HomeMy WebLinkAbout06-02-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF ~ L M ~~~ (~v-=~ COL`~iTY, PE'~NSYLVAMA
i et![10 :~:'(~) I'.~:L:1ed ''^c'.~C'•.ti. ~,~ti!0 1S a~9 i~ ye3."S ~ 3°.? CC OiCi.'C. appi;~(:es' ICf L~tIeC~ as Sic'. C!t;,~, ii bcl:)~V, di1L li:
st.pport thereci aver{s) the folio~,~;ne anu respectf~ul~, regt;atl,sj ihz_~rart of Letters ul tie appropriate form:
Decedent's Information
Name: ~ ~ _~) 11,! t I~r C, ~ C~'~ ~~"
a/k,'a:
a/k/a:
a/k/a:
Date of Death:
Lj~.LIS L~
Decedent was domiciled at death to
principal residence at ~~ (,(; a ~'~ L,~
Street address, Post Office and Zip Code
Decedent died at ~,(~ti~ ~
FileNo• ~~,~-~/~- ~~Q~
(Assigned by R/ Je.,gister) ll
Social Security No: ~ /~-' ~" ~ I I
A eat death:
- ti ~1~.C~ ~ l ~' v')!- (Suue) with his/her last
City, Township or Borough
County
Street address, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
-7 ~ `~ ~~
If dotnici[ed in Pennsytvania ............................ All personal property $ / ~ 1 (; (;(} : G., `)
If not domiciled in Pentrsytvania ........................ Personal property in Pennsylvania $
If trot domiciled in Pennsylvania ........................ Personal property in County $
value of reai estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VALUE.... $ (T~~ "(,~_
Real estate in Pennsylvania situated at: ~~ `~ ~L
(Attach a~itiona[ sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough County
L~ A• Petition for Probate and Grant of Letters Testamentary ~ ~~ `"~
I'etitioncr(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated ~ ~~ and Codicil(s)
thereto dated
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
adop ;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, durance absentia, durmtte minoritate
If Administration, e.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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
^NO EXCEPTIONS ^ EXCEPTIONS
n~
Petitioner(s), after a proper search has/have ascertained that Decedent left no W ill and was survived by the following sp~e (if any) and~rs (attach
additional sheets, if'necessary): y0 r.~ -~
L t 'r t C`7
Name Relationshi Address ~
v> lV --~~
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For.» aw-nz rw. lnillilnll Page 1 of 2 ~~~
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Oath of Personal Representative
CO~[~fONWEALTH OF PENNSYLVANIA }
,' 1 ss:
COCK i Y OF ~ ~~~~~ ~~~~~ ~~
I
Petitioner(s) Printed Name Petitioner(sj Printed Address. - "~
~`
~I l~' ~ ~~~1 -btii 1(L, ~'l ~ ~. l- L S w' ~ r I ~~- C.tJAy , Ti~~= t/:~--~ es>" S, • L
L-.1 '~ ~'1 ' L% .- ~C I ~ 3 ~ . F L~ C~ ~,~ ~ -~ ~1~ ~C~ ~~ ~ ~~ S ~ 1 'Ct t ~
Tlie Petitioner(s) above-named swear(s) or affirm(s) the statements
of Petitioner(s) and that, as Personal Representative(s) of the Dece~
. ~
Sworn to o~ affirmed and subscribed before ~`'~~
me th's j~$a ofd ' ,~~ "2!<
By: ,.~~ ~
o e egister
-~.,
~ ~~
in the foregoing Petition are true and correct to the best of the knowledge and belief
i~nt, the Petitioner(s) wt ill well a rd~truly administer the estate according to law.
d.. ti `-'` L ' Date ~ - 1 Z - ~ ~-
~ ~~~ yr Date (a •- i ~- -_ ! a--
Date
Date
BOND Required:~jYES ~NO
FEES:
Lett $ ~/ ~~.G7[?
ers ...................
( ~) Short Certificate(s)... ...
