HomeMy WebLinkAbout04-24-12.~
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: Joyce Lombardo
a/k/a: Joyce L. Lombardo
a/k/a:
a/k/a:
Date of Death: Apri14, 20
File No: ~~ ` ~~~ 7 ~~
(Assigned by Register)
Social Security No:
Age at death: 70
Decedent was domiciled at death in Cumberland County, Pennsylvania with her last principal residence at 607 Mill Race
Court. Carlisle, PA 17013, Cumberland County _-
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at Select Specialty Hospital Camp Hill PA 17011 Cumberland County
Street address, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania ............................All personal property $ 30.000.00
If not domiciled in Pennsylvania. . .. .. Personal property in Pennsylvania $
If not domiciled in Pennsylvania . ............ ...... ..... Personal property in County $
Value of real estate in Penns,,ylvania ......................................................... $120,000.00
TOTAL ESTIMATED VALUE.... $ 150,000.00
Real estate in Pennsylvania situated at: 607 Mill Race Court Carlisle Cumberland County, South Middleton Township. PA
(Attach 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 January 18. 1999 and Codicil(s~
thereto dated A Renunciation is signed by William Stape providing that the administration is to$~ handle by lit
State relevant circumstances (e.g. renunciation, death of executor, etc.) -`~ ~>r` '~' -~~
~~~~~nn r
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divorc~q,~vas`rtot a party to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), arrdct~`[tpt hav~t child borfi;or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. -' `,~-~ .:-r
0 NO EXCEPTIONS 0 EXCEPTIONS ~
~ -r-~
O B. Petition for Grant of Letters of Administration (If applicable) ~
c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, 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 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.
0 NO EXCEPTIONS 0 EXCEPTIONS
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):
Name Relationship Address
Form RW-02 rev. 10/11/2011 Page 1 of 2
1 Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SJ:
COUNTY OF CUMBERLAND }
Petitioner(s) Printed Name Petitioner(s) Printed s ^
Deborah March formerly known as 8 Oak Drive, Newville, PA 17241
Deborah Richardson L 'K CF
.n (`;'1i T
n r~ : -~~ PA
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 ecedent, the Petition`er(s) will well and t ly administer the estate acc ding to w.
Sworn to or firmed a subscr/~'jbed before ~ A Date y ~ ~ / ~
me thi ~a o ~tX ,c~X:~ ~ Date
By: ~:~~ Date
r the Re er Date
BOND Required: 0 YES d N O
FEES:
Letters .............. ......$ '' ' `~ ( )
Short Certificate(s).... .. _ ( )
Renunciation(s)....... .. ~Lv ( )
Codicil(s) ........... .. _ ( )
Affidavit(s).......... .. _
Bond .................. . _
Commission.... ..... ..
Other ' ~ _
... .... , ~
Automation Fee. ...... ........
..... ~7. ~'' ~
JCS Fee . ................ ~
........ ''~
TOTAL ............. ........ $
To the Register of Wills:
Please enter my appearance by my signature below:
A orney Signature: % i
P inted Name: Ronal Johnson, Esquire
upreme Court ID Number: 16453
irm Name: Andrews & Johnson
Address: 78 West Pomfret Street, Carlisle, PA 17013
Phone: 717-243-0123
Fax:717-243-0061
Email: rejohnson@pa.net
DECREE OF THE REGISTER
Estate of Joyce Lombardo File No: ~~~' ~~ ~` ~ ~%'~
a/k/a: Joyce L. Lombardo
AND NOW, _~
satisfactory proof having
the instrument(s) date ` ~ r
(and Codicil(s)) of Decedent.
~ ~~ ,c~~'~ ~-- , in consideration of the foregoing Petition,
presented before me, IT IS DECREED that Letters Testamentary
_ are hereby granted to Deborah March formerly known as Deborah Richardson
in the above estate and (if applicable) that
~~lescribed in the Petition be admitted to probate and filed of record as the last Will
Form RW-02 rev. !0/11/2011 PagO 2 Of 2
LOCAL R~~$TRAR'S CERTIFICATION OF DEAThI
WARMING: ~ '~ ,,,_~ I td-dt~~il(~te this copy by photostat or photograph.
