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HomeMy WebLinkAbout05-14-12Reset 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: SYLVIA M. KUTCHMAN a/k/a: a/k/a: a/k/a: Date of Death: 04/30/2012 File No: :~ ~ - ~ -;.~ - ~ `~~~ (Assigned by Register) Social Security No: Age at death• 93 Decedent was domiciled at death in CUMBERLAND County pp (Stare) with his/her last principal residence at 1716 LINCOLN DRIVE CAMP HILL PA 17011 ~ CUMBERLAND Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 1716 LINCOLN DRIVE CAMP HILL CUMBERLAND PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: /f domiciled in Pennsylvania ............................ All personal property $_ 100,000.00 If not domiciled in Pennsy[vania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsyh~ania ........................ Personal property in County $ Value of real estate in Penn,sylvania ................................ ................. $ 135,()()0 00 TOTAL ESTIMATED VALUE.... $ 235,000 00 Real estate in Pennsylvania situated at: 343 NORTH 19TH STREET CAMP HILL PA 17011 CUMBERLAND (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 MARCH 28, 2007 and Codicil(s) thereto dated State relevant circumstances (e.g. renunciation, death of execu[or, etc.) Except as follows: after the execution of the 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(8), 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., pendente lite, durante absentia, durante minoritate if Administration, c. t. a. or d.b.n.c.l;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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. NO EXCEPTIONS Q 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 Relationshi Address ,.. _., -- .-- . ~- ~ ~i -j_ „ ~ -i`i ~, 7 E_ ~% :; Z? C: ~._~ T. _..i ,. ._ rT1 D ~~ L~ L~ -~ ~or,n ltw-oz rev. loiuizou Page 1 of 2 The Petitioner(s) above-named swear(s) or afftrm(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 tr~ly administer the estate accordin to law. Sworn to or affirmed and subscribed before Z Date me this ~ ~~ day of ~~~ ~(~~ ': ' ;~ Date Date For the Register Date BOND Required: Q YES ~ NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters ..................... $ ~ ~ .~,!~~ ( ~~ )Short Certificate(s)...... ~~ O ( )Renunciation(s)........ . ( )Codicil(s) . ........... . ( )Affidavit(s)........... . Bond ....................... Commission ................. . Other Automation Fee..... =- JCS Fee . .................... -_ ~~=,' .4-:~ TOTAL ..................... $~`h iCl ,`Y; 00 0 Attorney Signature: ~~ Printed Name: SUSAN .HARTMAN Supreme Court ID Number: 65184 Firm Name: DUNCAN &HARTMAN, PC Address: 1 IRVINE ROW CARI.ISLF PA 17(113 Phone: 717-249-7780 Fax: 717-249-7800 Email: sn¢an n dnn anhartmanla~x~ ~nm DECREE OF THE REGISTER Estate of SYLVIA M. KUTCHMAN `" File No• ;;! ~ - ~ -- (.- ~ `. J ` a/k/a: AND NOW, ~ , in consideration of the foregoing Petition, satisfactory proof having bae presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to JANET K. LUSH in the above estate and (if applicable) that the instrument(s) dated _ ~ ~ ,~ ~,~ ~ r ~, ~ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FornsKW-02 rev. l0/l1;20/1 egister of Wills ` Page 2 of~2 Oath of Personal Representative _ Official Use Only t'r ~til )~ ~~_. ~~ l~ _v~ I COMMONWEALTH OF PENNSYLVANIA } ~i~,`~F~ ' ' '','I'~! (' 1. _...