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HomeMy WebLinkAbout08-31-12Roset~ PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF mberiand COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 yeaxs 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; degt~8 IpiFOt~titl0n Name: Joseflh F. But~tittnani File No: ~ (~ a/k/a: ~---- a/kla: < y Reg~ter} a/lda: Soelal Secwrity No: - ~~' 3 L ' S'a 3Sf Date of Death: 08/1 S/2012 ~ t "-" --Y--- Age at deatit• Decedent was domldled at death in ~~ ______ County, ,~ytvae;a (Scare} with his/hrr last Pn~t1~ residence at PA 17011 _ Sheet address, Pat Office aad;dp Code ,~; -._...__,..,_....._.._. Decedent died at ~' °~ ~ a010's~ ceeaty Street address, Peet Otyloe ani 7Jp Cak CYty, TowsrYp or Dores~~ Ceuty Stale Estintnto of value of decedmYs property at deem: ljdw»icdl'eer a Ala ..................... .Alt personal property S 1.500.00 I./~eola[owJclfatla~ ....................... Persatutl ' Ijaot ltt Pdumylrae~la . ...................... P W'~Y m Pennsylvania S Valtrs ®j,eai eapawe br h>~ivrrw~a ....................... ~, EgT~ATED VAI.IJE.... ~ M S t S 00 Rest estato in Peonaylvania situated at: (Attach oddtttoaarabeetc; +f neotssary.) Street address, Pat Office and 73p Code Ctty, Te~wesldp or BeeeasY ~.,ty ® 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 December 13, 2010 and Codicil(s) thereto dared Stale relevant ett+na~staaeel (eg. ~nsweJngesr, lraatr afekeersNr, erG) Excgtt as follows: aiinr me execution oftbo inatrumenl(s)offa+ed for probate Decedent did not marry,, was not divorced, was rat a party to spending ~'oroe p8 w6erem the l~da for divorce had been eambGshed as defined in 23 Pa C.S. § 3323(8), and did not have a child born or adopted; and Decedent was neimer the victim of a ta'lling nor ever adjudicated ~ incapecitaled per, Q NO EXCEPTIONS Q EXCEPTIONS Q B. Petition for Grant of Letters of Administration (If applicable) e.t.a., d.b.n., tLb.n.c.t.a., pendentelite, duranteabsentia, duranteminoritate If Administratitra, Ito. or db~.N.~tda, enter date of Will is Section A above astd cosniete list of ltei~. Except as follows: Decedent was rat a party to a patdiag divorce proceeding wherein the geamds for divoroe had boon established as defined in 23 Pa. C.S. § 3323(8) and was neither the victim of a Iditiutg nor ever adjudicated an iacapacitatexi person. © NO EXCEPTIONS Q EXCEPTIONS Petitioner(s), ai~cra proper search has/have asar7ained that Daxdent left no Will and was survived by the following sparse(ifsny) and heirs (artioclt arldirional sheets, tf ne~cersary): .t:" Form RW-02 Irv. IQ~11/2011 Page I of Z Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Ctunberland } } ss: } Official Use Only >~ECC . ~ i 0~ ~~,'l:. ~~ ;:,~i C~ RcC;; t cF~ ,v,, r'~';!1; ~ reririoner(s) Printed Name Petitioner(s) Printed Address 11 The Petitioner(s) above-Hamad swear(s) or affirm(s) the statements in the foregoing Pelidoat are true and to the best ofthe loiow - of Petitioner(s) and that, as Personal Repe+esentative(s) ofthe Decedent, the 'boner(s) wilt well and admiaister• the estate ~Se and belief according Oo law. Sworn to or atlimneci subscri before / Date _ ~ _ 3 / - ~ L me ' ~_ day of ~ bate B For pie Regfsoar ~~ Date BOND Required: Q YES Q NO FEES: Letters ................ ( `~"j )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ~.~ I ( ` ~ ..... . $__ ZO.~O 2G _ ~~ 1 ~..~t^L ........ Automation Fee ............... ~_ JCS Fee . .................... . ~ U TOTAL ..................... $ Te the Register of Wills: Ptease enter my appearanee by my aitinature below: Attorney Signature: Printed Name: Supreme Court ID Number: Firm Name: Address: Phone: Fax: Email: DECREE OF THE REGISTER Estate of Jo~snh F. I:~.,i File No: ~ (- ~ ate- -G G~ 5 AND NOW, __~~~P ~~~ ~D r ~I satisfactory P~f }~vrng presented before me, -~~~---' in considera{ion of the foregoing Petition, ItT YS DECREED that Letters are hereby granted to - the instrument(s) dated in the a estate and (if applicable) that described in the Petition be - _ Form RW-02 rev, 1GV11/20I! and filed of record as the last Will (and ~~~~~`/ H105.805 REV (9/111 _ _. __ _ _ _...__ _. _._ _._~_ _'~ _._-- RMF/vIl^. . LOCA~(~~~~R'S CERTIFICATION OF DEATH ~~==1' J+ WARN~;I~i~ al~eg~ltf9 duplicate this copy by photostat or photograph. Fee for thic .~Prt;f;.-~to Q~ nn ~h I ~ et ~r. ~ I pN ~' I ,. G /i/a.i ~ Certification Number Type/Print In Permanent ~~ Local Registrar Date Issued COMMONWEALTH OF PENNSYLVANIA ~ DlPARTMENT OF HEALTH ~ VITAL RECORDS CERTIFICATE OF DEATH 2. Sez 3. Social S•cuN Numb•r5tate File Number: L,t c t+ i G /~lRNi H 4. Dab of Death (MO/DaV/Yr) (Spell Mo) I iY MwaE (gd 3.7 AH6wsr i S U d 1 D y 6 D t of T.. ^ S~ 3S f ~?O / j Ai~ay /~, /938 nber _ I...~h.d~ ~... u_ Yef, decedent lived In _ ~'4fT P~w/Me ~.~ MrP No, depd•nt INed within Ilmita of _.. _._ .. ' _- ___ __ ....._ _...~~... u marnee w No Unknown Q Olvorpd ~,Newr Mauled Q Unknown aj _________, _......, __ ._ ..__ _ . ... _ This is to certify that the information here given is correctly copied from an original~Certificate ot~ Dei# h ~,~ _ duly filed with me as Local Registrar. The~q~i~~l Qftp~,,q~'~ ~;L~T ~ .certificate will be forwarded to the Stafe~' 1, ~M~~~p C~.r PA Records Offce for rmanent filing. P 18651927 an PI M6 o , 17a. Signet Funeral Service Ucensee o. c./w.~1.cs~.c Pa . ~-r so 17c. Nem~ end Complete Address of FuMr•1 Facility y ~ ie. Decedent's Education -Check the box that beK de~e Ib~~tl1. ~f 19 Decedent Hl ` 4- r- hlehest deeroe or level of school completed at the time of death. Q eth er•e• or less a bez that bef[ eeteNbef lWlOietti~r the deetedent No dl Ploma, 9th - 12th grade Is Sgnlfh/HI•P•n14LaCino. Check tM ^NO° box If decedent Is net S i h Hleh school eroeuab or GED completed Q S ll pan s /Hbpenl4Latino. (~ No, no[ Spansh/Hiagn144ti ome ee ee• credit, but no deeroe Q Aaaoelate deer.. (eg. AA AS) no Q Yef, Mexican, M•zlpn Amerlpn, Chipno , Q eacMbr'a decree ( .g. BA, AB, BS) Q Yef, Puerto Rican Q Yes Cuban Q Mesbr'a decree (•.g. MA, M5, MEne, MEd, MSW, MBA) Q Doetoraq (•.e- PhD, EED) or Professlonel deeroe , Q Yes, o[h•r Spanish/Hlspanl4Latlno •. MD ODS OVM LLB JD (Sp•Gfy) 21. Decedent's Single Race Sal{_Dealenetlon -Check ONLY ONE to Indicate what tM depdent considered himself or ${ White ~ Q le PaneN Q Black er Afrlun Amerlun Q Korean Q Samean Q Other PaN}l I l Q Ameripn Intllan or Alaska Native Q Vietnamese Q Af ien Indlan e s antler Q Don•t Know/Not Suro Q Other ASl~ Q F I Pino Q Netlve Ha alien Q Refused Q Other (Speclly) Q Guamanian or Chemorro eY PeRSON WIIO PRONOUNCES OR D CeRTFI D TN t• ronou • Mo Dry r 8/fs~/Z O~et Igo Lure ~` ~rson rJ ARttfs.t PA. I7o /, If __..., _ 16e. Method of Dlapoaltlon Burial G~I//q Cremation 36b. Date of Dlfpositien 16<. Plop of Dbpositlon (Name of cemetery, crematory, or Q R•movel from Sbte Q Donation /+ Other s ecl ) g'~t0~o.0/=~s.4TJt'OF FfERVEAI ~BME-ns~.4 16d. Location of Dlspoaltlon (City or Town State d it c. r as V tlN~f N!A GPOS~ ~~J •. u • /.. r•onm one MFp ~_._...... If Death Occurrod In a HosPRal: ~~InPetlent •••••••••• ........... ................ ........Y. E ~~~~ H D!•th Orcurrod SomewMro Other Thin i~YiofPital: / C Eme n Room/Out tlent Dead on Arrival Nurfln Noma/Ln -Term Caro Faellit ISb. Facility Name (If not Inatltutlon, elw ftroet and number; lSe. City or Town, late, an Ip Cede Other I RNORCwRC i(tAt,-rsI Seavrc~s C ~~r. of- ]PE/EApg1E w en aPP ce L pose er ~~ e iP~vlo3~-a ~.3 c yr VCA 11'1 _ 26. Part 1. Enter the chin of events-dlse•sea, Inlurles, or <omplic•tlona-that dlroetly <auaed tM death. 00 NOT enter terminal eyenta such as cardiac arrant A`PProxlmx[e rofplrotory arrest, or ventricular flbrlllatlon without showing tM etioleey DO NOT ABBREVIATE. Enter onl ~ In[•rval; y one cause on • Ilse. Add additional lines If nepssary Onset to Death IMMEDIATE CAUSE ~ ~ (Final dla•ase er condition resulting in death) as a co of): Due to (or nfequene b. -~ Sequ•nt1aI1V Ilat conditions, If any, leading to the puae ,9 ~` -Q too,.--f ~QI ` ~ ~.. D t sequence ot). ( < n i listed on Ilne a. Em•r the c i UNDERLYING UUSE •: Y6F¢j j (dlaaeae or Inlury tMt InRlated the events resultlnE d, In death) LAST. Dua to (or consequenp of): F ) 9 26. PaK 11. Enter ether aleniflrant onditi Ib 1 I F male: as a Due to (or conaequenp of): but not reaultlne In the undeN In Y e puce given In PaK 1 _ 27. Was •n autogV perfo ed7 Yes No 2B. Were autoPSY findings awllebl• to complete the pua• of death? ~ ~- Q Not proenant within pant year Q proenant at time o7 death Q Not pregnant, but proenant within 42 days of death Q Not proenant, but pregnant 43 eayf to 1 year before death Q Unknown If pregnant within the PaR year 3p. Did Tobacco Use Contribute to DeNh7 Q Yef Q Probably Q No •a~Unknown 32. Date of In u 1 ry (MO DaY r) (Spell Month) Yef No 31. Manner of Oeath QrNatural Homicide Q Accident Q Pendln Ntlon Q Suicide Q Could not be determined Q C rea - - laa..,eaeno. How Inlury oe<urrod: Q pQ Prly fr/gpperetor Q P•e.atNan No Q Other (Specify) G (Ch k ly •s) n rte/, `~rt17yi g phyfl i To the b• i oT y k wl•dee, e• th otturrod dW to the pose s J Pronouncing i GrtlfYine phyfl •n - To tM bast of my knowled ( )end manner atet•d ie, eeath occurred at the Lima, date, and plop, one due to the eause(a) and manner stated Meeipl Ez•min•r/COron•r n M b of examination, and/or Invstleatlon, In my opinion, death o~urr•dQM time, d.t•, •ne pl•p, and due to the cause(:) and manner st•Nd Slenaturo e} pKlfler: TRN of eertlfler:_ l!