... ~ . D~
( )Renunciation(s)...... ... ~
( )Codicil(s) .......... .. .
( )Affidavit(s)......... .. .
Bond ..................... ...
Commission ............... .. .
Oth r ..... ...
r~ ..... ... ~ v0
Automation Fee ............ ... _~, ~-D
JCS Fee . ................. ... f-~'L.
TOTAL .................. ... $ Xi l7 ~, 5 (3
Estate of ~ / •
a/k/a: ,
File No: ~ ~~~
AND NOW, ~/')~~, ~G~/ ,inconsideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS ECREED th~i,Letters
are hereby granted to ~~_
in the above estate and (if appli able) that
the instrument(s) dated - -
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(sll of Decedent
Forn: RW-03 rev. f0/11/20!!
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
Oal Use Only ~.
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COMMONWEALTH OF PEN NSV LVANIA ~ DEPARTMENT OF HEALTH _ VITAL RECORDS
f"C OT~CtI^ATC nip r~rw
- - e Number:
1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number q. Date of Death (MO/Day/Yr) (Spell Mo)
Vir into C_ Scheff Femal une 3, 2012
6a. Age-Last Birthday (Vrs) 56. Under 1 Vear Sc. Under 1 Da 6. Date of Birth (MO/Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country)
a, gg Mpntt,s Days Hogrs Minptes Nov 26 , 1922 Pal a NJ
7b. Birthplace (COUnfy)
8a. Residence (State or Foreign Country) 86. Residence (Street and Number -Include Api No.) 8c. Did Decedent Live in a Township?
PA 442 Walnut Bottom Rd _ Qyes
decedent lived in
,
[wp
Sd. Residence (COllnty)
Cumberland Se. Residence (Zip Code) ]_'70]_3 gj` No, decedent lived within limits of Card 3 ~ city/boro.
9. Ever in USA med Forces? 30. Marital Status at Time of Death ~ Married Widowed 11. Surviving Spouse's Name (If wife, given a prior to first marriage)
am
Q Yes ® No ~ Unknown O Dl..prced Q Never Married ~ Unknow
12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Lasi)
Arthur F_ Carr Eva R_ Levan
14a, Inf is Name 146. Relationship to Decedent
Lin°c~aa Lu o
9 daughter 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code)
0 123 Stonehouse Rd_, Carlisle, PA 17015
~i .......................................................... .......................................... ........ SSa: Place o Death Check on y one
~
If Death Occurred In a Hos ital:
p [~ Inpatient : ...........-...................~..
.................................... .....................................
If Death Occurred Somewhere Other Than a Hospital: Hospice Facility ~ Decedent's Home
~ Emergency Room/Outpatient Q Dead on ArriVai _ ~ Nursing Home/Long-Term Care Facility ~ Other (Specify)
15 b. Facility Name (If not Institution, give street and number; lSC. City or Town, State, and Zip Code 15d. County of Death
W Thornwald Home Carlisle PA 17013 Cumberland
16a. Method of Disposition Q Burial Cremation 16 b. Date of Disposition 16c. Place of Disposition (Name f cemetery, matory, or other place)
p Remgval frgm state p Dpnatlon Juno 5 , 201 Hoffman-Roth Funeral Home & Crematory
Other (Specify)
16d. Location of Disposition (City or Town, State, and Zip) 1Za. Signat of Funeral Service r Pe n Charge of Interment 176. License Number
Carlisle, PA 17013 138504
E 1?c. Name and Complete Address of Funeral Facility
Hoffman-Roth Funeral Home & Cremato , 219 North Hanover Street, Carlisle, PA 17013
m 18. Decedent's Education -Check the box chat best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR 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 htm self or herself (o be
.
