HomeMy WebLinkAbout04-30-12
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PETITION FOR GR~~T OF LETTERS
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REGISTER OF WILLS OF _ ~(,( (~~jr~~ COUNTY, PE~,:vS~~~~~,I ~~' _~.'
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Decedent's information
dame: F~OMQ-VN 0 V• Go~7Z
aik a:
a/k~'a:
ai k/a:
Date of Death: d t~ _ I $-~01 ~
File No: ~~ ~~ ~ ~~~` ~~~ ~~~
(assigned by Register)
Social Security No: 0~0 ~ "/4 •o~rotj )
Age at death: 88EARS
Decedent was domiciled at death in C UJhI'10P~GtJD County, `PENN A (Srcrre) with his/her last
,p.~ryin~cipalQresidence at o7 j()p $ErIT C R EE 1~ f3au1~ Vat~1~ fY1 C , c e htt~~ `Pa 1''1a~0
~ i ri E p(~i C~9 ES) Street address, Post Office and Zi Code City, Township or Borough County
Decedent died at ~ I~+b~'Y~~~r HASP*~na,..n t.-; t. ., _
'~ i~fnti ntr~..1.,,~1,._J De
Street address, Post Office and Zip Code ~ ~ City, Township or Borough County State
Estimate of value of decedent's property at death
If domiciled itt Pennsylvania ............................ All persona( property $ e2 C1Y000. U 0
If trot domiciled in Per:nsylvania ........................ Personal property in Pennsylvania $
If trot domiciled in Pennsylvania ........................ Personal property in County $
Valtte of real estate in Pennsylvania ......................................................... $ ~~ (/1/aNE
TOTAL ESTIivIATED VALUE.... $ ap~n~, ab
Real estate in Pennsylvania situated at:
(Attnch additional sheets, if necessary.)
Street address, Post Office and Zip Code City, Township or Borough
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
thereto dated
County
and Codicil(s)
State relevant circumstances (e.g. renunciation, death of executor, etc.)
Except as follows: after the execution ofthe 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., pendentelite, duranteabsentia, dttranteminoritute
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
iii 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 lefr no Will and was survived by the following spouse (ifany) and heirs (attach
udditiaurl sheets, if necessary):
Name Relationshi Address
Fa,,n aw-nz rev. lniuiznll Page i of 2
Oath of Personal Representative
CO~1_~tONWE:~LTI-f OF PF~vSYLVAVIA }
SS:
COi~ \TY Of
A,IVcIRA ~ ~,~ ~. +s
~~ OWN ~ c
l 05S
The Petitioner(s) above-named swear(s) or affirm(s) the statem the foregoing Petition are tnie and correct to the best of the lutowledge and belief
of Petitioner(s) and that, as Personal Representative(s) o ece nt, the Petitio r(s)~I well and tnily administer the estate according to law.
Sworn to or affirmed an hscrib~d before l/-~ Date ~"•~ '~~3'
me t i ~t~day of ;.~( ~l
Date
By' ~• ~ ~~ Date
~F r ie Register Date
BOND Required: ~`~'ES ~NO
FEES:
Letters .................... I
.. $ lJ)~ ~;
(~ )Short Certificate(s).... .. ------L"7 _'
( )Renunciation(s)....... . .
( ~ )Codicil(s) ........... . .
( )Affidavit(s).......... .. ~~__. L,
Bond ...................... --r-+
..
Commission ................ . .
Otl'~r
........
•--
Automation Fee. ..... `"' '-
JCS Fee . ....................
TOTAL ..................... $ ~`~-<=.t°^,'
To the Register of Wi!!s:
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 ~ r ~ ~ ~~' .~' ~ ~ ,~t' "%' File No: ;~ ~ - / ~- ~ ~ _ ~ f _.-
I~. s
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AND NOW, I~' /~%i ~ ~ ~ ~ , in consideration of the foregoing Petition,
satisfactory proof having bee presented before me, IT ISCREED that Letters ~ {y "~~. '-~~ ~~ ; r' i; / ~ rf _
are hereby granted to ~~--~-~'~~ ;~ 1 ~ ~~~. , ~ , / { r ~r` t'
- inthe above estate a::d (if applicable) that
the instrument(s) dated ~ ~(;,~ ,',/r{
described in the Petition be admitted to
F~~,~i aiv-nz ,~w. tniuiznit
the last Will (and Codicil(s)),pf Decedent.
