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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: Guy A. Romito, Jr.
a/k/a:
a/k/a:
a/k/a:
Date of Death: Julv 11, 2012
File No: ~ I - ~ a - ~l-~ ~ Q
(Assigned by Register)
Social Security No:
Age at death• 51
Decedent was domiciled at death in Cumberland County, Penn. lvania •
principal residence at 625 Woodland Ave Mt. Holl S tin s Cumberland Count PA 17065 (State) with his/her last
Street address, Post Office and Zip Code City, Township or Borough Coun
Ty
Decedent died at 2317 Wood Street Lancaster Lancaster PA 17603
Street address, Post Office and Zip Code City, Township or Borough Coun
tY State
Estimate of value of decedent's property at death:
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
[value of real estate in Pennsylvania ........................................................ .
TOTAL ESTIMATED VALUE... .
$ 10,000.00
$ n nn
$ 10.000.00
Real estate in Pennsylvania situated at: 625 Woodland Ave Mount Holly Spr1nQS PA 17065 Cumberland
(Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough Coun
ty
A. Petition for Probate and Grant of Letters Testamenta
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated November 3, 2010 and Codicil(s)
thereto dated None
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(8), 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., pendentelite, duranteabsentia duranteminoritate
If Administration, c.t.a. or db.n.c.a~a., enter date of Will in Section A above and com lete 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(8) 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 following
additional sheets, if necessary):
Name
Address
ruse (ifany) and ~~ (attach
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Form RW-02 rev. 10/11/2011
Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
To the Register of Wills:
Please enter my appearance by my signature below:
Petitioner(s) Printed Name Petitioner(s) Printed Address
Peter J. Russo 5006 E. Trindle Road Suite 203 Mechanicsb " ' ~~~5 i
(;t1M6ERl.~ID ~,
The Petitioner(s) above-named swear(s) or affirm(s) the statement foregoin a true and correct to the best of the knowledge and belief
of Petitiorer(s) and that, as Personal Representative(s) of ecedent, thq tone will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed before Date ~ 01 l a
met ' ~~ da of c
13 + ,~ Date
y Daze
For the Register Date
BOND Required: ®YES ~ NO
FEES:
Letters ...................... $ 45.00
( 5) Short Certificate(s)...... 20,00
( )Renunciation(s)........ .
( ) Codicil(s)....... ~..... .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other
I~ 111 ....... l~5•U
.......
Automation Fee ............... 5.00
JCS Fee ...............`...... 23.50
TOTAL ..................... $
A
Printed Name: Peter J. Russo
Supreme Court
ID Number: 72897
Firm Name:
Address:
~~G~J~uv~ _ ~.,
FiEt - ~ ; ~ `~,,~~ , ~
. ~; ~ ,+ a..,~
PM 2~ 54
Law Office of Peter J. Russo, P.C.
717-591-1755
717-591-1756
nn~ccn(c~i p~rla~v rnm
Phone
Fax:
Email:
DECREE OF THE REGISTER
}
} SS:
}
Estate of Guv A. Romito. Jr. File No: ~ ~ ' ~ O1- (f 4 (.~ !
a/k/a: - f
AND NOW, ____ ~^~~ , old, ~_, in consideration of the foregoing Petition,
satisfactory proof having bn presented before me, IT IS DECREED that Letters
are hereby granted to -~ f 2 a
in the above estate and (i pplicable) that
the instrument(s) dated ~ ~ -~~ - ZQ/A
described in the Petition be admttted to
Form RW-02 rev. 10/11/2011
a..., ~~,~u u~ rccora as the last wtll (and Codicil(s)) of
._~ ~~ m
Pale 2
HI05.805 REV (9/I1)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNI;° ,,r-~~~~ plicate this copy by photostat or photograph.
Fee for this certificate, $6.00
~~~~~ ~~~ 3~ ~~ ~. ~) 'T'his is to certify thax the information here given is
- correctly copied from an original Certificate of Death
- duly filed with me as local Registrar. The original
certificate will be forwarded to the State Vital
~~rJ 'vU~~'t~ Records Office for permanent filing.
P 1 R ~ ~ 7 X111 d CUMBERU~IVO CO.. PA ~~x ~--~
Certification Number
is
Type/Print In
Permanent
5 1
ai
F
S
~. t-~,~tcl~,~.~~„gc- JUG 15/2012
- Local Registrar Date Issued
COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
CERTIFICATE OF DEATH _. __
3d. Resldence (County) M't ~ HO
Cumber) nd ge. Resldence (ZI
f. Ever in US~yp,f mad Forces? 10. Marital Status at Tim
Q Yes Is?NO Q Unknown Q Divorced Q
L2. Father's Neme (First, Middle, Las[, Suffix)
Gu A_ Romito S
Loa. Informant's Name
Valerie E Romito
t oe:ii~ occ,i~~ed~i~ a'iio:"iiei............wt.+et .............