Q 8th grade or less is Spanish/Hispanic/Latino. Check the "N O" White Q Korean
No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. 0 Black or African American ~ Vletna mese
Q High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino ~ American Indian or Alaska Native ~ Other Asian
~ Some college credit, but no degree ~ Ves, Mexican, Mexican American, Chicano ~ Asian Indian 0 Native Hawaiian
0 Associate degree (e.g. AA, A6) O Ves, Puerto Rican
~ Chinese ~ Guamanian or Cha mono
'
~ Bachelor
s degree (e.g. BA, AB, BS) Yes, Cuban
lipino ~ Samoan
'
~
Master
Q gree (e.g. MA, M5, MEn MEd, MSW, MBA 0 panese
s de g, ) ~ Yes, other Spanish/Hispanic/Latino
Ja
0 Other Pacific Islander
~ Doctorate (e.g. PhD, Etl D) or Professional degree (Specify) Q other (Specify)
. MD DDS, DVM, LLB, JD
21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 2Za. Decedent's Usual Occupation -Indicate type of work
$] White ~ Japanese ~ Samoan done during most of working life. DO NOT USE RETIRED
.
~ Black or African American 0 Korean Q Other Pacific Islander Treasurer
Q American Indian or Alaska Native ~ Vietnamese ~ Don't Know/Not Sure
Q Asian Indian ~ Other Asian 0 Refused 22b. Kind of Business/Industry
~ Chinese ~ Native Hawaiian ~ Other (Specify)
Gas Company
Q FIIlpino ),~ Guamanian or Chamorro
ITEMS 23a - 23d MUST BE COMPLETED 23a Date Pronounced Dead (MO/Day Yr) 23b. Signature f Person Pronouncing Death (Only when applicable) 23c
License Number
CERTIFIES DEATH PRONOUNCES OR u-~~ ~ ~
~~~
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23d. a Signed (M9/Day/V r)
l
24. Time of Death ~ , t2N -aaa v
Jo L
~
~R _J 25. Was Medical Examiner or Coroner Contacted? 0 Ves No
CAUSE OF DEATH
Approximate
26. Part 1. Enter the chain of events--diseases, Injuries, or complications--that directly caused the death. DO NOT enter terminal a ents such as cardiac arrest Interval:
respiratory arrest, or Ventricular fibrlllatlon without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a Ilne. Add additional lines if necessary Onset to Death
IMMEDIATE CAUSE --------- -- -> a. p S (^f ~ V ~'1 ~LE~4
_
(Final disease o condition Due to (o as a co nseq uen~e of): -
resulting in death)
b._
Seq uentlaliy Its[ conditions, Due to (o as a consequ nce of):
if any, leading to the cause
listed on line a. Enter the
UNDERLYING CAUSE Due to (or as a ronsequen ce 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 significa ni cond't"o gntr'but'ne to d ath but not resulting in the underlying cause given in Part I 27. Was an autopsy pe rform ed7
D Yes No
2H. Were autopsy findings available
to mpiete the cause of death?
o
O Ves ~ No
29. If Female: 30. Dld Tobacco Use Contribute to Death? 31. Manner of Death
o ~ Not pregnant within past year ~ Ves ~ Probably ~ Natural 0 Homicide
0 Pregnant at time of death js~ No ~ Unknown ~ Accident ~ Pending Investigation
m ~ Not pregnant, but pregnant within 42 days of death 0 Suicide ~ Could not be determined
~ ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Yr) (Spell Month)
Q Unknown if pregnant within the 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 3?. If Transportation Injury, Specify: 36. Describe How Injury Occurred:
Q Ye ~ Driver/Operator 0 Pede trian
~ No ~ Passenger ~ Other (Specify)
39a. Certifier (Check only one):
~H Certifying physician - To the best of my knowledge, death occurred due to the c se(s) and m r stated
[] Pronouncing g. Certifying physician - To the best of my knowledge, death occurred at the time, d te, and place, and due to the c se(s) and m r stated
~ Medical Examiner/COrone O h is of examination, and/or investigation, in my opinion, death occurred at the time, date, antl place, and due So the cause(s) and manner stated
~ as
Signature of certifier:
(~l ~y Title of ce rtifler: License Number: R ~ ~ (6 ~ L'(( ~i
396. Name, Address and Zip Code of Person Completing Cause of Death (Item 26) 39c. Dale Sign (M /Day/Yr)
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istricS Nu
40- Regist rah 5/~D
m ber 41. Registra r'S Si
~ 42. Registrar File to (MO Day/Yr)
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CY~~ -~ 1 ~ ~ 1 '~~ ~~ `~
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43. Amendments
Disposition Permit No. L. J f ~ ~V~ L~ H1O5-143
REV 07/2011
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~~~~ ~~ i ~ ~~ ~, ~Tirgiriia C _
~~µr~ ~~.:_ ~,~~~ (Drive, Moorestown, Burlington
~~~}~~ d'~ ~c~re this to be my LAST
wills, codicils, and trusts.
