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Home My WebLink About08-07-12PETITION 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: James W Smith Decedent's Information Name: Thressa E Smith File No: 21 ~[~-' k~~ a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 376-05-3995 Date of Death: 07110/2012 Age at Death: 97 Decedent was domiciled at death in Cumberland County, pA (Stare) with his/her last principal residence at Green Ridge Village, Newville 17241 Newville Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Green Ridge Village, Newville 17241 Newville Cumberland PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: /f domiciled in Pennsylvania ...................... All personal property $ If not domiciled in Pennsylvania ................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................:.. $ /y~ D~aU TOTAL ESTIMATED VALUE $ Real estate in Pennsylvania situated at (Attach additional sheets, if necessary.) ^X A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated Street address, Post Office and Zip Code City, Township or Borough 05/31 /2005 County and Codicil(s) State relevant circumstances (e. g., renunciation, death of executor, etc.J 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., pedente lite, durante absentia. durante minoritate 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. ^ NO EXCEPTIONS ^ EXCEPTIONS ,~,, Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the followi Ouse (if arand heirs~tach additional sheets, if necessary): ,~-r~~- /~+ ~ ~..:7 w V vr.. ~~J~ ~,_~ rn z... r ~, _ -r-, Name Relationship Address 'T ' ~ ~ ' ? ,: _ -o : ,_, O ~ _ .__.. ~~ y ~ ca C~ Form RW-O2 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page t of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } } SS: } Official Use Only Petitioner(s) Printed Name Petitioner(s) Printed Address James W Smith 315 Robson Road Dillsburg, PA 17019 The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing P tition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative( f the Deceden~,/Pe~'tio r(s) will Vv II nd truly administer the estate according to law. Sworn to or affirmed and ubscribed before "" ~ Date ~~- ~ - me f ~ da of ~1I Date By: ~.' ~ Date For tt~e Register Date BOND Required? ~ YES ~ NO FEES: Z 'i Letters .......................................... $ ~ . C, ~: ( 2 )Short Certificate(s)......... 8.00 ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ............................................. Commission .................................. Other Will 15.00 Automation Fee ............................ 5.00 JCS Fee ....................................... 23.50 TOTAL ......................................... $ -57-50 I• `Zj To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: l%''~'6`--r Printed Name: Linda J. Olsen, Esq. Supreme Court n ~~ _ .-~ ID Number: 92858 ~p ^'' =z7 ~-O C G_~1 <..3 G7 C~ ~L Firm Name: Hazen Elder Law ~ ~ i~° 1 r=~ Address: 2000 Linglestown Rd. U`" Suite 202 ~r `t ` ~ ~ -i7 E- Harrisburg, PA 17110 = ~ - ~~n ~' CJi a Phone: 717-540-4332 Fax: 717-540-4313 E-mail: lolsen@hazenelderlaw.com DECREE OF THE REGISTER Estate of Thressa E Smith a/k/a: Date of Death: 07/10/2012 Social Security No: 376-05-3995 File No: 21 AND NOW, ~ ~~ L f ~~ o _ , in consideration of the foregoing Petition, satisfactory proof having been prese rd befo e, IT IS DECREED that Letters Testamentary are hereby granted to James W Smith in the above estate and (if applicable) that the instrument(s) dated 05/31/2005 described in the Petition be admitted to probate and filed of record as jh$ last Will (and Codicil(s)) of Decedent. ,~ f2egister of Wills t~~,~ ~~LQ f2~~ /-~~~ ~j ~~~~ Copyright (c) 2011 form software only The La ner Group Inc. ~_J'~~ Page 2 of 2 H105.905 REV.(8/I1) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. ~?