HomeMy WebLinkAbout06-12-12PETITION FOR GR-~NT OF LETTERS
REGISTER OF WILLS OF ~~~ 1 1 ~ 5 ~ \2~ch~7~cc-~ COUNTY. PEti~~SYLDANI:-~
Pe:.tiot:~_•(~, t:::m.:d be'.o~,~. ~~~o i~,~3.. ~ e, f'
~. ° 1~ ~e -s ~,e or eider, a^r..fiesl ter L,t~,,:, as t cif:°d bzlotiti~, and t
sr~.opor: ther_o[ a~.;,,a"s; ti~:~ toa;, .vu1~ and re~~ecttiili~ ~;,yt;.st(~i the ~ra:.~ of Let:;rs iu !ne _ippr~prtate orin:
Decedent's Inf'ormati n ,~
Name: ~ \'> 4~ If% `~ ~ _ 1`~( 1~~ ~ ~~' "
~ `" ~ File No: .~ ~ _ ~;f l,' ~ ",(..~
a/k, a. (Assigned by Register)
a/k/a:
a/k/a: Social Security No: L'' 1 C(- ~ ~S -,3 ~j ~L%
Date of Death: `~(~a r) ~ (~ , ;~~ r Age at death: `~ ~;
Decedent was domiciled at death in ("1;,rn~j~~ lc:,h~~ County, ~ ~.~i~S ' `U4v . ~- (stun) with his/her last
principal residence at 1~~ .,~~1~'6v'~ C 1,'r~;~ ~~C'C,rt ~-C~C1ni~Yl-C`~ y+:~ i 4 (~~;rytl,~~t 1[~-~ ~frjvr~'~./
Street address, Post Office and Zip Code ~s j, City, Township or Borough County /
Decedent died at "~3 ~6 ~„1~'lG~t°S`~~`n ~`4~'l i~~'t~ti~,1.~~ ~~ 9 ~~^ ~i..~~1~1~i'r~ ~~ L.
Street address, Post Of rce and Zip Code City, Township or Borough Count}' State
Estimate of value of decedent's property at death: U~~
If domiciled in Pennsylvania ........................... All personal property $
If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $
Ijteot domiciled in Pennsy!vania ........................ Personal property in County $
Value of real estate in Pennsy!vania ........................ . , , , , , , , .. , . $
.................
TOTAL ESTIMATED VALUE.... $
Real estate in Pennsylvania situated at
(Arta h additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township ar Borough County
~A. Petition for Probate and Grant of Letters Testa
mentary ~,~,~
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated ~ ~ f ~7 1 ,~ (.G ry~and Codicil(s)
thereto dated
State relevant circmnstances (e.g. renunciation, death of executor, 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(g), and did not have a child bortt or
ado ted; 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 life, durante absentia, durmtte minoritate
If Administration, c. t. a. ord.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 perso ri~-',-',; ~7
^NO EXCEPTIONS ^ EXCEPTIONS ~~ ^? x7
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the fol~' spgase (it~y) ands
additional sheets, ijnecessury): ~,
~ ,~' ,.''
Name
Relationshi rv _
Ad~dss '
"i
r' ~Cy
~ .c' i:J: rr't
C...?
Fo,-n, aw-nz ,~e~. roitt,zntt Page I of 2
Oath of Personal Representative
CO~IVIONWEALTH OF PENNSYLVANIA }
} SS:
cocNTY of _~',~, -ti~b~lct~l
Official Gse Only
Petitioner(s) Printed dame Petitioner(s) Printed Address
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 i'etitiotaer(s) and that, as Persona( Representative(s) of the Decedent, the Petitiot r )will well and truly administer the estate according to law.
