HomeMy WebLinkAbout07-13-12PETITION 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 requests the grant of Letters in the appropriate form:
Decedent's Information
Name: Fern M. Long ~ File No: 21 - 12 ~~` )
a/kia:
_ (Assigned by Register)
a!k/a:
a!k/a: Social Security No:
Date of Death: 07103/2012 Age at Death: 86
Decedent was domiciled at death in Cumberland County, pA (State) with his/her last
principal residence at g38 Oak Oval, Mechanicsburg 17055 Upper Allen Twp. Cumberland
Street address. Post Office and Zip Code City, Township or Borough _ t'ounty
Decedent died at 838 Oak Oval, Mechanicsburg 17055 Upper Allen Twp. 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 $
!f not domiciled in Pennsylvania ................. Personal property in Pennsylvania $
If not domiciled in Pennsylvania ................. Personal property in County $
Value of real estate in Pennsylvania........... $
Real estate in Pennsylvania situated at None
(Attach additional sheets, if necessary.)
310,040.OG
TOTAL ESTIMATED VALUE$ 310,000.00
Street address, Post Office and Zip Code
City, Township or Borough
[~ A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) that he/she/they islare the Executor(s) named in the Last Will of the Decedent, dated
thereto dated
County
06/10/2008 and Codicil(s)
(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 mar ,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.
QX NO EXCEPTIONS ^ EXCEPTIONS
^ B. Petition for Grant of Letters of Administration (If applicable)
c. t. a.; .n.; .n.c.t.a.; pe ente rte; urante a tsen ra; urante mrnontate
If Administration, c.t.a or d.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,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 person.
XQ NO EXCEPTIONS Q EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that OeoOdent left no Will and was survived by the following spouse (if any) and heirs (attach
additional sheets, if necessary).
Name Relationship Address --~
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Form RW-02 rev. 1o-f f-2011
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
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Petitioner(s) Printed Name Petitioner(s) Printed Address ~ ~
Joanne Kress 17714 Cricket Hill Drive
Germantown, MD 20874
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The Petitioner(s) above-named swears} or affirm(s) the statements i foregoing Petition are true and correct to the best of the knowledge ana
belief of Petitioner(s) and that, as Personal Representative(s) o~f11t-he ece ent, Petitioner(s) will a and truly minister the estate according t law.
Sworn to or,affirmed and subscribed before Date ~ ~.3 1.2
i ~ ~ 1 ~ ) ~ Date
me thi$-~i~ day of „~
By: lit i I ~I l l I ~ 11~/ i i ~ I . ;. A~ Date
_ ForYhe Register Date
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BOND Required? ~ Yes ""C No
FEES
Letters . ...........................................
~_ ) Short Certificate(s)..........
( )Renunciation(s) ...............
Codicil(s} .........................
c )Affidavit(s) .......................
Bond ... ...........................................
Commi ssion ...................................
Other
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Automation Fee.!.:
JCS Fee .........................................
TOTAL ...........................................
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To the Register of Wills:
Please enter my appearance by my signature below:
Attorney Signat re:
Printed Name: Gerald J Brinser
Supreme Court
ID Number: 09655
Firm Name: Brinser, Wagner 8 Zimmerman
Address: 6 E. Main Street
P.O. Box 323
Palmyra, PA 17078
Phone: 7171838-6348
Fax: 7171838-6912
E-mail: gjbrin@aol.com
DECREE OF THE REGISTER
Date of Death:
Social Security No:
Estate of Fern M. Long File No:
a!k/a:
07/03/2012
21-12 - (~
AND NOW, ~' --~\ `; ,~ , in consideration of the foregoing Petition,
satisfactory proof having been pros nted before me, IT IS DECREED that Letters Testamentary
are hereby granted to Joanne Kress
in the above estate and (if applicable) that the instrument(s) dated 06110/2008
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
egister of Wills
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COMMONWEALTH OF PENNSYLVANIA • DFPA0.TMENT OF HEALTH .VITAL RECORDS
CFRTIFI[ATF AF I]FATN
'Print In
~k,~wt 133-287
1. 0¢cedenl's legal Name (first, Mlpdk, last, 6uHM) I. Sea 3. Social 6ecurlry Number d. Date Of Death (MO/Day/Yr) (Spell Mo)
Fern M Lon Female 208 - 18 - 7693
Sa. Age-Las[ Birthday (Yes) 56. UtM<r 1 Year 6c. Unper l Da 6. Oate of Birth (MO/Da y/Year) (Spell Month) Ja. glrthylacg (City y d State or Foreign Country)
Months Davs HOgrs Minures Philaael liia, PA
86 Se camber 20 1925 m.Birtnvkc<(eoenm 1 a e 1a
Ha. Residence (State or Foreign Country) eb. gexidence (Street and Number ~ Include Apt NO.) ec. Did Decedent Live in a Townxhip7
Penns lvania f&yea,aeaaenteyla,n Upper Allen
twp
se. Realaena IcDDnM 836 Oak wal -
CLnnberland Be. Resklena (Zip Code) ^NO, tlecedent Ilvetl wiNin limits of city(bgm.
