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HomeMy WebLinkAbout04-20-12REGISTER OF WILL Y, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in st:pport thereof aver(s) the following and respectfully request(s) tha grant of Letters in the appropriate form: Decedent's Information --~- -+ (' (A N c( Na a/k/a: E.~ r ,1 y ~ K t: > O File No• _ ~ ` ~ t y- V ~ / (Assigned by Register) a/k/a: a/k/a. Social Security No: ~ r ~ ' ~ } 6 - (~ ~ ~'y• Date of Death: $ u N ~ i --1 1 bra l/ Age at death: ,3 Decedent was domiciled at death in ~ u~~'~ n 1.~~~ County, ~=RNs ~ r'v.~,~,,~ (stare) with his/her last principal residence at ~' u °~l (}2~ Kr ( (~ ((s /{ ~~ d .~ tVr.J e u w./~c 2 I.~,-;~ C' use,-tih~d Street address, Post Office and Ztp Code City, Township or Borough Count Y Decedent died at ~-j ~~ ~ a~ s /~ u.ii, ~~~' pt_ t~+ I ~ ~~ ~ 2,'1 i S •3 4 ~7 6~ 1~ -4. ~,c. /'12 ~ N. ~,~ i Street address, Post Office and 7rp Code Ctty, Townshtp or Borough County State Estimate of value of decedent's roe ~,~ ~ >r t p p rty at death: If domiciled in Pennsylvania ............................ All personal property $ ~ ~ ~~ ~ q) 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 VALUE.... $ ; .: - ~ z%~ s ~. o.^ ~ ~C /_ Real estate in Pennsylvania situated at: I UC' ~ I .~~ k tz{ 1 I ~ ~ (5 ~~V ~, _ t ,U+~ ~,J ~~~; n l ~ ~~ `~i ~ ~ d (Attach additional sheets, i(necessary.) Street address, Post Office and Ztp Code ~ City, Township or Borough Count Y ^` ~ A. Petition for Probate and Grant of Letters Testamentar ,- - ~ Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated ~~ i ~ ~ ~ ~°~ "~ thereto dated and Codicil(s) ---- -,-. 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 ma ~ ~' ~ "~'} ~ `' rry, was not divoreE~ii~ot a p~ to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), aill$ ~t haveschild bocn-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) -v "' _ `,, c. t. a., d. b. n., d.b.n.c.t.a., pendente life, durante absentia, duti7rtte minoritate If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and com fete 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 _ PETITIO~ FOR GRANT O LETTERS S OF Y?'I ~r COUNT Form RW-02 rev. !0/!!/1011 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, iJ necessary): Oath of Personal Representative COi~T~iONWE.aLTFi OF Pfi~iNSYLV.aNIA } } SS: COL'VT1' OF , .r.. s'"~ ' : OfficiatU9e,'Ptt• ,;% r '~ L U f ~ ~' is 4 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 to law. Sworn to or firmed a d subsc 'bed before L.->,1~~:--- 3 t._~i ~ , ~ ~ /iz me this ' ~ ay f ~,~ ~~ ~ Date By. Date Date a,.~ _or e Register ~ Date BOND Required: AYES ~NO FEES: Letters .................... ( ~l~) Short Certificate(s).... .. ~ .~ .. t- . ( )Renunciation(s)....... . . ( )Codicil(s) ........... . . ( )Affidavit(s).......... . . Bond ...................... .. Commissi ~.~ .............. Other .. --~- ~ .... .. ~ , o-c~ ........ Automation Fee .............. . JCS Fee . .................. TOTAL ..................... $=~I 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 of _ ~111~-~ ' lJ -~' P1~ I ,tll(.tU File No: ~j ' / c~ ~ ~ ~J ,S a/k/a: AND NOW, ' - !,~ ~ I ~ ~)~(~ , in consideration oft foregoing Petition, satisfactory proof having een presented before me, IT IS DECREED at Letters ` t'S-rLi`'%~~~c~~ are hereby granted to (~J j ' in the above estate and (if applicable) that the instrument(s) dated (~ Up described in the Petition be admitted to bate and filed of record as the last Will (a Codicil(s)) of Decedent. 