~~ ~ ~:~~F'~CE QF WARNING: It ~~gah~'du~(1~~~e this copy by photostat or photograph. ~~42 AUG -1 ,:ice`. ORPHAN' (~MgERLANi 6908223 No. C O t~ 2 Marina O'Reilly Matthew State Registrar ,~.• 2 8 2012 Date CERTIFICATr_ OF DEATH Permanent nk 1. Decedent': Legal Name (First, Mlddie, Lasf, Suf/ix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) Thressa E. Smith F 375-OS-3995- July 10,2012 Sa. Age-Last 9lrthday iYrs) Sb. Vntler 1 Vear Sc. Under 1 Da 6. Date o1 Birth (MO/Da•r,rVear) (Spell Month) 7a.~t hplac (City an~s Sate or Forei Country `r ~ ~ J v a n a e r+ Y e n n s y 9 7 Months Days Hours Minutes June 2 9, 1 9 1 5 ri U t 7b. Birthplace (County) But 1 e r ea. Residancn (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) Sc. Did Decedent Llva In a Township? Penns lvania 210 Bi S rin Road ves,d«.a.ntuy.dm North Newton twP. p Sd. Residence (County) g g Cumber 1 a n d He. Residence (Zip COtle) - O No, decedent livetl within limits of city/boro. 9. Ever in U~ Itrmed Forces? 10. MaHtal Status at Tlma of Death Married _ W I owetl 11. Surviving Spouae'z Name (If wife, give name prior to first marriage) Q yes ][j No Q Unknown Q Divorced Q Never Married Q Unknr~vn N o n e 12. Father's fl (first, Middle, st, Sufflx) ~ier Rohe G~'~i i t 3:. Mother's Name Prior to First Marriage st, M tldle, t) ~ l ~i r s op ay cut Pauline 14a. Informs +t's Name 14b. Relationship to Decedent 14c. 1 formant's (ling Adtlr treat f.Ity, State, d ~"~° 19 n ~ ett~ ~'~`~I~sr g James Smith Son burg, 70 . 315 Ro son ......................................................... ................................ ace o Deat t.hec o _ It Death Occurretl in a Hospital: ~( Inpatient : IT Dea t h Ot urretl Somewh:re Other Than a Hospital: ~{ Hospice Facility [~'~Dacadent's Home i5 Q Emergency Room/Outpatient Q Dead on Arrival ' ~ G Jp Nursing Home/i.org-Term Care Facility Other (Specs 16b. Fa<Ility Name (If not institution, give street •ntl number; 13 c. City or Town, d I Cod 15 Coun f De th l 9486 ~ `~e d ~~te,T~~ X7241 Green Ridge Village um r an - Newvi 16e. Method of Disposition Q Burlel Cremation i6b. Date of Disposition 16<. Place O} Disposition Neme of cemetery, crematory, or other piece) )~ Remo•: al from State )~ Donatl0 L.ther (Specify) Valley Crematory 7/12/2012 Lebanon Z 16d. Locatior of Disposition (City or Town, State, and Zip) ° 17a. Signature of Funeral Service Licensee ° n In Charge oT Interment 17b. License Number Lebanon,PA 17042 O 12432 L 17e. Name and Complete Atldress of Funeral'Facility 'liar Funeral Home Inc. 124 Ea No h St. Butler,PA 16001 °m' 18. Decedent's Education -Check the box that best describes the 19. Decedent of NlSpanie r_ Agin -Check the 20. Decedent's Raca -Check ONE OR MORE races to Indicate what highert degrre or level Of school completed at thetima Of tleath. box that best tlescrlbas whet' er the decedent the decadent consideretl himself or herself <o ba. Q Hth grade or less is Spanish/Hlspanl4Latino. Check the "N O" ~' White Q Korean Q NO dlplcma, 9th - 12th gratle box If tlacedant Is not Spanish/Hispanic/Latino. Q Black or African American )~ Vietnamese High school graduate or GED completed [x NO, not Spanish/Hispanic/1-etina Q American Indian or Alaska Native )~ Other Asian ~ SOme college credit, but n° tlegree Q Yes, Mexican, Mexican t-merican, Chicano Q Asian Indian O Native Hawaiian ~ Associate degree (e.g. AA, AS) O Ves, Puerto Rican Q Chinese Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, A8, BS) Q Ves, Cuban p FIIlpino ~ Samoan 0 Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispan a/Latino Q Japanese Q Other Paclflc Islander Doctor ste (w.g. PhD, Ed D) or Professional degree (Specify) - Q Other (Specify) . MO DOS DVM LLB JD 21. eaden-.'s Single Race Sel/-Designation -Check ONLY ONE to indicate what the decadent con: I