HomeMy WebLinkAbout09-14-12PETITION 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 Fellman ---J_ ' 2 `~~
-- File No: 2
a/k/a: Martha L. Fellman -. (Assigned by Register)
a/k/a:
a/k/a. Social Security No:
Date of Death: 5/11/2012 --_
Age at death: 78 __
Decedent was domiciled at death in Cumberland Coun Pennsylvania
principal residence at 700 Walnut Bottom Road 17013 Carlisle Borou h (State) with his/her last
Street address, Post Office and Zip Code -__Cumberland
City, Township or Borough
Decedent died at 700 Walnut Bottom Road 17013 Carlisle Borou h caanty
Street address, Post Office and Zip Code ---- CUmberland PA
City, Township or Borough Coun
Estimate of value of decedent's roe ~' State
P P rty at death:
If domiciled in Pennsylvania .... ......... .
• .................All personal property $ ---_- 10.000 OQ
Ijnot domiciled in Pennsyh'ania .............................Personal property in Pennsylvania $ ____
If not domiciled in Pennsylvania .............................Personal ro e
Value of real estate in Pennsylvania ................ P P rtY in County $ _ -
TOTAL ESTIMATED VALUE.... $ _ 10 000 0~
Real estate in Pennsylvania situated at: --
(Attach additional sheets, ifnecessary.) Street address, post Office and Zip Code - -- -
City, Township or Borough County
® A. Petition for Probate and Grant of Letters Testaments
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated 9/4/2___ 00~
thereto dated - and Codicil(s)
State relevant circumstances (e.g. renunciation, death of executor, etc.) --
Except asfollows: 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 ^ EXCEPTIONS ____-
^ B. Petition for Grant of Letters of Administration (if applicable) ___ _
c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durance mtnoritate
If Administration, c.t.a. or d.b.n.c.t.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(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
^ NO EXCEPTIONS ^ EXCEPTIONS _ _
Petitioner(s), after a proper seazch has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs (attach
additional sheets, if necessary):
Form RW-02 rev. 10/!1/2011
Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF CUMBERLAND } SS:
- }
Petitioner(s) Printed Name
7201 Catherine Drive
Petitioner(s)
---- ---Official Use Only --- -- - 1
fi~FC(J~~;~~~, ~``r~iCE 4F
'' ~ .a.
kc ~: ~..~ ~ ~~ ~: ;~ 1~ "?
!~ nrn ~ ~--_-~ -----.I
CUMBERL~~1~ CO., FA
"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, a Petitioner(s) will w 'and rely administer the estate according to law.
Sworn to or affirmed subs rib d before
the t ~~^'~ ~ ~
- day f 2 12 _ Date -~- /~/- ~',D/')-
~y - ---_ Date __
For the Register --- Date _
---_ Date
BOND Required: ^ YES ®NO
FEES:
To the Register of Wills:
Please enter my appearance by my signature below:
Letters ....................... $ 45.00
(4 )Short Certificates(s) ...... - 16.00
(1 )Renunciation(s) .......... 5.00
( )Codicil(s) ............. .
( )Affidavit(s) ............ .
Bond .........................
Commission .................... __
Other Will __- .. 15.00
Attorney 'nature:
t
` '~~
Printed Name: ChrlSta M Aplin
Supreme Court
ID Number: 207949
........ , -_- Firm Name: Jan L. Brown & Associates_
::::::: ; : ___ I Address: 845 Sir Thomas Court
Suite 12
-----
........ , arrisburo __PA 17109
__ ......:: ~ - - Phone: 717-541-5550 ____
Automation Fee ................. - 5.00 Fax: 717-541-9223 _ - ~
1cs Fee ....................... 23.50 Email: christailb verizon.net - ~
--- - -
-- ~
TOTAL ......................$ 109.50
DECREE OF THE REGISTER
Estate of Martha Fellman
a/k/a: Martha L. Fellman File No: 2 ~ ~ ~ Z ~ [ ~;p q'
AND NOW, ~ n~( I R //~ -------
satisfactory proof having een presented befo~e me, IT IS DECREED that Letters tnTestamenta of the foregoing Petition,
--------_ are hereby granted to Frances Teslar ~----- -
the instrument(s) dated 9/4/02 -- - in the above estate and (if applicable) that
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
Form RW-02 rev. 10/111201 /
egister of Wills `~~''-'°~ --
r ~~Pt,~ ~ e 2 of 2
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance wi
the Vital Statistics Law of 1953, as amended. th
t 1
s ~1t
~ ~ ~~~~t~~llegal to duplicate this co b hotostat or photograph.