7"~~ ~ egister of Wills ~ ~~ Form R4V-OZ rev. 10/!1/10/1 Page 2 of 2 carne v c ~c~~ .~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.00 P 17557017___ Certification Number 3 REV 11f2006 /PRINT IN iMANENT ACK INK 'I~hi~ is to ccrtii~ tlr~n the information here given is L~nrrectly alpied lilvn ale original Certii~icate of Death duly filed ~~~ith rite a~ Local Registrar. The original c~rtificatc ~~~ill he forwarded to the State Vital l~ecrn-ds (')fli:c~ fur hcrlnanent filing. JU 2 2 2011 ,~ _oca Re~rt. tray - ate Issued ~ _. x~ ~' ~~) ~O x.: - ~. _~; X;c'~ ~ ~:, b C` "Ti F COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH fSee Instruetlone and e:eemnlwa nn twvnee nl 1. Name of Daudem (Flret, middle, lea; eulAx Be~ty Lee Blando 2. Sex female 3. Sadal Security Number " 1 c r Lc IY V m 314 - 36- 6185 1. n of Deem (Nhnm, tley„ r ~ / 5. Age (Leer Birthtley) under 1 er Umler 1 B. Data of Bkm Mamh de 7. Bi and amts ar for ei coca W . Place of Death Chxk one Hours tA~ Other ~'e Hoe dal: 7 3 v,s u g . 2 8 , 1 9 3 7 Goshen ,Indiana Irgatlent ^ ER r oumaW", ^ DoA ^ Nursing Home ^ Resitlence ^ other - Spedly Bb. County of Deem Bc. City, Born, Twp. d Deem Bd. Fedsly Name (N not IrulmNm, give easel and number) 9. Wes Decedent of Hiapank Origar? No ^Ves 10. Race: American IMian, Black, While ek. , Isve~M Dauphin Harrisbur Harrisbur Hos tat ("r°°''D°~c"~"' 9 9 P i Martlan, Puerro Rken, etc.) whit e • 11. Decedenya lhwel non IOntl d wok done most d Ne. Do nW stele re 12. Was Decedere aver in ma 13. Decedem'e Eduutbn (Spedhy oMy highest grade corro kted) 14 MarMI Smu M r d N M Khd of Work I k n f B I l U S Arced Forus7 . s: ar e , ever eme4 W l 15. Survrvinq Spouse (II wtle, gwa maiden name) , admen assistance f t o nduany private Indust . . y Elementary / SerxrMery (o-12) College (1d or 5.) x osved' D"r01~ /SP~YJ ^y„ ,~ 12 7 married William Blando 16. Decedents Meirag Adtlreu (street cdy r town, elate, zip cede) Decedents Pennsylvania Did Decedent I ~idB1~ 17a. smle l rve in a 17c ^ vea, Decedent Lived in Twp. 1 0 0 4 Drexel H 111 S Blvd . '~"' Toxmehip? • Cum er t~ ~~ an 17b. Counry 17d.p"iesA lwBd wank, e°L ` New C d I L c y m ha r 1 a n r3 City/Boro 1 B. Famefs Name (Fast mkMle, last suffix) 19. MdWte Name Feat mitlde, maiden sumemeJ Howard Dembufsky ~ Lib y 20e. IMOmneM'e Nama (Type r Pnnt) W 1111 am B 1 a nd0 20b. InkrmeM's Metling Adrness SIreaS dry I town, state. zip coda) l 1004 Drexe Hills B1vd.,New Cumberland,PA17070 218. Method of Deposition ^ Crertbtron ^ Donenon BW I ^ R ih s ~ 21 b. Dale of D'spoatllm (Momh, tley, yearl 21c Place of DbposPoon (Name of cerrehry, cremakry or other guru) 21tl. Location (City /town, state, Tip cods) e emova arn tate wucr,maWnarDeMlonAUmMZM ^ olhx ~ ~ by M,dlul FaaminerlCormeR ^ Yas^ No June 23, 201 1 Tri-County Mem.Gardens Lewisberr PA1 7339 Y / oMtmerel ~ r person ad^9 ae ) 22b. Lcense Number 22c. Name and Adtlreas d FeclNly -013163-L usselman FH&CS,324 Hummel Ave.,Lemoyne,PA17043 nerts 23ea ony when urtllying phyeicyn u not eveiMhle et tlne d deem to 23a. Tome bast of my knowbdge, deem aaurted