records ffice for permanent filing. CiiMBE~~~c) cc~ P 18352971_ Certification Number Type/Print In Permanent al Q/ V• L /~ ~S ."~ Q . o -~ Lo g)strar Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ATV bek Ink a,.r..... . ~.... . - _ __ - - - " .........~ .-....~~.. Sex 3. Soelal Security Number 4. DKe o1 Duth (MO/Oay/Vr) (Spell Mo) 2 1 . . Deudent's Lapi Nama (First, Middle, UK, Suffix) 1-9601 Maneh 18 2012 bemcr.2.e 180-0 ~o/L.o~hy M. Cnou.ae 3tata or Foreign Country) 7 S ~ 2V Q~ ty(~~g e-last Birthday (Yrs) Sb. ndlr Yur Sc. Vnder 1 D+ 6. DKe of Birth (MO/Day/VUr) (Spell MenTh) A l'X a. g . Months D.ya Hera Mini,taa Ma ) (/J71 an t 16 1 91 3 h l e ettn eee ( , 7b. Blrt y .y D B e. Resid 9 8 (St~t or Foreign Country) gb. Residence (Street and Number -Include Ap ~ ~Z 8c. Old Decedent Llye In .Township? dlgedent uy.e In ~P• Ore: , PQ.n H b .C.VQrt.t.a 2 0l5 ~GL6~ SuJtd S~iree~ S y i d. $ ) ®NO, decedent IWed yvithin limits of S~-pPevtb bweg city/boro. d 21 C d C (C-A um D e e Be. Residence ( n P f DeKh Marrletl ® WI owed il. SurvNing Spouse's Name (If wife, give name prior to flat merrbge) Tl ,C • ~ L ~ 9 me o FOrces7 10. Marital Stetua K rm d , Ever fn VS A s ~ Yea ® No Q Vnknewn ~ DNprvYd D Nwar Married Q Unknown SiAflx) 13. Mother's Name Prior to Flrat Marriage (First, Middle, Lest) last MWdh Fi t ' , , rs , s Name ( 12. Father ee '02aa.i-e S~iiay¢~c Naug.e.e N h aug. a.a Cha~rf.ea Cep 16a. Informant's Name 14b. Relationship So Decedent 14G. In is Malling Address (Street end Number, City, SbYe, 21p Code) Chambehabwc Pa 17202 3346 S~ And/ceu~a 'D/L . Roben~ C. CiGau6e Son ....................... --.. ..-P~...............................-.. If DeKh Occurred In • HaspRe~: - CT~ In tllnt a. ace eat ec on one ... ... ........ ... ....... ....... ..... ... ........ ... ... .. ... .. ...............................-....................Y....-.- -.............-........-...... ...... H Death OCNrred Somewhere Other Then • Hospital: ~• Hospice Flcility ~ Decedent's Home Eme enq Room/OirtpetNnt Dud on ArrNli Nurain Homa/LOn Term Gre Facility Other (Specify) 15d County f DeKh 1~ F•clilty Name jlf ~~~~ Lion, give rtreK and number; . 15 ity or Town, Ke, antl Zlp Code Pa 17257 Cumben.P-anal ~~i,cppen.a~wcg P-(-a~op 16a. MKhod of Disposition ® Buri+l Q CremaHOn , 16b. Dlte 07 Dlspoaltion SBc. Place of Dlsposltkan (Name of pmetery, cremKery, or ether place) ~' p Remev.ifremst.te o oon,tlen 3-21 -207 2 Sp~c,i-ng fffX.e Cemet¢Jcy .~ on,er s eafv) antl Zip) n Sbtl T 37a. Lure Fu nl Service Uc Nor Person In Charge of Interment 17 b. License Number , , ow 16d. Loeetlon of DbpesRlOn ( Ity Or ~- Fd 014351-L Slu.ppen.abwL Pa 77257 1 Name d COmpIKe dM;s Funera Facility ¢ha,e f-lom2 772 We,a~ K,i..n Ste. Sh.L a bwr- PA 17 7 ¢~c ~un ~ ~'p ¢ e an ¢~L ='i~ e C ~ ~' . . , . , . . , edent's EdupHOn -Cheek Me box Mat best describes the 19. Deeedam of Mbpanle OMEin -Check the 20. DecltlenYa Race -Cheek ONE OR MORE rlCea to indicate whet lf t lg D h b f ~ . ec erse o e. or highest degree er level of school cemplaNd at the time of death. bex that best descrlbu whetMr the decedent the decedent considered himsel ~ Korean ' • " ( White $ NO ® gth Grade or less Is Spanish/Hlspani4Latine. Check the bex M decedent Is not Spanlih/Hispanic/Lltino. O Black or Ahlun Amerlon ~ Vietnamese Q NO diploma, 9th - 12th grade r GED cemphted ®No, not SPanbh/HlsPenic/Latino Q•Amerlcan Indian or Alaska NatlVe O Other Asian t l d e o gra ua ~ High schoo ru O Yes, Mexlcen, Mexican Amnion, Chluno ~ AFlan Indlen ~ Native Hawaiian t d d b ne ag it, u ~ Some college cre AS) O Yls, Puerto Rleen ~ CTUnase Q GuamaMan or Chamorro AA , ~ Assoc{Ka degree (og. YU, CuWn ~ Filipino Q Samoan BS) O 6A AB ' . , , s degree (e.g. Bachelor MS, MEng, MEd, MSW, MBA) O Ves, other Spanbh/Hlapmic/Latino ~ lapenese Q Other Pacific Islander MA Q Master's degree (e g , . . O Doctorate (e.g. PhD, Ed D) or PrOfesslonal degree (Specify) ~ O'[har (Specify) a. . MD DDS OVM LLB JO nation -Chick ONLY ONE to Indicate what the deodent considered himsel/ or heneN to be. 22a. Decedent's Vsual OcNpatlon -Indicate type of work f-Desi S l R ' g ice e s Sing e 21. Decedent ~ JaPlnaae O Samoan done during most of working life. DO NOT VSE RETIRED. ® White n American Q Korean O Other Paelfle Isander f{p(,(,a a Keeping Af i l k er r ca ~ B ac Amerlon Indlen er Alaska NatNe Q Vietnamese Q Don't Know/Not Sure Kind oT Business/Industry 22b . 0 Asian Indian - O Other Aalan ~ Refused 0 Chinese Q TMTive Hawaiian O Other (SPeclry) S~a~te [(n-(-V QfC./S.C~y ~ FIIIpMO ~ Gwmanlan or Chamorro ITEM MVST BE ~ PLETED 23a. Date Pron cad Dee (MO Day Yr) 23b. Sigmture of Parson Pronoun ng Onth Only w !n app table 3c. License Number 6Y PERSON WNO -RONOUN665 OR ,~ /~ . CERTFIES DEATH VVV 2Sd. Oat! Signed (MO aV/Yr 24. Time of Death • ~O if y~- ,~• /T/" 25. Was Madlgl Examiner or COromtr ConteetedT ~ Yes No CAUSE OF DEATH ~ Approximate Enter the chin Of events--diseues, inlurles, or eompllutions-thK directly caused the death. DO NOT enter terminal events such es cerdlsc arrest. Interval: PaR 1 Onset to Desth 26 H - . necessary e tl~ ology. DO NOT ABBREVIATE. En[e~only one Ouse on • Ilne. Add addiclonal Iinea e t showing the u respiratory arrest, or venMeu4r fibrillation witho ~ ~ ~~ ~~ ` t l ~ ~ ` ' ~~~ v ~ r 1 IMMEDIATE CAUSE > sequence ef): ~ Ou! to (or a a s a - ! (Final disease er condition ~ F, ` t7~ -`t•- E7 Z~ i resultln6 In death) ~/ \j~jl 'J ~ (x b. 7 SlqueMlaily Ilst conditlens, - Duet wn ee of)~- J if any. ie.ding to the a~,e e~ e~ ~ .- ~ r e ~ ~ ° _ ~~ ~. ~ ~l~~ E listed on Ilne a. Enter the Due to (or as • consequence of): ~ -.-VNDERLYIN6 CAVSE (disease or Injury that Inlt4ted the events resulting d. Due to (or as • eonsequenca of): ( h ST ~ In dest ) LA . 26. Pert il. Enter ocher i Ifl t dIH n frlbutlne to death but not resulting In the underlyln6 cause Gluon In PaK I 27. Was a autopsy parlor edT n Ves No , 28. Were autopsy findings • seeable desihT f the cause M comp N o Ye6 le: 30. Did Tobacco Use Contribute to Death? 33. Manner of Death If Fe 29 . ~~PP ~~NOt pregnant within part yu, 0 Ye` O Probably Q Nstursl 0 Homicide nt 0 Pending InveKl6atlon id A cc e Q Pregnant at Hme of duth ~.TT Unknown ~ ~ Suicide Q Could net be determined ~' ~ Not pregnant, but Pregnant within 42 days of deatF s to 1 year before duff 32. Date of Injury (MO/Day/Yr) (Spell Month) t 43 da ~ y ~ Not pregnant, but pregnan 33. Time of Injury p Unknown N pregnam wkhln the pass Yesi 34. Plsce of Injury (e.g. home; cenatroRlon site; farm; school) 39. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Spwelly: 38'Daseribe How Injury Occurred: Q Yes ~ Driver/OPerator ~ Pedestrian No O Passenger O Other (Specify) 39a~. Cyy~~ifler^Chlck only one): ~~CeKllyl g physiclen - TO the best of my knowledge, death occurred due to The cause(s) and manner atatetl O Pronouncing 8 Certifying Physician - To the best Of my knowledge, deKh occurred at the time, date, and plea, and due [o the cause(s) and manner slated n fated (a ) a n d m nd due to the c d i ece, e p d K the time, date, an h cc u o ~ Medical Examiner/Coroner - On the, b_ ylapf examina[lon, antl/or Inves[IgKlon, In my opinion, deaf p { ~ ~ -f ~ f ,/ ~ s v[ ,~ Signature of certifier: - OL/`--E- Title o1 certifier. , ' `\ J license Number: TYI ~ MOT I pSo 1 3 b. Name Address and 21 t Completing Cause of Duth (Item 26) " ~ -- -~ ~`o ~ Zn ~ 1 ~ 39c. Date 51 ed IMO/Day/Yr) 3 i 4 ~ v l to ( ~ cil istrar Flle ate (MO Day 42 R S O. ReglsTre is District Number 41. Registrar s Signature eg . { 3 ~ ~ ~ s~ 5 43. Amendments `z C B Disposl[ion Permit NO. 07393 HH _ REV 07/2011 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA OATH OF SUBSCRIBING WITNESS aaacaaaaaa<aaaaaaaaaaaaaaaaaaaaaa Estate of DOROTHY M. GROUSE, deceased CAROL G. REBUCK, a subscribing witness to the will presented herewith, being duly qualified according to law, deposes and says that she was present and saw the above testatrix sign the same and that she signed as a witness at the request of testatrix in her presence and in the presence of each other. ~~ Carol G. Rebuck 11173 Spring Ridge Road Shippensburg, Pennsylvania Sworn to or affirmed and subscribed before me this -J ~ day of April, 2012. n 0 n,~ Notary ublic ~, ~~ ,~ t ~ , i :~ cn T 1'V , --.. COMMONWEALTH OF PENNSYLVANIA NOTARIAL S ~C ~I n "~ ~' Q3 -j~~ '`` _',; ~"-`r EAL Karen L. Kimple, Notary public C .~ ~-. `~ hambersburg Boro F ranklin County ~ My commission expires June 07, 2013 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA OATH OF SUBSCRIBING WITNESS ttt<tt<ttttttt«ttttttttt<t<ttttt Estate of DOROTHY M. GROUSE, deceased )OEL R. ZULLINGER, a subscribing witness to the will presented herewith, being duly qualified according to law, deposes and says that he was present and saw the above testatrix sign the same and that he signed as a witness at the request of testatrix in his presence and in the presence of each other. Joel R. Zullinger 1441 Edgar Av Chambersburg, Pennsylvania C'~ r-- J7 ,r'~r Sworn to or affir ed and sub r' d before ~ ~ ~; ~T~ T~ me this ~ day of , 2012. 2~ m ._.., _ _ / ! zv~~ t~ `~ ~ ~. -- D `~ rri N ry ublic ~: ~ --~,, COMMONWEALTH OF PENNSYLVANIA Notarial Seal ' Carln L. Walter, Notary Public Chambersburg Boro, Franldln County My Commission Expires May 13, 2013 ~~sk mill ~n~r Lp~Y~mrnt I, Dorothy M. Crouse, of Shippensburg Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my Will hereby revoking any and all former Wills and Codicils thereto by me at any time heretofore made. FIRST: I direct that all my just debts and funeral expenses, including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease as a part of the expense of the administration of my estate. SECOND: I give, devise and bequeath the residue of my estate of every nature and wherever situate to my husband, Claire M. Crouse, providing he shall survive me by thirty (30) days. THIRD: Should my husband, Claire M. Crouse, predecease me, or die on or before the thirtieth (30th) day following my death, I give, devise and bequeath the residue of my estate of every nature and wherever situate to my children, namely, Robert C. Crouse, Kenneth E. Crouse, and Delores J. Jacoby, in equal shares, provided that the share of any child who predeceases me or dies on or before the thirtieth (30th) r~ day following my death shall be distributed to his or her issue, per stirpes, living on the thirty-first (31st) day following my death, and in default of any such then living issue such share shall be added to the share or shares for my other children. FOURTH: In the event that anyone entitled to a share of my estate should be .