Loading...
HomeMy WebLinkAbout04-19-12PETITION 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) thl following and respectfully requests the grant of Letters in the appropriate form: Linda M. Walke Decedent's Information File No: 21 -12 ~(~' Name: Lillian M Malachowski (Assigned by Register) a/k/a: alk/a: Social Security No: a!kla: Age at Death: 79 Date of Death: 0410212012 County, pA (State) with hislher last Decedent was domiciled at death in Cumberland Lower Allen Cumberland principal residence at 325 Wesle Drive, A lftment 3319, Mechanicsbur 17055 c;ry, Township or Borough county Street address, Post Office and Zip Code Cumberland PA Decedent died at 325 Wesley Drive, Apartment 3319, Mechanicsburg 17055 cry eo mahlp or Borough county state Street address, Post Office end Zip Code Estimate of value of decedent's property at death: $ 194,000.00 Ndomiciled in Pennsylvania ........................ All personal property If not domiciled in Pennsylvania ................. Personal property in Pennsylvania $ If not domiciled in Pennsylvania ................. Personal property in County $ Value of real estate in Pennsylvania........... TOTAL ESTIMATED VALUES 194,000.00 Real estate in Pennsylvania situated at (Attach additional streets, ff necessary.) County City, Township or Borough Street addr~sa, Pbat Office arW Zap Code QX A. Petition for Probate and Grant of Letters Testaments 01127-2009 and Codicil(s) Petitioner(s) aver(s) that helshe/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated (State rele((v)ant circumstances, e.g., renunciation, death o/executor, etc.) p rty dlvoroeapsoceeding wher~eln the ggurounds f~oe.divorce hadsbeeftn establishedaas defnedent23 Pa.tC.S.~§~3323(g)tand did nit have a chadbom ofending adopted; and Decedent was neither the victim of a killing nor ever ad)udicated an incapacitated person. QX NO EXCEPTIONS Q EXCEPTIONS (If applicable) ^ B. Petition for Grant of Letters of Administration c a ; ~.; , .n.c..a.; pe en a e; uran a sen la; uran a mino a If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above and comulete list of heirs. ~,..> Except as follows: Decedent was not a party to.pending divorce proceedingg wherein the,grounds for divorce had been established as defined in 23 Pa. C.S. § 3323 (g) and was neither the victim of a kliling nor ever adjudicated an Incapacitated person. O r,.a QX NO EXCEPTIONS Q EXCEPTIONS r1 ~ ~7 Petitioner(s), after a proper search haslhave ascertained that Deoedefd left no Will and was survived by the following spouse (if any) and heiA ~~ ~. r i T, additional sheets, if necessary): _y ~; j ~ ~ r s,.-! Page 1 of 2 Form RW-02 2v. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc:. Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } r ~ , , ~ ~..~~ Q~ couNTY of Cumberland } ss: - _ ~,~ Petitioner(s) Printed Name } +~ Petitioner(s) Printed Address Linda M. Walke 5081 Carrollton Drive W Harrisburg, PA 17112 O~ Clr~~1E{ ~~ ~; .r - C~; Pq the in th~edforegP belief of tPetttioner(sj and that a Personal Rep eseritative(sj of t ionerts) a l! tr II a d adm is b , Sworn to or affirmed and ubscribed before met ' ~ da of _~V ~ _ e it i n truy n te the estate according to law. Date 2 By: ~ ~ 6~-~ Date F rtheRegister Date Date BOND Required? ~ Yes No To the Register ofWi!ls: FEES Letters ~~~ Please enter my appearance by m y signature below: ................. $ I ~) Short Certificate(s Attorney Signature: ).......... ~ -° I )Renunciation(s) ............... , /1 _ ,~. M~a+ ( )Codicil(s) ......................... Affidavit(s) ....................... Bond .............................................. Printed Name: Debra K Wallet Commiss'o ................................... Supreme Court Other i ~ ~ ~ _ ID Number: 23989 Firm Name: Law Offices of Debra K. Wallet Address: 24 North 32nd Street Camp Hill, PA 17011 