Loading...
HomeMy WebLinkAbout06-19-12Reset 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 nn_ n Name: Samuel Irvin Conrad File No: U ~ ~' p(- f~~ ~~ a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 205-18-2454 Date of Death: April 27, 2012 Age at death: 86 Decedent was domiciled at death in Cumberland County, Pennsylvania (stare) with his/her last principal residence at 12 Moore Circle, Carlisle, PA 17013 South Middleton Township Cumberland Street address, Post Office and Zip Code City, Township or Borou gh County Decedent died at Holy Spirit Hospita1503 North 21st Street 17011 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: If domiciled in Pennsylvania ............................ All personal property $ 74,000.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ ~ ~~ If not domiciled in Pennsylvania ........................ Personal property in County $ ~ Op Value of real estate in Pe»nsylvanin ...................... ................................... $ ~ pp TOTAL ESTIMATED VALUE.... $ 74.000.00 Real estate in Pennsylvania situated at: None (Attach additional sheets, ifnecessary.) 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 July 15, 1997 and Codicil(s) thereto dated n/a. Anna Louise Conrad died on May 8, 2009 and Elizabeth A Payne has renunciated her appointment as Co- F.xecntrix in favor of Cathie C. MacArth rr, the former Cathie i R erc (See attached ctatPment from Cnnncell State relevant circumstances (eg. renunciation, death ojexecutor, 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 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.~a. or c~b.n.c.~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 defimed in 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 left no Will and was survived by the followin~ouse (if any}~d heirs (atta~i additional sheets, if necessary): ~Q ^~ ~ r~`t rrt~ C` "ri C7 Name Relationshi Addres c~-~k i ,; _ ...~' `^ ~i ~- ` , r..~ ~ -1 .. D. O ~7 Form RW-o2 rev. ~oi»nol~ Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND Official Use Only Petitioner(s) Printed Name Petitioner(s) Printed Address Cathie C. MacArthur formerl Cathie L. Beers 2730 N. 2nd Street Harrisbur PA 17110-1204 The Petitioner(s) above-named swear(s) or affirm(s) the statements in,t'he foregoing P 'tion aze true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Dece pt,~the i ' s) well and truly administer the estate according to law. Sworn to affirmed d subscribed be ore ~ ~~ ~~ /~ Date ~ ~ ~ ~ z--- me~lr~ay o ~ ~~ Date ,~ n i .. .. ,. .,. ~ the Register BOND Required: ®YES ®NO FEES: Letters ...................... $ 135.00 ( 10) Short Certificate(s)...... 40.00 ( 1) Renunciation(s)......... 5.00 ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other Will Fee ........ 15.00 ........ Automation Fee ............... 5.00 JCS Fee ..................... 23.50 TOTAL ..................... $ 223.50 Date Date To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: ~ Printed N e: Gary L. Rothschild Supreme Court ID Number: 62041 Firm Name: The Law Offices of Gary L. Rothschild Address: 221 For s Hills Driv , S ,i 'i5 ~Iarrisbug, PA 171 12 r r['1 ~"- Phone: (717) 540-3510 ~ >-! Fax: (7171540-3512 ' ~ Email: „ir„rt,i~.,.n ................... ~.-,, r ~-~'.'~ DECREE OF THE REGISTER ~,--. ~ _ ©_ C - ~s ~._, ~ rrt _., +~ `~ ~ o / rn Estate of Samuel Irvin Conrad File No: ,~'~ -~ ~ ~ ~,~[L'~h a/k/a: AND NOW, / ~~ ~ ~ /,/~ ~, , / , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS E~1tEED tha Lett Testa en are hereby granted to ~' ~ - ~~(~, ~ r' in the above estate and (if applicable) that the instrument(s) dated July 15, 1997 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. ~, ~a, ~ ~~ ~,~ ~ Register of Wills ~ ~ } ~ ~i 1 ` Form Rw-oz rev. ~oiniaoi! 