et me tlrte, date end dace stated. (Signature and tltlel 23b. License Number 23c. Date Sigurd (Monet, tlay. Veer) canny cause of deem. Imm6 2426 moat W corn sled d by parson e4w pronounces deem. 24, Time of Dee ( y ) 2s. Det Dead Momh, da . r ~ 26. Wes Cite Relerted ro Medal Examiner I Coroner rot a Reason Omer man Crematkn or Donation? ~ M. / ^ vas ]^•11G CAUSE OF DEATH (Sea InaWCtbro azempm•) i Approxlmeh imerveC Item 27. Part I: Feder tlm tllein of events - deeases, inpaies, a corrotlcatkns - new rectly~ T emer temtlnal evems suer as cardiac artesl, ~ Onset to Deem rea keto l m l k f Ml Pan II: Enter dMr ~ ~ but not resuning in the undartymg cease given in Pen I 26. Did Tobacco Use Cantrbum to Deam7 ^ ~ ~ m ~ ~ p ry arrea , a ve r ar u i mtlon wkhoul showin me etlol . IkgAEDIATE~ USE (Fmgl disease or . Ves Probabty ^ Unkrgwn o F caldtlan re m deem) ~ a. U. h WI(hl,{) .~j~(/Hn (.l. i ~~ 3 i ~ 29. ~I-I-F~em~sk: Due to (a ea a coreeeuence q: L!i'NOt pregnant within pall year uentlally Ibl conddon.,, it any, b. ~ m the uuee rated an i ^ Pregnant at fime of deem re a. Ertmr UNDERLYING CAUSE Due to (or as s coreequerics off: r ~ ^ Not r p egnanL but pregnant within 42 days (tlleeeee or into met urinated ma ry evenm raeNtlrig N tleam) LAST. o' i of loam Due la (or as a consequence >n: i ^ NM pregnant. bW pregnan143 days ro 1 yssr e. r Wlore seam ^ Unknown if pregnant within are past year 30a Wee an Aulapay 30b, Were Autopsy Fhdkgs 31. Mann r of Deam 32a. Dale d In)ury (MOrM, day, Year) 32b. Deeaibe How Injury Ocarted PenomvM7 Avei4bk Poor to Completion 32c. Place of In Wry: Home, Farts. SbeeL Fadory of Cause of Deem? atural ^ Homkitle , Olfice Building, eM. (SpecilyJ ~,/ ^ Ves Yr7 No ^Ves ^ No ^ AedMml ^ Pending Imeslgation 32d. Time of InjuN 32e. Irryury et Work? 321. II Tramponation Injury /Spern'N/ 32g. Larafion M Injury (Street c ity I sown, state) ^ Suicitle ^ Could Not W Determined M ^Ves ^ No ^ Onvr/Operetor ^ Passenger ^ PerbsMan Omer~speary~ 33e. Certl6er (cherA Dory ors) • CartNylrg phyakmn IPrmkmn cenitying cease of deem when aramer physician has pronourked deem and mmpmtetl rem 23 T h ) 33b Si el end TNe of Certlfier I o t e Wet of my knowbdge, deem occurred sae ro the u uae(e) end manner ae,hled _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • P - '•'1 ronouncing antl cMNykq phyaklsn (Physidan hour pronoundng deem end unllykg to cause of deem) ro tM Wal of mY krw.letlp,, e..th oeourted of me nma, dam, end guru, and sus to tW uuaep) and manner ss amted_ _ _ _ _ _ _ ^ Yedlul Examiner/Coroner _ _ _ _ _ _ _ _ _ _ _ • ~ r ~-• ~ h~ •}~~ UV / 33tl. Date Signed (Month, y, year) /Q~~ ~) I r I [~ l2-l /f ~ On tlm bum of awminaWn and / or InvMlgatkn, In my opinion, death occurtetl N the time, doh, Mtl puree, and dos ro nee uwsp) ertl merpmr e• amlxL ^ ' 31. W arson use of Deem (I 7)~ ~ ,~, / y y ~ / ~ / ~ 35. Reglshar s SI end Dlatrld 38 De Flbd 1 , tlay, year) - laiilaiil~i G ~ ti/' x ° .~ oi c 0 ON/ DisposiHOn Pertnn No. ~ ~ <0~3 G s ;-~, "I~~ r ~ _' V O +v -z-, ..