9. EVer in U6Armedforceal 10. Markal itagus at Tlme Dl Death ^Manid Widowed It. Surviving Spouse's Nam<(Ifwife, give name prior to Rrstmaniagel
^ Ves ~ ND ^ Unknown ^ OWOrcetl ^ Never Married ^ Unknow
12. Fathei s Name IFirzl. Middle, last, SuHia) 1 3. MoMels Name Prior to first Marriage (First, Middle, Last)
Lawrence S. Terrey Elsie M. Goeltz
14a. Inbrmant's Name 146. RelatlOnshlp to Decedent 14c.lnlormant's MailMg Address l6treet and Number, City, State, 2lp Cede;
Joanne L, Kress Dau hter 17714 Ckid~t Hill IY. C}~artnn hD 20879
........................................... ............. ...Q.............................................Sa.: P.~~.:B :. Dear... CB?c..on one...............................
... ..........................
if Death Ocwrted in a Hospital: ~ In bent If Death Occurred Somewhere Other Than a Hospital. LU Hospice Facility ~ Decedent's Home
~<i
^ Emeryency Room/OUtpatknt Dead on Arrival Nursin Home/ton -term Care Facility Other (S hI
lSb. facility Name (If not Instl[u[lon, gNe street and number; 15c. City Or Town, State, anp Zip Cotle ]Stl. County of OeatM1
838 Oak Oval Me h i Cumberland
I6a. Method o/ DISDOSItIOn [R Burial ^ Cremation
^ Removal from Slate ^ DondtlOn 166. Oate of Disposition t6c. Pkce of Disposition (Name o1 cemetery, crematory, or other place)
otn<r(sp«in,l July 9 2012 Trindle Spring Cemetery
16d. Locatlon of Disposition (City Or sown, State, and Eip1 1)a. a olfune/ Service Licensee or Verson in Charge of Interment
7 I]b license Number
Mechanicsbur PA 17055 - FD - 014889
n<. Name aria complete Address of wnenl Fxigry
Mal zzi 1 P
18 Decedent's Education -Check the box that best describes the 19 Decepenl of Hispanic Origin .Check the 10. Decetlent's Race -Check ONE OA MORE rates to indicate wM1at
highest degree or level of school completed at tM1e time of death. bpv that best tleuribes wM1etM1er tM1e tlecedent ne decetlem consitleretl Wmsel/ or herself to be.
^ BIM1 gratle or less Is Spanish/Hispanic/Latlnp Check [M1e "NO" ~ White ^ Korean
^ No tllploma, 9th - 12th grade b z if decedent is not Spanish/HisPamc/latlnn ^ Black or 4frican American ^ Vietnamese
® High school graduate Dr GED completed ~ ND, riot SpanisM1/Hlipam</lalln0 ^ American Indian or Alaska Na[rve ^ Other Asian
^ Some college credit, but no tlegree ^ Yei, Mexican, Mexican AmeN<an, Cht<an0 ^ Aaron Indian ^ Na[IVe Hawaiian
^ASSOCIate degrer(e.g. AA,A61 ^Ves, Puerto Rican ^Chlnese
^ Guamanian or Chamoro
^ Bachelor's degree Ie.g. BA, AB. BS) ^ Yes, Cuban ^ HnpinO ^ Samoan
^ Master's degree (e g. MA, MS, MEng, MEd, MSW. M9Aj ^ Yes, other 6Damsh/HtspanicJLahnO ^lapanese ^ Other Pacific Islander
^ DDCtorale(eg. PhO, ECD)or Professional degree (SpeciN)~__.___ _ _ ^ Other (Specify)`_
.. MD DDS OVM LLg ID
21. Decedent's Single Race Self-Designation ~ Check ONLY ONE t0 indl<at<what the decetlen[ cpnslderetl himself or herself to be 22a. Deed<nt'i Usual Occupation -Indicate type pl work
WM1ite ^lapanese ^ Samoan done during most el working Isle. DO NOT USE RETIRED.