Automation Fee... .......................... Phone: 717/737-1300 JCS Fee ......................................... ~ • Fax: 717!761-5319 TOTAL ........................................... $ E-mail: walletdeb~aol.com DECREE OF THE REGISTER Date of Death: 04!02/2012 Estate of Lillian M Malachowski Social Security No: 165-26-5337 a/k/a: File No: 21 -12 / ~ AND NOW, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary ~ in consideration of the foregoing Petition are hereby granted to Linda M. Walke in the above estate and (if applicable) that the instrument(s) dated n~ „„~nr,e described in the Petition be admitted to probate and filed of H105.805 REV (on n ~f~F.~ ~~~C6TRAR'S CERTIFICATION OF DEATH ~(AR~gIVG, lt';il~~1'~egal to duplicate this copy by photostat or photograph. I I l_ .~:,., i _ .. Fee for this certificate, $6. ~ ~ ,.' ~ ~~ ~~~ ~ 9 ~~~~ "~ ~ J This ;is to certify that the information here given is correctly copied from an original Certificate of Death CL~RK ~~ duly filed with me as Local Registrar. The original ~~P~t(~j'S Ct~URT certificate will be forwarded to the State Vital ~~ PA Records Office for permanent filing. P 18 4 7 4 7 7 ~F~'! P.r~n c, ` Certification Number ~ ~ ~{ / Type/Prln[ In Local Re istrar Date Issued Permanent COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS Black Ink CERTIFICATE OF DEATH 1. Decedent's Legal Name (First, Mlddie, Last, Suffix) State File Number: Lillian M. Ma 18chOwa ki 2. Sex 3. Social security Number 4. Date of Death (MO/Day r) (Spell Mo) sa. Age-Last 9lrtha.y (yrs) sb. under 1 y..r s~ ,,...._....__. _ _ Female 165-26-5337 w__. , .. ___ _ ^ Yes ®No ^ Unknown ~_ Divorced Q Never Married ^ Unknown r.:, decedent uyad In Lr~er Allen trop. No, tlepdent Ilved withln Ilmits of g Mra . Linda M. Welke - ~-- ~~~~--'~""~~ `° ~°C°Of°t 14c. Inro mant' - r Da ................................. I D u hter- :n-: aw SOt3l Carols $ J ~ yy eath Occurred In a Hos Pital: IJ Inpatient ~ •"'~•~••~•~• Emergency Room/OUtpatieni Oead on Arrival .....' o r ••~•- -••><.... ,eat on One ilf Daet11 Occurred Somewhere Othe~Than a'! `a~ . 15 b. Facility Nama (If hoe Instltutlon, glue street and number; Nursing Homa/Long-Term Care Facill 325 Wes le Drive A t . 3319 1st. city or Town, st.e., .nd zIP c°d. 16a. Method of Oispositlon Burial Q ® Cremati MCChanc isbur PA 17055 on ^ Removal hom Sbte O Donation Other (SpecHy) 166. Data of Dlsposltion i6c. Place of Dis{ 16d. Location o} Dlspositlon Clty or Tow S Apri 4, 2012 Cremation n, tate, and ZIp) Harrisburg PA 17109 17a si t e of Funeral sarviy~[~t.p'.! or~ ' ' , / 1'lc. Name and Complete Address o1 Funeral Facility Auer Cremation Servic £ ( / ~ ~' es o Pennsylvania Inc. 4100 Jonestown Road 18. Decedent's Education -Ch k ec the box ihst best describes the highest degree or level of school com l t d 19. Decedent of Hispanic Origin -Check the p e e at She time of death. Q 6th grade or less box that best describes whetMr the decedent ^ No diploma, 9th - 12th grade ^ Hi h h is Spanish/HlspanlULatino. Check the "NO" box if decedent I g sc ool graduate or GED completed s not s panish/HbpanlULatino. ®N Q Some college credk, but no tlegree o, not 5 Ish/His Pan Panic/4tino ® Associate degree (e.g. AA, AS) ^ Yes, Mexican, Mexitan American, Chicano ^ Bachelor's degree (e.g. BA, Ag, g5) Q Yes, Puerto Rican ^ Master's degree (e.g. MA, MS, MEng, MEd, MS W, MBA ) ^ yes, Cuban Q Yes th ^ Doctorate (e. PhD, EtlD B~ ) or Profesalonal degree , o er spanlsh/Hlspanlc/Latino e. MD DOS OVM LLB ID (Specify) 21. Decedent's single Race Self-Designation -Check ONLY ONE to indicate what the decadent considered himself or h ® White ^ Japanese Q Black or African American ^ Korean ^ Samoan ^ American Indlen or Alaska Natlye ^ Vletn•mese ^ Other Pacinc Islander Q Asian Indlen ^ Other Asian Q Don't Know/Not Sure Q Chinese ^ Native Hawaiian ^ Filipino ^ Refused ^ Other (specify) ^ Guamanian or Chemorro (u yy~ a7. a 2a. Decedent s Usual Occupation -Indicate type of roots one during most of working Ilfe. DO NOT USE RETIRED. A.egistered Nurse 26. Part 1. Enter the chain of t --diseases, Injurlea, or complicatlOns' that dl~ectVr YCA 11Y respiratory arrest, or ventrtcular flbrlllatlon without showing the atiolo Y causatl the death. DO NOT enter terminal events such as cardlsc arrest ~! /t By. DO NOT ABBREVIATE. Enter only one cause on a line. Add •dditlonal Imes if necessary IMMEDIATE CAUSE _______________> a. ~i 'J GT~ S ( /T r'~ C mAL((s~{V ~}(y-T ~42G1 IVpt (~ (Final disease or condition Due t0 (or as a co reswnng in death) nsaquence ot): b. Sequentially list conditions, Due to (or sequence of): if anY. leading to the cause as a con ItsMd on line a. Enter the UNDERLYING CUBE (tlisease or Injury that Due to (or as a consequence of): Initiated the events resulting d, In death) LAST. Due to (or as a consequence O/)• 26. Part Ii. Enter other Ir iti t ditl t Ib tl t h but not resultine in eh. I p not pregnant withln past year ~ °°acco use Contribute to Death? -r' ^ NO chant at time of tleath ^ Yea ^ Probably I _ Q pregnant, but pregnant within 42 days of death ~~NO )^ Unknown Q Not pregnant, but pregnant 43 dayc to 1 year before death 32. Date of In u Q Unknown If pregnant withln the past year ) ry (MO/Day r) (Spell Month) Approximate interval: Onset to Death 'r,~~eay4 to complete the rouse of death? natural ^ Homlclde Accident Q Pending Investiptlon swtme p coma not be determined yes -~ "~ I38. Describe How Injury Oeeurrod: No O PH Set/` Perator ^ Pedestrian _ O other (specify) In (cn k ly ) n Certifying physlclan - To the best of my knowledge, death occurred due to She cause(s) and manner stated ^ Pronouncing 14 Certifying physlclan - To the best of my knowledge, death occurred at the isms, date, and place, and due to the eau se(s) and manner stated ^ Medical Examiner/Coroner - On the basis o1 examination,/endue/or investiption, In my opinion, death occurred at the time, data, and place, and due to the cause(s) and manner stated Signature of certifier:_ /7l~ Title of certl/let: ~t D b. Name, Address and Zlp Code Of Person Completing Cause of Death (Item 26) License Number:_ n~ Q Q 1(~j fy~ ,/ot mYq 1 ~ ii'at 1 d•l' titY 3 N S"~ TY7'rtGl C.e ~G1 CG m i~7'! t %~et I `l v t ( 39c. Date Signed (MO/DaV/Yr) . Registrar's District Num 41. Registrar's Slgn~ure ~ /7 ^ A ~ U (3 20 1 i-- of PA 753 to Indicate what the decedent considered himself or her elf to be ® White , ^ Korean (~ Black or African gmerican Q Vietnamese Q American Indian or Alaska Native ^ Other Asian ^ Asian Indlen ^ Chinese ^ Native Hawallan ^ Filipino Q Guamanian or Chemorro ^ Japanese ^ Samoan ^ Q Other Pacinc Islander Other (SpecHy) Disposiflon Permit No. V 1 "'T (~~~~ H105-143 REV 07/2011 ]LAS°~ W~g,~, AI~g~ ~]ES~AI~][]E~T7C ~ .~ ,_.. .. ®~ =o `~' ~~ ',_ J ~ r -au ' ~ ~? : t; =;~ ~, D --1 ~~ C^ I, LILLIAN M. MALACI-IOWSKI, of Mechanicsburg, Cumberland County, L~ Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils that I have made, including the Will dated January 26, 1998. FIRST: All of my Estate, of whatever nature and wherever situate, I give, devise, and bequeath, in equal shares, to the following individuals who shall survive me by thirty (30) days: my son, TED R. WALKE, of Harrisburg, Pennsylvania; m dau hter T Y g INA McNAUGHTON, of New Oxford, Pennsylvania; my daughter, DEBRA D . WALKE, of Dallas, Texas; my daughter, DIANA L. WALKE, of San Francisco, California; my . granddaughter, MEGAN C. WALKS, of Harrisburg, Pennsylvania; my grandson, BENJAMIN R. WALKS, of Harrisburg, Pennsylvania; my granddaughter, ABIGAIL J. `~ WALKS, of Harrisburg, Pennsylvania; and one share to any grandchildren born after the date of this Will but before the date of my death. Should any of my beneficiaries fail to survive me by thirty (30) days, then this beneficiary's share is to be re-divided among my surviving beneficiaries listed in this paragraph. SE_: If any portion of my Estate shall be payable to a beneficiary who is less than eighteen (18) years of age, my Executrix may pay such share to the beneficiary's parent - =f .