ScYi~ff ? of 437
County, New Jersey
WILL, revoking all
Paul
08057,
other
F=RST . Debts and Expenses.
I direct that all of my just debts and funeral
expenses be paid as soon after my death as may be convenient.
SECOND : Residue.
I leave all of my estate remaining after satisfying
the debts and expenses set forth in Article First, above,
equally to my daughters VIRGINIA I. SHINN of Moorestown, New
Jersey, and LINDA M. LUGO of Palmyra, New Jersey. If either
of my daughters fails to survive me, I leave her share to her
issue, per stirpes, and if no issue, to my surviving
daughter.
THIRD . Young or Disabled Beneficiaries.
If any person under the age of 21 years, or any
person who is in the opinion of my Executor disabled by
advanced age, illness, or other cause becomes entitled to a
bequest under this Will, such bequest shall not be paid to
such person, but instead shall be paid to my Trustee
hereinafter named, to apply to his or her use the income
therefrom, and also such amounts of principal (even to the
extent of all) as the Trustee may deem appropriate for the
support and welfare of such beneficiary, and when such
beneficiary reaches the age of 21 years to distribute to him
or her the then remaining principal, if any; or in the case
of a disabled person becomes free of disability, to
distribute to him or her the then remaining principal, if
any. If the beneficiary should die before attaining said age
or freedom from disability, then upon his or her death, the
remaining principal shall be distributed to his or her then-
living issue, and in default thereof, to my then-living
issue. Distribution to issue shall be in equal shares per
stirpes.
FOURTH r Accelerated Termination.
If my Trustee, in his sole discretion, determines
that it is impractical to administer any fund held under this
Will as a trust, my Trustee, without further responsibility,
may pay the fund to the person then entitled to receive
income therefrom; or, if there is more than one such person,
to them in such amounts or proportions as my Trustee may from
time to time think appropriate. If any such person is a
minor or is, in my Trustee's opinion, disabled by advanced
age, illness, or other cause, my Trustee may pay the fund (or
his or her share of it) to his or her parent or guardian or
to any person or organization taking care of him or her or,
in the case of a minor, may deposit it as a savings account
in the minor's name, payable to him or her at majority. My
Trustee shall have no further responsibility for any funds so
paid or deposited.
F=FTH s Death Taxes.
My Executrixes shall pay out of my general estate,
as if they were my debts, all estate or inheritance taxes, by
whatever name called, becoming payable because of my death in
respect to all property comprising my estate for death tax
purposes, whether or not such property passes under this
Will.
s T XTH . Powers of Executrixes and Trustees.
l.(a) To retain and to invest in all forms of
real and personal property - regardless
of any limitations imposed by law on
investments by Executrixes or Trustees;
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4b) 'Io compromise claims;
(c) To join in any merger, reorganization,
voting trust plan or other concerted
action of security holders, and to
delegate discretionary duties with
respect thereto;
(d) To sell at public or private sale, to
exchange or to lease for any period of
time any real or personal property, and
to give options for sales or leases;
(e) To make loans;
(f) To borrow money, and to pledge property
as security for repayment of any funds
borrowed;
(g) To exercise any law-given option to treat
administrative or other expenses of my
estate as income-tax deductions, even if
they were paid from principal, and to
value my estate for tax purposes by an
optional method permitted by law in force
when I die, and without requiring
adjustments between income and principal
for any resulting effect on income or
estate taxes;
(
h) To distribute in cash or in kind, or
, partly in each.