6 Page 2 of 2 H 105.805 RHO' (9!i i I ~Oi2 JUN 19 LOC Cad :~~-R'S CERTIFICATION OF DEATH WA~s~:.l . ~ o duplicate this copy by photostat or photograph. ~L~~~ t irk ,~ ~ :-1..7 Fee for this certificate, $6.00 ~~ ~; a~ This is to c~'rtit~ that the infornJation here. liven i eorreetly copied~~i-(Jm an original Certificate of Deatl _ duly riled witi~ (ne as Lo~~al Re~zi>trar. `I-he origina certificate ~~:i?? ae tonvarded u:i the State. Vita ~P~~I~ ~~~~}~{j Records Ol~fire #•Ir permanent tilin~~. P 18487355 Local Re~istr~.x I)atc ]slued COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS CERTIFICOTF AF I7FOTH Certification Number Type/Print In Permanent Black Ink 6 O_Sa Y 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Numbers _ 4, Date of Death (MO/Day/Vr) (Spell Mo) Samuel =ruin Conrad Male 205-15-2454 April 27, 2012 Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Da 6. Dale of Birth (MO/Day/Yea r) (Spell Month) 7a. Birthplace (C(iy and State or Foreign Country) ~1 a6 Months Days Hours Min utes June 7 • 1925 7b. Birthplace (County) ClE?aL-f 1Ea1d Sa. Residence (State or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) 8<. Did Decedent Live In a Township? PA - 12 Moore Circle ~7 v¢:, eecedent rayed in Sot1Y1-t Mi c7dl rein 8tl. Residence (County) Twp, Cumberland Se. Residence (Zip Code) (] No, decedent Ilyed within limits of city/born. 9. Ever In US Armed Forces? 30. Marital Status at Time of D eath 0 Married ~ Widowed 11. Survlying Spouse's Name (If wife, give name prior to firs[ marriage) Ves Q No Q Unknown ~ Divorced Q Never Mauled ~ Unknow 12. Father's Name (First, Middle, Last, Sufflx~ 13. Mother's Namc Prior to First Marriage (Firs[, Middle, Last) Ssaac Nelson Conrad ~ Mabel Elizabeth Johns 14a. Informant's Name 14b. Relationship to DecedenC 14c. Informant's Mailing Address (Street and Number, City, State, ZI Code) g Lawrence 2_ Conrad son 105 Ege Dr_, Carlisle, PA 1701 G ___________ _ ______________________________ ............................................... _.... .. .... Sa_ P ace o Deat.,. C on Y one ,.......... ... C~.. ........ _ z If Death Occurred in a Hospital: [~ Inpatient ... ................. _ ________ __ (If Death Occurred Somewhere Other Than a Hos Ital~ ~~~~~ ~ ~~ ~~~~~~~~~ ~ ~ ""'"""'"""""'."""""' p ~ Hospice Facility ~ Decedent's Home ° Q Emergency Room/OUtpatlent Dead an Arrival • ~ Nursing Home/Long-Term Care Facility Other (Specify) aq 15 b. Facility Name (If not ins[itutlpn, give street and number; 16c. City or Town, State, d Zip Code i5d. County of Death Holy Spirit Hospital Camp Hill, PA 17011 Cumberland a 16a. Method of DisppsiTion Q Burial ® Cremation 16b. Date of Disposition 16c. Place of Disposition (Namc of cemetery, crematory, or other place) p Removal from state p Dpnaap^ Other (Specify) May 1 , 2012 Hof fman-Roth Funeral Home & Crematory ~ 36tl. Location of Disposition (City Town, State, and Zip) Carli l PA 17013 17a. 5}Rnaiure of Funeral Servic 'In Charge of Interment 17b. License Number / _ ( \ ~ s e, ,/ oi`~ JV ~ I`yA ~ 135504 E 1ZC. Namc and Complete Address of Funeral Facility ~ ° - 1 N H '7 ~ 18. Decedent's Education -Check the box that best tlescribes the r 19. Decedent of Hispanic O Igln -Check the 20. Decedent's Race -Check ONE Oft MORE races to Indicate what ~ highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. ~ 8th grade or less Is Spanish/Hispanic/Latino. Check the "NO" White 0 Korean ~ No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. ~ Black or African American 0 Vietnamese 0 High school graduate or GED completed Q So colle e redif but no de ree ~ No, no[ Spanish/Hispanic/Latino 0 American Indian or Alaska Native Q Other Asian Y M i i g , g Q Associate degree (e.g. AA, AS) es, ex can, Mex can American, Chicano ~ Asian Indian Q Native Hawaiian (] Yes, Puerto Rican Q Chinese 0 Gu ratan or Chamorro Bachelor's degree (e.g. BA, AB, BS) r' M t d ( MA M6 ME MEd MSW MBA ~ Yes, Cuban Q Filipino ~ Samoan V h h as e s egree e.g. , , ng, , , ) 0 Doctorate (e.g. PhO, Ed D) or Professional degree ~ es, ot er Spanis /Hispanic/Latino Q Japanese ~ OTher Pacific Isla nd¢r (Specify) Q Other (Spec) fY) . MD DDS DVM LLB JD 21. Decedent's Single Race Self-Designation -Cheek ONLY ONE to Indicate what the decedent considered himself or herself To be. 22a. Decedent's Vsual Occupation -Indicate type of work (~ White ~ Japanese ~ 0 Samoan done during most of working life. DO NOT USE RETIRED. Q Black or African American ~ Korean ~ American Indian or Alaska Native ~ Vietnamese Q Other Pacific Islander Q Don'i Know/Not Sure AreYLiteetural Engineer Q Asian Indian Q Other Asian ~ Refused 22b. Kind of Business/Industry ~ Chinese 0 Native Hawaiian Q Other (Specify) Te1e~..~y~One COm n ' • pa ]~ Filipino O Guamanian or Chamo rro Y ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dea Mo Day r) 236. Signature of Person Pronouncing Deat (Only when applicable 23c. License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH •~• t ~. .~~) o~ 23d. Date Signed (MO/Day/Vr) 24. Time of Death 25. Was Medical Examiner or Coroner Contacted? Q Ves Q No CAUSE OF DEATH 26. Part I. Enter the chain of events--diseases, Injuries, or compl Approximate tcatlons-that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval: respiratory arrest, or ventricular fibrillation without showing L ~e et gy. DO NOT ABBREVIATE. Enter only one cause on a Ilne. Add atldiVOnal lines if necessary Onset to Death ^ IMMEDIATE CAUSE ---------------> a. ' ~ l~L9 f ` s (Final d(seas¢ or condition /"j~ lti I d th) " Due to (or a ~ equence o ^ - n ' (~~~ resu ng n ea G b ~ ~ ~ ~G~~ t~ V , /'/ J( /' V] Sequentially list conditions, ~ Due To (or as a con eq a of): if any, leading to the cause listed on Ilne a. Enter the UNDERLYING CAVSE Due to (or as a consequence of): (disease or Injury that Initiated the events resulting d. In death) LAST. Due to (or as a consequence of): s 26. Part 11. Enter other slgnifica rat conditions contributing to dea th but not resulting in the underlying cause given In Part 1 27. Was an autopsy performed? O Yes ~ 3 28. Were autopsy findings available ~ to complete the cause of d¢athT Q Ves Q No 3 t 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Man~~]P.r of Death E Q Not pregnant within past year 0 Yes Q Probably ` ~ ~'Nattiral Q Homicide ~ ~ Pregnant at time of death 0/i loo Q Unknown ~ Accident Q Pending Inves[igatlon m ~ No[ pregnant, buc pregnant within 42 days of death ~ Suicide ~ Could not be determined ~ Q Not pregnant, but pregnant 43 days [0 1 year before death 32. Date of Injury (MO/Day/Vr) (Spell Month) ~ Unknown if prcgna of within Lhe past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury aT Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: 0 Yes Q Driver/Operator ~ Pedestrian ~ No ~ Passenger 0 Other (Specify) 39a. Cj~lifler (Check only one): ®~Certifying physician -. To the best of my knowledge, death oec u rr¢d due to the cause(s) and manner stated O Pronouncing 8. Certifying physics he best of my knowledge, death occurred at [he time, date, and place, and due to