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HomeMy WebLinkAbout04-12-12~C 1~,1 ~ ~ a ill l ~ ~! PETITION FOR G1~1~~~~E~SSt~ REGISTER OF WILLS OF COUNTY, PENNSYLVANIA Petitioners: named belo~.v. •.r"ho is-are l3 dears of age o: c tom' T etters as s ecitled balo•,v, and in support thereof aver(s) the following and respectfully request(~~~c~.~trs'ih'the apprupriatz form: Deceden 's Information //~~ ~~~ 2 ~,, Name: u ~Lt ~ `/¢tyN - J'tl42 t r File No: ~~~ !I~-(_J~-(J V!! a/k(a: 'IZGtSS /-[ u ~iLCt2 (Assigned by Register) a/k/a: a/k/a: Date of Death: f ~ , ZZ ZO + Z Decedent was domiciled at death in G'uh'~3incA-.v D County, principal residence at 31 CO-l~fLtS h ALIVE / ~>l CA/~ii° Street address, Post Ofnce and Zip Code Social Security No: 204 -~4 - SS 33 Age at death: Sd (Stare) with his/her last City, Township or Boroagh County Decedent died at CA-I2(71~N C~2lJxi t7N SC.~¢iIJE' /Ldl~t7y~E S(.cS(32ucKityv~t)t4 /1.7~ 1~4 !~/!~j Street address, Post Office and ZIp Code City, Township or Borough County ~^'GL ~It~ Estimate of value of decedent's property at death: Ijdomicded in Pennrylvania ............................ All personal property $ l~-U ` QC) O Ijnot domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ Ijnot domiciled in Pennryivania .......................: Personal property in County $ Value ojrealestatein Pennsylvania ..................... ........ $ "~ TOTAL ESTIMATED VALUE.... $ -~iF99~0 LS~~mm O Real estate in Pennsylvania situated at: 3 i C,~{E21 S >~ '~2t ~ ~ /Q Pt P ~ f/LL , P/~ C ~ n~~L/¢t'~ (Attach additional sheets, ijnecessary.) Street addreaa, Post Office and Zip Code Ctty, 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 W ill of the Decedent, dated (3 ~ /170'. 2C7~ and Codicil(s) thereto dated State relevant cirtutnatances leg, renunciation, death ojesecutor, eta) Except as follows: aftertheexecutionoftheinstntment(s)offeredfarprobateDecedentdidnotmatry,wasnotdivorced,wasnotaparrytoapending 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 bom or ad ud; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ~] NPO EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.ta., pendente life, duranteabsentiu, durance minoritate If Administration, c.t.a, or tt:b.n.c.~a., enter date of Will in Section A above and complete lisk 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 hasJhave ascertained that Becedent left no W ill and was survived bythe following spouse(if any) and heirs (attach additional sheets, if'necessary): Name Fnrm RW-42 rev. ltut t/70l t P8gC 1 Of 2 ,_ . _ , . ___ 1 � - ��`"� ,�_ .� r' �� ���,,�{.i . .t r Oath of Personal Representative �_,� t� "'ai�s�°TI� 1 , _�- _ �.. � � .._,. CO;�I�tONWEALTH OF PEti�iSYLVANi.� } � SS: r�;� r'���t f � ��i'� �' w� CnL'�iTY' OF � � `- Per,�icne;���=r:n.:u�a��e I Pz:uion:r!s;Pru::ed. ' � 1 � i /b-I�t�-t,c-s �c,�,�E��IZ 3 t Gr-�E��sK �cz��E C�'vk�f�..