~ -. ;'_. -r: ~ ~- f.-'• :. _, :~ C~ {'.J or guardian, as custodian for said minor, who shall deposit such share in the minor's name in a Uniform Gift to Minors' Act account in a savings institution of the Executrix's choosin g~ payable to the minor at majority. THIRD: All interests of any beneficiary in the income o~° principal of this Estate, while undistributed and in the possession of my Executrix, even though vested and distributable, shall not be subject to attachment, execution or sequestr;~tion for any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. FO- H: All inheritance, estate, and succession taxes (including interest and an Y penalties thereon) payable by reason of my death shall be paid out of and be charged generall against the principal of my residuary estate, without apportionment or r•i ht of y g reimbursement from any person. In the event that a substantial portion, as determined in the sole and absolute judgment and discretion of my Executrix, of the non-probate assets such as an annuit or Y mutual funds are directed to be paid to a beneficiary or beneficiaries, so that the taxes referred to herein would be paid out of the probate residue passing to the beneficiary or beneficiaries of this will (whether or not the same as the beneficiary or beneficiaries under the non-probate assets), my Executrix, in the Executrix's sole and absolute judgment and discretion, shall have the right to allocate the full or partial payment of the taxes to the beneficiary or beneficiaries of the non-probate assets. FIFTH: In addition to all rights and powers conferred by law, I authorize and empower my Executrix and her successors, in her absolute discretion and without necessity of obtaining court approval: A• To buy investments at a premium or discount. B • To hold property unregistered or in the name of a nominee. C• To give proxies, both ministerial and discretionary. D• To compromise claims. E• To join any merger, consolidation, reorganization, voting trust plan, or any other concerted action of security holders and to delegate discretionar duties Y wrth respect thereto. F• To lend to, and buy from, my estate. G• To borrow and to pledge real and personal property as security therefor. H• To sell at public or private sale for cash or credit: or partly for each, to exchange, or to lease for any period of time, any real or personal property, and to ive o do g p ns for sales, exchanges, or leases. I• To exercise any option permitted by law which she believes to be advantageous from the viewpoint of overall tax reductions, including, without limitation o f the foregoing, power and authority to claim administration or other expenses either as inco me tax deductions or inheritance or estate tax deductions, without regard to whether the were Y paid from principal or income and without requiring adjustments between principal and inco me for any resulting effect on income or estate taxes, and a deduction of such expenses for income tax purposes shall be given effect in computing the respective shares of all persons interested in my estate set forth herein, even though the effect is to increase the share of one beneficiar or class of beneficiaries hereunder at the expense of another; and to make such Y adjustments, if any, between beneficiaries with respect thereto as she shall deem appropriate in view of the nature of tree transaction and the amounts involved. J. K. To distribute in cash or in kind or partly in