Fee for this certificate. $6.00
P 18329430______
Certification Number
.--
TVP!/Print in
Permanent
vl
~^ `1
W
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~.,;~ Q, This i~ to ~~rtii~ stmt the lnformatiori here ~>i~(~n is
~'' ~~R 2~ ~~`~ ~ correctly c~ipied fto,n .u~ Original Certil~ic die of Death
duly filed ~~~ith )rn,° .(~ ~pca Registr«tr. The urisinal
C~ERE~ ~~ c(rtificate gill i~c (~In~~arded t(~~ the State b'iu([
r Records <)fi)ce for (~ler~~)Inen1 filint,
ORPNA~J S uOUR
CtJ~!RFR~ ~.~~I C~) ~~~ve.~~
-------- -.-~~ -_~1_~0>_2
I_Llcal Re(~(~tt~(r Gate, f5suc~d
COMMONWEALTH OF PEN NSVLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
f"C ~T~L~f"ATC !1c r~rw
- tll! NlJmblf:
1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo)
Joyce L_ Lombardo F_ 206-32-3854 April 4, 20"12
6a. Age-Last Birthday (Yrs) 56. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Vear) (Spell Month) 7a. Birthplace (City and State or Foreign Country)
Mgnth: Days Hours Minutes Carlisle PA
7
0 Yrs _ Oct . 1 8, 1 9 4 1 7b
eirtn
lac! (cp.,nt
)
b
.
p
y
CUm
_
Sa. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Ap[ No.) Sc. Oid Decedent Live in a Township?
PA 607 Mill Race Court ~jYls
SO_ Middleton
decla
tu
di
,
ln
ye
n
Sd. Residenc!(GOUnty) Carlisle PA 1 70'I 3
umb r 1 nd 8e. Residence (Zip Cod!) 1 7 Q 1 3 Q No, decedent lived within limits of city/boro.
9. Ever in US Armed Forces? lDacMarital S[a[us at Time of Death Q Married Q Widowed 11. Surviving Spouse's Name (If wife
gNe name
rior t
fi
t
i
'
,
p
o
rs
marr
age)
Q Yes „~
( ryo Q Unknown Ipl Divorced Q Never Married Q Unknown
12. Father's Name (Firs[, Middle, Last, Suffix) 13. Mother's Name Prior [o First Marriage (First, Middle, Last)
n Catherine Alice Schmohl
14a. Informant's Name 14b
Relationshi
t
D
d
'
.
p
o
ece
ent 14c. Informant
s Mailing Address (Street and Number, City, State, Zip Code)
o
G Deborah L_ March au ht r 8 Oak Drives Newville PA 17241
.......................................................... .......°"'........."""".....".'...,............a~...,ace. o. neat°' e~ on y one _
................ ............. __
.. ... ........
If Death occurred In a Hos Kai: ~ In '"'•••••""""' .. ••• '"' ""'.....
P pat ant
If D
h
"' """' "
~ .....
;
eat
Occurred Somewhere Other Than a Hos Ital~
""' """'
p ~1 Hospice Facility [~` Decedent's Home
Q Emergency Room/OUipatlent Q Dead on Arrlvai
N
ae' ursing Home/Long-Term Care Facility Other (Specify)
Q
lSb
Facilit
Name (If no[ instit
ti
l
•
.
y
u
on, g
ue street and number;
ISC. City or Town, State, and Zip Code SSd. County of Death
LL Select S ecilalt Hos ital Cam Hill A 1 Cumberland
16a. Method of Disposition Q Burial Cremation 16 b. Date of Disposition 16c. Place of Disposition (Name of cemetery
cremato
or oth
r
l
~
.€ ,
ry,
p
e
ace)
O Removal from State Q Donation
ocher(spe~lfy) 4J8/20'12 Hollinger FH/Crematory Snc_
2
~ 16d. Location of Disposition (City or Town, State, and Zip) 17 ignature of Funeral Sep~ic r Perso n Charge of Interment 17b. License Number
/Q <!na
L
Mt
HO11 S
i
'
g C
_
17065 `+
r
n s PA
FD-O"I "I 932-L
17c. Name and Complete Address of Funeral Facility rj Q '1 N
$a 1 t 1m~re j~.V
o
~' 1
Mt H
1 S r n s ~A ~ 7065
18
Deced
nt'
Ed
.
e
s
ucailon -Check the box Shat best describes the 19. Decedent of Hlspanlc Origin -Check the 20. Decedent's Race -Check ONE OR MORE races t
i
di
h
h
t- o
n
cate w
at
ighest degree or level of school completed at the Nme of death. box that best describes whether the decedent decedent considered hi
lf
h
mse
or
erself to be.
Q 8th gratle or less Is Spanish/Hispanic/Latino. Check the "NO" White Q Korean
Q No diploma, 9th - 12th grade b
ox If decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese
High school graduate or GED completed N
o, not Spanish/Hlspanlc/Latino Q American Indian or Alaska Native Q Other Asian
Q Some college credit
but no de
ree
,
g
Q Yes, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian
Q Ass
i
t
d
oc
a
e
egree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Guamani
Ch
'
Q
an or
a morro
Q Bachelor
s degree (e.g. BA, AB, BS) Q Yes, Cuban
Q Fill Pino ~ Samoan
Q Master's tlegree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino 0 Japanese
Q Other Paclflc Islander
Q Doctorat! (e.g. PhD, Edo) or Professional degree
(Specify) Q Other (Specify)
. MO DDS DVM, LLB JD
21. Decedent's Single Race Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate typ! of work
~T/JhKe
Q lapa nese Q Samoan done during most of working life. DO NOT USE RETIRED.