tared himself or herself fo be. 22a. Decedent's Usual Occupation -Indicate type of work [7~ White Q Japanese Q Samoan tlone during most of working Ilfe. DO NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacific Islande- Q American Indian or Alaska Native Q Vietnamese 0 Don't Know/Not Sun: H O m e m 8 k e r )~ Asian 'ndlan Q Other ASlan Q ReTUSed 22b. Kind of Business/Industry Q CFines4 Q Native Hawaiian Q Other (Specify) _ Non e )~ Filipinc Q Guamanian or Chamorro ITEMS 23a - 23d MUST BE COMPLETED 23a. Pronouncetl Dead (MO/Dey/Yr) 23b. S~O ture o Person Pronouncing Death my when applicable 23c. License rvumber BV PERSON WHO PRONOUNCES OR .~ \ 1~~ ~ ~ f'~ r ^ CERTIFIES DEATH ~\// ~W C, ~ , ( 23tl. Dat ~tl (MO/Dgy(yr~)~ 24. Time of Dea h I ~~ - ~~ _ 25. W . k la al Examiner or Coroner Contacted? Q Ves Q No CAUSE OFD Approximate 26. Part I. Enter the chain of events--diseases, injuries, Or tomplicatlOns--that directly causetl the death. DO NOT enter terminal events such as cardiac arrest. Interval: respiratory arrest, or veMrlcular fibrillation without showing the etiology. DO N OT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death / C ~ IMMEDIATE CAUSE -------------> a. ~'~(1~/YI, .n..5~ ~ ~' - ^'G.~~ ~ . ~ ~9~ ' (Final tl(sease or condition Due to (or es a consegUence of): resulting in death) b. _ Sequentlaily Ilst conditions, Due to (or as a consequence of): If any, leac'ingfo the cause - Ilsted on line a. Enter the _ UNDERLy+NG GUSE Due t° (or as a consequence of): (disease or injury[hat _ Initiated the events rezu Ring d. ~ in tlaaM) OAST. Due to (or as a conse~,us.ice of): S 26. Part 11. Enter others I f In h but not resulting in the underlying cause given In Part 1 27. Was an autopsy P~{~formed? Ves /(] N° ~ 28. Were autopsy Tintlings available £' [o complete the cause of death? D Yes Q No 3' 29. If Female: 30. Did Tob>cco Use Contribute t0 Death? 31. Manner of Death o Q Not pregnant within past year Q Yes Q Probably ~ Natural Q Homicide Q Pregnant at time Of death )~ N° Q Unknown Q Accident Q Pending Investigation ~' Q Noi pregnant, but pregnant within 42 days of death Q Suicide Q Could not be determined p Not pregnant, but pregnant 43 tlays to 1 year before death 32. Date of Injury (Mir/Day/Yr) (Spelt Month) Q Unk~ own If pregnant within the past year 33. Time of Injury 34. Place of ~~~!ury (e.g. home; construction site; Tarm; school) 35. Lowtk ~.~ of Injury (Street and Number. City, State. Zip Code) 36. Injury a< Work 37. IT Transportation Injury, Specify: 38. Describe How Injury Occurtetl: )~ Yes O Driver/Operator Q Petlestrian Q No Q Passenger )~ Other (Speclry) 39s tier (Check only one): ifying physician - To the best of my knowletlge, death occurred due to the cause(s) and n :Inner ztatatl ((!! Q Pronouncing & Certtlying physician -T° the bast of my knowletlge, death occurred at the t:m !, date, entl place, end due <O the cause(s) and m r stated Q Meditai Examiner/Coroner - On th of examination, and/or inves<iga[lon, in my Opin'on, de th rred at the time, date, entl place, entl due [o the cause(s) an d manner stated a a cu y 6lgnatllro :"i certifier: Title oT certl`i ar:_ ~ Cleanse Number: ~6/ O t } S - ~ 39b. Name, A~tlross and Zip Code Of P On Completing Cause Of Death (Item 26) 39c. Date Signetl (MO/Diy/Vr) Darr 1 Guistwite D. 210Big Spring Rd_ Newville,PA q-~It// Z 40. Registrar'. District Num ar 41. Istrar s Signature 1 7 /y - 42. Registrar le Date o D ey ) '+ ^ ' 43. Amendments ' Disposition Permit No.~~ / l0 ~~ H105-143 REV 07/2011 r` LAST WILL AND TESTAMENT OF THRESSA E. SMITH I, THRESSA E. SMITH, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will. 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. r-. J ry CQ r- ~~ ~ ~ ~ ~~ ~ .