of Wills ~ „/ 1
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TYpe/Print In COMMONWEAIiN OF PENNSYLVANIq • DEPARTMENT OF HEALTH • VITAL RECORDS
Perm'ne"` CERTIFICATE OF DEATH
1. Decedent's legal Name (First, Middle, Last, Suffix) 2. Sev 3. Social Security Number 4. Date of Death (MO/Day/rrl (Spell Mo)
Romayne G. Goetz Female 204-14-2651 April 1R, 2012
6a. Age-Last Birthday (Yrs) 56. Under S Vear Sc. Under 1 Da 6. Date of Birth IMP/D ay/Vear) lSpell Month) ]a. Birthplace (City and State or Foreign Country)
MPnms Davs Hpqra Mingtes February 3
1924 H estown Penns lvania
88 , ]b. Birthplace (County)
8a. 0.esidence (State or Foreign Country) Bb. 0.esidence (Street antl Number- Include Apt NO.) 8c. Did Decedent Live In a Townships
Penns lvania 304 E
Coover Street ^ves, aecedent rwedm twP.
8d. 0.esidence (CDUnry) .
1 d Be. 0.esidence (Zip CPde)170SS o, decedent lived within limits of MP hens Gb 1T'Q city/born.
9. Ever In US Armetl Forces? S0. Marital Status at Time of Death ^ Married ~ Widowed 11. Surviving Spouse's Name Ilf wife, give name prior [O Frst marriaeel
^Yes $1 NO ^Unknown ^Divorcetl ^Never Married ^Unknown
13. Fa[hei 5 Name (Firs[, Middle, Last, Suffix) l3. Mother's Name Prior [o Plrsl Marriage IFlrst Mitldle, Last)
Walter Rohland Effie Wagner
14a. Informant's Name 14b. Relattonshlp to Oecetlent 14c. Informant's Mailing Address lStreet and Number, Clty, State, Zip Code
a
O
Sandra J. Curlee Dau hter
1115 Andersontown Road Mechanicsb PA 17
C
.........................................................
.........
............................ ]fie. vlaceo Deatn Ch k
..........................,... «.. ~~.Y.one...............................
........ ... .. ...
.......
...
........
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.......
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If Death Occurred in a Hospital: patient ~ .
.
.
..
.
..
.
.
.
.
.
.
....
ece en
If Deatn Occurred Somewhere Other than a Hospital. (~ Hospice Facility ~ D d is Home
^Emergency ROOT/OU[patlenl ^Dead Pn Arrival
~ ^NUrsing Home/long~Term Care Facility O[her(Speclly)
16b. Facility Name (lf not Institution, [ive street and number; 16c. City or Town, Slate, and Zip Cotle Ifitl. County Ot Death
Hol S irit Hos ital Hill PA 17011 Cumberland
r 16a. Method of Disposition ^ Burial Cremation Sfib. Date of DispozlH"n 16c. Place of Disposition (Name of cemetery, crematory, or other place)
^ Removaurpmstate ^ DPnabpn A
il 20
20 2 Hollinger Crematory
- ^omer lsperlry) r
,
P
Z Ifid. location of DispositlPn IGIry or Town, State, and Zlp) 1]a. Signature of I Service Li ansee or Person in Charge of In[ermenl 1]b. License Number
v Mt. Holly Springs, PA ~~ FO-13A630
E 1]c. Name and Complete Address of Funeral Facility
8 Mal zzi Funeral H S k t z W PA
18. Decedent's Education -Check the bpv that best describes the 19. Decedent of Hispanic Origin ~ Check the Z0. Decedent's Race -Check ONE OR MORE races to Indicate what
highest degree or level of school completed at the time of death. bpv that best describes whether the tlecedenl me decedent consltleretl himself or herself to be.