~ - r; r :~7 ~ - _ ti -> Ci7 ~ C:.3 LAST WILL AND TESTAMENT -, ~ ~` BETTY L. BLANDO A -~` `•F' _ `--' I, BETTY L. BLANDO, of the Borough of New Cumberland, County of Cumberland, Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as my Last Will and Testament hereby revoking any and all former wills and any and all codicils thereto, by me at any time heretofore made. ARTICLE 1: FUNERAL AND BURIAL Section 1.01 I direct the payment of my legal debts, uninsured expenses of my last illness and funeral expenses from my estate as soon as practicable after my death. ARTICLE 2: DONATION OF ORGANS AND FUNERAL ARRANGEMENTS ~ Section 2.01 I herein direct my Executor to donate to a medical facility any of my bodily organs that can be utilized for transplant purposes only. Thereafter, I direct my Executor to cremate my remains and inter my remains in the burial plot owned by me in the Tri-County Memorial Gardens Corporation Cemetery located in Newberry Township, York County, Pennsylvania. ARTICLE 3: FAMILY Section 3.01 Husband Surviving. If my husband, WILLIAM BLANDO, survives me by thirty (30) days, then I give, devise and bequeath all of my property, real, personal and of every kind and description, wherever situated, as follows: (A) Specific Bequest. First, I make the following specific bequests: {LO3aoaz3.z} Page 1 of 6 __ _ _.___ (i) I give, devise and bequeath to Antioch College, Yellow Springs, Ohio, all of my shares of stock in General Electric Corporation and all of my shares in the S & S Mutual Fund, provided however that if Antioch College does not have an active and operating undergraduate program in Yellow Springs, Ohio, as of the date of my death, this gift shall lapse and the said shares shall become part of my Residuary Estate. (ii) I give, devise and bequeath unto MRS. PATRICIA SEIB (a/k/a MRS. OLIVER SEIB), of 622 E. Nashville Avenue, Corona, AZ 85641, my Haviland china dishware set of white porcelain with gold-white trim, my crystal, and my grape leaf-plated silverware i ~ set. (B) Residuarv Estate. All of the rest, residue and remainder of my estate I give, devise and bequest to my husband, WILLIAM BLANDO. Section 3.02 Husband Not Surviving. If my said husband fails to survive me by thirty (30) days, I give, devise and bequeath all of my property, real, personal and of every kind and description, wherever situated, in the following shares, to the institutions and individuals listed below: (A) I give, devise and bequeath ten (10%) percent of my estate to ANTIOCH COLLEGE, provided, however, that if Antioch College does not have an active and operating undergraduate program at Yellow Springs, Ohio, as of the date of my death, this gift shall lapse, and the remaining gifts shall {IA340423.2} Page 2 of 6 be adjusted on a pro-rata basis in accordance with the last paragraph of this Section 3.02. (B) I give, devise and bequeath ten (10%) percent of my estate to LOCAL (HARRISBURG AREA) CHAPTER OF THE AMERICAN HEART ASSOCIATION. (C) I give, devise and bequeath ten (10%) percent of my estate to LOCAL (HARRISBURG AREA) CHAPTER OF THE AMERICAN CANCER SOCIETY. (D) I give, devise and bequeath ten (10%) percent of my estate to LOCAL (HARRISBURG AREA) CHAPTER OF THE ALZHEIMERS ASSOCIATION. (E) I give, devise and bequeath ten (10%) percent of my estate to the NEW CUMBERLAND, PENNSYLVANIA, PUBLIC LIBRARY. `\ (F) I give, devise and bequeath ten (10%) percent of my estate to the LOCAL (HARRISBURG AREA) CHAPTER OF THE AMERICAN RED CROSS. (G) I give, devise and bequeath five (5%) percent of my estate to my friend, MS. JANET