^ Black or African American ^ Korean ^ Other Da<ifrc lslantler H
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er
^ American Intllan or Alaska Native ^ Vietnamese ^ Oon't Know/Not Sure
^ Asian Indian ^ Other Asian ^ Pefuutl 12b. Kind of 8uslness(Industrv
^ Chlnese ^ Native Hawayian ^ Other (Specify)
^Fdipino ^GUamanianDrCnamomD .-.-_- Ow11 H(xne
ITEMS 23a-I3d MUST gE COMPI.ETEO 23a. px! Pronounced Dead IMO Day/Yr) 23b. Signature of Verson Pronouncing Death (Only when appliable 23c. license Number
BY PERSON WNO PRONOUN('Eg OR
CERTIFIES OFATN JUl 3, 2012
I3d. Date Signed (MD(OaY/Yrl 14. Time d Death
A YOX . 7 : OO A. M. 15. Was Medical Examiner or Coroner COnta<ted2 Yes ^ NO
CAUSE OF DEATH Approaim
at
26. Part I. Enter the chain of eve Is~-tliseases, Inlurles, or <Omplicatlons--that dlrecHY causetl the death. DD NOi enter terminal events such as cardiac arrest Int<rval,
splratory arrest, Dr ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE Enter only one cause on aline Add atltlltlDnal lines it necessary Onset to Death
IMMEDInrE CnusE ~~----~---> a. Probable Myocardial Infarction
-
___
. - - _
Irnal alseax or <Dneitmn a,e LD Irn as a cpnaegDence pll:
resulting in dea[M1l ,
b. Atherosclerotic Coronary Arterv Disease _ _ _ ___
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dl
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gna. Due [o (or as a consequence Oil.
if any, leading to the cause '.
listed On Ilne a
ter N
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.
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e
UNDERLYING CAUSE Due t0 (or as a consequence oil.
(disease or Injury [hat '
i tetl [he even[3 resulting d.
in tleath) ULST. Duo [o (nr az a ronaequence o/). V
2fi. Part 11. Enter Other SknlfSant conditlOns Conti but nn t0 tleath but not exulting in the Underlying cause Hiven in Part I 2T. Was an autopsy metl7
O
^ Vea
NO
Remote MI, Hyperlipidemia 1H. Were au[OpsY Hn Ings available
to com0lete [he cause of death)
^ Yes ^ No
29. If Female: 3p. old Tobacco Use Contribute tO Dealh7 3l. Manner of Death
^ Not pregnant within past year ^ Yes ^ probably ~ Natural ^ HOmicitle
^ Pregnant at time of death ^ Np ^ Unknown [] Accident ^ PeMtng lnvestlgatlon
^ Not pregnant. but pregnant within dl daysMdeatl ^ Sulcitle ^ Could not be determined
^ not pregnam, but pregnant d3 days t01 year before dead 32. Date of Inlurv IMO/Day/Yr) (Spell Month)
^ Unknown if pregnant within the past year 33. Time 0l lnlury
3d. Plare of lnlury le.g. home: cons[rvttron site, farm; schooq 35 Location of rnlury (Street and Number, City. Slate, lip Code
36. lnlury at Work 3J. If Transportation lnlury. Specify 38. Describe How lnlury Ocrur•ed
p Y ^ D.N<r7oplraD. ^ P!e<a
~ rvo ^ passenger ^ Other (Spe<i(yl _
39a Certifier (Check Drily oriel.
