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HomeMy WebLinkAbout08-24-12Reset PETITION FOR GRANT OF LETTERS COUNTY, PENNSYLVANIA REGISTER OF WILLS OF CUMBERLAND 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 File No: ~ ~ ~ ~ J ~ ` ~~ Name: ESTHER M. BERKHEIMER (Assigned by Register) a/k/a: ESTHER MAE BERKHEIMER a/k/a: ,-.~.....r„ ,,,~ eme~nuD Social Security No: a/k/a: Age at death: 92 Date of Death: Janua 29 2012 State) with his/her last COttnt ~o....~~~tvania ~ Decedent was domiciled at death in Cumberland Y~ principal residence at 2910 Sunset Drive Cam Hill East Pennsboro Townshicity, Township or sorough County Street address, Post Office and Zip Code Decedent died at Lakeland Re Tonal Medical Center Lakeland Po1kDC° Township or 13orough County state Street address, Post Office and Zip Code y+ Estimate of value of decedent's property at death: $ 1,700.00 If domiciled in Pennsylvania ............................ All personal property If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................Personal property in County . • . , .. • • .... $ 175 (10(1_()0 Value of real estate in Pennsylvania .............................. . TOTAL ESTIMATED VALUE.... $ 176 700.00 Real estate in Pennsylvania situated at: 2910 Sunet Drive Cam Hill East Pennsboro To C; htTocnshibeor Boaough nt County Street address, Post Office and Zi Code ty+ p (Attach additional sheets, if necessary.) p A. Petition for Probate and Grant of Letters Testamenta Petitioner(s) aver(s) he/she/they is/are the Executor(s) named m the last Wtll of the Decedent, dated November 11, 2010 and Codicil(s) thereto dated N/A 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 divoand did not ha Pe a child bornt og divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ©. NO EXCEPTIONS 0 EXCEPTIONS $. Petition for Grant of Letters of Administration e t.aPpd.b.nfed.b.n.c.t.a., pendente 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 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. Page 1 of 2 Form RW-02 rev. 10/11/2011 Q NO EXCEPTIONS Q EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no W ill and was survived by the following spouse (if any) and heirs (attach Oath of Personal Representative "'4 Y~ iil ~~ ~µr , The Petitioner(s) above•-named swear(s) or affirm(s) the statements in the f egoing Petition are true ano correcr w u,c ~~~~ ~_ ~__~ ~~-~ •• ---a- ofPetitioner(s) and that, as Personal Representative(s) of the D ent a Petitioner will w 11 and tryly administer the Datee accor~g to la . ~ ~ ~' Swern to or affirmed and subscribed be ~ ~ ~ ~~ ~ '~ Date me t ~ ~- day of ~ Date $y; Date For the Regis~ier BOND Required: ~ YES ~ NO FEES: Letters ..................... . ( ~.. )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other •••••~" ~1i{ I ~ I ...... ~ .C7C~ I~ • d ~ ~ ~-)~ Automation Fee ........ JCS Fee .............. ....... ....... -8:013 TOTAL .............. ....... a To the Register of Wills: _ _ q~sn~P by my signature below: Attorney Signature: r ~ / Printed Name: Michael H Small Esquire Supreme Court ID Number: 19212 Firm Name: Address: .,,~ ~-.,«~, n~a,-,.