HomeMy WebLinkAbout09-25-12PETITION FOR GRANT OF LETTERS
REGISTER. OF WILLS OF Cumberland COUNTY, PENNSYLVANIA
Petitioner(s) named belov~, 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: I re Oy File No: of (' ~ ~y~~O u 7
a/k/a: _ (Assigned by Register)
a/k/a: _
tea; Social Security No:
Date of Death: 9/18/2012 Age at death: 93
Decedent was domiciled at death in Cumberland County, PA (State) with his/her last
principal residence at 730 Elkwood Drive 17070 Borough of New Cumberland Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 111 South Front Street 17101 City of Harrisburg Dauphin PA
Street address, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvan%t' ................................All personal property $ 5 ~ 000.00
If not domiciled in Pennsylvania .............................Personal property in Pennsylvania $
If not domiciled in Pennsylvania .............................Personal property in County $
Value of real estate in Penrs}~[vania .............................................................. $ 100, 000.00
TOTAL ESTIMATED VALUE.... $ 105,000.00
Real estate in Pennsylvania situa~:ed at: 730 EIkWOOd DrIVe 17070 Borough of New Cumberland Cumberland
(Attach additional sheets, ifnece.crary,) Street address, Post Office and Zip Code City, Township or Borough County
® A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) he/she/tiny is/aze the Executor(s) named in the last Will of the Decedent, dated 9/13/2004 and Codicil(s)
thereto dated ____
State relevant circumstances (e.g. renunciation, death ajexecutar, 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(g), and did not have a child born or
adopted; and Decedent was r;ither 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 lice, durante absentia, durante minoritate
If Administration, c.t.u. or d.b.n.c.t.a., enter date of Will in Section A above and comalete list of heirs.
Except as follows: Decedent ~as 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
t.a
Petitioner(s), after a proper :,earch has/have ascertained that Decedent left no Will and was survived by the following spouse (i~y) and heirs (~trch
additional sheets, rf necessa; , J: ~~ rv
Name Relationship Address r--
t".r . Clt ~_
nU
O ~ ~
-- N
O `'
fV
F;"°
? rr;
7
> '`._
- C~7
f'i't
Form RW-oz rev. loi!l.2o!! Page 1 of t
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
couNTV of Cumberland }
Official Use Only
1 i~~~~,~.j ~ ,~! b~tt~l ~ C
Petitioner(s) Printed Name Petitioner(s) Printed Address
Jennifer Ann Raves 744 Carol Street ~~~-'~~~ ''
New Cumberland QRP~ ~' ~` ~~ 070
Tye 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, the Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affrmed and subscrib d before ~1_,p~ a~ ~~~ Date ~ I as ~' a
me th' da of ~ ~2 ~ V-. Date
By: Date
For the Register Date
BOND Required: ^ YES ®NO
FEES:
Letters ....................... $ ~ G
( (.~ )Short Certificates(s) ......
( )Renunciation(s) ... ..... .
( )Codicil(s) ....... ..... .
( )Affidavit(s) ............ .
Bond .................. ......
Commission ................... .
Other
~~.~ ~'` ....... ~ • 0
Automation Fee ......... .
JCS Fee ................
TOTAL ................
...... 0
.....$
To the Register of Wills:
Please enter my appearance by my signature below:
Attorney Signature:
Printed Name: UaVIQ h. JTOne, tsqulre
Supreme Court
ID Number: 397$5
Farm Name: Stone LaFaver & Shekletski
Address: 414 Bridge Street
P.O. Box E
New Cumberland PA 17070
Phone: 717-774-7435
Fes: 717-774-3869
Email: dstone(a~stonelaw.net
DECREE OF THE REGISTER
Estate of Mildred L. Hory File No: ~ ~- ~oZ "~U~~
a/k/a:
AND NOW, ~ ~.~ ~,~ 2~ ~~ ~ 2 , in consideration of the foregoing Petition,
satisfactory proof having bean presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Jennifer Ann Raves
in the above estate and lif applicable) that
the instrument(s) dated 9/13/2004
described in the Petition be _~dmitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
egister of Wills (~ ~ ~ ~(~, ~
Form RW-02 rev. ]0,'1I~2011 ~ ~ (~~~~,~,~/'bJll~ ~.l e.2 Of 2
_ __ _
LOC~~~AR'S CERTIFICATION OF DEATH
WAR:ig~sr,:~11l~o duplicate this copy by photostat or photograph.
Fee for this certificate. $6.(111 ~~~~ S~~ ~~ PM I~~ ~~ This i; Iv crrrlil'~ tIa(1 the intiirrnation here give( is
rt)rrict9y coy~ieLi tfcli)~ ~(n (~riz~inal Certificate of Death
:~, ~~- - ('4u1~ Ci~c:~' With (,~ ns i,ocai Registrar. The original
~'~ (~~~~i~ c~.(tificatL ~.~i!E I)(~ ?.)rwurdc(I to the State Vital
~~R~~ ~.. ~ ReC(~rd, (~;f-ice i(n~ ~~)~~rOujneOt filing.