�� �- P'�i-� �� The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing Petition are tnie and correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the Deced nt,the Petit' ner(s)will well and truly administer the estate according to law. Swor��to or affirmed and subscribed before Date :ne t��'s � day of � � ,�i � Date ��L- �y��`, A t����l�f ii������,f�)'1 il I Date � Fur!he Re�istcr Date BOND iZequiK�ri::u YES �NO To tlae Register of Wi![s: FEES: Please enter my appearance by my signature below: Letters. . . . .. . . . . . .. . . . . . . . . . $ � % .C� Attorney Signature: ( l ) Short Certificate(s).. .. . . L(.L L ( )Renunciation(s).. . . . ... . ( )Codicil(s). . . . . . . . . . . . . ( )Affidavit(s).. . . . . . . . . . . Bond.. . . . . . . . . . . .. . . . . . . . . . . Printed Name: Commission. . .. . . . . . . . . . . . .. . Supreme Court Other . . . . .. �_ ID Number: . . ,���� ��� . . . . . . .. i ��� c;e, . . , . . . .. Firm Name: . . . .. . . . Address: . . . .. . .. Phone: � Automation Fee. . . . . . . . . . . . . . . �� -L°C' Fax: JCS Fee. .. . . . . . . .. . .. . . .. . . . � , ''C.i Email: TOTAL. .. . . . . . . . . . . . . .. . . . . $. ; `� DECREE OF THE REGISTER Estate of �'��i"\�� �`� �,,�1 l �p �LQ- 1� File No: �� �� ( - (>L� ;��.1� a/k/a: �-j� ►�� i�;'\C��1 k� �1.1-��C (.��1�i l l � t� AND NOW, }�-a> �� 1 ��, , x ��-- , in consideration of the foregoing Petition, satisfactory proof having been presented before me,IT IS DECREED that Letters �..G���('���,(�( ('� �� � are hereby granted to �, \ - " l� �— , � in the above estate and(if a tcable) tnat the instrument(s)dated �` — �`.� - `�C�-� ,___ described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))�f Decedent. �i��,�L �1� C',i ��G,'� �` �'Yl�,f���`X�k.f '��� � . Register of Will �� � ,_;.,n�C��,l.�u l�c`,1�� � Fo,�,,,rrcv-n? ,•�v. �nitlizn�� Page 2 of 2 __ H)09 ROs RFV l9/11) a . ~3~ LOC1C~~AR'S CERTIFICATION OF DEATH WAR~ii[t~is:~lle~~l o duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 402 APR i 2 F11 3~ 58 This is to certify that the information here given is correctly copied from an original Certificate of Death (~~( (~,,~ duly filed with me as Local Registraz. The original 'S vQ~T certificate will be forwarded to the State Vital +~~~~ ~ ~ , ~ Records Office for permanent filing. P 18160695 Certification Number ryp./vnrK In Permanent d FEB 2 41 1111 Local Registraz Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF NEALTN • VITAL RECORDS LFRTE KELATF ['fC f'fEJSTM _ _. 1. D•cnden2 i LeBe N.me (First. Middle, L•F4 3Y/11M) 2. Sex 3. 30c1e1 Security Num •r 4. Defe Ot DeeM (MO/Dny r) (Spell MO) Aan Marie Ruas Mueller male 209 - 54 - 5533 Fsbruar 22 2012 Se. Ats-fart BIK tl•y (Yra) Sb. UtM r Y•er Sc. Under De 6. DP<s of BIKh (MO/DOy/Ye•r] (Spell Month) J•. Blr[hplec• (City and Stall er FOr•lin Ceun[ry) - MonMR Deya Hours MlnKea r O P4a 8 1961 7b. Birthplace (County) ia. R•IWMq /Stern er proltn GounM B . RNlaansb (S[reeC end Numbsr- Include Apt No.) B[. Id D•cedMt LIVe In • TewnshipT Ps n fusels wna. antaaent lwaa In East Pennaboro twp. . RasM•np lcounty) C erish D 1vs N. ftultlenp (Zip Cod.) ]- QNO, d•esdant Ilwd whhln