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Home My WebLink About09-05-12I N TH E COURT OF COM M ON PLEAS OF CUM BERLAND COUNTY, PENNSYLVANI A REGISTER OF WI LLS PETITI O~V FOR PROBATE AND GRANT OF LETTERS Estate of aIk/a: a/k/a: a/k/a: Jean S. Crisafulli Jean S. Crisofulli ~aaeaa~d ESTATE N O: 21- 1,~ - ~~ /' SS NO: Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as appli~ble: ~7 A. Probate and Grant of Letters Testamentary or ^Administration c.t.a., or d.b.n.c.t.a. (corn~lei~e Part C also) and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary under the last Will of the above-named Decedent, dated Ju 1 y 1 6 , 1 9 9 8 and codicil(s) dated (State relevant circumstances, e.g. renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person, and was not a party tog pending divoroeproceeding at thetimeof death wherein groundsfor divorce had been established asdefined in 23 Pa. C.S~A. § 3323(8): N f A ^ B. Grant of Lettersof Administration ~~ ~ _ ~~~ (If appiicabl~, enter d.b.n., pendent lit duranteabaerrtia, durant~' itate) r-,-~ f'' .' ,_---~ f ~i~ - --~ = - _ T= _..~ C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived ~ . e. ~~ ~ -- following spouse (if any) and heirs (If Administration c.t.a. or d.b.n.c.t.a., enter date of Will in Section ~+d complete list of, _ _- heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a pares a pend divOa'~-` -~ proaeedingwherein groundsfor divorce had been established asprovided in 23 Pa. C.S.A. §3323(; kept as owsLL-= -'~~ name Address Relationshi to l~ USE ADDITIONAL SHEETSIF NECESSARY TH I S SECTI ON M UST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 1100 Crandon Wav, Mechanicsburg, PA 17050 (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 93 years of age, died August 5, 201 2 at Mechanicsburg, PA (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: 2 $ 5 0 0 0 ~ ~ 0 _If domiciled in PA All personal property $ r _If not domiciled in PA Personal properly in Pennsylvania $ --- _If not domiciled in PA Personal property in County $ - - - _Value of Real Estate in Pennsylvania $ , Total Estimated Value $ ~ Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature( Name(s~ & MailingAddre9e(es) Diana L. Moscato 7 Meadowood Place Boiling Springs, PA 17007 Interim Porm RW-U2 revised 12.2(,.10 by Cumberland County pending action by the Court Pale 1 of 2 _~ , OATH OF PERSONAL REPRESENTATIVE n ~~ ~_ Commonwealth of Pennsylvania ~~-- '. ~ ~~~ ~ -~~ 4, ~. County of Cumberland ~ ~-~ ~ ~' ~, C~ ~ ~ f_~- The Petitioner(s) herein named swear or affirm that the statements In the foregoing Pe~tion are t~ and'' o correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representatives) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed Cx ~~~~~ before me this ~ day of Diana L. Moscato September 2012 or the Register DECREE OF PROBATE AND GRANT OF LETTERS Estate of Jean S . Cr i s a f u 11 i ,Deceased File Number: 21- - ., a a Jean S. Criso u i AND NOW, this ~~~ay of September , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters x Testamentary of Administration are hereby granted to: (If applicably enter ct.a., d.b.n., d.b.n.ct.a., etc) Diana L. Moscato in the above estate and that instruments(s) dated July 1 6 , 1 9 9 8 described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decede~~t. Glenda Farner Stras au h Register of Wills ~~ 4 FEES: Letters ................... Will ....................... - ~'c~ Co icil(s) ............... ( ~ Short Certificates ( )Renunciations....... Bond ............................ Other ............................. Signature of Coun9e! Required to Enter Appearance Atty's Signature '~ ~~ ,~,~~~,_ PRINTED Name: Anthony L. DeLuca, Esq. Supreme Court ID No.: 1 8 0 6 7 Address: 1 1 3 Front St . , P . O . Box 358 Boiling Springs, PA 170 Phone: 717-258-6844 Fax: 717-258-3902 ~, Automation FEE......... 5.00 JCS FEE ................... 23.50 ~ ~~~ ~~ TOTAL ................ $ Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA No. 21- Estate of ~`7 ~'~-~~~ S • C`'G~`/' S~ ~ ~ ~~/~ ,Deceased U~TAVAILABI..E vVIT1NESS AFFII-AVIT I, ~la~~ ~ ~ G~i'vS c` ~ ~i`=c~ being duly sworn according to law, depose and say that I, the ^ Attorney ~ Personal Representative in the above referenced Estate, declare that ~~~'~ ~ w ~~ • ~~ :, ~ ~~ ~~=-~ and ~/,~ ~ ~ • /~~;- ~'~U~~g--~ ~~ -, whose signature(s) appears as subscribing witness(es) to the ~ Will or ^ Codicil of the above Testator is/are not readily available to prove the signature to the Testator by reason of Sworn to or affirme nil subscribed Befor ne his t day, of ,L~ , 20~ //J,i/t~'a- L' .' /~ ~ .~v ~/I _1 lam" /{..~' V ~' ~~~ Signature of Counsel/Personal Rpre tive J_; ~., ~~ ~S' ~ y:=.. ' '~ ~•~ ~_ c-~ c ::; ~ ~=~-; ~'='-+ _-~ ~A..' .~~ ~-~ ~. -:r; ~ _ =!_~ _ t ._~~ _; huty for Register of Wills ust sign in Register's Office) cn OATH OF NON-SUBSCRIBING WITNESS ~~~. ~~ / G~/GSC-~`~r~ and ~ sL~' ~ ~y i~ ~ ~ .-~t~~~v c~ .~ ~S'p c1 i~~~ (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that he is/she is/they are familiar with the signature of the above Testator of the ^ Will or ^ Codicil presented herewith and that he/she/they believe(s) the signature on the ^ Will or D Codicil is in the handwriting of the above Testator to the best of his/her/their knowledge and belief. Sworn to or affirmed and subscribed Before e th~s day of ~ ~~ t, ~~ ~. uty for Register of Wills Must sign in Register's Office) -- c~-x-, --- ~~~ CJ --r~ ----~. Signature ofNon-Subscribing Wi ness ... p?~i~-~ C ~, -GC-~' - -~~' Signature of No - ubscribing Witness h , ~~a ' T , :__~,sJ }'~4~?S~P--S ~~Ii~~~ CIj~IB~R~.-~~ Cfl„ PA ~ ~ Type/Print In COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH ~ VITAL RECORDS Permanent Black Ink CERTIFICATE OF DEATH State File Number: 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) JEAN S_ CR=SAFULL2 ug 5, 2012 Sa. Ago-Last Birthday (Vrs) 56. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/D ay/Year) (Spell Month) 7a. B1',~thplace ( t St to or For ign Country) ~ ~'' ~ ~ Months Days Hours Minute 3 1 1 9 1 8 , P . C 1 e ar f e 9 3 Au g ~ 7b. Birthplace (County) 8a. Residence (State or foreign Country) 8b. Residence (Street and Number -Include Apt No.) Sc. Did Decedent Live in a Township? PA es, decadent lived in Hampden twp. 8d. Residente~ (cpunty) ' 1 1 00 Crandon Way L11Tl t?8Z" lZnd L 8e. Residence (Zip Code) ONO, decadent lived within limits of city/boro. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death Q Married Widowed li. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Yes ~o Q Unknown Q Divorced Q Never Married Q Unknown N/ A 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) James Scannella Libra Juiliano 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number City, State, Zip Code) l 0 Michael S_ Crisafulli Son tson, NJ 08527 4 Corinne Court, Jac ~ v 15a. P ace o Deat G ec on one Y .......................................................... ........................................... If Death Occurred in a Hospital: ~ Inpatient ..... .......................................... ..................................... .................................... If Death Occurred Somewhere Other Than a Hospital: ~ Hospice Facility ~ Decedent's Home o Emer enc Room/Out atient Q g y p Q Dead on Arrival . Nursing Home/long-Term Care Facility Q Other (Specify) 15b. Facility Name (If not institution, give street and number; 1St. City or Town, State, and Zip Gode 15 d. County of Death Emeritus at Craekvi.ew Mechanicsburg, PA 17050 Cumberland 16a. Method of Disposition Q Burial Q Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) CO ~ Removal from State Q Donation 8/8/201 2 n Cemeter v t f H G Other (Specify) Entombment y e o ea e a ~ 16d. Location of Disposition (City or Town, State, and Zipj 17a. of Funeral Service License or Person in Charge of Interment 17b. License Number East Hanover, NJ 07936 012206E E 17c. Name and Complete Address of Funeral Facility Bu F one wn Rd- Grantville PA 17028 m 18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to indicate what ~ highest degree or Ievei of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. ~ 