Sworn to or ~f trmed an: ubscribed before ~ ,4!~Y,i ~ ~ ~i -~ti(,..'._ Date "- ,~.~" ~ ~"
me th:f° c~ ~ , ~ Date
BV. I; -- y
~P` Date
For the t?ej;Crt r Date
BOND Required: Q YES ~NO
FEES: "```"""'~~~~~~
Letters ...................... $ _: ~~~'
( ~~ )Short Certificate(s)...... _~J . (~';
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Comtnissiott ................. .
Odter ..... ,
`/
~,11~i1 ....... ~_ ~
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 if ~ ~ Y `1 ~,(' `1 ~ 1't C `l (VIC. Y1C ~ File No: -~ I j ~~ -~_. ~~~ (~ X
a/k/a:
AND NOW ~ ~ ~~ ~~ 1~
it ' ~ 1 ~ ~~' 1 ;~-- , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters `T `~ 1
~_. ~t L'~~'t : ~.:~
are hereby granted to 1''~Q I ~i,l (,j ~ . ~`~ I ~ ~ ~ ~; n i
in the above estate and (ii` applir_.able) that
the instrument(s) dated ~ ~~ - -
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
'L~~ li(l( ~-~- ~l a.i~~Ll~-~-1 f I t
Regtster of Wills
~" ~
~~ ; i 7 ~, '~) ~ a-~. E f,~ '
Foi~~~ nw-n? rw. lniuiznlt Fag~2 of 2
!{Illy \'l5 N1\' iyr:' I. - _- _. _.
LOCAL REGISTRAR`S tER'~~~:;~A1"It'i~+I~ ~ `~,:~'~.~~
0.NARNING: It is illegal to du~lic~t~~ t~, ~ie,~ .. ;1 ~-~^ :~~~~.a ~~ ._~k ; ~~ ,,~
I~ee fair this ccrtif~iratc. ~~(3.1~(i
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COMMONWEAITM OF PENNSYLVANIA • pEPARTMENi Oi NEAI iN • VITgL RECORDS
l`L ATFrta•nr
---------~-~_ ~• .~~..... Slate Frle Number'.
1. Decedent's Legal Name (First. Mitldle
Las[
Suffix)
,
,
2 Sea 3. Sacral Security Number 4. Date 01 peach (MO/Oay/Yr SDeII Mo) I
Charles R. Richmond
Male 019-28-3990 June 6
2012
9a
gge~last Birthd
Y
,
.
ay I
rsl Sb untler 1 near Sc. UMer i Da 6. Oate 01 BirtM1 IMO/Oay/Year) ISDeII MonlM1l Ja. Birthplace (City and State or Forei
n CO
g
Un[ry
Mpnmi D,vf HgUrf Mmgt<f ~ h n h
78 June S, 1939
)b eirtnpla[e(cggmyl eristo
ga. Reirtlen[e (State or Foreign COUntryl eb. Residence (Street antl Number -Include Apt NoH 8c Oid Decede
t L
I
i
n
rve
n a
ownshipl
Penns 1V is
Hart
xlen
~
{
¢
Yei, d<[ed<nt lived in
ga. R<frden[<ICpgmyl 190 Salem Church Road --------'w0
ClmLberland 8e Residence (lip Cotle) 1 ^NO, decetlent lived within limits al
sty/bar
9 Ever in US Armetl FOr[esi ]0 Marital Status at Time of Death ^ Married ^ Witlowed 11. Surviving Spouse's Name Ilf wit
i
y
c
<, g
O
ve name prior to llrst marriage
es ^NO ^Unknown Divorced ^Never Marrietl ^Unknown
12. Father's Name (First, Middle. Last, Su/fix)
Ralph N. Richmond l3. MOtM1er s Name Prior t0 Firs[ Marriage (Fir t, Mitldle, last)
14x
InlOrma
t'
N Fldith E. 9allam
0 .
n
s
ame 14b. Relationship to Oecetlent 14C. Informant's Mailing gtldress (Street and Number, CI[y, State, Zip Code,
Wend L. Brittain D
ht
~ au
er 14 h I
w
s
.......................................................... ................ eo 0eam c e k
lBa Plac
Ir0<mnoaor.ealnaHpfpital: C~ m 1.,s..gnryone ............................
he
!