~ under the age of twenty-one (21) years at the time for distribution to him or her, I constitute and appoint The First National Bank of Shippensburg, Shippensburg, Pennsyl- . , 'f_. vania or its successor, Trustee of any property which passes either under this Will or ,~ otherwise to said minor. Said Bank, as Trustee, shall in its sole discretion and with- out Order of Court, have the power to retain such property in kind or to sell the same, giving good title to any real estate, to invest and reinvest in stocks, bonds or other investments, without being limited to investments which would be legal for minors' r..:,.. funds, and to use principal as well as income from time to time as may appear.txa~be ~'7 ~' ~~ ~. necessary for the minor's welfare, comfort, medical care, recreation, -©rt as~i ~~ '" s-t ~'~ Z7~t~- ::l ~' " m ~> ~ _ -~ cn ~ cv Page One of a Three Page Will t,C~ x-~ ~1 education, without responsibility to the minor or to any person taking care of the minor; and any balance in the hands of said Bank, as Trustee, shall be distributed to said minor when he or she attains the age of twenty-one (21) years, If such minor dies prior to attaining the age of twenty-one (21) years, said Trustee is authorized in its discretion to pay part or all of his or her funeral expenses and the remaining balance in the hands of said Bank, as Trustee, shall be distributed to his or her personal representative. In the event the funds held by the Trustee for any minor become, in the opinion of the Trustee, too small for proper and efficient administra- tion, the Trustee, in its sole discretion, may deposit such funds in a savings account in the name of the minor, FIFTH: My Executor and Trustee shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without Court approval, and effective until actual distribution of all property: A. To retain any and all of the assets of my estate, real or personal, including stock of my corporate fiduciary, without regard to any principle of diversification or risk, v B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds, whether operated by my corporate fiduciary or others, without restriction to investments authorized for Pennsylvania fiduciaries, '~ as they deem proper, without regard to any principle of diversification or risk. ~~ C. To sell at public or private sale, to exchange 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 or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or controversy. F. To distribute in cash or in kind or partly each. G. To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. Page Two of a Three Page Will SIXTH: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. SEVENTH: I appoint my husband, Claire M. Crouse, Executor of this my Will. Should my husband, Claire M. Crouse, fail to qualify or cease to act as Executor, I appoint my son, Robert C. Crouse, Executor of this my Will. Should my son, Robert C. Crouse, fail to qualify or cease to act as Executor, I appoint The First National Bank of Shippensburg, Shippensburg, Pennsylvania or its successor, Executor of this my Will. EIGHTH: No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREC~', I have hereunto set my hand and seal to this, my Last Will and Testament consisting of three typewritten pages, the first two of which bear my signature in the margin for the purpose of identification, this ~~ R day of ~~=,MYU~,, ) , 1979. ~~ ~'~ (SEAL) Signed, sealed, published and declared by the above named Testatrix, Dorothy M. Crouse, as and for her Last Will and Testament in our presence, who in her presence, at her request and in the presence of each other have hereunto set our hands as attesting witnesses. (~ ! i ~ ~ ~ .~~~~ -~~ ~ ~ ~~, Addre s dress Page Three of a Three Page Will