8th grade or less is Spanish/Hispanic/Latino. Check the "NO" ® White ~ Korean ~ No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese Q High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native Q Other Asian Q Some college credit, but no degree Q Yes, Mexican, Mexican American, Chicano Q Asian Indian 0 Native Hawaiian ssociate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) ~ Yes, Cuban Q Filipino ~ Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispanic/Latino Q Japanese ~ Other Pacific Islander Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Specify) e. MO, DDS, DVM, LLB, JD 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work ~ White Q Japanese Q Samoan done during most of working Iffe. DO NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacificlslander Secretary Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) Pharmaceutical ~ Filipino ~ Guamanian or Chamorro ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (MO/Day/V r) 23b. Signature of erson Pronouncing Dea h (Only when applicable) 23c. License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH 'ry, >~ ~~ ZL7 Z ~ 23d. Date Signed (Mo/Day/Yr) 24. Time of Death _ - 1 ~-°" ~Z-"' ~Z~ V ~ -~ 25. Was Medica Examiner or Coroner Con cte Q Ves ,,,~~'IOo CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest. Interval: without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death respiratory arrest, or ventricular fibrillat io n / ~_ / IMMEDIATE CAUSE ---------------> a. G~ (Final disease or cond(tion Due to (or as a consequence of): resulting in death) ~~ T/~ b. J , y Due to (or as a consequence of): _ Sequentially list conditions, ///~~~ ` if any, leading to the cause ~ ~ In ,. ^ ^ i ~ 1~ ,., - ^ ^ ~J~„_, /~a ' ~ ~ `{J~ C (~, (~~ listed on line a. Enter the c. r L_~ r Y' 6 J~~ ~ UN DERLVING CAUSE Due to (or as a consequence of): s w (disease or injury that initiated the events resulting d. w V in death) LAST. Due to (or as a consequence of): S sfanificant conditions contributing to death but not resulting in the underlying cause given in Part I 26. P a rt 11. Enter oth e r 27. Was an autopsy performed? / '~ Q ~ Y ~ 7 i ~ ~ O ~• ~as~ - 1 ' ~~/~ \ ~ .ire ~ /'~~ ,C ~~ ~ ~ • /~ autopsy findings available 28. Were m + t..s i ~ T ~~ ~-/}- ~a (J l_ I`] to tom plate the cause of death? a Yes No 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death ~ ~'NOt pregnant within past year Q Yes Q Probably ~ Natural Q Homicide v Q Pregnant at time of death ~ No Q Unknown Q Accident Q Pending Investigation m Q Not pregnant, but pregnant within 42 days of death Q Suicide ~ Could not be determined ~ Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (Mo/Day/Yr) (Spell Month) Q Unknown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Yes Q Driver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated Pronouncing & Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated n ner stated y opinion, death occurred at the time, date, and place, and due to the cause(s) and ma Q Medical Examiner/COr ner On the basis of exa mi n anon, a r inygstigation, in m / ~ ~ / c ~ ~ 0~~~ J~~~ ~ ~ r ~ ~ L " License Number: tifie r: - Signature of certifie ~~6d~/Z ~/ J IA{6f ~ 39b. Name Address and Zip Code of Person Completing Cause of Death (item 26) - 39c. t Signed o/Day/Vr) ~~LL r fD~''1 (~'O~, ~ p22 iG P3 1-7 ~-1G~-1 -~ -( 4 - IG 40. Reglstra is District Number 41. Registrar's Signature ~ ~~ 42. Re istrar Flle Date (MO Day r) / / 43. Amendments v N . r..l ,--4 r--1 W ..