Loading...
HomeMy WebLinkAbout08-23-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY PENNSY Petitioner(s) named below, who is/are 18 ears of a e or older, a I ies for Letters as specified below, and in support thereof aveVANIA following and respectfully requests the grant of Letters in the a rop n ate form: PP P Daniel V. Bonawitz Dec dent's Inform^tinn Name: Mary R. Fortney File No: 21-12 a/k/a: a/k/a: (Assigned by Register) a/k/a: Date of Death: 07/28/2012 Decedent was domiciled at death in Cumberland County, principal residence at 11 East Locust Street, Enola 17025 Social Security No: Age at Death: g1 PA (State) with his/her last East Pennsboro Cumberland City, Township or Borough County Decedent died at Holy Spirit Hospital East Pennsboro Twp Cumberland PA Street address Post Office and Zip Code City, Township or Borough Count Y State Estimate of value of decedent's property at death: If domiciled in Pennsy/vania ...................... All personal property $ If not domiciled in Pennsylvania ................ Personal roe 250 000.00 P p rty in Pennsylvania $ /f not domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................... $ 80,000.00 TOTAL ESTIMATED VALUE $ 330,000.00 Real estate in Pennsylvania situated at 11 East Locust Street Enola Cumberland (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough ® A. Petition for Probate and Grant of ott Tee+ mew+~ Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated 11/02/2005 thereto dated 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 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(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 etters of Admini tr tion (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., Pedente lite, durance absentia. durante minoritate If Administration, c.t.a ord.b.n.c.t.a., gpter date of Will in a tion A above -nd romrlete list of hers. Except as follows: Decedent was not a party to pending divorce proceedin 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 adgudicated 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 (if any) and heirs (attach additional sheets, if necessary): Address ~, .- ~ C~ .. ^~ C:^ -~~ ~C/,Y ~ ~' ._.. ~ ~ . Form RW-02 rev. fall-loft D .. r- ^n c.n ~`~ ~^ Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } COUNTY OF Cumberland } SS: } Petitioner(s) Printed Name Daniel V. Bonawitz ,...`_~ ~.~r r iClt. L ~ . _LSJ Petitioner(s) Printed Address 12 Oatfield Lane Palmyra, PA 17078 „~.:. ; OhPHh'~`~ ~;UU~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, Petitioner(s) will ell and truly administer the estate according to law. Sworn to or affirmed a subscribed before _ ~, !~ met day of ® Date By: Date For the Register Date Date BOND Required? ~ YES ~ NO FEES: Letters . ..................... (~ .................... )Short Certificate(s)......... ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond .... ......................................... Commission .................................. rO'ther LA ~ I $ 2~ To the Register of Wills: Please enter my anoea below: Attornre~y Signature: Y V ! Printed Name: ichael L. Bangs Supreme Court ID Number: 41263 Firm Name: Bangs Law Office LLC Address: 429 South 18th Street Camp Hill, PA 17011 Automation Fee ............................ - JCS Fee ....................................... ' TOTAL ......................................... $ Phone: 7171730-7310 Fax: 717/730-7374 E-mail: mikebangs~verizon.net DECREE OF THE REGISTER Date of Death: 07/28/2012 Estate of _ Marv R. Fortnev Social Security No: a/k/a: n` 1 File No: 21-12 ' C'{ ~j AND NOW, ~{ )~,t~i~cC ~ ~~ t~~ n satisfactory proof having l~n presented before me, IT IS DECREED that Letters ~1L=_ , in consideration of the foregoing Petition, Testamentary are hereby granted to Daniel V. Bonawitz in the above estate and (if applicable) that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Wi I (and Codicil(s)) of Decedent- Copyright (c) 2011 form software only The Lackner ~i ~ In~Q~-~,& Q~I~ H105.805 REV (9/111 - - - - - - - LOCAL REF~ii~~ERTIFICATiON OF DEATH WARNING: It iit.ta'_i~u~a~e this copy by photostat or photograph. Fee for this certificate, $6.00 P 18702049 