the cause(s) and manner stated Q Medical Examiner/Coroner - O t) is amination, and/or investigation, In my opinion, d ~ x t h e t ime, date, and place, and due to the c se(s) a d m ed 'r dy t n Signature of certifier: ~~ F ~ / / f ~ w Title of certifier: ~"~t.C~~`La^'~ s License Number 3 N Addres 21p de of P n Com 1¢ttng Cause ( eath ( m 6) ^ _ , / 9c. Date 5 g Mo/ y/Yr) I ~C / L C ` .' l '•'_" l/ 4 .Registrar' Dist ct Number 41. Registrar' nature ~ 42. Registra le Date MO Day r) y~ 43. Amendments Disposition Permit NO. `/'I ~J1J~~~ REV 07/2011 LAST WILL AND TESTAMENT OF SAMiJFi. IRVIN CONRAD I, SAMUEL IRVIN CONRAD, of Middlesex Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declaze this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved wife, ANNA LOUISE CONRAD, to her own use and benefit absolutely. 3. In the event my said wife, ANNA LOUISE CONRAD, should predecease me or die at about the same time I do, such as in an accident or disaster common to both of us, I hereby direct all the rest, residue and remainder of my Estate to be divided and distributed as follows: A.) One-fourth (1/4) thereof shall be given to my grandchildren, including those born after the date of this will, who survive me, as a class, per capita. B.) Three-fourths (3/4) thereof shall be distributed in equal shazes amongst my children, per stirpes, to wit: Lawrence I. Conrad, Cathie L. Beers, and Elizabeth A. Payne. (It is understood that in the event one of my said children predeceases me and is survived by children that those children may take in their own right, per capita, under subparag. A above and may ,also ~~ take their per stirpital distribution through their parent's stocks). ~ ~ c ~? ~ _ -; K- ~; tD , ~~i 4. ~ ~-% r~ _ ~_~ ~ - ~] o~l.= v ~, I nominate, constitute and appoint my said wife, ANNA LOUISE CONRAD, to be ~ Executrix of this my Last Will and Testament. In the event that she should predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate, constitute and appoint my daughters, Cathie L. Beers and Elizabeth A. Payne, to be Co-Executrices in her place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. ~(C~F.o~u~ (1. Qyakle IN WITNESS WHEREOF, I have hereunto set my hand and seal this /S day of u ~ y , A.D. 1997. (SEAL) S L IRVIlV C NRAD Signed, sealed, published and declared by the above-named SAMUEL IRVIN CONRAD as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed ur names as witnesses. Q~l~.}~~ ~ F~~`~E (~ .~ ~Ql2 .~U~ I g PFD ~, ~~ ~OR~ ~V~S ~:;p~;RTOATH OF SUBSCRIBING WITNESS(ES) ,LAND CO., PA REGISTER OF WILLS -~.C~Q2LA-N ~~ COUNTY, PENNSYLVANIA C- ~ Estate of__4-~11~U,8~ 1d~V~~r1 ~,b ni^ rles ~' ~5~; 2 /c/s ~ Deceased ~ a subscribing witness to (Print Nan,e/s) the J$ Will Gl_C,s), presented herewith, {-being duly qualified according to law, depose(s) and say(s) that -s~}~e-/ he / +~-?~:;; was E present and saw the above Testator '.~-~°s~~,~- sign the same and that she / he /-.#~e~+- signed the same and that -sly./ he / rT-~: signed as a witness at the request of the Testator-~cstaT~lx in leer/ his (Signature) (Sheet Address) presence and in the presence of each other. G 26 (Signature) Charles ~: Sh. e/GES ~L _ ~ C°_/b user v~d. (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Niecaia/rliesdurq ~!~ loo ss (C,ty, State, Ztp) Executed oast of Register's Office Sworn to or affirm~e"d~ and subscribed before me this ~r'~-- day of ~~~+-~ Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. ~~s ~~~~i ~~1 Form R6P-03 rrev. l0.l3.OG Q ~. -r ~wr~t' ~~12 JUN { 9 {'" 2~ Of~ ~;,~_~.