^ Certifying physician - i0 the best pl my knowledge, deatM1 occurretl du<tD the causels) antl manner staled
^ pronouncing & Cettllying pM1ysiclan - to the best of my Mnowlepg<, death occurred at the lime, date, antl place, and due to the causels) and manner stated
Medical Eaaminer/CO.oner - Me hosts o e tion, 6pr investigat D n my opinion, death occurretl at the time, tlate and place, and tlue [o the causels) and manner sratee
/' na
a/ i
/
Signature of ttrtifler:
Ttle of certlHer.. ACtiRQ Coro Rer Lrcenx Number.
39b.Name, Address and 2lpCOde of PerxnCempleting Cause Of Death llhm :616375 Bas ehore Roads Suite l~l 39c. Dale Signed (MO/Day/Vrl
Matthew S. Stoner, Acting Coroner Mechanicsbur PA 17050 Jul 3 2012
40. Aegistrais District Number dl. Ae 's ais 6ignature
_ d2. ReBislrar Glk Date (MO DaylVr)
_
43. Amentlmenis
DlaooalnDn Perm,e ND. 0724474
HlDS-143
REV 0]/2011
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WILL
OF ORFE~.~,v', ~U~t~a.
Cl1NfPEF3l.At~iO CO., PA
FERN M. LONG
I, FERN M. LONG, currently of Upper Allen Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any and all
prior Wills and Codicils made by me.
L I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
IL I direct that all estate and inheritance taxes that may be assessed in consequence
of my death, shall be paid out of the principal of my general estate to the same effect as if
said taxes were expenses of administration and all property includable in my taxable
estate whether or not passing under this Will shall be free and clear thereof.
III. All the rest, residue and remainder of my estate, of whatever nature ar~d wherever
situate, including property over which I hold a power of appointment, I devise and
bequeath equally unto any daughter, Joanne Kress, and my son, Randall Long. If either of
them predeceases me his or her share shall pass unto his or her spouse. If either of them is
not survived by a spouse said share shall pass unto my other child named herein or his or
her surviving spouse.
I am intentionally omitting any reference to my daughters, Susanne and Robin.
IV. I appoint my daughter, Joanne Kress, Executrix of this my Will. In the event that
she fails to qualify or ceases to act as Executrix, I appoint my son-in-law, Donald Kress,
Executor of this my Will.
V. I direct that no bond be required of my fiduciaries for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I, FERN M. LONG, herewith set my hand to this my
Last Will, typewritten on two (2} sheets of paper including the attestation clause and
signatures of witnesses, this / «~~ day of ~-~ ,.r ~ , 2008.
,,~ ~ ~ _;,
~~ ~ ~ _(SEAL)
,~~~,-, -I- FERN M. LONG
,_ ,
Signed by FERN M. LONG, by her declared to be her Will in our presence, who
have hereunto subscribed our names as witnesses in her presence and at her request,
this le~ay of Tv ,J ~ , 2008.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF' LEBANON
WE, FERN M. LONG, GERALD J. BRINSER and ~Sh}TN y .~ . ~~ TERM
the testatrix and the witnesses, respectively, whose names are signed to the attached or
foregoing instrument, being first duly affirmed, do hereby declare to the undersigned
authority that the testatrix signed and executed the instrument as her Last Will and that
she signed willingly (or willingly directed another to sign for her), and that she executed
it as her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses and
that to the best of our knowledge the testatrix was at that time eighteen yeaxs of age or
older, of sound mind and under no constraint or undue influence.
FERN M. LONG 'a
,.
ITNESS
WI~ NESS•
Subscribed, sworn or affirmed and acknowledged before me by FERN M. LONG,
the tells''~~,,atrix, GERALD J. BRINSER and k~~-ty ~. ~-~-~5 ,witnesses,
this ~~"`day of Tt,vri~._.._ , 2008.
~ EAL)
otary Publi
COM~gONWEALTH OF PENNSY'i_V'ANIA
NOTARIAL SEAL
WENDY L. CRAWFORD. Natary Public
Palmyra Boro., Lebanon County
M Commission Expires September 10, 2009
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