~t1~2 ScP 14 PM 3~ 4Q:
ORPI-~~'S UJUR ,.
!~~~.. PA
No.
TYPe/Print In
Permanent
Black Ink
1. DepdenYS Legal Name (First, Middle,
~~yy ( 3a. Age-Last Birthday (Yrs) 3b. Under 1
p( { 78 Months
Ha. Residence (State or Foreign Country)
Pennsylvania
8d. Residence (County)
Cumberl
9. Ever rn u r..,rd Forces? 10. a
Yes ~ No ~ Unknown YI
S
1
Q Removal from State u __~ •DOnatip~cnl
Q Otoher (Specify)
1 L ti 1 Disposhlon (City or Town, State, and
S°haE'ffp-rstow~1, PA '17088
Marina O'Reilly Matthew
State Registrar
Jul ~-4 zn~2
Date
tier
~y8~~ ~
i~aof Dea'h((MO/2 Oy; r2(Spell Mp)
Y ,
.r Fopi~gn Country)
up n
city/boro.
ne prior to first marriage)
Last)
ry, State, Zip Code)
3rlisle, PA 1 70'1 3
May 1 6, 20,1 2 ~ ~-•• •••^'•'° er cemetery, crematory, or other place)
Etsans Cremation Service
~ ral seryl~e uoe
n i harge of Interment 17b. License Number
~-- FD-0"13674-L
Ighest de -'"" ""°p "^ •r at oast descHbes the
gram or level of school com latetl at the ti
e 19. Decedent of His -~ ^ ._,ys~ .~Cl
i
O
l
m
of death.
Q 8th grade or leas box that best dascribas
wh
eth
er the tlecedam
Q No diploma, 9th - 12th grade is Spanish/Hispanic/Latino. Chock the "NO"
Q High school graduate or GED completed box if dnc Cdent la not Spanish/Hispanic/Latino
~ Some college cratlit, but no degree .
Q No• o Spanish/Hispanic/Latinp
~ AaaociKa degree (e.g. qq, qS) Q Yes, Mexican, Mexican American
Chicano
~ Bachelor's degree (o.g. BA, AB, BS) ,
O Yes, Puerto Rican
Master's degree (a.g. MA, M5, MEng, MEd, MS W, MBA) ~ Yes, Cuban
~ Y
Dottorate (e.g. PhD, EdD) or Professional de
grey ea, other Spanlah/Hlspa nic/LatinP
s" (Specify)
L. Dacedant'
Singla Raca Self`Deslgnatlon -Check ONLY ONE to Indicate what th
White
d
~ Japanese
Q Black or African Am e
ecedent considered h(msel/ or
~ Samoan
erican ~ Korean
~ American Indian or Alaska Na[iye ~ Viet ~ Other Pacific Islander
namsae
~ Asian Indian Q Other A
i ~ Don't Know/NOL SU re
s
an
~ Chinese ~ Native Ha
i ~ Refused
wa
ian
O Filipino O Guamani ~ Other (Specify)
an or Chamorro
EMS 2Be -25 MU BE COMPL ED 23a. Date Pronounced Dead Mo Day rl 23
' PERSON WHO PRONOUNCES OR cl........_ _ .._._ _
s decedent conzldaretl h mOalf or hersOelf to be-to intlicete what
White ~ Korean
Black or African American ~ Vietnamese
American Indian or Alaska Native 0 Other Asian
Asian Indian ~ Native Hawaiian
Chinese ~ Guamanian or Chamorro
Ftllpino 0 Samoan
Japanese Q Other Pacific Islander
Other (Specify)
'to be. 22a. Decedent's Usual Occupation -Indicate type of wor
tlone during mosx of working life, DO NOT USE RETIRED.
'reacher
22b. Kind of Businecs/Industry --
Education
26. Part 1. Enter the chain o} CAUSE OF DEATH ° ~~aamrner or coroner contatted7 O yes No
ev __disaases, Injuries, or c
respiratory arrest, or ventricular fibrillati omplications-that direttl
Y caused the death
D
.
O NOT enter ter
on without showin the etiplo
8 gY. DO NOT ABBREVIATE
E Approximate
minal events such as ca rtllac arrest
IMMEDIATE CAUSE ----_____-
(Final di
~ .
nter only one cause
(/J~ Qy/~ j~
D ,
on a Ilne. Add additional Ilnes if necessary ~ Interval:
Onset to Death
sease or condition
resulting in tleath) - - "~~
~...r /~ _
D t ( q f) p
f
b.