~ } SS: COUNTY OF CUMBERLAND ~ j~~ !Te P C. r. H I(lilills R(:V i4;I •.; - - - _ -.. _. _ LQC'~EfG~-~IT R'S ~rERT'I~~~;~~'1~`-tV ~ ~; ~"~'~° WIARI`~~: ~'~s=iHega~ o' du dicatf~ this c:(.a ~~ _ ~iJ P ~~ ~ ~ ~hcrtc+s~:st car p~r(,~crairr~lr3t Fee for this certif(ei(te, `~6.a ~(r ~~' (~ ~~Y ~ ~ ~~ ~; s~ ;, t~ , 1111 `~`u\{t E)( M{' :.. C~ ( " ~ ~ y. 1 ~ ( ~ ~~ .. ~ 1 IF 1 jl~i ~ C(JMBcRLANp :;;:~~~ ~ of `~ *I ~ ~ ~ <3 ~ ,. Il ~~~C, ~(1 .~'C '~1a:C I~~l~ ~ f l r~l,,,i ; ,)~j~~ co.. P~ P Q ~.V ~~~ ~ r, r~ ~~~ ,~ ` ~ ~ 4 ~ -- - - 7 -_ _ - ~t~ `~ ~f~FNi ~1AY 9' ~ 1 2 0~ ~~ y. cerrihear)(~~l 1V~(~,Il)Z', ( --- _ - ~ - --- ~---- --- Type/Print In Permanent COMMONWEALTH O F PENNSYLVANIA DEPARTMENT OF HEALTH ~ VITAL RECORDS 02 ' ^~ Y I _~ T-~L.N ~ C VF Utq ~ ~"~ State File N 1. Decedent's legal Name (First, Middle Last Suffix) b , , um er: 2. Sex 3. Social Security Number 4. Date of Death (Mo/paY/Yr) (Spell Mo) S lute Kutchman Female 186- 0-612 6a. Age-Last Birthday (Yrs) Sb. Under 1 Vear Sc. Under 1 Da 6 D 1 0 012 . ate of Birth (MO/Day/Near 5 Months DAYS Mours Minutes ) ( Pell Month) ]a. Bl lace (City antl Sia[e or Foreign Count ) 93 ~~ ry g-etown PA pril 19, 1919 Mi 8a. Residence {,State or Fprei ]b. Birthplace (County) 8^ Country) 86. Residence (Street and N b um Penns 1 er -Include Apt No.) 8c. Did Decedent Live in a Township? y vania 1716 Lincoln Dr. Stl. Residen a (County) ~ - O Ves, decedent Ilyed In _ Cumber land twp. 8e. Residence (21p Code) 17011 0, decedent lived within limits of C3("CID F~~] 9. Ever in US Armed Forces? 10 11 M i . . ar tal Status at Time of Death 0 Married fy~~} Widowed 11. 6urv city/boro. Yes Q No Q Unknown O Divorced 0 N Tying Spouse's Name (If wife i , g ve Warne prior to first marriage) ever Married Q Unknown 12. Father's Name (First, Middle, Las[, Suffix) 13. Mother's Name Prior to First Marriage (Firs[, Middle, Last) Geor e W. Brinser 14a. Informant's Name Mar aret P. Cobel ° 14b. Relationshi Janet Ll1Sh P to Decedent 14c. Informant's Mailing Adtlress (Street and Numb Ci G er, ty, State, ZiP Cotlcl Dau h ae r ... sell R s R - _ ........................~--~--................ i iy o s r sle 1S If Dearn o«Drred in a HOSP1ta l : ....... ..........'"'""'"'...-............"'"'""""'"""""' ~ ce o Deat c e pn ...... In I ati t ...:...... ... .... 1 o ........ ....... ........ en J a g _ __ __ P ................... ...._.....".......... ;If Death Occurred Somewhere Other Than a Hospital: ~ ~'~~~ "'"-" _ Emer ~(HOSpiceFacilit gency Room/Out V Decedent's Ho patient ~ Dead on Arrival Nursin H ~~~ ~~ me ome/Long-Term Care Facility Other (Specify) is b. Facility Name (If not Institution, give street and n tuber; •15c u Cit T ~ . Y or own, State, and Zip Code 1716 Lincoln Dr. isd cn.,n f D ~, ry o eath Hill PA 17011 16a. Method of Disposition Burial ~ Cre CLlmberla ti d ma n on 16 b. Date of Dis Q Removal from State Q Donation Position 16c. Place of Disposition (Name of cemetery cre !