P 18800703 ~~ ~ s~P~s2o~2
~ ~ __1___
Certifieatian Nu(nher
Type/Print in
Permanent
~~
~_
i_,)~al Rcrt~t~~a(' 4late- Issued
COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH _ VITAL RECORDS
Suffix) ~ ~ ~ ~ Stara Flle Number:
1. Oetedent's legal Name (Pint, Middle, Last
,
2. Sex 3. Social Security Number 4. Oates of Oesth (MO/Day/Yr) (Spell Mo)
Mildred L. Hoy F
l
ema
e 160 - 16 - 5170 September 18, 2012
So
Age-Last Birthda
(Yr
) $b
d
.
y
s
. Un
er 1 Yaar Sc. Under 1 Da 6. Date of Birth (Me/Day/Year) (Spell Month) 7a. Birthplace (City and Stale or Foreign Country)
M
h
ont
s Day, Hpurs Minute: Tourist Park PA
93
February 2 , 1919 7b. Birthplace (County) Dau hin
Ba
R
id
S
.
es
ence (
tate or Foreign Country)- Sb. Residence (Street and Number -Include Apt No.) Hc. Did Decadent Live In a Township?
P ns lvania 7 30 Elkwood Drive O Vas, decedent lived in tw
Bd. Residence (County) p.
Cumberland ge. Residence (Zip GOde) 17070 ~JNo, eetedlnc eyed within limits of NeW Cumberland
city/born.
9. Ever In VS Armed ForeesT 10. Marital Status at Time of Death Married Widowed 11. Surviving Spouse's Name (H wife
give name
rior t
Q Y
fi
t
,
p
o
rs
marriage)
es ~, No Q Unknown ~ Divorced ~ Never Married ~ Unknow
12. Father's Name (First, Middle, Laat, Suffix) 13. Mother's Name Prior fo First Marriage (First
Middle
Last)
,
,
Elmer Ellsworth Reed Ethel Mae =dell
'
14a. Informant
s Name 14b. Relationship to Decadent 14c. Informant's Mailing Address (Street and Number, City, State, Ztp Code)
J
if
enn
er
A. Raves Granddau hter 744 Carol Street New Cumberland PA 17070
........
3 •
......... ......................................1 ..°: a<e o eC
.......................... =~..an.y one _ _ _ _
H Death O<curred In a Hospital: in tlant .........._ ............................. .........................'....... fy ......._....................
Pa If Death Occurred Somewhere Other Thsn a Hospital: `t~' ~HOSplca Facility ~
D
d
'
J
°
t ece
ent
t~l
s Home
EmK ancy Room/OUtpatllnt Dead on ArrWal ) Nursln Home/Long-Term Care Facility Other (Specify)
15 b. Facility Name (It not In
Nt
tl
~
z s
u
on, give street and number; SSC. City or Town, State, and 21p Code 15d. County of Death
H
i
arr
sbur Hos ital Harrisbur PA 17101 Dau hin
16
h
0. Met
od o7 Olaposltlon Burial Q Cremation 16b. Date ofbispos Lion 16c. Place of Dlsppsition (Name of cemetery
cremat
h
,
ory, or ot
er place)
O Rempyalfrp` stc~) p opnatlpn September 21 , Halifax Cemeter
oeo er s . S,
16d. LoeaU f Dlaposltlon (City or Town, State, and 21p) 17a. 51 n of ral Service Licensee or Person in Charge of Interment 17b
i
. L
cense Number
Halifax, PA 17032
FD 012 848 L
17
N
~' c.
ame and Complete Address o/ Funeral Facility
Parthemore FH 6 CS, Inc., P_O. Box 431, New Cumberland PA 17070
'
.
.- 1B. Decedent
s Education -Cheek the box that beat describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races tp indicate what
highest degree or level of school com
let
d
t th
i
p
e
a
e t
me of death. box that best describes whether the decedent the decedent considered himself or herself to be.
Q 8th grade or less
!s Spanish/Hispanic/LaUno. Check the "NO" White Q Korean
~ No diploma, 9th - 12th grade box if decadent is not S
anish/Hi
i
/L
i
~
p
span
c
at
no.