~.t Street P n Rnx 76 Palmyra PA 17078-0076 Phone: (717) 838-3030 Fax: 717 838-8867 Email: -'--,---•^'"'c nPt DECREE OF THE REGISTER File No: ~~ ~"~ ~q Estate of ESTHER M. BERKHEIMER a/k/a: ESTHER MAE BERKHEIMER a/k/a ESTHER M. STAFFORD AND NOW, ) ~ ~ > in consideration of the foregoing Petition, satisfactory proof having een presented before me, IT IS DECREED that Letters Testamentary are hereby granted to William L. Berlclteimer in the above estate and (if applicable) that the instrument(s) dated November 11 2010 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. ~~~ (~( ~ Register of Wills ,~ ~ ~`,~~ ~ ~~~ ~~ , ~L~ Page 2 of 2 Form RW-02 rev. 10/1l/1011 COMMONWEALTH OF PENNSYLVANIA } SS: ?li~c AUG ~`~ s ~ ~= J ~~,.,..,•,-v nF CUMBERLAND } m ~__.. ® - OFFICE of V®AL STATISTICS CERTIFIED COPY „I , ~,,, ~ LoD~rFlLENO- FLORIDA CERTIFICATE OF DEATH ~ _~ ~I. Y,... L°'CEbEMTS NAME (FaaLAAiddle, Last, SuHtr) 2. SEX - _ '. Er~ther Mae Berkheimer Female. N 3. DATE OF BIRTH (AbnHl, (hry, Year) 4e. AGEH.ael &Mday 1 1 Y 5. DATE OF DEATH (Month, t)ay. Year) January 8 , 1920 ~~"~/ 92 Manma °'y' Hover ~~ January 29 , 2012 B. SOCIALSECURITY NUMRER 7. BIRTHPLACE (CiryanO STete or Faelgn Cam1N) S. COUNTY OF DEATH 441-18-5209 Ransas City, Missouri Polk 2- PLACE OF DEATH HOSPRAL ~ Inpatient Emergenq RoarNOulpetien[ - Deatl on Arriva4 _ ((-Jack aNy oira/ NON-NOSPRAL - Fhapim FaCYHy _ Nursing Home/Long Term-Cara FrJlfty ~ DaseoxrYa Wome. OHu1r (Specify) 1a. FAgLITY NAME (Ilrat MaHfeeon, give sheaf adders) 11 a. CITY, TOWN, CR LOCATIONOF DEATH 11 b. INSIDE CITY LIPAITS? Lakeland Re Tonal Medical Center Lakeland. X Yea wn H2. MARITAL BTATUS (Specify) ' 13. SURVIVING SPOUSE'S NAME (H wile, ghe rtlaMen name) XMmded rAAerded,bmselaraatetl _wltlwretl _DNOrcatl _P1aYerMerdea William L Berkheimer -- T4e.1~31DENCE -STATE 14b. COUNTY 14c. CITY, TOWN, OR LOCATION Pennsylvania Cumberland Camp Aill H4d.STREET ADDRESS 1aa. APT. NO. 14f. ZIP CODE 14g. INSIDE CITY LIIAITS?' 2910 Sunset Drive 17011 X Yea Pa - 15erOEC!<TJENTS USUAL OCCUPATION (brdwte type al wmlr dare o'unrg most of wodeng Hk.} tSD. KIND OF BUSINESSlMDUS7RV ~~`~ Retired Guidance Counselor Education 1 d DECED'EMT'S RACE /Speciy the mca7raoea m ha7wb whet decadent considered heroel7RarseH to be. Mae Han Mrs rape maY lie spetifkd.{ _- 'White _BleakaAMCen Amerkan _AmerMSn lrWkna Akstan. Neale (Specify tribe) „_ Asian Indian , Cidneae - Filipblo _ Japereee -- Korean - ViMnarnece _ Other Asian (Specfy) r Nea49 HePYaken -Gwmernet a Chemorm _ Bemoan - Ogfa PaaHk IeL (Specfy) _ Otlaf (Spep!/y) 17. DEGEbENT CfP HISP/PNIC OR MATTWN ryRIGIM .van (H Yea, sOecHY) No Mexkan Puerb Rirsn Cuban _ CemeaUSouUi AmeAcen -~ - . '(SpxiyH`al cNaaprr was aHfeyanlcaAfeMYan bdgin.) - -' - -Oltar Hieperic.($peci/y/ _HaHan l3. bECEDHdf S EDUCATION (SPaepy the deGedenfY higneatdegrea a kvN axYaa mnrpAakd & ama adNYh.) 19. WAS DECEDENT EVER IN ' ~ U.S, ARMED FORCES? tlpt or Tees -High school but m defame - High achod dpbme M GED T „_CaWga orrt rb degree CoWrPp degree lSpecryl: Aaaodate BadwlaYB ~MeaPeYS „_DgGeteta -Y~ X No 2(P:F"ATHER'3 NAME (FeaC MfdcOe, Last Sw1bq 21.MVRiER'S NAME YFlrsb Middle, Malden Sumeale) Gear a Stich Meda Baudran 22e. INFORMANTS NAME Yffi. RELATI('fe1SHIPT,(?DECEOENI` -29§. INFORMANTS MNLHYG-STATE _~-^ • William L Berkheimer Husband Fenns lvania 23b. CITY OR TOWN 23a STREET ADDRESS _ 23d. ZIP CODE Ca Aill 2910 Sunset Drive 17011 • Pte . PI.ACEi~ DIBPOSITKkf (!lame of cwaNery, aemafoq', a oHter ptaoe) 25a. LOCATION -STATE 25'b. l-OC`ATION - CTf'f Ofi TOWN Lakeland Funeral Home Cremato ry Florida Lakeland rp 28e. METHS QF pBPOSITKJN _-,•, BraiM - EnbmbmerN gCtBraNlan ~ DonaGOh Rarnoval frrxn Stare ~ DtMr Spedty) 26b.~CREMATIDN, DONATION OA BURIAL AT SEA, 27e. ~CENSE NUM (ofLimeraes) 274.S16NANRE FUNERA RV ELICENSEE OH PERSON ACTING AS SUCH ~- BER WA6 i.1EFNCAI-EXAMNeER ~ .,,//~ // ' / 7 r APPROVAL GRANTED? -Yea No . V / . J~ J ~. NAME OF FUNERAL FACH-ITY 2~. F S MAILMG -STATE y~ '! 1„ake,land Funeral Home Florida ,CRY OR TCPWN 29c. STREET ADDRE89 29d 21P -~ ~! Lakeeland 2125 S Bartow Rasa 36801 ~~1l. CERTMFIER: - 6w1NYbte PhYMCtee- Tb~~Ne beat a my krowiedAe, dMdf oowrted at Ya Wee. ~. end pie, end doe tithe cpwe(&) mW rramer shred. •: 8 lFha'tAt oirei ' - On 11a beak a examMSOn, aorta tan, M aruaetlga ~ mY aPlMOn, death a¢cared et dre9ma, d~ arm peas. die b ew ceuae(9) arq manner awed 318. ( Mld 71Ba ei' ) - 31 b. DATE SIGNED (mNdmjyyyi 32 TNdE OF I7Ee'!H (2s hrJ 33. MEDK;M EXAMR4ER'9 CASE NIAaBEF ' u Q - Z Q 0220 ~ /,n D „ o . ._-'---'----- ! LICENSE NUMBER 3db. GERTIFlER'$ NAME ~ , 35. NAME A (:ND1NG PHYSKilldd (!t Darer 1iwtCaa'1Pe) 8 ' lea. CEH1IFIER'S -STATE 386. CffV Ofl R7WN 3Sc. STREET ADpRE58 3Bd.Z~CODE ~ Florida Lakeland 1324 Lakel.~zld 1~ills 81vd 33805 37. SLIBR~GiBTRAR - SlpnaNre Bret Dale AL REOISTRAH • S,brap.pa'. ~ ' ~ „ 3~. TE RLEDBY REGISTRAR (Adp., JJ+Y. Yr.l 9g. PROBABLE IdAM~R OF DFATH I ThefoMOwklg era ruder the }udedirabn a the medical eKaniear: 4D. RE D MFAIC,Ak, R D .TO ~, Natural ,_; ACadeM SWCitle -Hornid4la -PeMYp bMaatpagwi - UndRq!mirred CAUSE bF DEAAfi17 ~ Vas ~ W - _ 4i. CAUSE QF DEATH • PAM i Enbu tlta dfeaMea, inAeles. a compkoatlaa • tlMt d'peapy mWad U1e tkaN. ErAer Doty one ca use on a IYw. 1lgproakmek~ haervM: ~ {~aba61>aionson tmck) DONQT emer bnnirld evert arrh a8rbdia¢arteaL retyfaabry anwL wvenldaAer.~padm wMnw ehoweg 9a el~ogy. I Onset to~~DeaM ' MATE CAUSE ~ficaWaon t ~ //~ ~' . y1 w ~~ , /~,~ ~ ter. ,A,, `F t I ~VtT~ I ~' t ' C'~~~ ~ ,. ..- ..c W fi R r1~ 1V Y a. l~ ~ 3squatnkay HdcontllWax, ~~ ~ Ft62i C t~ ( IP My.kYkp m7M Ceuae p. . .IJRT /lJ , - k+w on Wle e, linertae ( lMlb®Rl.YY~1~ FikUSE , ry~ c ~ ~ a ~ _ h a vb +IN 'tl~ raaullKg kr deaNl LABI' ( - I a ' 'PABY g. Othaf but not naulWlg b der unAadyhg aura VYBtI In PAM k 4$e, WAS AN AUTOPSY 42b. Y/ERE AUTOPSY FM101NS AVAILABLE PFORI IED7 MPI ETE E ' . ~~ ~ f- , PE TO CO TH C QF DEATH i V Y "° N No ,T as es -• V p e3e. IF SLIH Y MENTIdNEb Ri PART I OR 11, ENTER REASON FOR V 43b. DATE ~ SURDERY (AAo., Day, Yrl 44. ~ TOBACCO 119E CDNTRIBUIE 70 DEATH? --- -Yea No -ProbedY _Unfaarm 45 IF FEMAEE, WAS S7# PRE®NAM WITMI84 THE PAST YEAR: . a _ Vas _„- No ~-„ LMieidvnr tl Yea, apacay lenelrarrla: ~ _aY Wne a dagkl ~ tdeYR t b A2 diyM~a dedaP ' - wlMa 43 tlaycb t years death _-_ ae. DATEOF II,IIIRY (MdrMA Day, Ye9lj 47. TIME OF INJURY (84 hry d& INJURW AT WORK7' s. LOICATI OP MLIURY -STATE s Yea ~~ ~ 43b CRY ORTDWN 49p. STREET ADORE&4 ~ 49tl. APT: NO. 40e. Tw CDDE 90 DESCRIBE HOW INJURY OCCt1RR® ~ 51. PLACE OF INJURY (eg. corafnMMPk;aHe, resaneant i`J ;~ "'!'T y~~~ ~~-~ ~-1 ,,~ IF TRANSP4RTAT~IJ N4URY, Sta. S4rfure o/Daeadeu -DrivadOperabr -Pewwtper _.Pedaslran ;_Oltwr (BpedM - ~I,;, Vl (r _41 ~.Tlq,adYtldNa _,,. CaNNWdvgr -S.U.V. -MOlacyole _PkAuq T+aadC Yrti &a NaavY T`<araptNl ,-_Wtrer f9peclbt l; ~~ E-!' ~f"~ " _.. -+ i y~ r -_ ' (. j r-~. _ c TsSc,ed FEB I! ~ 2012 a~ s~~ I r ~ f - 'THIS Q6CUMENT IS PRIMIrD fNi PNQTOCOpIEp ON SECURITY PAP€R WITH- A WAT€P1~1!( ~ 7NE GREAT w H A T / ,fie WARNING: SEAL. THE STATE ~ fLORiDA DO 1401' ACCEPT WITHOUT tlERIFYiNG THE PRESE'N4~ ~ T'F~ WATEAk~C. 11L17L _ THE QOCUMEN! FACE CgNiAINS A kNJITI•COi~0RE0 BACKGROUND AND GDLD EASE6 SEAL TFIE ~CK ~ :- _ ; ~ CONTAIriS SPECIAL LINES WITH TEXTAt~ SEALS! THERlAOCHROlAIC INK. • ''"~ ~ fORtNI 1947 (48104) .