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HomeMy WebLinkAbout06-08-12Reset 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: Matthew Callen, III File No: ,'h~ " ~~ ~u~ ~ (,', ` i , +~ a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: May 1, 2012 Age at death: 81 Decedent was domiciled at death in Cumberland County, Pennsylvania (Stare) with his/her last principal residence at 36 Lee Ann Court East Pennsboro Twn. Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 36 Lee Ann Court, Enola, PA 17025 East Pennsboro Twn. Cumberland Pennsylvania 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 $ 275,000.00 If not domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ 165,000.00 TOTAL ESTIMATED VALUE.... $ 440 000.00 Real estate in Pennsylvania situated at: 36 Lee Ann Court, Enola, PA 17025 East Pennsboro Twp. 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 February 25, 2012 and Codicil(s) thereto dated N/A State relevant circumstances (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(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 ([f applicable) c. t. a., d.b.n., d.b.n.c.t.a., penclente lite, durante absentia, durance minoritate If Administration, c.t.a. or d.b.n.c.t.a., enter date of Wilt 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 ~ EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (ifany) and heirs (attach additional sheets, if necessary): Name Relationshi Address x'~-.~-''xa © r~ ' ~ ~r n - .~ fTl 1 C ~ ' - t . . - a7 ~ -- r" t"t ( r ~ + r4 V" ` . ~ _, C.;~ ~ ._:! ~ ~ ~' w `~ Form Rw-oz rev. inini~on Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: } COUNTY OF CUMBERLAND Petitioner(s) Printed Name Petitioners; _ Kevin T. Callen 7637 Bland Drive Manassas Vir inia 20109 ~C"~ ` ' r~.~ ~ :;, :~ --i .. ~ W `i~t r-~ :~ 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 Decedent, the P ~%o,~{~s will well and truly administer the estate accordin to law. Sworn t r affirmed d subscribed before ~~//~-~~-----~'~ Date met is dad, ~ ~la Date y: ~.~~ Date _ For ~he Regis Date BOND Required: ~ YES Q NO FEES: Letters ...................... $ ~ ~~ ~ Gt, (~+~~) Short Certificate(s)...... ~ Ot7 ( 0) Renunciation(s)........ . ( 0) Codicil(s) ............ . ( 0) Affidavit(s)........... . Bond ........................ Commission ................. . Othe• ........ r / ........ ~ (,I Automation Fee ............... L~ JCS Fee. _~ ~ l) TOTAL ..................... $ °°-6.9~-•-' To the Register of Wills: Please enter my appearance by my signature below: Attorney ~Signatur~e: ~GGI~..d~..~ fO.u! `u° Printed Name: Shaun E. O'Toole Supreme Court ID Number: 44797 Firm Name: Law Firm of Shaun E. O'Toole Address: 220 Pine Street Harrisburg, Pennsylvania 17101 Phone: 717-695-0389 Fax: 717-213-0272 Email' cntnnle ntnnlelawfirm_cnm DECREE OF THE REGISTER _-, Estate of Matthew Callen, III File No: ~°~ ,r-; ,n z'~~ ') ._~-. a/k/a: - e' ~, (J~ AND NOW, ~L ~/) C'' d , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Kevin T. Callen in the above estate and (if applicable) that the instrument(s) dated February 25, 2012 described in the Petition be admitted to probate and filed of Form RW-02 rev. 10/!1/20[1 i as the last Will (and Codicil(s)) of Decedent. ~ ~, ,,,/ _ , f of Wills .-' >> L L CJ >'r n ~L ' .~r~~~a Page 2 of ~ '- _.~/ :~ ~ ' .~ ~~~ 5 '~' ~~~?~ = a ,f ~' It ~.' L. ,ti~ I S . . , , _ .. 212 Jt1N -8 P~ 2: 3y .., ,, K ~'./ 4 S" ~i~Hi4~lrs vvi.~~ ,. , ~. , r . , :.7 CUMBERt.~WG CO...~A ,~ ~ ~ ' e/Print In COMMONWEALTH OF PENNSVLVANIp • DEPARTMENT OF HEALTH • VITAL RECORDS ma"`"` CERTIFICATE OF DEATH I. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social SecOFlty Number 4. Date of Death IMO/Day/YrI (Spell Mo) Matthew Callen III Male 012 9a. Age-Last Blrthtlay IYrsj Sb. Untler 1 Vear Sc. Under 1 Da fi. Datp of Birth IMO/D ay year) ISpell Month )a. Birthplace ICiry and State pr Foreign Country) 81 Months Days Heprs Minate, Au ust 5 1930 New York New York g , ]b. Birthplace ICOUeryj New York Ba. Residence (State or Foreign Country) Bb. Residence IStreet and Number- Include Ap[ Np.j Bc. Did pecedent live In a Townshlp7 Penns 1Vanla 36 Lee Ann Court ~f Yes, decedent lived In Fa C} PpnnEatx'3rFT two. ed. Residence lCOUntyj Cumberland Be. Residence IZIp Codel 17025 ^No, decedent lived within limits of city/born. 9. Ever In US Armed Fortes? 10. Mar tai Status at Tlme of Death ^ Married ~ Widowed 11. Surviving Spouse's Name Ilf wife, give name prior t" firs[ marriage] ^Yes ®NO ^Unknown ^Divorced ^Never Marred ^Unknow ll. Father i Name IFlri[, Midtlle, Last, SuHlx) 13. Mother's Name Prlpr [o First Marriage (First, Middle, last) Matthew Callen Sr. Josephine Selba 14a. Informant's Name 14b. Relationship to Decedent ldc. informant's Mailing Address IStreet and Number, Ciry, State, Zip Codej ffi Kevin T. Callen Bon 7637 51and give Manassas VA 20109 (-i ........... .. ... ... ... ........... ......................................... ISa. P ace o Dea[ C ec ............................................... onYOne ............................... .............,................ ...................................... "' If Death Occurred in a Hospital: Inpatient ~ it/Death Occurred Somewhere Other Than a Hospital: ~ Hospice Faculty Decedent's Home ^ Emergency Room/Outpatient ^ Dead on Arrival ~ ~ Nursing Home/long-Term Care Faclliry ~ Other (Specify) lSb. Facility Name (lf not Ins[i[uHOn, give street antl number; 15c. Ciry or Town, State, and Zip Cotle 19d. County pf Death 36 Lee Ann Court ~lola, PA 17025 Cumberland 1fia. Method of OlspeslHOn ~ Burial ^ Cremation 16b. Date of Olzpesitipn 16c. Place of Olsposition (Name of cemetery, crematory, or other place) ^ Removal rpm state ^ opnatie" ngay 5, 2012 Paxtang Cemetery ptner Ispe[ityl Z 16d. Location of Disposition ICiry or town, State, and Zipl 1)a. Signature f u al Service ll ns Or Person in Charge of Interment e 3]b. Ucense Number Harrisburg, PA ~ ~~ i' FD-13A630 E 3)<. Name and Complete Atldress of Funeral Faclliry 18. Decedent's EducaHOn -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent s Race ~ Check ONE OR MOPE races to indicate what highest tlegre or level of school cpmpletetl al the time pf death. box that best describes whether the tlecetlent the decedent considered himself or herself to be. ^ BtM1 grade or less is Spanish/Hispanic/Latino. Check the "NO" White ^ Korean No diploma, 9th ~ 12th grade box it decedent is not Spanish/Hlspanic/Latino ^ Black or African American ^ Vietnamese High school graduate or GED completed W No, not Spanish/Hispanic/Latino ^ American Intlian or Alaska Na[IVe ~ Other Asian Some college cretlit, but no tlegree ^Ves, Mexican, Mexican Amen[an, Chicano ^ Asian Indian ~ Native Hawaiian ^ Associate degree Ie.g. AA, ASI ^Yes, Puerto Plcan ^ Chinese ^ Guamanian or Chamorro (Bachelor's degree Ie.e. BA, AB, BSI ^Ves, Cuban ^ Filipino ^ Samoan Master's degree le.g. MA, Mg, MEng, MEd, MSW, MBA) ^Yes, other Spanish/Hispanic/Latino ^lapanese ^ Other Pacific Islander ^ Doctorate (e g. PhD, EdD) or Professional degree Ifipecityl ^ Other (SpeciN) e.. MD, DDS, DVM, LL0 1D 21. Decedent's Single Pace Self-Designation ~ Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation ~ Intlica[e type of work White ^lapanese ^ Samoan done during most of working life. DO NOT USE RETIRED. Black or African American ~KOr<an ^Other Pacific Islander owner/Operator American Indian or Alaska Native ^ Vietnamese ^ Don't Know/Not Sure Asian Indian ^ Other Asian ^ Defused 226. Kind of Business/Industry Chinese ^ Native Hawaiian ^ Other (Specityj Tire Retail Sales ^Rnlplne ^wamamanprcnamprrp ITEM5234- 23d MUST BE COMPLETED 23a Date Pronounced Dead IMO/Day/Vrj 23b. Signature of Peron Pronouncing a[h IOnty when applicable] 23c. License Number BY PERSON WNO PRONOUNCES O0. CERTIFIES DEATH ` A^ , •~ ~' 1 I 1 ~ ~ ~ ~~~,~~(~ JU l ~~ ~ j J O~ 23d. Date Signed IMO/Day/Yr) 24. Time o De h _ . , .. _tL ,r) / ~ ~ ,, ``~ ~ 1N 25. Was Medical Examiner Dr Coroner Contacted? ^ Yes No CAUSE OF DEATH i Approximate 26. Part I. Enter the chain of ev ts~-diseases, Injuries, prcomplications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval: er poly one cause onallne. Add additional lines if necessary i Onset to Death respiratory arrest, or ventricular Rbrillation without showing [he etiol o g y. DO NOT AB B REVIATE. En t 14. 