each. To employ agents, legal counsel, brokers, and assistants, and to pay their fees and expenses as she may deem necessary or advisable to carry out the provisions oft his Will or any Trust. The powers granted hereunder shall be exercisable with respect to all real and personal property, including, but not limited to, income and principal held for :minors or disabled beneficiaries at any time, until the actual distribution of all property. .All powers, authoriti es and discretion granted here shall be in addition to those granted by law and shall be exercisabl e without leave of court. However, nothing herein shall be interpreted ar construed to encourage, authorize, empower, or permit the Executrix to act or causf; anyone to act in a manner contrary to or inconsistent with accepted standards of portfolio diversification and risk management. SIXTH: I nominate, constitute, and appoint my daughter-in-law, LINDA M. WALKE, of Harrisburg, Pennsylvania, as Executrix of this, my Last Will and Testament . In the event of the renunciation, death, resignation, or inability of my daughter-in-law to act f or whatever reason in this capacity, then I nominate, constitute, and appoint my dau hter TI g NA McNAUGHTON, as Executrix of this, my Last Will and Testament. I direct that no representative named above shall be required to post security for the faithful performance of her duties in any jurisdiction insofar as I am able by law to relie ve her of such obligation. Any of my representatives shall be entitled to reasonable coin ensatio P n for the performance of the duties set forth here. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ ~ ~RNKA~~ day of 2009, on this, the fifth of five typewritten pages. I have also signed the left-hand margin of the first four of these pages for purposes of identification onl Y• i LILLIAN M. MALACHOWS~ SIGNED, PUBLISHED, and DECLARED by the Testatrix, LILLIAN M. MALACHOWS~, as her Last Will and Testament, in the presence of us, who at h er request, in her presence, and in the presence of each other, have hereunto subscribed our n ames as witnesses. ~~ ~ litw/di s,,,~j J~(„ ~h~,~ic~s,Lw•S `~A 1~oSS 7'7-l ,c ~ D ~~ /~ C/ ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, LILLIAN M. MALACHOWSIG, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I si ned and executed the instrument as my Last Will and Testament; that I si ;ned i g g t willmgly; and that I signed it as my free and voluntary act for the purposes therein expressed. .~ LILLIAN M. MALACHOWSKI Sworn or affirmed to and subscribed before me by LILLIAN M. MALACHOWS~, the Testatrix, this v'_=7~ day of ~~~ Y'`j , 2009, Notary Pub c COMMONWEALTH OF PENNSYLVANIA Notarial Seal Mary M. Loper Notary Ptd~c Carnp FNA 13oro, Cumbertar>d Cotx~My My Commissiort E~ires Oct 27.2011 Member, Pennsylvania As:>ociation of Notaries AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Debra K. Wallet and ~iq~, rn' ~-~ ~~ ,the witnesses whose names are signed to the attached instrument, being duly qualified according to law, depose and sa that we were present and saw the Testatrix, LILLIAN M. MALACHOWSKI y sign and execute the instrument as her Last Will and Testament; that she executed it as :her free and volunt ary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatr' ix signed the Will as witnesses; and that, to the best of our knowledge, the Testatrix was a t that time 18 years of age or older, of sound mind, and under no constraint or undue influent e. ~Pµ+c 1C - L- ~... ~,,.d-~z,_ ~~- Sworn or affirmed to and subscribed before me by ~ ~ ` • and -~ ~ • ~ a ih r, ,witnesses, this --~~ day of ~~ r v , 2009. Notary Publi COMMONWEALTH OF PENNSYLVANIA Notarial Seal ~+ M• Lam. Notary PubNc Camp hfi'~ Bono, C~xnberiar`b Cour>~- MY Commission E~ires Oct 27, 2011 Member, Pennsylvania Association of Notaries