0th grade or less is Spanish/Hispanic/latino. Check [he "NO" ~ White ^ Korean
No tliploma, 9th-12th grade box if decedent is not 6panish/Hispanic/Latino. ^Black or African American ^ Vietnamese
High school graduate or GED completed ~NO, no[ Spanish/Hispanic/Latino ^ American Indian or Alaska Native ^ Other Asian
Some college credit, but no degree ^Yes, Mexican, Mexican American, Chicano ^ Asian Indian ^ Na[IVe Hawaiian
~ Associate degree Ie.g. M, AS) ^Yes, Puerto Rican ^ Chinese ^ Guamanian or Chamorro
Bachelor's degree (e.g. BA, AB, B6) ^Yes, Cuban ^ Filipino ~ Samoan
Mas[ei s degre<(e.g. MA, MS, MEng, MEd, MSW, MBA) ^Ves, other Spanish/Hispanic/latino ^lapanese ^ Other Pacific Islander
^ Doctorate lee-PhD, Ed0)or Professional degree (6pecify) ^ Other (Specify)
e..MD DDS DVM LLB 10
21. Decedent's Single Pace Self-Designation ~ Check ONLY ONE tP Indicate what the decedent consltlered himself or hersel/ to be. ZZa. Decedent's Usual Occupa[lon -Indicate type of work
White ^lapanese ^ Samoan done during most of working life. DO NOT USE RETIRED.
^Black or African American ^korean ^Other Pacific Islander Cafeteria Worker
American Indian or Alaska Native ^ Vietnamese ^ Don't know/Not Sure
^ASian Indian ^Other Asian ^Refusetl ZZb. Kind ol8usiness/Industry
Chinese ^ Nallve Hawaiian ^ Other (Specify)
Food Se1V1Ce
Filipino ^ Guamanian or ChamorrD
ITEM523a- 23tl MUST BE COMPLETED Zia. Date Pronouncetl Dead IMP/Day/Yr) 23b. 61gna[ure of Person Pronouncing Death (Only when applicable) Z3c. license Number
BY PERSON WHO PRONOUNCESOR
CERTIFIES DEATH /1 /)1~'~ ~~ ~~I~
rl I"
Z3d. Date Signetl IMO/Day/Vrl 14. Ti a of
Death
n
JS L~ Z6. Was Metlical Examiner or Coroner COntactetl? ^ Ves No
CAUSE OF DEATH i Apprpxlmare
26. Part I. Enter the chain of events--diseases, injuries, orcomplications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval:
ABBREVIATE. Enter only one tous
on a line. Add additional Imes If necessary Onset to Death
respiratory amen, or ventricular fibrillation withou
t
howing the etiology. DO NOT
e
s
C
n
l
'
IMMEDIATE CAUSE ---~----> a. VN/A -S~A~'C 1(.CwJA'C QL Ste)1 '
(Final tlizease or condition Due to for as a <Dnsequence o/I'.
resulting in death)
b.
Sequentially list rontlitions, Due to for as a consequence oi).
i/any, leading to the cause
nsrae on bne a. Enter me
UNDERLYING CAUSE Due to for as a consequence o/1'.
(disease Dr Injury that
_ ated the events resulting d. ______,_--_._. __
In death) LAST Due to for as a consequence o/)
S 26. Part 11. Enter other sienlficant conditions contributing to death but not resulting in the untlerlying cause given In Part I 2] n a~wpsv perror
Was
a
_ ^
Yes
f 28. Were autopsy findings available
to complete the cause or cream]
^ ves ^ NP
i 29. If Fem 30. Did Tobacco Use Con[rihele to Death] 31. Man~~eam
e of pregnant within past year ~ Tez ~ Pro~ly Q~tural ~ HDmlcide
Pregna t time of death ^ No ~ known ^ Accitlent ^ Pending Investigation
~' ~ Not pregnant, but pregnant within 42 daYS of deem ^ Suicitle ~ Could not be determined
Not pregnant, but pregnant 03 days to 1 year bebre tlea[h 3Z Date o(Injury IMO/Day/Vr) l6pell Month)
Unknown i/ pregnant within [he past year 33. Time of Inlury
34. Place o! Injury le,g. home; construction site; farm; school) 35. Location of Inlury (Street and Number, Ciry, State, Zip Code)
36, Inlury at Work 3]. If Transportation Inlury, Specify: 38, Describe How Inlury Occurred:
Yes ^ Driver/Operator ~ Pedestrian
No ^ Passentler ^ Other Specify)
39a. Ce (Check only one):
Certifying physician -TO [he best of my kno,/u~ e, death occurred due to [he causels) and manner stated
^ Pronouncing & Certifying physician ~ T" [I f st of my knowledge, death attuned at the time, date, and place, and due [o the causels) and manner stated
h occurred a[ the time, date, and place, and due [o [he cause(s) and moon r stated
^ Medical Examiner/Coroner - On the ba amina[lon, and/or Investigation, In my opinion, dea
e
t^
OIC(n)~H ~
~
License Number:
Signature of certlller: Title or certifier: lJ
396 Name, Address and 21p Code of Person CPmpleting Cause of Oeam tt [ 261
.~
/,
I 39c. Date Signed IM ~DaylVr)
l
~ /
,
.It..R.te N.~.FF.,.M ~Awan
R. CL<cRCF ~rz~~.... ~2 ng, fPP / y„q,
tract Number
40. fleglstrai s Dis
yfa
41. Regl Si(g~nature ~ i d2. RegisYar File Date IMO Day rl
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43. Amendments
ISS
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0693638 Hlos la3
Disposition Permit No. REV O]/2011
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LAST WILL AND TESTAMENT ~ ~-' `'~
~, C:.:3
OF - ' ~ ,'
ROMAYNE R. GOETZ ~~~~:~_ ,F.,,
I, ROMAYNE R. GOETZ, of 66 Ashburg Drive, Mechanicsburg, Silver spring
Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory,
do make, publish and declare this to be my Last Will and revoke any Wills and codicils
previously made by me.