~~~.T ~~ ~' .. I111111illlllllllllllll IIII IIIII IIIII IIIII IIII II . 3=4737x3 * 3 8 4 7 3 7 8 3 f t n~L hi tlj 2~ ~[7 2~ ~~ _, i_._: OFPH>~a~;'u ;vJRt !' ~~~"PA LAST WILL AND , rA1~~~TTT' , OF ESTHER M. BERKHEIMER I, ESTHER M. BERKHEIMER, having my legal residence at 2910 Sunset Drive, Camp Hill, East Pennsboro Township, Cumberland County, Commonwealth of Pennsylvania, do hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. FIRST: I direct that the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. SECOND: I direct that all furniture, furnishings, household goods, books, jewelry, clothing and other articles of personal property owned by me at the time of my death shall be distributed in accordance with the provisions of a certain memorandum which I may choose to prepare and keep with my Will. If for any reason said memorandum is not found and properly identified as such by my Executor within thirty (30) days after the filing of my Will for probate, then it shall be presumed that such memorandum was destroyed by me with intent to cancel the same, and all of the aforesaid property shall fall into and become part of my residuary estate hereinafter disposed of, according to the sole and exclusive discretion of my Executor. THIRD: I devise and bequeath all of the remainder of my estate and property, of whatsoever nature and wheresoever situate, subject only to the provisions of Paragraph SECOND herein, to my husband, WILLIAM L. BERKHEIMER, if he survives thirty (30) calendar days after my death. FOURTH: If my husband, William L. Berkheimer, does not survive thirty (30) calendar days after my death, I give, devise and bequeath the sum of One Hundred Fifty Thousand ($150,000.00) Dollars to my granddaughter, ELIZABETH A. PASSO, as Trustee, in trust, for my son, DAVID S. STAFFORD. My said Trustee shall hold, manage, invest and reinvest said share for so long as said beneficiary shall live; and, as in the absolute judgment and discretion of the said Trustee may be necessary or advisable, said share shall be used, paid or applied, by said Trustee, for his welfare, support, maintenance and general benefit. So much thereof as shall not be so paid, used or applied, shall be held and accumulated by said Trustee for said beneficiary. Payments applicable to the use of beneficiary as aforesaid may be made by the Trustee to the beneficiary, guardian or any other person having the care and custody of such beneficiary, or to such persons or in such other manner as the Trustee in her sole and absolute discretion believes will benefit such beneficiary. The Trustee may also make such payments directly to such beneficiary as the Trustee may deem advisable as an allowance to him. If my Trustee, in her sole and absolute discretion, determines that the size of the Trust Fund at any time as provided for herein does not warrant continuing the same in Trust, or that its administration would be impractical for any reason, the Trustee may, without further responsibility, pay such remaining fund or share to the beneficiary. z Should Elizabeth A. Passo predecease me or fail for any reason to serve as Trustee, I appoint MICHAEL H. SMALL, ESQUIRE, or his designee, as Trustee, with the same powers and privileges set forth above. Upon the death of David S. Stafford, my Trustee shall immediately distribute the remaining Trust funds equally to his children, ELIZABETH A. PASSO and DAVID H. STAFFORD, or