~ry
n
w
mer ez If Death Occurretl Somewhere Other Than a Hospital: p] Hospice Facility ~C1 Decedent's Home
^ E genry ROOM/Outpatient ^ D d
A
i
on
rr
val ~ Nursing Home/Long-Term Care Faculty ~ Other (Specify(
15b
Facility Name (II not in
tit
i
' ~
.
s
ut
on, give street and number
]6c. City or Town, State, antl Zip Code
1sa co
f
unty D
oearn
Carol Croxton Slane Residence
Harrisb PA 17110
~ Dauphin
16x. MetF.od 01 DispOSitlgn ^ Burial [~ Cremation i6b. Dale of Disposition 16c
place Of Dis
iti
N
.
pos
on (
ame of cemeter
^ Removal tram State ^ Donation Y. [rematory, or other place)
atherlsw[nvl one 7 2012 Holl
Cr for
1
\ 6d. LOCatipn Of DISpOSIIIOn (City or Town, State, and 2ipl I)a. Of a )[e . P<.s
eo
i
CM1
v on
n
arge of Interment 1)b license Number
Mt. Holly Springs, PA 17065
o FD - 014889
1)c. Name antl Complete Address OI Funeral Facility
Mal zzi Funeral Hone 8 Market laza Wa Mechanicsbur DA 17n55
18 D
d
'
° ece
ent
s Education - Check IM1e box that best describes the 19. Decedent of Hispanic Oriein ~ Check the 2D. Decedent's Race ~ Check ONE 00. MORE races t0lndi[ate what
highest degree or level of school
l
d
cOmD
ete
at the time of dea[M1. box Ina! best describes whether the decedent the decetlent considered himself or nersell tO be.
^ BIM1 8rade or less
is Spanish/Hispanic/la[ino. Cne[k IM1e'NO' ~ Whl[e ^ g
^
q diploma, 9tM1-12th grade
H
boa iidecedent is not Spanish/Hispanic/la[ino ^Black orgfn[an American Vietnamese
^ igh uhool
radua[e Or GEO Completed
e
No not Spanish/Hispanic/LdL1nD ~gmer can Indian or Alaska Native ^Other Asian
^ Some cOlleg cretlit, but no degre ^ Ves
<
Mexic
M
i
,
an.
ex
can American. Chicano ^ Asian IMlan ^ Native Hawaiian
^ A ociate tle8ree lee. AA, AS
v
~ y rtO R can
^ Chinese
^ Guamanian or CM1amorm
Bachelor's degree eg. BA AB, BSI
^ v s
Cuban
'
,
^ F
rliprno ^ Samoan
it '
^ Ma er z Degree leg. MA, MS, MEng, MEd, MSW, MBA) ^ Yes, other Spanish/Hgpamc/Latino ^ la0anese ^ O
P
h
t
er
a[rfic Islander
^ poctorate eg PhD, Ed Dl pr Profesf rOnal degree ISpecrfyl ^
O[M1er 5
le. MD, DDS. DVM, LIB, ID --- --- I peciryl,_. - _
21 Decetlent's Single Race Sell~Designation CM1eck ONLY ONF to indicate what IM1e decetlent consrtlered himself pr M1erself t0 be. 22a Decedent's Usual Occu
g] wn¢<
Pahon -Indicate t
f
k
ype °
wor
^ lawn< ^ sampan
tlOne tlunng most of working life 00 NOI USE RETIRED
^ Bla[k Or African American ^ KoreanSP ~ Dth
P
fi
i
er
aci
c
slander
^Amen[an lntlian Or glaska Native ^wetnamese ^DOril Know/Not Sure 1'eleVl$loll TeChnlClan
^ As an Indian ^ OiM1er gzran ^ R<fusetl 22b. Kind of Business/Industry
^Cnmese ~ Nati
H
ve
awaiian ^ Other SpecilY _ _ _ _ _ _ _ _
^Filipi^o ^Guamaoian or cnamorro ~ F,leCtrOn1C Repair
ITEMS 23x- 23d MUST BE COMRLETED 23x. Date Pronounced Dead IMO/Day/vrl 236 Signature n/Person Pronouncing Death (Only when applicable) 23c
BY PERSON WHO PRONOUNCESOR
License Number
.