-i ~-1 U C/] (~Y N I"7 0786208 H105-143 Disposition Permit No. REV 07/2011 ~.Ztt$t mill ttn~ ~rs~ttmPn~ of JEAN S. CRISAFULLI I, JEAN S. CRISAFULLI , also known as Jean S. Crisofulli, now residing in the municipality of the Township of Clark, County of Union and State of New Jersey, at 382 Carolina Street, being of sound and disposing mind, memory and understanding, hereby revoke all Wills and Codicils heretofore made by me and declare the following to be my Last Will and Testament: ARTICLE ONE I direct that all my j ust debts, my funeral and testamentary expenses be paid as soon as practicable after my death. ARTICLE TWO I give, bequeath and devise the rest, remainder and residue of my estate, whether real, personal or mixed, wheresoever situated or to which I may be entitled at my death, to my beloved Husband, PHILIP N. CRISAFULLI ,also known as Philip N. Crisofulli, absolutely. ARTICLE THREE In the event that my beloved Husband, PHILIP N. CRISAFULLI , should predecease me, I give, bequeath and devise the entirety of my Estate, whether real, personal or mixed wheresoever situated, to my beloved Children, DIANA L. MOSCATO, currently residing in Staten Island, New York, MICHAEL CRISAFULLI, currently residing in Jackson, New Jersey, and JAMES CRISAFULLI, currently residing in Effort, Pennsylvania, in equal shares, share and share alike. In the event, that any of my beloved children should predecease me, I give, bequeath and devise the deceased child's share equally, to whomever of their issue are living at the time of my death, per stirpes. ARTICLE FOUR All estate, inheritance, legacy, transfer, succession and other death taxes and duties, including interest and penalties thereon, assessed or imposed by reason of my death and upon or with respect to property passing under this Will or property not passing under this Will, shall be paid out of my residuary estate as an expense of administration. No part of said taxes shall be apportioned or prorated to any legatee or devisee under this Will or any person owning or receiving property not passing under this WiII. ~ r U r'j~ ~~~ --. .. .. - ~ T . ~ --~r _ ._. , "- t'7"1 D ~~ c.s~ e Z ARTICLE FIVE I hereby nominate, constitute and appoint, my beloved Husband, PHILIP N. CRISAFULLI, as sole Executor of this my Last Will and Testament. If my said Husband should predecease me or otherwise be incapable of acting as sole Executor, then and in that event, I nominate, constitute and appoint my beloved Daughter, DIANA L. MOSCATO, to act as alternate Executrix in his stead and place. I direct that no bond or other security be required of my sole Executor or alternate Executrix, as the case may be, for the faithful performance of their duties as such, either in the State of New Jersey or elsewhere, where it may be necessary or convenient to make proof of this my Will or to act in settlement of my estate. ARTICLE SIX In the event that any Beneficiary or Executor or Alternate Executrix under this Will shall die with me in a common disaster or die with me under such circumstances that it shall be impossible or difficult to determine which of us died first, or in the event that any such person shall die within sixty days of my death, I direct that such person predeceased me. IN WITNESS WHEREOF, I have Signed, Sealed, Published and Declared the foregoing instrument as and for my Last Will and Testament this r~ th day of S~ ~, , 1998. ,~ -- ~% -~~- ~.~'` JEAN S. CRISAFLT~,I ,Testatrix -2- The foregoing instrument, each page identified by the signature of the testatrix, JEAN S. CRISAFULLI, to be her Last Will and Testament, consisting of three pages, including self-proving section, in the presence of us, and each of us and who at her request and in her presence and in the presence of each other, all being present at the same time, have hereunto signed and subscribed our names as attesting witnesses, hereto, this i ~ th day of .~ ~~y , 1998. s~ v r~~ S. o ,Witness albs„ ~. taro ,Witness STATE OF NEW JERSEY ) ss. COUNTY OF UNION ) JEAN S. CRISAFULLI, the Testatrix herein, and the witnesses, gn~re~ ~ ~~t 4~na ~l~ and Alba 8 • P~~~A ,whose names are signed herein this instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument herein as her Last Will and Testament, signed willingly as her free and voluntary act for the purposes therein expressed, each witness signed this instrument in the presence and hearing of the Testatrix and to the best of each witness's knowledge, the Testatrix was over the age of 18 years or more, of sound mind and under no constraint or undue influence. •~ES YZo O n ~^~JEI~~3y~~~y,~A;y~~~Cc.7~~,L}CC~u/~SCC}~ -3-