limib of city/boro. 9. Ewr In US Arme brcesi 30. Marllel St•<ua at m• of Death MKrlea ows 11. Survlvlni Spoua•'a Name flf wile, ilw name prior to first marrvate) L]vea ~ NO Ounknown ~ Dwore.a ~ Nawr Married Ounknew MarrCUS Ru f Mueller 12. a[ •r • Nemn (First, Mldale, Lest, su x 13. MotM1er's Nem• Prbr t0 Flrrt Msrrlai• (FIn4 Mladla, Lart) ohn Vi cfe t Ruse oee a .Eliza a Rudman 1M. 1 ormant s N•ma 14b. R•I•HOnahip to Decedent 14c. Infermsnt's Mellini Adarefs (Street sntl Num •r, Clty. State, Zlp Coda) f a e S u e 1 Chs i rive am Hi11 PA 1 011 ............ u .................. .. .............. ......... ....... ........ N Death Occurred In • NOaPlbl: [] Inp•tlent .. e. tjca O ____•t__ ___!C On One .............................. ................ .................. ...... ............... .. .....--........ .. ... I! Oe•Ch Occurred Somewhere Other Then s NoaPltel: ~HOaPlce FacI1KY De[edent'a Naane n Rpom/Outpatient Daad On Arriwl Eme Nunin Nome/LOn -T rm 6ro Faclll Otfisr (S K ) SSb. FeNllty Nema 1 nqY Ins<KUtIOn, i1W stroK an num 16c. City er Town, State, and Zip Coae SSd. County e/ Death to i ante usha na P 1 a ~, 16a. M od tlf DIeP KIOn urla Cre)n•tlen 166. Data of DlaPOSi[lon 16c. Place bf DlsposKlan (Nema Of cemetery, crematory, er ether place) p wemW.lfrom stew ODenaMon ebruary 23a Dtn.r [i 2 12 Evans emator 16tl. LptKlen Iapoaltlon Clty or Town, Stab, •n Zlp) 171. Slin • Service Llcanwe or Person In Charts of Interment 1Jb. Ucenw Number Scheaffsretown• PA 17088 FS 012 849 L 1J0. N•m• Md Complete Aadreu N Funnel Facility Parttlamore FH & S Inc. PO Sox 431 Ne Cumberl nd PA 17070-04 1 16. Dep not a EdYGKIen = Chsc t .box <hK belt dHCrlb.a the 1!. Decedent M Nlapenlc Or {In - C •ck <he 3D. D•c.d.nt s Rece -Check ONE OR MOR r pF to Indicate whK 1= hiiWK d•tr•e or level W school nOmplatsa et the [Ima PT death. bex Mat beat descrlWa whether the aacetlant the decadent mnslderad himself or herself to W. ~ tth tratla er feu la Spenlsfi/Mlapenl44tino. Check the "NO^ i~ White ~ Korean Q No diploma, 8th - 12th [rase box N decedent Is not Spenlah/Hlapanlc/Latino. [] Black er African AmaACan Q VlKnam•b Q Hlih scfiool troduate Or GED cOmPlatetl (~ No, net SPenlah/HlsPenlc(Latino [] American indlan or Alaska Natlw [] Other Aalen [~ Some eAlln{n wdK, but no dair•e Q V•s, Maxiean. Mexican 4m•rlun, Chlceno Q Aalen Indian 0 NKIw Newallan Asbcleb deiro• 1•.B• AA, As) O Yaa, Puartb Riven Q Chinese ~ Guamanian or Chamort0 S MchalOr'a tlairoe (•.i. BA, A8, BS) ~ Vas. Cuhan Q Flliplne Q Samoan Heater's derive (e.i. MA, MS, MEnB, MEd, M$W, MBA) O V•+, other Spenlah/MHpanl4LS[Ino ~ lePaneae ~ O[Wr psclflc Islantlsr Ooeeereb (•.6. PIID, EAD) or Prohaaional dairae (Specify) [] Other (Specfy) . MD ODS OVM LLB J 11. O•CedenllSlntM Rece Sel -D•slinKlon -Check ONLY ONE to indicate what the deceaen< conaitlere hlmaeli or hlrself to be. 22a. Dewdent's Usual OccupeNOn - Indicate NPe of work 0 White Q Japanass Q Samoan tlbne aurlni moat bf worKin[ Ilfs. DO NOT US! RETIRED. (~ Black Or AMUn American O Kgreen O Other Peclflc islander (]Amancan lndlen Or AlaaW NKlva QVlafnamKe DOOn't Know/NO<SUro Admiaiatrativs AselatanL Q Nlen Inalen Q Other Alan ~ Refuaatl 336. Klntl of Buslnatz/Indus[ry Q Chlnes• O NatlVa N•wallen O OM•r (SPecIN) ~Flllpinp (~GUamanlanp CWmvrro State fsOYS1rntffent MP 2 e. to Proneune ee o ay r 23 tNturo b n PrenOYncini of n y w •n evp 10 a c, cenw um er ara0 '- i.