-~ n~...: ~ ~ ..jy' l7 ~ C_"i 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. ArtirlP TV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath according to the following: A. SIXTY-FIVE PERCENT (65%) of my estate to my son, JAMES W. SMITH, of Dillsburg, Pennsylvania, Per Stirpes. If JAMES W. SMITH predeceases me, leaving no surviving issue, I give, devise and bequeath his share IN EQUAL SHARES to the children of my son, EUGENE A. SMITH, Per Stirpes; and B. THIRTY-FIVE PERCENT (35%) of my estate to my son, EUGENE A. SMITH, JR., of Boiling Springs, Pennsylvania, Per Stirpes. Article V If a beneficiary under this Will has not attained the age ofthirty-five (35) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the terms in Article VI. 2 Article VI In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support, health, care and education of the child until the child attains the age of thirty-five (35) years. B. Upon attaining the age of thirty-five (35), the remaining principal and accumulated income of the child's share shall be distributed outright to the child. C. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. Arti~lP VTT In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: (a) to retain in the form received and/or 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, 3 (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (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 fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (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 Executor; to pay from my estate reasonable compensation for all their services, (i) to conduct along with or with others, any business in which I am engaged in or have an interest in at the 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. Article VIII I hereby appoint my sons, EUGENE A. SMITH, JR. and/or JAMES W. SMITH, to act jointly and/or individually, as Co-Trustees of any Trust(s) created in this Will. Article IX I nominate, constitute, and appoint my son, JAMES W. SMITH, Executor of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever 4 of my Executor, I nominate, constitute and appoint my grandson, MARK T. SMITH, of Lititz, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my Executor or successor Executor be permitted to serve without bond. In addition to those powers granted by law, I grant them 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 Executor or successor Executor shall receive reasonable compensation for services rendered to my estate. Article X In addition to the powers conferred by law, I authorize my Executor or successor Executor in his/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, (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, 5 (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; 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, THRESSA E. SMITH, hereby set my hand to this my Last Will and Testament, on I , 2005, at Harrisburg, Pennsylvania. THRESSA E. SMI In our presence, the above-named THRESSA E. SMITH signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Address 2000 Linglestown Rd., Suite 202, Harrisburg, PA 17110 2000 Linglestown Rd., Suite 202, Harrisburg, PA 17110 _6_ I, THRESSA E. SMITH, Testatrix, 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 THRESSA E. SMITH, the Testatrix, on - 3 > , 2005. v No ary P lic ~" T RESSA E. SMI COMMONWEALTH OF PENNSYLVANIA Notarial Seal Marielle F. Hazen, Notary Public Susquehanna Twp., Dauphin County My Commission Expires Sept. 23, 2006 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 Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she 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 subscribed to before me and `~ tness witnesses, on ~ - _~ / , 2005. ~/' Wi ness Notary P' blic COMMONWEALTH OF PENNSYLVANIA Notarial Seal Marielle F. Hazen, Notary Public Susquehanna Twp., Dauphin County My Commission Expires Sept. 23, 2006