ARTICLE ONE
Specific Bequest of Tangible Personal Property
__ _ _,.~
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I. To my son, WILLIAM B. GOETZ, III, I return the wooden cane rocking chair,
which he provided for me to use during my lifetime; and
2. To my granddaughter, JENNIFER GOETZ RETALLACK, I give my
Pfaltzgraff dishes; and
3. To my granddaughter's spouse, DEREK RETALLACK, I give my recliner.
In the event that I do not possess the above referenced property at the time of my death,
my estate shall not be obligated to obtain these items, and all of said bequests shall lapse.
I give and bequeath all the rest of my tangible personal property, including, but not limited
to, all my automobiles, furniture, furnishings, books, pictures, jewelry, china, linen, silver, clothing,
household effects and personal effects, and other tangible personal property of like nature (not
including cash, securities and other property used for the production of income), together with any
existing insurance thereon, to my daughter, SANDRA J. CURLEE (hereinafter my "Daughter"), if
my Daughter survives me by thirty (30) days; or, if my Daughter does not so survive me, such items
shall be sold and added to the residue of my estate to be divided as hereinafter provided.
ARTICLE TWO
Residuary Estate
L I give, devise and bequeath the sum of six thousand dollars ($6,000.00) to SILVER
SPRING PRESBYTERIAN CHURCH to be allocated as follows:
a. Two thousand ($2,000.00) dollars in memory of Evelyn Mae Rholand Yinger;
b. Two thousand ($2,000.00) dollars in memory of Caroline Rebecca Rholand Rice;
c. Two thousand ($2,000.00) dollars in memory of myself, Romayne Gloria
Rholand Goetz;
2. I give, devise and bequeath the sum of four thousand dollars ($4,000.00) to my
granddaughter, JENNIFER GOETZ RETALLACK and her spouse, DEREK
RETALLACK, or the survivor of them, or if neither of them survive me this gift shall
lapse and pass into the residue of my estate;
LAST WILL & TESTAMENT OF ROMAYNE R. GOETZ
Page 1 of 7
I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever
nature and wherever situated, to my daughter, SANDRA J. CURLEE, if my daughter survives me
by thirty (30) days; or, if my daughter does not so survive me, to the then living children of Jennifer
Goetz Retallack and Derek Retallack, per stirpes.
Insofar as I have failed to provide any residuary distribution for my son, William B. Goetz,
III, such failure has not been occasioned by accident or mistake, but rather is done in recognition of
the provisions I have made for him during my lifetime and of a certain $7,000.00 loan for which I
have never received repayment.
ARTICLE THREE
Payment of Taxes and Administrative Expenses
I direct that all estate, inheritance and other death taxes (other than generation-skipping
transfer taxes), and all interest and penalties thereon imposed by reason of my death with respect
to property subject to such taxes by reason of my death, whether such property passes through my
probate estate or outside of my probate estate, and payable to any federal, state or foreign taxing
authority, whether payable by my estate or by any recipient of such property, and all my funeral
expenses and estate administration expenses, shall be paid to the extent possible out of my
residuary estate passing under ARTICLE TWO hereinabove.