1s /~ ~ F Z - IMMEDIATE CAUSE ----------~---> a. ~~\ZXYGI ryTivV~Nf /'~~,f=/' (Final disease or condition Dve to Ior a q e ofl~ ~ resulting In death) /`- _ _ ,}, I ,/~ SepuentialN list conditions, D eta (or asa mnsmns "f): If any, leading to th<cause C ass y'^ 1 ~ ~~~ ~ listed on line a. Enter the v' l~]-0 k~1 ~4T U ERLY NG GU9E D ue to for as a consequence pN: ND I (disease or Injury that _ Inltlatetl [rte events resulting d. in tleath) LAST. Due [o Ior as a consequence of): S 26. Part II. Enter other si¢nificant cpntli[ipns contributin¢ to death but opt resulting in the untlerlying cause given in Part I 2]. Was an autopsy pertormetl7 ^Yes ~f46 I 28. Were au[ppsY findings available to omplete the cause of death? O ~ Vei ^ No ~ 29. It Female'. 30. Dltl Tobacco Use Contribute [o Deaths 31. Manner of Death o ~ Not pregnant within past yeas ^Yes ^ Probably lad-Nd[ural j] Homicide Pr<gna eof death t l Slav ^Unknown ^ Accitlent ~ Pending lnvestlgatlon , but pregnant within 42 days of dean ~ Not pregna nt ~ Suicide ~ Could not be determined Not pregnant, but pregnant d3 tlayz [p 1 year before dean 33. Date of Injury IMO/Day/Yr ISpell Month) Unknown it pregnant within [he past yeas 33. Time o/Injury ', 34. Place of Infury le.g. home; conztrvction site; farm; school) 35. Location of Injury IStreet antl Number, Ciry, State, Zip Codel 3fi. Injury at Work 3). If Transportation InlOry, Specify: 38. Describe Haw Injury Occurred-. ~ Ye ^ Driver/Operator ^ Petlestrian No ^ Passenger ^ Other lSpecity) 39a C ter (Check onN oriel: Certitying physician ~ Tp the best of my knowledge, tleath occurretl due to the causelsl and manner stated ^ Pronouncing & Certifying physician ~ To the best of my knowledge, death occurred at the [Ime, date, and place, and due to the causelsl and manner stated ^ Medical Examiner/Coroner ~ Ih ^bas s p11f a ~' Hon, and/or Investigation, in my opinion, deatyh o~ccur(r~ed al the Hme, date, and place, and due to t~he~ca~fu~sels~) a~n(d'7ma~nsne~r stated ~ ~ 4 I "su / TI[le of rertlfier. /v `' f] Ucense NUmber:IVl~V.1L~/^"l J(..U~ Signature of certifier: 39h. N e, Address antl Zip Code of Person Completing Ca se of Death II[em ZBl 39c. Dale Signed IMO/Day/Yr) Richard M. Ma ill 2151 Lin lestown Road rrisbur PA 17 1 40. Registrar's Ois[HC[ Number 41. Re Ist s Signature 42. Regis[nr Flle Date IMO Day/Yr) 43. Amendments MI08 1d3 Dispo:iron Permn Np. 0693680 REV m/gnu .. - -- _ -- -== ~F = -= r-i- - ==- MATTHEW CALLEN, III I, MATTHEW CALLEN, III, declare this to be my Last Will and Testament and hereby revoke all prior wills and codicils made by me. FIRST: At the time of the execution of this, my Last Will and Testament, I am a widower. My wife, Etta I. Callen passed away in 1990 and I never remarried. I have four (4) sons, Michael J. Callen, Matthew Callen, IV, Christopher P. Callen, and Kevin T. Callen. Any reference in this Will to "my children" is a reference to these four sons. SECOND: My Executor shall pay from the residue of my estate all my debts, funeral and administration expenses and all estate, inheritance, succession and transfer taxes imposed by the United States or any state, territory or possession which shall become payable by reason of my death. It shall not be necessary to file any claims therefore, nor to have them allowed by any court. THIRD: I give and bequeath such of my tangible personal property as is set forth in a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, to the persons therein designated. If I have not left a Letter of Instruction or for those articles of property not distributed under this Letter of Instruction, I direct that such items be distributed to my children, in equal shares, all of my tangible personal property which I own and insurance thereon, to be divided among them as they may select in as nearly equal shares as is practical. If there is any disagreement as to distribution, I direct my Executor to make such di st ribution. ~~he ~ ~ ~~ -~, decision of my Executor shall be final and binding. Any items not selected may ~ or ~ ~~ ~:=? s {~`j' ~'^1i._~ ~,.