Black or African American ~ Vietnamese
High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino Q American Indian or Alask
N
ti
a
a
ve Q Other Asian
Soma college credit, but no degree O Yes, Mexican, Mexltan American
Chicano Q Asian I
tli
,
n
an Q Native Hawaiian
Q Aasoclste tlegrae (e.g. AA, AS
) Yes, Puerto Rican
Chi
nese ~
~ Bachelor's degree
0 Guamanian or Chamorro
(e.g. BA, AB, BS)
~ yes, Cuban
I
~ FI
IPino Samoan
~ Master's degree e
g, )
( .g. MA, M5, MEn MEd, MSW, MBA Q Ves, other Spanish/Hispanic/Latlnp
~ Japanese Q Other Pacific Islander
~ Doctorate (e.g. PhD, Ed D) or Professional degree
(specify) Q Other (Specify)
. MD ODS DVM LLB JD
21. Decedent's Single Race Saif-Deslgnatlon -Check ONLY ONE to Indicate whet the decedent considered himself or herself to be
22a
Dec
d
t'
U
l
.
.
e
en
s
sua
Occupation -Indicate type of work
Q Whites Q Japanese Q Samoan d
one during most of working life. DO NOT VSE RETIRED.
Q Black or African American Q Korean Q Other Pacific Islander
Q American Indian or Alaska Natlva Q Vietnamese Q Oon't Know/Not Sure HOmE:mBS
Ce r
.
~ Asian Indian Q Other ASlan ~ Refused 22b
. Kind of Business/Industry
Q Chinese Q Native Hawaiian ~ Other (Specify)
Q FIIIPIno ~ GuamanlanorChamorro
Domestic
ITEMS 2!
e - 3g MUST M D 23a. ate Pronounce Dea Mo Day 236. at s of Person Pronouncing Death (Only when app Ica IeJ 23c. License Number
BY PERSON WHO PRONOUNCES OR ' `I
CERTIFIP3 OEATN s
23d. D Slgn Mo ay/Vr) 24. Time of Death
Pn'~ y 3 ~6~ra-
2S. Was edical Ezaminer or Coroner Contacted? ~ Yes ~ No
CAUSE OF DEATH
26. Part 1. Enter the chain of events--diseases, Injuries, or cpmplleations--[hat dlractl Approximate
y caused the death. DO NOT enter terminal events such as cardiac arrest I
respirato
arre
t
l
t
i
l
ry
n
erva
;
s
, or ventr
cu
ar flbrillatlon without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional Ilnes If necessary Onset to Death
i
.L
IMMEDIATE CAUSE _______________> a. P~ V rh ~ ~ rh.. ~ Tom. iy Q
`L»
(Final disease or condition Due to (or as a consequence of):
resulting in death) O
_
~ ~~ O ~
Sequantlally Ilsi conditions, Due to (or as a e
con
ue of)
q
:
if any, leading to the cause
listed on line a. Enter the
UNOERLYINa GUSE Due to (or as a conse
uence of)
~ q
:
(disease or Injury that
initiated the events resulting d.
~ In death) LAST. Due to (or as a ronseq uence pf):
S 26. Part 11. Enter ocher I Ifl t dill t Ib tl td d th but not resulting In the underlying cause given In Part I
~
' 27. Was an autopsy pert rmed7
Yes No
2g
W
i .
ere autopsy findings available
to romplete the cause of deathT
2
f
9. I
Female: 30. Old Tpbacco Use Contribute to Death? ~ Yes ~ No
Not pregnant within year 31. Manner of Death
Q Yes ~ Probabl
~ y
gnan ® Natural Q Homlcfde
Pre tat Lima ofd a[h
Q No a Unknown
Q Not pregnant, but prognant within 42 days of death
0 Accident Q Pending Investigation
`- Q Not prognant, but prognant 43 days to 1 year before death 32. oate of In Q Suicide Q Could not be determined
Jury (MO/Day/Vr) (Spell Month)
Q Unknown If prognant within the past year
33. Time of Injury
34. Place of Injury (e.g. home, construttion site; farm; school) 35. Locatlan of Injury (Street and Number
Ci
S
,
ty,
tate, Zip Code)
36. Injury at Work 37. If Transportation Injury, Specify: 3H. Describe How Injury Occurred:
Q Yas Q Driver/Operator ~ Pedestrian
Q No Q Passenger Q Other (Specify)
39a. Certifier (Check only one):
~ Certifying physician - To the best pf my knowledge, death occurred duo [o the cause(s) and m
t
r s
ated
~ Pronouncing ffi Certifying ph - To the best of my knowledge, death occurred at the time, date, and place, and due to the c se(s) and manner stated
Q Medical Examiner/GO(Of
b
1ef a
asis of examination, and/or Investigation, in my opl neon, death occurred at the time, date, and place, and due to that se(s) and manner st
au
t
d
a
e
Signature of ceKifler: Title of certifier:
3 License Number:
9 Namo, Addra ..g ZJp Code of plotin Cause~* t i
39 ate Signed M
~A ' ~'
gK/yr
AL J~i:~Ow- ,. i ~~pn~0 V -~N r/~o ~f-~°n'~~TR-L~iT
Hif IQFaS6Vit ~i- a's
4 '
O
~
, OY e
r
0
Reglstrer's Di
t
t N
.
s
r c
um er 41. Registrar nstur! 42. glstrar File Date Mo Day r
4 3. Amendments / Q ~ Z.