P u Inpatient,,,,,,,,,,,,,,,,
Q Emergen<m ROOm/OUtpetlent Q D d A I
LSb. F Illty Na a (If not Ina[Itutlon, gNe street and number;
2317 Wood St.
L6a. Method of Disposition Burial Q Crematl<
Q Removal from State 0 Donation
1~~/~3/19E
d Num Include Apt No.;
io~ane~er Ave
ley Spgs_PA
D Code)
of Death Married Q W
eNever Married Q Unknown
Yes, decedent lived In S M
No, decedent Ilved within limits of
Hospice Facility
.-... ~..~~.~.,., ... u.spos,<,on lc.,ty or Town, State, and Zip) 17a. Signature of Funeral Service Licensee o
Mt_ Hol1v Sr~rincrs PA 1 70 6 X~~.(L®/
l N d C plot Add f F I F Ility -=_-'~ a
~
o
Ba
3. Decedent's Education -Check the box that best describes the
gheat degree or l
l
f
h Mt.H
~1
S ri
19. Decedent of Hispanic Origin -Check the
eve
o
sc
ool completed at the time of death.
Q 8th grade or less box Shat best describes whether the decedent
No d{plome, 9th - 12th grade Is Spanish/Hispanic/La[Ino. Check the "NO"
Nigh school graduate or GED completed x If decedent Is not Spanish/Hispanic/Latino.
Q Some college credit, but no degree No, not Spanish/Hlspanic/Latlno
Q Associate degree (e
g. AA, AS) Q yes, Mexican, Mexican American, Chicano
f
Q Bachelor's degree ( .g. BA, AB
g5) Q Ves, Puerto Rican
,
Q Master's degroe (e.g. MA, M5, MEng, MEd
MSW
MBA
) Q yes, Cuban
Q Y
,
,
Q Doctorate
(e.g. PhD, EtlD) or Professional degree es, other Spanish/Hispanic/Latino
. MD DDS DVM LLB JD (Specify)
L....~DYye~''e''dent's Single Race Self-Deslgnatfon -Check ONLY ONE to in
hl dicate what the decedent considered hi
lf
s~rrv
te Q Japanese
Bl
k mse
or
Q Samoan
Q
ac
or African AmeNCan Q Korean
Q American I
di Q Other Paelflc Islander
n
an or Alaska Native Q Vietnamese
Q Asian Indian Q Don't Know/Not Sure
Q Other ASlan
Q Chinese Q Refused
Q Na[Ive Hawaiian
Q Fili
i Q Other (Specify)
p
no O Guamanian or Chamorro
EMS 29e - UST gE L ED
f PERSON WHO PRONOVNCES OR 23a. Date Prono Dea (MO Day r 23 . 5 gnature o Person Pr.
iRTIF1E5 DEATH T ///~'gL .d~ y ~
1 Leer
c ng Dest Only w en app is
71i~~.ZdiYi.' d'7' I Ri/r6o-3`.7i
25 W M dl 1 E
u Y
26
P
t L CAUSE OF DEATH N
.
ar
Enter the chal f
t~--diseases, injuries, or compl
respiratory arrest _
ications-that directly caused Me death
DO NOT
t Approximate
, or ventricular fibrillation without showing .
en
er terminal a
the atlolo vents such
gy. DO NOT ABBREVIATE
Enter
l as cardiac arrest. Interval:
IMMEDIATE CAUSE --------------->
a, ~ t ~ `~~~` ~ .
on
y one cause on a Ilne. Add add
~
L itional Ilnes If necessary i Onset to Death
(Final disease or condition ~~ ~ O .
tsg'Cf ~~(l (1
+ r
T
resulting in death) e~
D t ( ~
Q
q ne - -~++-s-~as-
b.