~ .. ~~ ... .:~:C7 ~' + ~ rr~ ~ 4 ~ ~'+ distributed in the sole discretion of my Executor and if sold, the net proceeds therefrom shall be added to the residue of my estate. FOURTH: I give and devise the reside of my estate, real, personal and mixed, of whatever kind and nature, and wherever situate at the time of my death, including any property over which I now have or hereafter acquire a power of appointment, unto my issue, per stirpes, provided that should any beneficiary have not yet attained the age of twenty-five (22), his or her share of the estate shall be distributed to the Trustee hereinafter named to be held and administered, IN TRUST, for the benefit of said beneficiary pursuant to the terms of Item FIFTH. FIFTH: The Trustee shall administer the share of any beneficiary who has not yet attained the age of twenty-two (22), IN TRUST, for the benefit of said beneficiary, as set forth herein: A. Trustee shall accumulate the net income and expend and apply so much of the net income, accumulated income, and principal of this trust as the Trustee, in its sole and absolute discretion, deems advisable for the health, maintenance, support and education (including vocational and college education, both undergraduate and graduate) of the beneficiary, after taking into consideration the beneficiary's other readily available assets and sources of income, or during illness or emergency. The Trustee may apply the net income, accumulated income, and principal of this trust for the health, maintenance, support and education of the beneficiary, should the beneficiary, by reason of age, illness, or any other cause, in the opinion of the Trustee, be incapable of disbursing it. B. When the beneficiary attaizis the age of t~.~enty-two (22) years, the Trustee shall distribute to the beneficiary all of the principal and accumulated income of the trust to the beneficiary. C. In the event that any beneficiary shall predecease the complete termination of the beneficiary's trust, the remaining principal and accumulated income of such beneficiary's trust shall be distributed to such beneficiary's surviving issue, if any, in equal shares; or if such beneficiary shall have no issue then living, then to such beneficiary's siblings, per stirpes, provided that if any such issue or siblings at such time have not attained the age of twenty-two (22), his or her_ share shall be distributed to the Trustee hereinafter named to be held and administered, IN TRUST, for the benefit of said issue or sibling pursuant to the terms of this Item FIFTH. SIXTH: I nominate, constitute acid appoint my sun, KEVIN T. CALLEN, as the Executor of this my Last Will and Testament, to serve without bond or security, and to make distribution of my estate in cash or in kind, or partly in cash and partly in kind, and in such manner as he may determine. I authorize, empower and direct my Executor to sell and convey, by good and sufficient deed, in fee simple estate, any and all of my real estate, at public or private sale, for such price or prices, upon such terms and conditions, as in his judgment is best for my estate, and to that end to sign, seal, execute, acknowledge and deliver all deeds or other instruments necessary therefore, as effectively as I could do if I were personally present. In the event my son, KEVIN T. CALLEN, does not survive me, or refuses to act as Executor or does not complete the duties of Executor, then