Q Black or African American Q Korean Q Othe
P
iFl
I
l
d
r
ac
c
s
an
er
Q American lndlan or Alaska Native Q Vietnamese Q Don't Know/NOt Sure Snventory ~A~}~~~i~=
Q Asian Indian Q Other Asian Q Refused 22b
Ki
d
f
.
n
o
Business/Industry
Q Chinese Q Native Hawaiian Q Other (Specify)
Q Filipino Q GuamanlanorChamorro Federal Government
ITEMS 23a - 23d MUST BE COMPLETED 23a. pate Pronounced Dead Mo Day r 236. SI nature of Per n Pronouncing a ih Only when applicable) 23c. License Num
BY PERSON WHO PRONOUNCES OR ~.~, /Q
CERTIFIES DEATH ~``~'/Ld ~L ~~~e.e,-~ ~
a yS~33 L
~
~
J
23d. Date Signed (MO/DaY/Vr) 24. Time
Of Death /n
1/`1--re'p`' a0
'
C
1
_O
O ' V ~ ~ 25. W edlcal Examiner or Coroner Contacted? Q Yes Q No
CAUSE OF DEATH
26. Part 1. Enter the chain of events--diseases, injuries, or complications--that direct) Approximate
y caused the death. DO NOT enter terminal events
h
suc
as ca rdlac arrest Interval:
respiratory arrest, or ventricular fibrlllatlon
w
ithout showing the
eti
o
logy. DO NOT ABBREVIATE
Enter onl
on
I
/
~
.
y
e cause on a
lne. Add additional Ilnes if necessary Onset to Death
~
/
~
IMMEDIATE CAUSE ---------------> a. /~^ ~Aw /L,r
(Final disease or condition Due to (or as a consequence of):
resulting In death)
b.
Sequentially Ifst conditions, Due to (or as a c sequence of):
on
If any, leading to the cause
listed on line a. Enter the
UN OERLVING CAUSE Due to (br as a consequence of):
(disease or injury that
Initiated the events resulting d.
~ in death) LAST. Due fo (or as a consequence f
o )
26. Part II. Enter other si¢nifica nt conditipns contrlbutino t d =th but not resulting In the underlying cause given In Part I
~ 27. Was an autopsy performed?
O Ves Q No
28. Were autopsy findings available
$ fo complete the cause of death]
V
~'
E
S 29. If Fe le: Q Yes No
30. Dltl Toys co Use Contribute to Deaths 31~~-. Ma~~~(p]yaaeeer of Death
Not pregnant within past year llR•C Q Probably cal Q Homicid
t
Q P
c
e°a'
regnan
e
a[ time of death Q No
Q Unknown Accident Q Pendi
Q Not
re
n
I
t
b
t
~
p
g
ng
an
,
u
nvestigation
pregnant within 42 days of death
Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In Q Suicide Q Could not be determined
Jury (MO/Day/Yr) (Spell Month)
Q Unknown if pregnant within [he pas[ year
33. Time of Injury
34. Place of Injury (e.g. home; construcY.ion site; farm; school) 35. Location of Injury (Street and Number, Clty, State, Zip Code)
36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred:
Q Ves Q Driver/Operator Q Pedestrian
Q No Q Passenger Q Other (Specify)
39a. Certifier (Ghee
only one):
z
Certifying phy ician - To the best of my knowledge, death o curved due to the cause(s) and manner stated
Pro
i
&
nounc
ng
Certifying physician - To the best of my knowledge, death occurred at the time, dace, and place, and due to the cause(s) and mann
t
t
d
Q
er s
a
e
Medical Examiner/COrO r - sis of examination, and/or inves[Igation, In my opinion, death
c mad at the time
date
and
lac
d d
!
,
,
p
e, an
ue to the cause(s) and manner std
ted
// ~~
Signature of certifier:
•
~
Title of certifier: /mot` License Number: /~~{ ~ ~3 S'I I I-L_
39b. Name, Address a Z p Cod! of Pers C''o/m/''pleting Cause of D~S~yth (Item 26 t_ 39c. Dace Signed (MO/Day r)
40
R
.
egistrar s District Nu~m\\ber 41. Registrar's tore 42.