.... . . .... . ... .. _. /1r'7 G. / Q ~._.rJ H305-143
~ ep\wills\HOYmildred\2-02
• ~
F.Y
O
N
LAST WILL AND TESTAMENT
-~ ~
~ ~,
-~--r
~~ ::
~ .
Q .
.~
C,-s
~ _
OF ~'`~ N'1 ~.) ~
~
i cti, :.
MILDRED L
HOY ~s N .,
r
.
i
3~ r
p ~~
I, MILDRED L. HOY, of the Borough of New Cumberland, Cumberland
County, Pennsylvania, declare this to be my last will and revoke any
will previously made by me.
ITEM I: I direct that my Executrix hereinafter named shall pay
all my just debts and funeral expenses as soon as conveniently may be
done after my decease from the residue of my estate.
ITEM II: I devise and bequeath all the rest, residue and
remainder of my estate of every nature and wherever situate, in equal
shares to my daughter, DENISE L. OPPEL, and my granddaughter, JENNIFER
ANN RAVES.
ITEM III: I appoint my Executrix and her successors guardian of
any property which passes, either under this will or otherwise, to a
minor and with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so, provided that this ap-
pointment of a guardian shall not supersede the right of any fiduciary
in its discretion to distribute a share where possible to the minor or
to another for the minor's benefit. Such guardian shall have the
power to use principal as well as income from time to time for the
Page 1 of 2
J ,~ ~
minor's support and education (incl
graduate and undergraduate) without
ability to provide for such support
for these purposes, without further
the minor's parent or to any person
uding college education, both
regard to his or her parent's
and education, or to make payment
responsibility, to the minor or to
taking care of the minor.
ITEM IV: I appoint my granddaughter, JENNIFER ANN RAVES,
Executrix of this my last will.
ITEM V: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of her duties in
any jurisdiction.
IN WITNESS WHEREOF, I, MILDRED L. HOY, have hereunto set my hand
and seal this {3 day of .fl,~'n„~ ... 2004.
MILDRED L. HOY
SIGNED, SEALED, PUBLISHED and DECLARED by MILDRED L. HOY, the
Testatrix above named, as and for her Last Will and Testament, and in
the presence of us, who at her request, in her presence and in the
presence of each other, have subscribed our names as witnesses.
~..
(~(/'' z
_ es Address
fitness
Address
Page 2 of 2
.RF:~~C `?~~iC~ 0~
OATH OF SUBSCRIBING WITNESS(ES~~~ SEP 2S PM 12~ 02
REGISTER OF WILLS ORPt-~;U'S C~i~Rr
Cumberland COUNTY, PENNSYLVANIA CUMBERLAND CU., PA
Estate of Mildred L. Hov ,Deceased
David H. Stone , (each a subscribing witness to
(Print Name/sJ
the 0 Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that he was present and saw the above Testatrix sign the same
and that she
the Testatrix
signed the same and that he signed as a witness at the request of
in her
(Signature)
(Street Address)
(City, State, ZipJ
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
day
of
presence and in the presence of a h o er.
(Signatu
414 Bridge Street
(Street Address)
New Cumberland PA 17070
(City, State, ZipJ
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this ~%~' day
of ()0~ .
/~-~°
Deputy for Register of Wills
Notary Public
My Commission Expires:
(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 notazization.
N
r
_'J~ y
~~
~~ ~
Zd~~~
~~
~Z~
Form RW-03 rev. 10.13.06
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
Cumberland COUNTY, PENNSYLVANIA
Estate of Mildred L. Hoy ,Deceased
f 12P2~~ r c Ic l~ ~ Pl'E
being duly qualified according to law, depose(s) and says(s) that he was
acquainted with Mildred L. Hov and an,
well-
familiar
with the handwriting and signature of the decedent, and that the signature of Mildred L. Hoy
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
Mildred L. Hoy is in '
rn~
(Signature)
~I ~l t rU . env l.A ~R
(Street Address)
Sith~l.~ 1Pt? (~2~
(City, State, Zip)
Executed in Register's Office
Sworn to yr affirmed and subscribed
before me this ~7~ day
of ~ ~(~ ,L' 2 ,
Deputy for Register of Wills
her own proper handwriting.
(Signature)
(Street Address)
(City, State, Zip)
r~
N '~
iT1
-v ~ r :a~
c'~G '. -t7 -, -,-.,
-
a
= ~ n
_
~ ~,
D 0 ~~
Form RW-04 rev. !0.!3.06