/(~ ~>y ,y r!L [~ ~) /
CEdRTIDFalES DEATH L ~ I 'w/ J- /V .L4~rV~ /34'L ./Xr.~ / 1 ~~ /IAI~ ~ Sd EE L
gned (M /pay/Vrl 24. me of Death
'1v/L ~'Y2'~ 25 Was Medi[al Examiner or Coroner COntactedl ^ Y Nq
CAUSE OF DEATH
26. Par[ L Enter the chain of events--diseases, In ones, or coin licahons~-[hat direal App`oximate
D
N
O
das
cn
rdiac arrest nerval:
espiratory arrest, or ventricular fibrillation without showsng tM1e etiology. DO NOT ABg EVIATE aEnte
r on
ly
One cause on aalinee Adtl
o
a
a
I Imez I/necessary Onset to Death
IMMEDIATE CAUSE ~~----.....--> , I SOe'}~rv~,{C ~p~a.M YU OA
'~'Y ~
T
/l.4Ka
(Final disease or <ontlition Due to (or a
--"- ----2~
s a consequence Of):
resulting in death)
b ~OUx+?Y f~fL_T>C~2iOSGC-6265~s /~ Y
e
s
b
li
l
S
r
egoen
,
y
ift [gndiupni, Dq D Ipr ai a [gnfegD<na qn _ _
ir,ny, le,eingmme cagfe
ta
e
fi
te
on
ne a. Enter me
UNOERLYINO CAUSE Due to (Or as a consequence all: ~ -
(tlisease or injury tM1at
ti f
d th
e
e events reinbing a.
in deatnl UST. Due to for as a consequence 00 _
V 26. Part ll. Enter otM1ers nf'ca dt b t d Ihbutnof resulting in the unde
l
i ~
r
y
ng cause given in Partl 2) Was an autOps
yperformedl ~+
M~~-Sn~}r~e
~
~ ^ Yef ,e,~
,
~/h~}ytf~
~ 2a were autopfy rindmgs ayaila ~/
& mplete [net use qr aeat ~~
0[0
a
v z 9 nFemale 3D 0 ve
^ No
a C
. aid mb,[[o use comnbgre moeaml
^ N01 pregna t within wit year 31. Manner of Death
^ ve ^ Probably ^ Natural ^ H
P
i
i
n
^
r<gnan[at
om
c
tle
rime of deatM1
^ NO ^Unknown ^ A
id
m cc
ent ^ Pending Investigat .l
^ Nat pregnant, but pregnant wlfM1in 4Z tlays of death
~ Suicitle
N
C
l
~
^
ou
tl not be determined
ol Dregnan[, but pregnant 43 tlays to 1 year before death 32. pate ql Injury IMO/Day/Y 5 II MonlM1
r31 De
^ unknownnpre
gna t within [he past year 33. time of Injury
3 A Place 01 InlurV (e.g. Home; construction site; /arm, schoOll 35. location o Iury (Street and Number, City, State, Zip Codel
3 fi Injury at Work 3). 11 iranspor[ation Injury. Specify: 38 Describe Now Injury Occurretl
~ ^ v ^ anger/opoaror ^ Peaesnr,n
^ No ^ Pas en8er ^ Ocher (specify)
3 9a Cert' r(CM1eck only onef
C
if
ert
ying physician To the be41 Of my knOwletlge. tleatM1 occurred due to the <ause(sl antl manner stated
^ PronO
nc
8 C
d
U
i
ert
wng physician to the best ql my knowletl8<, tleath occurred at the ti e, tlale, antl Dlaee, and eue to IM1e causes and
^ M
manner stated
n
cOical Ewa r/Coroner On the basis pl er ,and/or mveztlgation, rn my opinion, tleath o<curretl at the time, date, antl place, and due [° the causeli) and manner sta[ee
re gmer
i e pf [ernner _ gmberQS~ $ 533 L
t L ens
1
3 ame, Atltlr<s Zip Code eting Cause of Death (Item 2fi)
r
Op 39
Date SI /Day l
/
O~
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Regis[raispistnct Number 41 0.e
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Ois POSinon Permit No 0729_ H]DS.143
avv mnnn
LAST WILL AND TESTAMENT
OF
CHARLES R. RICHMOND
~Q
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I, CHARLES R. RICHMOND, now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may
have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum. I have handwritten or signed, located with my will or with my valuable papers and