M E N t c
Sequentially Ilst conditions, _ ~~ rca_~x~
if any, leading t0 the c
e D f ( r aqua of).
listed on Ilne a. Enter the
UNDERLYING GUSE
(disease or Injury that Due to (or sequen
as a con ee of):
Initiated the events resulting
in death) LAST, d,
Due to (or as a consequence of):
26. Pert 11. Enter other slenlflcant ditl • Ib tl t d h but not resulting In the under) in
y g cruse Riven in Pan 1
__ ...
f Female: to complete the cause of dea[hT
30. Did Tobacco Use Contribute to Dea[h7 31. Manner of Dea[h Q Yes No
Q Not ^rwrgnanf within past ar ¢ Natural
Q Preg tat time of deathye Q Yes Q Probably O_
AccldenY C7 Homicide
Q Not pregnant, but pregnant within 42 days of death ~° Q Unknown Q Pending Investigation
Q Unk pregn'nt, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Yr) (Spell Month) Q Suicide Q Could not be determined
O nown pregnant within the past year
Q Yes Q Driver/Operator Q Pedestrian lee. vescn oe row Injury Occurred:
Q No Q Passenger Q Other (Specify)
C rtifl (Ch k ly )
Ifyi g physician To the best of my knowledge, death occurred due to the cause(s) and manner stated
Pronouncing ffi Certifying physician - To the best of my knowledge, death occurred at the time, date, and lace, and due to [he c
~ Medical Examiner/Coroner- On the basis of examination dbri estlgatlon, In p se(sa and manner.stated
mY opinion, death occurred at the time, date, and pl ce, and due to the cause(s) and m nn r stated
Signature of certifier: Title of certifier _ Al '~7 a e
5. Name, Address end Zip Code of Person CPmple[ing Cause License Number: K n A ~b (gQ ~~
tam 26)
Q c~~~ ~~ D i Lt ~ ~~ ( ~'s P N~l~ `~~_ ` ` ~ ^ (1 s _ _ 39c. Date Signed (MO/Day/Yrl
twp.
i, PA 17065
D edent s Race Check ONE OR MORE races fo indicate what
decedent considered hlmseM or herself to be.
White Q Korean
Black or African American Q Vietnamese
American Indian or Alaska Natlye Q Other Asian
Asian Indian Q NaHVe Hawaiian
Chinese Q Guamanian or Chamorro
Filipino Q Samoan
Japanese Q Other Paelflc Islander
Other (Specify)
to be. ~22a. Decedent s Usual Oceupa[lon -Indicate type of wore
done during most of warking life. DO NOT USE RETIRED.
Disposition Permit No. l l ~ ~~' O I H105-143
- - --- - _ _ _. _. _ - REV Ol/2011
~~
U~ iLr,_1 i;;
{-~~ ~ ~- -
Last Will And Testament
of Z~~~?~UG 3q P~ 2~ 54
Guy A. Rom~to, Jr. "i_~ is
Cl1MBERlAND CO., PA
I, GUY A. ROMITO, JR., of Cumberland County, Pennsylvania, being of~ sound mind,
disposing memory and lull legal age, do hereby make, publish and declare this to be my Last Will
and Testament, hereby revoking all Wills and Codicils heretofore made by me.
PARAGRAPH 1. I direct my Executor or Executrix, as the case may be, to pay all of
my debts, funeral and administrative expenses as soon as convenient after my decease.
Furthermore, I direct that all state, inheritance, succession and other death taxes imposed
or payable by reason of my death and interest and penalties thereon with respect to all
property cor.~.posing of n1y givss estate for death tax purposes, whether or not such
property passes under this will, shall be paid by the Executor or Executrix of my estate.
PARAGRAPH 2. I direct my Executor or Executrix to make the following specific
gifts:
To VALERIE E. ROMITO, my 2001 Chevrolet Cobolt provided it is still a part of my
estate.
PARAGRAPH 3. My Executor or Executrix may, at his or her discretion,
compromise claims, borrow money, retain property for such length of time as he or she
Initials: ~• '9 ~
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 1 OF 8
may deem proper; lease and sell property for such prices, on such terms, at public or
private sales, as he or she may deem proper; and invest estate property and income
without restriction to legal investments unless otherwise provided hereunder. I authorize
and empower my Executor or Executrix to sell any realty and/or personalty owned by me
at my death and not specifically devised or bequeathed herein, at public or private sale or
sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I
could do if living. My Executor or Executrix is authorized and empowered to engage in
any business in which I may be engaged at my death, for such period of time after my
death as seems expedient to said Executor or Executrix.
PARAGRAPH 4. I give, devise and bequeath all of my estate of whatever nature and
wherever situate, including any residue of my estate, to my daughter„ MELINDA
ROMITO.
PARAGRAPH 5. If my daughter, MELINDA ROMITO, does not survive me by a
period of at least thirty (30) days, then my estate, including any residue of my estate, I
give, devise and bequeath in equal shares to any issue of my daughter, MELINDA
ROM 1 TO, in equal shares.
Initials: G _~4 i2
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 2 OF 8
PARAGRAPH 6. In the event that my daughter, MELINDA ROMITO, predeceases
me or fails to survive me by 30 days, and leaves no issue, I then give said deceased
Child's interest in all of my estate, including any residue of my estate as follows:
Ten percent (10%) of my estate or $5,000.00 whichever is the lesser to the AMERICAN
CANCER SOCIETY and the balance of my entire estate to VALERIE E. ROMITO.