2. These authorities shall be exercisable in
respect of all real and personal property at any time held by
my Executrixes or Trustees and shall continue in full force
until the actual distribution of all such property. All
powers, author ities, and discretion granted by this Will
shall be in addition to those granted by law and shall be
exercisable without leave of Court.
SEVENTH = Executrixes and Trustees.
1. I appoint my duaghters, VIRGINIA I. SHINN of 68
Wagon Bridge Run, Moorestown, New Jersey, and LINDA M. LUGO
of 602 Parry Avenue, Palmyra, New Jersey, to be co-
Executrixes and co-Trustees. If either of my dauthers fails
to qualify or ceases to act, my other daughter shall act as
sole Executrix and Trustee.
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2. With respect to my fiduciaries:
(a) Where co-fiduciaries are named and only
one qualifies, the fiduciary so
qualifying shall serve alone;
(b) Any fiduciary hereunder may renounce or
resign at any time, with or without
cause;
(c) My Executrixes or Trustees may designate
a corporation with fiduciary powers to
act as agent or custodian hereunder, may
delegate to it such duties as may be
appropriate (including investment
recommendation duties), may pay to it
reasonable compensation for its services,
and may discharge it, with or without
cause;
(d) No fiduciary named herein or pursuant to
the provisions hereof shall be required
to file a bond, or file an account of any
kind, and then only if specifically
ordered to do so on application of any
beneficiary, my Executrixes or Trustees,
or on a Court's own motion.
EIGHTH : Interpretation.
Whenever terms are stated in the masculine or
feminine gender, they shall be construed as applying to the
opposite gender as appropriate in context. If terms are
stated in the singular or plural, they shall be deemed to be
opposite as appropriate in context.
N=NTH . Definition of Survival .
Far purposes of this Will, a person shall not be
deemed to survive me if such person dies within 30 days of my
death, nor to survive another if such person dies with 30
days of the death of such other.
TENTH : Spendthrift Clause.
No interest in income or principal shall be
assignable by, or available to, anyone having a claim against
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a beneficiary before actual payment to the beneficiary.
EXECUTED: n '~ ~ 1996.
VTRGINI~, C . SCHEFF ~~•"
~,.
Signed, sealed, published, and declared by VIRGINIA C.
SCHEFF, the testatrix above-named, as and for her Will in the
presence of us, who at her request, in her presence, and in
the presence of each other, have hereunto subscribed our
names as witness thereto.
Peter Masnik
ose h Andl
STATE OF NEW JERSEY )
SS.
COUNTY OF CAMDEN )
O ~ J ~ 0 ~~{I ~~
~~~ ~ r~ 08 ars
~, ~ , .--.
VIRGINIA C. SCHEFF, Peter L. Masnik, and Joseph Andl,
the testatrix and witnesses, respectively, whose names are
signed to the attached instrument, being first duly sworn, do
hereby declare to the undersigned authority that the
testatrix signed and executed the instrument as her Last Will
and that she had signed willingly and that she executed it as
her free and voluntary act for the purposes therein
expressed; and each witness states that he or she signed the
Wiil as witness in the presence and hearing of the testatrix
and that, to the best of his or her knowledge, the testatrix
was at that time 18 or more years of age, of sound mind, and
-5-
under no constraint or undue influence.
-~~ ,~
VIRGINIA C. SCHEFF !' d%~
Peter L. Masnik
/T ~, i
r ` -C.
osep~ Andl
Subscribed, sworn to, and acknowledged before me by
VIRGINIA C. SCHEFF, the testatrix, and subscribed and sworn
to before me by peter L. Masnik and Joseph Andl,
witnesses, this 22nd day of February, 1996.
" fG~ 4.1~,„.~. ,..~C.-
lia Kalikman Masnik
Notary Public of New Jersey
My commission expires : 6-30-99
- ~~-