~; O=ATH OF SL~BSCRIBIti~G ~VIT~,rESS(ES) oRF~A-y'~ cc~uHT ,' REGISTER OF ~~'ILLS ~~ ~' ~''''t ` i' ~ h~ COUNTY, PENNSYLVANT~~ Estate of ~' 41~~1)~) ~-~~ ~' n ~-~ Deceased L, rl f 1 s ~ ~ : ,~ r ,.-- ,, M 1 . S; r~,s the 0 Will ^ Codicil(s) presented herewith, (each bein du ~ (each) a subscribing witness to say(s) that she / he /they was /were present and a~, ly qualified according to law, depose(s) and and that she / he /they signed the same and that she / he / theVe Testator /Testatrix sign the same the Testator /Testatrix in her /his presence and in the presence of each othertness at the request of (Signatw e) (Stt eet Address) '~ ~ (Cuy, State, Ztp) Executed in Register's Office Sworn to or affirmed/hand subscribed bef me this `1 ~ day of - >~~~ >~c.~ . .T (Signature) I ~S° C~~ ~ I~r . (Street Address) 1 ~G(~I 1s~~ ~~- ~ ~ ~~1 h- (City, State, Ztp) Executed oc~t of Register's Offce Sworn to or affirmed and subscribed before me this day of Deput}- for Reg, r of ~iiis Notary Public ?~1~ Co;iL-ni;sior, Expires: (Sig.^.atnre znd Seal of Notan or other ofciai gcr:i~ ed to administer oa;hs. Show date of expiration ofNo;a:y's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Forst RW-03 rev. 10.13.06 dti,.i~ ~...~{ ttL REC~?~1~r _' i R~~~1,J i ~ ~ ~.~' ,,.._ ,, ~'~~2 Jl~H I9 PM 2~ Q6 ;~;LF,.: ~.. _:: RENUNCIATION ORPt-iA~`5 ~1!JUR~ (~}MBPRLAND CO., P,4 REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of _.~~r Samuel Irvin Conrad Deceased I, Elizabeth A. Pa e (Print Name) , iri my capacity/relationship as daughter and named Co-Executrix in the will of the above Decedent, hereby renounce the right to admuuster the Estate of the Decedent and respectfully request that Letters be issued to my sister, Cathie C. MacArthur, the former Cathie L. Beers D ~ "/ (Date 612 Shenley Drive (SlreetAddress) Erie, PA 16505 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of ~ __ Deputy for Register of Wills Form RW-06 rev. 10.13.06 Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciaY n for the purposes fated within on this day of , Notary Public My Commission Expires: i ~- ~1..} - ~~ (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) TH OF PENNS1fLVAN NOTARIAL SEAL DARCIE A. NEtL,1'>`otary Public Born of Carlisle, Cumberland County My Commission Expires ~!ovember 24, 2013 THE LAW OFFICES OF GARY L. ROTHSCHILD 2215 Forest Hills Drive, Suite 35, Northwood Office Center, Harrisburg, PA 17112 Telephone (717) 540-3510 Facsimile (717) 540-3512 glrothlaw@comcast.net HAND DELIVERED Glenda Farner Strasbaugh, Register of Wills One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Samuel Irvin Conrad Dear Ms. Strasbaugh, June 19, 2012 n Q _ N ~ ~ ~' 0 "' ~ 2 ~; ~~ "" c ~~ ,~ ev ~~ + ri N ~~ I represent the Executrix of the above-referenced estate, Mrs. Cathie C. MacArthur. Mrs. MacArthur is presenting her Petition for Grant of Letters for her father's estate. Please accept this letter as an attachment to the Petition. I have obtained the Oath of one Subscribing witness, Attorney Charles E. Shields, III. Unfortunately, I was unable to obtain an Oath from the other subscribing witness. I made great efforts (correspondence and numerous phone calls over a six week period) in attempting to obtain the Oath, but without success. Accordingly, Mrs. MacArthur shall be provided two non-subscribing witnesses as part of her Petition for Letters Testamentary. Should you have any questions regarding the above or need additional information please feel free to contact me. Thank you for your anticipated attention to this matter. Very truly yours, ~:_ r ~\ Gary L. othschild Enclosures cc: Mrs. Cathie C. MacArthur (w/ enclosures)