Sequentially list conditions,
If any, leading to the cause Dua to (or as a consequence off:
Ilstetl on line e. Enter the
c
UNOERLVING CAUSE
.,, (disease or Injury that Due to (or sequence on:
as a con
Initiated the events resulting d
In death) LAST. -
26. P+rt 11. Enter other slaniflca t D..e to (or as a consequence of):
~ tlitl
t Ib tl t
but not resulting in the under) in
V g cause given in Part 1
'
~
27. Was an auto
CJ Yes Pry Parfo ed7
~
29. If Fa}tfale:
' 28. oWera autoPSY flntlin
ailable
t co
plate the
[
~ Not pregnant within past year
30. Dld Tobacco Use Co tribute to De
th cause f death?
w Vea
~
Q Pregnant at time of death
~ Not pregnant
but
re a
T
~ Yes ~~ ~robably
~ N No
31. Mier of Death
L~IY+t
r
l
,
p
gnant within 42 tlays of daatt
0 Not pregnant
but O ~ Unknown u
a
0 Homicide
O A
,
pregnant 43 tlays to 1 year before d
~ Unknown H
re eath
32
D
t ccident ~ Pending Inyesti
Ba[IPn
Q S
l
i
p
gnant within the
past year .
a
e o/ In
Jury (MO/Day/Yr) (Spell Month) u
c
tle
~ Couitl not be determined
34. Place of injury (e.g. home; construction site; farm; school) 33. Time of Injury
33. Location of Injury (Street and Number, City, State
21
Cod
36. Injury at Work
37. if Transportation Injury, Specfy: ,
p
e)
Q Yes ~ Driver/Operator ~ Pedestri 36. Describe How Injury Occurred:
No an
Q Passenger
Q Other (Specify)
39a. C~r(Ipler (Check o
C nly one):
rtl/ying physician - To the bert of my knowletl
ge
death
0 Pron
occu
,
ouncing R Corti In
fv g physician - To the bast of my kno
Q Medical E rred due fo the cause(s) and m r stated
wletl
tl
ge,
xaminer/Coroner - On the bast amination
eath occurratl at the time, date, and lace, and due to
end/orJnv i P
e th
,
SI
gna[ure of certifier. e cauae(s
/~
si gation, In my opinion, death occurred a
time, data, and place
a
tl d
c
39b. N e, AdE
~
f^ sz antl 21p Cotla of Person mpleting Cause ~
Title of certifier-
f ,
n
ue to tne
(s) antl m
C annex taxed
Lice
~
-
s
o
J
`''~ Deat (Item 26) nse Num bar:
~ J n ~)
7 j /
D f-
~j
(i
j 4D- Registrar's DIStRCt Number , ~ JY ~,~JJ ~/ L~
~ 39c. D to Signed (MO/Day/Vr)
/
/
d
r` 41. Reg
~ istrar's Signature 7 ~ J %"'
1
~ Z
~
C
43. Amendments 42. Registry File Date Mo Day
r
~ ~ _
O O
~ X15
~
~ ~,
.: ~~: -
;5 ~
~
a
DiznnaiHOn Perm It N.r_ 0748639
-- H305-143
-" - - - _ _ REV O7/2011
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH ~ VITAL RECORDS
CERTIFICATE OF DEATH
•st, Suffix) Ste
2. Sex 3. Social Security Number
Sc. Under 1 Da Femal 208-24-04'I 3
6. Date of Birth (MO/Day/YSar) (Spell Month) 7a. Birthplace (Ll1
Days Hours Minutes
January l3, '1934 Harr
86. Residence (Street and Number- Include A t N 7b. Birthplace (Cc
P o.) 8c. Did Dautlent LiYa in a Township?
700 Walnut Bottom Road O~Ves, decedent lived in 1
8e. Residence (21p Code) ~ No, decadent Iiyed within limits of
arltal Status at Tima of Death ~ Marred p wmowea 11. Survivin S
Divorced Q Never Married ~ Unknown E Pouae' =Name (If
,, ~~,Ic
~,
RENUNCIATION
~~s2 SEP t 4 PPS 3~ 4U
REGISTER OF WILLS
C MBERI-AND COUNTY, PENNSYLV TT~~)~~~P1F~~" ""~'~~
A~(~l61BERLAND CO., PA
21-12- I~j
Estate of
,Deceased
I, Robert F Ilman
(Print Name) , in my capacity/relationship as
Ex cutor
of the above Decedent, hereby renounce the right to
administer th E
e state of the Decedent and respectfully request that Letters be issued to
Franc -s T lar
6/13/2012
(Date)
~.
tgnature)
212 B North W t Street
(Street Address)
rl' PA 17013
(City State, Zrp)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deputy for Register of Wills
Form RW-06 rev. 10.13.06
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renun~3~ti~on for the
pm'p~es stated within on this day
of _ c Inc ~c,n
,~.