ARTICLE FOUR
Protective Provisions
The principal of my estate and the income therefrom, so long as the same are held by my
Executor, shall not be subject to anticipation, assignment, pledge, sale or transfer in any manner,
nor shall any beneficiary have power in any manner to charge or encumber his/her interest in my
estate, nor shall the said interest of any beneficiary be liable or subject in any manner while in the
possession of my Executor for any liability of said beneficiary, whether such liability arises from
said beneficiary's debts, contracts, torts, or other engagements of any type.
ARTICLE FIVE
Powers of Executor
In addition to and without limiting the powers conferred by case law, by statute, and by
other provisions hereof, my Executor shall have the following rights and powers exercisable
without the need for court approval:
(A) Accept and Retain Investments. To accept and retain any form of real or
personal property received by transfer, devise, bequest or otherwise without being required to
diversify and without being limited to the types of investments in which fiduciaries are
authorized by law to invest. This authority shall specifically include the authority to accept and
retain any stock of a corporate fiduciary hereunder, or in any corporation which controls or is
LAST WILL & TESTAMENT OF ROMAYNE R. GOETZ
Page 2 of 7
controlled by it, or any other corporation in which it holds any ownership interest, together with
any stock dividends received thereon, or any stock acquired in the exercise of subscription rights,
or received by reason of any consolidation, merger or reorganization, without liability for such
retention.
(B) Invest. To invest and reinvest in any form of real or personal property without
limitation by any law applicable to investments by fiduciaries.
(C) Voting Rights. To vote a security in person or by proxy, to participate in or
consent to any merger, reorganization, dissolution, liquidation, voting trust plan, or other action
affecting any securities held hereunder, and; to exercise conversion, subscription, and other rights
of whatever nature.
(D) Title To Property. To register or hold securities and/or other property in the
name of a nominee or nominees, including that of a clearing corporation, a depository, in book
entry form, or to retain securities and/or other property unregistered or in a form permitting
transfer by delivery.
(E) Sale, Lease and Other Dealings with Property. To sell, from time to time, at
public or private sale, exchange, lease, encumber, option or otherwise dispose of all or any
portion of assets held hereunder; to make, execute and deliver deeds, mortgages, leases,
assignments and other documents necessary to carry out any of the powers granted hereunder,
which shall specifically include the authority to grant leases which extend beyond the period
authorized by law, and; to partition, subdivide, improve and impose any restrictions on real estate
held hereunder and enter into agreements concerning the partition, subdivision, improvement,
zoning or management of any such real estate.
(F) Borrow. To borrow money from any person or institution and pledge property
as security for repayment of funds.
(G) Distributions in Kind. To make distributions in cash or in kind, or partly in
each, and; to allot different kinds of properly to different shares without regard to differences in
the income tax basis of such property. Any such designation, division, allocation, apportionment
or valuation of property shall be binding and conclusive on all parties.
(H) Power to Distribute Outright. In any instance where property would be
immediately distributable to a beneficiary of a trust, distribution may be made directly to such
beneficiary without funding such trust. The receipt of any such distribution by any such
beneficiary shall be a full acquittance of the fiduciary making such distribution as to any amounts
so distributed.
(I) Settle Claims. To institute, prosecute and defend any and all legal proceedings;
and compromise, release, adjust and/or settle any debt or claim.
(J) Employment of Agents. To employ agents including attorneys, accountants, and
others to perform administrative duties.
(K) Disclaimer. To disclaim any interest in property which would devolve to me or
to my estate by whatever means, including but not limited to the following means: as a
beneficiary under a will, as an appointee under the exercise of a power of appointment, as a
person entitled to take by intestacy, as a donee/beneficiary of an inter vivos transfer, as a
LAST WILL & TESTAMENT OF ROMAYNE R. GOETZ
Page 3 of 7
beneficiary under any insurance policy, as a beneficiary under an individual retirement account or
annuity, and as a beneficiary under any qualified or non-qualified retirement plan.
(L) Properly Distributable to Minors and Persons Under a Disability. Any property
(whether income or principal) distributable to a beneficiary of my estate who is under a disability
may be paid directly to such beneficiary, to the parent or guardian of such beneficiary, to a
custodian selected by my Executor (other than my Executor) under the Pennsylvania Uniform
Transfers to Minors Act or under a similar act of any other state, or to persons caring for or
having custody of such beneficiary (other than my Executor), or may be applied for such
beneficiary's benefit by payment to such other persons, organizations or institutions (other than
my Executor) as my Executor may select, and the receipt of any such payee shall be a full release
therefor. The receipt of any such payments by any such person shall be a full acquittance of my
Executor as to any amounts so paid. Any beneficiary hereunder shall be considered to be under a
disability while under the age of twenty-one (21) years or at any time when, in the opinion of my
Executor, such beneficiary is incapacitated in any way so as to be unable to properly manage
his/her affairs.