~PllteON WNO PRONOUNCLB OR ~ ~~ Z~ < ~ r 7<-- Date slimed (MO/Day ) 24. nme of t JE./17a 7 ~ 33 . ~~ e',Zo( a- •~ S S 23. Was Mn Cal Examiner or COrbner COnbcTea? Yaa No CAUSE OF DEATH Appwxlm.t. 26. Pert I. Enta! the rhaln of avenb--dKeams, InluNaa, er rompllcKlons--thK diroctly caused the death. DO NOT •nbr brminal events such as caralac arras[ Inbrval: BV. DO NOT ABBRE VI TE. Enter only bn• uusa On • IMe. Add addltlonal Ilnsf If nsNaaary ~ Onset Co Death respiratory arrert, Or wntneular flbrlllatlen without ahowlni Me sLlol A /I /^ ~- ~ IMMEDIATE GUSE ----------> e. `)Yal~fQ45-{seftL O YirQS'h (~ Ce fFln•I tliseese or condition Due to far as a cpnbgwnce oh: reaultlni In death) b. SnqunKlally lint wndKlons, Dua tb (Or as s consequence of): If any, laadlnt to the cnusa IKba en Ilrn a. Eller the c. i UNDERLYING GYBC Due to IOY as • ronsequenc• P~: (aluaaa or Injury MK i In KOtetl the swnb roultlnB tl. In death) LAST. Due eo (er as • tanaequanw of): y~ 2B. Pirt II. Enter otMr but not raauKlnB In t e underlYlnE Cause liven in Part 1 2J. Waa an eutoPsV PerformedT $ V•s Ne S e 28. Wsro Wtepry ftndmis eyall•bls to tamPtK• Chs cause et MaMT p Ysa NP p : 9. I Femeln: 3D. Did Tebecco Uae ConCrlbutn to OaKhT S3. Msnner of O••[II a S Not Pr•tnant wKltlfi Past Year 0 Yes Q Probably atural O Hemlcide a 3 Preirlant et Hms Of dee<h ~ No ~ Unknown ~ Acclaen[ ~ Penalnl Investll•[lon ~' ~ Not proinant, but proinenf Within 42 aaYS of death (~ Suicide d Ceuld nbt b• Oatarminsa Q Net pre(nent, but prainent 43 dsri to 3 year b•fors death 32. Dats of Injury (Me/D•Y/Yrj (Spell Month Unknown N Proinanf within tM Past war 33. Tlma of Injury 4. Place el lnJury e.i. hems; conaTYUCtIOn altei hrm: acheei) 35. Lecatlon o Injury lStMet antl Number, Clty, State, ZiP Cbae) 36. Injury et Ork 97. HTrenaPPrtetlen Injury, Specify: 38. CJ•sGMba How Inury Occurrsd: V•s Q DrlVer/Operator 0 PadKMan 0 No ~ P•ssnniK O Other (SPecIN) 39a. Csrtl b C •ck P ly one): ' nrtlNlni Physlcl n -TO the WK of my knowleai• death occurred tlua tv [fie cause(s) and manner stated Pronounclni i GRINIn{ p1,Wiclan - Tp the Wet of my knowledq, dsKh occurraa K the rims, sate, and piece, antl du<b !ha cause(s) .na manner mtaa ~ Maalul Examiner/COron•r - On tfie WsU xamin•tlOn, anaJvr Ihyestlptien, In my opinion, death oeeurretl at the Uma, acts, antl piece, ana dw t0 the cause(s) ana mepner stated L ! p ` •t7 Title OT certifier: rt•"~ Ucense Number: ~"~1 b L~ ~• b C Sline<Yfe OF cerNfler: 39b. Name, Addrou an P C PnraOn pNtlni fiu» of Death (Item 261 l aC L N 3E1ruyA Sac. sb lined IMO/DaY/Yf) • strafe aL Ct Ym ar 1. RaB a[rKf IinatY yJ~ 2. e{lairar. DaY OOW 43. Amendments O~ ~Ot3 w' HIOS-143 DHposlden permit No. OT1D REV OJ/2011 /a- ~3 a C_.) G > :: i I.