R
egistra File Da[! (M
O
Day
1
~~
V
I
~
t
~
43. Amendments-~
~ C `~ ~ V tam
Disposition Permit No. n ~ ~ ~ `-r~
H305-143
REV 07/2011
- r
I'[ f-~(`~I: ~ ll. 1
n r.r~ _tJ
RENUNCIATION
~: 's t ~?R 24 ~'~~ ~: ~ 1
CLERK
REGISTER OF WILLS ~RpN,AN ~,,~"~~%~i~ T
CUMBERLAND l~„l~}=Fi,, ?,r ~, ; i , PP.
COUNTY, PENNSYL~~NIA
Estate of Joyce Lombardo
Deceased
I, William Stape , in my capacity/relationship as
(Print Name)
Executor
of the above Decedent, hereby renounce the right to
administer the Estate of~the Decedent and respectfully request that Letters be issued to
Deborah March formerly known as Deborah Richardson
April 19, 2012 ~G~`
(Date) (Signature)
~D ~ ~~ l/ /~d ~ GJ~
(Street Address)
Cdr//,~~t°, ~i~ / yD/r
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of ,
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 ~ day
of ~~' l ,a ~') ~~~ 17...E
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
Notary Public
My Commission
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
COMMONWE~-TH OF PENNSYLVANIA
NOTARIAL SEAL Public
SHELLY SEXTON, Notary
Carlisle Boro, Cum ~~ andl 26un2015
My Commleslon Exp AP
LAST WILL AND TESTAMENT
OF
JOYCE LOMBARDO
~~
'~',nzc'
,-
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I, JOYCE LOMBARDO, of South Middleton Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby
make, publish and declare this as and for my Last Will and Testament, hereby revoking all
other wills and codicils heretofore made by me.
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FIRST: I direct that all my just debts and funeral expenses, including my
grave marker, shall be paid from the assets of my estate as soon as practicable after my
decease.
0
b
0
a
ti
SECOND: I give and bequeath certain of my miscellaneous household goods,
personal effects, furniture and jewelry to the persons designated in accordance with my last-dated
memorandum prepared by me prior to my death and enclosed with this my Last Will and
Testament
THIRD: I give, devise and bequeath the residue of my estate, of every
nature and wherever situate, to my children, equally, namely, DEBORAH RICHARDSON
and WILLIAM STAPE provided that the share of any child who predeceases me or dies on or
before the thirtieth day following my death, shall be distributed to his or her issue, per stirpes,
living on the thirty-first day following my death, and in default of such then living issue, such
share shall be added to the share or shares for my other children.
FOURTH: 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.
FIFTH: I nominate, constitute and appoint my children, DEBORAH
RICHARDSON and WILLIAM STAPE, or the survivor of them, as Executors of this my
Last Will and Testament.
SIXTH: I direct my Executors and their successors shall not be required
to give bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last
Will and ~stament, consisting of two (2) typewritten pages, each identified by my signature,
this ~_ day of January, 1999.
(SEAL)
Jo e Lombardo
Signed, sealed, published and declared by the above-named Testatrix, JOYCE
LOMBARDO, as and for her Last Will and Testament, in the presence of us, who, at her
request, in her sight and presence, and in the sight and presenc~,,of each other, have hereunto
cnhcrriherl nnr namPC ac witnPCCPe ?~ ) /~1
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND )
SS.
I, JOYCE LOMBARDO, Testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will and Testament; that I signed it willingly; and that
I signed it as my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by JOYCE LOMBARDO, the
Testatrix, this ~ ~ day of January, 1999.
,.~..a,_.,......__ ~__--
°'°"`°"~ ARRL SEAL
SHELLY D. SEXTON, NOTARY PUBLIC a mbardo, Testatrix
CARLISLE BORO, CUMRB~~~~ ZBUN999 -,
hA`(COMMISSION EX.
Member, 4'ennsyivania Association of Nail
No Public
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND )
SS.
We, RONALD E. JOHNSON and-~.~y~y{L Q ~~J~`~~ ,the witnesses
whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw Testatrix sign and execute
the instrument as her Last Will and Testament; that Joyce Lombardo, signed willingly and
that she executed it as her free and voluntary act for the purpose therein expressed; that each
of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best
of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and
under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON
and -r"~`Ay I.CN~- P flti~~~ t,.3s , wi~esses, this ~~ ~da~January, 1999.
NO`~aR1AL SEAL
SHELLY Q. SEXTON, NOTARY PUBLIC (SEAL)
CARLISLE BORO, CURABERLAND COUNTY ,Witness
MY COMMISSIQh EXPIRES APRIL 26,1999 O ~~^ ~ ~^^ ,
Member, I'ennsYlvania Association of Notaries
Notary Publi