ARTICLE SIX
Fiduciaries
(A) Appointment of Executor. I appoint my Daughter, SANDRA J. CURLEE as
Executor of this Will (my said Executor and any successor Executor or co-Executors shall be
referred to herein as my "Executors" or "Executor"). Upon the death, renunciation or resignation
of my Daughter, I appoint my attorney, SHELLY J. KUNKEL, as successor Executor.
(B) Miscellaneous. Any successor Executor shall succeed to the capacity of its
predecessor without re-conveyance or transfer of property and have all of the rights, powers,
authorities and discretion conferred upon the original Executor. No successor Executor shall be
obligated to examine the accounts, records, or acts of a previous Executor, as the case may be, nor
shall any such successor Executor in any way or manner be responsible for any act or omission to
act on the part of any such previous Executor, as the case may be. No Executor serving hereunder
at any time shall be required to file any bond or enter security in any Court or jurisdiction in which
such fiduciary may be called upon to act.
ARTICLE SEVEN
Interpretation
(A) Child, Children, Grandchild Grandchildren and Issue. Whenever the terms
"child," "children," "grandchild," "grandchildren" and "issue" are used herein, such terms shall
be interpreted to include adopted persons as well as natural persons, provided in each instance
that the adoptee is under the age of eighteen (18) years at the time of adoption. Such terms are
also intended to include persons in gestation at any pertinent time under this Will, provided such
persons survive birth by thirty (30) days. In applying any provision of my Will which refers to a
LAST WILL & TESTAMENT OF ROMAYNE R. GOETZ
Pale 4 of 7
person's "issue, per stirpes", the children of such person are heads of their respective stocks of
issue, whether or not any child of such person is then living.
(B) Survival Clauses. If any beneficiary hereunder should die within ninety (90)
days after my death or within ninety (90) days after any other person the survival of whom
determines such beneficiary's rights hereunder, then such beneficiary shall be deemed to have
predeceased me or such other person, as the case may be, for all purposes hereunder.
(C) Governing; Law. This Will shall be construed and governed in all respects by
and in accordance with the laws of the Commonwealth of Pennsylvania.
(D) Gender and Number. Where appropriate except where the context otherwise
requires, whenever used herein, the singular includes and plural, the plural the singular and
words of any gender shall be applicable to all genders.
(E) Headin sg /Ca tp ions. The headings/captions of Articles, Sections and Paragraphs
used herein are for convenience of reference only and shall have no significance in the
construction or interpretation of this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this my
Last Will and Testament, consisting of seven (7) typewritten pages, including this attestation clause
and the following Acknowledgme;~?t and Affidavit, to be executed, declared and published this
E' day of -~~~`~-~.~-~~~-• , 2005, at Camp Hill, Pennsylvania.
-~-- ~..~
ROMAYNE R GOET
On this J~ ~" day of ~~ ~.~;,~t ;~~~, 2005, ROMAYNE R. GOETZ declared to
us, the undersigned, that the foregoing instru~ient was her Last Will, and she requested us to act as
witnesses to the same and to his signature thereon. She thereupon signed said Will in our presence,
we being present at the same time. We now, at her request, in her presence, and in the presence of
each of us, hereby subscribe our names as witnesses thereto. By so doing, each of us declares that
he or she believes this Testator to be of sound mind and memory.
Wi~sses:
(~~ ~~
Witness
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LAST WILL & TESTAMENT OF ROMAYNE R. UOETZ
Page S of 7
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
I, ROMAYNE R. GOETZ, the Testator, 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; that I signed it willingly and that I signed it as my free and
voluntary act for the purposes therein expressed.
ROMAYNE . GOETZ <.'"
Sworn or affirmed to and acknowledged before me by ROMAYNE R. GOETZ, the Testator
this ~ day ofd , 2005.