~. ; . ,~,; , -, ~--; -~~ ~~ .:s- C7 ;.~. LAST WILL AND TESTAMENT -~ ~~~~ OF ~~~ ANN M. MUELLER I, ANN M. MUELLER, of the Commonwealth of Pennsylvania, being of sound mind, and understanding, do make and publish this, my Last Will and Testament, hereby and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Executor to pay all my legally enforceable funeral expenses, administration expenses, and inheritance, estate, succession or excise which I owe or may become due on account of my death, as soon as may be convenient my decease. SECOND: I give, devise and bequeath all of my property, be it real, personal and whatsoever or wheresoever the same may be situate at the time of my death to my band, MARKUS R MUELLER, if he survives me. THIRD: In the event my husband, MARKUS R MUELLER, predeceases me, I devise and bequeath all of ~Y, property,. be it Zeal, perso}~a- and ,mixed whatsoever or the same may be situate at the time of rr~y d,,eath~Fto my ~~aughter, JENNA THERINE MUELLER, providing sloe has atkai~e tlle~e of twst~tlw~te (2,() years a; the of my death. In the event my daughter, JENNA CATHERINE MUELLER, has not the age of twenty-one (ll) years at the time of my death, I direct that her share of my shall pass In Trust as set forth in Paragraph Fourth of this, my Last Will and Testament. GREGORY M. KERWIN ,.. TERRENCE J. KERWIN +~ % '» ~ 4 JOSEPH ~. KERWIN age 1 of 3 Pages (SEAL) HOLLY MCGLURE KERWIN ANN M. MUELLER ATTORNEYS AT LAW FOURTH: In the event my husband, MARKUS R. MUELLER, predeceases me and my daughter, JENNA CATHERINE MUELLER, has not. attained the age of twenty-one (Z1) at the time of my death, then I nominate, constitute and appoint WILLIAM BALCHUNAS and MELANIE BALCHUNAS as Co-Trustees for the benefit of my daughter, JENNA CATHERINE MUELLER. I authorize WILLIAM BALCHUNAS and MELANIE BALCHUNAS, as Co-Trustees, to expend so much from the principal and/or income of the Trust as may be necessary in their sole discretion for the health, education and support of my daughter, JENNA CATHERINE MUELLER. The Trust created herein shall terminate when my daughter attains the age of twenty-one (ZI) years, at which time the remaining principal and any accumulated income shall be paid to said child outright. FIFTH: In the event my husband, MARKUS R. MUELLER, predeceases me and my daughter, JENNA CATHERINE MUELLER, has not attained the age of eighteen (18) years at the time of my death, then I nominate, constitute and appoint WII.LIAM BALCHUNAS and MELANIE BALCHUNAS as Co-Guardians of the Person of my daughter, JENNA CATHERINE MUELLER. SIXTH: I nominate, constitute and appoint my husband, MARKUS R. MUELLER, as Executor of this, my Last Will and Testament, authorizing and empowering him to sell and convey any and all real estate which I own at the time of my death. In the event my MARKUS R. MUELLER, predeceases me or is unable or unwilling to serve as of this, my Last Will and Testament, then I nominate, constitute and appoint BALCHUNAS and MELANIE BALCHUNAS as Co-Executors of this, my Last GREGORY M. KERWIN TERRENGE J. KERWIN JOBEPN D. KERWIN HOLLY MCCLURE KERWIN ATTORNEYS AT LAW Will and Testament. 