€ , m tory, pro her place) Other (Specify) OS~OS~2 012 a v . 16d. Location of Disposition (City or Town, State, and Zi R0111n Green Cemeter P) 1] a, ture of Funeral Service Licensee Per Charge of Interment 1]b. License Number CaEIEp Hi 11, PA 17011 E 1]c. Name and Complete Address of Funeral Facility 01.4819 M ers-Horner Funeral Home Inc. 1903 Ma k m r et St. Cam Hill PA 17011 18. Decetle ni's Etl ucation -Check the box that best describes the 19 D ~ . ecedent of H4spanlc Origin -Check the 20. Decedent's Race -Check ONE OR MORE highest degree or level of school completed a[ the time of death box th b . r at to indicate what ~ 8th grade or less i est describes whether the decedent the tlecetlent c nsitle retl him o lf se or herself to be_ s Spanish/Hispanic/Latino. Check the "NO" ~ No diploma, 9th - 12th grade box if decedent is no[ 5 ~ White (] Korean Q Hi h h Panish/His l i g pan oo graduate or GEp completed ~N c/Latino. Black or African American ~ Vietnamese Q Some college credit, but no degree e ~ not Spanish/Hispa nlc/La [ino O American Indian or Alaska Native ~ Other Asian u Y ~ASSOCiate de s, Mexlca n, Mexican American, Chicano O Asian Indian O Native Hawaiia gree (e.g. AA, AS) Q Ves Puerto Rican ' , n Bachelor O Chinese s degree (e.g. BA, AB, BS) ~ Ves Cuban O Guamanian or Ch ~ ' , amorro Master s degree (e.g. MA, M5, ME:ng, MEd, MSW, MBA) ~ yes 0 Filipino O Samoan other SPanlsh/Hi , spanic/Latino ~ Doctorate (e.g. PhD, EdD) or Professional degree O Japanese ~ Other Pacifi I l c s ander . MD DDS OVM LLB JD (Specify) ~ Other (Sped 21. Decedent's Single Race Self-Designation -Check ONLY ONE fo indicate what the de d ce ent considered himself or herself to be. 22a. Decede Wt's Usual Occu White ~ Japanese O Samoan Patlon -Indicate type of work O Black or Afri A can merican ~ Korean 0 Other Pacific Isla ntler done during most of working life. DO NOT USE RETIRED. Amer(can Indian or Al k N as a ative ~ Vietnamese Q Don't Know/Nat Sure p Asian Indian Re is tered Nurs ~ Other A i s e Q Chinese an ~ Refusetl 226. Kind g8usiness/Industry ~ Native Hawaiian 0 Other (S if pec y) O FIIlpino ~ Guamanian Pr Chamorro ITEMS 23a - 23d MUST BE COMPLETED 23 Date Pronounced D Health Insurance Co d ea . (MO DaY/Yr) 236. Si BV PERSON WHO PRONOUNCES OR gn atu re of Person Pronouncing Death (Only when a li CERTIFIES bl pp ca e! 23c. License Number DEATH 3D /~ A 23d to Signed (MO/Day/V r) 24 Ti f ~ ~ . .,~ ~-Q-_ ./ / ~~~~~ fQn ~I /~/~{~ / /~~ /~~O ~~j~ me oL ~Death /'~,~~ U r, /l/ ~)Z 1[ ~~'711/Y /~ `+~ ©~ !T/ ~ ! /// ___ /// ~~~ f ~~~ C ~ / O ~N 25. Was Medical Exa m i ner or Coro n e r C o nt a cted? yes o CAUSE OF DEATH 26 Part I Ente [h h . . r e c ain of events--diseases, Injuries, or complications--that directl cau d h i i A y se resp t PProx m ate e death. DO NOT enter terminal a ents such a ardlac a est ratory arrest, or ve ntr~cular 1'ibr{Ilation without h Ing the etlolo s c r I s ow `~ r gy DO NOT A . nt Lrval: BBREVIATE- Enter only one cause on a line. Add additional lines if necessary Onset C ~ o Death IMMEDIATE