J (SEAL)
Notary Pu lic
My Commission Expires:
COMMONW i F P NIA
Notarial seal
Helen E. Rasmussen, Notary Public
Camp Hill Baro, Cumberland County
My Commisseen Expires P.ug. 2, 2Q07
Member, PeunsYS«as;ia „ssaciatior oP tdotarles
LAST WILL & TESTAMENT OF ROMAYNE R. GOETZ
Page 6 of 7
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
and ,the witnesses w ose names are signed to the attached or
foregoing i trument, b ing duly qualified according to law, do depose and say that we were
present and saw ROMAYNE R. GOETZ, sign and execute the instrument as the Testator's free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at the
time twenty-one (2I) or more years of age, of sound mind and under no constraint or undue
influence.
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Sworn or affirmed to and acknowledged before me by S~ e I ~ y J .. l~ u n ~~ ,
,S-~~ ~ .u ~ A • ~~re z ~ and ~.a, r.~ A . Kati ~ the
wi en sses, this ~~''` day of , 2005.
(SEAL)
of u lie
My Commission Expires:
COMMONVJ '' F', OF NIA
Notarial Seal
Helen E. Rasmussen, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires Aug. 2, 2007
Member, Per~nsy!var.;a fssociation of Notaries
LAST WILL & TESTAMENT OF ROMAYNE R. GOETZ
Page 7 of 7
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CODICIL TO THE LAST WILL AND TESTAMENT _
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ROMAYNE R. GOETZ
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I, ROMAYNE R. GOETZ, of the Borough of Mechanicsburg, Cumberland County,
Pennsylvania, the within named Testatrix, do hereby make and publish this Codicil to my Last
Will and Testament dated January 4, 2005, hereby revoking and making void all previous
Codicils heretofore made by me.
I hereby modify ARTICLE TWO of my said Last Will and Testament as follows:
1. I give, devise and bequeath the sum of six thousand dollars ($6,000.00) to
SILVER SPRING PRESBYTERIAN CHURCH to be allocated as follows:
a. Two thousand ($2,000.00) dollars in memory of Evelyn Mae Rohland
Yinger;
b. Two tho~~sand ($2,000.00) dollars in memory of Caroline Rebecca
Rohland Rice;
c. Two thousand ($2,000.00) dollars in memory of myself, Romayne Gloria
Rohland Goetz;
2. This item is intentionally omitted;
Page l of 4
CODICIL TO THE LAST WILL AND TESTAMENT OF ROMAYNE R. GOETZ
I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever
nature and wherever situated, to my daughter, SANDRA J. CURLEE, if my daughter survives me
by thirty (30) days; or, if my daughter does not so survive me, to the then living children of Jennifer
Goetz Retallack and Derek Retallack, per stirpes.
Insofar as I have failed to provide any residuary distribution for my son, William B. Goetz,
III, such failure has not been occasioned by accident or mistake, but rather is done in recognition of
the provisions I have made for him during my lifetime and of a certain $7,000.00 loan for which I
have never received repayment.
In all other respects, I confirm and ratify my aforesaid Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand to this Codicil of my Last Will
and Testament this ~~ day of October, 2005.
WI SS:
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ROMAYN . GOETZ
Page 2 of 4
CODICIL TO THE LAST WILL AND TESTAMENT OF ROMAYNE R. GOETZ
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
W E, ~ ~' to ~ ~ - K~~ k.s~ and ~•~- ~ ~, ~ `-~-~~'
the witnesses whose names are attached to the foregoing document, being duly qualified
according to law, do depose and say that we were present and saw Testatrix sign and execute the
instrument as the Codicil to her Last Will and Testament; that she signed willingly and that she
executed it as her free and voluntary act for the purposes therein expressed; that each subscribing
witness in the hearing and sight of the Testatrix signed the Codicil as witnessed and that to the
best of our knowledge the Testatrix was at the time 18 or more years of age, of sound mind and
under no constraint or undue influence.
Sworn or affirmed and subscribed before me by ~~e~ ~y ~J ~~t,e,~
and ~ ~ this / 3 ~ day of ~/~ ~ ,
ZQQS, COMMONW ~ TH QF PEA~iSY~.~fii~i__
Notarial fiord
Helen E. Rasmussen, Notary Pablic ~ ~,.-~
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Camp Hill Borg Curnberland County __ -fie
My Commission Expires Auk. 2, 2007 NOT AR PUBLIC
Member, Pennsylvania Association of NotariFs
Page 4 of 4