FONER, of 920 Brandt Avenue, New Cumberland, Pennsylvania 17070; (H) I give, devise and bequeath twenty (20%) of my estate to PINNACLE HEALTH HOSPICE OF HARRISBURG, PENNSYLVANIA. (I) I give, devise and bequeath fifteen (15%) percent of my estate to my sister-in-law, MS. ANGELINE CULFOGIENIS, and my nephew STEVE {L0340423.2} Page 3 of 6 CULFOGIENIS, and my nephew JAMES CULFOGIENIS, who survive me, in equal shares. In the event that any of the beneficiaries listed above in Paragraphs A through I of this Section 3.02 fails to survive me, the share of my estate that would have gone to that beneficiary had that beneficiary survived me shall be pro-rated among the surviving beneficiaries listed in Paragraphs A through I of this Section 3.02 in accordance with their respective shares in my estate. Moreover, if, but only if, all three (3) of the beneficiaries set forth in Paragraph I of this Section 3.02 fail to survive me, the fifteen (15%) percent of my estate that would have been split among such beneficiaries had one or more of them survived me shall be pro-rated among the surviving beneficiaries listed in Paragraphs A through H of this Section 3.02. _~ ~ ARTICLE 4: Executor ~ Section 4.01 I nominate, constitute and appoint my husband, WILLIAM BLANDO, as Executor of this, my Last Will and Testament. Should he fail to survive me, or should he refuse or be unable to serve, I nominate, constitute and appoint my friend, BYRON HEELER, of Friedens, Pennsylvania, as my Executor. If both my husband, WILLIAM. BLANDO, and my friend, BYRON HEELER, fail to survive me or are unable or refuse to serve, I nominate, constitute and appoint my sister-in-law, ANGELINE CULFOGIENIS, as my Executrix. Section 4.02 My Executor shall not be required to furnish a bond for the faithful performance of his duties as Executor. In addition to all other powers granted by law, my Executor shall have the power, in my Executor's sole discretion, to make distributions in cash or in kind, or partly in each, and the power to determine which assets shall be sold and which shall be distributed in kind, without notice to or consent by any beneficiary. {IA340423.2} Page 4 of 6 z IN WITNESS WHEREOF, I have hereunto set my hand and seal to the original of this Will consisting of six (6) consecutively numbered typewritten pages, the first four (4) of which are signed by me in the left margin of each page, this G~ ~ day of , 2008. ~ -~ ~ ~~ (SEAL) BETTY L. BLANDO Signed, sealed, published and declared by the above-named BETTY L. BLANDO, as and for her Last Will and Testament, in the presence of us and each of us, who, at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and year last above written. l'-Gl,r0 j ~• I\GZ~I Gr Residing at~f~~l,.~1 u(~(.~e ~ v !~ ; /~~} 170 ~i/~~~ Witness 1Uc~la' ~i~~ Residing at ' ~ ~~ / ~/ ~ ~7G O -~-ZG6c. i ss {L0340423.2} Page 5 of 6 COMMONWEALTH OF PENNSYLVANIA COUNTY OF ,~au„pl~,~y~ We, BETTY L. BLANDO, ~~-rv 1 and the Testatrix ankl.~he witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 2~~ `' Sworn and subscribed before me this o7d~day of Fcbrvavu , 2008. COMMONVb'EALTH OF PENNSYLVANIA Notarial Seal Tracy A. Meisi~ Tr~an. Notary P~~ City Of Harrisburg, l7auptun MY Commission E~ires Feb. 22010 ~ (~ fir' - ~ r Notary P blic {IA340423.2} Page 6 of 6 SS: