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HomeMy WebLinkAbout08-24-12Reset 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: Martha Jane Lamprey a/k/a: a/k/a: a/k/a: Date of Death: Au>;ttst 10, 2012 Decedent was domiciled at death in Essex House C~ principal residence at 20 N 12th Street. Ant. 333 Street address, Post Office and Zip Code Decedent died at 503 N 21st Street Came Hill, PA -Cumberland Countv. PA File No• ~ ~ - ~ j~ - (~~~,~~ (Assigned by Register) Social Security No: Age at death: 66 (State) with his/her 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: If domiciled in Pennsylvania ............................ All personal property $ 12,000.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ value of real estate in Pennsylvania ......................................................... $ TOTAL ESTIMATED VALUE.... $ 12.000.00 Real estate in Pennsylvania situated at: N/A (Attach additional sheets, if necessary.) Street address, Post Office snd 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 thereto dated 9/23/2000 and Codicil{s) State relevant circumstances (eg. 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(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 O EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c. t. a., d. b. n., d.b.n.c.t.a., pendente lite, durante absentia, durante minoritate If Administration, c.t.a. or ti;b.n.c.i;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(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. O NO EXCEPTIONS Q 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, ifnecessary): Name Relationshi Address ° ~~ C ~ i~~> fl ~~~ A . ~ ~~ i CJ1 C1 Form RW-02 rev. IO/1 //201 t Page 1 of t Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } } SS: } Official Use Only ~~.~.~r~; ~ ~ . , ~~,_..5. Petitioner(s) Printed Name Petitioner(s) Printed Address E ' S. Lam re 515 Coun Club Rd. Cam Hill PA 17011 WMBERtAND CO„ PA 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 well and truly administer the estate accord' g to law. Sworn to or affirmed and subscribed before //-~~ L)ate ~ Y me ~ day of Date BY' Uate For the Register Date BOND Required: Q YES ~ NO FEES: Letters ...................... $ LQ(~ . [~) ( 3 )Short Certificate(s)...... I ~ . C1 e) ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ,...,,,, Automation Fee ............... JCS Fee . .................... ~-~ <~ TOTAL ..................... $ ~ 0 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 Estate of Martha Jane Lamnrev File No: ~ ~ ~ ~ ~ - ~.'~~~.-~ a/k/a: AND NOW, __ J~~~,~~( ~ ~ a ~ 6l ~ , in consideration of the foregoing Petition, satisfactory proof having b n presented before me, IT IS DECREED that Letters ~~P~C IVl C Y'1 ~1 (ZJ are hereby granted to ~; t 1 C 5 ~ C'l YY~t~ (~ D.- C in t e abov estate and (if applicable) that the instrtunent(s) dated ~ ~2,C)C~P1 descnbed m the Petrtton be admttted o probate and filed of record as the last Will (and Codicil(s)) of Decede ~~_ ~ ] Register of Wills ~ Form RW-02 rev. !0/ll/2011 ; ~ Page 2 of 2 Hint.3p$ RF,V /9/l n _.. __ _. _.._. LOCAL~~ ,,~~'S CERTIFICATION OF DEATH WARNIN~'~fst`ega(I uplicate this copy by photostat or photograph. _4J Fee for this certificate, $6.00 20I2 AUG 24 ~~ ~ ~ : 5 ~ This is to certify that the information here given is correctly copied frorn an original Certificate of Death _ duly filed with me as Local Registrar. The original `'"' "' certificate will be forwarded to the State Vital oRPHA~'J~~ C,L1~}Cr Records Office for permanent filing. P 18 615 7 4 7 ~~~° co„ PA ~~~ 1~ ~U613 12 Certification Number 'Type/Print in Permanent 2! Local Registrar Date Issued COMMONWEALTH OF PEN NSVLVANIA • DEPARTMENT OF HEALTH • VITAL RECO RpS f COTSLaf`AT~ ~ 1. Decedent's Legal Name (First, Middle, Last, Sufflz) Stat! Flle Number: 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) Sa. Age-Last Birthday (Vr Sb. nder 1 Vear Sc. Under 1 De 6. Date of Birth (MO/Day/Vea r) (Spell Month) Ta. Birthplace (City and Stat! or Forei n Count g ry) Months Oays Hours Mlnu[as isbur Pa 66 Januar 31 1946 7b Birth la (C . p ce ounty) yn Sa. Residence (State or Foreign Country) 8b. Residence (Street and Number -include Apt No.) Bc. Did Decedent Live In a Townshi T p Bd. Ip8 en~e (county> 20 North 12th Street oyes, detedent eyed in nxp Cumberland 8e. Residence (Zip Coda) o, decedent Ilved within limits of Lemoyne city/boro. 9. Ever in US,~~cAsS~rmed ForcesT 30. Marital Staf us at Time of Death Q Married Q WI owed 11 Su rvivin S ' . g pouse s Name (If wife, given a prior to first marriage) Q Yes tgNO Q Unknown ~ Divorced Q Never Married Q Unknow am 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marria e (First Middl g , e, Last) Daniel Buser Grace Fink 14a. Informant's Name 14b. Relationship to Decedent 34c. Informant's Malling Address (Street and Number, City, State, 21p Code) Eric ~ re Son 515 Countr Club Road Hill Pa 17011 ~ . g ......................................................... ..................._..................,........ i..a: P gCe 4. ° :at... ec on y one __ _____ If Death Occurred In a Hos ital: urred Somewh ~ ~~~~ "" """""""""'"'"'""""'" `~' ' P Inpatient ;If Death Occ ere Other Than a Hos 'tal~ "'"" PI - Hospice Facilit ~ E ' e~~~~~~~~ J 4 y 0 pecedent s HOm mergency Room/Outpatient 0 Dead on Arrival Nursing Home/Long-Term Care Facility Other (Specif ) i b ~ d z y 5 . Facility Names (If not Institution, give street and number) i5c. City or Town, State, and Zlp Code `~"' 15d. County of Death 16a. Method of Disposition Burial 70 Cumberland Q Cremation 16b. Date of Disposition 16 Pl c. ace of Disposition (Name of cemetery, crematory, or other place) Q Removal from States Q Donation oener(sPe~lf ) A v u ust 14 20 2 Hollin er Cremator 16d L ti f ~ . oca on o Disposltlon (City or Town, State, and Zip) of Funera Person i Ch n arge of Interment 1Tk>. License Number Mt Holl tin s Pa 011654-L ITC. Nama and Complete Address of Funeral Facility ~ '- 16. a ant s E uca on - ac t e ox t a bas ascribes cadent of Hispanic OriRln -Check the 20. Dec dent's Race -Check ONE OR MORE races to indicate what highest degree or level of school completed at the time of d th b ea . ox that best describes whether the decedem t h e decedent considered himself or herself to be Q 6th grad! or less .. r . rr,r Is Spanish/Hispanic/Latino. Check the "Np" Lp•White Korean Q No diploma, 9th - 12th grade b f ox i decedent Is not Spanish/Hispa nlc/Latino. Black or African American Q Vletna mete Q High school graduate or GED completed ~N not Spanish/Hispanic/Latlnp Q American Indian or Alask o So a ll N ti d s a a co age cre ve Q Other Asian it, but no degree ~j Ves, Mexican, Mexican American, Chicano Q Asian Indian oclate de ree (e AA N i A g Q ,g. , at ve Hawaiian S) Q Yea, Puerto Rican _ Q Bachelor's degree Q Chinese (e.g. BA, AB, BS) Q yes Ian or Chamorro Q Cuban , FIII i Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino 0 Q Japes nose 0 Other Paclflc Islander Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Spaci . MD DDS DVM LLB JD fy) 21. Decedent's Single Rac! Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to be 22a Decedent's U 'White l O . . sua ccupatbn -Indicate type of work Q Japanese Q Sam a d Bl d k e one ac Q uring most of working life. DO NOT USE RETIRED. or African American Q Korean Q Oth r Paclflc Islander Q American Indian or Alaska Native Q Vietnamese Q Don't Know/NOi Sure Administrative Asst Q Asian Indian Q Other ASlan Q Refused Q Chinese Q Native Hawaiian 22 b. Kind of Business/Industry Q Other (Specify) Q FIIIPIno Q Guamanian or Chamorro SI Area Iiii7l..ln1 t lie e ITEMS 3a - 23 MUST BE COMPLETED 23a. Date Pronounced Dead Mo Day Yr) 236 natu P SY . re o PERSON WHO PRONOUNCES OR g erson Pronouncing Death Only when applicable 23c. License Number CERTIF/E DEATH 8' ~ (, ("Z 23d. Date SI n!d (MO/Day/Yr) 24. Time of Death _ / I'. / S ~ O ~ O ~ ~~ ' Z S ~7 2S. Was Medical Examiner or Coroner ContattedT [~ Yes Q N o CAUSE OF DEATH ate 26. Part 1. Enter the chain of events--diseases, Injuries, or compllcatlons--that diroc[ly caused the death. DO NOT enter terminal event res irato r t h i Ap p ry a s suc res as cardiac arrest , or ventricular fibrillat i on w it nterv hout Showi al ng the eti ol ogy. DO NOT ABBREVIATE. Enter only one cause on a line Atld d . a ditional lines if necessary Onset to Death / ~ / ' C / ~ t t ~ IMMEDIATE CAUSE --------------> a. Ac+~-rE C~~/~~ ~~K.~S-I~_ (Final disease or condition Due to (or as a consequen of): ca resulting In death) ~ N S T G b. ~ ~' E G~HOLA-f~/G1bC/~-->r2C//VbML} ' Sequent(ally list conditions, Due to (or sequence of); If any, leading to the cause as a con listed on Ilne a. Enter the VNDERLYING CAVSE Due to (or (disease or Injury that as a consequence of): F Inltlatatl the events resulting d. In death) LAST. Oue to (or as a consequence of): 26. Part 11. Enter other siRniflcant condltlo t ib ti d but not resulting In the underlying cause given In P rt I ~ a 2']. Wa auto psy pe~rt~ edT O Y '°~ es ~ No 2B. Were autopsy findings avallabie to complete the cause of deathT 29. If Female: Q Not pregnant within past year 30. Did Tobacco Use Contribute to Death? Q Yes Q No 31. M Hoer of Death ~ Q Pregnant at time of death Q Yes ~Q,/Probably Natural Homicide V nknown N t Q NO o Q a y/ pregnant, but pregnant within 42 daVS of death Q Accident Q Pending Investigation ~ Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In Suicide Jury (MO/Des Yr Q Q Coved no[ be determined Y/ ) (Spell Month) Q Unkn If own pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 3S L . ocation of Injury (Street and Number, Ci ty, State, Zip Code) 36. Injury at Work 37. If Transportation In)ury, Specify: 38. Describe How Injury Occurred: O Yes Q Driver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39~er[ifier (Check only one): Car[If i y ng physicist, - To the best of my knowledge, death octurrod due to the cause(s) and manner stated Pronouncin Jai C tif g er ying physician - To [he best of my knowledge, death occurred at the time, date, and place and due to th Q Medical Examiner/C , e cause(s) and manner stated oroner - On the basis of examination, and/or Investigation, In my opinion, death occurred at the time dat d , e, an place, and du< <o the cause(s) and m r tested Signaturo of car[Iflar: 3 M D ~.s Title of certifier: License Numkrer: N/ ~ ~ ~ ~ ~ ~~ 9b. Name, Address and 21p Code of Person Completing Cause of Death (Item 26) 39<. Date Signed (MO/Day/Vr) a 1.-~clci row ..ter! o ~--t ' ~(-~ f ~ ~ 4 . 0. Registrar's strict Number 41. Registrar s Slgn 42. Reg is[rar FI a Date Mo Day r) ~~'~~/ 4 CC --yy 3. Amendments Q~/~..~/ r-~s~0~~ Disposltlon Permit No.~J /e' ~S~ ~_~~_ H10S-143 REV OT/2011 LAST WILL AND TESTAMENT OF MARTHA J. LAMPREY ., I, MARTHA J. LAMPREY, currently residing at 203R Four , Seasons Lane, Enola, Cumberland County, Pennsylvania 17025, being of sound mind, memory and understanding do hereby make and publish this my Last Will And Testament hereby revokin all g press Wi~3s and Codicils made by me. ~ ~ ~ ~ o ,. c~-~ Item I• I order and direct that all of m ~~~ o~. ~ funeral expenses and inheritance taxes ma be - Y paid a ~oon = ~ ran' .~ as D ~ conveniently possible immediately after my death. -' Item II. I may leave a written list, which will be dated and either in my own handwriting or signed by me, that sets forth my wishes regarding distribution of specific personal property. The list may include proceeds from any insurance policies. If I do, then I intend it to qualify as a amendment to this Will. If it should be determined that any such list does not qualif y as an amendment to this Will, it is my hope that those entitled to share in my estate will nevertheless respect it. Item III. I give and bequeath all my jewelry to DAWN I,pll~gEy, provided that she is still married to my son, ERIC SHANE LAMPREY. Item IV. All of the rest, residual, and remainder of my estate, real, personal and mixed of whatever kind and wheresoever situated, is hereby given and bequeathed to my son, ERIC SHANE LAMPREY, provided that he survives me for 30 days. Item V. I hereby nominate and appoint my son, ERIC SHANE LAMPREY, to be the Executor of my estate. If he is unable or unwilling to serve, then I nominate and appoint my son's wife, DAWN ~MPREy, provided that she is still married to my son or was married to him at the time of his death or incapacity. Item VI. Should my son predecease me or not survive me for a period of 30 days, then and in that event I direct that all of the rest, residual and remainder of my estate, real, personal. and mixed of whatsoever kind and wheresoever situated, is hereby given and bequeathed to DAWN LAMPREY, provided that she survives me for a period of 30 days and was married to my son at the time of his death. Item VII. Should DAWN LAMPREY not qualify, predecease me or not survive me for a period of 30 days, then and in that event I direct that all of the rest, residual and remainder of my estate, real, personal and mixed of whatsoever kind and wheresoever situated, is to be sold and the proceeds derived therefrom are to be equally divided, PER CAPITA, between my GRANDCHILDREN. Item VIII. I direct that neither the Executor nor the Executrix appointed under this Will shall be required to post any bond or provide any security to serve in that capacity. 2 Item IX. I confer on my Executor, in addition to those powers granted by law, the following powers to be exercised in a prudent manner and applicable to all property constituting a part of my estate: A. To retain and to invest in all forms of real and personal property, without being confined to investments authorized by a statutory list, without being required to diversify and regardless of any principal of law limiting delegation of investment responsibilities by executors or trustees; B. To compromise claims and to abandon any property which, in my executor's opinion, is of little or no value; C. To sell at private or public sale, to exchange or to lease for any period of time, any real or personal property, and to give options for sales or leases; D. To borrow from anyone, even if the lender is an executor hereunder, and to pledge property as security for repayment of the funds borrowed; E• To join in any merger, reorganization, trust or other concerted action of security holders, and to delegate discretionary duties with respect thereto; 3 H F. To employ and to rely upon the advice given_4by investment counsel, to delegate discretionary authority to make changes in investments to investment counsel, and to pay investment counse l reasonable compensation in addition to any fees otherwise paid to my executor; G. To employ a custodian, to hold property unregistered or in the name of a nominee (including the nominee of any institution employed as custodian), and to pay reasonable compensation to the custodian in addition to any fees otherwise payable to my executor; H. To procure and carry at the expense of my estate insurance of kinds, forms and amounts deemed advisable by my executor to protect my estate and my executor against any hazard; I. To commence or defend at the expense of my estate any litigation affecting my estate deemed advisable by my executor; J. To conduct alone or with others any business in which I am engaged or in which I have any interest at my death, with all the powers of any owner with respect thereto, including the power to .delegate 4 discretionary duties to others, to invest o property held hereunder in such business ..and -to organize a partnership or corporation to carry out such business; and FC. To distribute in cash or in kind. IN WITNESS WHEREOF, I, MARTHA J. LAMPREY, have to this my Last Will And Testament hereunto set my hand and seal this ~~ day of ~u ~~ 8A J. LAMPRE SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, MARTHA J. LAMPREY, as and for her Will, in our presence, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereto set our hands as witnesses: NAME ~C~ ~~`~~~~, ~ RESIDING AT S`~ ~~ /7© 7a NAME ~ RESIDING AT 5 STATE OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND . I, MARTHA J. LAMPREY, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for the purposes therein expressed. ~~' ~ ~~ We, having been duly qualified according to law, depose and say that we were present and saw MARTHA J. LAMPREY sign the foregoing instrument as her Will; that she signed it as her free and voluntary act for the purposes therein expressed; that we in her sight and hearing and at her request signed the Will as witnesses; and that to the best of our knowledge she was at the time 18 years or more of age, of sound mind, and under no constraint or undue influence. ~4- ~~-J Witness ~~ Witness Subscribed, sworn to, or affirmed, and acknowledged before me by the above-named testatrix and by the witnesses whose names appear, on this ~~ day of •I~ 20 i// Notary Public MNWAM N. IIBpRO NW STg~ ~rY Public East Aennsboro Twp., Cumbe~a~ Co My Commission Expires March ~ 2004 6