I nominate, constitute and appoint my son, MICHAEL J. CALLEN, as the alternate Executor, to serve without bond or security. My 3 alternate Executor shall have all of the powers, privileges, duties and immunities granted to my Executor as provided herein. SEVENTH: I hereby nominate, constitute and appoint my sons, MICHAEL J. CALLEN and MATTHEW CALLEN, IV, as Co-Trustees of any Trust created herein, to exercise all of the powers conferred upon trustees by law, and all of the discretionary powers granted herein. The Co-Trustee and any successor trustee shall be entitled to compensation for services from time to time during the period in which they are performed. If and in the event that either Co-Trustee refuses or is unable to act as Trustee, predeceases me or dies before the termination of any trusts herein created, the other Co-Trustee shall serve as the sole Trustee. EIGHTH: My Trustee is authorized to invest, reinvest and keep the trust assets invested in such real and personal estate as a prudent man of intelligence and discretion would do for himself, for investment and not for speculation, giving due regard to the safety of the principal and the adequacy of the income, without being limited to the so-called "legal investment" in the Commonwealth of Pennsylvania. NINTH: No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in my estate or any trust created herein in any manner other than by the valid exercise of a Power of Appointment. No part of my estate or any trust created herein, shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. 4 IN WITNESS WHEREOF, I, MATTHEW CALLEN, III, the Testator, have to this my Last Will and Testament, set my hand and seal this ~~ day of ~~wu~ , 2012. /~ ~~, ~~~ ~, ''~ ~ ~,: . ,~ t 4. ~ ~~ '~ '~ ~ ,-r°~I~ (SEAL) MATTHEW CALL Signed, sealed, and published and declared by the above named 'Testator, as and for his Last Will and Testament, in the presence of us, who have hereunto subscribed our names at his request, as witnesses hereto, in the presence of the said Testator, and of each other. The preceding document consists of this and four (4) other consecutively numbered typewritten pages. residing at ~v/, J ~~~G ~ ~~~ G~ ~ ~ ~ ~ r ~ ~/~ ~ re._~dmg at 5 ACI~NOWLEDG ~~rTLN'I' COMMONWEALTH OF PENNSYLVANIA j SS.. COUNTY OF DAUPHIN ) I, MATTHEW CALLEN III, 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged befare me by MATTHEW CALLEN, III, the Testator, this ZS day of Ftbr~,..~_, _, ?012. 'r - i `: -~= Testator - --- --_-- `° ~ ~ cr~-- (SEAL) (rotary Public or Attorney AFFinAVi'T COMMONWEALTH OF PENNSYLVANIA ) SS.: COUNTY OF DAUPHIN ) ~ ~ //~~ We, ` and G 7 ~~~~ ,the Witnesses who e name are si ned to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his Last Will; that the Testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the will as a witness; and that to the best of our knowledge the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirm d and acknowledged before me by ~ ,and ~~ L Gh/l ~ ~~~ c° r7 ,witnesses, this ZS day f ~~ , 2012. G~~'l~"~' "~, ~rttTes ~L ~-l~~/`z-~ ~~, Wit ss ,'~"x-- ~o of ~~/~~ (SEAL) Notary Public or Attorney ATTORNEY AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS.: COUNTY OF DAUPHIN ) On this, the _~~ ~'~~~' day of J~Li<,~ ,'<~ , 2012, before me, the undersigned officer, personally appeared Shaun E. O'Toole, kno~ vn to me or satisfactorily proven to be a member of the bar of the highest court of Fennsylvania, and, being fully aware of the criminal penalties relating to unsworn falsification to authorities, certified that he was personally present when the foregoing acknowledgment and affidavit were signed by the Testatrix and witnesses. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. C.Otlh50[4WEAl_7i-~! U'~P pF_tiT•3SYL\!API~A ._ "NOTARIAL ~; c,_s,_.._~ - ! ~ t,, h~~~'~iDA L LANG Notary Public '~-~1~~-i'~~fc. ,~~ ;/`~)'~;~.~~ -(SEAL) Uu. pi~in County + Notary Public ~. _ . ~ Expires August 9, 2012