CAUSE ---- ® ~ N _- / - --- ------ s a. l-°`( A ~ E /L~ ~_- . (Final disease or condition Due to (o resulting in death) cons q ence of)~ --- r a e _ b ~4~- ~- L ~ G . , s w / l ,~ sequenualN usi tpnmtions / I ~ >~-r D , Die o (pr if any, leading to ue ~a~se as a cp nseq ue ~e of>: --- € ) ~"/ listed on Ilne a. Enter the c. -_-/ 7~~Tl+J/)/ ~j ~^ UNDERLYING CAUSE / ~ - D ue to (or (disease or injury that as a consequence of): -~ - -- ___ F Initiated the events resulting d, in death)LAST. '~ Due to (or as a consequence of): ---- - a_J 26. Part 11. Enter other slgnifica n[ c_ditlons contributin t d th but not resulting in the d un erlyin g cause given in Part I 2]. Was an autopsy perfo ed? m Ves No y ]8. Were a opsy findings a ailabie ° ' 29. If Female: to co pieta the cause of death? Eo O No[ pregnant within past year Q Pregnant at ti f 30. Did Tobacco Use Contribute to Death? 0 Yes ~ No 31. of Death O Yes O Prob bl ~ u m me o death ~ Not pregnant, but pregnant within 42 days of death a y , Nat ral ~ NO ~ Unknown 0 gccid t O tl t- Q Nqt pregnant, but pregnant 43 days to 1 year before death en Pend n Investi ~ Suicide O G 3 l O Unknown if pregnant within the past year 2. Date of in ould not be deter m fined Jury (Mo/pay/Yr) (Spell Month) ~ 34. Place of Injury (e.g. home; construction site; farm; school) 33. Time of Injury 35 L . ocation of Injury (Street antl Number, City, State, Zip Code) 3 6. Injury at Work 37. If Transportation Injury, Specify: Yes 38. Describe How Injury Occu rretl: 0 Q Driver/Operator ~ Pedestrian No ~ Passenger ~ Other (Specify) 3 9a. Cee Iffier (Check only one): rtifying physician - To the best of my knowledge, deatrtlying physician - To the best of my knowledge, death occurred du o the c e(s) and m Q Pronouncing 8 Certif e [ aus nn r st i h t d y ng p a e ysician - To the best of O Metlic I Examiner/Coroner - On the basis of ex my knowledge, death occ ed ai the t me, d ce, nd place, and du the se(s) and m d r st.rhe S f ~n my opinion, death o ed a the ~me~da e, and place and tlu r 3 e , e ~y~ ( ) )d'/ ed - certifier: 9b. Name A dre d ~ ~~~~ d i - , ss an Zip Code of Person Co License Nu/Fiber: LT ~ y ~ rA .t~ 39c Date Si n d (MO D ay/ V r ) 4 0. Regisira is Dis[ric[ Number r ^ ' ' ~ ~ 4 41. Registrar s SI e-c~ ~/ ~ 42. Registrar F-le ate (MO/Day`/Vr) 3. Amend menis .~// ~ / Z_ Disposition Permit No._ 0740448 H105-143 REV 0]/2011 ~'i.~. '~..,,J LAST WILL TESTAMENT OF I, SYLVLA M. KUTCHMAN, of the Borough of Camp Hill, , Commonwealth of Pennsylvania, being of sound and dis osin mi ~~~~~~d~.~~F~ty understandin do hereb make p g ~`~ PA g~ y ,publish and declare this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. i bequeath certain articles of my tangible personal property in accordance with a written list made by me during my lifetime. In the absence of designation of such a list, said articles of tangible personal property shall be distributed to my children, WILLIAM J. KUTCHMAN and JANET K. LUSH, in equal shares. THIRD. I give, devise and bequeath my Stock Portfolio as follows: A. Unto my daughter, JANET K. LUSH, Fifty Percent (50%) share of