~~
J
otary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTARIAL SEAL
CHRISTA M APLIN
Notary Public
LOWER PAXTON TWP., DAUPHIN COUNTY
My Commission Expires Nov 16, 2013
LET WILL AND TESTAMENT
OF
MARTHA FELLMAN
I, MARTHA FELLMAN, now domiciled in York County, Pennsylvania, declare this to be
my Last Will and Testament. I revoke all other wills and codicils that I may have previously made.
Art=
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after m
Y
death.
Arta-_
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and
be
charged generally against the principal of my residuary estate without reimbursement from an
person. This provision is not a waiver of any right which my Executor has to cl ' Y
aim reimbursement
for any such taxes which become payable as the result of any prop~y over which I have the ow
p er
of appointment.
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Article III
I give, devise and bequeath in accordance with any memorandum which I have either
handwritten or signed, located with my will or with my valuable papers and found within 30 da s
y of
the probate of my will. Gifts may only be to persons who survive me or to organizations which ex'
ist
at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Arh- cle IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my son, ROBERT FELLMAN, of York Co
Pennsylvania. In the event that ROBERT FELL ~tY~
MAN predeceases me or fails to survive me by
thirty (30) days, I give, devise, and bequeath the remainder of my estate, of whatsoever natur
e and
wheresoever situate to my niece, FRANCES TESLAR, of Dauphin County, Penns lvania.
Y
If FRANCES TESLAR predeceases me or fail to survive me by thirty (30) days, I ive
devise and bequeath her share to her issue who survive me, per sti es. g '
rp
Arti_cle_ V
I nominate, constitute, and appoint my son, ROBERT FELLMAN, of York Coun
Pennsylvania as Executor of my Last Will and Testament. In the event h',
of the renunciation, death, or
inability to act, for any reason whatsoever of my Executor, I nominate, constitute and a o'
pp int my
mece, FRANCES TESLAR as successor Executrix ofmy Last Will and Testament. I direct that m
Y
Executor or successor Executrix be permitted to serve without bond and in addition to those powers
granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to
file any qualified disclaimer I could have filed if living. My Executor or successor Executrix shall
receive reasonable compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executor and successor Executrix,
in his/her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate or
personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(fl to file any federal income tax return for any year for which I have not filed such return
prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for all their services,
-3-
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
(j) to receive reasonable compensation in accordance with their standard schedule of fees in
effect while their services are performed.
IN WITNESS WHEREOF, I, MARTHA FELLMAN, hereby set my hand to this my Last
Will and Testament, on
2002, at Harrisburg, Pennsylvania.
MARTHA FELL
In our presence, the above-named MARTHA FELL
her Last Will and Testament and now at her request, in her pN re enc~el and in the pe sen a of eabe
other, we sign as witnesses. h
A_
s~s~ i o
-4-
I, MARTHA ~'ELLMAN, Testatrix, who signed the foregoing instrument, having been duly
qualified according to law, acknowledge that I signed and executed this instrument as my Will, and
that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
MARTHA FELLMAN, the Testatrix
on - ~ 2002.
!~~~ ~c~0% 1Y~ ~
Public a-~'' ~~
MARTHA FELLMAN
NOTARIAL SEAL
ARRISBURG,~DAUP~ COUNn
MY COMMISSION EXPIRES MARCH ~ 2006
We, the undersigned witnesses who signed the foregoing instrument bein dul
according to law, depose and say that we were present and saw the Testatrix~si g Y qualified
instrument as her Will; that she signed and executed it willingly as her free and veluntd exact forts
purposes therein expressed; that each of us in her sight and hearin si ~ the
that to the best of our knowledge, that she was at that time ei tee ~ 8 the Will as witnesses, and
sound mind, and under no constraint or undue influence. ~ ~ ~ years or more of age, of
Sworn to or affirmed and
subscribed to before me
by ~ S.1
and ric ~ ~ C ud~.
witnesses, on _ ~
2002.
otary Public
JESSICA A. HOLLAND, NOTARY PUBLIC _ 5
CITY Of HARRISBURG, DAUPHIN COUNTY
MY COMMISSION EXPIRES MARCH 4 2006
Witness
~ L
Witness