found within 30 days of the probate of my will. Gifts may only be to persons who survive me or
to organizations which exist at my death, and if there is a conflict, the memorandum having the
latest date shall govern. To the extent no such memorandum is found, or all of my tangible
personal property is not disposed of pursuant thereto, my tangible personal property shall be
added to my residuary estate and pass under Article IV hereof.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my daughter, WENDY L. BRITTAIN, of Cumberland
County, Pennsylvania, per stirpes.
Article V
I nominate, constitute and appoint my daughter, WENDY L. BRITTAIN, as Executrix
of my Last Will and Testament. I direct that my Executrix be permitted to serve without bond.
In addition to those powers granted by law, I grant her power to distribute in cash or in kind, in
like or in unlike shares, and to file any qualified disclaimer I could have filed if living. My
Executrix shall receive reasonable compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executrix, in her absolute
discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
2
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any
beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Executrix; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
(j) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF, I, CHARLES R. RICHMOND, hereby set my hand to this
L.-~-' ~ ~
my Last Will and Testament, on ~ ~ , 2008, at Harrisburg, Pennsylvania.
~~~ ~ ~~
CHARLES R. RICHMOND
In our presence, the above-named CHARLES R. RICHMOND signed this and declared
this to be his Last Will and Testament and now at his request, in his presence, and in the
presence of each other, we sign as witnesses.
'J .
~ Name ~ ' ' Address
. ~~t.iu~.ck~ •~~ NCO /1l"T /`--/1-~.h ,UV~. l~t~,C~, ~~ /-7cs~.r /tGrSSllRf1 Gd/cps
1 fn 1111tP 7 7 ^l`.,,~3---rn--~~-'~i ]~ D`
--v 200 Lin~lestown Rd Suite 202 Harrisburg rA 17110
3
I, CHARLES R. RICHMOND, Testator, who signed the foregoing instrument, having
been duly qualified according to law, acknowledge that I signed and executed this instrument as
my Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
CHARLES R. RICHMOND, the Testator
on ~ c,'~~ ; ~ ,S , 2008.
No y u i
~ l
~~~/_
CHAR ES R. RICHMOND
COMMONWFF~:.:~s _f= PENNSYLVANIA
NotariFV Seal
Mariellc F. Ha?c,s~. Notary Public
Susquehanna 'iws,,, Dauphin
My Cottunission Exptres Sept, 23, 2 10
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testator sign and execute this
instrument as his Will; that he signed and executed it willingly as his free and voluntary act for
the purposes therein expressed; that each of us in his sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or
more of age, of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subsc ibed to before me
by ~~rhlC~ ~{ . sf' ~
and m~ ~C I S . ~'Y11 L
witnesses, on f-f t~ ~ ~,;( 5 , 2008
Not y Pub i
COMMONWEALTH _s~t~NSYLVANIA
Notarial Seal
Mariellc F. Hazen, Notary Public
Susquehanna "Itvp., pauphin County
MY Commission Expires Sept, 23, 2010
-,.
Witness
Witness
4