my Wachovia Securities Account; B. Unto my son, WILLIAM J. KUTCHMAN, Ten Percent (10%) share of my Wachovia Securities Account; C. Uni:o my granddaughter, SUMMER ROSE HOWARD, Ten Percent (10%) share of my Wachovia Securities Account; D. Unto my granddaughter, SIERRA A. LUSH, Ten Percent (10%) share of my Wachovia Securities Account; E. Unto my grandson, KEITH KUTCHMAN, Ten Percent (10%) share of my Wachovia Securities Account; and F. Unto my granddaughter, AMANDA KUTCHMAN, Ten Percent (10%) share of my Wachovia Securities Account. FOURTH. I give, devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wheresoever situate as follows: A. Forty Percent (40%) unto my son, WILLIAM J. KUTCHMAN. or his issue, per stirpes. B. Forty Percent (40%) unto my daughter, JANET K. LUSH, or her issues, per stirpes. C. The remaining Twenty Percent (20%) unto my grandchildren, KEITH KUTCHMAN, SUMMER ROSE HOWARD, SIERRA A. LUSH and AMANDA KUTCHMAN, in equal shares, per stirpes. FIFTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary ~~ ,-:~ u estate. SIXTH. I hereby nominate, constitute and appoint my daughter, JANET K. LUSH, as Executrix of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of JANET K. LUSH, I nominate, constitute and appoint my grand'.daughters, SUMMER ROSE HOWARD and SIERRA A. LUSH as Co- Executrix of this my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting security in connection with her duties, as such, in any jurisdiction in which she may be called upon to act: insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. IN WITNESS WIEIEREOF, I have hereunto set my hand and seal to this, my Last WiII and Testament, consisting of two typewritten pages this ,~8~ da of MG(/~'1/h , 2007. y SYL A M. KUTCHMAN Signed, sealed, published and declared by the above named Testatrix SYLVIA M. KUTCHMAN 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 presence of each other, have hereunto subscribed our names as witnesses. /? G~~~. COMMONWEALTH OF PENNSYL VANIA . SS. COUNTY OF CUMBERLAND I, SYLVIA M. KUTCHMAN, 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. SYL .kA M. KUTCHMAN Sworn or affirmed to and acknowledged hefore me, by SYLVIA M. KUTCHMAN this -; x, i ~ _ ~ ,' UtY~~~. N ryP blc~ COMMONWEALTH OF PENNSYL VANIA COUNTY OF CUMBERLAND day _-'~-_____NOTARIAL SEAL 2007. Kathy L. Mummert, Notary Public Borough of Carlisle, Cumberland Co,, Pq~ My Cornrnisc6r 3 .~~rres Aug. 71, 2007 ~ ~_~. _ - SS. We, , ~,,- ~ ~-~r=:r ~~~ ~~ 1"~~~i r~l and } i.~.C; r ~ .~ ~ i L ~ t"; 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 SYLVIA M. KUTCHMAN sign and execute the instrument as her Last Will; that she signed willingly and that she executed as her free and voluntary act for the purposes 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 eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by - ~~~~~E~ ~ r';,:~~~ fr,ri~~11 ~c..~~E' ~, i ~~;'l~~l ,, this ~x ` , day of ~~'~', ;i. ~~~ t ~"1 ,, ., and ,witnesses, 2007. Notary.~u lic NOTARIAL SEAL ~ Kathy L. Mummert, Notary Public ,rough of Carlisle, Cumberland Co., Pq _1'~~t• G09?'C^'v`.~~i='"~ "=„r~;res Aug. 71, 2007