-/l b. Name, Addrou and 21P Co Perron Cempletine Cauw o1 Death (INm 2g) ~ Upnfe Number: ~ O ~' fS' - [~ 7R. ~'~ RRVa^ ai w 1 T'~ ~a .Sd >F1S FlTaN ST. age. D.se slenw IMO/D.y/Yr) str ct ~A Ra.1,sLE A . r v 1. Reg r gn• ro 70 (! S $ (t s / : i Amend nts 4 rtror t• Mo Dey r I Dispoaltlon Permit No. ~ ~/ ~~ 9 - HIOS-143 REV D7/2011 4'' ~ ~ Pt the decedent wnald•rod himOfNf or harseRlf to be. to Ineipte what ~Whlte Q Korean Q Bleak or African American Q VI•tnemese Q Ameripn Indlan or Alaska Native Q Other Aalan Q Asian Indian Q Chln•se Q Native Hawaiian Q FIIIPino Q GuamMlen or Chemorro Q lapenese Q Samoan Q Other Paclflc Islantler Q Other (Specify) self to be. ~22•. D•ceeent s UsuN 0<cupatlon - Indicate type of won done du Nne moat of worklne Ilfe. DO NOT USE RETIRED. WILL OF JOSEPH F. BUCHIGHANI ^wT I, Joseph F. Buchighani of Cumberland County, Cam, ~ ~, ;x; Pennsylvania, declare this to be my last Will and hereby revll.. c prior Wills and Codicils. ~~ ~ ~ ~' c 1. I direct that all m ust debts, °~~'~ . -v `- ~-; t=; y j funeral expenses G -~ gravemarker and administrative expenses shapaid ~ ~= from my residuary estate as soon as practicabl~'after m~ ~~ c death. .c- ~, 2. I direct that all ii ~heritance, estate, transfer, succession and death taxes of any kind whatsoever which may lip payable by reason of my death shall be paid out of my residuary estate. 3. I direct that my entire estate be distributed as follows: A. I direct that my entire estate go to Ricky Stains, Anthony Stains and Joshua Michael Stains in equal shares. B. Should Ricky Stains, Anthony Stains or Joshua Michael Stains predecease me their share shall lapse and be divided into equal shares ~etwean the surviving children. LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 4. I appoint J~~~nna Stains as Guardian of the estate of Ricky Stains, Anthony Stains and Joshua Michael Stains should I die before they attain the age of 18 year. 5. I appoint Thomas Herweg Executor of this my last Will. If Thomas Herweg should predecease me or cease to act in such capacity, I appoint Casey Aiello as alternate. 6. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. ~, ~ `~~ 7. I direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. IN WITNESS WHEREOF, I have ereunto set my hand this _ day of , 201"0. ` ~. J seph F. Buchighani LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and two other pages was on the day and date hereof signed, published and declared by Joseph F. Buchighani as and for his last Will in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 WITNES /~/ .~, WITNESS ACKNO~EIVLEDGMENT State of Pennsylvania ss County of Cumberland I, Joseph F. Buchighani, the Testator, 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 the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. L~ J eph F. Buchighani Sworn to or affirmed and. cknowledge before me y Joseph F. Buchighani the Testator, this / day of _ nn~n NOTARl/~L, 3.~.._w__~.~__._. 8e~phsn J. ry ~~el~Fl~ Bor~~ ~'~~~~~ ~~. ~,~ ~ otary Public/Attorney ~ ~n la?~+ ~k~~I~sr.~~ ~~ ~d13 ~ LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 .--~ A'F'FIDAVIT State of Pennsylvania ss County of Cumberland ,-- We, ~~~ and i ~ ~y.r, 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 Testator sign and execute the instrument as his last Will; that the Testator signed willingly and executed it as his free and voluntary act for ti'1e purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the Will as a witness; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~~~ Sworn to or a 'rmed ands scribed to befy~re me by witnesses, this ---~-= day of //~~, NOTi~A1gL v c ~~vtisn.~. H~~' ~4~Vota P blio Attorney k ry ubN+c ... , _ ,s,~.„. _ _ ;; ~ , ,r