2 of 3 Pages ~~% ~C ~~~~~~~ (SEAL) A M. MUELLER I further direct that my Executor or personal representative shall not be required to post bond to act in said capacity. IN WITNESS WHEREOF, I, ANN M. MUELLER, have hereunto set my hand and seal, GREGORY M. KERWIN TERRENCE J. KERWIN JOSEPH D. KERWIN HOLLY MCCLURE KERWIN ATTORNEYS AT LAW to this, my Last Will and Testament, this L day of ~ ~ ~ , 2008. SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testatrix, ANN M. MUELLER, as and for her Last Will and Testament, in the presence of us, who at her request and in the presence of each other, have hereunto set our names as witnesses: ~vC • (SEAL) ANN M. MUELLER F Pag ~ f 3 Pa~es D: \PJW\NILL\>hueller. Ann. wpd OATH OF SUBSCRIBING WITNE~~~S~ ~ ~ ~~ ~. 5~ G~E~tK Cc REGISTER OF WILLS ,tt~~p~~J~S COUa~ CUMBERLAND COUNTY, PENNSYLVA'NIRi`~~ Gtr-. PA Estate of ANN M, MUELLER TERRENCE J. KERWIN and JOSEPH D. KERWIN (each) a subscribing witness to (Print Name/sf theme Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that ~/ they vaxt/were present and saw the above r /Testatrix sign the same and that >k+s/they signed the same and that ~lns6cl~z/they sjgneyt'as a witness at the request of the ~Tcalat~d Testatrix in her / kus presence and in the presen of aGh other. ~~- ~ _ (Sigmtturef T E E J. KERWIN (Signature) H D. KERWIN 276 Wagon Road 100 ri Road (Street Address) (Street Address Millersburg, PA 17061 (City, Stare, ZipJ Lvkens. PA- 17048 (City, State, Zip) Deceased Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register o TH OF PENNSYLVANIA NaarW Sad nna a uoyd. Hoary PubNc waahkgmn'rwp., ot+v~+~Y My CommNabn Fxptss Spt 15, 2015 hAsrttbrr at Pleatias Executed out of Register's Office Sworn to or affirmed and subscribed before me this 4th day of __April 2012 otar Public `~~~~ Y My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized [o administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. !0. /3.06 KERWIN & KERWIN, LLP ATTORNEYS AT LAW 4243 ROUTE 209 GOVERNORS' ROW ELIZABETHVII.LE, PA 17023 27 NORTH FRONT STREET _ HARRIS$URG, PA 17101 (717)362-3213 _ (717)896.9089 (717)238-4763 FAX (717) 362-4439 Pleare Reply To: 0 ELIZABETHVH.LE OFFICE April 4, 2012 Register of Wills of Cumberland County CUMBERLAND COUNTY COURTHOUSE 1 Courthouse Square Carlisle, PA 17013-3387 Re: The Estate of Ann M. Mueller Dear Sir or Madam: PATRICK E. KERWIN (1913-1997) GREGORYM.KERWIN- GMKERWINQAotmai6com TERRENCE J. KERWIN - TjK~Kerwinlawtirm.com JOSEPH D. KERWDV - JDKQKerwialawllrm.com HOLLYMcCLURE KERWIN-HMKQa Kerwinl~rvfirm.eom As per your request, please find enclosed herewith the Oath of Subscribing Witness for the Estate of Ann M. Mueller. In the event you require any additional information, please advise. Very truly yours, ~~. TERRENCE J. KERWIN TJK:tII Enclosure