Certification Number TVW/Print In Permanent °ur2 AU6 23 ~~- - This is to certify that the information here given is correctly copied from an original Certificate of Death ,y._~-r~;~. duly filed with me. as Local Registrar. The. original ~RFHA~ir~ certificate will be fclrwarded to the State Vital ~~~~{3[,~([ Records Office for permanent filing. Local egistrar Date issued COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH _____ __ _- ° ~ w lath! or Forelin Country)--- 8b. Resldenu (Stroh and NumMr -Inc cad! Apt Penna. Bd. Resldenu (County) 1 1 E° Locust Street Cumber 1$nCl 6!, Rlsldlnee (21p Cod!) 9. Ever in US Armed Forces? 10. Markel StNYI at Tlme of Death Marclld Q Yu ~NO Q Unknown Q Diwrud Q Never Married Q Vnkrn 12. Father's Name (First, Mltldle, last, Suffix) Harvey Monroe Fake 14e. Informant's Name 14b. Relatlonshlp to Decedent Joan A. Bonawitz Dau hter ........................................................ _ Ir Ds•th oeturrsd In . Hown.l: yes. ....~ ........................................... • ! o ...!. Emer np lent ~ IT Dlatl~ Oecurrod Some nN Room/Out atllnt Deed on Arrival Nurse Hems, SSb. Facility Name (If not Institutlen, give street end number; lSe. Glty or Tewn, Stetr Hol S irit H ~, 16 Method o Disposition Burial Cramatkan 16b. Date o1 Dlsposltbl Q Rem OtMrr(S 5lclte 0 Donation 8~ •~ 2 0 1 2 16d. Lou[lon of DlsposRlon (City or Town, State, and Zlp) 17a. re of Fnner Camp Hill, PA '1707'1 ~~ 17c. Name and Complete Addross of Funeral Faclllry 2! Se 00 6 Yes, deudent lured In F g g B 11 T1 frS 1]n n twp No, decedent I Wed wlthln limits of _._ ._ .rent: Morri Melons Addr..f (s:rester nJo Drive: ............................ • HeaPltal: WJ~w.i - -- --_~~ ~ awry, crematory, or other place) Rolling Green Cemetery ~~ L~see or Person In Charge of Interment I7b. License Number ~~-~ 01 2206E 028 u en[ s Eduuflon -Cheek tM box that best dlacrlWs the 19. Decadent of Hispanic OriBln - CMU the 20. Decedent's Raee -Check ONE OR MORE highest dgroe or Iw I of school completed at tM time of death b . rous to indicate whet ox that hart descrlbu wMMer the deudent the deudent eonsiderod hlmseN or Mne)f to be. Q 8th grade or lase Is Spanlah/His No diploma PanlULatlno. Cheek the "NO" Whit 9th - 12th rad , g e e Korean Q High seheol graduab or 6ED eempleted hex H decedent b not Spanlah/HlspeniULatino. 0 Bieck or African Ameriun ~ Vietnamese ®No net Spanish/Hl , Q Seme cone aPaniULatino 0 American Indian or Alaska Native Q Other Asian ge croak, but no degree Q Yes, Mexfun, Mexican Ameriun, Chicano Q Aaaoclab de8ree (e g AA glen I AS) di . . . , n an 0 Yes, Puerto Rican Q Native Hawaiian Q BacMlor's tleiru (l.g. M, AB Q Chlnue BS) , ~ Yea, Cuban 0 Guamanian or Chamorro Q Master's da9ree (a.g. MA, MS, MEng, MEd, MSW Q FIIlpino ~ Samoan MBA) ~ V h , es, ot ers 0 Doctorate (e.g. PhD, EdD Panish/HlspanlULaLino ~ Japanese or Prolusional degree ~ Other Pacific Islander (Specify) . MD DDS OVM LLB 1D 0 Other (Spael/y) 21. Decedent's Single Raee 5!N-Designation -Check ONLY ONE to Indlub what the deudent considered hlmseN er Mrself to be. 22e. Decedent's Us White ~ Japanese l O ua <cu ~ Samoan Patton - Indicate type Of were Bleak or Afrlun American doll d i K ® ur 0 ng most of working IHe. DO NOT USE RETIRED. erpn Q Other Paelflc Islander Q American Indian or Alaska Native Q Vietnamese Q Don't K Homemaker /N Is now ot sure ~ As1a ~l~dian ~ Other ASlan 0 R f e used Q Chln Q Natlw Hawaiian ~ Other (SPacNy) 22b. Kind of Business/Industry Fili in p o _ O Guamanian or Chamorro 0 Wn 25. Was Medlin Examiner or Coroner Contacted? ~ Yes ~ No 26. -aK L Eller tM chain of .vent:-d ~-IJSE OF DEATH Teases, InJuries, or compllutlona-that directly caused the doth. DO NOT enter terminal events such et cardiac arrost Approximate rospiratery arrest, or wntrlcular fib Illation without skewing the etiology. DO NOT ABBREVIATE. Enter only one cause on Interval' a Ilne. Add atldltienal Ilnu If necessary ~ Onset to Oeath IMMEDIATE CAUSE -----_.___a RP~•)7~ n- \e (Final disuse or condition Duet (or as a consequence ofl. I resultini In death) -- b. Sequentially Ilse eontlhions, Ifany, leadini to tM cause /~ q /J 3: } dIMSVe~ ©/ Bav.a.2 ~tF•c £2 D t (O a eonsequence~- i -- .°$. ? CCCr~G((( Ilatld on line a. Enter the UNDERLYING GVB[ (disuse or Injury that Initiated the wants resulting d. In death) tAST. ~~K ~~ ~~ ~/J T"'~(/~.Y / D . •• • wnae9wnc or). /~ D ~n~n n e Due to (or as saqulnc ar ( / ( 26. P!K 11. Enter other alenlflcant condlti t Ib t h but not resulting In the under) in Y 8 cause given In Part 1 J 27. Was an wtoPSY Performed? '~'- Yes Ne 29. 1/ F male: 28. Wero autoPSY Hndings ayallable to wmpleb eke cause of death? ~ ._ 30. Did Tobacco Use Contribute to Deeth7 ~- Not pregnant wlthln past year Q Prognant at time of Math 0 Nos 0 Probably 0 Not pregnant, but Prognan[ wl[hln 42 tleYS of death 0 0 Unknown ~ Not prognant, but pregnant 43 days to 1 ypr before death 32. Date of In u Mo/Da ~ Unknown If pregnant within the Part War J ry ( Y r) (Spell Month) Yes No 31. ManMr of Death Natural Q Homicide 0 Accident ~ Pending Inwatigation Q Sultlde ~ Could not W determined Q yes ~ Oriver/Operator 0 Pedestrian ~ raucnee Mow Injury Occurrod. ~ No ~ Paspnpr 0 ether (Specify) 39a. Grtifllr (Che<k only one): r>~'CertMYing phYSlebn - To the best of my knowledge, tleath occurrotl due to the sa(s) and manner stated L] Pronouncing J4 Grtllying phwlclan - To the but o/ my knowledp, death oaurrld at the time, date, and place, and dw to the cw ~ Medical Examiner/GOroner - On the basis of exam atlon, and/or Inwstl tl n, In s!(s) and manner stated / H o my opinion, death occurred at the time, data, end place, and due to thlelu se(s) d manner :rated signature of eer[Ifler: ntle of certifier:- /yl ~ Sf 3 ~T 7i3S 39b. me, Adtlross and ZiJp Code o Person Completing ~ of Death~lm 261 Vicensa Number: /Cl M , -~ j( ~y /~'_~t^~.~ ,r( Q ' ~`') 39e. Date Signed (MO Dsy/yr) 4 ei after s D strict Um 4 Reilstra s 1 FT 7~ 3A ~ ri - gnaturo eg stray FI a to Mo Day 43. Amendments ~ ~ 3 O ~ o2Q~ Disposition Permit No. 0 7 6 2 2 9 0 H105-143 REV 07/2011 ~~'~' I, MARY R. FORTNEY, of Enola, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ~~ ~ ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker 0~ and all expenses of my last illness, and any and all taxes and assessments imposed by any `mod ~ governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, in equal shares to my daughter JOAN A. BOO ~AWITZ r`~ „~-, O rv and my grandson, DANIEL V. BONAWITZ, or to the survivor of them, who survi~y dea~ by thirty (30) days. ~~'~,. ~,~ W `-.=r~ ~~ ITEM III. I give, devise, and bequeath all the rest, residue, and remainder ~~y ~ ~- ~., possessions and estate of every nature and wherever situate , in equal shares to my daughter .c ~+ JOAN A. BONAWITZ and my grandson, DANIEL V. BONAWITZ, or to the survivor of them, who survives my death by thirty (30) days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my grandson DANIEL V. BONAWITZ executor of this my last will. Should my grandson predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I appoint my daughter JOAN A. BONAWITZ executrix of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court 0 ~ approval and until actual distribution of all property: to compromise any claim or controversy; 4~ N to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; 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, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 2 IN WITNESS WHEREOF, I have hereunto set my hand this oZ `~ day of 2005. MARY R. FOR Y 3 The preceding instrument, consisting of this and THREE other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by MARY R. FORTNEY, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 1 ~._ ~, ~,_..r ~~ 4 COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~'~zYz MARY R. F TN~EY Sworn or affirmed to and acknowledged l~ef*~r y the st r a ed above t~iis ay f ~, 2005. Notary Pu~bli NOTARIAL ~, WENDY S. CIiESBRO, PubYc Lower Allen Twp., ~ ~ E May 10, COMMONVV~AZTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) WE, ~ c,~i~ ~;~ ~ ~CLe,v 6.( and ~ ~q ~/ /T ~a nJ ~l ltd /~~Z~ ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue Su~~orn r-- affi d acknowledged bef t ' day of _ ~ , 2005. N Nr6TARIAL SEAL WENDY S. CHESBROCu~~Notarf- PubNa lower ANen Twp., ~~riad My Comrt~eion E~k~es May 10, 5