PARAGRAPH 7. In the event that any heir or beneficiary who inherits under this my
Last Will and Testament is under the age of thirty-one (31) years at the date of my death,
then the share of all such heirs and beneficiaries who are under the age of thirty-one (31)
years at the date of my death shall be held in trust by the Guy A. Romito, Jr. Family Trust
and pursuant to the terms and conditions thereof.
PARAGRAPH 8. I nominate and appoint my attorney, PETER J. RUSSO, ESQUIRE
and The Law Offices of Peter J. Russo, P.C. of Mechanicsburg, PA to be the Executor of
this my Last Will and Testament. If my attorney predeceases me, and his firm fails to
qualify or is not able or does not serve for whatever reason, then I appoint VALERIE E.
ROMITO to be Executrix of my estate, whereby said substitute Executrix shall have the
same powers as the original Executor hereunder.
PARAGRAPH 9. I nominate and appoint my I nominate and appoint my attorney,
PETER J. RUSSO, ESQUIRE of Mechanicsburg, PA to be the to serve as trustee of the
Initials:
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 3 OF 8
Guy A. Romito, Jr. Family Trust. I hereby ask that my trustee consult with VALERIE E.
ROMITO, as needed, with decisions in regards to my trust If my attorney predeceases me,
fails to qualify or is not able or does not serve for whatever reason, then I appoint the then
guardian of Melinda Romito to serve as trustee of the trust created in this will, whereby
each substitute Trustee shall have the same powers as the original Trustee hereunder.
PARAGRAPH 10. In the event of my death, my Executor and any successor Executor
or Executrix is hereby ordered and directed to take all steps possible to assure that my
minor child, MELINDA ROMITO is placed in the custody of VALERIE E. ROMITO.
PARAGRAPH 11. Any guardian appointed by this will or by order of court shall take
all reasonable measures to assure a continuing liberal visitation schedule with Valerie
Romito, my family and Melinda's maternal relatives.
PARAGRAPH 12. No person(s) shall benefit hereunder unless such beneficiary shall
survive me by thirty (30) days.
PARAGRAPH 13. No Executrix, Executor, Trustee or Guardian acting hereunder
shall be required to post bond or enter security in this or any other jurisdiction.
Initials: ~ ~!~
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 4 OF 8
PARAGRAPH 14. No beneficiary may assign or anticipate his or her interest in any
income or principal held or distributable hereunder; and no beneficiary's creditors may
attach or otherwise reach any such interest.
PARAGRAPH 15. The validity and administration of any trust established hereunder
and any question or disputes relating to the construction or interpretation of any said trusts
shall be governed and construed in accordance with the laws of the Commonwealth of
Pennsylvania.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this_~_day of
November 2010.
GUY A. ~OMITO, Jl~.
Initials: G -q/i?
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 5 OF 8
..
The preceding instrument, consisting of this and six other typewritten pages, was on the date
thereof signed, by the above-named Testator as his Last Will, in the presence of us, who at his
request, in his presence and in presence of each other, have subscribed our names as witnesses
hereto.
Witness:
Witness:
Initials: G.~9. ~
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 6 OF 8
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, GUY A. ROMITO, JR., whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed this 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.
GUY A. R MITO, JR.
Sworn to and subscribed
before me this day of
November 2010
Notary P lic
COMMONWEALTH OF PENNSYLVANUI
Notatlal Seal
Ashley R. Makokry Notary Publk
M~an~n ~P•. Oumberland County
Oct 12, 2011
of Npgries
Imtlals: ~.~9.
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 7 OF 8
. r
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We' Av~nber ~-.~~ lard and (~LrrK~C1Ce rt ~~ ,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 GUY A. ROMITO, JR., Testator, sign and
execute the instrument as his Last Will; and that he executed it as his free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of the Testator signed
the Will as witnesses; and that to the best of our knowledge the Testator was at the time 18 or
more years of age, of sound mind and under no constraint or undue influence.
a~~
WITNESS:
C fit ~G~Q C.' /l.~ ~
WITNESS:
Sworn to and subscribed
before me this ~ day of
November 2010
Notary Pu is
CO"'~"~ON~ ~snvaNra
liuc-vdan T~vp : c~oiu~ity
Oct. 12, 2011
Initials: ~ .A ~Z " "~~ or Notaries
LAST WILL AND TESTAMENT OF GUY A. ROMITO, JR.
PAGE 8 OF 8