their respective issue, per stirpes, in a manner consistent with the provisions set forth herein. FIFTH: If my husband, William L. Berkheimer, does not survive thirty (30) calendar days after my death, then I give, devise and bequeath all of the rest, residue and remainder of my estate and property, of whatsoever nature and wheresoever situate, subject only to the provisions of Paragraphs FIRST through FOURTH set forth above, in six (6) equal shares, as follows: A. One (1) equal share to my granddaughter, ELIZABETH A. PASSO, per stirpes; B. One (1) equal share to my grandson, DAVID H. STAFFORD, per stirpes; C. One (1) equal share to my granddaughter, SARAH A. PARKER, per stirpes; D. One (1) equal share to my granddaughter, JESSICA R. SPAULDING, per stirpes; 3 E. One (1) equal share to my granddaughter, ERICHA R. HORNAMAN, per stirpes; and F. One (1) equal share to my grandson, ISAAC M. HAGENBUCH, per stirpes. SIXTH: All estate, inheritance, succession and other death taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the principal of my general estate, as if such taxes were administration expenses, without apportionment or right of reimbursement. I authorize my legal representative to pay all such taxes at such time or times as may be deemed advisable. SEVENTH: I appoint my husband, WILLIAM L. BERKHEIMER, Executor of this Will and direct that he be permitted to serve without bond and without any intervention of any court except as required by law. I authorize my Executor to sell, encumber, mortgage, invest, distribute in kind, or retain any items of property of my estate in such manner as he shall deem proper, limited only by his own discretion. If for any reason my Executor appointed under this Will should fail to serve in that capacity, I appoint my granddaughter, ELIZABETH A. PASSO of Camp Hill, Pennsylvania, my Executrix, with the same powers and privileges set forth above. 4 IN WITNESS WHEREOF, I have at Palmyra, Pennsylvania, this 11th day of November , 2010, set my hand and seal to this, my Last Will and Testament, consisting of five (5) pages. ~,~ , ~~~.,. J ~/ ~~~~20~ ; ~ (SEAL) Esther M. Berkheimer SIGNED, sealed, published and declared by ESTHER M. BERKHEIMER, the above- named Testatrix, as and for her Last Will and Testament, 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 witnesses. ~ / ~ ~ ~ /// esidence: 12 N • Clearview Drive Palmyra, PA 17078 nc 826 Cornwall Road Residence: Lebanon, PA 17042 5 OATH OF SUBSCRIBING WITNESS(ES) ,.r., © ItiJ ~}~t.,~I REGISTER OF WILLS ~~ c > ~~> CUMBERLAND COUNTY, PENNSYLVANIA t- ~ ~ ~ ' ~ r'- `T U~= `z -- n~, -~, cn `'7 Sn Estate of Esther M. Berkheimer, a/k/a Esther Mae Berkheimer, a/k/a Esther M. Stafford , IIeceased Michael H. Small, Esquire and Patricia A. Baylor , (each) a subscribing witness to (Print Name/s) the ~ Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence of each other. (Signature) L-(Se ature)~ 12 N. Clearview Drive (Street Address) Palmyra, PA 17078 (City, state, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills 826 Cornwall Road (Street Address) Lebanon, PA 17042 (City, State, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~~i~ day of J - ~ a%d ~~V~~a Notary Public My Commission Expires: ~~.Sj1,6 (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. COMMONWEALTH OF P •YLVANIA NOTARIAL SEAL Form RW-03 rev. !0.13.06 HEATHER A. STONER, Notary Public Palmyra Boro., Lebanon County My Commission Expires March 25, 2016